International Journal of Environmental Research and Public Health

27 pages, 6977 KiB

Open AccessArticle

Urbanization and Health Inequity in Sub-Saharan Africa: Examining Public Health and Environmental Crises in Douala, Cameroon

by Babette Linda Safougne Djomekui, Chrétien Ngouanet and Warren Smit

Int. J. Environ. Res. Public Health 2025, 22(8), 1172; https://doi.org/10.3390/ijerph22081172 - 24 Jul 2025

Abstract

Africa’s rapid urbanization often exceeds the capacity of governments to provide essential services and infrastructure, exacerbating structural inequalities and exposing vulnerable populations to serious health risks. This paper examines the case of Douala, Cameroon, to demonstrate that health inequities in African cities are [...] Read more.

Africa’s rapid urbanization often exceeds the capacity of governments to provide essential services and infrastructure, exacerbating structural inequalities and exposing vulnerable populations to serious health risks. This paper examines the case of Douala, Cameroon, to demonstrate that health inequities in African cities are not simply the result of urban growth but are shaped by spatial inequities, historical legacies, and systemic exclusion. Disadvantaged neighborhoods are particularly impacted, becoming epicenters of health crises. Using a mixed-methods approach combining spatial analysis, household surveys and interviews, the study identifies three key findings: (1) Healthcare services in Douala are unevenly distributed and dominated by private providers, which limits access for low-income residents. (2) Inadequate infrastructure and environmental risks in informal settlements lead to a higher disease burden and an overflow of demand into better-equipped districts, which overwhelms public health centers across the city. (3) This structural mismatch fuels widespread reliance on informal and unregulated care practices. This study positions Douala as a microcosm of broader public health challenges in rapidly urbanizing African cities. It highlights the need for integrated urban planning and health system reforms that address spatial inequalities, strengthen public health infrastructure, and prioritize equity—key principles for achieving the third Sustainable Development Goal (ensuring good health and well-being for all residents) in sub-Saharan Africa. Full article

(This article belongs to the Special Issue SDG 3 in Sub-Saharan Africa: Emerging Public Health Issues)

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27 pages, 464 KiB

Open AccessReview

Caffeine in Aging Brains: Cognitive Enhancement, Neurodegeneration, and Emerging Concerns About Addiction

by Manuel Glauco Carbone, Giovanni Pagni, Claudia Tagliarini, Icro Maremmani and Angelo Giovanni Icro Maremmani

Int. J. Environ. Res. Public Health 2025, 22(8), 1171; https://doi.org/10.3390/ijerph22081171 - 24 Jul 2025

Abstract

This narrative review examines the effects of caffeine on brain health in older adults, with particular attention to its potential for dependence—an often-overlooked issue in geriatric care. Caffeine acts on central adenosine, dopamine, and glutamate systems, producing both stimulating and rewarding effects that [...] Read more.

This narrative review examines the effects of caffeine on brain health in older adults, with particular attention to its potential for dependence—an often-overlooked issue in geriatric care. Caffeine acts on central adenosine, dopamine, and glutamate systems, producing both stimulating and rewarding effects that can foster tolerance and habitual use. Age-related pharmacokinetic and pharmacodynamic changes prolong caffeine’s half-life and increase physiological sensitivity in the elderly. While moderate consumption may enhance alertness, attention, and possibly offer neuroprotective effects—especially in Parkinson’s disease and Lewy body dementia—excessive or prolonged use may lead to anxiety, sleep disturbances, and cognitive or motor impairment. Chronic exposure induces neuroadaptive changes, such as adenosine receptor down-regulation, resulting in tolerance and withdrawal symptoms, including headache, irritability, and fatigue. These symptoms, often mistaken for typical aging complaints, may reflect a substance use disorder yet remain under-recognized due to caffeine’s cultural acceptance. The review explores caffeine’s mixed role in neurological disorders, being beneficial in some and potentially harmful in others, such as restless legs syndrome and frontotemporal dementia. Given the variability in individual responses and the underestimated risk of dependence, personalized caffeine intake guidelines are warranted. Future research should focus on the long-term cognitive effects and the clinical significance of caffeine use disorder in older populations. Full article

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

19 pages, 909 KiB

Open AccessViewpoint

The Big Minority View: Do Prescientific Beliefs Underpin Criminal Justice Cruelty, and Is the Public Health Quarantine Model a Remedy?

by Alan C. Logan and Susan L. Prescott

Int. J. Environ. Res. Public Health 2025, 22(8), 1170; https://doi.org/10.3390/ijerph22081170 - 24 Jul 2025

Abstract

Famed lawyer Clarence Darrow (1857–1938) argued strongly for an early-life public health approach to crime prevention, one that focused on education, poverty reduction, and equity of resources. Due to his defense of marginalized persons and his positions that were often at odds with [...] Read more.

Famed lawyer Clarence Darrow (1857–1938) argued strongly for an early-life public health approach to crime prevention, one that focused on education, poverty reduction, and equity of resources. Due to his defense of marginalized persons and his positions that were often at odds with his legal colleagues and public opinion, he was known as the Big Minority Man. He argued that the assumption of free will—humans as free moral agents—justifies systems of inequity, retributive punishment, and “unadulterated brutality.” Here, the authors revisit Darrow’s views and expand upon them via contemporary research. We examine increasingly louder argumentation—from scholars across multiple disciplines—contending that prescientific notions of willpower, free will, blameworthiness, and moral responsibility, are contributing to social harms. We draw from biopsychosocial perspectives and recent scientific consensus papers calling for the dismantling of folk psychology ideas of willpower and blameworthiness in obesity. We scrutinize how the status quo of the legal system is justified and argue that outdated notions of ‘moral fiber’ need to be addressed at the root. The authors examine recent arguments for one of Darrow’s ideas—a public health quarantine model of public safety and carceral care that considers the ‘causes of the causes’ and risk assessments through a public health lens. In our view, public health needs to vigorously scrutinize the prescientific “normative” underpinnings of the criminal justice system. Full article

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11 pages, 248 KiB

Open AccessArticle

Food Security Among South Asian Americans: The Role of Availability, Affordability, and Quality of Culturally Appropriate Food

by Monideepa B. Becerra, Farhan Danish and Valentina Chawdhury

Int. J. Environ. Res. Public Health 2025, 22(8), 1169; https://doi.org/10.3390/ijerph22081169 - 24 Jul 2025

Abstract

Background: South Asian Americans (SAA) are one of the fastest-growing immigrant groups in the U.S. and face significant health disparities, particularly regarding chronic diseases like diabetes, hypertension, and cardiovascular disease. Dietary patterns play a crucial role in these disparities, with acculturation to Western [...] Read more.

Background: South Asian Americans (SAA) are one of the fastest-growing immigrant groups in the U.S. and face significant health disparities, particularly regarding chronic diseases like diabetes, hypertension, and cardiovascular disease. Dietary patterns play a crucial role in these disparities, with acculturation to Western diets linked to poorer health outcomes. Despite this, the impact of food insecurity on dietary habits among SAAs remains underexplored. This study aims to examine the availability, cost, and quality of ethnic food items and how food insecurity influences dietary practices in Southern California’s SAA population. Methods: The study was conducted in San Bernardino County, California, with field data collection focused on five South Asian ethnicity-specific grocery stores and three Western grocery stores. We assessed the availability and cost of key ingredients for commonly prepared SAA dishes. Additionally, focus group interviews were held with South Asian immigrants to understand food insecurity challenges and dietary adaptations. Results: The study found significant disparities in food availability and cost between SAA-ethnic grocery stores and Western stores. SAA stores were less accessible and more widely dispersed, with an average distance of 10 miles between them. While ingredients like ginger paste and cumin powder were available in both types of stores, items such as ghee, fenugreek seeds, and black gram were harder to find in Western stores. Focus group participants noted that ethnic foods, especially vegetarian ingredients, were more expensive than Western alternatives, leading many to substitute traditional meals with cheaper, less nutritious options. Participants also raised concerns about the poor quality of items in ethnic stores, such as expired produce, which further limited their food choices. Conclusions: Food insecurity, driven by limited availability, high cost, and poor quality of ethnic foods, poses significant challenges to the SAA community’s diet and health. Addressing these barriers could improve food security and health outcomes among SAA immigrants. Full article

(This article belongs to the Special Issue Role of Social Determinants in Health of Vulnerable Groups)

11 pages, 274 KiB

Open AccessArticle

Cardiovascular and Functional Consequences of Lung Function Impairment in Northern Thai Agricultural Workers

by Anurak Wongta, Muhammad Samar, Nan Ei Moh Moh Kyi, Tipsuda Pintakham, Nootchakarn Sawarng and Surat Hongsibsong

Int. J. Environ. Res. Public Health 2025, 22(8), 1168; https://doi.org/10.3390/ijerph22081168 - 23 Jul 2025

Abstract

In low- and middle-income countries, notably in rural agricultural populations exposed to environmental and occupational dangers, respiratory impairment and noncommunicable diseases (NCDs) are major public health issues. This cross-sectional study examined the associations between lung function, functional capacity, and cardiovascular responses to the [...] Read more.

In low- and middle-income countries, notably in rural agricultural populations exposed to environmental and occupational dangers, respiratory impairment and noncommunicable diseases (NCDs) are major public health issues. This cross-sectional study examined the associations between lung function, functional capacity, and cardiovascular responses to the Six-Minute Walk Test (6MWT) in 137 adults from San Pa Tong District, Northern Thailand. Lung function was assessed using spirometry, and participants were classified accordingly. Hemodynamic parameters, including blood pressure, heart rate, rate-pressure product, and oxygen saturation, were measured before and after the 6MWT. Participants with impaired lung function walked significantly shorter distances (p = 0.004), and walking distance was positively correlated with forced vital capacity (FVC) and forced expiratory volume in one second (FEV₁). Logistic regression confirmed that walking distance independently predicted lung function impairment after adjusting for age and sex. Cardiovascular responses to exercise also varied significantly across demographic subgroups. These findings support the use of the 6MWT as a practical, cost-effective, and scalable method for detecting lung function impairments in resource-limited rural settings. To our knowledge, this is among the first studies to demonstrate the predictive value of the 6MWT for lung function impairment in a Southeast Asian agricultural population. Full article

16 pages, 342 KiB

Open AccessArticle

Home Cultivation of Cannabis in a Context of Prohibition: Results from Two Online Cross-Sectional Surveys of People Using Cannabis Daily in France

by Martin Bastien, Salim Mezaache, Cécile Donadille, Laélia Briand Madrid, Maëla Lebrun, Victor Martin and Perrine Roux

Int. J. Environ. Res. Public Health 2025, 22(8), 1167; https://doi.org/10.3390/ijerph22081167 - 23 Jul 2025

Abstract

In recent decades, European countries have seen a substantial increase in home cultivation of cannabis. In France, the prevalence of cannabis use continues to increase despite its possession, sale, and cultivation being strictly illegal. The present study aimed to describe the profile and [...] Read more.

In recent decades, European countries have seen a substantial increase in home cultivation of cannabis. In France, the prevalence of cannabis use continues to increase despite its possession, sale, and cultivation being strictly illegal. The present study aimed to describe the profile and motivations of people in France who cultivate cannabis at home. We separately analyzed data from two convenience samples of people who use cannabis daily in France, based on two online cross-sectional surveys. In the first analysis (N = 3840), we used a multivariable logistic regression model to assess factors associated with home cultivation as the main source of cannabis supply. In the second analysis (N = 574), we described participants’ motivations for home cultivation and their cultivation patterns. In the two samples, 11% and 16% reported home cultivation as their main source of supply, respectively. Age, male gender, stable housing, living with a partner, consuming cannabis in herbal form, smoking joints with little or no tobacco, smoking cannabis from a bong or pipe, non-smoking modes of cannabis administration, and using cannabis exclusively for therapeutic reasons were all positively associated with home cultivation, while urban area of residence and at-risk alcohol use were negatively associated. The main reason reported for home cultivation was to manage quality. Few reported selling some of their crop, and most were self-sufficient. Finally, we interpret this practice as a personal response to cannabis prohibition and the unregulated market. Accordingly, possible harm reduction strategies are discussed. Full article

13 pages, 675 KiB

Open AccessArticle

Performance of Risk Scores in SARS-CoV-2 Infection: A Retrospective Study

by Alessandro Geremia, Arturo Montineri, Alessandra Sorce, Anastasia Xourafa, Enrico Buccheri, Antonino Catalano, Pietro Castellino, Agostino Gaudio and D.O.CoV Research

Int. J. Environ. Res. Public Health 2025, 22(8), 1166; https://doi.org/10.3390/ijerph22081166 (registering DOI) - 23 Jul 2025

Abstract

Prognostic scores that help allocate resources and time to the most critical patients could have potentially improved the response to the SARS-CoV-2 pandemic. We assessed the performance of five risk scores in predicting death or transfer to the intensive care unit (ICU) or [...] Read more.

Prognostic scores that help allocate resources and time to the most critical patients could have potentially improved the response to the SARS-CoV-2 pandemic. We assessed the performance of five risk scores in predicting death or transfer to the intensive care unit (ICU) or sub-intensive care unit (SICU) in hospitalised patients with SARS-CoV-2 infection, with the three aims of retrospectively analysing the effectiveness of these tools, identifying frail patients at risk of death or complications due to infection, and applying these tools in the event of future pandemics. A retrospective observational study was conducted by evaluating data from patients hospitalised with SARS-CoV-2 infection. Among 134 patients considered, 119 were enrolled. All patients were adults, with a mean age of 64 years, and were hospitalised in the Infectious Diseases Division. We compared the five scores using receiver operating characteristic curves and calculation of the areas under the curve (AUCs) to determine their predictive performance. Four of the five scores demonstrated a high accuracy in predicting mortality among COVID-19-positive patients, with AUCs between 0.749 and 0.885. However, only two of the five scores showed good performance in predicting transfer to the ICU or SICU, with AUCs ranging from 0.740 to 0.802. The 4C Mortality Score and COVID-GRAM presented the highest performance for both outcomes. These two scores are easy to apply and low cost. They could still be used in clinical practice as predictive tools for frail and elderly patients with SARS-CoV-2 infection, as well as in the event of future pandemics. Full article

(This article belongs to the Special Issue Control and Prevention of COVID-19 Spread in Post-Pandemic Era)

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2 pages, 192 KiB

Open AccessCorrection

Correction: Wiedermann et al. Health Information Use and Trust: The Role of Health Literacy and Patient Activation in a Multilingual European Region. Int. J. Environ. Res. Public Health 2025, 22, 570

by Christian J. Wiedermann, Verena Barbieri, Stefano Lombardo, Timon Gärtner, Patrick Rina, Klaus Eisendle, Giuliano Piccoliori, Adolf Engl and Dietmar Ausserhofer

Int. J. Environ. Res. Public Health 2025, 22(8), 1165; https://doi.org/10.3390/ijerph22081165 - 23 Jul 2025

Abstract

In the original publication [...] Full article

(This article belongs to the Special Issue Reducing Health Disparities: The Role of Health Literacy and Health Promotion)

16 pages, 351 KiB

Open AccessArticle

Pre-Exposure Prophylaxis Use Among Cisgender and Transgender Adult Entertainment Workers in Brazil

by Policardo Gonçalves da Silva, Lariane Angel Cepas, Isadora Silva de Carvalho, Álvaro Francisco Lopes de Sousa, Guilherme Reis de Santana Santos, Caíque Jordan Nunes Ribeiro and Ana Paula Morais Fernandes

Int. J. Environ. Res. Public Health 2025, 22(8), 1164; https://doi.org/10.3390/ijerph22081164 - 23 Jul 2025

Abstract

Adult entertainment work may be associated with increased vulnerability to sexually transmitted infections, particularly HIV. In Brazil, pre-exposure prophylaxis (PrEP) for HIV infection has been available through the Brazilian Unified Health System (SUS) since November 2017, representing a significant advancement in public sexual [...] Read more.

Adult entertainment work may be associated with increased vulnerability to sexually transmitted infections, particularly HIV. In Brazil, pre-exposure prophylaxis (PrEP) for HIV infection has been available through the Brazilian Unified Health System (SUS) since November 2017, representing a significant advancement in public sexual health policy. The objective of this study was to understand the individual and social determinants that promote PrEP use among adult entertainment workers. This was a cross-sectional, analytical, and quantitative study. A multivariate modeling approach was employed to identify factors independently associated with PrEP use. The study included 254 adult entertainment workers using oral PrEP through the SUS, predominantly young adults (141; 55.5%), SUS users (248; 97.6%), single (213; 83.9%), non-white (142; 55.9%), cisgender (148; 58.3%), and heterosexual (152; 59.8%). Factors independently associated with greater PrEP use included having adult entertainment as the main source of income (aPR: 2.69; 95% CI: 1.86–3.95), prior use of PEP (aPR: 2.49; 95% CI: 1.63–3.81), undergoing any type of health treatment (aPR: 1.56; 95% CI: 1.15–2.12), and having a history of STIs (aPR: 1.51; 95% CI: 1.10–2.08). Conclusion: PrEP use in this population was strongly influenced by structural and contextual factors, indicating that the availability of the technology alone does not ensure its effectiveness. Full article

13 pages, 424 KiB

Open AccessReview

by Anna Castaldo, Jesus Francisco Javier Leon Garcia, Alessandra D’Amico, Giulio Perrotta and Stefano Eleuteri

Int. J. Environ. Res. Public Health 2025, 22(8), 1163; https://doi.org/10.3390/ijerph22081163 - 22 Jul 2025

Abstract

Background: Sexuality is a central aspect of being human, even if people experience it in different ways in various stages of life. Sexuality in older people may be expressed, as well as affection, companionship, touch, and physical contact. However, older peoples’ sexual needs [...] Read more.

Background: Sexuality is a central aspect of being human, even if people experience it in different ways in various stages of life. Sexuality in older people may be expressed, as well as affection, companionship, touch, and physical contact. However, older peoples’ sexual needs are not properly considered by themselves, caregivers, or healthcare professionals. Reviews on barriers related to identification and satisfaction of sexual needs of people living in nursing home are scarce. In this scenario we intended to summarize the state of evidence regarding sexual need identification and satisfaction among older people living in nursing homes and possible barriers that could limit sexual need identification and satisfaction. Methods: We carried out a narrative review. The included studies responded to the research question, using the following key words: nursing homes, sexuality or sexual need, or sexual behavior, older people. Searched databases included PubMed, Embase, CINAHL, PsycInfo, and Scopus. Results: After searching and screening we included 22 studies, finding three main topics: 1. identification of sexual needs by residents and healthcare personnel attitude and practice; 2. barriers and reasons hindering the identification of sexual needs; and 3. manifestation and satisfaction of sexual needs. Conclusions: The findings showed that nursing homes’ residents have different sexual needs, but there are many organizational, educational, and cultural barriers and negative attitudes of healthcare personnel. Supporting nursing home residents to express their sexual needs is a challenge for the healthcare professionals and managers of nursing homes. Full article

(This article belongs to the Section Health Care Sciences)

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10 pages, 375 KiB

Open AccessArticle

Attainment of Community-Based Goals Is Associated with Lower Risk of Hospital Readmission for Older Australians Accessing the Australian Transition Care Program

by Salih A. Salih, Andrew Koo, Niamh Boland and Natasha Reid

Int. J. Environ. Res. Public Health 2025, 22(8), 1162; https://doi.org/10.3390/ijerph22081162 - 22 Jul 2025

Abstract

This study aimed to examine the 6-month hospital readmission rate for Transition Care Program (TCP) clients and its association with community goal attainment. This was a single-site retrospective cohort study of TCP clients admitted from 2014 to 2019. Goals were set at TCP [...] Read more.

This study aimed to examine the 6-month hospital readmission rate for Transition Care Program (TCP) clients and its association with community goal attainment. This was a single-site retrospective cohort study of TCP clients admitted from 2014 to 2019. Goals were set at TCP entry and coded as goals ‘within the home’ or ‘in the community’. Hospital readmissions were tracked using electronic health records. Logistic regression, area under the curve, and number needed to treat were the primary analyses performed. Of 747 (66.8% female and 33.2% male) client episodes, 164 (22%) resulted in a hospital readmission. Clients who were not readmitted to hospital set and achieved a higher number of community-based goals (1.08 vs. 0.8, p = 0.01 and 0.8 vs. 0.6, p = 0.001). Utilising a logistic regression model, each additional community goal achieved was associated with a 30% reduction in risk of readmission to the hospital (OR: 0.69, 95%CI: 0.5–0.8; p = 0.002), adjusted for age, sex, MBI change, number of home goals achieved, hospital length of stay and number of comorbidities. Achieving community-based goals can reduce the risk of hospital readmission by 30% after adjusting for demographic and clinical variables. Full article

(This article belongs to the Special Issue Care and Services in Healthy Aging)

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19 pages, 451 KiB

Open AccessReview

A Scoping Review on the Economic Impacts of Healthy Ageing Promotion and Disease Prevention in OECD Member Countries

by Ezgi Dilek Demirtas and Antoine Flahault

Int. J. Environ. Res. Public Health 2025, 22(8), 1161; https://doi.org/10.3390/ijerph22081161 - 22 Jul 2025

Abstract

The economic impact of health promotion and disease prevention interventions in ageing populations remains debated, as theories of morbidity compression and expansion offer contrasting views on the relationship between life expectancy and duration of morbidity. A MEDLINE search was conducted to identify studies [...] Read more.

The economic impact of health promotion and disease prevention interventions in ageing populations remains debated, as theories of morbidity compression and expansion offer contrasting views on the relationship between life expectancy and duration of morbidity. A MEDLINE search was conducted to identify studies evaluating the economic impact of health promotion or primary or secondary prevention interventions in OECD countries, over a lifetime time horizon. Among the 29 studies included, 16 reported cost-saving interventions (reducing costs while improving health outcomes), 11 reported cost-effective interventions (health gains at an acceptable additional cost based on an established threshold), and two presented cost-ineffective interventions (costs exceeding the threshold for the health benefits achieved). Interventions targeting diabetes and obesity prevention were cost-saving; cancer screening and fall prevention strategies were cost-effective; whereas interventions targeting rare diseases were cost-ineffective. Regulatory interventions were also cost-saving, while most programme-based interventions were cost-effective. Cost-saving or cost-effective interventions generally adopted broader analytical perspectives, while cost-ineffective ones employed narrower perspectives. The four studies that incorporated competing risks—despite using a narrower healthcare sector perspective—still found the interventions to be cost-saving or cost-effective interventions. None of the included studies assessed whether interventions led to morbidity compression or expansion. Only a few studies considered equity impact; those that did reported improved outcomes for disadvantaged groups, in regulatory and community-based interventions. Further research is needed to quantify morbidity outcomes and enhance methodological consistency, particularly with respect to analytical perspectives, the integration of competing risks, and the inclusion of equity analyses. Full article

(This article belongs to the Special Issue Risk Reduction for Health Prevention)

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14 pages, 280 KiB

Open AccessReview

Workplace Discrimination Against Pregnant and Postpartum Employees: Links to Well-Being

by Kimberly T. Schneider, Sarah C. Williams and Rory E. Kuhn

Int. J. Environ. Res. Public Health 2025, 22(8), 1160; https://doi.org/10.3390/ijerph22081160 - 22 Jul 2025

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Abstract

Pregnancy-related discrimination at work is a concern for many employees who navigate the pregnancy and postpartum stages of parenthood while working in the early-to-middle stages of their careers. Although there is legislation prohibiting pregnancy-related discrimination and ensuring accommodations postpartum, empirical evidence indicates many [...] Read more.

Pregnancy-related discrimination at work is a concern for many employees who navigate the pregnancy and postpartum stages of parenthood while working in the early-to-middle stages of their careers. Although there is legislation prohibiting pregnancy-related discrimination and ensuring accommodations postpartum, empirical evidence indicates many pregnant and postpartum employees still experience such behaviors. In this narrative review, we focus on describing the range of behaviors assessed in studies on pregnancy-related discrimination in several cultures, situating the occurrence of discrimination within theoretical frameworks related to stereotypes and gendered expectations. We also review evidence of employees’ postpartum experiences with a focus on the transition back to work, along with breastfeeding challenges related to pumping and storing milk at work. Regarding coping with pregnancy-related workplace discrimination and postpartum challenges during a return to work, we review the importance of social support, including instrumental and emotional support from allies and role models. Full article

(This article belongs to the Special Issue How Reproductive Life Events Influence Women's Mental Health)

18 pages, 1044 KiB

Open AccessReview

Mercury Exposure and Health Effects in Indigenous People from the Brazilian Amazon—Literature-Scoping Review

by Maria da Conceição Nascimento Pinheiro, Fabiana Costa Cardoso, Leonardo Breno do Nascimento de Aviz, José Aglair Barbosa de Freitas Junior, Márcia Cristina Freitas da Silva, Margareth Tavares Silva, Dirce Nascimento Pinheiro, Saul Rassy Carneiro, Elaine Rodrigues Pinheiro and Tereza Cristina Oliveira Corvelo

Int. J. Environ. Res. Public Health 2025, 22(8), 1159; https://doi.org/10.3390/ijerph22081159 - 22 Jul 2025

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Abstract

Background and purpose: Indigenous people in the Brazilian Amazon are exposed to mercury by eating methylmercury-contaminated fish. The lack of information on the health effects of prolonged exposure to mercury hinders the implementation of mitigation programs offered by the Brazilian government. This article [...] Read more.

Background and purpose: Indigenous people in the Brazilian Amazon are exposed to mercury by eating methylmercury-contaminated fish. The lack of information on the health effects of prolonged exposure to mercury hinders the implementation of mitigation programs offered by the Brazilian government. This article aims to evaluate the studies that have investigated mercury exposure in indigenous people living in the Brazilian Amazon. Methods: A scoping review of the literature was conducted from studies published between 1995 and 2024 in Portuguese, English, and Spanish that evaluated mercury (Hg) concentrations in hair samples in indigenous people from the Brazilian Amazon. Results: Using total mercury (TotalHg) values in hair samples, we analyzed exposure levels, prevalence, and toxic effects. We found 15 epidemiological studies with a cross-sectional design and sample sizes ranging from 31 to 910 participants. Four studies involved children and mothers, four of which were associated with clinical outcomes and three of which analyzed genetic polymorphism. Most of the communities evaluated had a high prevalence of mercury exposure, showing levels ranging from 0.8 to 83.89 µg/g, and the highest average TotalHg concentration was found among the Kayabi. Mercury was associated with hypertension, cognitive disorders, worse mental health indicators and central and peripheral neurological disorders. Conclusions: It is concluded that indigenous people in the Brazilian Amazon experience exposure levels that are causing damage to their health, and control measures must be adopted to prevent the situation from worsening. Full article

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Int. J. Environ. Res. Public Health, Volume 22, Issue 8 (August 2025) – 14 articles

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