About

Amanda Wilson is an Assistant Professor in the Department of Community, Environment and Policy at the Zuckerman College of Public Health. She studies microbial exposure and risk assessment, risk-risk tradeoffs, human behavior, and exposure modeling. Dr. Wilson received her PhD in environmental health sciences at the University of Arizona and completed her postdoctoral training at the Rocky Mountain Center for Occupational and Environmental Health in the Department of Family and Preventive Medicine at the University of Utah. Her research includes addressing asthma and microbial risk-risk tradeoffs for healthcare workers conducting surface cleaning and disinfection, as well as developing risk assessment tools for school nurses to reduce the spread of respiratory viral diseases in schools. Other projects involve evaluating risk perceptions of Arizona residents regarding advanced water purification and biosolid applications, with funding from the U.S. Army and the Arizona Board of Regents. She is a 2024 alumna of The Grainger Foundation Frontiers of Engineering, National Academy of Engineering cohort, and seeks to apply exposure science and engineering methodologies with community engagement to increase public health impact.

Research topics

• Medicine
• Virology
• Surgery
• Psychology
• Biology
• Internal medicine
• Dentistry
• Emergency medicine
• Environmental health
• Intensive care medicine

Selected publications

• Lung Function Trajectories in Young, Mid-adult Life Predict Premature Mortality

  American Journal of Respiratory and Critical Care Medicine · 2025-05-01

  article

  Abstract Rationale: Whether lung function in young to mid-adult life predicts premature mortality is unknown. Here, we aimed to identify lung function trajectories in the general population (age 25-50 years) and test their association with premature mortality. Methods: TESAOD is a longitudinal, population-based cohort initiated in 1972 in Tucson, Arizona, with extensive phenotypic, physiologic and molecular information collected at baseline and 12 follow-up surveys, completed approximately every two years. Vital status of participants was ascertained through multiple National Death Index searches up to January 1, 2021. We applied group-based trajectory modeling (GBTM) to identify patterns of lung function between 25-50 years using z-scores of FVC and FEV1/FVC, after stratification by sex and adjusting for age and height. Trajectories were also modeled for other risk factors: BMI, systolic and diastolic blood pressure (BP), pack-years, and serum C-reactive protein (CRP) levels. Patterns of dyspnea (mMRC dyspnea scale) during this age interval were defined as never, inconsistent (<50% of surveys), and persistent (≥50% of surveys). CDC sex-specific life expectancies were used to assess premature mortality, with individuals who died before their sex-specific life expectancy classified as cases, and individuals who either survived beyond their life expectancy or were still alive as of January 1, 2021 were classified as controls. Risks for all-cause and cardiopulmonary (COPD or cardiovascular) mortality were determined using Cox proportional hazards regression, with lung function trajectories as the main predictor and age, sex, dyspnea patterns, as well as trajectories for BMI, BP, pack-years and CRP as covariates. Results: Simultaneous modeling of FVC and FEV1/FVC (N=1298) identified a reference (normal), a large FVC, and five suboptimal trajectories (mildly, moderately, and severely reduced FEV1/FVC [lowRATIO]; and mildly and severely reduced FVC with preserved FEV1/FVC [lowFVC]), each with associated probabilities of group membership. Suboptimal trajectories were characterized by deficits that were largely established by age 25. After adjusting for covariates, the severely lowFVC and severely lowRATIO trajectories were associated with the highest increase in premature all-cause mortality risk (Table). The moderately and severely lowRATIO trajectories exhibited the highest risk for premature mortality from COPD (combined adjHR=67.1, p=0.008), whereas the mildly and severely lowFVC had the highest risk for premature cardiovascular mortality (combined adjHR=5.6, p=0.004). Conclusions: GBTM identified seven distinct lung function trajectories between ages 25-50, with suboptimal patterns associated with increased risk of premature mortality from cardiopulmonary causes. This supports the relevance of early tracking of lung function as a metric for overall health.

  PublisherDOI

• Applying a Risk‐Risk Tradeoff Economics Approach to the Occupational Health of Nurses: Economic and Microbial Risk Analysis

  Risk Analysis · 2025-10-23

  articleOpen accessSenior author

  ABSTRACT Public health challenges are increasingly complex, and interventions reducing the risk of one health outcome may increase the risk of another. We focus on the increased risk of occupational asthma (OA) for nurses and the decreased risk of occupational infections from contaminated surfaces from intensifying cleaning and disinfection protocols (i.e., during the COVID‐19 pandemic). A risk–risk trade‐off approach allows for the calculation of tolerable risks. We then determine, through a quantitative microbial risk assessment, critical concentrations of SARS‐CoV‐2 hygiene standards for surfaces that would achieve those tolerance levels. We find that, on average, in three out of our four scenarios, nurses prefer contracting a respiratory viral illness over OA around 80% of the time. Knowing another person who has contracted a respiratory viral infection (RVI) is negatively related to increasing respiratory viral infection risk. Critical concentrations were <0.01 viral particles/cm 2 , implying frequent monitoring of viral concentrations on surfaces is needed to ensure risk targets are achieved. When applied to occupational health trade‐offs for nurses engaging in cleaning and disinfection, we show that high environmental hygiene standards are needed.

  PublisherOA PDFDOI

• Knowledge gaps and education opportunities on direct potable reuse: Interviews with customers of a large, southwestern United States water utility

  The Science of The Total Environment · 2025-09-30

  articleOpen access1st authorCorresponding

  Water scarcity is a global public health threat that has increased urgency in implementing new sustainable practices to protect water supplies, such as the use of direct potable reuse, or “advanced water purification (AWP)". The study objective was to use interviews to characterize knowledge gaps and community outreach strategies to increase successful AWP implementation in an arid city in the southwestern United States. Through partnership with a water utility in an urbanized area of Arizona, 6000 individuals were emailed for invitation to participate in interviews. Interviews were conducted over Zoom and transcribed verbatim. Transcripts underwent inductive thematic analysis. Twenty-two individuals participated in interviews, and saturation of themes was reached. Five main themes emerged: 1) Conflation of filters with all treatment and the influence of residential technologies, 2) individual-level control over decisions to use advanced purified water, 3) desire for regulation, testing, and transparency about testing results, 4) concerns about specific chemicals, 5) educational resources to strengthen community engagement. Participants expressed lack of knowledge about how water is delivered to their residences by expressing the desire for opting in or out of system-wide treatment approaches. They also expressed wanting more support in interpreting testing results and having access to multiple outreach modalities. There is a growing body of evidence supporting increased outreach from utilities and governmental entities for water reuse adoption. This work provides insights into why the public may be in support or not of AWP and what information they need to form an opinion. • “Filtration” may be conflated with other water treatment approaches for the public. • Some people want to opt in/out of direct potable reuse at municipality scales. • Greater transparency and education about testing results is needed. • Concerns about chlorine and fluoride indicate a need for more outreach. • People desire a variety of community engagement modalities.

  PublisherDOI

• Corrigendum to “Quantitative microbial risk assessment (QMRA) tool for modelling pathogen infection risk to wastewater treatment plant workers” [Water Research volume 260 (2024) 121858]

  Water Research · 2025-02-19

  erratumOpen accessSenior authorCorresponding
  PublisherDOI

• Improving delayed discharge in gastrointestinal surgery patients: An integrative review

  International Journal of Nursing Studies Advances · 2025-09-08 · 1 citations

  reviewOpen accessSenior author

  Background: Delayed discharge is a global challenge that strains healthcare systems and affects patient outcomes. In gastrointestinal surgery patients, delays often result from a continuum, clinical complications prolong the acute stay and create additional care needs, such as rehabilitation and specialised homecare, which lead to further delays. However, existing literature provides limited insight into this patient group, as most studies generalise the issue. A focused integrative review is therefore needed to synthesise the causes, impacts, and strategies of delayed discharge and to inform more effective discharge planning. Objective: This review aims to synthesise evidence related to delayed discharge in patients undergoing gastrointestinal surgery. Specifically, it seeks to: (1) identify multi-level contributing factors (patient, clinical, and healthcare system); (2) evaluate significant clinical and economic impacts on patients, family, healthcare staff and healthcare system; and (3) identify and describe effective interventions implemented to promote timely and safe discharge in this population. Method: A literature search was conducted across CINAHL, Medline, Scopus, Cochrane, and PsycINFO databases for studies published from 2000 to January 2025. Keywords used included "delayed discharge," "factors," "impact," "gastrointestinal surgery," and "intervention." Inclusion criteria focused on peer-reviewed studies involving adult gastrointestinal surgery patients in acute hospital settings. Two authors independently screened titles, abstracts, and full texts using the Joanna Briggs Institute SUMARI software. The methodological quality of studies was assessed using the Joanna Briggs Institute critical appraisal tools. Data extraction focused on study characteristics, factors, impacts, and interventions, followed by a deductive narrative analysis to identify patterns and relationships. Results: < 0.0001). Conclusion: Delayed discharge in gastrointestinal surgery patients stems from a complex interplay of patient, surgical, and systemic factors, affecting both individual and healthcare system. Evidence supports nurse-led and multidisciplinary approaches in mitigating delays, improving outcomes and enhancing healthcare efficiency. Future research should employ qualitative or mixed-methods approaches to explore the psychosocial impacts on patients, families, and healthcare staff, in collaboration with comprehensive, multidisciplinary discharge strategies.

  PublisherDOI

• Quantifying fomite hotspots and targeted hygiene impacts in a hotel lobby

  International Journal of Hygiene and Environmental Health · 2025-04-29

  articleOpen access

  reduction, p < 0.0001). The proportion of cross-contaminated surfaces (i.e., non-seeded sites testing positive) decreased from 13 % to 2 %, and the overall percentage of positive surfaces dropped from 50 % to 42 %. QMRA modeling demonstrated that infection risks from a single fomite-hand-face contact were highest for rhinovirus, rotavirus, and adenovirus. Following intervention, infection risk was reduced by over 97 % for all modeled pathogens. Risk levels for all viruses and bacteria met the U.S. EPA and WHO benchmark of less than 1 infection per 10,000 exposures used in drinking water guidelines. Notably, bacterial infection risks, already low pre-intervention, were further reduced to meet the more stringent 1 infection per 1,000,000 risk threshold. This is the first study to integrate real-world human behavior, viral tracer data, and QMRA modeling to assess Targeted Hygiene in a hospitality setting. Findings support the implementation of evidence-based hygiene protocols that prioritize high-risk surfaces and timing, offering a sustainable approach to reducing infection risks in public environments.

  PublisherDOI

• Could hybrid work schedules offer infection risk reductions? Insights from a CO2 sensor and modeling study

  Building and Environment · 2025-03-18 · 2 citations

  articleOpen accessSenior authorCorresponding
  PublisherOA PDFDOI

• Navigating the challenges of NT-proBNP result disclosure in clinical research

  Journal of Clinical and Translational Science · 2025-01-01

  articleOpen access

  Background: The Office of Human Research Protections and the National Academy of Sciences, Engineering, and Medicine (NASEM) recommend the return of individual research results (IRRs) to study participants as a strategy to build public trust in science. However, the feasibility of sharing IRRs is unclear. Within a National Institutes of Health (NIH) funded parent study about Long COVID, we embedded the My ILLInet RECOVER Return of Results study to explore clinician-level considerations (e.g., validity, actionability, recommendations for follow-up) about returning a clinically used biomarker for heart failure (N-terminal pro-B-type natriuretic peptide, (NT-proBNP) collected as part of the NIH RECOVER study protocol. Approach: Clinicians participated in a three-phase modified Delphi process that sought their input to guide appropriate follow up recommendations the research team should provide to research participants with an abnormal NT-proBNP. Results: Clinicians agreed that NT-proBNP results could be returned to study participants. However, consensus was not reached on specific NT-proBNP thresholds that warrant immediate medical attention versus general follow-up. Discussion: Lack of clinical context presents a challenge in returning IRRs. Clinicians expressed concerns about the potential harm caused by misinformation or misinterpretation of these findings. While the NASEM report offers guidance on communicating IRRs, careful consideration is essential to ensure that clinical uncertainty is conveyed clearly, minimizing the risk of misinterpretation. Conclusion: The feasibility of returning IRRs to study participants depends, in part, on sufficient clinical context for the information to be actionable.

  PublisherOA PDFDOI

• Environmental Health Risk Assessment and Management: Community Engagement for Water Reuse Technologies

  2025-05-15 · 1 citations

  preprintOpen access1st authorCorresponding

  While there is an emerging consensus among scholars, academic researchers, and environmental advocates that community engagement is essential for effective environmental health risk assessment and management, robust engagement does not occur often enough. To help promote community engagement in environmental health risk assessment and management, we provide rationales and approaches. We illustrate our points with a case study concerning water reuse, as water recycling technologies expand across the U.S. and the world to address water scarcity and increased water demand, considering a community engagement continuum framework. Formal environmental risk assessment has always had a required component for public notification to seek comments, but it is arguably not meaningful community engagement, as it is often done after the risk assessment is completed (without input) and in response to contamination without multi-directional community engagement. We show how effective multi-directional engagement of the community from the beginning of the risk assessment process can help to ensure that risk assessment and management are fair and effective. We also discuss some potential obstacles to effective community engagement concerning environmental health risk assessment and management and offer some recommendations for engineers, risk assessors, and policymakers.

  PublisherDOI

• Making waves: Moving beyond the 1 in 10,000 benchmark in quantitative microbial risk assessment (QMRA) through evidence-informed risk approaches and systems decision-making

  Water Research · 2025-11-04

  reviewSenior author
  PublisherDOI

Frequent coauthors

• Kelly A. Reynolds

  44 shared

• Robert S. Dittus

  26 shared

• John F. Schnelle

  26 shared

• Rachael M. Jones

  23 shared

• E. Wesley Ely

  22 shared

• Marco‐Felipe King

  University of Leeds

  20 shared

• Mark H. Weir

  The Ohio State University

  19 shared

• Lynn B. Gerald

  19 shared

Education

• Environmental Health Sciences PhD, Community, Environment & Policy

  University of Arizona

  2020

• Environmental Health Science MS, Community, Environment & Policy

  University of Arizona

  2018

• Environmental Science BS, Soil, Water, and Environmental Science

  University of Arizona

  2013

Awards & honors

• Mentored Research Scientist Career Development Award (K01) f…
• Catalyst Award from the American Lung Association
• 2024 alumna of The Grainger Foundation Frontiers of Engineer…