Green Health, Volume 2, Issue 1 (March 2026) – 7 articles

Climate change poses a growing threat to global health, yet healthcare systems contribute substantially to environmental harm through energy use, waste, and greenhouse gas (GHG) emissions. Among hospital departments, Intensive Care Units (ICUs) are among the most resource- and energy-intensive, generating disproportionately high greenhouse gas (GHG) emissions. The aim of this systematic review is to synthesize the literature on the environmental footprint of ICUs and to develop evidence-based strategies for creating sustainable ‘Green ICUs’ in accordance with the PRISMA 2020 guidelines. Peer-reviewed studies published between 2012 and October 2025 were identified through searches of major biomedical databases. Eligible studies examined the impacts of climate change on human health and infectious diseases, the ecological footprint of medical imaging and personal protective equipment, and sustainability interventions relevant to adult intensive care units. The environmental footprint of ICUs ranges from 88 to 178 kg CO₂-equivalents per patient per day. High electricity consumption, especially from heating, ventilation, and air-conditioning (HVAC) systems, along with single-use medical supplies and diagnostic imaging, drives this impact. Life-cycle assessments consistently demonstrate that reusable textiles, optimized energy systems, and rationalized diagnostic practices significantly reduce emissions and waste. Educational and behavioral interventions were effective in reducing unnecessary consumable use while maintaining patient safety. A “Green ICU” model integrating energy efficiency, sustainable procurement, waste reduction, and staff education can substantially reduce environmental harm without compromising quality of care. Full article

The last few years have been marked by intense debates about the environmental agenda. Forums all over the world are discussing effective actions that can mitigate the effects of human actions on the environment. What was once destined for the imposed policy of developed countries upon emerging ones is now a global policy. Countries, nations, and the corporate world need to adopt urgent measures to make their activities less impactful before the feared tipping point is reached. In this context, hospitals (public and private) take on a fundamental role. As major consumers of water, generators of waste, and sources of high greenhouse gas emissions, hospital ecosystems must re-evaluate their processes to ensure the efficient use of water and energy resources. Although still a recent action, the Green Health concept has been disseminated globally, contributing to the achievement of the Sustainable Development Goals. The present study analyzes the current landscape of Green Health within the Brazilian context, based on a review of scholarly literature. To this end, consultations were made to publications deposited in the period from 2003 to 2025, whose information was processed and used to generate similarity visualization maps. This exploratory study sought to provide a proof of concept by defining a baseline to assess how the term ‘Green Health’ is being appropriated by researchers in Brazil. The results indicate that even though there are some actions in Brazil directed toward Green Health practices, they are modest and lack greater integration, especially regarding research on the topic. Full article

Cholera outbreaks are prevalent in coastal regions, where hydroclimatic factors play a critical role. However, evidence on their associations with different genotypes remains limited, and global projection remains lacking. We compiled cholera data from EnteroBase and WHO weekly reports covering 110 coastal countries from 1980 to 2022. A generalized additive model was used to examine the associations between hydroclimatic factors and different cholera serotypes and genotypes. We further projected future cholera occurrences for each coastal country under three climate change scenarios from 2025 to 2100. During the study period, Wave 3 of O1 replaced Wave 1 as the predominant genotype of cholera, while cholera O139 remained at low levels and only occurred in Asia. At the country–year level, each 1 °C increase in sea surface temperature (SST) was significantly associated with cholera occurrence (OR: 1.032, 95% CI: 1.023 to 1.040) and Wave 3 of O1 (OR: 1.149, 95% CI: 1.097 to 1.203). Drainage density (m/km²) and coastline ratio (%) were positively related to cholera, with ORs of 1.067 (95% CI: 1.046 to 1.087) and 1.022 (95% CI: 1.019 to 1.027). For future projections, five trend patterns were identified under different emission scenarios, with most countries showing increased cholera risk due to global hydroclimatic changes, peaking under the SSP585 scenario. Our findings reveal associations between hydroclimatic factors and different cholera genotypes and project future cholera risk across coastal countries, thereby providing evidence to inform genotype-specific surveillance and targeted prevention strategies at the global scale. Full article

Pancreatic cancer (PC) is among the deadliest cancers worldwide, with rising incidence and mortality. In Italy, marked regional differences in PC mortality suggest that diet may play a significant role. Data from 56 food categories across 20 regions were analyzed for PC standardized mortality ratios (PC-SMRs) from 2003 to 2022. The results showed significantly higher PC mortality in northern Italy compared to the South. Spearman correlations identified specific dietary drivers: “positively correlated” foods more prevalent in the North, such as beef, processed meat, yogurt, and non-alcoholic beverages, were associated with higher PC-SMRs; conversely, “negatively correlated” foods, including veal, lamb, flour, legumes, tomatoes, were consumed more in southern regions with lower mortality. Regional disparities in antioxidant micronutrients like selenium and carcinogenic factors like alcohol also aligned with mortality gradients. In conclusion, regional food consumption patterns significantly correlate with PC mortality in Italy. The higher adherence to Mediterranean-style dietary components in the South appears to provide a protective effect, whereas Westernized patterns in the North are associated with increased risk. This study aimed to investigate the association between regional food consumption patterns and PC mortality across Italy, using PC-SMR and household food expenditure data. Full article

Dengue is the most concerning mosquito-borne neglected tropical disease globally. The disease is caused by the dengue virus (DENV) and transmitted by the vector mosquito species belonging to the genus Aedes Meigen, 1818, particularly Aedes aegypti (Linnaeus, 1762) and Aedes albopictus (Skuse, 1895). In 2024, global cases of dengue exceeded 7.6 million, with India reporting 233,519 cases. These statistics underscore the ongoing challenge of managing dengue outbreaks worldwide. For generations, tribal communities across India have employed medicinal plant-based extracts as mosquito and other insect repellents. Plant-based phytochemicals are largely preferred over synthetic insecticides due to their perceived safety, non-toxicity to non-target organisms, and environmental sustainability. This review provides a comprehensive overview of various phytochemicals extracted from Indian medicinal plants for their larvicidal activity against Aedes mosquitoes. Furthermore, the article also reviews the mode of action of these phytochemicals, including neurotoxicity, mitochondrial dysfunction, sterol carrier protein-2 inhibition, midgut cytotoxicity, insect growth regulation disruption, and antifeedant activity, which aids in formulating dengue vector control strategies. Based on this review, Ecbolin B from Ecbolium viride, Alizarin from Rubia cordifolia, and Azadirachtin from Azadirachta indica exhibited better larval mortality rates against Ae. aegypti, with LC50 values recorded at 0.70, 1.31, and 1.7 ppm, respectively. Full article

Background: Healthcare is a large contributor to greenhouse gas (GHG) emissions, contributing to climate change and health impairments. However, the magnitude of health and climate benefits of local and regional GHG mitigation strategies has not been well quantified. Few studies have demonstrated the use of public tools for this purpose in healthcare facilities. Methods: We evaluated several renewable energy and energy efficiency scenarios focused on one academic medical center in New York State. We used the Environmental Protection Agency’s (EPA) publicly available AVoided Emissions and geneRation Tool to estimate avoided GHG and health-harmful air pollutant emissions. The economic value of the resulting avoided health and climate damages was quantified using EPA’s CO-Benefits Risk Assessment screening tool. Results: Transitioning one healthcare institution to 100% solar energy and improving energy efficiency by 25% could yield approximately $807,000 to $1.5 million in annual health savings, with an additional $2.3 million benefits in avoided climate damages. There is an approximate $108.5–$196.6 million in annual climate and health benefits when extrapolating these energy solutions to hospitals across the same state. Conclusions: There are significant health savings from healthcare GHG mitigation strategies. This application of publicly available and accessible tools demonstrates ways to integrate climate and health benefits into local decision-making around climate change mitigation and sustainability efforts. Full article

Amphibians, as sensitive bioindicators, reflect environmental health issues that also impact human communities through shared pathways, including contaminated water and agricultural products. This perspective addresses the need to standardize the reporting of anomalies (defined as significant phenotypic deviations from typical morphology, structure, or coloration) in amphibians in Mexico, where inconsistent terminology and incomplete data limit their utility for environmental monitoring. We propose a framework that includes a classification of anomalies (structural and chromatic) and a field-based physical examination protocol to systematically document these cases. The approach integrates detailed guidelines to ensure comprehensive reporting and data comparability, addressing geographic and taxonomic biases. Recent findings highlight that over 50% of anomaly reports in Mexico are incidental, with predominant cases in Ambystomatidae, Hylidae, and Ranidae, and linked to anthropogenic pressures such as agrochemicals. The framework promotes interdisciplinary collaboration, citizen science, and emerging technologies like artificial intelligence for sustainable monitoring. By standardizing the detection and reporting of anomalies, this proposal strengthens the role of amphibians as sentinels of ecosystem health, with applications in Mexico and other regions facing high environmental degradation. Full article