International Journal of Environmental Research and Public Health

Virtual reality (VR) is increasingly used in healthcare for surgical training, rehabilitation, and psychotherapy, generating high-frequency “immersive telemetry” from user behaviour and, in some cases, physiological sensing. Such data may reveal sensitive clinical and non-clinical attributes. This structured narrative review synthesizes literature published from 2021 through October 2026 on privacy risks in healthcare and therapy-oriented VR, emphasizing data collected in clinical and home deployments, threats across the data lifecycle, and technical, organizational, and governance mitigations. Four recurring risk drivers were identified: sensitivity and identifiability of immersive telemetry; re-identification, profiling, and inference from non-traditional health data; limitations of informed consent and transparency in vendor and third-party analytics pipelines; and heightened exposure in telehealth and home settings. Analysis of GDPR and HIPAA highlights tensions around data minimization, purpose limitation, and accountable data sharing. Proposed safeguards include encryption and access control, privacy-preserving analytics, local or edge processing, and governance controls, but no single measure provides end-to-end protection. Healthcare VR therefore requires lifecycle-based privacy risk assessment, clearer governance of immersive telemetry and third-party processing, and interdisciplinary design integrating clinical, technical, and regulatory perspectives.

Extreme heat and humidity are increasing globally, with direct implications for heat-related mortality. This study examined associations between daily natural-death counts and heat exposure in the five district municipalities of Limpopo Province, South Africa, where isolated surges in excess deaths were detected by mortality surveillance in November 2023 and December 2024. We combined spatially averaged district-level meteorological observations from 1 January 1991 to 20 July 2025 with daily mortality data from 1 January 2022 to 10 May 2025 and analysed the Excess Heat Factor (EHF) and apparent temperature (AT) in calendar-matched case-crossover models of observed death counts for all ages and ages 60 yrs and older. EHF entered the models as its positive part in local severity units. The analysis showed that absolute humidity, maximum temperature, minimum temperature and diurnal temperature range increased across districts, with the fastest proportional increases in the extreme exposure categories. At provincial level, for all ages, each severity unit of lag 0–1 EHF was associated with a mortality rate ratio of 1.191 (95% confidence interval, CI: 1.168–1.214) and extreme heatwave days carried rate ratios of 1.830 (95% CI: 1.652–2.027). Each interquartile-range increase in AT was associated with rate ratios of 1.074 (95% CI: 1.061–1.088). The EHF–mortality association was present in every district and heterogeneous in magnitude ranging from 1.092 (1.036–1.151) to 1.231 (1.169–1.296) across the districts, whereas the AT association was small and spatially uniform once EHF was included in the model. For both EHF and AT (and combined), the association with mortality was ubiquitously amplified in all models, in all districts for the 60-yrs-and-older age class. A proposed EHF-based warning was tested retrospectively and showed that both mortality surges were preceded by “warning-level” EHF alerts in every district. A district-specific, severity-based EHF alert scheme, evaluated here against the 2022–2025 mortality series, could improve municipal heat-health warning systems in Limpopo and provides a template for similar analyses elsewhere in South Africa.

Parental phubbing, whereby parents engage with their smartphones while in the presence of their children, is an emerging concern that may affect parent–child communication and adolescents’ psychosocial well-being. This study explored adolescents’ experiences and perceptions of parental phubbing. Semi-structured interviews were conducted with 17 adolescents (10 girls, 7 boys; aged 14–15 years) from one English-medium school in Bengaluru, India, predominantly from upper- and upper-middle-class families, focusing on patterns of social interaction, parental smartphone use, and adolescents’ emotional experiences of being phubbed. The interview data were analysed thematically using Braun and Clarke’s reflexive thematic analysis. Five themes were generated: judging which phone use is acceptable, accepting being second, speaking up, walking away, and imagining oneself as a future parent. From these, we propose a non-linear interpretive map in which acceptance, speaking up or staying silent, and withdrawal are connected by several routes and not by a fixed sequence. The findings illustrate how routine digital behaviour may shape adolescents’ emotional experiences and patterns of engagement with their parents. Attending to this subtle form of digital disruption may help to promote healthier parent–adolescent relationships and family digital well-being.