International Journal of Environmental Research and Public Health

25 pages, 504 KiB

Open AccessReview

Evaluating User Safety Aspects of AI-Based Systems in Industrial Occupational Safety: A Critical Review of Research Literature

by Jaroslava Huber, Bernhard Anzengruber-Tanase, Martin Schobesberger, Michael Haslgrübler, Robert Fischer-Schwarz and Alois Ferscha

Int. J. Environ. Res. Public Health 2025, 22(5), 705; https://doi.org/10.3390/ijerph22050705 (registering DOI) - 29 Apr 2025

Abstract

AI technologies are becoming increasingly prevalent in industrial workplaces, extending their applications beyond productivity to critical areas such as occupational safety. From our perspective, it is important to consider the safety of these AI systems for users already at the research and development [...] Read more.

AI technologies are becoming increasingly prevalent in industrial workplaces, extending their applications beyond productivity to critical areas such as occupational safety. From our perspective, it is important to consider the safety of these AI systems for users already at the research and development stage, rather than only after deployment. Therefore, in this review, we synthesize publications that propose such AI-based safety systems to assess how potential risks are addressed early in their design and prototype stages. Consequently, we explore current advancements in AI-driven, sensor-based, and human-centered applications designed to enhance occupational safety by monitoring compliance, detecting hazards in real time, or assisting users. These systems leverage wearables and environmental sensing to proactively identify risks, support decision-making, and contribute to creating safer work environments. In this paper, we categorize the technologies according to the sensors used and highlight which features are preventive, reactive, or post-incident. Furthermore, we address potential risks posed by these AI applications, as they may introduce new hazards for workers. Through a critical review of current research and existing regulations, we identify gaps and propose key considerations for the safe and ethical deployment of trustworthy AI systems. Our findings suggest that in AI- and sensor-based research applications for occupational safety, some features and risks are considered notably less than others, from which we deduce that, while AI is being increasingly utilized to improve occupational safety, there is a significant need to address regulatory and ethical challenges for its widespread and safe adoption in industrial domains. Full article

(This article belongs to the Special Issue Navigating the AI-Driven Workplace: Emerging Challenges and Innovative Solutions in Occupational Health and Safety)

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19 pages, 9566 KiB

Open AccessArticle

Associations Between 10-Year Physical Performance and Activities of Daily Living Trajectories and Physical Behaviors in Older Adults

by Mikael Anne Greenwood-Hickman, Weiwei Zhu, Abisola Idu, Laura B. Harrington, Susan M. McCurry, Andrea Z. LaCroix, Pamela A. Shaw and Dori E. Rosenberg

Int. J. Environ. Res. Public Health 2025, 22(5), 704; https://doi.org/10.3390/ijerph22050704 (registering DOI) - 29 Apr 2025

Abstract

Physical function is likely bidirectionally associated with physical activity (PA), sedentary behavior (SB), and sleep. We examined trajectories of physical function as predictors of these behaviors in community-dwelling adults aged ≥65 y without dementia from the Adult Changes in Thought cohort. Exposures were [...] Read more.

Physical function is likely bidirectionally associated with physical activity (PA), sedentary behavior (SB), and sleep. We examined trajectories of physical function as predictors of these behaviors in community-dwelling adults aged ≥65 y without dementia from the Adult Changes in Thought cohort. Exposures were trajectories of physical performance (short Performance-Based Physical Function [sPPF]) and self-reported activities of daily living (ADL) impairment. Outcomes were device-measured PA and SB and self-reported sleep. We fit linear mixed-effects models to define trajectory slopes and intercepts for each functional measure over the prior 10 years. We used multivariable linear regression to investigate the relationship between trajectory features and outcomes, using bootstrap confidence intervals. Participants (N = 905) were 77.6 (SD = 6.9) years old, 55% female, 91% white, and had a median sPPF score of 9 (IQR = [8, 11]) and median impairment of 1 ADL (IQR = [0, 2]) at the time of activity measurement (baseline). Steeper decreases in sPPF (0.3-unit, 25% of the range) were associated with fewer steps (−1180, 95% CI = [−2853, −185]) and less moderate-to-vigorous PA (−15.7 min/day [−35.6, −2.3]). Steeper increases in ADL impairment were associated with 35.0 min/day (4.3, 65.0) additional sitting time, longer mean sitting bout duration (3.5 min/bout [0.8, 6.2]), fewer steps (−1372 [−2223, −638]), less moderate-to-vigorous PA (−13 min/day [−22.6, −5.0]), and more time-in-bed (25.5 min/day [6.5, 43.5]). No associations were observed with light PA or sleep quality. Worsening physical function is associated with lower PA and higher SB, but not with light-intensity movement or sleep quality, supporting the bidirectional nature of the relationship between physical function and physical behaviors. Full article

(This article belongs to the Special Issue Aging Strong: Promoting Exercise and Nutrition to Combat Frailty in Older Adults)

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11 pages, 884 KiB

Open AccessReview

Health Disparities at the Intersection of Racism, Social Determinants of Health, and Downstream Biological Pathways

by Roland J. Thorpe, Jr., Marino A. Bruce, Tanganyika Wilder, Harlan P. Jones, Courtney Thomas Tobin and Keith C. Norris

Int. J. Environ. Res. Public Health 2025, 22(5), 703; https://doi.org/10.3390/ijerph22050703 (registering DOI) - 29 Apr 2025

Abstract

Despite overall improvements in the accessibility, quality, and outcomes of care in the U.S. health care system over the last 30 years, a large proportion of marginalized racial and ethnic minority (minoritized) groups continue to suffer from worse outcomes across most domains. Many [...] Read more.

Despite overall improvements in the accessibility, quality, and outcomes of care in the U.S. health care system over the last 30 years, a large proportion of marginalized racial and ethnic minority (minoritized) groups continue to suffer from worse outcomes across most domains. Many of these health disparities are driven by inequities in access to and the scope of society’s health-affirming structural resources and opportunities commonly referred to as structural drivers or social determinants of health—SDoH. Persistently health-undermining factors in the social environment and the downstream effects of these inequities on neurocognitive and biological pathways exacerbate these disparities. The consequences of these circumstances manifest as behavioral, neurohormonal, immune, and inflammatory and oxidative stress responses, as well as epigenetic changes. We propose a theoretical model of the interdependent characteristics of inequities in the SDoH driven by race-based discriminatory laws, policies, and practices that eventually culminate in poor health outcomes. This model provides a framework for developing and validating multi-level interventions designed to target root causes, thereby lessening health disparities and accelerating improved health outcomes for minoritized groups. Full article

(This article belongs to the Special Issue 3rd Edition: Social Determinants of Health)

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19 pages, 902 KiB

Open AccessArticle

The Positive Influence of Individual-Level Disaster Preparedness on the Odds of Individual-Level Pandemic Preparedness—Insights from FEMA’s 2021–2023 National Household Survey

by Dionne Mitcham and Crystal R. Watson

Int. J. Environ. Res. Public Health 2025, 22(5), 702; https://doi.org/10.3390/ijerph22050702 (registering DOI) - 29 Apr 2025

Abstract

Objective: To explore the possible association and trends between individual-level disaster preparedness status (for natural, technological, and human-caused hazards) and the level of pandemic preparedness during the COVID-19 pandemic among adults in the U.S. from 2021 through 2023. Methods: Multivariate logistic regression was [...] Read more.

Objective: To explore the possible association and trends between individual-level disaster preparedness status (for natural, technological, and human-caused hazards) and the level of pandemic preparedness during the COVID-19 pandemic among adults in the U.S. from 2021 through 2023. Methods: Multivariate logistic regression was conducted using data from the U.S. Federal Emergency Management Agency’s (FEMA) annual National Household Survey (NHS) from 2021 to 2023 to identify statistically significant variables associated with personal pandemic preparedness behavior among participants of the nationally representative survey during the COVID-19 pandemic. Results: Overall, the results showed that the proportion of respondents that were considered prepared for a pandemic peaked in 2021 (54.0%) and steadily decreased in the following years (2022: 43.3%; 2023: 41.3%) highlighting the need for pandemic preparedness resources and educational campaigns to be available prior to a pandemic occurring. The final multivariate logistic regression models featuring consistent significant covariates demonstrated a highly statistically significant relationship between individual-level disaster preparedness and pandemic preparedness across all three study years (2021: odds ratio (OR): 21.35, standard error (SE): 2.59, p < 0.001; 2022: OR: 9.26, SE: 0.87, p < 0.001; 2023: OR: 6.75, SE: 0.59, p < 0.001). Conclusions: The significant results suggest individuals who are prepared for a disaster have higher odds of being prepared for a pandemic. These findings support the continued increase in collaboration between emergency management and public health entities to jointly support the development of evidence-based resources to increase personal preparedness for both disasters and pandemics. Full article

(This article belongs to the Special Issue Health Emergencies and Disasters Preparedness)

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11 pages, 801 KiB

Open AccessArticle

Cardiovascular, Hemodynamic, and Anthropometric Adaptations Induced by Walking Training at FATmax in Obese Males and Females over 45 Years Old

by Laurence Mille-Hamard, Iman Momken, Jean-Pierre Koralsztein and Véronique Louise Billat

Int. J. Environ. Res. Public Health 2025, 22(5), 701; https://doi.org/10.3390/ijerph22050701 (registering DOI) - 29 Apr 2025

Abstract

Aims and Objectives: The present study aimed to examine the effects of 6 months of unsupervised training, walking at maximal fat oxidation (FATmax), on body composition and cardiovascular function at rest and exercise, in middle aged obese subjects. Methods and results: A single [...] Read more.

Aims and Objectives: The present study aimed to examine the effects of 6 months of unsupervised training, walking at maximal fat oxidation (FATmax), on body composition and cardiovascular function at rest and exercise, in middle aged obese subjects. Methods and results: A single group with pre-test/post-test study design was conducted. Eighteen obese subjects (11 males and 7 females) over 45 were engaged in a non-supervised walking training for 6 months, 40 min, 3 times per week, at the targeted HR corresponding to FATmax (5.5 ± 0.6 km·h⁻¹). This training modality led to a reduction in obesity-related indicators among participants, including weight (−3.7 ± 3.4 kg), BMI (−1.4 ± 1.3 kg/m²), waist circumference (−5.6 ± 4.7 cm), and body fat percentage (−2.1 ± 2.7%). However, we observed a great variability in this response to training according to individuals. Furthermore, heart rate and rate of pressure product (RPP) at rest significantly decreased (6% and 11% respectively) as well as the cardiac load during exercise (RPP −11% and cardiac cost −8%) after training. In conclusion, walking at FATmax is an efficient non-supervised training modality, allowing improvement in both body parameters and cardiovascular markers at rest and during exercise in middle age obese subjects. Even if body parameter changes were modest, the cardiac load decrease is an important factor for reducing the risk of cardiovascular diseases in this population. Full article

(This article belongs to the Special Issue Long-Distance Running for Sport and Public Health: Advances in Methods, Technologies, and Applications)

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1 pages, 180 KiB

Open AccessRetraction

RETRACTED: Wee et al. Triaging Medical Referrals Based on Clinical Prioritisation Criteria Using Machine Learning Techniques. Int. J. Environ. Res. Public Health 2022, 19, 7384

by Chee Keong Wee, Xujuan Zhou, Ruiliang Sun, Raj Gururajan, Xiaohui Tao, Yuefeng Li and Nathan Wee

Int. J. Environ. Res. Public Health 2025, 22(5), 700; https://doi.org/10.3390/ijerph22050700 (registering DOI) - 29 Apr 2025

Abstract

The journal retracts and remove the article Triaging Medical Referrals Based on Clinical Prioritisation Criteria Using Machine Learning Techniques [...] Full article

22 pages, 1199 KiB

Open AccessArticle

Post-Traumatic Growth in Volunteers Following the 2023 Kahramanmaraş Earthquakes

by Kader Demiröz, Mehtap Kılıç and Sevda Demiröz Yıldırım

Int. J. Environ. Res. Public Health 2025, 22(5), 699; https://doi.org/10.3390/ijerph22050699 (registering DOI) - 28 Apr 2025

Abstract

The 6 February 2023 Kahramanmaraş earthquakes were devastating events that caused widespread destruction. This mixed-methods study examined post-traumatic growth (PTG) in volunteers who participated in the relief efforts. A total of 169 volunteers participated in the quantitative phase, completing a standardized PTG measure. [...] Read more.

The 6 February 2023 Kahramanmaraş earthquakes were devastating events that caused widespread destruction. This mixed-methods study examined post-traumatic growth (PTG) in volunteers who participated in the relief efforts. A total of 169 volunteers participated in the quantitative phase, completing a standardized PTG measure. In-depth interviews were conducted with 14 volunteers during the qualitative phase. The study found that gender had a significant effect on total PTG scores. Additionally, gender, earthquake experience, and volunteer organization were significant factors in the “change in self-concept” sub-dimension. Gender was the only significant factor in the “change in philosophy of life” sub-dimension. Qualitative analysis revealed that participants experienced trauma symptoms after the earthquake but also reported positive changes in self-concept and life philosophy. This study suggests that disasters can lead to PTG, despite the presence of trauma symptoms. Further research is needed to explore PTG in different disaster response groups. Full article

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14 pages, 1397 KiB

Open AccessArticle

The Ability of the Hopkins Symptom Checklist-5 to Identify Generalized Anxiety Disorder and Major Depressive Disorder in the General Population

by Benedicte Kirkøen, Ragnhild Elise Ørstavik, Anne Reneflot, Jens Christoffer Skogen, Børge Sivertsen and Ann Kristin Skrindo Knudsen

Int. J. Environ. Res. Public Health 2025, 22(5), 698; https://doi.org/10.3390/ijerph22050698 (registering DOI) - 28 Apr 2025

Abstract

Background: The Hopkins Symptom Checklist (HSCL) is a widely used measure of anxiety and depression symptoms. The short form HSCL-5 is especially suitable for large population-based studies, but its ability to detect mental disorders in the general population remains unknown. The aim [...] Read more.

Background: The Hopkins Symptom Checklist (HSCL) is a widely used measure of anxiety and depression symptoms. The short form HSCL-5 is especially suitable for large population-based studies, but its ability to detect mental disorders in the general population remains unknown. The aim of the study was to assess how well the HSCL-5 identified cases of generalized anxiety disorder (GAD) and major depressive disorder (MDD) measured by the Composite International Diagnostic Interview (CIDI) 5.0 and to find the optimal sex-specific cut-off levels of the HSCL-5. Methods: Participants from the population-based Trøndelag Health Study (HUNT) in Norway were recruited for the current study. Between April and September 2020, 1343 participants (64% women) aged 20–65 years completed the CIDI, followed by the HSCL-5. The overall agreement between the HSCL-5 and GAD or MDD measured by CIDI was examined with Receiver Operator Characteristics (ROC) analysis. Sensitivity, specificity, positive predictive value (PPV), and negative predictive values (NPV) for different cut-off levels were assessed. Results: The area under the curve for GAD or MDD was 0.90 (CI 95% = 0.85–0.95) for women and 0.85 (CI 95% = 0.68–1.00) for men. For women, a cut-off level of ≥1.80 had the best balance between sensitivity (85%) and specificity (84%), while the corresponding numbers were ≥2.00, 73%, and 93% for men. The global PPV was 21%, while the NPV was 99%. Conclusions: The HSCL-5 has high sensitivity and specificity for identifying cases of GAD or MDD. In the current study, the positive predictive value of HSCL-5 was low. Full article

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

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14 pages, 298 KiB

Open AccessArticle

Factors Associated with the Enjoyment of Physical Education Class for Children with Special Educational Needs

by Julie Dalgaard Guldager, Laura Mørk Emtoft, Line Nørgaard Remmen and Anette Lisbeth Bentholm

Int. J. Environ. Res. Public Health 2025, 22(5), 697; https://doi.org/10.3390/ijerph22050697 (registering DOI) - 28 Apr 2025

Abstract

Enjoying physical education class (PE) is important for children with special educational needs (SEN) due to its impact on their physical and mental health. However, there is a research gap concerning children with SEN and their enjoyment of PE. This exploratory study investigated [...] Read more.

Enjoying physical education class (PE) is important for children with special educational needs (SEN) due to its impact on their physical and mental health. However, there is a research gap concerning children with SEN and their enjoyment of PE. This exploratory study investigated how school children with and without SEN report enjoyment of physical education class and explored associated factors. A cross-sectional survey was conducted among school children with and without SEN. Both groups reported very high enjoyment of PE, but children without SEN had higher enjoyment. Among children with SEN, boys, those attending schools in East Denmark, and those engaged in leisure physical activity reported higher enjoyment levels, while children from larger schools consistently reported lower enjoyment levels. Understanding the differences in PE enjoyment between children with and without SEN is crucial for educators and policymakers to develop inclusive practices that ensure equitable experiences for all children, fostering a positive and supportive environment in school PE programs. Our findings highlight nuanced differences in PE enjoyment perceptions between children with and without SEN, emphasizing the need to consider diverse student characteristics when designing PE programs to enhance overall enjoyment. Full article

(This article belongs to the Special Issue Child Physical Activity and Health)

18 pages, 892 KiB

Open AccessReview

What Is the Impact of Unemployment as an Adverse Experience? Post-Traumatic Stress Disorder and Complex Post-Traumatic Stress Disorder: A Meta-Analysis

by Marcelo Nvo-Fernandez, Valentina Miño-Reyes, Carlos Serrano, Hedy Acosta-Antognoni, Fabiola Salas, Claudio Vásquez Wiedeman, Francisco Ahumada-Méndez and Marcelo Leiva-Bianchi

Int. J. Environ. Res. Public Health 2025, 22(5), 696; https://doi.org/10.3390/ijerph22050696 (registering DOI) - 28 Apr 2025

Abstract

This meta-analysis examined how unemployment, a psychosocial stressor, influences post-traumatic stress disorder (PTSD) and complex PTSD (CPTSD). It specifically explores unemployment as a risk factor for trauma, with emphasis on CPTSD, and investigates economic variables, including the GINI coefficient, as potential moderators. A [...] Read more.

This meta-analysis examined how unemployment, a psychosocial stressor, influences post-traumatic stress disorder (PTSD) and complex PTSD (CPTSD). It specifically explores unemployment as a risk factor for trauma, with emphasis on CPTSD, and investigates economic variables, including the GINI coefficient, as potential moderators. A systematic search in Web of Science, Scopus, and PubMed yielded 33 studies comprising more than 57,000 participants. Odds ratios (OR) were computed, and a random-effects model was used to synthesize the findings. Meta-regression analyses were conducted to evaluate the effects of economic inequality (GINI) and nominal gross domestic product (NGDP), but neither moderator reached statistical significance; this is addressed in detail in the Discussion. The results revealed that unemployment significantly elevated the risk for PTSD (OR = 1.500; logOR = 0.3826; PI: 0.457–4.702) and CPTSD (OR = 2.180; logOR = 0.7430; PI: 0.501–8.808), with a stronger impact on CPTSD. These findings emphasize unemployment as a pivotal predictor of trauma, especially CPTSD, broadening the traditional focus on interpersonal factors. They also highlight the importance of integrating psychosocial and economic variables into clinical assessments and public health policies. Addressing both unemployment and economic inequality could be critical for effective interventions and prevention efforts, underscoring the need for further multidisciplinary research. Full article

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

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13 pages, 420 KiB

Open AccessSystematic Review

Learning from COVID-19: A Systematic Review of the IHR-SPAR Framework’s Role in the Pandemic Response

by Ida Santalucia, Michele Sorrentino, Claudio Fiorilla, Sabrina Tranquilli, Giordana Strazza, Paolo Montuori, Raffaele Palladino, Maria Fiore, Margherita Ferrante and Maria Triassi

Int. J. Environ. Res. Public Health 2025, 22(5), 695; https://doi.org/10.3390/ijerph22050695 (registering DOI) - 27 Apr 2025

Abstract

The International Health Regulations (IHR) provide a global framework for health security, requiring annual reporting on 35 indicators across 15 core capacities via the State Parties Annual Reporting (SPAR) tool. The COVID-19 pandemic exposed gaps in the IHR framework and monitoring systems, prompting [...] Read more.

The International Health Regulations (IHR) provide a global framework for health security, requiring annual reporting on 35 indicators across 15 core capacities via the State Parties Annual Reporting (SPAR) tool. The COVID-19 pandemic exposed gaps in the IHR framework and monitoring systems, prompting calls for reform. This systematic review analyzed the correlations between IHR-SPAR scores and pandemic outcomes across nine studies (2020–2024), selected using the PRISMA guidelines. The study quality was assessed using the Joanna Briggs Institute’s tool for cross-sectional studies. Of 1019 screened studies, nine met the inclusion criteria. Higher SPAR scores generally correlated with lower COVID-19 incidence and mortality, although some high-scoring countries experienced severe outbreaks. Middle-income countries showed the greatest improvement, particularly in risk communication and emergency response, while zoonotic disease capacities saw little progress. While the SPAR tool aids monitoring, it requires revisions to better reflect real-world pandemic responses. High SPAR scores do not always indicate effective crisis management. This study recommends integrating more dynamic, operational, and context-sensitive indicators to enhance the global preparedness for future health emergencies. Full article

(This article belongs to the Special Issue Pandemic Preparedness: Lessons from COVID-19, Arboviral Outbreaks, and Other Emerging Infectious Diseases)

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19 pages, 651 KiB

Open AccessArticle

Depressive Symptoms Among South African Construction Workers: Associations with Demographic, Social and Work-Related Factors, and Substance Use

by Rita Peihua Zhang, Paul Bowen and Peter Edwards

Int. J. Environ. Res. Public Health 2025, 22(5), 694; https://doi.org/10.3390/ijerph22050694 (registering DOI) - 27 Apr 2025

Abstract

The construction industry exhibits higher rates of depression in its workforce compared to other industries. This study investigates the association between the prevalence of depressive symptoms and various demographic (e.g., age, ethnicity, education), social, and work-related factors (e.g., relationship status, living environment, work [...] Read more.

The construction industry exhibits higher rates of depression in its workforce compared to other industries. This study investigates the association between the prevalence of depressive symptoms and various demographic (e.g., age, ethnicity, education), social, and work-related factors (e.g., relationship status, living environment, work situation) and behavioural factors (e.g., alcohol and drug use). Survey data collected from 496 male construction workers working in the Western Cape were analysed using binomial logistic regression to determine the associations. The results showed that ‘Black African’ construction workers exhibited lower levels of depressive symptoms than ‘Other’ ethnic groups, and workers with at least secondary education had the highest levels of depressive symptoms compared to workers with other levels of education. Workers who were single or living with other adults without children had a significantly higher risk of depression compared to those in other forms of family relationships. Substance use was found to be associated with lower levels of depressive symptoms, suggesting that construction workers use alcohol and drugs as a coping strategy for short-term depressive symptom reduction. Construction organisations should develop strategies to protect the mental health of construction workers, particularly those who are prone to depression. Full article

(This article belongs to the Special Issue Substance Use Disorder and Other Mental Health Comorbidities: Evidence-Based Approaches to Prevention and Treatment)

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13 pages, 281 KiB

Open AccessArticle

The Quality of Life and Associated Factors Among Older Adults in Central Nepal: A Cross-Sectional Study Using the WHOQOL-OLD Tool

by Rubisha Adhikari, Rajani Shah, Kamal Ghimire, Birat Khanal, Sunil Baral, Anisha Adhikari, Dinesh Kumar Malla and Vishnu Khanal

Int. J. Environ. Res. Public Health 2025, 22(5), 693; https://doi.org/10.3390/ijerph22050693 (registering DOI) - 27 Apr 2025

Abstract

Ensuring people’s quality of life (QOL) has become increasingly challenging due to population aging. This study aimed to investigate the QOL among older people and factors associated with it in an urban setting of Central Nepal using the World Health Organization Quality of [...] Read more.

Ensuring people’s quality of life (QOL) has become increasingly challenging due to population aging. This study aimed to investigate the QOL among older people and factors associated with it in an urban setting of Central Nepal using the World Health Organization Quality of Life (WHOQOL-OLD) tool. A cross-sectional study was conducted in Central Nepal. The association between QOL and independent variables was first examined using a univariate analysis of variance followed by multiple linear regressions. The mean age of the 366 participants was 70 years (standard deviation [SD]: 8.2 years). The mean of the overall QOL scores was 74.37 (SD: 7.82). Older people who were literate (regression coefficient (β): 1.909; 95% confidence interval (CI): 3.771 (1.986, 5.556)), who had an annual household income of NPR 40,000 (Nepalese Rupees) or more (β: 1.909: 95% CI: 0.337, 3.480), who reported health services as accessible (β: 4.019; 95% CI: 0.666, 7.371) and affordable (β: 3.176; 95% CI: 1.327, 5.025), and who reported partaking in physical activity (β: 2.107; 95% CI: 0.607, 3.606) had higher QOL scores compared to their respective counterparts. A holistic model of service using the social determinants of health framework is essential to improve the well-being of older people in Nepal. Full article

(This article belongs to the Section Global Health)

33 pages, 68063 KiB

Open AccessArticle

The Socio-Environmental Impact in the Adjacent Settlements of a Former Foundry

by Griselda Vázquez-Quintero, Daniel Lira-Hernández, César Damián Pérez-Olmos, María Cecilia Valles-Aragón, Leonor Cortes-Palacios, César Guillermo García-González, Ireyli Zuluamy Iracheta-Lara, Myrna Concepción Nevárez-Rodríguez and Gilberto Sandino Aquino-de los Ríos

Int. J. Environ. Res. Public Health 2025, 22(5), 692; https://doi.org/10.3390/ijerph22050692 (registering DOI) - 27 Apr 2025

Abstract

Mining has caused major pollution, especially in poorly regulated areas. The former Ávalos Foundry in Chihuahua, Mexico left toxic contamination after its closure in 1997, affecting the nearby settlements. This study examines the socio-environmental impact on residents adjacent to the site. A total [...] Read more.

Mining has caused major pollution, especially in poorly regulated areas. The former Ávalos Foundry in Chihuahua, Mexico left toxic contamination after its closure in 1997, affecting the nearby settlements. This study examines the socio-environmental impact on residents adjacent to the site. A total of 5773 dwellings were considered, with 4634 inhabited by 14,187 persons. A survey to 465 residents assessed sociodemographic aspects, environmental perceptions, and disposition to community participation. Tap water samples from 70 homes were analyzed for metals and compared to Mexican, American and European regulatory standards. Water pollutant dispersion was modeled using ArcGIS interpolation. Residents face economic, social, environmental, and health issues from ongoing contamination. Several suffer respiratory and skin diseases linked to excessive dust from the proximity to mining waste and unpaved streets. While the majority consider their lives comfortable or very comfortable, many would not have moved there if aware of the risks before moving. Despite concerns, most residents are reluctant to engage in community efforts to address the pollution. Tap water tests revealed levels above the regulatory standards of arsenic, copper, chromium, iron, manganese, and nickel, posing serious health risks. This study calls for immediate action, including awareness and health campaigns, environmental remediation, and intersectoral collaboration to secure funding for long-term solutions. Full article

(This article belongs to the Collection Environmental Risk Assessment)

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18 pages, 281 KiB

Open AccessArticle

My Pillow Is Filled with Tears… Syrian Refugees’ Journey to Australia: Narratives of Human Courage and Resilience

by Rosemary Qummouh, Sheridan Linnell, Shameran Slewa-Younan and Sera Harris

Int. J. Environ. Res. Public Health 2025, 22(5), 691; https://doi.org/10.3390/ijerph22050691 (registering DOI) - 27 Apr 2025

Abstract

This article showcases Syrian refugees’ narratives of trauma and survival, through a phenomenological approach to in-depth research, with refugees who have resettled in Australia. It explores their journey towards resettlement, highlighting the nexus between displacement in the home–transit–host countries and the biopsychosocial determinants [...] Read more.

This article showcases Syrian refugees’ narratives of trauma and survival, through a phenomenological approach to in-depth research, with refugees who have resettled in Australia. It explores their journey towards resettlement, highlighting the nexus between displacement in the home–transit–host countries and the biopsychosocial determinants of mental health. Since the 2011 uprising, over 12 million Syrians have been displaced, both internally and worldwide. A refugee’s journey to safety often involves multiple displacements and exposure to dangerous, life-threatening, and dehumanising experiences. We have therefore adopted a qualitative approach that counters this dehumanisation by honouring the unique humanity in the voice of each of our research participants. This article aims to portray the nuanced interdependence between the individual, social, and political contexts of seven Syrian refugees’ lived experiences through an in-depth consideration of what they have told us, how they narrate their stories, and the meanings they ascribe to what they have experienced. The findings of this small yet eloquent study reinforce the insight that the journey to resettlement is far from linear and that resettlement itself is a process marked by recurrent and persistent complexities. The article suggests that the resilience of these refugees is best understood as an ethical and altruistic commitment to collective well-being, transcending notions of individual fortitude. Full article

(This article belongs to the Special Issue Refugee Health and Well-Being: Psychological, Behavioral and Biochemical Insights)

28 pages, 3945 KiB

Open AccessSystematic Review

Green Environments for Sustainable Brains: Parameters Shaping Adaptive Neuroplasticity and Lifespan Neurosustainability—A Systematic Review and Future Directions

by Mohamed Hesham Khalil

Int. J. Environ. Res. Public Health 2025, 22(5), 690; https://doi.org/10.3390/ijerph22050690 (registering DOI) - 26 Apr 2025

Abstract

As global urbanisation is rising and public health challenges intensify, this systematic review is conducted at a critical time to explore and explain the associations between the parameters of green environments and nuanced adaptive neuroplasticity in the human brain to advance the development [...] Read more.

As global urbanisation is rising and public health challenges intensify, this systematic review is conducted at a critical time to explore and explain the associations between the parameters of green environments and nuanced adaptive neuroplasticity in the human brain to advance the development of health-focused sustainable cities and buildings in line with the concept of neurosustainability. This review includes studies involving participants of all ages and genders, with no restrictions on health conditions, exposed to green environments regardless of built environment comparisons. A systematic search of Scopus, PubMed, and Web of Science identified relevant studies published up to November 2024. The risk of bias was assessed using the PEDro scale and ROBINS-I domains, and data were analysed narratively due to heterogeneity. Twenty-three studies were included, conducted across the USA, UK, Germany, Spain, Bulgaria, the Netherlands, Japan, and South Korea. Findings reveal that green environments are associated with positive, region-specific brain changes across the lifespan, surprisingly from before birth to late adulthood. While forests showed more significant effects than blue spaces or urban green spaces, residential greenness emerged as a consistently effective exposure, especially within a 300–500 m buffer around home addresses, provided that sky visibility is present. Notably, no studies have examined green architecture or biophilic interiors, although they are more proximal, are associated with greater exposure time, have antagonistic effects, and may potentially limit sky visibility, highlighting a key gap for future research. Limitations include heterogeneity in exposure definitions, methodologies, and targeted brain regions. Still, this review offers a novel synthesis, providing insight into how greening the built environment may sustain not only the planet but also the plasticity of the brain. This review is registered with INPLASY (INPLASY2024110103) and forms part of a doctoral research project funded by the Cambridge Trust in partnership with the Jameel Education Foundation. Full article

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14 pages, 1284 KiB

Open AccessArticle

Dietary Fluoride Exposure During Early Childhood and Its Association with Dental Fluorosis in a Sample of Mexican Adolescents

by Gina A. Castiblanco-Rubio, Emily C. Hector, Jose Urena-Cirett, Alejandra Cantoral, Howard Hu, Karen E. Peterson, Martha M. Tellez-Rojo and E. Angeles Martinez-Mier

Int. J. Environ. Res. Public Health 2025, 22(5), 689; https://doi.org/10.3390/ijerph22050689 (registering DOI) - 26 Apr 2025

Abstract

Dental fluorosis indicates past fluoride intake. People living in Mexico City are exposed to fluoridated salt, which contributes significantly to fluoride intake. This study aimed to (1) estimate fluoride intake during early childhood and fluorosis prevalence in permanent teeth in adolescence and (2) [...] Read more.

Dental fluorosis indicates past fluoride intake. People living in Mexico City are exposed to fluoridated salt, which contributes significantly to fluoride intake. This study aimed to (1) estimate fluoride intake during early childhood and fluorosis prevalence in permanent teeth in adolescence and (2) identify intake windows associated with higher fluorosis scores in upper central incisors (UCIs). We included 432 participants from the ELEMENT project (Early-Life Exposures in Mexico to Environmental Toxicants), with data on fluoride intake at ages 1–5 and fluorosis (TFI) at adolescence. Median intakes ranged from 0.56 at age 1 to 1.14 mg/day at age 5, exceeding recommendations. All adolescents had some level of fluorosis, predominantly mild (62% with TFI 2). For every 0.1 mg of daily fluoride intake at age 1, the odds of higher TFI in UCIs were 1.08 [95% CI: 1.00–1.17]. At age 2, the odds were marginally significant [OR: 1.07; 95% CI: 1.00–1.16]. In conclusion, for participants of ELEMENT: (1) fluoride intake during early childhood exceeded recommendations and the prevalence of mild fluorosis in adolescence was high, and (2) fluorosis in UCIs was associated with dietary exposure during the first two years of life and may be used in future ELEMENT studies as exposure biomarkers. Full article

(This article belongs to the Special Issue Influence of Population Exposure to Fluoride on Oral Health)

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10 pages, 536 KiB

Open AccessArticle

What Guides Organizations’ Current Dementia-Related Practices Across Four Canadian Provinces?

by Maria Baranowski, Nancy Jokinen, Leslie Udell, Sandy Stemp, Tracey Berman and Shahin Shooshtari

Int. J. Environ. Res. Public Health 2025, 22(5), 688; https://doi.org/10.3390/ijerph22050688 (registering DOI) - 26 Apr 2025

Abstract

We conducted a survey to learn what guides current dementia-related practice to support community-dwelling adults with intellectual and developmental disabilities who may be experiencing dementia in Canada. We invited organizations working in health, disability, or senior sectors in 4 Canadian provinces to complete [...] Read more.

We conducted a survey to learn what guides current dementia-related practice to support community-dwelling adults with intellectual and developmental disabilities who may be experiencing dementia in Canada. We invited organizations working in health, disability, or senior sectors in 4 Canadian provinces to complete an online cross-sectional survey between April and July 2023. A total of 173 people completed the survey, representing 125 unique organizations, and nearly half resided in Ontario. The most common support and services provided to adults with intellectual and developmental disabilities and their families were related to residential care, day programming, and group home living. Half of our survey respondents reported that they followed dementia-related practice guidelines. The most common guideline followed and early detection tool used were from the National Task Group on Intellectual Disabilities and Dementia Practices and the National Task Group-Early Detection and Screen for Dementia, respectively. Lack of awareness about guidelines and detection tools, challenges to implement the same, and organizational needs for future training and service provision were identified. Commitment to resources to monitor adults with IDD who may be experiencing dementia is recommended to provide meaningful support and service to them and their families. Full article

(This article belongs to the Special Issue Promoting Mentation: Assessment and Support for Dementia, Depression and Delirium)

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16 pages, 1623 KiB

Open AccessArticle

Where Muscle Matters: How Regional Differences, Pain, and Gender Define Gamer Health

by Joanne DiFrancisco-Donoghue, Min-Kyung Jung, Matteo J. Balentine and Hallie Zwibel

Int. J. Environ. Res. Public Health 2025, 22(5), 687; https://doi.org/10.3390/ijerph22050687 (registering DOI) - 26 Apr 2025

Abstract

Competitive gaming presents unique musculoskeletal challenges due to prolonged sitting and repetitive hand and arm movements. This study explores gender-specific regional lean body mass (LBM) differences and their associations with musculoskeletal discomfort in competitive gamers. Sixty participants (30 gamers and 30 matched controls; [...] Read more.

Competitive gaming presents unique musculoskeletal challenges due to prolonged sitting and repetitive hand and arm movements. This study explores gender-specific regional lean body mass (LBM) differences and their associations with musculoskeletal discomfort in competitive gamers. Sixty participants (30 gamers and 30 matched controls; 15 males and 15 females in each group) underwent DXA scans to assess total and regional LBM, handgrip strength tests, and self-reported musculoskeletal pain surveys. Controls were matched for age and BMI and reported comparable academic and screen time but were not engaged in competitive gaming. Male gamers exhibited significantly reduced forearm (p < 0.05) and upper body LBM (p < 0.001), alongside lower grip strength (p < 0.001), compared to controls. Female gamers demonstrated lower upper body LBM (p = 0.01) but showed no significant differences in forearm lean mass or grip strength. In male gamers, negative correlations were observed between forearm LBM and lower back pain (r = −0.59, p < 0.01), highlighting the protective role of regional LBM against discomfort. Extended gaming duration was associated with increased musculoskeletal pain in both sexes (p < 0.05). These findings emphasize the need for targeted ergonomic interventions and physical conditioning programs to address muscle imbalances and reduce injury risk in esports athletes. Future research should focus on longitudinal and interventional designs to optimize musculoskeletal health and performance in this growing population. Full article

(This article belongs to the Special Issue Physical Fitness and Injury Prevention in Athletes)

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