Distributive justice in environmental health hazards from industrial contamination: A systematic review of national and near-national assessments of social inequalities

Promotion of environmental public health and environmental justice in communities affected by large and long lasting industrial contamination: methods applied and lessons learned from the case study of Porto Torres (Italy)

Introduction

Communities affected by large scale and long lasting industrial contamination are often keen to understand whether their health has been impaired by such contamination. This requires answers that integrate environmental public health and environmental justice perspectives. At these sites, exposure scenarios from environmental contamination over time by multiple chemicals, often involving different environmental matrices, are complex and challenging to reconstruct.

Methods

An approach for describing the health of such communities in association with environmental contamination is presented, with the methods applied across the three domains of environmental contamination, population exposure and toxicology, environmental and social epidemiology, and environmental public health communication. The approach is described with examples from its application to the case study of Porto Torres, a town with a substantial industrially conditioned evolution.

Results

Activities in the field of environmental contamination, population exposure and toxicology focus on the collection and systematization of available contamination data, the identification of priority pollutants based on their toxicological profiles, the qualitative assessment of the likelihood of exposure for the population to priority pollutants and their known health effects. Environmental and social epidemiology methods are applied to describe the health profiles and socioeconomic conditions of the local population, taking into account multiple health outcomes from local information systems and considering specific diseases based on exposure and toxicological assessments. The environmental public health communication methods are directed to produce a communication plan and for its implementation through interaction with local institutional and social actors. The interpretation of health profiles benefits from a transdisciplinary analysis of the results.

Discussion

The proposed approach combines the needs of environmental public health and environmental justice allowing the integration of multidisciplinary knowledge to define recommendations for reducing and/or preventing hazardous environmental exposures and adverse health effects, stimulating the interactions between stakeholders, and making the study results more accessible to citizens.

Creating safety amidst chronic contamination: A mixed-method analysis of residents' experiences in a Southern Italian steel town

This study analyses how residents create safety in Taranto, Italy, a city located next to one of the largest steel plants in Europe. Combining long-term ethnographic research with an online-based survey, our study shows that most respondents recognise and criticise the presence of environmental risks in their daily lives but encounter such risks in complex ways. Contrary to previous scholarship suggesting that pollution can result in alienating residents from their lived environment, this research shows that acute awareness of environmental risks does not necessarily undermine attachment to place but rather can co-exist with or even strengthen it. Our findings propose first that residents experience and understand environmental risk mostly through air pollution, but often situate risks outside of their own neighbourhood and inscribe different meanings to such risk. Second, residents mitigate environmental risk through practices aimed at creating safety, such as moving away from the industrial area or using everyday practices and reflecting on their responsibility for actions. Third, we argue that residents create safety through an attachment and entitlement to place and emotional detachment from pollution and institutional failures. Finally, in line with residents' concerns about safety and how to secure it, this study embraces a shift in its analytical focus from risk to the quest for safety. By doing so, it provides novel insights into environmental risk perception in industrially polluted areas and reveals the often-contradictory sentiments and practices that such areas invoke in residents.

Development of a Multifaceted Perspective for Systematic Analysis, Assessment, and Performance for Environmental Standards of Contaminated Sites

Contaminated soil and groundwater can pose significant risks to human health and ecological environments, making the remediation of contaminated sites a pressing and sustained challenge. It is significant to identify key performance indicators and advance environmental management standards of contaminated sites. The traditional study currently focuses on the inflexible collection of related files and displays configurable limitations regarding integrated assessment and in-depth analysis of published standards. In addition, there is a relative lack of research focusing on the analysis of different types of standard documents. Herein, we introduce a cross-systematic retrospective and review for the development of standards of the contaminated sites, including the comprehensive framework, multifaceted analysis, and improved suggestion of soil and groundwater standards related to the environment. The classification and structural characteristics of different types of files are systematically analyzed of over 300 national, trade, local, and group standards for the contaminated sites. It exhibits that trade standards are the main types and testing methods are the important format within numerical considerations of soil standards. The guide standard serves as a crucial component in environmental management for investigating, assessing, and remediating of contaminated sites. Future improvement plans and development directions are proposed for advancing robust technical support for effective soil contamination prevention and control. This multidimensional analysis and the accompanying suggestions can provide improved guidance for Chinese environmental management of contaminated sites and sparkle the application of standards in a wide range of countries.

Ethnic and socioeconomic inequalities in air pollution exposure: a cross-sectional analysis of nationwide individual-level data from the Netherlands

BACKGROUND

Air pollution contributes to a large disease burden and some populations are disproportionately exposed. We aimed to evaluate ethnic and socioeconomic differences in exposure to air pollution in the Netherlands.

METHODS

We did a nationwide, cross-sectional analysis of all residents of the Netherlands on Jan 1, 2019. Sociodemographic information was centralised by Statistics Netherlands and mainly originated from the National Population Register, the tax register, and education registers. Concentrations of NO2, PM2·5, PM10, and elemental carbon, modelled by the National Institute for Public Health and the Environment, were linked to the individual-level demographic data. We assessed differences in air pollution exposures across the 40 largest minority ethnic groups. Evaluation of how ethnicity intersected with socioeconomic position in relation to exposures was done for the ten largest ethnic groups, plus Chinese and Indian groups, in both urban and rural areas using multivariable linear regression analyses.

FINDINGS

The total study population consisted of 17 251 511 individuals. Minority ethnic groups were consistently exposed to higher levels of air pollution than the ethnic Dutch population. The magnitude of inequalities varied between the minority ethnic groups, with 3-44% higher exposures to NO2 and 1-9% higher exposures to PM2·5 compared with the ethnic Dutch group. Average exposures were highest for the lowest socioeconomic group. Ethnic inequalities in exposure remained after adjustment for socioeconomic position and were of similar magnitude in urban and rural areas.

INTERPRETATION

The variability in air pollution exposure across ethnic and socioeconomic subgroups in the Netherlands indicates environmental injustice at the intersection of social characteristics. The health consequences of the observed inequalities and the underlying processes driving them warrant further investigation.

FUNDING

The Gravitation programme of the Dutch Ministry of Education, Culture, and Science, the Netherlands Organization for Scientific Research, the Netherlands Organisation for Health Research and Development, and Amsterdam University Medical Center.

Assessing lead exposure in U.S. pregnant women using biological and residential measurements

There is strong scientific evidence for multiple pathways of human exposure to lead (Pb) in residential settings, particularly for young children; however, less is known about maternal exposure during pregnancy and children's exposure during early lifestages. A robust, multi-faceted secondary analysis was conducted using data collected by the National Institute of Child Health and Human Development in the 2009-2014 National Children's Study Vanguard Studies. Descriptive statistics summarized Pb concentrations of maternal blood, maternal urine, and house dust vacuum samples collected during pregnancy and residence surface wipes collected both during pregnancy and six months post-partum. The maternal blood Pb level geometric mean was 0.44 μg/dL (n = 426), with no women having values ≥ 5 μg/dL; creatinine-adjusted maternal urinary Pb geometric mean was 0.43 μg/g (n = 366). These blood and urine concentrations are similar to those observed for females in the general U.S. population in the National Health and Nutrition Examination Survey 2010-2011 cycle. A modest correlation between maternal blood Pb and surface wipe measurements during pregnancy was observed (Spearman r = 0.35, p < 0.0001). Surface wipe Pb loadings obtained in mother's homes during pregnancy (n = 640) and from areas where children spent the most time at roughly 6 months of age (n = 99) ranged from 0.02 to 71.8 ng/cm2, with geometric means of 0.47 and 0.49 ng/cm2, respectively, which were relatively low compared to other national studies. Survey responses of demographic, lifestyle, and residence characteristics were assessed for associations with blood concentration and surface wipe loading. Demographic (e.g., race/ethnicity, income, education, marital status) and housing characteristics (e.g., year home built, paint condition, own or rent home, attached garage) were associated with both maternal blood and surface wipe loadings during pregnancy. The availability of residential environmental media and extensive survey data provided enhanced understanding of Pb exposure during pregnancy and early life.

Methods in Public Health Environmental Justice Research: a Scoping Review from 2018 to 2021

PURPOSE OF REVIEW

The volume of public health environmental justice (EJ) research produced by academic institutions increased through 2022. However, the methods used for evaluating EJ in exposure science and epidemiologic studies have not been catalogued. Here, we completed a scoping review of EJ studies published in 19 environmental science and epidemiologic journals from 2018 to 2021 to summarize research types, frameworks, and methods.

RECENT FINDINGS

We identified 402 articles that included populations with health disparities as a part of EJ research question and met other inclusion criteria. Most studies (60%) evaluated EJ questions related to socioeconomic status (SES) or race/ethnicity. EJ studies took place in 69 countries, led by the US (n = 246 [61%]). Only 50% of studies explicitly described a theoretical EJ framework in the background, methods, or discussion and just 10% explicitly stated a framework in all three sections. Among exposure studies, the most common area-level exposure was air pollution (40%), whereas chemicals predominated personal exposure studies (35%). Overall, the most common method used for exposure-only EJ analyses was main effect regression modeling (50%); for epidemiologic studies the most common method was effect modification (58%), where an analysis evaluated a health disparity variable as an effect modifier. Based on the results of this scoping review, current methods in public health EJ studies could be bolstered by integrating expertise from other fields (e.g., sociology), conducting community-based participatory research and intervention studies, and using more rigorous, theory-based, and solution-oriented statistical research methods.

Integrative literature review: Ethylene oxide exposure signs and symptoms

BACKGROUND

Although ethylene oxide (EtO) gas is designated as a human carcinogen, extant literature reports mixed findings on the health effects of exposure. The disparate findings may reflect industry bias as many studies were funded by a large chemical industry lobby.

OBJECTIVE

To conduct an integrative review of studies free from industry bias to facilitate compilation of a comprehensive list of reported signs and symptoms of EtO exposure.

METHODS

We reviewed 1887 papers of which 42 articles met inclusion criteria. The authors conducted this review in accordance with PRISMA guidelines. The presence of bias was assessed using Joanna Briggs Institute checklists.

RESULTS

Non-industry biased literature confirmed serious adverse health effects associated with EtO exposure at the occupational, hospital, and community level. EtO represents a carcinogen, neurotoxin, and respiratory irritant.

CONCLUSION

After removal of industry-biased studies, EtO was unequivocally found to pose a threat to human health. There remains a gap in the number of studies examining community-level exposure, which is essential to understanding the impact of EtO. Given that EtO-emitting facilities are concentrated in diverse and disadvantaged communities, further study of EtO exposure health effects is warranted to inform public policy on toxic air emissions.

Sociodemographic Factors Are Associated with the Abundance of PFAS Sources and Detection in U.S. Community Water Systems

Drinking water contaminated by per- and polyfluoroalkyl substances (PFAS) is a widespread public health concern, and exposure-response relationships are known to vary across sociodemographic groups. However, research on disparities in drinking water PFAS exposures and the siting of PFAS sources in marginalized communities is limited. Here, we use monitoring data from 7873 U.S. community water systems (CWS) in 18 states to show that PFAS detection is positively associated with the number of PFAS sources and proportions of people of color who are served by these water systems. Each additional industrial facility, military fire training area, and airport in a CWS watershed was associated with a 10-108% increase in perfluorooctanoic acid and a 20-34% increase in perfluorooctane sulfonic acid in drinking water. Waste sector sources were also significantly associated with drinking water PFAS concentrations. CWS watersheds with PFAS sources served higher proportions of Hispanic/Latino and non-Hispanic Black residents compared to those without PFAS sources. CWS serving higher proportions of Hispanic/Latino and non-Hispanic Black residents had significantly increased odds of detecting several PFAS. This likely reflects disparities in the siting of PFAS contamination sources. Results of this work suggest that addressing environmental justice concerns should be a component of risk mitigation planning for areas affected by drinking water PFAS contamination.

Just Transition on air quality governance: a case study of heavy-duty diesel truck protests in Taiwan

Just Transitions are gaining attention in environmental research, and most studies have focused on climate change; however, the insights from this work may be usefully applied to the rarely discussed area in just transition studies. This article uses traditional dimensions of environmental and social justice, such as distributive, procedural, recognition, and restorative justice, to understand why heavy-duty diesel truck drivers fought back against stricter air pollution regulations while demanding destigmatization. The protest resulted in policy failure, and Taiwan's transition to cleaner, newer diesel trucks were halted. This study finds that the key social contextual factor in Taiwan's transportation industry was the labor relations of license-leasing. The drivers' protest began with a lack of procedural justice, and communication occurred only after the law was passed. There was insufficient regard for procedural justice, and although the drivers were concerned, the new rule would significantly impact their right to work and life. Furthermore, the drivers felt disrespected and even carried the stigma of creating environmental pollution. The article assumes that the results should be different if the governance mechanism can handle the key factor in a social context and make appropriate arrangements for the four dimensions of Just Transition. This argument may be relevant for other countries looking to transition from older diesel vehicles to cleaner vehicles through Just Transition.

Downing the Master's Tools? New Research Strategies to Address Social Determinants of Health Inequalities

A dramatic increase in the volume of research literature referencing social determinants of health (SDH) since the report of the World Health Organization Commission on the topic in 2008 has not been matched by expansion of policies and interventions to reduce health inequalities by way of SDH. This article argues that familiar hierarchies of evidence that privilege clinical epidemiology as used in evidence-based medicine are inappropriate to address SDH. They misunderstand both the range of relevant evidence and the value-based nature of standards of proof. A richer conceptual armamentarium is available; it includes several applications of the concepts of epidemiological worlds and the lifecourse, which are explained in the article. A more appropriate evidentiary approach to SDH and health inequalities requires "downing the master's tools," to adapt Audre Lorde's phrase, and instead applying a multidisciplinary approach to assessing the evidence that adequately reflects the complexity of the relevant causal pathways. Doing so is made more difficult by the power structures that shape research priorities, yet it is essential.

Cross-level interaction between individual education and regional chemical fertilizer consumption on the risk of hypertension: evidence from the China hypertension survey

Hypertension is a common and costly public health burden in China, while the interaction effects of individual and contextual level factors on the risk of hypertension remain unclear. This study aimed to investigate whether the interaction effects between individual education and regional chemical fertilizer consumption are associated with the risk of hypertension based on a cross-level interaction perspective. Data was from the China Hypertension Survey (CHS) study, which used a nationally representative sample, and was conducted between 2012 and 2015. A total of 379 467 participants aged over 18 years from 221 counties in 31 provinces were included. A cross-sectional study design and two-level logistic models were conducted to investigate the cross-level interaction between individual education and regional chemical fertilizer consumption on the risk of hypertension after adjusting for potential confounding variables. Compared to individuals with high education (college or more), the adjusted OR (95%CI) for hypertension among those in the high school, middle school, and elementary school or less was 1.16 (1.12-1.21), 1.25 (1.20-1.30), and 1.49 (1.43-1.55), respectively. The association between regional chemical fertilizer consumption and hypertension was not significant. Interaction analysis showed that regional chemical fertilizer consumption was associated with an increased risk of hypertension for individuals with lower education. These patterns were consistent after stratified by sex. This study provided evidence from the Chinese population that interaction between individual education and regional chemical fertilizer was associated with risk of hypertension. Future research and policy aimed to improve population health and reduce hypertension could address the regional context of population as well as individual factors.

Development of a new methodology for multifaceted assessment, analysis, and characterization of soil contamination

It is important to identify key performance and core progress features of soil contamination management practices. Traditional research currently focuses on numerical statistics of contaminated sites but exhibits structural limitations regarding cross-assessment and in-depth analysis of published findings. Herein, we report a multidimensional perspective to assess the environmental management performance of soil contamination via systematic and historical development of construction land risk control and remediation lists (RCRLs). The considered contaminated sites are mainly concentrated in Northern China, Yangtze River Delta, Pearl River Delta, and Sichuan-Chongqing regions. Monthly historical overviews indicate that most lists are updated 4-5 times within 32 months. Direct chemical-related industrial production results in the largest number of contaminated sites. Arsenic and lead are the most common heavy metals of concern in soil contamination. The fiscal revenue index exhibits the best positive performance in terms of the number of contaminated sites. By employing the site number, update frequency, and published contents of different calculation proportions, ten types of integrated assessment indicators (IAIs) are established to evaluate the environmental achievements in various provincial regions in regard to soil contamination protection. This multifaceted strategy can provide advanced guidance for Chinese environmental management and expand the application of soil pollution risk control and remediation in a wide range of countries.