Theodore R. Smith, Ph.D.
Professor of Medicine and Pharmacology
Director, Center for Healthy Air, Water and Soil
Education and Training
Ph.D.: Miami University, Experimental Psychology
Postdoctoral Fellowship: Massachusetts Institute of Technology
Research Interests
My research is primarily focused on environmental determinants of disease in urban environments. My formal training is in experimental psychology and measurement, and I have a breadth of experience spanning the academic, civic, and private sectors. I have specifically focused on delivering new models and methods for health research.
Many of my projects have included robust engagement between academic institutions and local government, and they often involve applications of new technologies with significant community engagement. My interest in novel environmental clinical monitoring includes work in new digital health surveillance and support technologies for respiratory disease, directly associated with environmental factors such as air pollution. I also have extensive experience working in local and state government, having served as the city of Louisville, Kentucky's first Chief Innovation Officer.
In that role, a major focus of my work was conducting place-based community health projects such as the AIRLouisville exposure study which became a precursor to our current Green Heart Louisville project. More recently, I have built a research program to study the use of wastewater monitoring for the city of Louisville, Kentucky’s Corrections system and preliminary work with a network of senior living centers.
This work has been extended, post-pandemic, to include wastewater screening for non-communicable disease risk from exposure to volatile organic compound air pollution and PFAS chemicals.
Featured Publications
Find all papers and citations via ResearchGate
- Yeager R, Keith RJ, Riggs DW, Fleischer D, Browning MHEM, Ossola A, Walker KL, Hart JL, Srivastava S, Rai SN, Smith T, Bhatnagar A. Intra-neighborhood associations between residential greenness and blood pressure. Sci Total Environ. 2024 Oct 10;946:173788. doi: 10.1016/j.scitotenv.2024.173788. Epub 2024 Jun 18. PMID: 38901580.
- Han D, Linares P, Holm RH, Chandran K, Smith T. Wastewater threshold as an indicator of COVID-19 cases in correctional facilities for public health response: A modeling study. Water Res. 2024 Aug 15;260:121934. doi: 10.1016/j.watres.2024.121934. Epub 2024 Jun 12. PMID: 38908309.
- Jin A, DuPré N, Holm R, Smith T, Kavalukas S. Environmental Levels of Volatile Organic Compounds, Race, and Socioeconomic Markers Correlate with Areas of High Colorectal Cancer Incidence. J Racial Ethn Health Disparities. 2024 May 16. doi: 10.1007/s40615-024-02030-z. Epub ahead of print. PMID: 38755478.
- Chigwechokha P, Nyirenda RL, Dalitsani D, Namaumbo RL, Kazembe Y, Smith T, Holm RH. Vibrio cholerae and Salmonella Typhi culture-based wastewater or non-sewered sanitation surveillance in a resource-limited region. J Expo Sci Environ Epidemiol. 2024 May;34(3):432-439. doi: 10.1038/s41370-023-00632-z. Epub 2024 Jan 4. PMID: 38177335.
- Holm RH, Rempala GA, Choi B, Brick JM, Amraotkar AR, Keith RJ, Rouchka EC, Chariker JH, Palmer KE, Smith T, Bhatnagar A. Dynamic SARS-CoV-2 surveillance model combining seroprevalence and wastewater concentrations for post-vaccine disease burden estimates. Commun Med (Lond). 2024 Apr 9;4(1):70. doi: 10.1038/s43856-024-00494-y. PMID: 38594350; PMCID: PMC11004132.
- Anderson LB, Ness HD, Holm RH, Smith T. Wastewater-Informed Digital Advertising as a COVID-19 Geotargeted Neighborhood Intervention: Jefferson County, Kentucky, 2021-2022. Am J Public Health. 2024 Jan;114(1):34-37. doi: 10.2105/AJPH.2023.307439. Epub 2023 Oct 19. PMID: 37856730; PMCID: PMC10726935.
- Klaassen F, Holm RH, Smith T, Cohen T, Bhatnagar A, Menzies NA. Predictive power of wastewater for nowcasting infectious disease transmission: A retrospective case study of five sewershed areas in Louisville, Kentucky. Environ Res. 2024 Jan 1;240(Pt 2):117395. doi: 10.1016/j.envres.2023.117395. Epub 2023 Oct 12. PMID: 37838198; PMCID: PMC10863376.
- Marin-Ramirez A, Mahoney T, Smith T, Holm RH. Predicting wastewater treatment plant influent in mixed, separate, and combined sewers using nearby surface water discharge for better wastewater-based epidemiology sampling design. Sci Total Environ. 2024 Jan 1;906:167375. doi: 10.1016/j.scitotenv.2023.167375. Epub 2023 Sep 27. PMID: 37774884.
- Sokoloski KJ, Holm RH, Smith M, Ford EE, Rouchka EC, Smith T. What is the functional reach of wastewater surveillance for respiratory viruses, pathogenic viruses of concern, and bacterial antibiotic resistance genes of interest? Hum Genomics. 2023 Dec 18;17(1):114. doi: 10.1186/s40246-023-00563-8. PMID: 38105239; PMCID: PMC10726489.
- Bhatnagar A, Keith R, Yeager R, Riggs D, Sears C, Bucknum B, Smith T, Fleischer D, Chandler C, Walker KL, Hart JL, Srivastava S, Turner J, Rai S. The Green Heart Project: Objectives, Design, and Methods. medRxiv [Preprint]. 2023 Dec 5:2023.12.05.23299461. doi: 10.1101/2023.12.05.23299461. PMID: 38105951; PMCID: PMC10723507.
- Keith RJ, Holm RH, Amraotkar AR, Bezold MM, Brick JM, Bushau-Sprinkle AM, Hamorsky KT, Kitterman KT, Palmer KE, Smith T, Yeager R, Bhatnagar A. Stratified Simple Random Sampling Versus Volunteer Community-Wide Sampling for Estimates of COVID-19 Prevalence. Am J Public Health. 2023 Jul;113(7):768-777. doi: 10.2105/AJPH.2023.307303. Epub 2023 May 18. PMID: 37200600; PMCID: PMC10262242.
- Holm RH, Osborne Jelks N, Schneider R, Smith T. Beyond COVID-19: Designing Inclusive Public Health Surveillance by Including Wastewater Monitoring. Health Equity. 2023 Jun 15;7(1):377-379. doi: 10.1089/heq.2022.0055. PMID: 37351532; PMCID: PMC10282970.
- Hassard F, Smith TR, Boehm AB, Nolan S, O'Mara O, Di Cesare M, Graham D. Wastewater surveillance for rapid identification of infectious diseases in prisons. Lancet Microbe. 2022 Jun 7:S2666-5247(22)00154-9. doi: 10.1016/S2666-5247(22)00154-9. Epub ahead of print. PMID: 35688168; PMCID: PMC9173719.
- Wood, L. A., Tomlinson, M. M., Pfeiffer, J. A., Walker, K. L., Keith, R. J., Smith, T., ... & Hart, J. L. (2021). Time spent outdoors and sleep normality: A preliminary investigation. Population Medicine, 3(March), 1-6.
- Kaplin, A., Junker, C., Kumar, A., Ribeiro, M. A., Yu, E., Wang, M., ... & Bhatnagar, A. (2021). Evidence and magnitude of the effects of meteorological changes on SARS-CoV-2 transmission. PloS one, 16(2), e0246167.
- Smith, T., Cassell, G., & Bhatnagar, A. (2021, January). Wastewater surveillance can have a second act in COVID-19 vaccine distribution. In JAMA Health Forum (Vol. 2, No. 1, pp. e201616-e201616). American Medical Association.
- Fuqua, J., Rouchka, E., Waigel, S., Sokoloski, K., Chung, D., Zacharias, W., ... & Bhatnagar, A. (2021). A rapid assessment of wastewater for genomic surveillance of SARS-CoV-2 variants at sewershed scale in Louisville, KY. medRxiv.
- Fontenele, R. S., Kraberger, S., Hadfield, J., Driver, E. M., Bowes, D., Holland, L. A., ... & Varsani, A. (2021). High-throughput sequencing of SARS-CoV-2 in wastewater provides insights into circulating variants. medRxiv.
- Swaminathan, S., Morrill, J., Qirko, K., Smith, T., Wysham, N., & Toro, B. (2020). A Patient Feedback Driven, Stacked Machine-Learning Approach to At-Home COPD Triage.
- Baba, S., Smith, T., Hellmann, J., Bhatnagar, A., Carter, K., Vanhoover, A., & Caruso, J. (2020). Space Flight Diet-Induced Deficiency and Response to Gravity-Free Resistive Exercise. Nutrients, 12(8), 2400.
- Casey, J. A., Su, J. G., Henneman, L. R., Zigler, C., Neophytou, A. M., Catalano, R., ... & Barrett, M. A. (2020). Coal-fired power plant closures and retrofits reduce asthma morbidity in the local population. Nature Energy, 5(5), 365-366.
- Casey, J. A., Su, J. G., Henneman, L. R., Zigler, C., Neophytou, A. M., Catalano, R., ... & Barrett, M. A. (2020). Improved asthma outcomes observed in the vicinity of coal power plant retirement, retrofit and conversion to natural gas. Nature energy, 5(5), 398-408.
- Kaplin, A. I., Junker, C., Kumar, A., de Amorim Ribeiro, M. A., Yu, E., Wang, M., ... & Bhatnager, A. (2020). Evidence and magnitude of seasonality in SARS-CoV-2 transmission: Penny wise, pandemic foolish?. medRxiv.
- Yeager, R. A., Holm, R. H., Saurabh, K., Fuqua, J. L., Talley, D., Bhatnagar, A., & Smith, T. R. (2020). Wastewater sample site selection to estimate geographically-resolved community prevalence of COVID-19: A research protocol. medRxiv.
- Kumar, A., Wang, M., Riehm, A., Yu, E., Smith, T., & Kaplin, A. (2020). An Automated Mobile Mood Tracking Technology (Mood 24/7): Validation Study. JMIR Mental Health, 7(5), e16237.
- Swaminathan, S., Gerber, A., Qirko, K., Wysham, N., Corcoran, E., & Smith, T. (2019). A digital therapy for proactively managing exacerbations and delivering therapeutic benefit to patients with moderate to severe asthma.
- Swaminathan, S., Qirko, K., Wysham, N., Corcoran, E., Smith, T., & Gerber, A. N. (2019). A Therapeutic Machine-Learned Triage Methodology for Moderate to Severe Asthmatics. Available at SSRN 3327368.
- Smith TR, Mattingly TJ, Slabaugh L. Improving health determinants outside of the clinic does not mean outside of clinical science. Healthc (Amst). 2019 Jun 27. pii: S2213-0764(19)30148-4. doi: 10.1016/j.hjdsi.2019.06.001.
- Yeager RA, Smith TR, Bhatnagar A. Green environments and cardiovascular health. Trends Cardiovasc Med. 2020 May;30(4):241-246. doi: 10.1016/j.tcm.2019.06.005. Epub 2019 Jun 18. PMID: 31248691; PMCID: PMC7995555.
- Smith TR, Bhatnagar A. Enviromics: understanding aging. Aging (Albany NY). 2018 Dec 14;11(1):9-10. doi: 10.18632/aging.101709. PMID: 30552309; PMCID: PMC6339787.