Exposure to Per- and Polyfluoroalkyl Substances and Timing of Puberty in Norwegian Boys: Data from the Bergen Growth Study 2.

Per- and polyfluoroalkyl substances (PFAS) are widespread environmental contaminants with endocrine-disruptive properties. Their impact on puberty in boys is unclear. In this cross-sectional study, we investigated the association between PFAS exposure and pubertal timing in 300 Norwegian boys (9-16 years), enrolled in the Bergen Growth Study 2 during 2016. We measured 19 PFAS in serum samples and used objective pubertal markers, including ultrasound-measured testicular volume (USTV), Tanner staging of pubic hair development, and serum levels of testosterone, luteinizing hormone, and follicle-stimulating hormone. In addition to logistic regression of single pollutants and the sum of PFAS, Bayesian and elastic net regression were used to estimate the contribution of the individual PFAS. Higher levels of the sum of perfluorooctanesulfonic acid (PFOS), perfluorooctanoic acid (PFOA), perfluorononanoic acid (PFNA), and perfluorohexanesulfonic acid (PFHxS) were associated with later pubertal onset according to USTV (age-adjusted odds ratio (AOR): 2.20, 95% confidence interval (CI): 1.29, 3.93) and testosterone level (AOR: 2.35, 95% CI: 1.34, 4.36). Bayesian modeling showed that higher levels of PFNA and PFHxS were associated with later pubertal onset by USTV, while higher levels of PFNA and perfluoroundecanoic acid (PFUnDA) were associated with later pubertal onset by testosterone level. Our findings indicate that certain PFAS were associated with delay in male pubertal onset.

[Care, nature and heritage: shared care practices and thinking]. / Soins, nature et patrimoine : pratiques et pensées d'un soin partagé.

Essentially based on the domination of nature, Western progress has proved as much a source of material comfort and increased life expectancy as it has been destructive and unequal. Ecological collapse and health challenges compel us to mobilize more holistic approaches to care, integrating patients and caregivers, nature and the environment as partners. As a shared function, care can be understood as a founding democratic principle.

Climate Change Projections for Stroke Incidence in Taiwan: Impact of 2 °C and 4 °C Global Warming Level.

OBJECTIVES: This study aimed to establish the exposure-lag-response effect between daily maximum temperature and stroke-related emergency department visits and to project heat-induced stroke impacts under global warming levels (GWL) of 2 °C and 4 °C. METHODS: Stroke-related emergency department visits in Taiwan from 2001 to 2020 were identified using the National Health Insurance Research Database (NHIRD). The study population consisted of 1,100,074 initial stroke cases matched with 2,200,148 non-stroke controls. We employed Distributed Lag Nonlinear Models (DLNM) in a case-crossover study to investigate the association between temperature and stroke. Generalized Estimating Equations (GEE) models with a Poisson function were used to correlate high-temperature exposure with annual stroke incidence rates. Projections were made under two global warming scenarios, GWL 2.0 °C and 4.0 °C, using Coupled General Circulation Model (GCMs). Baseline data from 1995 to 2014 were transformed for spatial distribution at the township level. Geographic Information System (GIS) spatial analysis was performed using Quantum GIS 3.2.0 software. RESULTS: DLNM exposure-lag-response effect revealed that daily maximum temperature exceeding 34 °C significantly increased the risk of stroke-related emergency department visits, particularly for ischemic stroke. Under the 2 °C GWL scenario, the frequency of days with temperatures surpassing 34 °C is projected to rise substantially by the median year of 2042, with a further increase to 92.6 ± 18.0 days/year by 2065 under the 4 °C GWL scenario. Ischemic stroke showed the highest increase in temperature-related incidence rates, notably rising from 7.80% under the GWL 2 °C to 36.06% under the GWL 4 °C. Specifically, the annual temperature-related incidence rate for ischemic stroke is expected to increase significantly by 2065. Regions such as Taichung, Hsinchu, Yilan, and Taitung demonstrated pronounced changes in heat-related ischemic stroke incidence under the GWL 4 °C. CONCLUSIONS: The findings emphasize the importance of addressing temperature-related stroke risks, particularly in regions projected to experience significant temperature increases. Effective mitigation strategies are crucial to reduce the impact of rising temperatures on stroke incidence and safeguard public health.

Quantifying China's iron and steel industry's CO2 emissions and environmental health burdens: A pathway to sustainable transformation.

Assessing the iron and steel industry's (ISI) impact on climate change and environmental health is vital, particularly in China, where this sector significantly influences air quality and CO2 emissions. There is a lack of comprehensive analyses that consider the environmental and health burdens of manufacturing processes for ISI enterprises. Here, we present an integrated emission inventory that encompasses air pollutants and CO2 emissions from 811 ISI enterprises and five key manufacturing processes in 2020. Our analysis shows that sintering is the primary source of air pollution in the ISI. It contributes 71% of SO2, 73% of NO x , and 54% of PM2.5 emissions. On the other hand, 81% of total CO2 emissions come from blast furnaces. Significantly, the contributions of ISI have resulted in an increase of 3.6 µg m-3 in national population-weighted PM2.5 concentration, causing approximately 59,035 premature deaths in 2020. Emissions from Hebei, Jiangsu, Shandong, Shanxi, and Inner Mongolia provinces contributed to 48% of PM2.5-related deaths in China. Moreover, the transportation of air pollutants across provincial borders highlights a concerning trend of environmental health inequality. Based on the research findings, it is crucial for ISI manufacturers to prioritize the removal of outdated production capacities and adopt energy-efficient and advanced techniques, along with ultra-low emission technologies. This is particularly important for those manufacturers with substantial environmental footprints. These transformative actions are essential in mitigating the environmental and health impacts in the affected regions.

Socioeconomic Inequalities in the External Exposome in European Cohorts: The EXPANSE Project.

Socioeconomic inequalities in the exposome have been found to be complex and highly context-specific, but studies have not been conducted in large population-wide cohorts from multiple countries. This study aims to examine the external exposome, encompassing individual and environmental factors influencing health over the life course, and to perform dimension reduction to derive interpretable characterization of the external exposome for multicountry epidemiological studies. Analyzing data from over 25 million individuals across seven European countries including 12 administrative and traditional cohorts, we utilized domain-specific principal component analysis (PCA) to define the external exposome, focusing on air pollution, the built environment, and air temperature. We conducted linear regression to estimate the association between individual- and area-level socioeconomic position and each domain of the external exposome. Consistent exposure patterns were observed within countries, indicating the representativeness of traditional cohorts for air pollution and the built environment. However, cohorts with limited geographical coverage and Southern European countries displayed lower temperature variability, especially in the cold season, compared to Northern European countries and cohorts including a wide range of urban and rural areas. The individual- and area-level socioeconomic determinants (i.e., education, income, and unemployment rate) of the urban exposome exhibited significant variability across the European region, with area-level indicators showing stronger associations than individual variables. While the PCA approach facilitated common interpretations of the external exposome for air pollution and the built environment, it was less effective for air temperature. The diverse socioeconomic determinants suggest regional variations in environmental health inequities, emphasizing the need for targeted interventions across European countries.

The urban air quality nexus: Assessing the interplay of land cover change and air pollution in emerging South Asian cities.

Air quality degradation presents a significant public health challenge, particularly in rapidly urbanizing regions where changes in land use/land cover (LULC) can dramatically influence pollution levels. This study investigates the association between LULC changes and air pollution (AP) in the five fastest-growing cities of Bangladesh from 1998 to 2021. Leveraging satellite data from Landsat and Sentinel-5P, the analysis reveals a substantial increase in urban areas and sparse vegetation, with declines in dense vegetation and water bodies over this period. Urban expansion was most pronounced in Sylhet (22-254%), while Khulna experienced the largest increase in sparse vegetation (2-124%). Dense vegetation loss was highest in Dhaka (20-77%) and water bodies (9-59%) over this period. Concentrations of six major air pollutants (APTs) - aerosol index, CO, HCHO, NO2, O3, and SO2 - were quantified, showing alarmingly high levels in densely populated industrial and commercial zones. Pearson's correlation indicates strong positive associations between APTs and urban land indices (R>0.8), while negative correlations exist with vegetation indices. Geographically weighted regression modeling identifies city centers with dense urban built-up as pollution hotspots, where APTs exhibited stronger impacts on land cover changes (R2 > 0.8) compared to other land classes. The highest daily emissions were observed for O3 (1031 tons) and CO (356 tons) at Chittagong in 2021. In contrast, areas with substantial green cover displayed weaker pollutant-land cover associations. These findings underscore how unplanned urbanization drives AP by replacing natural land cover with emission sources, providing crucial insights to guide sustainable urban planning strategies integrating pollution mitigation and environmental resilience.

Pathways to strengthen the climate resilience of health systems in the Peruvian Amazon by working with Indigenous leaders, communities and health officers.

BACKGROUND: Indigenous knowledge and responses were implemented during the COVID-19 pandemic to protect health, showcasing how Indigenous communities participation in health systems could be a pathway to increase resilience to emergent hazards like climate change. This study aimed to inform efforts to enhance climate change resilience in a health context by: (1) examining if and how adaptation to climate change is taking place within health systems in the Peruvian Amazon, (2) understanding how Indigenous communities and leaders' responses to climatic hazards are being articulated within the official health system and (3) to provide recommendations to increase the climate change resilience of Amazon health systems. METHODS: This study was conducted among two Peruvian Amazon healthcare networks in Junin and Loreto regions. A mixed methodology design was performed using a cross-sectional survey (13 healthcare facilities), semistructured interviews (27 official health system participants and 17 Indigenous participants) and two in-person workshops to validate and select key priorities (32 participants). We used a climate-resilient health system framework linked to the WHO health systems building blocks. RESULTS: Indigenous and official health systems in the Peruvian Amazon are adapting to climate change. Indigenous responses included the use of Indigenous knowledge on weather variability, vegetal medicine to manage health risks and networks to share food and resources. Official health responses included strategies for climate change and response platforms that acted mainly after the occurrence of climate hazards. Key pathways to articulate Indigenous and official health systems encompass incorporating Indigenous representations in climate and health governance, training the health work force, improving service delivery and access, strengthening the evidence to support Indigenous responses and increasing the budget for climate emergency responses. CONCLUSIONS: Key resilience pathways call for a broader paradigm shift in health systems that recognises Indigenous resilience as valuable for health adaptation, moves towards a more participatory health system and broadens the vision of health as a dimension inherently tied to the environment.

Redlining in New York City: impacts on particulate matter exposure during pregnancy and birth outcomes.

BACKGROUND: Evidence suggests historical redlining shaped the built environment and health outcomes in urban areas. Only a handful of studies have examined redlining's association with air pollution and adverse birth outcomes in New York City (NYC). Additionally, no NYC-specific studies have examined the impact of redlining on birth weight. METHODS: This longitudinal cohort study analysed data from the National Institute of Health Environmental Influences on Child Health Outcomes Programme to investigate the extent to which maternal residence in a historically redlined neighbourhood is associated with fine particulate matter (PM2.5) exposure during pregnancy using multivariable regression models. Additionally, we examined how maternal residence in a historically redlined neighbourhood during pregnancy influenced birth weight z-score, preterm birth and low birth weight. RESULTS: Our air pollution model showed that living in a historically redlined census tract or an ungraded census tract was associated with increased PM2.5 exposure during pregnancy. We also found living in a historically redlined census tract or an ungraded census tract was associated with a lower birth weight z-score. This finding remained significant when controlling for individual and census tract-level race, ethnicity and income. When we controlled PM2.5 in our models assessing the relationship between redlining grade and birth outcome, our results did not change. DISCUSSION: Our study supports the literature linking redlining to contemporary outcomes. However, our research in ungraded tracts suggests redlining alone is insufficient to fully explain inequality in birth outcomes and PM2.5 levels today.

Pan American climate resilient health systems: a training course for health professionals.

Objectives: To describe the development, implementation, and results of a training course designed to equip health professionals from the Pan American Health Organization region with the knowledge and tools needed to adapt health systems to current climate realities. Methods: The Pan American climate resilient health systems course was a 9-week live-virtual course in March-April 2023, which was delivered through Zoom and offered in English, Spanish, and French. All lectures were delivered by local and regional climate and health experts. The curricular foundation of this initiative was the Global Consortium on Climate and Health Education core competencies for health professionals. Participants completed pre- and post-course surveys. Results: A total of 1212 participants attended at least one of the nine sessions and 489 (from 66 countries) attended at least six sessions. Of these, 291 participants completed both the pre- and post-course surveys which were used in the analysis. Longitudinal survey results suggested an improvement in participants' climate and health communication, an increased frequency of incorporating climate knowledge in professional practice, and improved confidence in engaging in climate initiatives. At the same time, many participants expressed a need for additional training. Conclusions: The results indicate that live-virtual courses have the potential to empower health professionals to contribute to climate resilience efforts by: increasing their communication skills; changing their professional practice; increasing their ability to lead climate and health activities; and preparing them to assess vulnerability and adaptation in health systems, measure and monitor environmental sustainability, and apply a health equity lens.

A Nationwide Survey Following the Devastating 2022 Floods in Pakistan: Current State of Knowledge, Attitude, and Perception Toward Climate Change and Its Health Consequences.

BACKGROUND:  Climate change (CC) persists as a critical public health concern, vividly demonstrated by Pakistan's severe unprecedented flooding from June to October 2022. The interplay between floods and CC highlights the urgent need to comprehend their complex dynamics. Given Pakistan's significant geographical vulnerability to CC events, assessing public awareness of CC becomes essential. This study aims to evaluate public knowledge, attitudes, and perception (KAP) regarding CC and its implications for overall health, reflecting onto governmental policies and community-based guidelines and enhancing preparedness for future natural calamities of similar magnitude. METHODS:  A nationwide cross-sectional survey of Pakistani adults covering all provinces of the country was conducted from January to March 2023 using a prevalidated questionnaire. A purposive sampling strategy was used to enroll participants in the study. Where appropriate, the chi-square test or Fisher's exact test was used to compare KAP among the sociodemographic groups. Multivariate analysis was used to explore predictors of knowledge. Crude and adjusted odds ratios (ORs) were calculated considering a p value of ≤0.05 as significant. RESULTS:  Among the 714 respondents, 265 (37.1%) of the respondents' residential areas were affected by the floods in Pakistan. A total of 663 (92.9%) of the participants had heard of CC, with 302 (42.3%) choosing "social media/WhatsApp" as their source of information. Increased flooding and changes in rainfall patterns were selected by 679 (95.1%) and 661 (92.6%) participants, respectively, as the most recognized CC. "Deforestation" was the most indicated reason for CC by 675 (94.5%) participants. Multivariate analysis revealed that females (OR: 1.31, 95% CI: 1.16-2.00; p < 0.001), individuals who were affected by recent floods (OR: 1.13, 95% CI: 1.05-3.34; p = 0.003), and individuals who were medical students/healthcare workers (OR: 1.49, 95% CI: 1.24-2.48; p < 0.001) had greater knowledge of CC than their counterparts. CONCLUSIONS:  The study reported an encouraging prevalence of knowledge of CC, positive attitudes, and practices toward CC, with an interest in learning and doing more to address the health effects of CC. With the ongoing global CC and a monsoon season forecast of similar intensity for the years to come in Pakistan, identifying groups with less knowledge of CC warrants a targeted education program to maximize awareness. Based on the study findings, social media platforms and interventions in educational institutes should be essential to mitigate the CC events in Pakistan and other vulnerable regions in the area.

Analyzing the impact of heavy metal exposure on osteoarthritis and rheumatoid arthritis: an approach based on interpretable machine learning.

Introduction: This investigation leverages advanced machine learning (ML) techniques to dissect the complex relationship between heavy metal exposure and its impacts on osteoarthritis (OA) and rheumatoid arthritis (RA). Utilizing a comprehensive dataset from the National Health and Nutrition Examination Survey (NHANES) spanning from 2003 to 2020, this study aims to elucidate the roles specific heavy metals play in the incidence and differentiation of OA and RA. Methods: Employing a phased ML strategy that encompasses a range of methodologies, including LASSO regression and SHapley Additive exPlanations (SHAP), our analytical framework integrates demographic, laboratory, and questionnaire data. Thirteen distinct ML models were applied across seven methodologies to enhance the predictability and interpretability of clinical outcomes. Each phase of model development was meticulously designed to progressively refine the algorithm's performance. Results: The results reveal significant associations between certain heavy metals and an increased risk of arthritis. The phased ML approach enabled the precise identification of key predictors and their contributions to disease outcomes. Discussion: These findings offer new insights into potential pathways for early detection, prevention, and management strategies for arthritis associated with environmental exposures. By improving the interpretability of ML models, this research provides a potent tool for clinicians and researchers, facilitating a deeper understanding of the environmental determinants of arthritis.

Impact of various microplastics on the morphological characteristics and nutrition of the young generation of beech (Fagus sylvatica L.).

Microplastics have the capacity to accumulate in soil due to their high resistance to degradation, consequently altering soil properties and influencing plant growth. This study focused on assessing the impact of various types and doses of microplastics on beech seedling growth. In our experiment, we used polypropylene and styrene granules with diameter of 4.0 mm in quantities of 2.5% and 7%. The hypothesis was that microplastics significantly affect seedlings' nutritional status and growth characteristics. The research analysed seedlings' nutrition, root morphological features, above-ground growth, and enzymatic activity in the substrate. Results confirmed the importance of microplastics in shaping the nutritional status of young beech trees. Microplastic type significantly impacted N/P and Ca/Mg stoichiometry, while microplastic quantity influenced Ca/Al and Ca+K+Mg/Al stoichiometry. Notably, only in the case of root diameter were significantly thicker roots noted in the control variant, whereas microplastics played a role in shaping the leaves' characteristics of the species studied. The leaf area was significantly larger in the control variant compared to the variant with polypropylene in the amount of 2.5% and styrene in the amount of 7%. Additionally, the study indicates a significant impact of microplastics on enzyme activity. In the case of CB and SP, the activity was twice as high in the control variant compared to the variants with microplastics. In the case of BG, the activity in the control variant was higher in relation to the variants used in the experiment. Research on the impact of microplastics on the growth of beech seedlings is crucial for enhancing our understanding of the effects of environmental pollution on forest ecosystems. Such studies are integral in shaping forestry management practices and fostering a broader public understanding of the ecological implications of plastic pollution.

Environmental impact of infant feeding type, accessories used and maternal dietary habits: The GREEN MOTHER-I project, a cross-sectional study protocol.

INTRODUCTION: Breastfeeding (BF) is the healthiest form of nutrition for babies and is recommended exclusively (EBF) for at least the first six months of life. The carbon footprint of formula feeding (FF) has been studied, but that of BF is unknown. AIM: To identify the environmental impact of three types of infant feeding taking into account the accessories needed and the diet of postpartum women in the baby's first month of life. METHODS: This is a multicentre, cross-sectional study conducted in the Barcelona North Metropolitan Area (Catalonia, Spain). The participating sites are primary care settings that will recruit 408 postpartum women (4-6 weeks) as per inclusion/exclusion criteria. The data will be collected through a GREEN MOTHER Survey that includes 4 dimensions: 1) socio-demographic and clinical data; 2) data on the newborn and accessories used in infant feeding; 3) general data on the mother's diet (food consumption habits), and 4) recording of 24 h of the mother's diet. The data analysis will be performed to check the prevalence of infant feeding types at birth and month 1, as well as a comparative analysis of three types of infant feeding on environmental impact (climate change; water consumption, and scarcity). ETHICS: This project was approved by the Research Ethics Committee of the Jordi Gol i Gurina University Institute Foundation for Primary Health Care Research (IDIAP) under code 22/101-P dated 22/02/2023. DISCUSSION: A second phase of the GREEN MOTHER study is planned, which will consist of an educational intervention to promote breastfeeding, nutrition and sustainability. This intervention will be based on the results obtained in Phase I. We expect that the project results - through the publication and dissemination of scientific papers and reports among relevant stakeholders (association of community midwives, healthcare and primary care attention professionals and the public) - will increase public awareness of breastfeeding and its impact on sustainability. TRIAL REGISTRATION: Both phases of the GREEN MOTHER study protocol were registered in ClinicalTrials.gov, NCT05729581.

Environmental impact of single-use versus reusable gastroscopes.

INTRODUCTION: The environmental impact of endoscopy is a topic of growing interest. This study aimed to compare the carbon footprint of performing an esogastroduodenoscopy (EGD) with a reusable (RU) or with a single-use (SU) disposable gastroscope. METHODS: SU (Ambu aScope Gastro) and RU gastroscopes (Olympus, H190) were evaluated using life cycle assessment methodology (ISO 14040) including the manufacture, distribution, usage, reprocessing and disposal of the endoscope. Data were obtained from Edouard Herriot Hospital (Lyon, France) from April 2023 to February 2024. Primary outcome was the carbon footprint (measured in Kg CO2 equivalent) for both gastroscopes per examination. Secondary outcomes included other environmental impacts. A sensitivity analysis was performed to examine the impact of varying scenarios. RESULTS: Carbon footprint of SU and RU gastroscopes were 10.9 kg CO2 eq and 4.7 kg CO2 eq, respectively. The difference in carbon footprint equals one conventional car drive of 28 km or 6 days of CO2 emission of an average European household. Based on environmentally-extended input-output life cycle assessment, the estimated per-use carbon footprint of the endoscope stack and washer was 0.18 kg CO2 eq in SU strategy versus 0.56 kg CO2 eq in RU strategy. According to secondary outcomes, fossil eq depletion was 130 MJ (SU) and 60.9 MJ (RU) and water depletion for 6.2 m3 (SU) and 9.5 m3 (RU), respectively. CONCLUSION: For one examination, SU gastroscope have a 2.5 times higher carbon footprint than RU ones. These data will help with the logistics and planning of an endoscopic service in relation to other economic and environmental factors.

Awareness and perceptions of contaminants in the Dehcho and sahtú regions of the Northwest Territories.

The development and dissemination of health messaging is a critical component of reducing health disparities. Participants (n = 87) from a human biomonitoring study in six Dene communities responded to a survey about health communication regarding contaminants. The survey included questions on awareness of health messages and risk perceptions related to country foods and contaminants. The vast majority of participants reported eating country foods (99%) and heard that country foods had beneficial nutrients (90%). Seventy per cent of respondents had heard or seen messages about fish with high levels of mercury, and 60% had concerns about the safety or quality of country foods they consumed. Respondents who reported decreasing the number of fish they ate since hearing the messages about fish and mercury had lower (p = 0.04) mercury concentration in hair, compared to those who had not heard the messages. However, no differences in hair mercury were observed for respondents who reported to have changed their fishing location, chosen smaller fish or eaten less predatory fish since hearing the messages. Results indicate the need to examine reasons for self-reported behaviour changes, in addition to awareness. The conclusions of this study can inform the development of messaging and risk management decisions about contaminants within Indigenous populations.

Higher ultraviolet light exposure is associated with lower mortality: An analysis of data from the UK biobank cohort study.

We aimed to examine associations between ultraviolet (UV) exposure and mortality among older adults in the United Kingdom (UK). We used data from UK Biobank participants with two UV exposures, validated with measured vitamin D levels: solarium use and annual average residential shortwave radiation. Associations between the UV exposures, all-cause and cause-specific mortality were examined as adjusted hazard ratios. The UV exposures were inversely associated with all-cause, cardiovascular disease (CVD) and cancer mortality. Solarium users were also at a lower risk of non-CVD/non-cancer mortality. The benefits of UV exposure may outweigh the risks in low-sunlight countries.

Changes in Nutritional Habits and Lifestyles Associated With COVID-19 in Jazan, Saudi Arabia: A 2022 Cross-Sectional Survey.

BACKGROUND: The COVID-19 pandemic impacted dietary habits and physical activity patterns, with some long-term consequences. This study evaluated the effects of the pandemic on adults' dietary habits and physical activity in Jazan and compared them to pre-pandemic. METHODS: An analytical cross-sectional survey was conducted among conveniently selected 559 individuals in Jazan, Saudi Arabia, in February 2022 using a validated online questionnaire. Data was collected to assess changes in eating habits, food intake, and weight before and 21 months after lifting of COVID-19 curfew restrictions in the region. Chi-square and McNemar's tests were used for analysis. RESULTS: The proportion of individuals consuming homemade meals decreased from 50.6% (n=283) before the pandemic to 46.5% (n=260) during the pandemic, while the proportion of participants consuming less than three meals per day increased from 42.2% (n=236) to 45.4% (n=254), and breakfast consumption decreased significantly from 58.1% (n=325) to 53.5% (n=299) (p = 0.033). There was an increase in the consumption of fast food from 10.7% (n=60) to 12.0% (n=67) and dining at restaurants from 18.4% (n=103) to 19.3% (n=108); however, these increases were not statistically significant compared to pre-pandemic rates. During the pre-COVID-19 period, 46.9% (n=262) reported engaging in physical activity one to three times a week, whereas this frequency decreased to 41.3% (n=231) during the pandemic (p = 0.017). In contrast, a significant increase was observed in the duration of computer usage as prior to the pandemic, 20.2% (n=113) reported spending more than five hours per day on the computer, while this proportion increased to 31.8% (n=178) during the pandemic (p < 0.001). Furthermore, a considerable proportion of both males and females, constituting over one-third (n=189) of the total sample, reported an increase in body weight. CONCLUSION: The findings suggest that the adult population in the Jazan region of Saudi Arabia experienced significant lifestyle changes during the COVID-19 pandemic, including altered dietary patterns and a significant decline in physical activity. To mitigate potential adverse effects on future well-being, it is crucial to implement enduring initiatives promoting healthy lifestyles.

Arsenic exposure and measures of glucose tolerance in Bangladeshi adults: A cross-sectional study.

Background: Arsenic has been associated with diabetes and impaired glucose tolerance in many studies, although some reports have shown null findings. Methods: We conducted a cross-sectional study among 300 adults in Bangladesh. Participants were randomly selected from a roster of 1800 people who previously participated in studies of arsenic and skin lesions. We measured fasting glucose and insulin levels. We assessed drinking water arsenic concentration using graphite furnace atomic absorption spectrophotometry (GF-AAS) and toenail arsenic concentration using inductively coupled mass spectrometry (ICP-MS). We ran covariant-adjusted, linear regression and spline models to examine associations of arsenic concentrations with the homeostatic model assessment of insulin resistance (HOMA-IR), a marker of insulin resistance, and HOMA of beta-cell function (HOMA-ß), a marker of beta-cell function. Results: Among 285 participants with complete data, the median (IQR) arsenic concentration was 4.0 (6.9) µg/g in toenails and 39.0 (188.5) µg/L in drinking water. Arsenic concentrations were not associated with insulin resistance or beta-cell function. HOMA-IR was 0.67% lower and HOMA-ß was 0.28% lower per µg/g increment in toenail arsenic, but these effect estimates were small, and confidence intervals crossed the null value. Conclusions: Although arsenic exposure has been associated with diabetes, we found no evidence of an adverse effect on insulin resistance or beta-cell function.

Multidimensional structural racism and estimated cancer risk from traffic-related air pollution.

BACKGROUND: Traffic-related air pollutants have been associated with a variety of adverse human health impacts, including cancers. In the United States, numerous studies have documented racial inequities in neighborhood exposures to traffic-related air pollution. Emerging evidence suggests that structural racism may influence neighborhood exposures to air pollutants. However, existing research has largely focused on residential racial segregation, one indicator of structural racism. This study developed a multidimensional measure of structural racism to examine the relationship between structural racism and estimated cancer risk from air pollutants in Georgia. METHODS: Carcinogenic air toxics data were obtained from the US Environmental Protection Agency's 2019 Air Toxics Screening Assessment and sociodemographic data from the American Community Survey. Guided by stakeholder input, county-level data on residential segregation, education, employment, incarceration, economic status, political participation, and homeownership were used to create a multidimensional county-level structural racism index. Relative risks (RRs) were estimated for associations between structural racism and elevated (top 10% in Georgia) estimated cancer risk from air toxics. RESULTS: Multilevel analyses revealed a significant association between multidimensional structural racism and exposure to carcinogenic traffic-related air pollutants. Neighborhoods in the highest quartile of structural racism exhibited an elevated cancer risk from traffic-related air pollutants (RR, 7.84; 95% CI, 5.11-12.05) compared to neighborhoods with lower levels of structural racism. CONCLUSIONS: Multidimensional structural racism was associated with estimated cancer risk from traffic-related air pollution in Georgia. Findings can inform future studies and policy interventions that address racial inequalities in exposure to traffic-related air pollution.

Modulatory Effects of Vitamin D: A Possible Approach to Mitigate Air Pollution Related Pregnancy Complications.

Approximately 99% of people on the planet breathe air that exceeds the World Health Organization's permitted threshold for pollution. South Asia is home to the world's most polluted cities. Population-based studies have suggested that women's reproductive health outcomes are worsening due to air pollution. Preeclampsia, miscarriage, gestational diabetes, high blood pressure, and unfavorable birth outcomes, including preterm birth, low birth weight, or even stillbirth are all linked to exposure to air pollution during pregnancy. It is estimated that 0.61 million deaths in India alone were related to indoor air pollution. Females frequently cook in the household using solid fuel as a primary combustion source. Women in the regions with the highest population density are disproportionately affected by high levels of poor-quality indoor air. Recently, it has been proposed that air pollution has a distinct role in the onset of vitamin D deficiency. Numerous studies have explored associations between low vitamin D level and various female reproductive health conditions since the discovery of the vitamin D receptor. It is worthy to note that some of these reproductive health conditions positively correlate with the severity of air pollution. In this study, the evidence has been synthesized on vitamin D's protective properties and dietary and pharmaceutical interventions have been discussed to show their beneficial effects in decreasing the long-term negative impacts of air pollution on women's health.