Projected impact of climate change on human health in low- and middle-income countries: a systematic review.

Low- and middle-income countries (LMICs) contribute relatively little to global carbon emissions but are recognised to be among the most vulnerable parts of the world to health-related consequences of climate change. To help inform resilient health systems and health policy strategies, we sought to systematically analyse published projections of the impact of rising global temperatures and other weather-related events on human health in LMICs. A systematic search involving multiple databases was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to identify studies with modelled projections of the future impact of climate change on human health. Qualitative studies, reviews and meta-analyses were excluded. The search yielded more than 2500 articles, of which 70 studies involving 37 countries met criteria for inclusion. China, Brazil and India were the most studied countries while the sub-Saharan African region was represented in only 9% of studies. Forty specific health outcomes were grouped into eight categories. Non-disease-specific temperature-related mortality was the most studied health outcome, followed by neglected tropical infections (predominantly dengue), malaria and cardiovascular diseases. Nearly all health outcomes studied were projected to increase in burden and/or experience a geographic shift in prevalence over the next century due to climate change. Progressively severe climate change scenarios were associated with worse health outcomes. Knowledge gaps identified in this analysis included insufficient studies of various high burden diseases, asymmetric distribution of studies across LMICs and limited use of some climate parameters as independent variables. Findings from this review could be the basis for future research to help inform climate mitigation and adaptation programmes aimed at safeguarding population health in LMICs.

Commentary: A road map for future data-driven urban planning and environmental health research.

Recent advances in data science and urban environmental health research utilise large-scale databases (100s-1000s of cities) to explore the complex interplay of urban characteristics such as city form and size, climate, mobility, exposure, and environmental health impacts. Cities are still hotspots of air pollution and noise, suffer urban heat island effects and lack of green space, which leads to disease and mortality burdens preventable with better knowledge. Better understanding through harmonising and analysing data in large numbers of cities is essential to identifying the most effective means of disease prevention and understanding context dependencies important for policy.

Aconitate decarboxylase 1 mediates the acute airway inflammatory response to environmental exposures.

Background: Environmental lipopolysaccharide (LPS) and microbial component-enriched organic dusts cause significant lung disease. These environmental exposures induce the recruitment and activation of distinct lung monocyte/macrophage subpopulations involved in disease pathogenesis. Aconitate decarboxylase 1 (Acod1) was one of the most upregulated genes following LPS (vs. saline) exposure of murine whole lungs with transcriptomic profiling of sorted lung monocyte/macrophage subpopulations also highlighting its significance. Given monocyte/macrophage activation can be tightly linked to metabolism, the objective of these studies was to determine the role of the immunometabolic regulator ACOD1 in environmental exposure-induced lung inflammation. Methods: Wild-type (WT) mice were intratracheally (i.t.) instilled with 10 µg of LPS or saline. Whole lungs were profiled using bulk RNA sequencing or sorted to isolate monocyte/macrophage subpopulations. Sorted subpopulations were then characterized transcriptomically using a NanoString innate immunity multiplex array 48 h post-exposure. Next, WT and Acod1-/- mice were instilled with LPS, 25% organic dust extract (ODE), or saline, whereupon serum, bronchoalveolar lavage fluid (BALF), and lung tissues were collected. BALF metabolites of the tricarboxylic acid (TCA) cycle were quantified by mass spectrometry. Cytokines/chemokines and tissue remodeling mediators were quantitated by ELISA. Lung immune cells were characterized by flow cytometry. Invasive lung function testing was performed 3 h post-LPS with WT and Acod1-/- mice. Results: Acod1-/- mice treated with LPS demonstrated decreased BALF levels of itaconate, TCA cycle reprogramming, decreased BALF neutrophils, increased lung CD4+ T cells, decreased BALF and lung levels of TNF-α, and decreased BALF CXCL1 compared to WT animals. In comparison, Acod1-/- mice treated with ODE demonstrated decreased serum pentraxin-2, BALF levels of itaconate, lung total cell, neutrophil, monocyte, and B-cell infiltrates with decreased BALF levels of TNF-α and IL-6 and decreased lung CXCL1 vs. WT animals. Mediators of tissue remodeling (TIMP1, MMP-8, MMP-9) were also decreased in the LPS-exposed Acod1-/- mice, with MMP-9 also reduced in ODE-exposed Acod1-/- mice. Lung function assessments demonstrated a blunted response to LPS-induced airway hyperresponsiveness in Acod1-/- animals. Conclusion: Acod1 is robustly upregulated in the lungs following LPS exposure and encodes a key immunometabolic regulator. ACOD1 mediates the proinflammatory response to acute inhaled environmental LPS and organic dust exposure-induced lung inflammation.

Developing a new tool to capture the nature dose to reduce loneliness and improve quality of life.

Recognition of the health benefits of nature contact has increased. Simultaneously, growing numbers of people worldwide experience loneliness. There is a movement towards prescribing nature-based activities to improve/promote social connections, health, and quality of life. Yet, what constitutes a therapeutic nature dose is not well understood, due in part, to the lack of instruments that capture the characteristics of nature-based activities and measure 'nature dose.' We created a nature dose measurement tool to fill this gap by capturing various aspects of contact with nature and perceptions regarding park access, quality, naturalness, psychological distance to nature, and biodiversity. This tool will facilitate greater understanding of how natural areas, nature-based activities, and nature exposure reduce loneliness and promote health-related quality of life. Measuring nature dose with standardized tools and documenting benefits will generate the evidence base needed to design, implement and evaluate nature-based social interventions for improving health and quality of life.•This tool captures the nature dose to reduce loneliness and promote quality of life.•Constructs range from park quality and access, to mood, to biodiversity perceptions.•The standardized nature dose tool will help design nature-based social interventions.

The One Health approach in urban ecosystem rehabilitation: An evidence-based framework for designing sustainable cities.

Rapid urbanization has led to negative, and sometimes unintended, consequences on biodiversity and human health. While cities offer numerous advantages in meeting the basic needs of a growing population, they also pose less apparent and longer-term health costs. To address the multifaceted impacts of urbanization, an evidence-based design framework for establishing mitigation and regeneration actions is essential. Via a "One Health" approach, this perspective provides recommendations and strategies for the urban ecosystem rehabilitation of future cities, placing biodiversity and ecosystem services at the core of designing healthy and sustainable urban spaces. The framework we propose is based on a Hub and Spoke model to integrate diverse perspectives from public and private sectors and declined in a six-building-blocks structure. This will ensure that efforts are sustainable, health-centered, socially inclusive, and grounded in high-quality data, reinforcing the essential connection between healthy environments and thriving communities.

Disaster management training for environmental health: A narrative literature review.

The growing frequency and severity of disasters worldwide have highlighted the need for environmental health practitioners to be equipped with specialised training to respond effectively to evolving public health contexts. Disasters can have long-lasting impacts on the environment and environmental health services, necessitating prompt and effective responses. However, the current environmental health workforce faces challenges in acquiring the necessary competencies to address environmental health threats during disasters. This narrative review synthesises existing literature on disaster management education for environmental health professionals, exploring current training, advancements and emerging trends. The review follows Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines and includes a total of 45 records that met inclusion criteria (compromising 15 peer-reviewed articles and 30 training records) published between 2002 and 2023. Findings highlight the expansion of environmental health degree programmes to include disaster management, better preparing newly qualified practitioners. However, a knowledge gap remains for previously qualified practitioners. High-income countries prioritising capacity building for environmental health practitioners in disaster management are better equipped to respond to and mitigate disasters. Contribution: The review suggests that with proper basic training for disaster responders, more lives can be saved during and after disasters. It highlights the insufficiency of current training programmes and emphasises the need for advanced role-specific training for environmental health practitioners. The review emphasises the need for advanced role-specific training, community assessment skills and focused disaster response strategies to enhance environmental health practitioners' ability to respond to disasters and improve public health resilience. Enhanced training, capacity building and collaboration are necessary to improve the competencies, skills and knowledge of environmental health practitioners in disaster risk management and public health emergencies.

An insight into impact of nanomaterials toxicity on human health.

In recent years, advances in nanotechnology have significantly influenced electronics manufacturing, industrial processes, and medical research. Various industries have seen a surge in the use of nanomaterials. However, several researchers have raised the alarm about the toxicological nature of nanomaterials, which appear to be quite different from their crude forms. This altered nature can be attributed to their unique physicochemical profile. They can adversely affect human health and the environment. Nanomaterials that have been released into the environment tend to accumulate over time and can cause a significant impact on the ecosystem and organisms with adverse health effects. Increased use of nanoparticles has led to increased human exposure in their daily lives, making them more vulnerable to nanoparticle toxicity. Because of their small size, nanomaterials can readily cross biological membranes and enter cells, tissues, and organs. Therefore, the effect of nanomaterials on the human environment is of particular concern. The toxicological effects of nanomaterials and their mechanisms of action are being researched worldwide. Technological advances also support monitoring new nanomaterials marketed for industrial and household purposes. It is a challenging area because of the exceptional physicochemical properties of nanomaterials. This updated review focuses on the diverse toxicological perspective of nanomaterials. We have discussed the use of different types of nanoparticles and their physiochemical properties responsible for toxicity, routes of exposure, bio-distribution, and mechanism of toxicity. The review also includes various in vivo and in vitro methods of assessing the toxicity of nanomaterials. Finally, this review will provide a detailed insight into nano material-induced toxicological response, which can be beneficial in designing safe and effective nanoparticles.

Machine learning-assisted laccase-like activity nanozyme for intelligently onsite real-time and dynamic analysis of pyrethroid pesticides.

The intelligently efficient, reliable, economical and portable onsite assay toward pyrethroid pesticides (PPs) residues is critical for food safety analysis and environmental pollution traceability. Here, a fluorescent nanozyme Cu-ATP@ [Ru(bpy)3]2+ with laccase-like activity was designed to develop a versatile machine learning-assisted colorimetric and fluorescence dual-modal assay for efficient onsite intelligent decision recognition and quantification of PPs residues. In the presence of alkaline phosphatase (ALP), the laccase-like activity of Cu-ATP@ [Ru(bpy)3]2+ was enhanced to oxidize colorless o-phenylenediamine (OPD) into dark-yellow 2,3-diaminophenazine (DAP) via electron transfer, appearing a new yellow fluorescence at 550 nm. Meanwhile, the red fluorescence of Cu-ATP@ [Ru(bpy)3]2+ at 600 nm was quenched due to the internal filter effect (IFE) of DAP towards Cu-ATP@ [Ru(bpy)3]2+. However, the selective inhibition of PPs toward ALP activity enabled to observe a dual-modal response of PPs concentration-dependent decrease in colorimetric signal and enhancement in the fluorescence intensity ratio of F600 nm/F550 nm. On this basis, both the colorimetric and fluorescence images were captured and processed with a home-made WeChat applet-installed smartphone to extract the corresponding image color information, thus achieving machine learning-assisted onsite real-time and dynamic intelligent decision recognition and quantification of PPs residues in real samples, which shows a promising potential in safeguarding food safety and environmental health.

Effectiveness of noise barriers in sensitive urban areas: a comprehensive study on noise reduction strategies and public health implications.

This study investigates the effectiveness of noise management strategies, focusing on installing barriers to reduce urban noise pollution, particularly around hospitals. The research in Sakarya, Turkey, employs comprehensive noise measurements and modeling techniques to evaluate barrier interventions. The study included 24-h noise averages and specific measures for daytime, evening, and nighttime noise levels, using SoundPlan software for modeling and mapping. Results reveal that noise levels frequently exceed international thresholds, especially in high-traffic areas. However, introducing noise barriers significantly reduces noise levels, particularly at specific measurement points, demonstrating their effectiveness. This underscores the crucial role of noise management strategies in sensitive urban areas and highlights the urgency for proactive interventions to manage noise pollution. The study identifies the need for future research, including long-term studies to assess noise barriers' durability and sustained effectiveness, and the integration of other noise reduction measures such as green infrastructure. Practical applications of this research include informing urban planners and policymakers about effective strategies for mitigating noise pollution and improving public health. In conclusion, this study provides valuable insights into urban noise management by empirically demonstrating the effectiveness of barrier interventions in reducing noise pollution. It underscores the importance of proactive measures to protect human health and preserve environmental balance in sensitive urban areas. The findings advocate for the broader implementation of noise barriers and other complementary strategies in urban planning to enhance the quality of urban life.

Disinfectants efficacy in reducing pathogens related to health-care infection associated in universities hospitals of Gorgan, North of Iran.

BACKGROUND: Disinfection has a fundamental role in the control of pathogens in the hospital environment. This study was designed to assess the efficacy and functional impact of disinfectants in reducing pathogens related to healthcare associated infections (HAIs) in hospitals. METHODS: This observation study was conducted at three university hospitals in Gorgan, Iran, from May to Oct 2023. The data including used disinfectants and microbiological examination were obtained from the infection control unit of each hospital. RESULTS: The results showed that a variety of disinfectants from intermediate to high levels were employed in accordance with the World Health Organization (WHO) protocols. The microbial result revealed that 31.6% (286 out of 906) of the sample had at least one microorganism. Among identified organisms, Bacillus spp. were the predominant species followed by Staphylococcus epidermis, fungus genera, Enterobacter spp., Enterococcus spp., Pseudomonas spp., Escherichia coli, Alcaligenes spp., Staphylococcus aureus, Citrobacter spp., Corynebacterium spp., Klebsiella spp., Acinetobacter spp., Micrococcus spp., Staphylococcus saprophyticus, and Serratias spp. The highest prevalence rates of microorganisms were observed in the wards of ICU, emergency, internal medicine, and women's ward. The chi-square test revealed a significant relationship between the presence of organisms and hospital wards (P < 0.05). CONCLUSION: The presence of pathogens indicates a defect in the disinfection process, probably due to both little attention to disinfection protocols and multidrug resistance. It is not yet possible to eliminate pathogens from the hospital environment, but it can be minimized by education intervention, standardizing disinfecting processes, and monitoring by the infection control committee.

Development, Evaluation, and Long-Term Outcomes of Environmental Health and Land Reuse Training-Part 1: Developing Environmental Health and Land Reuse Trainings for the Environmental Health Workforce and Their Community Partners.

This article is the first in a series of three that describes the development and delivery of the Environmental Health and Land Reuse (EHLR) Basic Training and the first pilot of the EHLR Immersion Training. The EHLR Basic Training is based on the 5-step Land Reuse Model from the Agency for Toxic Substances and Disease Registry (ATSDR). Through a collaboration with the National Environmental Health Association (NEHA), we developed the EHLR Basic Training in two modalities: virtual/live (maintained by ATSDR) and online/asynchronous (maintained by NEHA). The modules include: 1) Engaging With Your Community, 2) Evaluating Environmental and Health Risks, 3) Communicating Environmental and Health Risks, 4) Redesigning With Health in Mind, and 5) Measuring Success: Evaluating Environmental and Health Change. From June 2019-August 2022, ATSDR and NEHA delivered 10 EHLR Classroom Basic Trainings, launched the EHLR Online Basic Training, and developed the EHLR Immersion Training. We piloted the EHLR Immersion Training in July 2022, March 2023, and July 2023. Our participants included science, technology, engineering, and mathematics (STEM) students from Diné College who were in a Summer Intern Program; tribal environmental professionals; NEHA members in environmental health careers; and environmental professionals, students, and community members who were engaged in environmental work or environmental justice. We have learned that individual training modules can be used for specific learning needs among our participants. Perhaps more importantly, we have learned that undergraduate students and community members can and should be engaged in EHLR Training. The results of the evaluation and long-term follow-up of the EHLR Training will be presented in the second and third articles in this series.

The Use of Digital Health Services to Combat E-Waste Health Hazards: A Review on the Impact and Awareness in Southwest Nigeria.

The rapid advancement of technology has led to a significant increase in electronic waste (e-waste), posing serious health and environmental risks, particularly in developing regions like Southwest Nigeria. This review explores the utilization of digital health services to combat the health hazards associated with e-waste exposure. Digital health technologies, including mobile health applications, telemedicine, and electronic health records, play a critical role in raising awareness about e-waste toxicity, monitoring health impacts, and providing remote healthcare services to at-risk populations. This manuscript discusses the effectiveness of these technologies in promoting safer e-waste handling practices and mitigating health risks, highlighting their potential in supporting public health interventions in underserved areas. The study underscores the need for strategic investments and policy support to enhance the adoption of digital health solutions in managing e-waste hazards by analyzing current challenges and opportunities, ultimately contributing to better health outcomes and environmental sustainability.

Learning from the Montreal Protocol to improve the global governance of antimicrobial resistance.

The Montreal Protocol has played a critical role in promoting global collective action to phase out the use of ozone-depleting substances, ultimately preventing millions of cases of skin cancer, cataracts and other health issues related to ultraviolet radiation exposure. This success entails transferable lessons for coordinated action required to improve the global governance of other challenges. Like ozone depletion, antimicrobial resistance (AMR) is a challenge of the global commons, requiring coordinated actions across human, animal and environmental sectors. We identify equity, flexibility and accountability as three core governance principles that underlie the success of the protocol and employ the 3-i framework to understand how interests, ideas and institutions contributed to the protocol's success. Equity-promoting strategies consisted of an inclusive negotiation process, supporting developing countries with multilateral funding and a progressive compliance model. Flexibility was built into the protocol through the development of country-specific strategies, reorienting incentive structures for industry and facilitating regular amendments in response to emerging scientific evidence. Accountability was promoted by mobilising public advocacy, establishing targets and enforcement mechanisms and conducting independent scientific and technical assessments. Applying our proposed principles presents an opportunity to improve the global governance of AMR. Finally, we acknowledge limitations to our analysis, including our focus on a single environmental treaty, significantly greater funding requirements and multifacetted stakeholder involvement in the case of AMR, differing market and incentives structures in antibiotic development and distribution, and ethical concerns with using trade restrictions as a policy tool.

Identifying priority populations for lung cancer screening intervention using neighborhood-level factors and cancer registry data.

To evaluate the association of neighborhood level economic, environmental, and social indicators with lung cancer (LC) incidence and mortality. Data for adult incident LC cases in Allegheny County, Pennsylvania, diagnosed between 2015-2019 were obtained from Pennsylvania cancer registry. Cases were summarized at census-tract level. Publicly available data on neighborhood deprivation index (NDI), built environment, and racial isolation at census-tracts were linked to cases. Poisson regression was used to compute relative risk (RR) for LC incidence and mortality, adjusting for covariates. A total of 3256 LC cases were included in the analyses. About 68% were ≥65 years, 54% female, 14% Black or African American, and 63% deceased. Results of the multivariable model found that increasing quintiles (Q) of NDI were significantly associated with increasing risk of LC incidence and mortality. The RRs (95% confidence interval) of LC incidence for Q2, Q3, Q4 and Q5 were 1.36 (1.21-1.52), 1.55 (1.40-1.72), 1.68 (1.51-1.87), 2.08 (1.82-2.38), respectively, compared with Q1 (P trend <0.01). The corresponding RRs for LC mortality were 1.46 (1.27-1.68), 1.63 (1.42-1.88), 1.74 (1.51-2.01), 2.04 (2.02-2.88) (P trend <0.01). Targeted interventions for LC prevention and early detection in high NDI neighborhoods may be more effective to reduce LC health disparities.

The enigma of mitochondrial epigenetic alterations in air pollution-induced neurodegenerative diseases.

The incidence of neurodegenerative diseases is a growing concern worldwide, affecting individuals from diverse backgrounds. Although these pathologies are primarily associated with aging and genetic susceptibility, their severity varies among the affected population. Numerous studies have indicated air pollution as a significant contributor to the increasing prevalence of neurodegeneration. Cohort studies have provided compelling evidence of the association between prolonged exposure to different air toxicants and cognitive decline, behavioural deficits, memory impairment, and overall neuronal health deterioration. Furthermore, molecular research has revealed that air pollutants can disrupt the body's protective mechanisms, participate in neuroinflammatory pathways, and cause neuronal epigenetic modifications. The mitochondrial epigenome is particularly interesting to the scientific community due to its potential to significantly impact our understanding of neurodegenerative diseases' pathogenesis and their release in the peripheral circulation. While protein hallmarks have been extensively studied, the possibility of using circulating epigenetic signatures, such as methylated DNA fragments, miRNAs, and genome-associated factors, as diagnostic tools and therapeutic targets requires further groundwork. The utilization of circulating epigenetic signatures holds promise for developing novel prognostic strategies, creating paramount point-of-care devices for disease diagnosis, identifying therapeutic targets, and developing clinical data-based disease models utilizing multi-omics technologies and artificial intelligence, ultimately mitigating the threat and prevalence of neurodegeneration.

Microcystin-LR in drinking water: An emerging role of mitochondrial-induced epigenetic modifications and possible mitigation strategies.

Algal blooms are a serious menace to freshwater bodies all over the world. These blooms typically comprise cyanobacterial outgrowths that produce a heptapeptide toxin, Microcystin-LR (MC-LR). Chronic MC-LR exposure impairs mitochondrial-nuclear crosstalk, ROS generation, activation of DNA damage repair pathways, apoptosis, and calcium homeostasis by interfering with PC/MAPK/RTK/PI3K signaling. The discovery of the toxin's biosynthesis pathways paved the way for the development of molecular techniques for the early detection of microcystin. Phosphatase inhibition-based bioassays, high-performance liquid chromatography, and enzyme-linked immunosorbent tests have recently been employed to identify MC-LR in aquatic ecosystems. Biosensors are an exciting alternative for effective on-site analysis and field-based characterization. Here, we present a synthesis of evidence supporting MC-LR as a mitotoxicant, examine various detection methods, and propose a novel theory for the relevance of MC-LR-induced breakdown of mitochondrial machinery and its myriad biological ramifications in human health and disease.

Exploring Endophytic Fungi as Natural Antagonists against Fungal Pathogens of Food Crops.

The yield and quality of cultivated food crops are frequently compromised by the prevalent threat from fungal pathogens that can cause widespread damage in both the pre-harvest and post-harvest stages. This paper investigates the challenges posed by fungal pathogens to the sustainability and yield of essential food crops, leading to significant economic and food security repercussions. The paper critiques the long-standing reliance on synthetic fungicides, emphasizing the environmental and health concerns arising from their widespread and occasionally inappropriate use. In response, the paper explores the potential of biological control agents, specifically endophytic fungi in advancing sustainable agricultural practices. Through their diverse symbiotic relationships with host plants, these fungi exhibit strong antagonistic capabilities against phytopathogenic fungi by producing various bioactive compounds and promoting plant growth. The review elaborates on the direct and indirect mechanisms of endophytic antagonism, such as antibiosis, mycoparasitism, induction of host resistance, and competition for resources, which collectively contribute to inhibiting pathogenic fungal growth. This paper consolidates the crucial role of endophytic fungi, i.e., Acremonium, Alternaria, Arthrinium, Aspergillus, Botryosphaeria, Chaetomium, Cladosporium, Cevidencealdinia, Epicoccum, Fusarium, Gliocladium, Muscodor, Nigrospora, Paecilomyces, Penicillium, Phomopsis, Pichia, Pochonia, Pythium, Ramichloridium, Rosellinia, Talaromyces, Trichoderma, Verticillium, Wickerhamomyces, and Xylaria, in biological control, supported by the evidence drawn from more than 200 research publications. The paper pays particular attention to Muscodor, Penicillium, and Trichoderma as prominent antagonists. It also emphasizes the need for future genetic-level research to enhance the application of endophytes in biocontrol strategies aiming to highlight the importance of endophytic fungi in facilitating the transition towards more sustainable and environmentally friendly agricultural systems.