Environmental pollutants and exosomes: A new paradigm in environmental health and disease

This study investigates the intricate interplay between environmental pollutants and exosomes, shedding light on a novel paradigm in environmental health and disease. Cellular stress, induced by environmental toxicants or disease, significantly impacts the production and composition of exosomes, crucial mediators of intercellular communication. The heat shock response (HSR) and unfolded protein response (UPR) pathways, activated during cellular stress, profoundly influence exosome generation, cargo sorting, and function, shaping intercellular communication and stress responses. Environmental pollutants, particularly lipophilic ones, directly interact with exosome lipid bilayers, potentially affecting membrane stability, release, and cellular uptake. The study reveals that exposure to environmental contaminants induces significant changes in exosomal proteins, miRNAs, and lipids, impacting cellular function and health. Understanding the impact of environmental pollutants on exosomal cargo holds promise for biomarkers of exposure, enabling non-invasive sample collection and real-time insights into ongoing cellular responses. This research explores the potential of exosomal biomarkers for early detection of health effects, assessing treatment efficacy, and population-wide screening. Overcoming challenges requires advanced isolation techniques, standardized protocols, and machine learning for data analysis. Integration with omics technologies enhances comprehensive molecular analysis, offering a holistic understanding of the complex regulatory network influenced by environmental pollutants. The study underscores the capability of exosomes in circulation as promising biomarkers for assessing environmental exposure and systemic health effects, contributing to advancements in environmental health research and disease prevention.

Human health and the health of Planet Earth go together

The emergence of the planetary health approach was highlighted by the report of The Rockefeller Foundation-Lancet Commission on Planetary Health in 2015 and changed how we comprehend human well-being. The report advocates integrating the health of other living beings and Earth's natural systems as intrinsic components of human health. Drawing on over three decades of experience in respiratory epidemiology and environmental health, this article outlines how my perspective on human health underwent a transformative shift upon reading the abovementioned report. The planetary health approach offers a lens through which human health issues and potential solutions can be understood within the context of the Anthropocene. It addresses the pressing existential challenges arising from humanity's transgression of planetary limits. Embracing the planetary health paradigm within the field of health sciences can catalyze transformative changes essential for cultivating a sustainable and equitable future.

A messaging standard for environmental inspections: is it time?

Environmental health (EH) services in the United States lag behind other areas of public health and health care with respect to information system interoperability and data sharing. This is partly due to an absence of well-defined use cases, the lack of direct economic drivers and resources to improve, the multiple jurisdictional elements that govern EH services across the United States, and no central organization to drive modernization of EH data. We summarize the status of EH information systems; argue for greater interoperability, including use cases for a messaging standard for environmental inspections; and present recommendations to better align EH services and data modernization efforts currently underway in other areas of public health.

A Systematic Review of Pervasiveness, Bioaccumulation and Subduing Environmental Health Challenges

The Niger Delta environment is under serious threat due to heavy metal pollution. Many studies have been conducted on the heavy metal contamination in soils, water, seafood and plants in the Niger Delta ecosystem. However, there is a lack of clear understanding of the health consequences for people and strategies for attaining One Health, and a dispersion of information that is accessible. The study focused on investigating the contamination levels, distributions, risks, sources and impacts of heavy metals in selected regions of the Niger Delta. Prior studies revealed that the levels of certain heavy metals, including Cd, Pb, Cu, Cr, Mn, Fe and Ni, in water, sediment, fish and plants in most Niger Delta ecosystems were higher than the acceptable threshold attributed to various anthropogenic stressors. In the reviewed Niger Delta states, ecosystems in Rivers state showed the highest concentrations of heavy metals in most sampled sites. Groundwater quality was recorded at concentrations higher than 0.3 mg/L World Health Organization drinking water guideline. High concentrations of copper (147.915 mg/L) and zinc (10.878 mg/L) were found in Rivers State. The heavy metals concentrations were greater in bottom-dwelling organisms such as bivalves, gastropods and shrimp than in other fishery species. Heavy metal exposure in the region poses risks of communicable and non-communicable diseases. Diverse remediation methods are crucial to reduce contamination levels, but comprehensive strategies and international cooperation are essential to address the health hazards. Actively reducing heavy metals in the environment can achieve One Health objectives and mitigate disease and economic burdens.

The Struggle to Regulate Precarious Work Arrangements to Minimize Their Adverse Effects on Health and Safety in Australia

As in other countries, the growth of precarious work arrangements in Australia from the late 1970s has had significant adverse effects on occupational health and safety (OHS). While there is now a large body of global research on this issue and its connection to the rise of neoliberalism, there has been less investigation of efforts to address these problems. This article reviews regulatory interventions in Australia over the past two decades. It particularly focuses on industrial relations regulation, which can play a critical role in addressing at least some of the underlying reasons why precarious work undermines OHS. The most significant of these changes were passed by the Australian Parliament in February 2024, including a highly controversial but world-leading creation of minimum standards for platform workers.

Chemodiversity in freshwater health

Dissolved organic matter may offer a way to track and restore the health of fresh waters.

The injustice of risk avoidance: the limitations of fish consumption restrictions as institutional controls for superfund sites

The Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA) is a landmark environmental policy. It broadly empowers the federal government to manage hazardous waste sites to ensure the protection of human and environmental health. In many ways, CERCLA is the result of the environmental justice movement, and public concern about hazardous sites. Because the goal of CERCLA is explicitly managing risk from hazardous sites, it is central to the regulatory structure for management of environmental injustice in the United States of America. However, CERCLA does not fully consider the full scope of environmental justice, and may fail to fully ensure environmental justice for communities impacted directly by proximity to hazardous sites. Specifically, the use of institutional controls such as fish consumption advisories as long terms risk management strategies may prolong and compound environmental injustice as a matter of policy.

Residents' experiences during a hydrogen sulfide crisis in Carson, California

BACKGROUND

In early October 2021, thousands of residents in Carson, California began complaining of malodors and headaches. Hydrogen sulfide (H2S), a noxious odorous gas, was measured at concentrations up to 7000 parts per billion (ppb) and remained above California's acute air quality standard of 30 ppb for a month. Intermittent elevations of H2S continued for 3 months. After 2 months of malodor in this environmental justice community, a government agency attributed the H2S to environmental pollution from a warehouse fire. Research has yielded conflicting results on the health effects of H2S exposure at levels that were experienced during this event. This research fills a critical need for understanding how people perceive and experience emergent environmental health events and will help shape future responses.

METHODS

Through a community-academic partnership, we conducted 6 focus groups with 33 participants who resided in the Carson area during the crisis. We sought to understand how this incident affected residents through facilitated discussion on topics including information acquisition, impressions of the emergency response, health symptoms, and ongoing impacts.

RESULTS

The majority of participants were women (n = 25), identified as Latina/o (n = 19), and rent their homes (n = 21). Participants described difficulty obtaining coherent information about the emergency, which resulted in feelings of abandonment. Most participants felt that local government and healthcare providers downplayed and/or disregarded their concerns despite ongoing odors and health symptoms. Participants described experiencing stress from the odors' unknown health effects and continued fear of future odor incidents. Residents sought to take control of the crisis through information sharing, community networking, and activism. Participants experienced longer term effects from this event, including increased awareness of pollution and reduced trust in local agencies.

DISCUSSION

This study demonstrates the necessity of clear, comprehensive, and prompt responses by relevant decisionmakers to chemical emergencies to appropriately address residents' fears, curb the spread of misinformation, and minimize adverse health effects. Participant responses also point to the benefit of supporting horizontal community networks for improved information sharing. By engaging directly with community members, researchers and disaster responders can better understand the various and complex impacts of chemical disasters and can improve response.

Cohort profile: China undergraduate cohort for environmental health study

The China Undergraduate Cohort (CUC) is an ambispective cohort study with its major purpose to better understand the effects of lifetime environmental exposures on health outcomes. We recruited 5322 college students with an average age of 18.3 ± 0.7 years in China from August 23, 2019 to October 28, 2019. Follow-up surveys were conducted annually. The dataset comprises individual demographic data (e.g. age, sex, height, weight, birth date, race, home address, annual family income, contact information), health-related behavior data (smoking status, smoking cessation, passive smoking exposure, drinking habit, physical activity, dietary status), lifestyle data (physical exercise, dietary habit, length of time spent outdoors), disease history (respiratory disease history, cardiovascular disease history, urinary system disease history, etc.), mental health status data (sleep quality, self-reported stress, anxiety and depression symptoms), lung function and blood samples data. Preliminary results from our cohort have found the association between air pollution, summer heat and mercury exposure and lung function among young adults in China.

Pre-emergence herbicides widely used in urban and farmland soils: fate, and potential human and environmental health risks

We determined the distribution, fate, and health hazards of dimethenamid-P, metazachlor, and pyroxasulfone, the effective pre-emergence herbicides widely used both in urban and agricultural settings globally. The rate-determining phase of sorption kinetics of these herbicides in five soils followed a pseudo-second-order model. Freundlich isotherm model indicated that the herbicides primarily partition into heterogeneous surface sites on clay minerals and organic matter (OM) and diffuse into soil micropores. Principal component analysis revealed that soil OM (R2, 0.47), sand (R2, 0.56), and Al oxides (R2, 0.33) positively correlated with the herbicide distribution coefficient (Kd), whereas clay (R2, ‒ 0.43), silt (R2, ‒ 0.51), Fe oxides (R2, ‒ 0.02), alkaline pH (R2, ‒ 0.57), and EC (R2, ‒ 0.03) showed a negative correlation with the Kd values. Decomposed OM rich in C=O and C-H functional groups enhanced herbicide sorption, while undecomposed/partially-decomposed OM facilitated desorption process. Also, the absence of hysteresis (H, 0.27‒0.88) indicated the enhanced propensity of herbicide desorption in soils. Leachability index (LIX, < 0.02-0.64) and groundwater ubiquity score (GUS, 0.02‒3.59) for the soils suggested low to moderate leaching potential of the herbicides to waterbodies, indicating their impact on water quality, nontarget organisms, and food safety. Hazard quotient and hazard index data for human adults and adolescents suggested that exposure to soils contaminated with herbicides via dermal contact, ingestion, and inhalation poses minimal to no non-carcinogenic risks. These insights can assist farmers in judicious use of herbicides and help the concerned regulatory authorities in monitoring the safety of human and environmental health.

The Bioethics of Environmental Injustice: Ethical, Legal, and Clinical Implications of Unhealthy Environments

Environmental health remains a niche topic in bioethics, despite being a prominent social determinant of health. In this paper we argue that if bioethicists are to take the project of health justice as a serious one, then we have to address environmental injustices and the threats they pose to our bioethics principles, health equity, and clinical care. To do this, we lay out three arguments supporting prioritizing environmental health in bioethics based on bioethics principles including a commitment to vulnerable populations and justice. We also highlight and advocate for environmental law efforts that align with these priorities, focusing specifically on the need for a right to a healthy environment. Our intention is to draw attention to the legal and ethical concepts that underlie the importance of a healthy environment, and urge bioethicists to prioritize both legal and ethical advocacy against environmental injustices in their practice.

Multiple biomarkers in pufferfish as a proxy of environmental health in brazilian marine protected areas

Marine Protected Areas (MPAs) are designed to conserve biodiversity and vulnerable ecosystems. This study aimed to assess the environmental quality of three Brazilian MPAs, based on the integrated analysis of biomarkers in pufferfish. The MPAs are differentiated by the degree of anthropogenic influences. The Barra do Una Estuary sustainable reserve (JUR) is a reference area due to its low levels of contamination and species diversity. The Cananéia Estuarine System (CAN) has been recognized as a biosphere reserve by UNESCO, as well as a Ramsar wetland. This MPA was influenced by upstream mining activities, resulting in the introduction of metals in the estuarine waters and the discharge of untreated urban sewage. The São Vicente estuary (SSV) lacks proper sanitation infrastructure. All collections were conducted during winter season, and, after collection, the animals were euthanized, their soft tissues were removed, and multiple biomarkers were analyzed in the gills and liver, as biometric, genotoxic, biochemical, and morphological. A one-factor multivariate analysis was applied to evaluate the differences between the data sets, and the matrices were analyzed using PERMANOVA to evaluate the "estuary" factor. The results were integrated using PCA with a 0.4 cut value and an Enhanced Integrated Biomarker Response (EIBR) was calculated. PCA was correlated with biochemical, genotoxic, and morphological biomarkers. In general, SVV differed from CAN and JUR as shown by both univariate and multivariate analyses. SVV also showed the highest EIBR, followed by CAN. Organisms from SSV showed greater gill pathology, elevated AChE activity and lipoperoxidation (LPO), and micronuclei frequency. CAN present intermediate EIBR, with severe pathologies in the liver. CAN seems to present an intermediate environmental quality between SSV and JUR indicating the importance of the existence of MPAs for environmental conservation and the need to monitor such areas, to maintain their suitable environmental quality.

Conceptualizing the Role of the Microbiome as a Mediator and Modifier in Environmental Health Studies: A Scoping Review of Studies of Triclosan and the Microbiome

PURPOSE OF REVIEW

Triclosan is an endocrine-disrupting antimicrobial additive that is suspected of contributing to antibiotic resistance and altering the microbiome. In this scoping review, we summarize what is known about the association between triclosan exposure and the microbiome using evidence from in vivo and epidemiologic studies.

RECENT FINDINGS

Our review includes 11 rodent studies, seven fish studies, and five human studies. Evidence from animal studies suggests that triclosan decreases the diversity of the microbiome, although only one epidemiologic study agreed. Most studies suggest that triclosan alters the microbial community beta diversity, but disagree on which taxa contributed to compositional differences. Taxa in the Bacteroidetes, Firmicutes, and Proteobacteria may be more influenced by triclosan than those in other phyla. Studies on triclosan and the microbiome were scarce and were inconclusive as to the effects of triclosan on the microbiome. Additional research is needed to clarify windows of heightened susceptibility of the microbiome to triclosan. We recommend guidelines for future microbiome research in environmental health to increase comparability across studies.

High toxicity of agro-industrial wastewater on aquatic fauna of a South American stream: Mortality of aquatic turtles and amphibian tadpoles as bioindicators of environmental health

The aim of this study was to characterize an aquatic system of Santa Fe province (Argentina) receiving wastewater from agro-industrial activities (mainly dairy) by in situ assessment (fauna mortality, physicochemical, microbiological, and pesticide residues measurement), and ecotoxicity bioassays on amphibian tadpoles. Water and sediment samples were obtained from the Los Troncos Stream (LTS), previous to the confluence with the "San Carlos" drainage channel (SCC), and from the SCC. Biological parameters (mortality and sublethal biomarkers) were used to evaluate ecotoxicity during 10-day exposure of Rhinella arenarum tadpoles to LTS and SCC samples. Nine pesticides were detected in both LTS and SCC. Chemical and biochemical oxygen demand, ammonia, and coliform count recorded in SCC greatly exceeded limits for aquatic life protection. At SCC and LTS after the confluence with SCC, numerous dying and dead aquatic turtles (Phrynops hilarii) were recorded. In the ecotoxicity assessment, no mortality of tadpoles was observed in LTS treatment, whereas total mortality (100%) was observed in SCC treatments in dilution higher than 50% of water and sediment. For SCC, median lethal concentration and the 95% confidence limits was 18.30% (14.71-22.77) at 24 h; lowest-observed and no-observed effect concentrations were 12.5% and 6.25%, respectively. Oxidative stress and neurotoxicity were observed in tadpoles exposed to 25% SCC dilution treatment. In addition, there was a large genotoxic effect (micronuclei test) in all sublethal SCC dilution treatments (6.25%, 12.5%, and 25%). These results alert about the high environmental quality deterioration and high ecotoxicity for aquatic fauna of aquatic ecosystems affected by agro-industrial wastewater. PRACTITIONER POINTS: Great mortality of turtles was observed in a basin with a high load of agro-industrial wastewater. San Carlos Channel (SCC), where effluents are spilled, is environmentally deteriorated. The water-sediment matrix of SCC caused 100% lethality in tadpoles. SCC dilutions caused neurotoxicity, oxidative stress, and genotoxicity on tadpoles.

Integrated environmental health assessment: Proposed approaches to exposure during chemical incidents

An integrated environmental health exposure assessment (IEHA) refers to the integration of human biomonitoring data (HBM) and environmental measurements and aims to optimize the exposure assessment process. Due to lack of data, this approach remains an issue during chemical incidents. This study aims to explore integrated exposure approaches for assessing human health risks during chemical incidents. Based on the Preferred Reporting Items of Systematic reviews and Meta-Analyses statement, a literature analysis was performed. A level of confidence ranging from 1 to 4 was established to define the quality and strength of data used to undertake an IEHA approach. Twenty-seven articles (n = 18) and texts (n = 9) from Europe (41%) and the United States (37%) were analyzed. Among the 18 scientific articles, 61% (n = 11) presented a quantitative approach and 17% (n = 3) presented a qualitative approach. Quantitative approaches must be based on accurate data, coupled with predictive models. Of all the scientific papers, 40% (n = 7) responded to a confidence level greater than or equal to 2. Uncertainties detected through the integrated exposure approaches were related to input data, analytical methods, and HBM reference value interpretations. During chemical incidents, direct measurements were the most relevant data. Few scientific studies have developed an integrated approach during emergency situations. However, when this was used, they presented a high level of confidence by defining levels of exposure that support decision-making processes. Despite the multiple approaches, there was a lack of guidelines allowing an integrated risk assessment to be performed during an emergency chemical exposure. Integr Environ Assess Manag 2024;20:481-497. © 2023 SETAC.

Differential Participation, a Potential Cause of Spurious Associations in Observational Cohorts in Environmental Epidemiology

Differential participation in observational cohorts may lead to biased or even reversed estimates. In this article, we describe the potential for differential participation in cohorts studying the etiologic effects of long-term environmental exposures. Such cohorts are prone to differential participation because only those who survived until the start of follow-up and were healthy enough before enrollment will participate, and many environmental exposures are prevalent in the target population and connected to participation via factors such as geography or frailty. The relatively modest effect sizes of most environmental exposures also make any bias induced by differential participation particularly important to understand and account for. We discuss key points to consider for evaluating differential participation and use causal graphs to describe two example mechanisms through which differential participation can occur in health studies of long-term environmental exposures. We use a real-life example, the Canadian Community Health Survey cohort, to illustrate the non-negligible bias due to differential participation. We also demonstrate that implementing a simple washout period may reduce the bias and recover more valid results if the effect of interest is constant over time. Furthermore, we implement simulation scenarios to confirm the plausibility of the two mechanisms causing bias and the utility of the washout method. Since the existence of differential participation can be difficult to diagnose with traditional analytical approaches that calculate a summary effect estimate, we encourage researchers to systematically investigate the presence of time-varying effect estimates and potential spurious patterns (especially in initial periods in the setting of differential participation).

Environmental Health Literacy Regarding Fine Particulate Matter and Related Factors Among Village Health Volunteers in Upper Northern Thailand

OBJECTIVES

Fine particulate matter pollution has emerged as a significant life-threatening issue in Thailand. Recognizing the importance of environmental health literacy (EHL) in disease prevention is crucial for protecting public health. This study investigated EHL levels and aimed to identify associated factors among village health volunteers (VHVs) in the upper northern region of Thailand.

METHODS

A cross-sectional study was conducted to collect data from 710 VHVs using the EHL assessment tool developed by the Department of Health, Thailand.

RESULTS

The overall EHL score was moderate (mean, 3.28 out of a possible 5.0), with the highest and lowest domain-specific mean score for the ability to make decisions (3.52) and the ability to access (3.03). Multiple linear regression revealed that the factors associated with EHL score were area of residence (urban areas in Chiang Mai: B=0.254; urban areas in Lampang: B=0.274; and rural areas in Lampang: B=0.250 compared to rural areas in Chiang Mai), higher education levels (senior high school: B=0.212; diploma/high vocational certificate: B=0.350; bachelor's degree or above: B=0.528 compared to elementary school or lower), having annual health checkups compared to not having annual health check-ups (B=0.142), monthly family income (B=0.004), and individuals frequently facing air pollution issues around their residence (B=0.199) compared to those who reported no such issues.

CONCLUSIONS

The VHVs exhibited moderate EHL associated with residence area, education, health check-ups, family income, and residential air pollution. Considering these factors is vital for enhancing VHVs' EHL through strategic interventions.

Mechanism of the adverse outcome of Chlorella vulgaris exposure to diethyl phthalate: Water environmental health reflected by primary producer toxicity

As a ubiquitous contaminant in aquatic environments, diethyl phthalate (DEP) is a major threat to ecosystems because of its increasing utilization. However, the ecological responses to and toxicity mechanisms of DEP in aquatic organisms remain poorly understood. To address this environmental concern, we selected Chlorella vulgaris (C. vulgaris) as a model organism and investigated the toxicological effects of environmentally relevant DEP concentrations at the individual, physiological, biochemical, and molecular levels. Results showed that the incorporation of DEP significantly inhibited the growth of C. vulgaris, with inhibition rates ranging from 10.3 % to 83.47 %, and disrupted intracellular chloroplast structure at the individual level, while the decrease in photosynthetic pigments, with inhibition rates ranging from 8.95 % to 73.27 %, and the imbalance of redox homeostasis implied an adverse effect of DEP at the physio-biochemical level. Furthermore, DEP significantly reduced the metabolic activity of algal cells and negatively altered the cell membrane integrity and mitochondrial membrane potential. In addition, the apoptosis rate of algal cells presented a significant dose-effect relationship, which was mainly attributed to the fact that DEP pollutants regulated Ca2+ homeostasis and further increased the expression of Caspase-8, Caspase-9, and Caspase-3, which are associated with internal and external pathways. The gene transcriptional expression profile further revealed that DEP-mediated toxicity in C. vulgaris was mainly related to the destruction of the photosynthetic system, terpenoid backbone biosynthesis, and DNA replication. Overall, this study offers constructive understandings for a comprehensive assessment of the toxicity risks posed by DEP to C. vulgaris.

An integrated deep-learning model for smart waste classification

Efficient waste management is essential for human well-being and environmental health, as neglecting proper disposal practices can lead to financial losses and the depletion of natural resources. Given the rapid urbanization and population growth, developing an automated, innovative waste classification model becomes imperative. To address this need, our paper introduces a novel and robust solution - a smart waste classification model that leverages a hybrid deep learning model (Optimized DenseNet-121 + SVM) to categorize waste items using the TrashNet datasets. Our proposed approach uses the advanced deep learning model DenseNet-121, optimized for superior performance, to extract meaningful features from an expanded TrashNet dataset. These features are subsequently fed into a support vector machine (SVM) for precise classification. Employing data augmentation techniques further enhances classification accuracy while mitigating the risk of overfitting, especially when working with limited TrashNet data. The results of our experimental evaluation of this hybrid deep learning model are highly promising, with an impressive accuracy rate of 99.84%. This accuracy surpasses similar existing models, affirming the efficacy and potential of our approach to revolutionizing waste classification for a sustainable and cleaner future.

Microplastics in oral healthcare products (OHPs) and their environmental health risks and mitigation measures

The environmental input of microplastics from personal care products has received significant attention; however, less focus has been paid to oral healthcare products. The present study assessed the occurrence of microplastics in commercially available oral healthcare products such as toothbrushes, toothpastes, toothpowder, mouthwash, dental floss, and mouth freshener spray that have a pan-India distribution. The extracted microplastics were quantified and characterised using a microscope and ATR-FTIR. All products showed microplastic contamination, where toothbrushes showed the maximum particles (30-120 particles/brush) and mouth freshener sprays (0.2-3.5 particles/ml) had the least abundance. Fragments, fibres, beads, and films were the various shapes of microplastics observed, where fragments (60%) were dominant. Various colours such as pink, green, blue, yellow, black, and colourless were observed, where colourless (40%) particles were dominant. Microplastics were categorized into three sizes: <0.1 mm (63%), 0.1-0.3 mm (35%), and >0.3 mm (2%). Four major types of polymers, such as polyethylene (52%), polyamide (30%), polyethylene terephthalate (15%), and polybutylene terephthalate (3%), were identified. Risk assessment studies such as Daily Microplastics Emission (DME), Annual Microplastics Exposure (AME), and Polymer Hazard Index (PHI) were carried out. The DME projection for India was the highest for mouthwash (74 billion particles/day) and the least for mouth freshener sprays (0.36 billion particles/day). The AME projection for an individual was the highest in toothbrushes (48,910 particles ind.-1 yr.-1) and the least in mouth freshener sprays (111 particles ind.-1 yr.-1). PHI shows that the identified polymers fall under the low-to high-risk categories. This study forecasts the community health risks linked to microplastics in oral healthcare products and suggests mitigation strategies. It has the potential to shape environmental policy development in response.

A comparison of different professional profiles

Environmental exposures are responsible for a quarter of morbidity and mortality rates globally. Primary care professionals work in a privileged position to detect and intervene on environmental health matters. Nevertheless, due to lack of specific training, international literature shows that primary care health professionals have limited skills to deal with those. The objectives of this study were to assess the levels of environmental health (EH) knowledge and competence of a sample of 446 health professionals and students in the Basque Country and explore the presence that EH has on their daily practice. Only a very small proportion of participants had received training and took environmental clinical history regularly. Participants were confident to deal, and actually dealt, with tobacco, pollen and sun exposures but less able to address topics like biomarkers, pesticides and endocrine disruptors. Finally, and in accordance to previous works, we found moderate levels of EH knowledge and skills in our sample, and observed that nurses and nursing students reported higher EH skills than other professional profiles but scored lower in knowledge. Despite the manifold impacts of environmental exposures on health, interventions to strengthen health professionals' EH competence are required.

Optimization strategy of community planning for environmental health and public health in smart city under multi-objectives

As population density increases, environmental hygiene and public health become increasingly severe. As the space where residents stay for the longest time and have the most profound impact on their physical and mental health, the quality of the environment in urban communities largely determines the degree to which residents engage in physical activity, bear the risk of pollution exposure, and obtain healthy food. Therefore, in order to ensure the physical and mental health of residents, this study proposes community planning guided by environmental hygiene and public health, and establishes an environmental health assessment system for this purpose. This system evaluates the community environment from four aspects: land use, service facilities, site convenience, and environmental quality. Established the diversity, density, road network connectivity and facilities accessibility nine criteria, as well as the land function of mix, plot ratio, food environment, network ring α and connected β index, pavement risk level, green configuration and neighborhood material environment disorder degree of 27 indicators of community built environmental evaluation index system. The data is collected through field survey, questionnaire distribution, resident interview and data mapping, and the established evaluation index system is used to evaluate the construction environment of the community. The experimental research data included population data, CAD plan, land use data, street data, POI point data, building data and bus station data, etc. 273 questionnaires were distributed, 264 were recovered, 8 invalid questionnaires were removed, and 256 valid questionnaires were obtained. These experiments confirm that land use, service facilities, site convenience, and environmental quality have a significant impact on the built environment of communities, with impact weights of 0.513, 0.227, 0.135, and 0.125, respectively. The above weights are calculated based on the index judgment matrix and the eigenvectors. The scores of land use, service facilities, site convenience, and environmental quality for the study subjects were 3.44, 1.46, 0.94, and 0.51, respectively, among them, the land use score is less than 3.85, the 1 service facility score is less than 1.71, the site convenience score is less than 1.01, and the environmental quality score is less than 0.94; indicating that the community has serious problems such as single land use types, pollution exposure, and difficulty in obtaining healthy food. Therefore, community planning and transformation based on land use, service facilities, venue convenience, and environmental quality can effectively improve the physical and mental health of residents. In the specific community transformation plan, artificial intelligence and data-driven methods can be used to optimize the land use plan, service facility configuration, site convenience transformation and environmental quality improvement, so as to formulate the optimal community transformation plan and improve the comfort and happiness of community residents. In the future, on the basis of the existing research, the selection of community types will be further enriched and the research cases will be expanded. And through the in-depth practical study of the case, the constructed evaluation index system is optimized and improved to make it more scientific. At the same time, as urban renewal and design have entered the era of stock planning, based on the more perfect evaluation index system, more specific and detailed system discussion of the built communities with public health problems, in order to provide more detailed services for the construction of a better and healthy living environment in the future.

Toxicological impact of strobilurin fungicides on human and environmental health: a literature review

Fungicides are specifically used for controlling fungal infections. Strobilurins, a class of fungicides originating from the mushroom Strobilurus tenacellus, act on the fungal mitochondrial respiratory chain, interrupting the ATP cycle and causing oxidative stress. Although strobilurins are little soluble in water, they have been detected in water samples (such as rainwater and drinking water), indoor dust, and sediments, and they can bioaccumulate in aquatic organisms. Strobilurins are usually absorbed orally and are mainly eliminated via the bile/fecal route and urine, but information about their metabolites is lacking. Strobilurins have low mammalian toxicity; however, they exert severe toxic effects on aquatic organisms. Mitochondrial dysfunction and oxidative stress are the main mechanisms related to the genotoxic damage elicited by toxic compounds, such as strobilurins. These mechanisms alter genes and cause other dysfunctions, including hormonal, cardiac, neurological, and immunological impairment. Despite limitations, we have been able to compile literature information about strobilurins. Many studies have dealt with their toxic effects, but further investigations are needed to clarify their cellular and underlying mechanisms, which will help to find ways to minimize the harmful effects of these compounds.

Communities catalyzing change with data to mitigate an invisible menace, traffic-related air pollution

OBJECTIVES

To identify strategies and tactics communities use to translate research into environmental health action.

METHODS

We employed a qualitative case study design to explore public health action conducted by residents, organizers, and public health planners in two Massachusetts communities as part of a community based participatory (CBPR) research study. Data sources included key informant interviews (n = 24), reports and direct observation of research and community meetings (n = 10) and project meeting minutes from 2016-2021. Data were coded deductively drawing on the community organizing and implementation frameworks.

RESULTS

In Boston Chinatown, partners drew broad participation from community-based organizations, residents, and municipal leaders, which resulted in air pollution mitigation efforts being embedded in the master planning process. In Somerville, partners focused on change at multiple levels, developer behavior, and separate from the funded research, local legislative efforts, and litigation.

CONCLUSIONS

CBPR affords communities the ability to environmental health efforts in a way that is locally meaningful, leveraging their respective strengths. External facilitation can support the continuity and sustainment of community led CBPR efforts.

Recent advances in degradation of N,N-diethyl-3-toluamide (DEET)-an emerging environmental contaminant: a review

N,N-Diethyl-3-toluamide (DEET) is a commonly used insect repellent, which acts as an organic chemical contaminant in water and considered as an emerging contaminant which has been observed worldwide. It gets discharged into the environment through sewage waste. The various methods have been used to degrade DEET, such as UV based, ozonation, photocatalytic degradation, and biodegradation (based on the metabolic activity of fungi and bacteria). However, less research has been done on the degradation of DEET by deploying nanoparticles. Therefore, biodegradation and nanotechnology-based methods can be the potential solution to remediate DEET from the environment. This review is an attempt to analyze the routes of entry of DEET into the atmosphere and its environmental health consequences and to explore physical, chemical, and biological methods of degradation. Furthermore, it focuses on the various methods used for the biodegradation of the DEET, including their environmental consequences. Future research is needed with the application of biological methods for the degradation of DEET. Metabolic pathway for biodegradation was explored for the new potent microbial strains by the application of physical, chemical, and microbial genomics; molecular biology; genetic engineering; and genome sequencing methods.

[Symptom Distress, Social Support, Spiritual Well-Being, and Quality of Life Among Women With Gynecologic Cancer]

BACKGROUND

Women with gynecological cancers experience physical and mental distress due to their diagnosis, surgery, adjuvant chemotherapy, and radiotherapy, all of which have adverse physical, mental, social, and spiritual impacts on their quality of life.

PURPOSE

This study was designed to examine the correlations among symptom distress, social support, spiritual well-being, and quality of life as well as the predictors of quality of life in women with gynecological cancers.

METHODS

This was a cross-sectional correlational study. A total of 91 women with gynecologic cancer were recruited from a medical center in central Taiwan. A demographic characteristics questionnaire, the World Health Organization Quality of Life Brief Questionnaire Taiwanese version, the Chinese Modified Symptom Distress Scale, the Chinese Simplified Social Support Scale, and the Spiritual Well-Being Scale were used for data collection. Correlation and multiple regression analyses were performed on the data.

RESULTS

Symptom distress was found to correlate negatively with spiritual well-being as well as with the physical health, psychological health, and environmental health domains of quality of life. Social support and spiritual well-being were found to correlate positively with all four domains of quality of life. Social support was identified as the main predictor of quality of life.

CONCLUSIONS / IMPLICATIONS FOR PRACTICE

Symptom distress, social support, and spiritual well-being should be incorporated into nursing education to improve medical staff awareness of these issues and promote the timely evaluation of patient needs. Moreover, medical staff should provide appropriate social and spiritual support and multi-disciplinary care as well as make referrals when necessary to related support groups to improve clinical care quality to enhance patient quality of life.

Increases in trade secret designations in hydraulic fracturing fluids and their potential implications for environmental health and water quality

Hydraulic fracturing is an increasingly common method of oil and gas extraction across the United States. Many of the chemicals used in hydraulic fracturing processes have been proven detrimental to human and environmental health. While disclosure frameworks have advanced significantly in the last 20 years, the practice of withholding chemical identities as "trade secrets" or "proprietary claims" continues to represent a major absence in the data available on hydraulic fracturing. Here, we analyze rates of trade secret claims using FracFocus, a nationwide database of hydraulic fracturing data, from January 1, 2014 to December 31, 2022. We use the open-source tool Open-FF, which collates FracFocus data, makes it accessible for systematic analysis, and performs several quality-control measures. We found that the use by mass of chemicals designated as trade secrets has increased over the study time period, from 728 million pounds in 2014 to 2.96 billion pounds in 2022 (or a 43.7% average yearly increase). A total of 10.4 billion pounds of chemicals were withheld as trade secrets in this time period. The water volume used (and therefore total mass of fracturing fluid) per fracturing job has shown a large increase from 2014 to 2022, which partly explains the increase in mass of chemicals withheld as trade secrets over this time period, even as total fracturing jobs and individual counts of proprietary records have decreased. Our analysis also shows increasing rates of claiming proppants (which can include small grains of sand, ceramic, or other mineral substances used to prop open fractures) as proprietary. However, the mean and median masses of non-proppant constituents designated as trade secrets have also increased over the study period. We also find that the total proportion of all disclosures including proprietary designations has increased by 1.1% per year, from 79.3% in 2014 to 87.5% in 2022. In addition, most disclosures designate more than one chemical record as proprietary: trade secret withholding is most likely to apply to 10-25% of all records in an individual disclosure. We also show the top ten reported purposes that most commonly include proprietary designations, after removing vague or multiple entries, the first three of which are corrosion inhibitors, friction reducers, and surfactants. Finally, we report the top ten operators and suppliers using and supplying proprietary chemicals, ranked by mass used or supplied, over our study period. These results suggest the importance of revisiting the role of proprietary designations within state and federal disclosure mechanisms.

Racism as a public health issue in environmental health disparities and environmental justice: working toward solutions

BACKGROUND

Environmental health research in the US has shown that racial and ethnic minorities and members of low-socioeconomic groups, are disproportionately burdened by harmful environmental exposures, in their homes, workplace, and neighborhood environments that impact their overall health and well-being. Systemic racism is a fundamental cause of these disproportionate exposures and associated health effects. To invigorate and inform current efforts on environmental justice and to raise awareness of environmental racism, the National Institute of Environmental Health Sciences (NIEHS) hosted a workshop where community leaders, academic researchers, and NIEHS staff shared perspectives and discussed ways to inform future work to address health disparities.

OBJECTIVES

To share best practices learned and experienced in partnerships between academic researchers and communities that are addressing environmental racism across the US; and to outline critical needs and future actions for NIEHS, other federal agencies, and anyone who is interested in conducting or funding research that addresses environmental racism and advances health equity for all communities.

DISCUSSION

Through this workshop with community leaders and researchers funded by NIEHS, we learned that partnerships between academics and communities hold great promise for addressing environmental racism; however, there are still profound obstacles. To overcome these barriers, translation of research into plain language and health-protective interventions is needed. Structural changes are also needed in current funding mechanisms and training programs across federal agencies. We also learned the importance of leveraging advances in technology to develop creative solutions that can protect public health.

Association between environmental mercury exposure and allergic disorders in Korean children: Korean National Environmental Health Survey (KoNEHS) cycles 3-4 (2015-2020)

Although previous studies have suggested potential adverse effects of mercury on a child's immune system, the associations have been inconsistent. We aimed to determine the association between urinary mercury levels and allergic diseases in Korean children with high mercury exposure. Data from 853 and 710 children aged 6-11 years in the Korean National Environmental Health Survey (KoNEHS) cycle 3 (2015-2017) and cycle 4 (2018-2020) were analyzed. We examined the association between mercury exposure and the prevalence of atopic dermatitis (AD), asthma, allergic rhinitis (AR), and allergic multimorbidity. After adjusting for all covariates, the urinary mercury level was positively associated with AD in the 2015-2017 study (OR = 1.34, 95% CI = 1.01, 1.79) and AR in 2018-2020 study (OR = 1.46, 95% CI = 1.01, 2.10). Pooled effects showed OR of 1.34 (95% CI = 1.01, 1.79) for AD and 1.47 (95% CI = 1.01, 2.12) for allergic multimorbidity. The association with allergic multimorbidity was greater in boys (OR = 1.88, 95% CI = 1.01, 3.49) than in girls (OR = 1.25, 95% CI = 0.73, 2.14). These results suggest that environmental mercury exposure may exacerbate symptoms of atopic dermatitis and allergic multimorbidity in children.

The effects of cool roofs on health, environmental, and economic outcomes in rural Africa: study protocol for a community-based cluster randomized controlled trial

BACKGROUND

High ambient air temperatures in Africa pose significant health and behavioral challenges in populations with limited access to cooling adaptations. The built environment can exacerbate heat exposure, making passive home cooling adaptations a potential method for protecting occupants against indoor heat exposure.

METHODS

We are conducting a 2-year community-based stratified cluster randomized controlled trial (cRCT) implementing sunlight-reflecting roof coatings, known as "cool roofs," as a climate change adaptation intervention for passive indoor home cooling. Our primary research objective is to investigate the effects of cool roofs on health, indoor climate, economic, and behavioral outcomes in rural Burkina Faso. This cRCT is nested in the Nouna Health and Demographic Surveillance System (HDSS), a population-based dynamic cohort study of all people living in a geographically contiguous area covering 59 villages, 14305 households and 28610 individuals. We recruited 1200 participants, one woman and one man, each in 600 households in 25 villages in the Nouna HDSS. We stratified our sample by (i) village and (ii) two prevalent roof types in this area of Burkina Faso: mud brick and tin. We randomized the same number of people (12) and homes (6) in each stratum 1:1 to receiving vs. not receiving the cool roof. We are collecting outcome data on one primary endpoint - heart rate, (a measure of heat stress) and 22 secondary outcomes encompassing indoor climate parameters, blood pressure, body temperature, heat-related outcomes, blood glucose, sleep, cognition, mental health, health facility utilization, economic and productivity outcomes, mosquito count, life satisfaction, gender-based violence, and food consumption. We followed all participants for 2 years, conducting monthly home visits to collect objective and subjective outcomes. Approximately 12% of participants (n = 152) used smartwatches to continuously measure endpoints including heart rate, sleep and activity.

DISCUSSION

Our study demonstrates the potential of large-scale cRCTs to evaluate novel climate change adaptation interventions and provide evidence supporting investments in heat resilience in sub-Saharan Africa. By conducting this research, we will contribute to better policies and interventions to help climate-vulnerable populations ward off the detrimental effects of extreme indoor heat on health.

TRIAL REGISTRATION

German Clinical Trials Register (DRKS) DRKS00023207. Registered on April 19, 2021.

Locally acquired strongyloidiasis in remote Australia: why are there still cases?

In Australia, strongyloidiasis primarily affects returned travellers, Vietnam veterans and refugees or asylum seekers, and First Nations people. Non-overseas acquired cases are seen almost exclusively in Australian First Nations remote communities. Australian First Nations communities have one of the highest rates of strongyloidiasis in the world. Our work has shown that strongyloidiasis is a disease of poverty. Acknowledging this is important-we need to shift the lens to socioeconomic factors, particularly environmental health hardware such as working toilets and sewerage systems, showers and laundries, and effective wastewater and rubbish removal. The rates of strongyloidiasis in First Nations communities is a result of decades of inadequate, poorly constructed and/or poorly maintained housing, and poor environmental health hardware (hereafter hardware). The solution lies in adequate funding, resulting in well designed and maintained housing and appropriate hardware. Governments need to allow First Nations communities themselves to take the lead role in funding allocation, and design, construction and maintenance of their housing and hardware. This will ensure housing and hardware fulfils cultural and physical needs and desires, and protects health. Improving housing and hardware will also improve other health outcomes. This article is part of the Theo Murphy meeting issue 'Strongyloides: omics to worm-free populations'.

[Current major public health challenges]

After COVID-19 pandemic, there are still many public health challenges in the world. The double burden of communicable and non-communicable diseases is still heavy in many countries. Mental health and injury are crucial public health problems which are often neglected. Environmental health and food and drug safety are closely related to human health, to which further management and intervention are needed. These problems have different impacts on people at different life stages, resulting in health problems throughout the life course. The current status of public health is far from the requirements set by the Sustainable Development Goals of United Nations or the initiative of "Healthy China 2030". It is necessary for governments and related departments of all countries to consider public health in all policy development to tackle the major challenge to public health.

Microplastic pollution and heavy metal risk assessment in Perca fluviatilis from Anzali wetland: Implications for environmental health and human consumption

The worldwide increase of anthropogenic contaminants in aquatic ecosystems has raised concerns, particularly heavy metals and microplastics (MPs), posing potential health risks for aquatic organisms. Therefore, this study aimed to investigate the presence of heavy metals (Cu, Ni, Pb, Cd, Hg, Zn, Mn, As, V, Co, Cr, Fe, and Se) and MPs in the muscle, liver, and gills of Perca fluviatilis Linnaeus 1758 from Anzali Wetland during the autumn-winter 2021 and spring-summer 2022 periods. The mean concentration of metals in the muscle was lower than that in the liver and gills. The highest level of metal in the liver, gills, and muscle was related to Fe (4.049 ± 1.192, 3.605 ± 0.878, and 3.459 ± 0.895 μg/g, respectively), while the lowest concentration in the muscle was related to Co (0.011 ± 0.004 μg/g), and in the liver and gills was related to Se (0.013 ± 0.004 and 0.012 ± 0.003 μg/g, respectively) and As (0.013 ± 0.004 and 0.012 ± 0.004 μg/g, respectively). The concentration of metals in summer was higher than in other seasons. The Hazard Index (HI) and Target Hazard Quotient (THQ) values below 1 indicate that consuming this fish does not pose any risk to consumers in terms of metal contamination. Moreover, MPs were identified in the gills of all fish, while no MPs were found in the muscle and liver. The mean number of MPs in the gills was 3.5 ± 1.02 item/individual, and the number of MPs in spring (4.6 ± 0.84 item/individual) was higher than in autumn, winter and summer (4.2 ± 1.22, 3 ± 1.63, and 2.4 ± 0.51 item/individual, respectively). The MPs were dominated by fiber in shape, black in color, 300-1000 μm in size, and nylon in polymer. No significant correlation was found between metal concentrations and MPs, except for Co.

Decoding the effect of demographic factors on environmental health based on city-level PM2.5 pollution in China

Although considerable health effects are gained from air quality improvement action plans implemented in China recently, they may have been amplified or offset due to the complexity and uncertainty of the changing demographic factors. In this study, we developed a framework for analyzing the effects of demographic factors on environmental health effects, focusing on three aspects: population scale, age structure, and spatial distribution. We quantified the above three effects by investigating how the health endpoint changed by the three demographic factors, based on a strategy of counterfactual and step-by-step relaxing hypothesis. We found that the increasing population scale and population aging caused 44,279 to 292,442 premature deaths, which offset the health effect of air quality improvement efforts for China. The change in population spatial distribution, in general, has little impact on the health effects of air quality improvement. Furthermore, the three effects are distributed unevenly across regions, especially the spatial distribution effect. Considering the widespread effect of demographic factors, PM2.5 concentration should be further reduced, and the aged population and mega-cities should be targeted for managing air quality in a cost-effective manner.

[Environmental risks and health literacy: a systematic review]

BACKGROUND

Environmental factors can play an important role in pathogenesis. However, the understanding of the relationship between environmental risks and health in the general population appears to be poor. The aim of this systematic review is to describe the state of research on the relationship between health literacy (HL) or environmental health literacy (EHL) and environmental risks differentiated by the researched environmental risks, the affected population, the measurement and level of HL or EHL, and their interaction with other variables.

METHODS

A systematic literature search was conducted using the Pubmed, Scopus, and LIVIVO databases. Original studies in German or English that investigated HL or EHL in the context of an environmental risk or pollutant in a population were included. The Navigation Guide was used to assess the methodological quality of the studies.

RESULTS

Twenty-four studies were included in the qualitative analysis. The operationalization of HL or EHL was heterogeneous in 22 studies. Nine studies referred to environmental issues in general, and 15 studies analyzed individual environmental risks. Eleven studies referred to the general population, 12 to specified target groups, and 1 study examined both. The level of HL or EHL proved to be in need of improvement in all populations. Interventions such as trainings were able to increase HL or EHL.

DISCUSSION

The heterogeneous operationalizations impede the comparability of the studies. Future work should target the standardization of methodological aspects. Overall, it appears that interventions such as trainings were conducive to improving HL or EHL. In practice, this should therefore be given greater focus in order to increase HL or EHL.

Alternative methods go green! Green toxicology as a sustainable approach for assessing chemical safety and designing safer chemicals

Green toxicology is marching chemistry into the 21st century. This emerging framework will transform how chemical safety is evaluated by incorporating evaluation of the hazards, exposures, and risks associated with chemicals into early product development in a way that minimizes adverse impacts on human and environmental health. The goal is to minimize toxic threats across entire supply chains through smarter designs and policies. Traditional animal testing methods are replaced by faster, cutting-edge innovations like organs-on-chips and artificial intelligence predictive models that are also more cost-effective. Core principles of green toxicology include utilizing alternative test methods, applying the precautionary principle, considering lifetime impacts, and emphasizing risk prevention over reaction. This paper provides an overview of these foundational concepts and describes current initiatives and future opportunities to advance the adoption of green toxicology approaches. Chal-lenges and limitations are also discussed. Green shoots are emerging with governments offering carrots like the European Green Deal to nudge industry. Noteworthy, animal rights and environ-mental groups have different ideas about the needs for testing and their consequences for animal use. Green toxicology represents the way forward to support both these societal needs with sufficient throughput and human relevance for hazard information and minimal animal suffering. Green toxi-cology thus sets the stage to synergize human health and ecological values. Overall, the integration of green chemistry and toxicology has potential to profoundly shift how chemical risks are evaluated and managed to achieve safety goals in a more ethical, ecologically-conscious manner.

Revisiting the porter hypothesis within the economy-environment-health framework: Empirical analysis from a multidimensional perspective

The question of whether environmental regulation fosters technological innovation and green development, as a nuanced extension of the Porter hypothesis, constitutes a focal point in contemporary research. Despite this attention, the literature often omits a multifaceted evaluation framework for green development and fails to consider multiaspectual environmental regulation and technological innovation. This study develops a comprehensive model of green total factor productivity (GTFP), situating the Chinese economy within an economy-environment-health nexus. The extended Crépon-Dugeut-Mairesse model is employed to revisit the "strong", "weak", and "narrow" Porter hypotheses. The analysis reveals that formal environmental regulation exerts a crowding-out effect on research and development (R&D), whereas informal environmental regulation exhibits a facilitating effect, corroborating the narrow version of the Porter hypothesis. Both categories of regulation contribute to substantial innovation. Following the incorporation of R&D factors, heterogeneity in the "weak" Porter hypothesis emerges in the Chinese context, contingent upon specific types of environmental regulation and technological innovation. Environmental regulation positively influences GTFP, affirming the "strong" Porter hypothesis, primarily through the vector of technical progress change. A developmental trajectory to enhance GTFP is thus articulated: judicious environmental regulation leads to R&D, which in turn fosters innovation quality, subsequently affecting the technical progress change index and ultimately GTFP. Correspondingly, policy recommendations are delineated across three dimensions: judicious environmental regulation, targeted innovation support, and regional coordination.