Dr. Carl Michael Shy, MD, DrPH, was a distinguished American physician, epidemiologist and public health educator with a long career in preventive medicine and academic leadership. He was Professor and Professor Emeritus in the Department of Epidemiology at the University of North Carolina (UNC) Gillings School of Global Public Health, in Chapel Hill, NC, where he served for over three decades, including three years as Epidemiology Department chair. He was born October 23, 1931 and died May 3, 2026. He began his studies with an eye to being a minister, but veered to medicine and public health. He graduated from Marquette University School of Medicine in 1962, followed by completing his DrPH from the University of Michigan in 1967.
Dr. Shy’s early career focused on air pollution and respiratory diseases, where he authored studies on the Chattanooga (TN) School Children Study while on staff at the Research Triangle Park office of the Environmental Protection Agency. Dr. Shy's research on the health effects of air pollution had a major impact on US public policy and legislation. A significant contribution was in studying nitrogen dioxide (NO2) exposures in communities and the adverse effects on respiratory function and illnesses in children. This work led to regulation of NO2 and other pollutants in emissions from catalytic converters in automobiles. He also was critical to documenting the health hazards of airborne lead thereby helping to provide the scientific basis and impetus for legislation for two hazardous air pollutant—NO2 and lead. He joined the UNC Epidemiology Department part time in 1968 and became a full professor in 1977. He has been a long-time member of the International Society for Environmental Epidemiology (ISEE).
This remembrance is designed to share his contributions to environmental and occupational epidemiology first from the perspective of his work as an educator and his public health impact more broadly, and then from the recollections from two students whose doctoral work Dr. Carl Shy supervised.
In 1993, Dr. Shy developed an innovative problem-based learning format for a large-lecture introductory epidemiology course required of all public health graduate students. In 1998, he co-developed one of the first totally online courses (EPID 160) at Gillings with Epidemiology faculty member Lorraine Alexander, DrPH. The online format developed is still used for the current online version of the course today. Dr. Alexander who co-taught this class with Carl for almost 10 years, remembers Carl as someone who was an innovative educator, always willing to try something new, especially to bring the insights and wonder of epidemiology to non-epidemiologists.
David Goldsmith joined the Epidemiology Department in 1975 and took classes relevant to the work of the UNC Rubber Study that involved Epidemiology, Biostatistics, and Environmental Sciences. That large research project aimed to understand health risks to workers in U.S. rubber industry plants. He worked and collaborated with Drs. McMichaels, Tyroler, Kleinbaum, Smith, and Cassel. After receiving his MSPH in 1977, he was admitted to the doctoral program but took a year off to work at the National Academy of Sciences in Washington, DC in 1978. Returning to UNC led to a close collaboration with Dr. Shy focusing on respiratory health impacts related to exposure to wood dust. This required the braiding of three academic loaves at once: seeking approval from a furniture manufacturer to permit us to study their workers, developing a research protocol to measure pulmonary function and administer a symptom questionnaire, and writing a grant to pay for the study, including industrial hygiene sampling for wood dust (conducted by colleagues from the Morgantown WV office of the National Institute Occupational Safety and Health. Writing the grant meant almost continual revision of a document analyzing the published literature on lung ailments among woodworkers that was incorporated into the dissertation. That overly long chapter, with Dr. Shy’s editing led to a review paper in the Scandinavian Journal of Work, Environment, & Health in 1988; a second paper was published on the pulmonary symptoms and flow volumes of the workers in the Journal of Occupational Medicine also in 1988. Dr. Shy’s steady hand was everywhere in the doctoral work, completed in 1983, and in the published papers.
Dr. Shy was the principal dissertation advisor to Dr. Deborah Winn, who earned her Ph.D. in Epidemiology from the UNC School of Public Health (now the Gillings School of Global Public Health) in 1980. Dr. Winn's dissertation work involved a large case-control study to understand reasons underlying the high rate of oral and pharyngeal cancer in the Southeastern United States. Her findings on the strong association between using smokeless tobacco – snuff – and oral cancer risk led to an article she authored with Dr. Shy and others in the New England Journal of Medicine. The study was extensively cited in subsequent legislation requiring warning labels on smokeless tobacco products in the United States and conclusions by the World Health Organization’s International Agency for Research on Cancer (IARC) that classified smokeless tobacco as a known human carcinogen (Volume 83).
Dr. Shy’s guidance throughout the dissertation process was critical to Dr. Winn’s successfully completing the project. She credits Dr. Shy with his crucial insight to ensure the scientific quality of the research. And, like Dr. Goldsmith’s experience, Dr. Shy was also supportive and helpful as both tackled the many moving parts of these ambitious projects and instilled in them the confidence to work through obstacles inherent in epidemiology field work. Dr. Winn appreciated Dr. Shy’s counsel as she organized research collaborations with multiple North Carolina Hospitals, a federal research agency--National Cancer Institute, the NC Health Statistics agency, interviewers, and, of course, the research study participants. Without the continuous support of Dr. Shy these projects could not have succeeded.
Drs. Shy, Winn and Goldsmith co-edited a book — Silica, Silicosis & Cancer — that was published in 1986 by Praeger Publishers, propelling the issue to the international stage and boosting Dr. Goldsmith's career interest in this topic. Silica, Silicosis & Cancer began as an international conference hosted by UNC in Chapel Hill in 1984. There were 135 scientists who contributed to the book. Drs. Winn and Goldsmith edited and wrote multiple chapters, with Dr. Shy using his diplomatic skills to smooth the feathers of authors who wanted their work to be featured more than space permitted. After the book was published Dr. Goldsmith was asked by IARC, part of the World Health Organization (WHO) in Lyon France, to be a member of the monograph writing team evaluating silica dust as a carcinogen. The expert committee judged the evidence to be "probable" when IARC published volume 42 in 1987. The IARC reviewed the animal and human cancer literature again with Dr. Shy as chair of the panel of experts, and the international reviewers judged the evidence for silica dust to be a "known" human carcinogen in 1997 (volume 86). There was a third assessment of evidence in 2012, with the IARC reconfirming the 1997 finding (volume 100C).
Dr. Shy's academic accomplishments and his large contributions to environmental epidemiology are clear from reading his list of publications and the very large number of students and colleagues who benefited from his teaching and guidance. We highlighted his sizable contributions to three critical (and global) public health issues – smokeless tobacco and oral cancer risk, wood dust and respiratory ailments, and silica, silicosis and cancer. Dr. Carl Shy was beloved by his family and by the many students whom he mentored over his thirty years at the Epidemiology Department at UNC Gillings School of Global Public Health. As an epidemiologist, he shone as a benevolent and assured boat captain, who invited us to the bridge, and then gave us the wheel so we could become the public health professionals he knew could steer the boat. His memory and insights continue to quietly guide our intellectual progress and commitment to public health.
Drs. Goldsmith, Winn, and Alexander acknowledge the help of Vic Schoenbach, Doug Dockery, and Karin Yeatts who offered insights and corrections to this remembrance.