The effect of environmental health education on microplastic pollution awareness.

OBJECTIVE: The aim of this research is to investigate the effect of environmental health education given at the ninth-grade level on the microplastic pollution awareness level of students. METHODS: This pretest-posttest experimental study with a randomized control group was conducted between 2022 and 2023 in three high schools in a province in eastern Turkey. The sample of the study consisted of 90 ninth-grade students (experimental group: 45, control group: 45), and the sample magnitude was determined by power analysis. Tools such as the "Personal Information Form" and "Microplastic Pollution Awareness Scale (MPAS)" were used to collect data. Training was given to the experimental group as a nursing intervention in a total of four sessions at 15-day intervals. No intervention was applied to the individuals in the control group. RESULTS: While no significant difference was observed in the MPAS total score in the control group according to the pretest and posttest mean scores, a significant difference was observed in the MPAS total score in the experimental group (p < 0.05). When the posttest mean scores of the experimental and control groups were examined, it was observed that the posttest mean scores of the experimental group were higher than the posttest mean scores of the control group and there was a statistically significant difference (p < 0.05). CONCLUSION: It was observed that the microplastic pollution awareness level of the experimental group students who received environmental health training increased significantly. The issue of environmental health should be integrated into the education curriculum in schools and students' awareness levels should be increased.

Ambient heat exposure patterns and emergency department visits and hospitalizations among medicare beneficiaries 2008-2019.

OBJECTIVE: To assess the association between ambient heat and all-cause and cause-specific emergency department (ED) visits and acute hospitalizations among Medicare beneficiaries in the conterminous United States. DESIGN: Retrospective cohort study. SETTING: Conterminous US from 2008 and 2019. PARTICIPANTS: 2% random sample of all Medicare fee-for-service beneficiaries eligible for Parts A, B, and D. MAIN OUTCOME MEASURES: All-cause and cause-specific (cardiovascular, renal, and heat-related) ED visits and unplanned hospitalizations were identified using primary ICD-9 or ICD-10 diagnosis codes. We measured the association between ambient temperature - defined as daily mean temperature percentile of summer (June through September) - and the outcomes. Hazard ratios and their associated 95% confidence intervals were estimated using multivariable Cox proportional hazards regression, adjusting for individual level demographics, comorbidities, healthcare utilization factors and zip-code level social factors. RESULTS: Among 809,636 Medicare beneficiaries (58% female, 81% non-Hispanic White, 24% <65), older beneficiaries (aged ≥65) exposed to >95th percentile temperature had a 64% elevated adjusted risk of heat-related ED visits (HR [95% CI], 1.64 [1.46,1.85]) and a 4% higher risk of all-cause acute hospitalization (1.04 [1.01,1.06]) relative to <25th temperature percentile. Younger beneficiaries (aged <65) showed increased risk of heat-related ED visits (2.69 [2.23,3.23]) and all-cause ED visits (1.03 [1.01,1.05]). The associations with heat related events were stronger in males and individuals dually eligible for Medicare and Medicaid. No significant differences were observed by climatic region. We observed no significant relationship between temperature percentile and risk of CV-related ED visits or renal-related ED visits. CONCLUSIONS: Among Medicare beneficiaries from 2008 to 2019, exposure to daily mean temperature ≥ 95th percentile was associated with increased risk of heat-related ED visits, with stronger associations seen among beneficiaries <65, males, and patients with low socioeconomic position. Further longitudinal studies are needed to understand the impact of heat duration, intensity, and frequency on cause-specific hospitalization outcomes.

Consumption of Tap Water and Sociodemographic-Associated Characteristics: A Nationwide Cross-Sectional Study.

Safe water is a global public health concern amid increasing scarcity and pollution. Bottled water production and consumption contribute to these problems. This study examines tap water consumption in Italy, assessing associated sociodemographic factors and related health outcomes such as obesity and self-perceived health status. Data from the Italian National Statistics Institute's "Aspects of daily life" survey (N = 45,597) were analyzed. Covariates included education, age, gender, economic status, region, concerns about waste and climate change, consumption of carbonated drinks excluding water, alcohol consumption, consumption of vegetables, consumption of snacks, body mass index, and self-perceived health status. Bivariate analyses and mixed-effect logistic regression models explored the associations. People who drink tap water made up 19,674, with a higher prevalence in people aged 45 to 59 old, people with a graduate/post-graduate degree diploma, with optimal economic resources, people concerned about waste production and climate change, and those coming from the north-east regions of Italy. Underweight people showed a higher prevalence of TW consumption as well as those who less than occasionally drank carbonated drinks, drank alcohol, consumed vegetables more than once a day and snacks less than once a week, dairy products more than once a day, sweet less than once a week, cured meat less than once a week, and chicken meat less than once a week, those with no consumption of sheep meat, consumption of beef meat less than once a week and consumption of pork meat less than once a week, and those with a satisfactory level of perceived health status. Regressions showed that all other age classes are less likely to drink tap water than people younger than 20 years old. The category with "inadequate" economic resources is more likely to consume tap water. Low educational classes show a low likelihood of consuming tap water as well as islands. A concern about waste production and climate change is associated with an increased likelihood of consuming tap water. Tap water consumption was negatively associated with obesity but not with a satisfactory self-perceived health status. Insights from this study can inform public health strategies.

The process, outcomes and context of the sanitation change induced by the Swachh Bharat Mission in rural Jharkhand, India.

BACKGROUND: The Indian Swachh Bharat Mission (SBM) was launched in 2014 with the goal to make India open defecation (OD) free by October 2019. Although it is known that the ambitious goal was not achieved, the nature of the sanitation change brought about by the SBM in different parts of India is poorly understood. One reason is a dearth of case studies that would shed light on the performance of the SBM simultaneously across its different domains. This article provides an example of such study. Employing a Process, Outcomes, Context approach, the objective is to understand the process and outcomes of the SBM-induced sanitation change in a specific context of rural Jharkhand. METHODS: The study utilizes data collected through field research conducted in the rural areas of Ranchi district, Jharkhand, a state in east-central India. This data was obtained via repeated cross-sectional household surveys conducted at the beginning and at the end of the SBM, supplemented by key informant interviews with SBM stakeholders. FINDINGS: We identified political support of SBM implementation and its acceptance amongst the population. Female community workers became key agents of SBM implementation at local level. The SBM increased toilet coverage in the study area from 15% to 85% and lowered the OD rate from 93% to 26%. It substantially reduced structural inequalities in access to toilets, furthered social sanitation norms, improved some of the attitudes towards toilet use, but impacted less on hygiene and sanitation knowledge. The implementation mainly concentrated on the construction of subsidized toilets but less on improving public understanding of safe sanitation practices. CONCLUSIONS: Although the SBM reduced sanitation inequalities in access to toilets in the study area, the behaviour change component was underplayed, focusing more on spreading normative sanitation messages and less on public education. Sustainability of the observed sanitation change remains a key question for the future. This article calls for more systematic production of geographically situated knowledge on the performance of sanitation interventions.

Unveiling the relationships between eco-anxiety, psychological symptoms and anthropocentric narcissism: The psychometric properties of the Turkish version of the Hogg eco-anxiety scale.

The increasing number of losses and damages caused by the climate crisis has rendered the psychometric assessment of the climate crisis more important than ever, specifically in developing countries, such as Turkey. The aim of this study was to examine the psychometric properties of the Turkish version of the Hogg Eco-Anxiety Scale (HEAS-13), using exploratory structural equation modeling (ESEM) on the cross-sectional data collected from 445 adults (286 females and 159 males; Mage = 29.76, range 18-65). The results supported the four-factor solution of the original version in the Turkish sample. Further analysis confirmed the invariance of the HEAS-13 across genders. The results demonstrated significant correlations of the HEAS-13 subscales with the Brief Symptom Inventory (BSI) and the Anthropocentric Narcissism Scale (ANS), except for that between the behavioral symptoms subscale of the HEAS-13 and the ANS. Both the total and the subscale scores of the HEAS-13 were also found to be reliable, given the internal consistency and test-retest reliability values. The Turkish version of the HEAS-13 can expand the scientific understanding of eco-anxiety, which can help develop mental health services to mitigate the negative mental health impacts of the environmental crisis.

Ambient air temperature exposure and foetal size and growth in three European birth cohorts.

INTRODUCTION: Ambient air temperature may affect birth outcomes adversely, but little is known about their impact on foetal growth throughout pregnancy. We evaluated the association between temperature exposure during pregnancy and foetal size and growth in three European birth cohorts. METHODS: We studied 23,408 pregnant women from the English Born in Bradford cohort, Dutch Generation R Study, and Spanish INMA Project. Using the UrbClimTM model, weekly ambient air temperature exposure at 100x100m resolution at the mothers' residences during pregnancy was calculated. Estimated foetal weight, head circumference, and femur length at mid and late pregnancy and weight, head circumference, and length at birth were converted into standard deviation scores (SDS). Foetal growth from mid to late pregnancy was calculated (grams or centimetres/week). Cohort/region-specific distributed lag non-linear models were combined using a random-effects meta-analysis and results presented in reference to the median percentile of temperature (14 °C). RESULTS: Weekly temperatures ranged from -5.6 (Bradford) to 30.3 °C (INMA-Sabadell). Cold and heat exposure during weeks 1-28 were associated with a smaller and larger head circumference in late pregnancy, respectively (e.g., for 9.5 °C: -1.6 SDS [95 %CI -2.0; -0.4] and for 20.0 °C: 1.8 SDS [0.7; 2.9]). A susceptibility period from weeks 1-7 was identified for cold exposure and a smaller head circumference at late pregnancy. Cold exposure was associated with a slower head circumference growth from mid to late pregnancy (for 5.5 °C: -0.1 cm/week [-0.2; -0.04]), with a susceptibility period from weeks 4-12. No associations that survived multiple testing correction were found for other foetal or any birth outcomes. CONCLUSIONS: Cumulative exposure to cold and heat during pregnancy was associated with changes in foetal head circumference throughout gestation, with susceptibility periods for cold during the first pregnancy trimester. No associations were found at birth, suggesting potential recovery. Future research should replicate this study across different climatic regions including varying temperature profiles.

Assessment of Safe Drinking Water Handling Practices in Households of Northern India: A Cross-Sectional Study.

Background Waterborne diseases are the most common form of infectious disease, spreading from contaminated water, especially in a developed country. These diseases are a major concern for the environment and public health. The living conditions in developing countries like India affect the water-handling practices, which make the population vulnerable to waterborne diseases. The inability to access safe drinking water also adds to this. Water safety for a community relies on water collection, treatment, storage, and handling in the household setting. Therefore, the burden of waterborne disease can be reduced by treating point-of-use drinking water, including improving handling and transport. Objectives The aim was to assess the safe drinking water handling practices in households. The objectives were to assess the safe drinking water-handling practices, namely, treatment, storage, lid status of the storage vessel, and water drawing technique, and to estimate the sources of safe drinking water. Methods This cross-sectional study was conducted in the Etawah district on a total of 312 eldest female family members actively working in the kitchen. Descriptive analysis and Chi-Square test were applied to the collected data and a p-value <0.05 at 95% confidence interval (CI) was taken as statistically significant. Results Overall, 135 (85.9%) households in urban areas relied on public supply. However, in rural areas mostly 130 (83%) households depended on private supply. In water-handling practices, 276 (88.4%) used some method to purify drinking water, a total of 209 (67%) households kept the lid of the storage container covered, and 249 (79.8%) households drew water either by pouring or scooping with a long handle. Conclusion The study concluded that both private and public sources were used for drinking water. Regarding water-handling practices, most households drank purified water, kept their containers covered, and drew water either by scooping or pouring from storage containers. Those who drank purified water mostly belonged to nuclear families and had private sources of drinking water.

A near-zero quiescent power breeze wake-up anemometer based on a rolling-bearing triboelectric nanogenerator.

Wind sensors have always played an irreplaceable role in environmental information monitoring and are expected to operate with lower power consumption to extend service lifetime. Here, we propose a breeze wake-up anemometer (B-WA) based on a rolling-bearing triboelectric nanogenerator (RB-TENG) with extremely low static power. The B-WA consists of two RB-TENGs, a self-waking-up module (SWM), a signal processing module (SPM), and a wireless transmission unit. The two RB-TENGs are employed for system activation and wind-speed sensing. Once the ambient wind-speed exceeds 2 m/s, the wake TENG (W-TENG) and the SWM can wake up the system within 0.96 s. At the same time, the SPM starts to calculate the signal frequency from the measured TENG (M-TENG) to monitor the wind speed with a sensitivity of 9.45 Hz/(m/s). After the wind stops, the SWM can switch off the B-WA within 0.52 s to decrease the system energy loss. In quiescent on-duty mode, the operating power of the B-WA is less than 30 nW, which can greatly extend the service lifetime of the B-WA. By integrating triboelectric devices and rolling bearings, this work has realized an ultralow quiescent power and self-waked-up wireless wind-speed monitoring system, which has foreseeable applications in remote weather monitoring, IoT nodes, and so on.

The environmental awareness of nurses as environmentally sustainable health care leaders: a mixed method analysis.

BACKGROUND: People worldwide are concerned with the possibility of climate change, microplastics, air pollution, and extreme weather affecting human health. Countries are implementing measures to reduce environmental impacts. Nurses play a vital role, primarily through Green Teams, in the process of promoting sustainable practices and minimizing the environmental footprint of health care facilities. Despite existing knowledge on this topic, assessing nurses' environmental awareness and behavior, including the barriers they face, is crucial with regard to improving sustainable health care practices. AIM: To analyze the environmental awareness and behavior of nurses, especially nurse leaders, as members of the Green Team and to identify areas for improvement with regard to the creation of a sustainable environment. METHODS: A sequential mixed-method study was conducted to investigate Spanish nurses. The study utilized an online survey and interviews, including participant observation. An online survey was administered to collect quantitative data regarding environmental awareness and behavior. Qualitative interviews were conducted with environmental nurses in specific regions, with a focus on Andalusia, Spain. RESULTS: Most of the surveyed nurses (N = 314) exhibited moderate environmental awareness (70.4%), but their environmental behavior and activities in the workplace were limited (52.23% of participants rarely performed relevant actions, and 35.03% indicated that doing so was difficult). Nurses who exhibited higher levels of environmental awareness were more likely to engage in sustainable behaviors such as waste reduction, energy conservation, and environmentally conscious purchasing decisions (p < 0.05). Additionally, the adjusted model indicated that nurses' environmental behavior and activities in the workplace depend on the frequency of their environmental behaviors outside work as well as their sustainable knowledge (p < 0.01). The results of the qualitative study (N = 10) highlighted certain limitations in their daily practices related to environmental sustainability, including a lack of time, a lack of bins and the pandemic. Additionally, sustainable environmental behavior on the part of nursing leadership and the Green Team must be improved. CONCLUSIONS: This study revealed that most nurses have adequate knowledge, attitudes, and behaviors related to environmental sustainability both inside and outside the workplace. Limitations were associated with their knowledge and behaviors outside of work. This study also highlighted the barriers and difficulties that nurses face in their attempts to engage in adequate environmental behaviors in the workplace. Based on these findings, interventions led by nurses and the Green Team should be developed to promote sustainable behaviors among nurses and address the barriers and limitations identified in this research.

Seasonal extreme temperatures and short-term fine particulate matter increases pediatric respiratory healthcare encounters in a sparsely populated region of the intermountain western United States.

BACKGROUND: Western Montana, USA, experiences complex air pollution patterns with predominant exposure sources from summer wildfire smoke and winter wood smoke. In addition, climate change related temperatures events are becoming more extreme and expected to contribute to increases in hospital admissions for a range of health outcomes. Evaluating while accounting for these exposures (air pollution and temperature) that often occur simultaneously and may act synergistically on health is becoming more important. METHODS: We explored short-term exposure to air pollution on children's respiratory health outcomes and how extreme temperature or seasonal period modify the risk of air pollution-associated healthcare events. The main outcome measure included individual-based address located respiratory-related healthcare visits for three categories: asthma, lower respiratory tract infections (LRTI), and upper respiratory tract infections (URTI) across western Montana for ages 0-17 from 2017-2020. We used a time-stratified, case-crossover analysis with distributed lag models to identify sensitive exposure windows of fine particulate matter (PM2.5) lagged from 0 (same-day) to 14 prior-days modified by temperature or season. RESULTS: For asthma, increases of 1 µg/m3 in PM2.5 exposure 7-13 days prior a healthcare visit date was associated with increased odds that were magnified during median to colder temperatures and winter periods. For LRTIs, 1 µg/m3 increases during 12 days of cumulative PM2.5 with peak exposure periods between 6-12 days before healthcare visit date was associated with elevated LRTI events, also heightened in median to colder temperatures but no seasonal effect was observed. For URTIs, 1 unit increases during 13 days of cumulative PM2.5 with peak exposure periods between 4-10 days prior event date was associated with greater risk for URTIs visits that were intensified during median to hotter temperatures and spring to summer periods. CONCLUSIONS: Delayed, short-term exposure increases of PM2.5 were associated with elevated odds of all three pediatric respiratory healthcare visit categories in a sparsely population area of the inter-Rocky Mountains, USA. PM2.5 in colder temperatures tended to increase instances of asthma and LRTIs, while PM2.5 during hotter periods increased URTIs.

High-confidence structural annotation of substances via multi-layer molecular network reveals the system-wide constituent alternations in milk interfered with diphenylolpropane.

The spectral database-based mass spectrometry (MS) matching strategy is versatile for structural annotating in ingredient fluctuation profiling mediated by external interferences. However, the systematic variability of MS pool attributable to aliasing peaks and inadequacy of present spectral database resulted in a substantial metabolic feature depletion. An amended procedure termed multiple-charges overlap peaks extraction algorithm (MCOP) was proposed involving identifying collision-trigged dissociation precursor ions through iteratively matching mass features of fragmentations to expand the spectral reference library. We showcased the versatility and utility of established strategy in an investigation centered on the stimulation of milk mediated by diphenylolpropane (BPA). MCOP enabled efficient unknown annotations at metabolite-lipid-protein level, which elevated the accuracy of substance annotation to 85.3% after manual validation. Arginase and α-amylase (|r| > 0.75, p < 0.05) were first identified as the crucial issues via graph neural network-based virtual screening in the abnormal metabolism of urea triggered by BPA, resulting in the accumulation of arginine (original: 1.7 µg kg-1 1.7 times) and maltodextrin (original: 6.9 µg kg-1 2.9 times) and thus, exciting the potential dietary risks. Conclusively, MCOP demonstrated generalisation and scalability and substantially advanced the discovery of unknown metabolites for complex matrix samples, thus deciphering dark matter in multi-omics.

Assessing the water quality in a World Heritage Site using biomarkers in top fish predators.

The use of biomarkers in fish for biomonitoring is a valuable approach to reveal effects of human impacts on biota health. Top predator fish are effective models for monitoring human activities' impacts on aquatic ecosystems. The Guaraguaçu River is the largest river-system on coastal region of South Brazil and a World Heritage site. The river receives contaminants from disorderly urban growth, including discharges of domestic sewage and small fishery boats, particularly during the tourist season. Our study aimed to assess impact of anthropogenic activities on water quality in the Guaraguaçu River by analyzing environmental contamination biomarkers in the top fish predator Hoplias malabaricus. Fish were collected using a fyke net trap across sectors representing a gradient of anthropic impact: sector 1 - pristine; sector 2 - impacted; and sector 3 - less impacted. Water samples were collected to analyze the presence of trace elements and pesticide. Biomarkers of the antioxidant system, histopathology, genotoxicity, neurotoxicity, and concentration of trace elements were analyzed in fish tissues. In water samples Al, Fe and Mn were detected, but no pesticides were found. In fish muscle, zinc and iron were detected. Brain acetylcholinesterase activity decreased in impacted sectors, indicating neurotoxic effects. The antioxidant system increased activity in gills and liver, and damage from lipoperoxidation was observed, particularly in sector 2 when compared to sector 1, suggesting oxidative stress. Histopathological biomarkers revealed lesions in the liver and gills of fish in impacted sectors. Micronuclei, a genotoxicity biomarker, were observed in organisms from all sectors. Our results demonstrate detrimental effects of poor water quality on biota health, even when contaminants are not detected in water.

Inspiring basic and applied research in genome integrity mechanisms: Dedication to Samuel H. Wilson.

This Special Issue (SI) of Environmental and Molecular Mutagenesis (EMM), entitled "Inspiring Basic and Applied Research in Genome Integrity Mechanisms," is to update the community on recent findings and advances on genome integrity mechanisms with emphasis on their importance for basic and environmental health sciences. This SI includes two research articles, one brief research communication, and four reviews that highlight cutting edge research findings and perspectives, from both established leaders and junior trainees, on DNA repair mechanisms. In particular, the authors provided an updated understanding on several distinct enzymes (e.g., DNA polymerase beta, DNA polymerase theta, DNA glycosylase NEIL2) and the associated molecular mechanisms in base excision repair, nucleotide excision repair, and microhomology-mediated end joining of double-strand breaks. In addition, genome-wide sequencing analysis or site-specific mutational signature analysis of DNA lesions from environmental mutagens (e.g., UV light and aflatoxin) provide further characterization and sequence context impact of DNA damage and mutations. This SI is dedicated to the legacy of Dr. Samuel H. Wilson from the U.S. National Institute of Environmental Health Sciences at the National Institutes of Health.

Childcare centre soil microbiomes are influenced by substrate type and surrounding vegetation condition.

Urban development has profoundly reduced human exposure to biodiverse environments, which is linked to a rise in human disease. The 'biodiversity hypothesis' proposes that contact with diverse microbial communities (microbiota) benefits human health, as exposure to microbial diversity promotes immune training and regulates immune function. Soils and sandpits in urban childcare centres may provide exposure to diverse microbiota that support immunoregulation at a critical developmental stage in a child's life. However, the influence of outdoor substrate (i.e., sand vs. soil) and surrounding vegetation on these environmental microbiota in urban childcare centres remains poorly understood. Here, we used 16S rRNA amplicon sequencing to examine the variation in bacterial communities in sandpits and soils across 22 childcare centres in Adelaide, Australia, plus the impact of plant species richness and habitat condition on these bacterial communities. We show that sandpits had distinct bacterial communities and lower alpha diversity than soils. In addition, we found that plant species richness in the centres' yards and habitat condition surrounding the centres influenced the bacterial communities in soils but not sandpits. These results demonstrate that the diversity and composition of childcare centre sandpit and soil bacterial communities are shaped by substrate type, and that the soils are also shaped by the vegetation within and surrounding the centres. Accordingly, there is potential to modulate the exposure of children to health-associated bacterial communities by managing substrates and vegetation in and around childcare centres.

Carbon Neutral Hand Surgery: Simple Changes to Reduce Carbon Footprint.

Introduction: Rapid climate change poses a major challenge to healthcare. The operating room is especially responsible for carbon emission, with 20% to 70% of hospital waste traced back to the operating room. This literature review aims to suggest changes that can be made in hand surgery for a more sustainable practice. Methods: A literature search was conducted from PubMed, Medline, and other online search engines with the keywords "carbon footprint, environmental health, carbon neutral, plastic surgery, hand surgery, surgery." Results: "Reduce, Reuse, Recycle, Research, Rethink and Culture" was the framework used to recommend a more carbon neutral practice. In reduction, techniques such as cutting down oversupply of materials, adopting protocols to perform cases in ambulatory settings, and simple measures to reduce energy were identified as valuable methods. Modified sterilization techniques and reprocessing single-use devices were techniques identified for reuse and recycling involved single-stream recycling, staff training, and donation of basic surgical supplies. Research involved adopting data-driven programs for life cycle assessment of all equipment in the operating room, while the use of telemedicine and "green meetings' were suggested for rethinking. Finally, strategies to encourage a team approach to environmental responsibility were discussed. Conclusion: Carbon neutral practice must be implemented to safeguard sustainable and cost-effective operating rooms and healthcare systems. Hand surgery can pave the way for other specialties through the use of available resources to develop guidelines for carbon neutral practice. This requires active effort from hand surgeons to act as role models for other healthcare professionals.

Introduction : Les changements climatiques rapides constituent un défi majeur pour les soins de santé. La salle d'opération est particulièrement responsable de l'émission de carbone avec 20% à 70% des déchets hospitaliers rapportés aux salles d'opération. Cette revue de la littérature vise à suggérer les changements qui peuvent être apportés dans la chirurgie de la main pour une pratique plus durable. Méthodes : Une recherche bibliographique a été menée dans les bases de données PubMed, Medline et autres moteurs de recherche en ligne avec les mots-clés suivants : empreinte carbone, santé environnementale, carbone neutre, chirurgie plastique, chirurgie de la main et chirurgie. Résultats : « Réduire, Réutiliser, Recycler, Rechercher, Repenser et Culture ¼ a été le cadre utiliser pour recommander une pratique plus neutre en matière de carbone. Sous « réduction ¼, des techniques telles que des coupures dans l'excès d'approvisionnement en matériaux, l'adoption de protocoles permettant de traiter des cas en ambulatoire et des mesures simples pour réduire la consommation d'énergie sont des méthodes qui ont été jugées utiles. Des techniques de stérilisation modifiées et de retraitement de dispositifs à usage unique sont des techniques identifiées pour la réutilisation; le recyclage a impliqué une collecte en vrac, la formation du personnel et le don de fournitures chirurgicales de base. La recherche a nécessité d'adopter des programmes pilotés sur des données pour l'évaluation du cycle de vie de tout équipement de la salle de l'opération pendant que le recours à la télémédecine et aux réunions respectueuses de l'environnement était suggéré pour le thème « repenser ¼. Enfin, des stratégies visant à encourager une approche d'équipe envers la responsabilité environnementale ont été discutées. Conclusion : Une pratique carbone neutre doit être mise en œuvre pour protéger les salles d'opération durables et rentables ainsi que les systèmes de soins de santé. La chirurgie de la main peut ouvrir la voie à d'autres spécialités par l'utilisation des ressources disponibles afin d'élaborer des lignes directrices pour l'empreinte carbone de la pratique. Cela nécessite un effort de la part des chirurgiens de la main pour devenir des exemples pour les autres professionnels de santé.

River water pollution in Lebanon: the country's most underestimated public health challenge.

Background: Due to the several interconnected crises that Lebanon has been facing for the past 4 years, many important social and environmental issues have been overlooked until more "pressing" ones are dealt with. Consequently, water pollution in Lebanon continues to worsen. Aim: This study aimed to describe the microbiological and chemical properties of the 10 main rivers in Lebanon and to assess their suitability for irrigation, while exploring some of the solutions to the problem. Methods: This cross-sectional study evaluated the pollution level of water from 10 rivers in Lebanon in June 2023 and their suitability for irrigation. Samples were collected at 3°C and their quality parameters were measured. Statistical analysis was conducted using R statistical software version 4.0.2. Results: Compared to the Food and Agriculture Organization (FAO) guidelines for safe irrigation water use, 4 out of the 10 samples had pH levels exceeding the permissible threshold, resulting in severe limitations on their usability. Three rivers had nitrate concentrations that exceeded the approved range, thus constraining their severe usage. Among the rivers, 60% had Escherichia coli levels higher than the permissible spectrum and 40% had faecal coliform counts exceeding FAO's upper limit recommendation. All water sources, however, had total dissolved solid levels that were within the recommended range. Conclusions: Polluted water can have a negative impact on human, wildlife and ecosystem health. Most of the assessed rivers in our study contained bacterial colonies, above the maximum recommended internationally. There is therefore an urgent need to address pollution issues in Lebanese waters to make them suitable for irrigation and other uses.