A new perspective to improve the treatment of Lianhuaqingwen on COVID-19 and prevent the environmental health risk of medication

Lianhuaqingwen (LH), one traditional Chinese medicine (TCM), has been used to treat the coronavirus disease 2019 (COVID-19), but its ecotoxicity with potential human health security has not been well investigated. To overcome such adverse effects and improve its medication efficacy, an intelligent multi-method integrated dietary scheme, screening, and performance evaluation approach was developed. Thirteen LH compounds were selected, and the main protease (Mpro) was used as the potential drug target. Resulted information showed that the more compounds of LH added, the higher medication efficacy obtained using multi-method integrated screening system, expert consultation method, and molecular dynamics simulation. Pharmacodynamic mechanism analysis showed that low total energy and polar surface area of LH active compound (i.e., β-sitosterol) will contribute to the best therapeutic effect on COVID-19 using quantitative structure-activity relationships (QSAR) and sensitivity models. Additionally, when mild COVID-19 patients take LH with the optimum dietary scheme (i.e., β-lactoglobulin, α-lactalbumin, vitamin A, vitamin B, vitamin C, carotene, and vitamin E), the medication efficacy were significantly improved (23.58%). Pharmacokinetics and toxicokinetics results showed that LH had certain human health risks and ecotoxicity. This study revealed the multi-compound interaction mechanism of LH treatment on COVID-19, and provided theoretical guidance for improving therapeutic effect, evaluating TCM safety, and preventing human health risk.

The role of N6-methyladenosine methylation in environmental exposure-induced health damage

The health risks caused by environmental pollution have long been of substantial concern. With the development of epigenetics, a large number of studies have demonstrated that N6-methyladenosine (m6A) modification is involved in the regulation of various important life activities associated with various diseases. Recent studies have revealed that m6A plays a key role in health damage caused by environmental exposure by regulating post-transcriptional gene expression. Therefore, our study outlined the effects of environmental pollutant exposure on m6A methylation and its regulator levels. Moreover, we found that m6A methylation modifications were involved in the development of various health damages by regulating important life activities in vivo, such as reactive oxygen species imbalance, apoptosis, epithelial-mesenchymal transition (EMT), and inflammatory processes. More importantly, we delved into the regulatory mechanisms of m6A methylation dysregulation in environmental pollution-induced diseases. Finally, by examining the published literature, we found that methyltransferase-like protein 3 (METTL3) and fat mass- and obesity-associated protein (FTO) were potentially used as biomarkers of health damage induced by particulate matter exposure and heavy metal exposure, respectively. The current studies on regulators of METTL3 and FTO were more promising to bring new perspectives for the treatment of environmental health-related diseases.

State-of-the-art methods for exposure-health studies: Results from the exposome data challenge event

The exposome recognizes that individuals are exposed simultaneously to a multitude of different environmental factors and takes a holistic approach to the discovery of etiological factors for disease. However, challenges arise when trying to quantify the health effects of complex exposure mixtures. Analytical challenges include dealing with high dimensionality, studying the combined effects of these exposures and their interactions, integrating causal pathways, and integrating high-throughput omics layers. To tackle these challenges, the Barcelona Institute for Global Health (ISGlobal) held a data challenge event open to researchers from all over the world and from all expertises. Analysts had a chance to compete and apply state-of-the-art methods on a common partially simulated exposome dataset (based on real case data from the HELIX project) with multiple correlated exposure variables (P > 100 exposure variables) arising from general and personal environments at different time points, biological molecular data (multi-omics: DNA methylation, gene expression, proteins, metabolomics) and multiple clinical phenotypes in 1301 mother-child pairs. Most of the methods presented included feature selection or feature reduction to deal with the high dimensionality of the exposome dataset. Several approaches explicitly searched for combined effects of exposures and/or their interactions using linear index models or response surface methods, including Bayesian methods. Other methods dealt with the multi-omics dataset in mediation analyses using multiple-step approaches. Here we discuss features of the statistical models used and provide the data and codes used, so that analysts have examples of implementation and can learn how to use these methods. Overall, the exposome data challenge presented a unique opportunity for researchers from different disciplines to create and share state-of-the-art analytical methods, setting a new standard for open science in the exposome and environmental health field.

Enhancing community participation for environmental health improvement in rural Tanzania: Evidence from Bukombe district

Community participation has become a dominant approach in environmental health-related projects, yet, its enhancement has remained a challenge. This study examines ways of enhancing community participation in environmental health-related initiatives in rural areas of Tanzania. A total of one hundred people (n = 100) were engaged in this study. An embedded case study design was employed, in which multiple methods such as household questionnaires, in-depth interviews, focus group discussions, and document analysis were used in collecting empirical data. Findings show that integration of the community into the development agenda and facilitating communities to access required equipment and tools is vital for enabling participation in environmental health-related matters. Effective and efficient leadership, mobilisation, and sensitisation of communities are operational and functioning strategies to improve environmental health through community participation, while retribution measures may prevent environmental pollution. There is a definite need for the integration of community participation as a key aspect of environmental-related projects and programs in the development policy aiming at improving the environmental health of communities.

Cumulative Impacts of Diverse Land Uses in British Columbia, Canada: Application of the "EnviroScreen" Method

(1) Objectives: Cumulative impacts refer to the legacies of land use decisions on environmental, community and health values. New integrative impact assessment tools are required to assess cumulative impacts on diverse values to meet sustainability goals in the 21st century. In this contribution, the CalEnviroScreen methodology-a screening tool capable of merging environmental, socioeconomic and health data-is applied to Local Health Areas in British Columbia, Canada. (2) Methods: The CalEnviroScreen is a method that standardizes environmental, socioeconomic and health data to depict an indicator's percentile rank in the distribution of all units of analysis. The method combines indicators to measure four dimensions of pressure: environmental exposures, environmental effects, socioeconomic conditions, and sensitive populations (i.e., health outcomes). We create two versions of EnviroScreen: one following the CalEnviroScreen suite of indicators, and another that uses nuanced indicators to approximate the realities of industrial land uses present in British Columbia. BCEnviroScreen scores are plotted by race/ethnicity to understand potential racial inequities in cumulative exposures. (3) Results: The BCEnviroScreen has a greater likelihood of quantifying the cumulative impacts of diverse industries and land uses present across resource-dependent parts of the province, relative to the more urban-centric CalEnviroScreen indicator suite. Analyzing the distribution of BCEnviroScreen scores by race/ethnicity suggests that visible minority populations may be inequitably exposed to cumulative impacts in BC. (4) Conclusion: EnviroScreen tools hold significant potential to influence Canadian environmental health policy. This research demonstrates the applicability of the tool to British Columbia and other jurisdictions, illustrates how indicators can be tailored to better represent regional context, and shows how the tool can be used to screen for potential environmental health injustices.

Exposure to several polychlorinated biphenyls (PCBs) is associated with chronic kidney disease among general adults: Korean National Environmental Health Survey (KoNEHS) 2015-2017

We investigated the association between major persistent organic pollutants (POPs) exposure and chronic kidney disease (CKD) among general adult population of Korea. For this purpose, a subset of the adult population (n = 1276) participated in Korean National Environmental Health Survey (KoNEHS) Cycle 3 (2015-2017) were analyzed for twenty-four POPs in serum, including organochlorine pesticides (OCPs), polychlorinated biphenyls (PCBs), and polybrominated diphenyl ethers (PBDEs), and were derived for estimated glomerular filtration rate (eGFR) and urinary albumin-to-creatinine ratio (uACR). Multivariable linear regression was conducted to assess the association between POPs exposure and CKD-related parameters including eGFR and uACR. As sensitivity analyses, principal component analysis was conducted. Moreover, the U.S. National Health and Nutrition Examination Survey (NHANES) 1999-2004 data were chosen to compare with the observations of the Korean adults. Approximately 7.7% of the Korean adult population possessed CKD based on either eGFR (<60 ml/min/1.73 m²) or uACR (≥30 mg/g) criteria. Among the POPs that were detected in ≥70% of the subjects, PCB153 (β = -1.61, 95% CI: -2.55, -0.67, P = 0.001) and PCB180 (β = -1.47, 95% CI: -2.53, -0.40, P = 0.007) exhibited significant associations with decreased eGFR, especially in females. In male participants, hexachlorobenzene (HCB) was associated with eGFR (β = -0.79, 95% CI: -1.53, -0.04, P = 0.040). Sex-dependent associations with eGFR were also shown in the PCA model. Moreover, the sex-dependent associations of PCBs were similarly observed in the adult populations of the US NHANES. However, POPs exposure was not associated with uACR, regardless of association model or population. The observed associations of PCBs are supported by several experimental studies reported elsewhere. To our knowledge, it is the first report that suggests significant associations of PCBs and HCB with eGFR among general population, and further validations in other populations are warranted.

Environmental health literacy for Anishinaabe (Great Lakes Native American) fish consumers: A randomized control trial

BACKGROUND

Fish consumption comprises an important part of what the Anishinaabe (Great Lakes Native Americans) call "minobimaadiziiwin" which translates roughly to "living in a good way". Industrial activity leading to the accumulation of persistent contaminants in fish disrupts minobimaadiziiwin. Our team of academic and Anishinaabe scientists co-developed a fish consumption advisory for the Anishinaabe using software that can be accessed via mobile phones and/or the internet.

OBJECTIVES

The software, Gigiigoo'inaan ("our fish") is designed to improve environmental health literacy using culturally congruent messaging and aesthetics. We tested the following hypotheses: 1) the Gigiigoo'inaan would encourage consumption of fish high in Polyunsaturated Omega-3 fatty acids (PFUA-3) whilst minimizing contaminant intake (methylmercury (MeHg) and Polychorinated Biphenyls (PCBs)); and 2) intervention participants will be more likely than controls to achieve a favorable n-3 PUFA/MeHg consumption ratios.

METHODS

We conducted a randomized controlled trial with prospective self-reported fish consumption using automated email surveys. One-month pre and one month post, control and intervention outcome variables were calculated per participant as µg/kg/day of MeHg, µg/kg/day of PCB, g of fish, and mg/day of EPA+DHA. These were modeled using an analysis of covariance (ANCOVA) with a-priori covariates: age, sex, and tribal affiliation.

RESULTS

Most participants in both trial arms reported eating relatively elevated amounts of fish yet remained within advisory guidelines for contaminants. EPA+DHA:MeHg ratios were also favorable in most participants. Advisory limits for contaminants were exceeded by relatively few participants in the study.

DISCUSSION

Gigiigoo'inaan was previously reported to increase confidence, the current user feedback confirms this. Most participants ate fish but did not exceed the advisory limits, which demonstrates Environmental Health Literacy progress in the region despite a lack of observed behavior change during the trial. A small number of participants exceeded contaminant intake guidelines which matches the pilot work for this study.

The Intersection of Immigrant and Environmental Health: A Scoping Review of Observational Population Exposure and Epidemiologic Studies

BACKGROUND

Transnational immigration has increased since the 1950s. In countries such as the United States, immigrants now account for > 15 % of the population. Although differences in health between immigrants and nonimmigrants are well documented, it is unclear how environmental exposures contribute to these disparities.

OBJECTIVES

We summarized current knowledge comparing immigrants' and nonimmigrants' exposure to and health effects of environmental exposures.

METHODS

We conducted a title and abstract review on articles identified through PubMed and selected those that assessed environmental exposures or health effects separately for immigrants and nonimmigrants. After a full text review, we extracted the main findings from eligible studies and categorized each article as exposure-focused, health-focused, or both. We also noted each study's exposure of interest, study location, exposure and statistical methods, immigrant and comparison groups, and the intersecting socioeconomic characteristics controlled for.

RESULTS

We conducted a title and abstract review on 3,705 articles, a full text review on 84, and extracted findings from 50 studies. There were 43 studies that investigated exposure (e.g., metals, organic compounds, fine particulate matter, hazardous air pollutants) disparities, but only 12 studies that assessed health disparities (e.g., mortality, select morbidities). Multiple studies reported higher exposures in immigrants compared with nonimmigrants. Among immigrants, studies sometimes observed exposure disparities by country of origin and time since immigration. Of the 50 studies, 43 were conducted in North America.

DISCUSSION

The environmental health of immigrants remains an understudied area, especially outside of North America. Although most identified studies explored potential exposure disparities, few investigated subsequent differences in health effects. Future research should investigate environmental health disparities of immigrants, especially outside North America. Additional research gaps include the role of immigrants' country of origin and time since immigration, as well as the combined effects of immigrant status with intersecting socioeconomic characteristics, such as race/ethnicity, income, and education attainment. https://doi.org/10.1289/EHP9855.

Environmental health and risk assessment metrics with special mention to biotransfer, bioaccumulation and biomagnification of environmental pollutants

The environment pollutants, which are landed up in environment because of human activities like urbanization, mining and industrializations, affects human health, plants and animals. The living organisms present in environment are constantly affected by the toxic pollutants through direct contact or bioaccumulation of chemicals from the environment. The toxic and hazardous pollutants are easily transferred to different environmental matrices like land, air and water bodies such as surface and ground waters. This comprehensive review deeply discusses the routes and causes of different environmental pollutants along with their toxicity, impact, occurrences and fate in the environment. Environment health and risk assessment tools that are used to evaluate the harmfulness, exposure of living organisms to pollutants and the amount of pollutant accumulated are explained with help of bio-kinetic models. Biotransfer, toxicity factor, biomagnification and bioaccumulation of different pollutants in the air, water and marine ecosystems are critically addressed. Thus, the presented survey would be collection of correlations those addresses the factors involved in assessing the environmental health and risk impacts of distinct environmental pollutants.

Comparison of GPS imputation methods in environmental health research

Assessment of personal exposure in the external environment commonly relies on global positioning system (GPS) measurements. However, it has been challenging to determine exposures accurately due to missing data in GPS trajectories. In environmental health research using GPS, missing data are often discarded or are typically imputed based on the last known location or linear interpolation. Imputation is said to mitigate bias in exposure measures, but methods used are hardly evaluated against ground truth. Widely used imputation methods assume that a person is either stationary or constantly moving during the missing interval. Relaxing this assumption, we propose a method for imputing locations as a function of a person's likely movement state (stop, move) during the missing interval. We then evaluate the proposed method in terms of the accuracy of imputed location, movement state, and daily mobility measures such as the number of trips and time spent on places visited. Experiments based on real data collected by participants (n=59) show that the proposed approach outperforms existing methods. Imputation to the last known location can lead to large deviation from the actual location when gap distance is large. Linear interpolation is shown to result in large errors in mobility measures. Researchers should be aware that the different treatment of missing data can affect the spatiotemporal accuracy of GPS-based exposure assessments.

Coupled effects of microplastics and heavy metals on plants: Uptake, bioaccumulation, and environmental health perspectives

Microplastic pollution has severe ecological and environmental concerns because of its enormous production and discharge in natural ecosystems worldwide. Microplastics interact with heavy metals and metalloids like arsenic, chromium, copper, cadmium, and lead in soil and can cause detrimental effects on soil structure and microbial activities and subsequently impact the plants and human health. This article focuses on microplastic translocation from soil to plants together with heavy metals. Microplastic exposure impacts biomass, photosynthetic activity, chlorophyll content, root and shoot length in the plants through apoplastic and symplastic pathways. Microplastics can also indirectly affect the plant growth by changing soil nutrient content and microbial community structure. At the same time, microplastics can absorb heavy metals and increase phytotoxicity in plants. However, the current knowledge about the coupled effect of heavy metals and microplastics bioaccumulation in plants is limited. It is postulated that heavy metals and microplastics collectively impact the chlorophyll content, photosynthetic activity, and induction of reactive oxygen species in plants. This work also outlines the environmental health perspectives based on microplastic and heavy metals toxicity and provides a guideline for future research on the coupled effects of heavy metals and microplastics on plants and humans.

Toxicoepigenetics and Environmental Health: Challenges and Opportunities

The rapidly growing field of toxicoepigenetics seeks to understand how toxicant exposures interact with the epigenome to influence disease risk. Toxicoepigenetics is a promising field of environmental health research, as integrating epigenetics into the field of toxicology will enable a more thorough evaluation of toxicant-induced disease mechanisms as well as the elucidation of the role of the epigenome as a biomarker of exposure and disease and possible mediator of exposure effects. Likewise, toxicoepigenetics will enhance our knowledge of how environmental exposures, lifestyle factors, and diet interact to influence health. Ultimately, an understanding of how the environment impacts the epigenome to cause disease may inform risk assessment, permit noninvasive biomonitoring, and provide potential opportunities for therapeutic intervention. However, the translation of research from this exciting field into benefits for human and animal health presents several challenges and opportunities. Here, we describe four significant areas in which we see opportunity to transform the field and improve human health by reducing the disease burden caused by environmental exposures. These include (1) research into the mechanistic role for epigenetic change in environment-induced disease, (2) understanding key factors influencing vulnerability to the adverse effects of environmental exposures, (3) identifying appropriate biomarkers of environmental exposures and their associated diseases, and (4) determining whether the adverse effects of environment on the epigenome and human health are reversible through pharmacologic, dietary, or behavioral interventions. We then highlight several initiatives currently underway to address these challenges.

Pyrimethanil and chlorpyrifos air concentrations and pregnant women's urinary metabolites in the Infants' Environmental Health Study (ISA), Costa Rica

BACKGROUND

Only few studies have compared environmental pesticide air concentrations with specific urinary metabolites to evaluate pathways of exposure. Therefore, we compared pyrimethanil and chlorpyrifos concentrations in air with urinary 4-hydroxypyrimethanil (OHP, metabolite of pyrimethanil) and 3,5,6-trichloro-2-pyridinol (TCPy, metabolite of chlorpyrifos) among pregnant women from the Infant's Environmental Health Study (ISA) in Matina County, Costa Rica.

METHODS

During pregnancy, we obtained repeat urinary samples from 448 women enrolled in the ISA study. We extrapolated pyrimethanil and chlorpyrifos concentrations measured with passive air samplers (PAS) (n = 48, from 12 schools), across space and time using a Bayesian spatiotemporal model. We subsequently compared these concentrationswith urinary OHP and TCPy in 915 samples from 448 women, usingseparatemixed models andconsidering several covariables.

RESULTS

A 10% increase in air pyrimethanil (ng/m3) was associated with a 5.7% (95% confidence interval (CI 4.6, 6.8) increase in OHP (μg/L). Women living further from banana plantations had lower OHP: -0.7% (95% CI -1.2, -0.3) for each 10% increase in distance (meters) as well as women who ate rice and beans ≥15 times a week -23% (95% CI -38, -4). In addition, each 1 ng/m3 increase in chlorpyrifos in air was associated with a 1.5% (95% CI 0.2, 2.8) increase in TCPy (μg/L), and women working in agriculture tended to have increased TCPy (21%, 95% CI -2, 49).

CONCLUSION

The Bayesian spatiotemporal models were useful to estimate pyrimethanil and chlorpyrifos air concentrations across space and time. Our results suggest inhalation of pyrimethanil and chlorpyrifos is a pathway of environmental exposure. PAS seems a useful technique to monitor environmental current-use pesticide exposures. For future studies, we recommend increasing the number of locations of environmental air measurements, obtaining all air and urine measurements during the same month, and, ideally, including dermal exposure estimates as well.

A review of practical statistical methods used in epidemiological studies to estimate the health effects of multi-pollutant mixture

Environmental risk factors have been implicated in adverse health effects. Previous epidemiological studies on environmental risk factors mainly analyzed the impact of single pollutant exposure on health, while in fact, humans are constantly exposed to a complex mixture consisted of multiple pollutants/chemicals. In recent years, environmental epidemiologists have sought to assess adverse health effects of exposure to multi-pollutant mixtures based on the diversity of real-world environmental pollutants. However, the statistical challenges are considerable, for instance, multicollinearity and interaction among components of the mixture complicate the statistical analysis. There is currently no consensus on appropriate statistical methods. Here we summarized the practical statistical methods used in environmental epidemiology to estimate health effects of exposure to multi-pollutant mixture, such as Bayesian kernel machine regression (BKMR), weighted quantile sum (WQS) regressions, shrinkage methods (least absolute shrinkage and selection operator, elastic network model, adaptive elastic-net model, and principal component analysis), environment-wide association study (EWAS), etc. We sought to review these statistical methods and determine the application conditions, strengths, weaknesses, and result interpretability of each method, providing crucial insight and assistance for addressing epidemiological statistical issues regarding health effects from multi-pollutant mixture.

O3 concentration and duration of exposure are factors influencing the environmental health risk of exercising in Rio Grande, Brazil

Ozone (O₃) represents a great threat to human health, contributing to respiratory diseases and premature mortality. This pollutant is often considered a critical pollutant in regions of southern Brazil. Exposure to this pollutant during vigorous physical activity should be the subject of thorough investigations due to the increased ventilation rate and altered breathing pattern present during vigorous physical activity that result in greater inhalation of O₃. Thus, this study aimed to evaluate the health risk of exposure to low, mean, and high concentrations of O₃ during different durations of exercise in the city of Rio Grande (southern Brazil). Healthy young men (n = 45) performed cardiopulmonary exercise testing, and ventilation rate data were collected to predict total ventilation and pollutant inhalation during a 5 km running session. The O₃ concentration in the city of Rio Grande was obtained from data reported by the Copernicus Atmosphere Monitoring Service (CAMS). The environmental health risk was calculated based on the potential intake dose. The lowest, mean, and highest concentrations of O₃ detected during the monitoring period were 32.5, 64.9, and 115.2 µg/m³, respectively. In all evaluated scenarios, there was a toxicological risk (RQ > 1), except when exercising when the O₃ concentration was lowest for the shortest length of time (p < 0.001). As the concentration of O₃ and the duration of the exposure increase, the health risk is increased. Therefore, O₃ concentration and duration of exposure are factors influencing the health risk of exercising. These findings are extremely relevant in cities that have high levels of O₃, such as the city of Rio Grande.

Extensive investigation and beyond the removal of micro-polyvinyl chloride by microalgae to promote environmental health

Microplastics (MPs) remediation via algae could be a prospective strategy to address MPs pollution concerns. In this study, Chlorella sp. GEEL-08 was exposed to different gradient concentrations ranging from 0 to 200 mg L^-1 of polyvinyl chloride (PVC_0.2μm). Microalgal growth, total nitrogen (TN), total phosphorus (TP), and cations (Cu, Zn, Na, and K) removal were investigated. The oxidative stress enzymes such as superoxide dismutase (SOD) and malonaldehyde (MDA) were also assessed. The addition of 50 mg L^-1 mPVC resulted in the highest growth along with >99% removal of nutrients (TN and TP) and >80% removal of cations. However, the addition of 100-200 mg L^-1 mPVC inhibited microalgal growth by 8.8-12.3%. The stress-induced by mPVC was highly observed at 200 mg L^-1 mPVC on the 4th d with 70.8 U mg_prot^-1 and 62.3 nmol mg_prot^-1 of SOD and MDA, respectively. Fourier-transform infrared spectroscopy (FTIR) spectra confirmed that microalgal biomass retained mPVC. Thermogravimetric analysis/derivative thermogravimetric analysis (TGA/DTG) spectra showed that the organic matter of microalgal biomass attached with mPVC was decomposed faster than control, indicating the possibilities of using this biomass for pyrolysis and the formation of bio-products.

Health, Pesticide Adjuvants, and Inert Ingredients: California Case Study Illustrates Need for Data Access

BACKGROUND

Many pesticide products are mixtures of multiple chemicals. These include active ingredients intended to kill pests, and so-called inert ingredients intended to improve the physical characteristics of the product. In addition, shortly before applying a pesticide product, applicators often mix adjuvants into the sprayer tank. Adjuvants are products designed to improve the performance or physical properties of a pesticide spray mixture. Manufacturers may use a particular chemical compound both as an inert ingredient within pesticide products and as a component of adjuvant products. Nonetheless, regulations dictate that data on use are publicly available only for the portion used in adjuvants. Adjuvants are exempt from federal registration, but are defined as pesticides in California. Based on that definition, California has identified α-(p-nonylphenyl)-ω-hydroxypoly(oxyethylene) (APNOHO) as the most widely used pesticide in the state, applied to more than 10 million acres annually. That quantified use includes only agricultural acres treated with adjuvants containing APNOHO. Total APNOHO use is likely higher because manufacturers also use the chemical as an inert ingredient within pesticide products, although data on such use are shielded by regulation.

OBJECTIVES

We use APNOHO as a case study to demonstrate that the use of adjuvants and inert ingredients is difficult to track because relevant information is not publicly available. We synthesize information that suggests widespread agricultural use of alkylphenol ethoxylates, such as APNOHO, may pose significant human and environmental health risks. We then make recommendations for future research and policy.

METHODS

We used information from California's pesticide use reporting system and the U.S. Environmental Protection Agency (EPA) to estimate use of APNOHO. We used U.S. EPA and European databases, as well as published research, to identify human and environmental health hazards of APNOHO. We focused on research showing that APNOHO is an endocrine-disrupting chemical.

DISCUSSION

Within California, APNOHO is applied in more than 150 adjuvant products. Nationwide, it is used as an inert ingredient in at least 650 pesticide products. Exposure to APNOHO is associated with endocrine disruption, birth defects, and aquatic toxicity. We suggest that the case of APNOHO illustrates the larger problem of a lack of publicly available data on use and toxicity of many adjuvants and pesticide inert ingredients. We recommend that researchers and regulators include adjuvants and inert ingredients when evaluating pesticide hazards, including endocrine disruption. We also recommend regulatory requirements to identify all ingredients on product labels. https://doi.org/10.1289/EHP10634.

Integrating Interprofessional Collaborative Practice Into Occupational and Environmental Health and Safety Education: Results of a Feasibility Study

OBJECTIVE

Although occupational health and safety programs are expected to prepare graduates to function in an interprofessional collaborative environment, research to support training in this area is far less common in this discipline than among clinical programs. We incorporated interprofessional education (IPE) competencies into an occupational health and safety course for graduate students in diverse disciplines (public health, engineering, nursing) and evaluated effectiveness.

METHODS

We assessed course offerings for content learning and attitudes toward IPE and analyzed data using a mixed-methods approach.

RESULTS

In general, students increased their understanding of the role of other disciplines, confidence in working in interprofessional teams, and valuation of IPE.

CONCLUSION

Introducing IPE competencies into graduate education in worker health and safety is feasible and can equip students to more effectively work in occupational health-oriented multidisciplinary teams.

Environmental Health Responses to COVID 19 in Western Australia: Lessons for the Future

The COVID-19 pandemic tested the health system of Western Australia (WA) and the relatively new overarching legislative framework that guided the state-wide public health response to the pandemic. This study aimed to evaluate the experiences and roles of environmental health officers (EHOs) in WA during the management of COVID-19 and to identify any policy changes that are needed to facilitate the rapid deployment of EHOs during a future public health crisis. An online survey with 78 respondents was administered and analysis was both qualitative and quantitative. It was found that participants believed there was inadequate resourcing, workforce shortages, increased workloads, and a lack of recognition and integration of the profession within the COVID-19 response. Notably, more than 65% of the respondents believed they could have been better utilised during the pandemic. This research has demonstrated that the COVID-19 pandemic in WA had clear gaps in its processes for managing responses and resilience to pandemics. Policy recommendations outlining a more efficient and integrated delivery of environmental health services throughout the state during emergencies are discussed.

Occurrence of multidrug resistant Gram-negative bacteria and resistance genes in semi-aquatic wildlife - Trachemys scripta, Neovison vison and Lutra lutra - as sentinels of environmental health

Emergence of antimicrobial resistance (AMR) in bacterial pathogens has been recognized as a major public health concern worldwide. In the present study, antimicrobial resistant Gram-negative bacteria (AMRGNB) and AMR genes were assessed in semi-aquatic wild animals from a highly populated and intensive farming region of Spain, Catalonia. Cloacal/rectal swab samples were collected from 241 animals coming from invasive species Trachemys scripta (n = 91) and Neovison vison (n = 131), and endangered-protected species Lutra lutra (n = 19). Accordingly, 133 (55.2%) isolates were identified as AMRGNB. Escherichia coli and Pseudomonas fluorescens were among the bacteria most frequently isolated in all animal species, but other nosocomial agents such as Klebsiella pneumoniae, Salmonella spp. or Citrobacter freundii, were also prevalent. The phenotypic susceptibility testing showed the highest resistance to β-lactams (91%). Molecular analysis showed 25.3% of turtles (15.4% ESBL/Ampc genes), 21% of Eurasian otters (10.5% ESBL/Ampc genes) and 14.5% of American minks (8.4% ESBL/Ampc genes) were positive to AMR genes. The genotyping frequency was tetM (20.6%), blaCMY-2 (13%), ermB (6.1%), blaCMY-1 (4.6%), blaCTX-M-15 (3.1%) and mcr-4 (0.8%). Turtles had a larger prevalence of AMRGNB and AMR genes than mustelids, but American mink carried mcr-4 colistin-resistance gene. Moreover, cluster analysis of AMR gene distribution revealed that an ESBL/AmpC cluster in a highly populated area comprising big metropolitan regions, and another tetM/emrB cluster in an expended area with highly intensive livestock production. Although the mcr-4 positive case was not included in those clusters, that case was found in a county with a high pig farm density. In conclusion, semi-aquatic wild animals are a good sentinel for environmental contamination with AMRGNB and AMR genes. Therefore, One Health Approach is urgently needed in highly populated regions, and with intensive livestock production like Catalonia.

A process for creating data report-back tools to improve equity in environmental health

BACKGROUND

Although there is increasing interest in reporting results of environmental research efforts back to participants, evidence-based tools have not yet been applied to developed materials to ensure their accessibility in terms of literacy, numeracy, and data visualization demand. Additionally, there is not yet guidance as to how to formally assess the created materials to assure a match with the intended audience.

METHODS

Relying on formative qualitative research with participants of an indoor air quality study in Dorchester, Massachusetts, we identified means of enhancing accessibility of indoor air quality data report-back materials for participants. Participants (n = 20) engaged in semi-structured interviews in which they described challenges they encountered with scientific and medical materials and outlined written and verbal communication techniques that would help facilitate engagement with and accessibility of environmental health report-back materials. We coupled these insights from participants with best practice guidelines for written materials by operationalizing health literacy tools to produce accessible audience-informed data report-back materials.

RESULTS

The resulting data report-back materials had a 7th -grade reading level, and between a 4th -8th grade level of overall document complexity. The numeracy skills required to engage with the material were of the lowest demand, and we incorporated best practices for risk communication and facilitating understanding and actionability of the materials. Use of a rigorous assessment tool provides evidence of accessibility and appropriateness of the material for the audience.

CONCLUSIONS

We outline a process for developing and evaluating environmental health data reports that are tailored to inspire risk-reduction actions, and are demonstrably accessible in terms of their literacy, numeracy, and data visualization demand. Adapting health literacy tools to create and evaluate environmental data report-back materials is a novel and evidence-based means of ensuring their accessibility.

Effects of Residential Environmental Screening and Perception Surveys on Superfund Environmental Health Risk Perceptions

Residents at one of the nation’s largest and longest-operating Superfund sites (Butte, Montana) have expressed environmental health risk perceptions that often diverge from those of EPA and other official stakeholders responsible for the investigation and remediation of site contamination aimed at protecting human health and the environment. A random sample of Butte residents participated in a study of how home-based environmental screening influences environmental health perceptions. Participants completed surveys measuring environmental health perceptions before and after a home site screening of soil and drinking water for lead and arsenic conducted by the research team. Local air monitoring for the same contaminants was also completed during the study period. The home-based screening intervention improved the alignment of subjective participant environmental health perceptions with objective environmental screening measures. Key features of the process that helped achieve this effect included (1) co-locating the collection of participant perceptions and individualized screening measurements; (2) sharing environmental screening results in a clear and unbiased manner; and (3) conducting this work independent of agencies and organizations with direct responsibility for Superfund-related cleanup activities. Empowering residents of a Superfund community with knowledge of the specific kinds and levels of environmental contamination in their home environment may help overcome the gap between agency conclusions regarding environmental health risk and the perceptions of community members.

Research Capacity Training on Environmental Health and Noncommunicable Diseases in the Country of Georgia: Challenges and Lessons Learned during the COVID-19 Pandemic

COVID-19 presented challenges for global health research training programs. The Clean Air Research and Education (CARE) program, which aims to enhance research capacity related to noncommunicable diseases and environmental health in the country of Georgia, was launched in 2020—as the COVID-19 pandemic began. At its foundation is mentorship and mentored research, alongside formal didactic training, informal training/meetings, and other supports. Current analyses examined CARE’s initial 1.5 years (e.g., program benefits, mentorship relationships) using data from an evaluation survey among trainees and faculty in January 2022. Trainees (100% response rate: n = 12/12; 4 MPH, 8 PhD) and faculty (86.7% response rate: n = 13/15; 7 Georgia-based, 6 United States-based) rated factors related to mentor-mentee relationships highly, particularly mutual consideration of each other’s thoughts, opinions, and perspectives; one major challenge was completing goals planned. Trainees and faculty identified several growth experiences and program benefits (e.g., skills development, expanding professional network) but also identified challenges (e.g., meeting program demands, communication gaps, unclear expectations)—exacerbated by the pandemic. Findings underscore the importance of strong mentorship relationships and that the pandemic negatively impacted communication and clarity of expectations. Given the likely ongoing impact of the pandemic on such programs, program leaders must identify ways to address these challenges.

Lead Toxicity and Environmental Health Justice Stories in Black and White Woodcut Portraits

BACKGROUND

Omaha, Nebraska, has a lead-contaminated superfund site and substandard housing that pose risks for childhood lead exposure. Healthy Housing Omaha (formerly, Omaha Healthy Kids Alliance), an environmental health nonprofit, partnered with the fourth author, an artist, and a newspaper to raise awareness about lead poisoning by publishing portraits and stories of affected community members.

METHODS

The authors analyzed an interview with the artist, photographs of portraits published in a local newspaper, and quotations from portrait sitters.

RESULTS

Shared stories of lead exposure and poisoning conveyed in the portraiture and printmaking processes revealed structural racism as an emergent theme.

CONCLUSIONS

Arts-based research methods, such as portraiture, can be scaled and applied to support national and international community engagement efforts to advocate for environmental justice and public health.

The growing concern of chlorpyrifos exposures on human and environmental health

Chlorpyrifos (CP) and its highly electrophilic intermediates are principal toxic metabolites. The active form of CP i.e. chlorpyrifos oxon (CP-oxon) is responsible for both the insecticidal activity and is also of greater risk when present in the atmosphere. Thus, the combined effects of both CP, CP-oxan, and other metabolites enhance our understanding of the safety and risk of the insecticide CP. They cause major toxicities such as AChE inhibition, oxidative stress, and endocrine disruption. Further, it can have adverse hematological, musculoskeletal, renal, ocular, and dermal effects. Excessive use of this compound results in poisoning and potentially kills a non-target species upon exposure including humans. Several examples of reactive metabolites toxicities on plants, aquatic life, and soil are presented herein. The review covers the general overview on reactive metabolites of CP, chemistry and their mechanism through toxic effects on humans as well as on the environment. Considerable progress has been made in the replacement or alternative to CP. The different strategies including antidote mechanisms for the prevention and treatment of CP poisoning are discussed in this review. The approach analyses also the active metabolites for the pesticide activity and thus it becomes more important to know the pesticide and toxicity dose of CP as much as possible.

How different COVID-19 recovery paths affect human health, environmental sustainability, and food affordability: a modelling study

BACKGROUND

The COVID-19 pandemic arrived at a time of faltering global poverty reduction and increasing levels of diet-related diseases, both of which have a strong link to poor outcomes for those with COVID-19. Governments responded to the pandemic by placing unprecedented restrictions on internal and external movements, which have resulted in an economic contraction. In response to the economic shock, G20 governments have committed to providing US$14 trillion stimuli to support economic recovery. We aimed to assess the impact of different COVID-19 recovery paths on human health, environmental sustainability, and food sustainability.

METHODS

We used LandSyMM, a global gridded land use change model, to analyse the impact of recovery paths from COVID-19. The paths were illustrated by four scenarios that represent different pandemic severities (including a single or recurrent pandemic) and alternate modes of recovery, including a transition of food demand towards healthier diets that result in changes to the food system: (1) solidarity and celery, (2) nothing new, (3) fries and fragmentation, and (4) best laid plans. For each scenario, we modelled the economic shocks of the pandemic and the impact of policy measures to promote healthier diets in the years after the COVID-19 pandemic, including the supply of and demand for food, environmental outcomes, and human health outcomes. The four scenarios use established future population growth and economic development projections derived from the Shared Socioeconomic Pathways 2. We quantified the outcomes from more societally cooperative pandemic responses that result in reduced trade barriers and improved technological development against less cooperative responses.

FINDINGS

Repeated pandemic shocks (the fries and fragmentation and best laid plans scenarios) reduce the ability of the lowest income countries to ensure food security. A post-pandemic recovery that includes dietary transition towards the consumption of less meat and more fruits and vegetables (the solidarity and celery scenario) could prevent 2583 premature deaths per million in 2060, whereas recovery paths that are focused on economic recovery (the fries and fragmentation scenario) could trigger an additional 778 deaths per million in 2060. The transition of dietary preferences towards healthier diets (the solidarity and celery scenario) also reduces nitrogen fertiliser use by 40 million tonnes and irrigation water by 400 km³ compared with no dietary change in 2060 (the nothing new scenario). Finally, the scenario with dietary transition increases the affordability of the average diet.

INTERPRETATION

The economic impact of the COVID-19 pandemic is most visible in low-income countries, where a reduction in growth projections makes a greater difference to the affordability of a basic diet. A change in dietary preferences is most impactful in reducing mortality and the burden of disease when income levels are high. At lower income, a transition towards lower meat consumption reduces undernourishment and diet-related mortality.

FUNDING

The Global Food Security's Resilience of the UK Food System Programme project, with support from the Biotechnology and Biological Sciences Research Council, Economic and Social Research Council, Natural Environment Research Council, and the Scottish Government.

Quantitative methods for climate change and mental health research: current trends and future directions

The quantitative literature on climate change and mental health is growing rapidly. However, the methodological quality of the evidence is heterogeneous, and there is scope for methodological improvement and innovation. The first section of this Personal View provides a snapshot of current methodological trends and issues in the quantitative literature on climate change and mental health, drawing on literature collected through a previous scoping review. The second part of this Personal View outlines opportunities for methodological innovation concerning the assessment of the relationship between climate change and mental health. We then highlight possible methodological innovations in intervention research and in the measurement of climate change and mental health-related variables. This section draws upon methods from public mental health, environmental epidemiology, and other fields. The objective is not to provide a detailed description of different methodological techniques, but rather to highlight opportunities to use diverse methods, collaborate across disciplines, and inspire methodological innovation. The reader will be referred to practical guidance on different methods when available. We hope this Personal View will constitute a roadmap and launching pad for methodological innovation for researchers interested in investigating a rapidly growing area of research.

Human Health, Environmental Quality and Governance Quality: Novel Findings and Implications From Human Health Perspective

Human health and wellbeing are intimately linked to the state of the environment. The current study emphasizes the role of environmental quality, government policies, and human health. This paper provides a detailed literature review of existing findings regarding our key variables of interest. The results argue that the implications of poor government policies and environmental pollution for rising economic development have led to poor environmental quality and health issues for humans. Based on earlier investigations, the present study reviewed the state-of-the-art review and determined innovative insights for outdoor and indoor environment difficulties. This study provides a detailed review of human health, environmental quality, and governance quality. In addition, the study conducts an empirical analysis using the annual data of low-income countries from 1996 to 2020. Government actions and health systems must be modified immediately to address these rising concerns successfully. The report offers policy recommendations for addressing health, governance, and environmental change mitigation issues, all of which are directly or indirectly related to the study. This article presents an overview of environmental change's health impacts and explores how health hazards may be reduced or eliminated through effective adaptation strategies.

Does Hazardous-Waste Testing Follow Technical Guidance, Thus Help Protect Environmental Justice and Health?

Does representative hazardous-waste-site testing tend to follow or to violate government technical guidance? This is an important question, because following such guidance promotes reliable risk analysis, adequate remediation, and environmental-justice and -health protection. Yet only government documents typically address this question, usually only when it is too late, when citizens have already exhibited health harm, allegedly from living or working near current/former hazardous-waste sites. Because no systematic, representative, scientific analyses have answered the preceding question, this article begins to investigate it by posing a narrower part of the question: Does representative US testing of volatile-organic-compound (VOC) waste sites tend to follow or to violate government technical requirements? The article (i) outlines US/state-government technical guidance for VOC testing; (ii) develops criteria for discovering representative US cases of VOC testing; (iii) uses the dominant US Environmental Protection Agency method to assess whether these representative cases follow such guidance; (iv) employs the results of (iii) to begin to answer the preceding question; then (v) discusses the degree to which, if any, these results suggest threats to environmental health or justice. Our initial, but representative, results show that almost all US VOC-waste-site testing (that we investigated) violates government technical requirements and systematically underestimates risks, and this may help justify less expensive, potentially health-threatening cleanups, mostly in environmental justice communities. We outline needed future research and suggest two strategies to promote following government technical guidance for hazardous-waste testing.

Enhancing Data Integration, Interoperability, and Reuse to Address Complex and Emerging Environmental Health Problems

Environmental health sciences (EHS) span many diverse disciplines. Within the EHS community, the National Institute of Environmental Health Sciences Superfund Research Program (SRP) funds multidisciplinary research aimed to address pressing and complex issues on how people are exposed to hazardous substances and their related health consequences with the goal of identifying strategies to reduce exposures and protect human health. While disentangling the interrelationships that contribute to environmental exposures and their effects on human health over the course of life remains difficult, advances in data science and data sharing offer a path forward to explore data across disciplines to reveal new insights. Multidisciplinary SRP-funded teams are well-positioned to examine how to best integrate EHS data across diverse research domains to address multifaceted environmental health problems. As such, SRP supported collaborative research projects designed to foster and enhance the interoperability and reuse of diverse and complex data streams. This perspective synthesizes those experiences as a landscape view of the challenges identified while working to increase the FAIR-ness (Findable, Accessible, Interoperable, and Reusable) of EHS data and opportunities to address them.

Environmental health impacts of microplastics exposure on structural organization levels in the human body

The ubiquitous prevalence of microplastics pollution has raised concerns about microplastics' potential risks and impacts on the global environment. However, the potential human health risks and impacts of microplastics remain largely unexplored. By providing an overview regarding the interaction of microplastics and human health, this review extends current knowledge on the potential impacts of microplastics pollution on humans from an environmental health perspective. The paper firstly presents the characteristics of microplastics as well as the status of global microplastics pollution. As for human health, the potential hazards of microplastics are reflected by toxic chemical components, vectors of contaminants, and physical damage. Extensive microplastic pollution on ecosystems due to human activities leads to inevitable human exposure, which may occur by dietary, inhalation and/or skin contact. Accordingly, microplastics exposure is closely associated with human health. This study explores the potential interactions of microplastics with the biological organization at various levels, including chemical, cellular, tissue, organ, and system levels. The review concludes by highlighting five urgent perspectives and implications for future research on microplastics: 1) Developing a standard terminology and research methods; 2) Reinforcing microplastics pollution governance; 3) Exploring innovative strategies and technologies; 4) Engaging the public and change behaviour; and 5) Adopting a transdisciplinary approach.

Setting Requirements for a Dashboard to Inform Portuguese Decision-Makers About Environment Health in an Urban Setting

Dashboards are being increasingly used in the health field, and literature points out that accurate and efficient dashboards require not only dealing with data issues, but also ensuring that dashboards are user-friendly and that incorporate users' views and needs. The integration of evidence and data into decision aiding tools, such as dashboards, to assess and monitor environmental health (EH) in urban settings requires careful design. Departing from EH evidence and making use of the views of EH stakeholders and experts, this study aimed at defining requirements for a dashboard to help decision-makers analyzing and visualizing EH information in the Lisbon urban context. In order to set those requirements, it was combined a user-centered with a design card approach to engage EH potential end-users so as to collect their visualization preferences and gather information related to dashboard requirements. Specifically, three online group semi-structured interviews, involving 11 potential end-users from different organizations, were conducted; design cards with a set of visualization options regarding 17 indicators of built and natural environment determinants were used in the interviews to capture participants' preferences and their rationale; questions about other dashboard features were also asked; and the results from the interviews were synthesized into four separate, but interrelated features, and operationalized into 11 requirements for a dashboard to monitor EH in Lisbon. This study contributes to EH literature by producing knowledge to inform dashboard construction, by highlighting issues related with the usability, analysis, and visualization of data to inform EH decision-making in urban contexts, and by designing an approach that can be replicated to other EH dashboard contexts.

Investigating the association of environmental exposures and all-cause mortality in the UK Biobank using sparse principal component analysis

Multicollinearity refers to the presence of collinearity between multiple variables and renders the results of statistical inference erroneous (Type II error). This is particularly important in environmental health research where multicollinearity can hinder inference. To address this, correlated variables are often excluded from the analysis, limiting the discovery of new associations. An alternative approach to address this problem is the use of principal component analysis. This method, combines and projects a group of correlated variables onto a new orthogonal space. While this resolves the multicollinearity problem, it poses another challenge in relation to interpretability of results. Standard hypothesis testing methods can be used to evaluate the association of projected predictors, called principal components, with the outcomes of interest, however, there is no established way to trace the significance of principal components back to individual variables. To address this problem, we investigated the use of sparse principal component analysis which enforces a parsimonious projection. We hypothesise that this parsimony could facilitate the interpretability of findings. To this end, we investigated the association of 20 environmental predictors with all-cause mortality adjusting for demographic, socioeconomic, physiological, and behavioural factors. The study was conducted in a cohort of 379,690 individuals in the UK. During an average follow-up of 8.05 years (3,055,166 total person-years), 14,996 deaths were observed. We used Cox regression models to estimate the hazard ratio (HR) and 95% confidence intervals (CI). The Cox models were fitted to the standardised environmental predictors (a) without any transformation (b) transformed with PCA, and (c) transformed with SPCA. The comparison of findings underlined the potential of SPCA for conducting inference in scenarios where multicollinearity can increase the risk of Type II error. Our analysis unravelled a significant association between average noise pollution and increased risk of all-cause mortality. Specifically, those in the upper deciles of noise exposure have between 5 and 10% increased risk of all-cause mortality compared to the lowest decile.

[Community Innovation and Regional Sustainability: A Case Study of Environmental Health Education in Siaogang Hospital, Kaohsiung Medical University]

Kaohsiung Municipal Siaogang Hospital is located in southern Kaohsiung City, a major nexus of land, sea, and air transportation. Thus, the hospital is on the frontlines of strengthening Kaohsiung International Airport's epidemic prevention measures and preventing the spread of COVID-19 and other epidemic viruses to Taiwan from other countries. Kaohsiung Medical University integrates on-campus academic research, teaching services, and medical institution resources and has long promoted community care plans in conjunction with the public sector. A disused public sector space repurposed by the university into a distinctive day care center is being further used as a service-learning platform linking medical education to communities, allowing university students to enter the community and apply what they have learned to improve quality of life, community health, and well-being. "Happy Kaohsiung Healthy City-Siaogang District Environmental Education and Health Promotion Sustainable Development Plan", which responds to the issues and needs of air pollution and health promotion in the city's Siaogang District, designates Kaohsiung Municipal Siaogang Hospital as the core base of local practice, connecting multidisciplinary schools and units as well as cross-regional resources to promote practical programs such as air quality talent education, environmental testing and research, campus health education and publicity, air pollution syllabus, and community care and care, fulfilling the university's social responsibilities.

The dynamic impacts of environmental-health and MDR-TB diseases and their influence on environmental sustainability at Chinese hospitals

The purpose of this study is to identify at what extent multidrug-resistant tuberculosis (MDR-TB) diseases effect on environmental health issues in selected provinces of Chinese hospitals. In survival analysis approach, this study employs the Cox proportional hazard model (CPM) to incorporate the duration of event, probability of occurrence of an event, and the issue of right censoring. An advantage of using CPM is that one does not need to specify the distribution of baseline hazard H₀ (t) as it considers a common value for all units in population. The results indicate that male and travel expenditures have negative association with the duration of cure. Furthermore, the medical expenditures and the spatial characteristic of time expenditure have positive association with the duration of cure of MDR-TB patients. The inconsistent behavior of males in taking medicines as compared to females and males is also more prone to tuberculosis (TB).

Aristolochic acid I as an emerging biogenic contaminant involved in chronic kidney diseases: A comprehensive review on exposure pathways, environmental health issues and future challenges

Described in the 1950s, Balkan Endemic Nephropathy (BEN) has been recognized as a chronic kidney disease (CKD) with clinical peculiarities and multiple etiological factors. Environmental contaminants - aromatic compounds, mycotoxins and phytotoxins like aristolochic acids (AAs) - polluting food and drinking water sources, were incriminated in BEN, due to their nephrotoxic and carcinogenic properties. The implication of AAs in BEN etiology is currently a highly debated topic due to the fact that they are found within the Aristolochiaceae plants family, used around the globe as traditional medicine and they were also incriminated in Aristolochic Acid Nephropathy (AAN). Exposure pathways have been investigated, but it is unclear to what extent AAs are acting alone or in synergy with other cofactors (environmental, genetics) in triggering kidney damage. Experimental studies strengthen the hypothesis that AAI, the most studied compound in the AAs class, is a significant environmental contaminant and a most important causative factor of BEN. The aim of this review is to compile information about the natural exposure pathways to AAI, via traditional medicinal plants, soil, crop plants, water, food, air. Data that either supports or contradicts the AAI theory concerning BEN etiology was consolidated and available solutions to reduce human exposure were discussed. Because AAI is a phytotoxin with physicochemical properties that allow its transportation in environmental matrices from different types of areas (endemic, nonendemic), and induce CKDs (BEN, AAN) and urinary cancers through bioaccumulation, this review aims to shed a new light on this compound as a biogenic emerging pollutant.

Cluster Modeling of Environmental and Occupational Health and Safety Management Systems for Integration Support

Many organizations around the world recognize the complementarity of public and environmental health and focus their attention on the effective management of both health and environmental risks. For this purpose, they often use the international standards ISO 14001 and ISO 45001. However, when a company intends to implement multiple standards simultaneously, the challenge of overlapping increases. Therefore, the objective of article is to analyze the requirements and documented information of two management system standards: environmental management systems (EMS), according to ISO 14001, and occupational health and safety management systems (OH&S), according to ISO 45001. A combination of content analysis and clustering methods was used to conduct the research. Visualization of the interrelationships between the requirements of the standards was done using TouchGraph Navigator. The outputs of the analysis can serve managers in the integrated implementation of these management systems as well as auditors during the review and check process when formulating recommendations for the improvement of management systems. Integrated implementation comes with multiple benefits, including reduced bureaucracy and management costs, a simplified certification process, improved internal management, and facilitation of continuous improvement.

A Rapid Review of Environmental Health Gaps in Antimicrobial Resistance and Water-Related Research from 1990-2020

Antimicrobial resistance (AMR) is a pervasive global health threat linked to human antimicrobial misuse and abuse, food production, and broader environmental contamination. While global agencies promote a multi-sectoral One Health system approach to equitably combat human, animal, and environmental health AMR risks, it is widely acknowledged that the human and animal sectors dominate discussions. Given this disproportionate focus, identification of critical research gaps is needed to develop stewardship plans that equitably address One Health AMR threats. This review used natural language processing and term frequency algorithms to classify 12,638 records from 1990–2020 thematically in order to highlight sectoral prioritization and gaps. It also specifically assessed water-related gaps as water is recognized as both a primary environmental dissemination pathway and key means of intervention. Drawing from systemic health and integrated water management lenses, this review found that themes related to plant, wildlife, and environmental-related AMR threats—in particular, the role that environmental (ambient) waters play in AMR development, transmission, and spread—are under-prioritized as compared to human and food animal health concerns regardless of geographic region or income level. Further prioritization of these themes is needed to strengthen the environmental dimension of One Health AMR responses and systemically protect global health.

Sensitivity of environmental performance index based on stochastic dominance

The Environmental Performance Index (EPI) is a popular sustainability index. It is a composite index which ranks 180 countries based on their environmental performance in 32 indicators. Using the EPI data and stochastic dominance efficiency methodology, this paper examines the sensitivity to the subjective weights assigned to the indicators and categories of environmental performance. The findings show a remarkable variation in environmental performance based on alternative weights which are selected using Stochastic Dominance criteria. Except for 2020, the environmental health category in EPI gets relatively higher importance in the optimal scenario, and ecosystem vitality gets relatively higher weights in the inferior scenario, suggesting that the environmental health category achievements have been relatively higher for most countries over time. The ranking analysis also shows major variations in country rankings with alternative weights. Two countries, Maldives and Gabon, would have experienced more than 100 position changes in their rankings with alternative weights. Furthermore, 67 countries would have experienced 30 or more position changes in their rankings and 37 countries experienced an EPI score change of more than 50 (out of 100) with alternative weights. Overall, the results illustrate the importance of sensitivity analysis of composite indices to increase reliability and transparency.

Mapping agricultural use of pesticides to enable research and environmental health actions in Belgium

Given the many public health and environmental impacts associated with the use of pesticides, comprehensive pesticide application data are a high priority for environmental and health professionals, government agencies, and community groups in Wallonia (Belgium). In that context, geographic information system (GIS) approaches for mapping estimates of agricultural pesticide use were developed in the present study. Data on pesticide application rates and high-resolution annual datasets of the geographic distribution of crops were used to complete this analysis in Wallonia over the period 2015-2017. The method was implemented in Python in order to allow easy update and improvements of maps, or to segment maps by individual pesticides, chemical groups of pesticides (e.g. insecticides, herbicides), etc. Linked databases were created to classify, select, and possibly weight AIs according to specific requests and criteria. The results provide a first map of agricultural pesticide use in Wallonia, which depicts the best picture up to now of their geographic distribution. Maps of fungicides, herbicides, and plant growth regulators showed quite similar spatial patterns as the map of the combination of all pesticides. In contrast, the insecticide map showed a specific pattern related almost exclusively to dwarf-tree orchards in some municipalities in northern Wallonia. This research work is a preliminary result on the spatial characterization of agricultural pesticide use in Wallonia and give a valuable basis for research and environmental health actions in Belgium. Forthcoming developments will focus on exposure characterization to agricultural pesticides using GIS models. Using this information, policymakers will able to detect potential priority zones and take action to check and reduce agricultural pesticide loads in the environment.

Analysis of changes in air pollution quality and impact of COVID-19 on environmental health in Iran: application of interpolation models and spatial autocorrelation

In the global COVID-19 epidemic, humans are faced with a new challenge. The concept of quarantine as a preventive measure has changed human activities in all aspects of life. This challenge has led to changes in the environment as well. The air quality index is one of the immediate concrete parameters. In this study, the actual potential of quarantine effects on the air quality index and related variables in Tehran, the capital of Iran, is assessed, where, first, the data on the pollutant reference concentration for all measuring stations in Tehran, from February 19 to April 19, from 2017 to 2020, are monitored and evaluated. This study investigated the hourly concentrations of six particulate matters (PM), including PM2.5, PM10, and air contaminants such as nitrogen dioxide (NO₂), sulfur dioxide (SO2), ozone (O3), and carbon monoxide (CO). Changes in pollution rate during the study period can be due to reduced urban traffic, small industrial activities, and dust mites of urban and industrial origins. Although pollution has declined in most regions during the COVID-19 quarantine period, the PM2.5 rate has not decreased significantly, which might be of natural origins such as dust. Next, the air quality index for the stations is calculated, and then, the interpolation is made by evaluating the root mean square (RMS) of different models. The local and global Moran index indicates that the changes and the air quality index in the study area are clustered and have a high spatial autocorrelation. The results indicate that although the bad air quality is reduced due to quarantine, major changes are needed in urban management to provide favorable conditions. Contaminants can play a role in transmitting COVID-19 as a carrier of the virus. It is suggested that due to the rise in COVID-19 and temperature in Iran, in future studies, the effect of increased temperature on COVID-19 can be assessed.

Defining a new perspective in Environmental Health: the healing environment

With pollution-related health problems on the rise, the focus of modern Environmental Health (EH) has mostly been placed on toxicology and exposure science. Despite the importance of toxicological aspects, the environment should be studied not only to identify pollution-related hazards, but also to investigate potentially therapeutic and health-enhancing effects of its elements. Generally speaking, it is possible to benefit from a natural environment with a full-immersion experience or with a single-element interaction. Recently, scientific evidence is accumulating on the beneficial effects of natural settings for well-being promotion and psycho-physical health, especially for stress reduction and prevention of stress-related conditions. In light of these considerations, the paradigm of EH can change: the environment we live in should be considered not only as a precious resource to be protected against pollution (thus preventing the consequent health hazards), but, in a proactive vision, also as a potential source of elements capable of actively maintaining and promoting health and well-being.

Problem Definition and Community Participation in Environmental Health Interventions: An Exploratory Study of Groundwater Arsenic Remediation

Arsenic, a known carcinogen, naturally occurs in the groundwater in large parts of West Bengal, a state in eastern India. Communities that depend on groundwater face twice the lifetime mortality risk for cancers, cardiovascular diseases, and developmental disorders. This study, focused on arsenic-affected communities in the state of West Bengal, offers an initial exploration of how local stakeholders construct groundwater arsenic as a health problem. Arsenic remediation interventions involve a host of international, regional, and local stakeholders (public health departments, government engineers, community health workers, consultants, hydrologists, etc.). How an environmental health problem is constructed has implications for who is considered responsible, what causes it, and pertinently, how/whether affected communities participate in addressing the problem. Drawing from a culture-centered approach, this fieldwork-based study offers three distinct yet related problem construction discourses, viz. social/political, technical and personal, in how the problem of arsenic is construed locally, and how such discourses are related to a particular conceptualization of community participation in environmental health.

Field and Remote Sensors for Environmental Health and Food Safety Diagnostics: An Open Challenge

Major foodborne disease outbreaks have clarified the close interconnection and interdependence between the health of humans, animals, and the environment [...]

Insights into Improving Risk and Safety Communication through Environmental Health Literacy

Messages and materials developed to communicate risk to the public are often misunderstood because the public misperceives risk, science information is too complex, leading to audience misunderstandings, and an overarching focus on the details of the problem without supplying solutions or actions to keep the public safe. This article describes the creation of a communication model to improve risk communication that includes safety information. The authors describe essential components of Risk and Safety Communication based on features of Environmental Health Literacy (EHL), which informed the creation of a protocol for developing risk communication messages and materials. An online training module was developed to aid communicators in creating information to enable the public to protect themselves, their family, and their community, leading to improved comprehension of how the environment impacts health. These principles were developed in a series of focus groups, identifying how the public perceives risk, how they prefer to receive communication, and how participants respond to materials developed using the principles. Important topics discussed are understanding the literacy levels of the target audience, applying that understanding to developing messages, how risk perception leads to misperceptions and how to address those misperceptions by using plain language when developing focused messages and materials.