International Journal of Environmental Research and Public Health

13 pages, 369 KiB

Open AccessPerspective

Early Warning Signs for Monitoring Airborne Respiratory Virus Transmission

by Qingyang Liu

Int. J. Environ. Res. Public Health 2025, 22(7), 1151; https://doi.org/10.3390/ijerph22071151 (registering DOI) - 20 Jul 2025

Abstract

Airborne respiratory viruses (e.g., influenza, respiratory syncytial virus (RSV), and SARS-CoV-2) continue to pose a serious threat to global public health due to their ability to spread through multiple transmission pathways. Among these, aerosol transmission stands out as a key route, particularly in [...] Read more.

Airborne respiratory viruses (e.g., influenza, respiratory syncytial virus (RSV), and SARS-CoV-2) continue to pose a serious threat to global public health due to their ability to spread through multiple transmission pathways. Among these, aerosol transmission stands out as a key route, particularly in enclosed environments. However, current monitoring systems have major limitations in sensitivity, standardization, and high time resolution. This study provides a summary of the latest information on the monitoring technologies for respiratory virus aerosols. It discusses the technical and ethical challenges in real-world applications. In addition, this study proposes practical solutions and future development pathways. The aim of this study is to provide theoretical support for building a dynamic, precise, and effective early warning system for monitoring variants of airborne respiratory viruses Full article

(This article belongs to the Section Environmental Health)

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27 pages, 1004 KiB

Open AccessArticle

A Conceptual Model for Strengthening Family Capabilities Through a Process of Care

by James Reid, Chanté Johannes, Shenaaz Wareley, Collen M. Ngadhi, Avukonke Nginase and Nicolette V. Roman

Int. J. Environ. Res. Public Health 2025, 22(7), 1150; https://doi.org/10.3390/ijerph22071150 (registering DOI) - 20 Jul 2025

Abstract

Family capabilities shape the well-being of individuals and families, particularly in diverse sociocultural contexts. However, existing frameworks often fail to capture the complexities of family dynamics, particularly in South Africa. This limitation is addressed in this study by developing a new conceptual model, [...] Read more.

Family capabilities shape the well-being of individuals and families, particularly in diverse sociocultural contexts. However, existing frameworks often fail to capture the complexities of family dynamics, particularly in South Africa. This limitation is addressed in this study by developing a new conceptual model, through an ethic of care lens, to understand family. A Human-Centered Design strategy is employed, utilizing workshops to gather and deductively interpret data. A sample of 53 participants is recruited from two communities in South Africa. The Listening Guide approach is used to analyze the data, alongside thematic analysis, to identify overarching themes. The findings reveal tangible needs (material and physical requirements), as well as intangible needs (emotional and psychological support). The relation between these needs and harms highlights how care is shaped in families. While families endeavor to meet intangible needs, many fail to communicate these intangible needs, which also leads to harm. This is exacerbated when the primary caregiver within the family, the ‘glue’, has needs for care that are not met. In addition, the findings reveal the interrelatedness of care in family dynamics among family members, and help to explore the boundaries, capacities, and capabilities of what families do and how they care. Full article

(This article belongs to the Special Issue The Impact of Family Capabilities on the Wellbeing and Mental Health of Family Members)

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17 pages, 1038 KiB

Open AccessArticle

Pet Flea and Tick Control Exposure During Pregnancy and Early Life Associated with Decreased Cognitive and Adaptive Behaviors in Children with Developmental Delay and Autism Spectrum Disorder

by Amanda J. Goodrich, Daniel J. Tancredi, Yunin J. Ludeña, Ekaterina Roudneva, Rebecca J. Schmidt, Irva Hertz-Picciotto and Deborah H. Bennett

Int. J. Environ. Res. Public Health 2025, 22(7), 1149; https://doi.org/10.3390/ijerph22071149 (registering DOI) - 19 Jul 2025

Abstract

Approximately 18% of U.S. children experience cognitive and behavioral challenges, with both genetic and environmental contributors. We examined if household insecticides, particularly those used in and around the home and on pets, are associated with neurodevelopmental changes. Data were from children aged 24–60 [...] Read more.

Approximately 18% of U.S. children experience cognitive and behavioral challenges, with both genetic and environmental contributors. We examined if household insecticides, particularly those used in and around the home and on pets, are associated with neurodevelopmental changes. Data were from children aged 24–60 months in the CHARGE study with the following classifications: autism spectrum disorder (ASD, n = 810), developmental delay (DD, n = 192), and typical development (TD, n = 531). Exposure to indoor, outdoor, and pet insecticides was reported for the period from three months pre-conception to the second birthday. Cognitive and adaptive functioning were assessed using the Mullen Scales of Early Learning and Vineland Adaptive Behavior Scales. Linear regression was used to evaluate associations by diagnostic group, adjusting for confounders. Flea/tick soaps, shampoos, and powders used during year two were significantly associated with lower cognitive and adaptive scores in children with ASD after FDR correction. Flea/tick skin treatments in early pregnancy were associated with reduced scores in the DD group, though not significant after correction, especially when used with high frequency. No associations were observed in TD children. These findings underscore the need to examine early-life exposure to non-agricultural insecticides as modifiable risk factors for neurodevelopment. Full article

(This article belongs to the Section Environmental Health)

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12 pages, 1120 KiB

Open AccessArticle

A Temporal Comparison of 50 Years of Australian Scuba Diving Fatalities

by John M. Lippmann

Int. J. Environ. Res. Public Health 2025, 22(7), 1148; https://doi.org/10.3390/ijerph22071148 (registering DOI) - 19 Jul 2025

Abstract

Australian scuba fatalities over 50 years were examined to determine temporal changes over two consecutive periods, 1972–1999 and 2000–2021. The Australasian Diving Safety Foundation database and National Coronial Information System were searched to identify scuba deaths from 1972 to 2021. Historical data, police [...] Read more.

Australian scuba fatalities over 50 years were examined to determine temporal changes over two consecutive periods, 1972–1999 and 2000–2021. The Australasian Diving Safety Foundation database and National Coronial Information System were searched to identify scuba deaths from 1972 to 2021. Historical data, police and witness reports, and autopsies were recorded and comparisons made between the two periods. Of 430 total deaths, 236 occurred during 1972–1999 and 194 during 2000–2021, with average annual fatalities of 8.4 and 8.8, respectively. The proportion of males reduced (83% to 76%) and median ages rose (33 to 47 years) with a large rise in the percentage of casualties among people aged 45 years or older (24% to 57%). There were increases in certified divers (64% to 81%) and in the proportion of divers who were with a buddy at the time of their incident (17% to 27%), as well as a decrease in out-of-gas incidents (30% to 25%). A reduction in primary drowning (47% to 36%) was accompanied by more than a doubling of cardiac-related disabling conditions (12% to 26%). The substantial increase in casualties’ ages and of the proportions of casualties aged 45 or more and of females between the periods indicate the inclusion of a broader cohort of participants and ageing of longtime divers. The reduction in primary drowning was likely due to increased training and improvements in equipment, particularly BCDs and pressure gauges. The rise in cardiac-related deaths was due to an older and more obese cohort. Improved health education and surveillance and improved dive planning are essential to reduce such deaths. Full article

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16 pages, 315 KiB

Open AccessArticle

Development and Validation of the Intimate Partner Violence Workplace Disruptions Assessment (IPV-WDA)

by Kathryn Showalter, Laneshia Conner, Rebecca Bosetti, William Burrows and Rujeko Machinga-Asaolu

Int. J. Environ. Res. Public Health 2025, 22(7), 1147; https://doi.org/10.3390/ijerph22071147 (registering DOI) - 19 Jul 2025

Abstract

A vast majority of survivors of intimate partner violence (IPV) experience economic abuse, including but not limited to, employment sabotage. The purpose of this study is to further understand IPV by testing a technology-inclusive abuser-initiated workplace disruption measurement in an exploratory factor analysis [...] Read more.

A vast majority of survivors of intimate partner violence (IPV) experience economic abuse, including but not limited to, employment sabotage. The purpose of this study is to further understand IPV by testing a technology-inclusive abuser-initiated workplace disruption measurement in an exploratory factor analysis (EFA) so that future researchers can better examine and address economic abuse. Using a sample of survivors (N = 312) employed in the nursing profession in the United States, who may be uniquely impacted by technology, we used complete data to examine experiences of abuser-initiated workplace disruptions, including those that utilized cellphones (e.g., excessive texting, harassment of coworkers, preventing educational advancement). The results revealed a two-factor structure: one containing a variety of direct and indirect workplace disruptions relevant to the nursing profession (73% of variance) and a second containing only cell-phone related harassment (9% of variance). Implications for healthcare employers seeking to protect employees from IPV, as well as policymakers, are included. Full article

(This article belongs to the Special Issue Models and Approaches to Workplace Health Promotion and Well-Being with Diverse Population Groups)

12 pages, 910 KiB

Open AccessArticle

Sexual Harassment of Cisgender Women University Students: How the Gender Composition of Colleges Relates to Differential Prevalence

by Natalie Q. Poole, Christopher J. Cannon, Amy L. Gabriel, Emma J. Briles and Matt J. Gray

Int. J. Environ. Res. Public Health 2025, 22(7), 1146; https://doi.org/10.3390/ijerph22071146 (registering DOI) - 19 Jul 2025

Abstract

Gender harassment is the most common variant of sexual harassment and is often seen in male-dominated workplaces. Importantly, persistent gender harassment produces pronounced impairment in psychological and occupational domains. The current study aimed to examine the degree to which academic fields and degree [...] Read more.

Gender harassment is the most common variant of sexual harassment and is often seen in male-dominated workplaces. Importantly, persistent gender harassment produces pronounced impairment in psychological and occupational domains. The current study aimed to examine the degree to which academic fields and degree programs that are largely male dominated are associated with higher rates of sexual harassment than female-dominated programs. Four academic fields were chosen for their gender disparity—business, engineering, health sciences, and education. Consistent with hypotheses, cisgender women students in the college of engineering were most likely to experience gender harassment by peers and faculty. Implications and future directions are discussed. Full article

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18 pages, 683 KiB

Open AccessArticle

The Global COVID-19 Pandemic Experience: Innovation Through Environmental Assessment and Seropositivity Surveillance

by Robert M. Park

Int. J. Environ. Res. Public Health 2025, 22(7), 1145; https://doi.org/10.3390/ijerph22071145 - 18 Jul 2025

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Abstract

Objectives: To confirm a conjecture from year 2020 of the SARS-CoV-2 (COVID-19) pandemic suggesting policy alternatives to substantially reduce mortality burden. Methods: Data from a global COVID-19 database comparing different countries on cumulative mortality and vaccination were analyzed in conjunction with surveys of [...] Read more.

Objectives: To confirm a conjecture from year 2020 of the SARS-CoV-2 (COVID-19) pandemic suggesting policy alternatives to substantially reduce mortality burden. Methods: Data from a global COVID-19 database comparing different countries on cumulative mortality and vaccination were analyzed in conjunction with surveys of seropositivity. Predictions of final mortality burden under an alternate policy scenario for Japan were calculated and the COVID-19 outcomes for China were assessed. Results: By 2025, Western countries (US, UK, Brazil and Italy) had cumulative mortality rates in the range of 3339–3548 deaths per million, about 6-fold higher than East Asian and New Zealand ‘zero-COVID’ countries. Moderate virus suppression in Japan produced the lowest cumulative mortality of the countries analyzed; if earlier policies had been maintained, the predicted cumulative mortality rate by 2025 would be one-tenth that of the US, UK, Brazil and Italy and one-half to one-third that of other zero-COVID countries. For China, transitioning from a zero-COVID policy in 2022–2023, the estimated 2025 cumulative mortality was 1607/million, half that of Western countries. Conclusions: To minimize COVID-19 mortality would require: (1) Innovation on systematic sampling of ambient airborne virus exposure to sustain low but non-zero virus levels across entire populations, and (2) seropositivity assessment (instead of mass PCR testing for new cases) for calibrating exposure management, and tracking and protecting high-risk populations. Full article

(This article belongs to the Section Environmental Health)

29 pages, 1411 KiB

Open AccessArticle

Adapting a Participatory Group Programme for Caregivers of Children with Complex Neurodisability from Low-, Middle-Income Countries to a High-Income Setting: Moving from “Baby Ubuntu” to “Encompass”

by Kirsten Prest, Kirsten Barnicot, Catherine Hurt, Frances Badenhorst, Aleksandra Borek, Melanie Whyte, Phillip Harniess, Alea Jannath, Rachel Lassman, Christopher Morris, Rachel Osbourne, Tracey Smythe, Cally J. Tann, Keely Thomas, Emma Wilson, Angela Harden and Michelle Heys

Int. J. Environ. Res. Public Health 2025, 22(7), 1144; https://doi.org/10.3390/ijerph22071144 - 18 Jul 2025

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Abstract

The “Baby Ubuntu” programme is a well-established, low-cost, community-based intervention to support caregivers of children with complex neurodisability, like cerebral palsy, in low- and middle-income country (LMIC) contexts. This process-focused paper describes our utilisation of the ADAPT guidance to adapt “Baby Ubuntu” for [...] Read more.

The “Baby Ubuntu” programme is a well-established, low-cost, community-based intervention to support caregivers of children with complex neurodisability, like cerebral palsy, in low- and middle-income country (LMIC) contexts. This process-focused paper describes our utilisation of the ADAPT guidance to adapt “Baby Ubuntu” for use in ethnically and linguistically diverse, and economically deprived urban boroughs in the United Kingdom (UK). The process was guided by an adaptation team, including parents with lived experience, who explored the rationale for the intervention from local perspectives and its fit for this UK community. Through qualitative interviews and co-creation strategies, the perspectives of caregivers and healthcare professionals substantially contributed to the “Encompass” programme theory, drafting the content, and planning the delivery. Ten modules were co-produced with various topics, based on the “Baby Ubuntu” modules, to be co-facilitated by a parent with lived experience and a healthcare professional. The programme is participatory, allowing caregivers to share information, problem solve, and form supportive peer networks. The “Encompass” programme is an example of a “decolonised healthcare innovation”, as it aims to transfer knowledge and solutions developed in low- and middle-income countries to a high-income context like the UK. Piloting of the new programme is underway. Full article

(This article belongs to the Special Issue Health Intervention for Young Children with or at Risk for Disabilities)

12 pages, 641 KiB

Open AccessArticle

Do Patients with Complaints Attributed to Chemicals in the Environment Trust in Biomonitoring as a Valid Diagnostic Tool? A Prospective, Observational Study from a German University Outpatient Clinic

by Claudia Schultz, Catharina Sadaghiani, Stefan Schmidt, Roman Huber and Vanessa M. Eichel

Int. J. Environ. Res. Public Health 2025, 22(7), 1143; https://doi.org/10.3390/ijerph22071143 - 18 Jul 2025

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Abstract

Biomonitoring often yields normal results in patients who report environmental sensitivities, such as in multiple chemical sensitivity. This study examined whether biomonitoring results influence disease attribution and perception. Patients over 18 presenting for the first time to the University Environmental Medicine Outpatient Clinic [...] Read more.

Biomonitoring often yields normal results in patients who report environmental sensitivities, such as in multiple chemical sensitivity. This study examined whether biomonitoring results influence disease attribution and perception. Patients over 18 presenting for the first time to the University Environmental Medicine Outpatient Clinic in Freiburg with suspected complaints linked to heavy metals, wood preservatives, pesticides, solvents, or mold spores were included. Illness perceptions were assessed before and after biomonitoring using the Illness Perception Questionnaire (IPQ-R). Of 358 patients, 51 met inclusion criteria; 3 showed relevant findings, and 15 did not attribute their symptoms to environmental causes at baseline. The remaining 33 patients were analyzed. After receiving a normal biomonitoring result, only seven patients (21%) altered their illness attribution. These individuals also reported milder perceived consequences, less personal control over the illness, and showed lower levels of somatization and compulsiveness than those who maintained their original attribution. Most patients remained convinced of an environmental cause despite unremarkable findings. This suggests that a substantial subset of patients is strongly attached to an environmental explanation for their symptoms, with stable attribution linked to higher psychological symptom burden and a belief in personal control over the illness. Full article

(This article belongs to the Section Environmental Health)

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16 pages, 500 KiB

Open AccessArticle

Periodontal Health Knowledge of Schoolteachers: A Cross-Sectional Study

by Khansa Taha Ababneh, Fathima Fazrina Farook, Lama Alosail, Maram Ali Alqahtani, Norah Gharawi and Afrah Alossimi

Int. J. Environ. Res. Public Health 2025, 22(7), 1142; https://doi.org/10.3390/ijerph22071142 - 18 Jul 2025

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Abstract

Background/Objectives: Schoolteachers play a central role in shaping their students’ beliefs and attitudes towards oral health. Our aim was to investigate the oral and periodontal health knowledge of schoolteachers in Riyadh and factors affecting this knowledge. Methods: Government schoolteachers from representative [...] Read more.

Background/Objectives: Schoolteachers play a central role in shaping their students’ beliefs and attitudes towards oral health. Our aim was to investigate the oral and periodontal health knowledge of schoolteachers in Riyadh and factors affecting this knowledge. Methods: Government schoolteachers from representative areas of Riyadh (n = 895) responded to a structured questionnaire. Descriptive statistics, t-tests, one-way analysis of variance, and multiple linear regression (p ≤ 0.05). Results: Teachers demonstrated good basic oral/periodontal health knowledge (mean score = 60.21 ± 10.68). Most knew that toothbrushing is necessary to preserve dental (78.66%) and periodontal (57.88%) health; that gingival bleeding (74.41%), swelling (64.25%), and abscess formation (52.96%) are signs of periodontal disease; about 63% identified dental biofilm as an etiologic factor, and 58% knew that periodontitis may cause gingival recession and influence systemic health (74.07%). However, only 38% knew that dental flossing is necessary to preserve periodontal health, and 66.03% believed that gingival health can be restored with a special toothpaste. Teachers who were female, older in age, worked in north Riyadh, and taught the intermediate stage demonstrated statistically significantly better knowledge than the other categories. Conclusions: The studied sample of schoolteachers possesses acceptable basic oral health knowledge but has inadequate knowledge of periodontal health. Factors influencing teachers’ knowledge were age, gender, region of work, and teaching stage. Full article

(This article belongs to the Section Health Care Sciences)

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25 pages, 324 KiB

Open AccessArticle

Psychological Flexibility and Inflexibility of University Students: An In-Depth Qualitative Study

by Wendy Cervantes-Perea, Jone Martínez-Bacaicoa and Manuel Gámez-Guadix

Int. J. Environ. Res. Public Health 2025, 22(7), 1141; https://doi.org/10.3390/ijerph22071141 - 18 Jul 2025

Viewed by 100

Abstract

In the Hexaflex model of Acceptance and Commitment Therapy (ACT), psychological flexibility refers to the ability to openly embrace difficult thoughts and emotions while acting in alignment with personal values. In contrast, psychological inflexibility involves rigid avoidance and control strategies that hinder adaptive [...] Read more.

In the Hexaflex model of Acceptance and Commitment Therapy (ACT), psychological flexibility refers to the ability to openly embrace difficult thoughts and emotions while acting in alignment with personal values. In contrast, psychological inflexibility involves rigid avoidance and control strategies that hinder adaptive functioning. Although previously studied, more culturally relevant evidence is needed to inform interventions that promote well-being and mental health among Latin American students. This study explored manifestations of psychological flexibility and inflexibility in 15 undergraduate students from the University of Magdalena in Colombia (mean age = 20.13 years; 53.33% female) through semi-structured, face-to-face interviews (~45 min each). Data were analyzed using Interpretative Phenomenological Analysis (IPA), focusing on how participants described and made sense of their experiences. A total of 25 emergent themes were identified and grouped into 12 subordinate themes, mapped onto the 6 core ACT processes. The participants reported efforts to control or avoid distressing internal experiences, often resulting in difficulty acting in accordance with their values. The findings highlight a recurring ambivalence between avoidance and acceptance, and barriers to committed action, underscoring the dynamic interplay between flexibility and inflexibility. These results support the relevance of ACT-based interventions, such as structured group sessions that foster acceptance, mindfulness, and values-based behavior. Integrating this training into counseling and academic support services could enhance students’ well-being and performance. Future research should examine these dynamics longitudinally and across diverse contexts. Full article

(This article belongs to the Section Behavioral and Mental Health)

14 pages, 1435 KiB

Open AccessArticle

Association Between Diet, Sociodemographic Factors, and Body Composition in Students of a Public University in Ecuador

by Angélica María Solís Manzano, María Victoria Padilla Samaniego, Verónica Patricia Sandoval Tamayo, Edgar Rolando Morales Caluña, Katherine Denisse Suarez Gonzalez, Tannia Valeria Carpio-Arias and Patricio Ramos-Padilla

Int. J. Environ. Res. Public Health 2025, 22(7), 1140; https://doi.org/10.3390/ijerph22071140 - 18 Jul 2025

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Abstract

Body composition is associated with multiple factors. The main objective of this study is to determine the association between diet and sociodemographic factors on the body structure and composition of university students at a public university in Ecuador. This cross-sectional study allowed for [...] Read more.

Body composition is associated with multiple factors. The main objective of this study is to determine the association between diet and sociodemographic factors on the body structure and composition of university students at a public university in Ecuador. This cross-sectional study allowed for the collection of detailed body composition and dietary data from 204 students (41.7% men and 58.3% women, with an average age of 23.3 ± 4.4 years). The study was conducted using validated questionnaires and bioimpedance techniques. Statistical analysis included ANOVA tests, complemented by a PCA-Biplot, to examine the relationships between study variables. Statistical analysis revealed that men’s birthplace had a significant impact on several body measurements, such as hip circumference and weight, but no significant differences were observed in body structure and composition based on nutrient intake. Furthermore, larger upper-arm circumference in women was correlated with higher fat intake. The results of the multivariate analysis indicated a differential influence of dietary components on body composition. The study highlights the need for nutritional intervention strategies and educational programs that consider the diversity of students’ backgrounds to promote healthy habits and mitigate the negative effects of eating habits and irregular physical activity patterns on their health and body composition. Full article

(This article belongs to the Section Health Care Sciences)

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21 pages, 2570 KiB

Open AccessArticle

Exploration of Providers’ Perceptions and Attitudes Toward Phage Therapy and Intentions for Future Adoption as an Alternative to Traditional Antibiotics in the US—A Cross-Sectional Study

by Subi Gandhi, Dustin Edwards, Keith Emmert and Bonnie Large

Int. J. Environ. Res. Public Health 2025, 22(7), 1139; https://doi.org/10.3390/ijerph22071139 - 18 Jul 2025

Viewed by 110

Abstract

Antibiotic resistance presents a global threat, making the swift development of alternative treatments essential. Phage therapy, which employs bacterial viruses that specifically target bacteria, shows promise. Although this method has been utilized for over a century, primarily in Eastern Europe, its use in [...] Read more.

Antibiotic resistance presents a global threat, making the swift development of alternative treatments essential. Phage therapy, which employs bacterial viruses that specifically target bacteria, shows promise. Although this method has been utilized for over a century, primarily in Eastern Europe, its use in the US remains limited. This study aimed to assess the awareness and willingness of US healthcare providers to adopt phage therapy in response to the growing issue of antibiotic resistance. A survey of 196 healthcare providers, primarily MDs and DOs, found that while 99% were aware of antimicrobial resistance, only 49% were knowledgeable about phage therapy as a treatment for resistant bacterial infections. Nonetheless, 56% were open to considering phage therapy, and this willingness was associated with prior knowledge, concerns about antibiotic resistance, previous training, and confidence in recommending it (p < 0.05). Our study of U.S. healthcare providers revealed key findings about their views on phage therapy as a potential alternative for treating bacterial infections. Credible information is essential to promoting phage therapy use among U.S. providers via educational initiatives, clinical guidance, and research dissemination to promote phage therapy use among U.S. providers. Evidence-based education and clinical guidance help providers make sound decisions on the appropriate and safe use of phage therapy. Full article

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12 pages, 530 KiB

Open AccessArticle

Diminished Social and Leisure Engagement in Community Dwelling-Older Adults with Apathy

by Katherine J. Valles, Emmeline Ayers, Joe Verghese and Mirnova E. Ceïde

Int. J. Environ. Res. Public Health 2025, 22(7), 1138; https://doi.org/10.3390/ijerph22071138 - 18 Jul 2025

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Abstract

Background: Apathy predicts functional and cognitive decline in community-dwelling older adults. However, the behavioral correlates of apathy, which could promote cognitive decline have not been described. Our objective was to investigate the associations of apathy with leisure and social engagement. Methods: N = [...] Read more.

Background: Apathy predicts functional and cognitive decline in community-dwelling older adults. However, the behavioral correlates of apathy, which could promote cognitive decline have not been described. Our objective was to investigate the associations of apathy with leisure and social engagement. Methods: N = 538 older adults enrolled in the Central Control of Mobility in Aging study. We used the GDS3A, a 3-item subscale of the Geriatric Depression Scale, to define apathy and the frequency of participation in cognitive, physical, and social leisure activities. Linear regression models were conducted to assess the association between apathy and its behavioral correlates: social engagement and leisure activity participation. Covariates included age, gender, education level, multimorbidity, and dysphoria. Results: Apathy was present in 29.7% of participants and was significantly associated with less frequent participation in physical activity days per week (−1.688. p = 0.003) but not cognitive (−1.094, p = 0.252) or social (−0.654, p = 0.103) leisure activities. Apathy was also associated with a decreased social behavior composite score (−0.055, p < 0.001), Social Network Index (−0.478, p = 0.003), and Medical Outcomes Study Social Support scores (−0.26, p = 0.001). Conclusions: Our findings suggest that apathy presents with reduced participation in physical leisure activities and reduced social engagement, which may provide a way for clinicians and caregivers to identify apathy in the future. Full article

(This article belongs to the Special Issue The Role of Neighborhood Social Networks in Health Behaviors and Healthy Aging)

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14 pages, 359 KiB

Open AccessArticle

Association Between Physical Activity, Sedentary Time, and Quality of Life in Patients with Chagas Disease During COVID-19 Pandemic in Brazil: A Cross-Sectional Study

by Isis Gabrielli Gomes Xavier, Patrícia Mello Andrade, Rodrigo de Lima Vitor, Tayná Cruz Barros, Whesley Tanor Silva, Luciana Fernandes Portela, Marcelo Teixeira de Holanda, Luiz Henrique Conde Sangenis, Gilberto Marcelo Sperandio da Silva, Flavia Mazzoli-Rocha, Fernanda de Souza Nogueira Sardinha Mendes, Andréa Rodrigues da Costa, Marcelo Carvalho Vieira, Daniela Palheiro Mendes de Almeida, Cláudia Maria Valete, Alejandro Marcel Hasslocher-Moreno, Henrique Silveira Costa, Vitor Barreto Paravidino, Tatiana Rehder Gonçalves, Roberto Magalhães Saraiva and Mauro Felippe Felix Mediano Show full author list Hide full author list

Int. J. Environ. Res. Public Health 2025, 22(7), 1137; https://doi.org/10.3390/ijerph22071137 - 18 Jul 2025

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Abstract

Background: COVID-19 led to social isolation, potentially reducing physical activity (PA), increasing sedentary time, and lowering quality of life (QoL). This study investigated the association between these factors in patients with Chagas disease (ChD) during the pandemic. Methods: This cross-sectional study included 187 [...] Read more.

Background: COVID-19 led to social isolation, potentially reducing physical activity (PA), increasing sedentary time, and lowering quality of life (QoL). This study investigated the association between these factors in patients with Chagas disease (ChD) during the pandemic. Methods: This cross-sectional study included 187 patients with ChD. PA and sedentary time were assessed by the IPAQ-short and QoL by the WHOQOL-Bref. The relationship between PA levels and sedentary time with QoL were assessed using unadjusted and adjusted generalized linear models. Results: The highest tertile of total PA was positively associated with the psychological (Exp β = 1.11; 95% CI: 1.02–1.22) and environmental (Exp β = 1.12; 95% CI: 1.01–1.23) QoL domains. The intermediate (Exp β = 1.12; 95% CI: 1.01–1.25) and highest (Exp β = 1.14; 95% CI: 1.02–1.27) tertiles of moderate-to-vigorous PA were positively associated with the physical domain. Similarly, both the intermediate (Exp β = 1.11; 95% CI: 1.01–1.22) and highest (Exp β = 1.12; 95% CI: 1.01–1.21) tertiles of moderate-to-vigorous PA were positively associated with the psychological domain. The highest tertile of sedentary time was associated with a decrease in the physical domain (Exp β = 0.88; 95% CI: 0.79–0.98). Conclusions: Higher levels of total and moderate-to-vigorous PA were associated with better QoL, while greater sedentary time was associated with poorer QoL. Full article

(This article belongs to the Special Issue One Size Does Not Fit All: New Strategies to Improve Overall Health and Physical Activity Behavior in Vulnerable Populations)

14 pages, 662 KiB

Open AccessArticle

Changes in Body Mass Index Among Korean Adolescents Before and After COVID-19: A Comparative Study of Annual and Regional Trends

by Seongjun Ha

Int. J. Environ. Res. Public Health 2025, 22(7), 1136; https://doi.org/10.3390/ijerph22071136 - 18 Jul 2025

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Abstract

This study aimed to longitudinally analyze changes in body mass index (BMI) among Korean middle and high school students before and after the COVID-19 pandemic. Data were obtained from the national-level Physical Activity Promotion System (PAPS), collected between 2018 and 2024. A total [...] Read more.

This study aimed to longitudinally analyze changes in body mass index (BMI) among Korean middle and high school students before and after the COVID-19 pandemic. Data were obtained from the national-level Physical Activity Promotion System (PAPS), collected between 2018 and 2024. A total of 171,705 adolescents aged 13 to 18 were included in the analysis (86,542 males and 85,163 females), with a mean age of 15.2 years (SD = 1.68). Time-series analysis and two-way analysis of variance (ANOVA) were conducted to examine differences in BMI by year, sex, region (capital vs. non-capital), and urban–rural classification. The results indicated a significant increase in BMI during the pandemic period (2020–2022), peaking in 2022, followed by a gradual decline thereafter. Notably, male students and those living in rural or non-capital areas consistently exhibited higher BMI levels, suggesting structural disparities in access to physical activity opportunities and health resources. This study employed the Socio-Ecological Model and the Health Equity Framework as theoretical lenses to interpret BMI changes not merely as individual behavioral outcomes but as consequences shaped by environmental and policy-level determinants. The findings underscore the need for equity-based interventions in physical education and health policy to mitigate adolescent health inequalities during future public health crises. Full article

(This article belongs to the Special Issue Advances in Primary Health Care and Community Health)

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11 pages, 305 KiB

Open AccessArticle

Teachers’ Perspectives on the Impact of an Outdoor-Based Self-Care Training Program on Student Mental Health

by Katie A. Bucher, Connor M. Moriarty, Adam Lazarchak and Russell K. McIntire

Int. J. Environ. Res. Public Health 2025, 22(7), 1135; https://doi.org/10.3390/ijerph22071135 - 18 Jul 2025

Viewed by 84

Abstract

As mental health disorders in the U.S. increase at an alarming rate, schools are looking for prevention and mitigation interventions for their students. This study reports teachers’ perspectives on the effectiveness of a school program situated at the intersection of self-care and nature-based [...] Read more.

As mental health disorders in the U.S. increase at an alarming rate, schools are looking for prevention and mitigation interventions for their students. This study reports teachers’ perspectives on the effectiveness of a school program situated at the intersection of self-care and nature-based interventions at a vocational technical high school. Eight classes received between one and four “Intro to Well-Being” sessions, designed to take students outside and develop self-awareness, sense of connection, and reduce stress. Upon the conclusion of the program, classroom teachers were interviewed to identify the perceptions of the sessions and their impact on student and classroom outcomes. Teachers described the sessions as beneficial to students’ expression of emotions, mindfulness skills, personal/social connections, and classroom atmosphere. Teachers also reflected on challenges and provided recommendations for future implementation. Outdoor-based self-care programs, administered at schools, may be a promising program model to support the social and emotional health of students. Full article

(This article belongs to the Special Issue Mental Health and Wellbeing of Children and Adolescents)

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2 pages, 184 KiB

Open AccessCorrection

Correction: Martin et al. The Health Literacy of First Year Physiotherapy and Speech Pathology Students and Their Perceived Future Roles in Supporting Their Clients’ Health Literacy. Int. J. Environ. Res. Public Health 2023, 20, 6013

by Romany Martin, Jade Cartwright and Marie-Louise Bird

Int. J. Environ. Res. Public Health 2025, 22(7), 1134; https://doi.org/10.3390/ijerph22071134 - 18 Jul 2025

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Abstract

The authors have requested that the following changes be made to the original publication [...] Full article

24 pages, 816 KiB

Open AccessReview

Implementation of Behavior Change Theories and Techniques for Physical Activity Just-in-Time Adaptive Interventions: A Scoping Review

by Parker Cotie, Amanda Willms and Sam Liu

Int. J. Environ. Res. Public Health 2025, 22(7), 1133; https://doi.org/10.3390/ijerph22071133 - 17 Jul 2025

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Abstract

(1) Background: Physical activity (PA) is a key modifiable risk factor for chronic diseases, yet many adults do not meet PA guidelines. Just-in-time adaptive interventions (JITAIs), a type of mobile health (mHealth) intervention, offer tailored support based on an individual’s context to promote [...] Read more.

(1) Background: Physical activity (PA) is a key modifiable risk factor for chronic diseases, yet many adults do not meet PA guidelines. Just-in-time adaptive interventions (JITAIs), a type of mobile health (mHealth) intervention, offer tailored support based on an individual’s context to promote PA. Integrating behavior change techniques (BCTs) and theories is critical to the design of effective mHealth interventions. Understanding which BCTs and theories work best can inform future JITAI development. (2) Objective: The objective of this study is to examine how behavior change theories and BCTs are implemented in mHealth PA JITAIs and assess their relationship with PA-related outcomes. (3) Methods: This scoping review followed the PRISMA-ScR guidelines. A total of 29 studies were included. (4) Results: The most commonly used BCTs include prompts/cues (n = 29), goal-setting (behavior) (n = 15), and feedback on behavior (n = 14), while self-determination theory (n = 4) and social cognitive theory (n = 4) are the most commonly used theories. However, there is insufficient evidence as to which theories and BCTs are most effective in eliciting effective PA behavior change. (5) Conclusions: Clearer reporting and integration of BCTs and behavior change theories, along with optimized user interfaces, are needed to improve the intervention quality, replicability, and long-term effectiveness of PA JITAIs. Full article

(This article belongs to the Special Issue Challenges and Opportunities for Digital Health Interventions to Improve Health Services Quality)

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24 pages, 3050 KiB

Open AccessArticle

Assessing Occupational Safety Risks and Challenges Among Informal Welders in Pretoria West, South Africa

by Marvin Mashimbyi, Kgotatso Jeanet Seisa, Muelelwa Ramathuthu and Maasago Mercy Sepadi

Int. J. Environ. Res. Public Health 2025, 22(7), 1132; https://doi.org/10.3390/ijerph22071132 - 17 Jul 2025

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Abstract

Background: Informal welders in Pretoria West face growing occupational safety risks due to hazardous working environments and limited regulatory oversight. Despite the high-risk nature of their work, many remain unaware of relevant safety legislation and inconsistently use personal protective equipment (PPE). This study [...] Read more.

Background: Informal welders in Pretoria West face growing occupational safety risks due to hazardous working environments and limited regulatory oversight. Despite the high-risk nature of their work, many remain unaware of relevant safety legislation and inconsistently use personal protective equipment (PPE). This study aimed to investigate the occupational safety risks, challenges, and levels of compliance with safety practices among informal welders in Pretoria West, South Africa. Methods: A cross-sectional mixed-methods approach was employed, incorporating both qualitative and quantitative designs. Data were collected from 40 male welders (aged 20–55 years) using structured questionnaires, observational checklists, and semi-structured interviews. Descriptive statistics were generated using Microsoft Excel, while thematic content analysis was applied to the qualitative data. Results: Eighty-five percent (85%) of welders reported using gas welding, and more than half had received training in welding and PPE use; however, 47.5% had no formal training. A high prevalence of work-related injuries was reported, including burns, cuts, and eye damage. Common safety concerns identified were burns (42.5%), electric shocks (35%), and malfunctioning equipment. Observational data revealed inconsistent PPE use, particularly with flame-resistant overalls and eye protection. Qualitative insights highlighted challenges such as demanding client expectations, hazardous physical environments, and inadequate equipment maintenance. Many sites lacked compliance with occupational safety standards. Conclusion: The study reveals critical gaps in safety knowledge, training, and PPE compliance among informal welders. These deficiencies significantly elevate the risk of occupational injuries. Strengthening occupational health and safety regulations, improving access to PPE, and delivering targeted training interventions are essential to safeguard the well-being of welders and those in their surrounding communities. Full article

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21 pages, 691 KiB

Open AccessSystematic Review

Breast Cancer Survivors’ Perception on Health Promotion and Healthy Lifestyle: A Systematic Review and Qualitative Meta-Synthesis

by Luca Guardamagna, Orejeta Diamanti, Giovanna Artioli, Lorenzo Casole, Matteo Bernardi, Francesca Bonadies, Enrico Zennaro, Gloria Maria Modena, Tiziana Nania and Federica Dellafiore

Int. J. Environ. Res. Public Health 2025, 22(7), 1131; https://doi.org/10.3390/ijerph22071131 - 17 Jul 2025

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Abstract

Aims: To systematically review and synthesize qualitative research exploring the Breast Cancer Survivors (BCSs)’ perception of health promotion interventions and informing strategies to mitigate recurrence risk within five years post-treatment and improve clinical outcomes. Specifically, this study addresses the question: “How do women [...] Read more.

Aims: To systematically review and synthesize qualitative research exploring the Breast Cancer Survivors (BCSs)’ perception of health promotion interventions and informing strategies to mitigate recurrence risk within five years post-treatment and improve clinical outcomes. Specifically, this study addresses the question: “How do women diagnosed with breast cancer perceive health promotion interventions for recurrence prevention?” Design: A systematic review and qualitative meta-synthesis were performed. Data Sources: A systematic search of scientific databases (CINAHL, MEDLINE, and Scopus) was undertaken in November 2024. The reference list was cross-referenced and hand-searched to identify additional articles. Review Methods: Studies were included if they met the following criteria: they were primary qualitative studies focusing on BCSs within five years post-treatment, involving participants who had completed surgery, radiotherapy, or chemotherapy in the same time frame, as this period is critical for monitoring recurrence and implementing health promotion interventions. Only studies published in peer-reviewed journals and written in Italian, English, French, or Spanish were considered, provided that an abstract and the full text were available. Moreover, eligible studies had to be conducted in high-income or middle-income countries. Studies were excluded if they focused exclusively on advanced or metastatic breast cancer, if they involved mixed cancer populations without reporting separate data for BCSs, or if they were non-qualitative studies or gray literature. The review study protocol was registered in the PROSPERO database (CRD42024626033). Results: The literature search identified 490 records, 13 articles from databases, and 3 articles identified via other methods (web and citation searching) that met inclusion criteria. A narrative synthesis approach allowed the emerging five themes: (I) Challenges, (II) Self-motivation and empowerment, (III) The relationships as a facilitator, (IV) Barriers to change, and (V) Proactive support strategies. Conclusions: Addressing internal and external factors that influence health behaviors is essential to improve adherence, reduce recurrence risk, and enhance quality of life. Tailored interventions, social support, and healthcare engagement are crucial in this effort. Impact: Our meta-synthesis highlighted significant challenges as well as valuable resources for health promotion among BCSs, suggesting practical and tailored approaches to improving the adoption of healthy behaviors, supported by relationships and targeted support strategies. Full article

(This article belongs to the Section Global Health)

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13 pages, 1243 KiB

Open AccessArticle

A Tandem MS Platform for Simultaneous Determination of Urinary Malondialdehyde and Diphenyl Phosphate

by Gabriela Chango, Diego García-Gómez, Carmelo García Pinto, Encarnación Rodríguez-Gonzalo and José Luis Pérez Pavón

Int. J. Environ. Res. Public Health 2025, 22(7), 1130; https://doi.org/10.3390/ijerph22071130 - 17 Jul 2025

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Abstract

This study presents an advanced analytical method for the simultaneous quantification of malondialdehyde (MDA), a biomarker of oxidative stress, and diphenyl phosphate (DPhP), a metabolite of the organophosphate flame retardant triphenyl phosphate (TPhP), in human urine. The method integrates hydrophilic interaction liquid chromatography [...] Read more.

This study presents an advanced analytical method for the simultaneous quantification of malondialdehyde (MDA), a biomarker of oxidative stress, and diphenyl phosphate (DPhP), a metabolite of the organophosphate flame retardant triphenyl phosphate (TPhP), in human urine. The method integrates hydrophilic interaction liquid chromatography (HILIC), a type of liquid chromatography suitable for polar compounds, for MDA separation, and an online restricted access material (RAM), a preconcentration column, for DPhP isolation, achieving high specificity and sensitivity. Validation with certified urine samples confirmed its robustness across diverse analyte concentrations and complex biological matrices. The optimized clean-up steps effectively minimized carryover, allowing for high-throughput analysis. Application to 72 urine samples revealed a significant positive correlation (ρ = 0.702, p-value = 1.9 × 10⁻⁷) between MDA and DPhP levels, supporting a potential link between oxidative stress and TPhP exposure. The subset analysis demonstrated a statistically significant moderate positive correlation in women (ρ = 0.622, p-value = 0.020), although this result should be interpreted with caution because of the limited sample size (N = 14). This method provides a powerful tool for biomonitoring oxidative stress and environmental contaminants, offering valuable insights into exposure-related health risks. Full article

(This article belongs to the Special Issue Research on Environmental Exposure, Pollution, and Epidemiology)

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12 pages, 419 KiB

Open AccessFeature PaperArticle

An Exploratory Retrospective Analysis of Racial Disparities in Fall-Related Injuries Among Black and White Breast Cancer Survivors Receiving Chemotherapy

by Asmaa Namoos, Dina Ramadan, Rashema Meekins, Vanessa Sheppard and Nicholas Thomson

Int. J. Environ. Res. Public Health 2025, 22(7), 1129; https://doi.org/10.3390/ijerph22071129 - 17 Jul 2025

Viewed by 283

Abstract

Purpose: This exploratory retrospective analysis examined racial disparities in fall-related injuries among Black and White breast cancer survivors who received chemotherapy, focusing on the risks associated with specific chemotherapy regimens. Methods: Using real-world data from the TriNetX research platform, we analyzed a cohort [...] Read more.

Purpose: This exploratory retrospective analysis examined racial disparities in fall-related injuries among Black and White breast cancer survivors who received chemotherapy, focusing on the risks associated with specific chemotherapy regimens. Methods: Using real-world data from the TriNetX research platform, we analyzed a cohort of 3223 Stage I–III breast cancer survivors with complete data on race, chemotherapy exposure, and fall-related injuries. The final sample included only Black and White patients treated with chemotherapy between 1 January 2019 and 31 December 2023. Fall events within six months post-chemotherapy were analyzed. Logistic regression models evaluated associations between chemotherapy type and fall risk by race. Results: Black breast cancer survivors experienced a significantly higher rate of fall-related injuries (14.7%) compared to White survivors (10.0%) (p < 0.001). The risk was especially elevated among Black patients receiving Cyclophosphamide, Docetaxel, and Carboplatin. Conclusion: This study highlights racial differences in chemotherapy-associated fall risk. While the findings are observational and limited by data availability, they underscore the need for more inclusive survivorship care and further investigation using detailed clinical and contextual variables. Real-world platforms like TriNetX can help identify early signals of disparities that merit prospective study. Full article

(This article belongs to the Special Issue Breast Health and Cancer Awareness: Addressing Breast Cancer Disparities from Etiology to Survivorship)

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18 pages, 5039 KiB

Open AccessArticle

Global Research Trends on Water Contamination by Microorganisms: A Bibliometric Analysis

by Zoila Isabel Cárdenas Tirado, Isaías Wilmer Duenas Sayaverde, Rosario del Socorro Avellaneda Yajahuanca, Sdenka Caballero Aparicio, Kelly Myriam Jiménez de Aliaga, Edo Gallegos Aparicio, Maria Antonieta Rubio Tyrrel, Maria do Livramento Fortes Figueiredo, José Wicto Pereira Borges, Rosilane de Lima Brito Magalhães, Denise Andrade, Daniela Reis Joaquim de Freitas, Ana Raquel Batista de Carvalho and Maria Eliete Batista Moura

Int. J. Environ. Res. Public Health 2025, 22(7), 1128; https://doi.org/10.3390/ijerph22071128 - 17 Jul 2025

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Abstract

Water is an essential resource for life; however, the quality of available water on the planet has been compromised due to various factors, including microbiological contamination. Objective: To analyze the global scientific production of microbiological water contamination using bibliometric methods. Method: A search [...] Read more.

Water is an essential resource for life; however, the quality of available water on the planet has been compromised due to various factors, including microbiological contamination. Objective: To analyze the global scientific production of microbiological water contamination using bibliometric methods. Method: A search for scientific articles was conducted using the advanced query function in the Web of Science™ database, specifically in its core collection, on 26 February 2025. Data from 2000 articles were analyzed using the Bibliometrix package in R (version 4.2.1) and the Biblioshiny application (version 2.0). Results: The evaluated articles were published between 1952 and 2025, with a peak in publications in 2022. The journal Water Research stood out as the most relevant, publishing 128 articles. The Egyptian Knowledge Bank was identified as the most productive institution, while China had the highest number of contributing authors. The most cited article received 475 citations. Additionally, KeyWords Plus™ highlighted the focus of the studies on ecological and biotechnological methods for contaminant removal, as well as the presence of waterborne pathogens and their inactivation methods. Conclusions: The results show a growing interest in the development of ecological and biotechnological methods for contaminant removal and pathogen inactivation in water. The integration of artificial intelligence with real-time monitoring systems emerges as a promising strategy for improving water quality management. These findings highlight the relevance of the topic for public health and health education. Full article

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1 pages, 177 KiB

Open AccessRetraction

RETRACTED: Muniba; Yu, B. Does Innovative City Pilot Policy Stimulate the Chinese Regional Innovation: An Application of DID Model. Int. J. Environ. Res. Public Health 2023, 20, 1245

by Muniba and Baorong Yu

Int. J. Environ. Res. Public Health 2025, 22(7), 1127; https://doi.org/10.3390/ijerph22071127 - 17 Jul 2025

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Abstract

The journal retracts the article “Does Innovative City Pilot Policy Stimulate the Chinese Regional Innovation: An Application of DID Model” [...] Full article

27 pages, 1139 KiB

Open AccessReview

Screening Measures of Perinatal Mental Health and Wellbeing in Fathers: A Scoping Review

by Vincent Mancini, Yonatan Ambrosio Lomeli, Thomas P. Nevill, Thomas B. Marsh, Ezra Kneebone and Alka Kothari

Int. J. Environ. Res. Public Health 2025, 22(7), 1126; https://doi.org/10.3390/ijerph22071126 - 16 Jul 2025

Viewed by 293

Abstract

Accurately screening fathers for perinatal mental health problems requires well-validated screening instruments that assess the expression of paternal perinatal mental distress. This study aimed to identify and describe the psychometric properties of perinatal mental health screening instruments administered to paternal cohorts within the [...] Read more.

Accurately screening fathers for perinatal mental health problems requires well-validated screening instruments that assess the expression of paternal perinatal mental distress. This study aimed to identify and describe the psychometric properties of perinatal mental health screening instruments administered to paternal cohorts within the past two decades. A scoping review was conducted following Arksey and O’Malley’s scoping review framework and is reported in line with the PRISMA-ScR guidelines. A systematic search of Embase, PsycINFO, Medline, and ProQuest databases identified peer-reviewed literature published within the past 20 years that implemented a screening instrument for fathers’ perinatal mental health within the first 12 months of their child’s birth. Twenty-eight instruments used to screen fathers’ perinatal mental health were identified across 36 studies. The instruments most frequently assessed symptoms of depression. Only five were explicitly developed for fathers and while these instruments produced promising results, further evaluation is necessary before they can be considered a superior screening method compared to existing instruments. Full article

(This article belongs to the Special Issue Mental Health Services in Primary Care Settings: Challenges, Opportunities and Best Practices)

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28 pages, 5314 KiB

Open AccessArticle

Environmental Cyanide Pollution from Artisanal Gold Mining in Burkina Faso: Human Exposure Risk Analysis Based on a Conceptual Site Model

by Edmond N’Bagassi Kohio, Seyram Kossi Sossou, Hela Karoui and Hamma Yacouba

Int. J. Environ. Res. Public Health 2025, 22(7), 1125; https://doi.org/10.3390/ijerph22071125 - 16 Jul 2025

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Abstract

Artisanal and small-scale gold mining (ASGM) in Burkina Faso increasingly relies on cyanide, intensifying concerns about environmental contamination and human exposure. This study assessed free cyanide levels in water and soil across three ASGM sites—Zougnazagmiline, Guido, and Galgouli. Water samples (surface and groundwater) [...] Read more.

Artisanal and small-scale gold mining (ASGM) in Burkina Faso increasingly relies on cyanide, intensifying concerns about environmental contamination and human exposure. This study assessed free cyanide levels in water and soil across three ASGM sites—Zougnazagmiline, Guido, and Galgouli. Water samples (surface and groundwater) and topsoil (0–20 cm) were analyzed using the pyridine–pyrazolone method. Data were statistically and spatially processed using SPSS version 29.0 and the Google Earth Engine in conjunction with QGIS version 3.34, respectively. A site conceptual model (SCM) was also developed, based on the literature review, field observations, and validation by multidisciplinary experts in public health, toxicology, ecotoxicology, environmental engineering, and the mining sector, through a semi-structured survey. The results showed that 9.26% of the water samples exceeded the WHO guideline (0.07 mg/L), with peaks of 1.084 mg/L in Guido and 2.42 mg/L in Galgouli. At Zougnazagmiline, the water type differences were significant (F = 64.13; p < 0.001), unlike the other sites. In the soil, 29.36% of the samples exceeded 0.5 mg/kg, with concentrations reaching 9.79 mg/kg in Galgouli. A spatial analysis revealed pollution concentrated near the mining areas but spreading to residential and agricultural zones. The validated SCM integrates pollution sources, transport mechanisms, exposure routes, and vulnerable populations, offering a structured tool for environmental monitoring and health risk assessment in cyanide-impacted mining regions. Full article

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15 pages, 1238 KiB

Open AccessArticle

Assessing Heat–Health Vulnerability Through Temporal, Demographic, and Spatial Lenses: A Time-Stratified Case-Crossover Analysis in New York State

by Heather Aydin-Ghormoz, Temilayo Adeyeye, Wanhsiang Hsu and Neil Muscatiello

Int. J. Environ. Res. Public Health 2025, 22(7), 1124; https://doi.org/10.3390/ijerph22071124 - 16 Jul 2025

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Abstract

New York State (NYS) has experienced warming outpacing the national average, and heat events are increasing. This case-crossover study uses conditional logistic regression to estimate how maximum heat index affects heat-related illness across temporal, demographic, and spatial groups in NYS, from May to [...] Read more.

New York State (NYS) has experienced warming outpacing the national average, and heat events are increasing. This case-crossover study uses conditional logistic regression to estimate how maximum heat index affects heat-related illness across temporal, demographic, and spatial groups in NYS, from May to September, 2008–2019. The highest risks were in May (Relative Risk (RR) = 1.81, CI: 1.72, 1.90) and August (RR = 1.86, CI: 1.79, 1.94). Older adults, especially those aged 85 and above, are at greatest risk (RR = 1.83, CI: 1.71, 1.96). The Southern Tier climate region had a higher risk (RR = 1.93, CI: 1.80, 2.07) than several other regions. Overall, similar risk between rural and urban NYS was observed. Rural non-Hispanic Black (RR = 2.38, CI: 1.78, 3.19) populations had a higher risk than their urban counterparts. This study was innovative for NYS, providing a deeper understanding of heat–health risks to vulnerable sub-groups. This can assist with facilitating targeted interventions and public health messaging during the periods of highest risk, such as promoting awareness of cooling centers and air-conditioning benefits. Full article

(This article belongs to the Section Environmental Health)

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13 pages, 898 KiB

Open AccessArticle

The Impact of Air Quality on Patient Mortality: A National Study

by Divya Periyakoil, Isabella Chu, Ndola Prata and Marie Diener-West

Int. J. Environ. Res. Public Health 2025, 22(7), 1123; https://doi.org/10.3390/ijerph22071123 - 16 Jul 2025

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Abstract

Introduction: Air pollution is a risk factor for a variety of cardiopulmonary diseases and is a contributing factor to cancer, diabetes, and cognitive impairment. The impact on mortality is not clearly elucidated. Objectives: The goal of this study is to determine the impact [...] Read more.

Introduction: Air pollution is a risk factor for a variety of cardiopulmonary diseases and is a contributing factor to cancer, diabetes, and cognitive impairment. The impact on mortality is not clearly elucidated. Objectives: The goal of this study is to determine the impact (if any) of air pollution on the 5-year mortality of patients in the American Family Cohort (AFC) dataset. Methods: The AFC dataset is derived from the American Board of Family Medicine PRIME Registry electronic health record data. It includes longitudinal information from 6.6 million unique patients from an estimated 800 primary care practices across 47 states, with 40% coming from rural areas. The Environmental Protection Agency’s Air Quality Index (AQI) measures were downloaded for the study period (2016–2022). Using the Python library pandas, the AFC and EPA datasets were merged with respect to date, time, and location. Cox Regression Models were performed on the merged dataset to determine the impact (if any) of air quality on patients’ five-year survival. In the model, AQI was handled as a time-independent (time-fixed) covariate. Results: The group with AQI > 50 had an adjusted hazard of death that was 4.02 times higher than the hazard of death in the group with AQI ≤ 50 (95% CI: 3.36, 4.82, p < 0.05). The hazard of death was 6.73 times higher in persons older than 80 years of age (95% CI: 5.47, 8.28; p < 0.05) compared to those younger than 80 years of age. Black/African American patients had a 4.27 times higher hazard of death (95%CI: 3.47, 5.26; p < 0.05) compared to other races. We also found that regional effects played a role in survival. Conclusions: Poor air quality was associated with a higher hazard of mortality, and this phenomenon was particularly pronounced in Black/African American patients and patients older than 80 years of age. Air pollution is an important social determinant of health. Public health initiatives that improve air quality are necessary to improve health outcomes. Full article

(This article belongs to the Special Issue Air Pollution Exposure and Its Impact on Human Health)

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18 pages, 549 KiB

Open AccessArticle

Rethinking Smoking and Quitting in Low-Income Contexts: A Qualitative Analysis with Implications for Practice and Policy

by Monique T. Cano, Oscar F. Rojas Perez, Sara Reyes, Blanca S. Pineda and Ricardo F. Muñoz

Int. J. Environ. Res. Public Health 2025, 22(7), 1122; https://doi.org/10.3390/ijerph22071122 - 16 Jul 2025

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Abstract

Despite a general decline in smoking rates among the U.S. population, smoking among low-income populations remains disproportionately high, likely due to the social determinants of health. To inform tailored approaches and responsive public health policies, the aim of this study was to qualitatively [...] Read more.

Despite a general decline in smoking rates among the U.S. population, smoking among low-income populations remains disproportionately high, likely due to the social determinants of health. To inform tailored approaches and responsive public health policies, the aim of this study was to qualitatively explore the sociocultural contexts, attitudes, and behaviors regarding smoking and quitting in a sample of low-income adults who smoke. In-depth, semi-structured qualitative interviews were conducted with 20 adults. Participants were recruited through local safety-net primary care clinics and community sites. A thematic analytic approach was utilized to analyze transcribed interviews. In exploring smoking and quitting within the context of low-income individuals, the following six themes were identified: caught between health and tobacco use; the nuances of context; roadblocks to quitting; motivation without movement; a temporary escape; and one size does not fit all. Insights into sociocultural and environmental contexts that shape smoking and quitting among low-income individuals revealed a complex interplay of factors that perpetuate smoking behavior and make it difficult to achieve sustained cessation. The study findings point to the importance of patient-centered and collaborative approaches that tailor smoking cessation efforts to the unique needs and lived experiences of low-income people who smoke. Full article

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Int. J. Environ. Res. Public Health, Volume 22, Issue 7 (July 2025) – 182 articles

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