Green Health

Background: Although there is a considerable body of research evidence on active school travel (AST), the number of children walking to school has decreased over the years in Australia, as well as around the world. Different factors influence AST; the most cited in Melbourne is traffic safety perception. Traffic safety perception is influenced by built environment elements, and improving the built environment can enhance parental perception of traffic safety. Studies have shown that lateral separation from traffic and the provision of a buffer improve the perception of traffic safety, and this has to be explored for children walking to school based on the existing ground situation on a typical street near a school in Melbourne. Based on this background, a pilot study was carried out before the main study to test the reliability and validity of the survey questionnaire. Methods: The survey instrument was developed based on perceptions and/or AST studies, and included safety and probability aspects of the perception construct to elicit responses on perception. The perception of traffic safety was to be rated based on the streetscape videos embedded in the survey. The reliability was tested using Cronbach’s alpha and validity was explored through exploratory factor analysis. The study also checked the feasibility of the recruitment method and whether there would be an observable outcome from the study. The participants were recruited online through community Facebook groups. Results: The survey instrument had excellent reliability (α = 0.945) and was valid. The recruitment method through a Facebook community group was apt for recruiting participants. The preliminary analysis of the pilot data revealed a difference in perception ratings based on the streetscape element intervention. Conclusions: The survey instrument can be used for similar AST research, as it proved to be reliable and valid. Full article

Despite growing attention to corporate environmental responsibility, there is limited understanding of the psychological and social mechanisms linking corporate environmental responsibility to employees’ coworker-focused pro-environmental behaviors in the workplace, such as advocacy directed at peers. This study examined the influence of corporate environmental responsibility on employees’ coworker pro-environmental advocacy in the Chinese energy sector, with a sample of 1528 employees. Focusing on the mediating roles of long-term orientation, meaningful work, and sense of community, the research integrates insights from Social Exchange Theory, Self-determination Theory, and Affective Events Theory. The data were analyzed using structural equation modeling (SEM) to test the hypothesized relationships. The findings revealed that corporate environmental responsibility positively impacted employees’ advocacy for eco-friendly behaviors among coworkers through forward-thinking attitudes, intrinsic motivation, and strengthened social bonds. The study offers theoretical contributions by unpacking the interplay of individual and organizational factors and provides practical recommendations for cultivating an environmentally conscious culture through value alignment, meaningful work initiatives, and fostering a strong sense of community. Full article

Objectives: We performed this systematic review of epidemiological studies to clarify the association between incense and mosquito-coil burning and the risk of nasopharyngeal carcinoma (NPC). Methods: A search of studies published through October 2024 in the MEDLINE and EMBASE databases was performed, supplemented by searches of reference lists, recent reviews, and Chinese databases. The quality of the included studies was assessed, with special attention paid to exposure assessment. Random-effects meta-analysis estimated the pooled odds ratios (OR) and 95% confidence interval (CI) whenever applicable. Results: One cohort and twelve case–control studies were identified. Meta-analysis of one cohort study and four case–control studies with reasonable quality found an increased risk associated with incense burning during adulthood (pooled OR = 1.46; 95% CI 1.24–1.72). Five case–control studies assessed the association between exposure to incense smoke during childhood and NPC risk, and the pooled OR was 1.22 (95% CI 0.76–1.96) associated with incense burning at birth and was 1.37 (95% CI 1.10–1.71) for exposure at the age of 10 years. The pooled OR for mosquito-coil burning during adulthood was 1.31 (95% CI 0.99–1.74). None of the four previous case–control studies found an increased risk of NPC associated with mosquito-coil burning during childhood. Conclusions: Our findings suggest an increased NPC risk associated with burning incense and mosquito coils. More high-quality epidemiological studies with refined exposure assessments are warranted. Full article

Gastrointestinal (GI) endoscopy is a daily procedure in clinical practice but contributes substantially to healthcare’s environmental footprint. Data on sustainability policies in Switzerland, however, remain scarce. This study aimed to assess the implementation of sustainability practices among members of the Swiss Society of Gastroenterology (SGG-SSG). We conducted a web-based cross-sectional survey between September 2023 and January 2024, targeting all 463 practicing Swiss gastroenterologists listed in the latest SGG-SSG roster. The survey comprised eleven questions covering four domains: respondent demographics; waste and single-use device management and procurement; digitalization; and work–life balance. A total of 161 respondents participated (response rate: 34.8%). Less than half (45.1%) reported waste sorting, while policies for single-use device reduction (23.5%) and waste minimization initiatives (27.8%) were even less common. Nearly half (48.8%) reported including sustainability considerations in procurement policies. In contrast, 52.8% reported having policies to promote work–life balance, and 88.2% reported policies requiring the use of electronic health records, reflecting significant progress in digitalization. While procurement and digitalization efforts are more widely implemented, further coordinated action is needed. Future research should investigate professional attitudes, institutional barriers, and strategies to enhance the adoption of environmentally responsible practices in GI endoscopy. Furthermore, professional societies (particularly SGG-SSG), hospital administrators, and cantonal health authorities must coordinate to establish national standards, integrate sustainability into accreditation, and implement incentives and accountability to reduce the environmental impact of GI endoscopy without compromising quality of care. Full article

Air pollution is one of the major global environmental challenges, particularly in urban and industrial areas, where multiple sources emit pollutants that compromise air quality and threaten human health. This study aims to analyze the effects of air pollution on the health of vulnerable urban populations, emphasizing monitoring techniques for key pollutants and comparing national and international air quality standards through a literature review. It also discusses the implications of these pollutants considering the 2030 Agenda, highlighting environmental education as a strategy for pollution mitigation, public awareness, and strengthening air quality policies. A qualitative and descriptive methodology was adopted, based on national and international research publications between 2005 and 2023, using databases such as PubMed, Scopus, Web of Science, LILACS, and Google Scholar, with descriptors including “Air Pollution,” “Industrialization,” “Public Health,” and “Environmental Education.” The results indicate that industrial and transportation activities are the main sources of air pollution, contributing to an increase in cases of asthma, lung cancer, and cardiovascular diseases, as well as negatively impacting ecosystems and the economy. Even when pollutant levels comply with legal standards, vulnerable populations experience higher morbidity and mortality rates, highlighting the need for more stringent protection policies. Comparisons between the standards of the World Health Organization (WHO), the European Union (EU), the United States Environmental Protection Agency (EPA), and the National Council for the Environment (CONAMA) reveal significant disparities in exposure limits. The WHO and the EU, aligned with Sustainable Development Goals (SDGs) 3 and 13, advocate for stricter limits, while EPA and CONAMA regulations remain less stringent. This gap emphasizes the importance of internationally harmonized, evidence-based, and equitable air quality policies. Combating air pollution requires an integrated approach that combines stricter regulations, continuous monitoring, emissions control strategies, and environmental education. Promoting environmental awareness among children and young people can encourage behavioral changes and civic engagement. Environmental education, along with political and social responsibility, remains a fundamental path to mitigating health impacts and promoting sustainable development, in line with the 2030 Agenda. Full article

The 2026 opening of the Gordie Howe International Bridge between Windsor, Ontario, Canada and Detroit, Michigan, USA, with its multi-use trail for cyclists and pedestrians, is projected to catalyze cross-border trail tourism and help further revitalize these two border cities. Both Windsor and Detroit have unique, extensive trail systems with compelling destinations. However, cross-border trail tourism institutionalization needs improvement. Tourism, greenway, and destination partners should explore creating a boundary organization to foster and market cross-border trail tourism. Recommendations from a 2024 cross-border trail tourism conference include: develop strategies for community engagement and storytelling to enhance cultural connections between regions; strengthen ties between trail groups and environmental organizations to provide trail experiences that reconnect people with the river and other natural resources; support the region’s efforts to obtain a UNESCO World Heritage Site designation for the Underground Railroad and support the Canadian federal designation of Windsor’s Ojibway National Urban Park; strengthen collaborations between tourism and cycling partners to promote and market cross-border trail tourism; institutionalize greenway assessments (every 5–10 years) to evaluate trail segment completions, gaps, potential route improvements, safety improvements, equity considerations, etc., and to keep greenways in the public consciousness; and measure and broadly communicate the economic impact of cross-border trail tourism resulting from the bridge. Full article

Mangrove forests provide critical ecosystem services, including carbon sequestration, shoreline protection, and serving as a food resource for coastal communities. However, these ecosystems face increasing environmental risks due to industrial and urban pollution, particularly contamination by heavy metals. This study assessed environmental quality in mangrove areas of Babitonga Bay, southern Brazil, using biomonitoring with the oyster Crassostrea rhizophorae and the mangrove tree Laguncularia racemosa. Sediment analyses revealed significantly elevated concentrations of copper, nickel, aluminum, and iron in Vila da Glória compared to Espinheiros, exceeding Brazilian environmental guidelines for copper and zinc. Biomonitoring results indicated high accumulation of arsenic and zinc in L. racemosa leaves, while oysters from Espinheiros exhibited higher concentrations of multiple heavy metals and smaller anatomical dimensions compared to those from Vila da Glória. Strong negative correlations were found between metal concentrations in oyster tissues and sediments, suggesting complex bioavailability dynamics. The study demonstrates the applicability of C. rhizophorae and L. racemosa as possible bioindicators of metal contamination in mangrove ecosystems. These findings underscore the importance of integrating biomonitoring approaches into coastal environmental health assessments to inform public health policies and conservation strategies aimed at promoting balanced ecosystem and human health. Full article

Background: College students face significant stress from academic demands and high pressures, which can contribute to long-term physical and mental health issues. Existing stress-relief strategies are not always immediately available to this population, highlighting the need for accessible, low-cost solutions. Methods: This randomised controlled trial examined the effects of nature exposure on stress and well-being in a sample of 29 healthy college students compared to a healthy control group (n = 28). The intervention group engaged in 30 min walks in a natural environment four times per week over a four-week period. Stress levels and general well-being were assessed using validated self-report questionnaires administered before and after the intervention period, allowing for a comparison of changes in mental health outcomes between an intervention and control group. Eye-tracking analysis during a battery of cognitive tests assessed cognitive functioning. Findings: The intervention was associated with a greater reduction in psychological distress over time (β = −2.98, p = 0.007) and showed a trend toward reduced burnout symptoms (β = −0.12, p = 0.08) compared to the control group. These associations are independent of sex, age, BMI, smoking status, COVID-19 history, and previous diagnosis of mental illness. An increase in the number of saccades during the visual working memory task was observed in the intervention group compared to controls (β = 5.01, p = 0.046), while saccadic activity in other tasks remained unchanged. No significant effects were found for the neurocognitive performance measures. Conclusions: These findings suggest that short-term nature exposure may support psychological well-being and mental engagement in young adults. Our research highlights the use of walking in nature as a realistic and accessible strategy to promote mental health and neurocognitive functioning among students. Full article

The present controlled experimental research addresses the effects of exposure to nature on workers’ well-being and job performance in a work-confined setting. Ten individuals working in an open-space office inside a Portuguese military bunker were exposed to simulated nature (audio sounds and/or video images of nature). Quantitative physiological (heart rate) and self-reported measures (perceived positive and negative emotions, environment restorativeness, and work performance) were taken. Results indicate that exposure to nature during working time in confined places, through simulating a window with a view of nature and/or by introducing sounds of nature, promotes physiological and emotional well-being at work (heart rate significantly decreases, positive emotions significantly increase, and negative emotions decrease), and significantly increases employees’ perception of workplace restorative qualities. The results on work performance were non-significant. The present findings contribute to the evidence of the restorative effects of nature exposure during work. The research bridges a gap by considering workplaces where real nature exposure is not feasible and examining the evidence on the beneficial biophilic interventions (the restorative effects of simulated nature) within confined environments. The strategy to use videos and audio of nature may improve the structural conditions of work, benefiting well-being in these types of work settings. Full article

The NewEcoSmart project addresses the need to foster inclusive green and digital transitions in rural habitat sectors by systematically assessing local socio-technical readiness and tailoring capacity-building interventions. We adapted the validated SCIROCCO Exchange Maturity Self-Assessment Tool—selecting eight dimensions relevant to environmental, technological and social innovation—and conducted a two-phase evaluation across three pilot sites in Italy, Portugal and Spain. Phase 1 mapped stakeholder evidence against predefined criteria; Phase 2 engaged local actors (45+ adults, SMEs and micro-firms) in a self-assessment to determine digital, green and entrepreneurial skill gaps. For each domain of the SCIROCCO Tool, local actors can assign a minimum of 0 to a maximum of 5. The final score of the SCIROCCO tool can be a minimum of 0 to a maximum of 40. Quantitative maturity scores revealed heterogeneous profiles (Pacentro and Majella Madre = 5; Yecla = 10; Adelo Area = 23), underscoring diverse ecosystem strengths and limitations. A qualitative analysis, framed by Smart Healthy Age-Friendly Environments (SHAFE) domains, identified emergent training needs that are clustered at three levels: MACRO (community-wide awareness and engagement), MESO (decision-maker capacity for strategic planning and governance) and MICRO (industry-specific practical skills). The adapted SCIROCCO tool effectively proposes the assessment of socio-technical maturity in rural contexts and guides the design of a modular, multi-layered training framework. These findings support the need for scalable deployment of interventions that are targeted to the maturity of the local ecosystems to accelerate innovations through equitable green and digital transformations in complex socio-cultural settings. Full article

Climate change remains one of the existential threats to humanity in particular and life on earth in general. It presents significant impacts on food and nutritional security, health, and the general well-being of living organisms globally. Despite global efforts to tackle the climate crisis, the record shows that limited progress has been made in curbing the problem. Consequently, this study intends to address the following research question: How does the climate crisis affect indigenous food systems, farmers’ livelihoods, and local communities in the study area? This study was conducted in the Tolon district of the northern region of Ghana from 2017 to 2022. Grounded in the theoretical prism of political ecology and indigenous knowledge perspective, we selected individuals who were smallholder farmers, students, faculty members, extension officers, and an administrator from the Ministry of Food and Agriculture. The data were gathered through in-depth interviews, focus groups, and workshops and analyzed using coding, thematization, and inferences drawn from the literature and authors’ experiences. This study discovered some of the effects of a changing climate, including the extinction of indigenous food crops, poor yield resulting in poverty, and food and nutritional insecurity. This study concludes that failure to tackle climate change could pose a greater threat to the survival of smallholder households in Ghana. Full article

In order to meet the Paris Agreement and EU Green Deal, the demand for critical minerals (e.g., cobalt, nickel, lithium, and rare earth elements) is growing exponentially. With their demand arise urgent concerns about the injustices of their supply chain, including concerns about labour exploitation, environmental degradation, and child labour. This literature review examines news media, blogs, governmental and NGO reports, and academic sources to assess the risk of child labour in the extraction of 34 EU-designated critical minerals, 17 of which are considered ‘strategic.’ Using a combined risk reduction and assessment framework, the study identifies high-risk minerals (cobalt, graphite, nickel, aluminium, copper, and rare earth elements) and high-risk countries (the Democratic Republic of the Congo, Mozambique, India, the Philippines, Indonesia, and Myanmar). The findings reveal the broader negative impact on communities of mining, including increased vulnerability to child trafficking and sexual exploitation. Thus, the risk of child labour does not imply its actual occurrence due to the biased undercount of child labour numbers. Recommendations include further research, raising awareness of children’s rights, supporting household livelihoods, and improving traceability in artisanal and small-scale mining to ensure a just transition. Full article

Background: Published studies have documented the association between sunshine duration and depression symptoms; however, the evidence regarding the long-term effects and potential mechanisms remains insufficient. This study aimed to examine the association between sunshine duration and incident depression and to explore potential mediating pathways. Methods: A total of 336,805 participants from the UK Biobank were included in the study. Meteorological exposures were estimated using the bilinear interpolation approach and time-weighted method. The association between sunshine duration and incident depression was examined through the time-dependent Cox proportional hazard model and generalized propensity score model. Vitamin D, calcium, immune biomarkers, an aggregated inflammation score (INFLA-score), and sleep pattern were selected as the potential mediators. Causal mediation analysis was employed to elucidate underlying mediating effects. Results: With a median follow-up of 13 years, 13,862 cases of incident depression were identified. Sunshine duration demonstrated a negative association with the incident depression. The effects were stronger among the elderly, alcohol consumers, individuals who spent less time outdoors, and those who were less physically active. Vitamin D, calcium, INFLA, neutrophils, and monocytes emerged as the top five contributors of immune biomarkers to the natural indirect effect. The combined mediating effect of top five biomarkers and sleep pattern accounted for 30% of the total effect of sunshine duration on the incident depression. Conclusion: Our study suggests that longer sunshine duration might mitigate depression through vitamin D-related metabolism, inflammation, and sleep pattern. It may serve as an effective natural antidepressant, particularly for the elderly, alcohol consumers, less outdoor spenders, and those who were less physically active. Full article

This study aimed to identify and analyse the main difficulties faced by family farmers in producing and supplying vegetables through short food supply chains. Semi-structured interviews were conducted with seven family farmers in a large city in southern Brazil. We sought to include at least one farmer supplying each of the main identified outlets: schools, restaurants, supermarkets, street markets, and consumer groups. Contacts were obtained through rural producer organisations. Data were recorded, transcribed, and analysed using thematic analysis. Three groups of difficulties emerged: (i) production—including seasonality, pest, and disease management, climate-related losses, and limited technical support; (ii) sales—such as price competition, logistical challenges, and inconsistent demand; and (iii) consumption—particularly low consumer habits regarding vegetable purchase and preparation, and preference for non-seasonal products. The study concludes that the main challenges to strengthening short food supply chains are the limited engagement of young people in farming, lack of specialised technical assistance, climate-related risks, bureaucratic barriers, and the high costs of organic certification. Farmers also reported logistic difficulties and constraints in supplying restaurants due to demand for a narrow range of products disregarding seasonality. At the consumer level, habits shaped by conventional food systems emerged as obstacles. Strategies such as alternative markets, farmer organisations, supportive public policies, and initiatives to promote cooking skills and consumer awareness are key to enhancing resilience and expanding the supply of healthy foods. Full article

Twin pregnancies have a higher risk of preterm birth (PTB) than single pregnancies, but studies about prenatal air pollution exposure and PTB in twin pregnancies are still scarce. To explore associations of prenatal fine particulate matter (PM_2.5) exposure with PTB in twins, we collected birth data from 21 hospitals across China. Data on PM_2.5 and its compositions (NO₃⁻, BC, NH₄⁺, SO₄²⁻, and OM) were collected from Tracking Air Pollution. Generalized linear models were used to examine associations of air pollution with PTB. Each IQR increment in PM_2.5, NH₄⁺, SO₄²⁻, NO₃⁻, BC, and OM during entire pregnancy, the OR (95% CI) were 1.46 (1.34–1.59), 1.54 (1.39–1.70), 1.34 (1.25–1.44), 1.44 (1.30–1.59), 1.28 (1.20–1.37), and 1.28 (1.18–1.38), respectively. The results of trimester-specific analyses followed the patterns as seen during the entire pregnancy (all p < 0.05). The PAF of PTB attributable to PM_2.5 was 40.75% (95% CI: 32.5%, 48.26%) in the total population. Participants living in warmer regions and lower residential greenness were more susceptible to PM_2.5. Our findings suggest pregnant women should avoid severe air pollution exposure throughout pregnancy. Reducing heat exposure and increasing green spaces in communities can reduce PTB risk. Full article

Plastic pollution is one of the leading global problems of modern society. The growing demand for and production of plastic polymers has caused bisphenol A (BPA) and its emergent substitute molecules bisphenol S and F (BPS and BPF) to be present in water, food, and soil worldwide, exposing humans to endocrine disruptors. Exposure to these compounds has been associated with pathologies such as diabetes, obesity, hypertension, and psychiatric disorders. Interestingly, hypovitaminosis D (or low 25(OH)D) is also associated with this class of diseases. Therefore, the present work, for the first time, explores the relationship patterns between urinary bisphenols (BPs) and low 25(OH)D in a large general cohort (NHANES 13–16). Descriptive statistical analyses, comparative analyses, linear regressions, and binomial and multinomial logistic regressions were performed. Descriptive and comparative analysis, and simple linear regressions, showed different trends between BPs, and binomial logistic regressions showed that only BPS is a risk factor of low 25(OH)D, independently of age, BMI, gender, diabetes, dyslipidemia, smoking, and vitamin supplements consumption; odds ratio (95% confidence interval) of 1.10 (1.04–1.17). The different trend patterns observed in urinary bisphenols show that, despite being structurally similar molecules and potential analogs, they may affect the body in different ways. From an integrated perspective, this could represent an even greater potential threat than that posed by BPA alone. Future integrated studies will be required to further explore and clarify this emerging paradigm. Full article

Introduction: Ecological networks (ENs) are critical frameworks designed to protect biodiversity, enhance habitat connectivity, and provide ecosystem services in fragmented landscapes. Urban ecological networks (UENs) adapt this concept to address the challenges posed by urbanization, habitat fragmentation, and climate change. Methods: This systematic review follows the PRISMA methodology, with the search strategy applied across PubMed, Scopus, and Web of Science. Articles published until 29 July 2025, were evaluated based on their alignment with One Health domains: human, animal, and ecosystem health. The included studies underwent independent review and quality assessment using the Newcastle–Ottawa Scale. Results: Only nine of the 228 articles that were found satisfied the requirements for inclusion. These studies examined UENs’ effects on biodiversity, species migration, and climate resilience but lacked direct evaluation of human health impacts. Key findings highlighted the role of ecological corridors in improving habitat connectivity, promoting biodiversity, and mitigating climate-related fragmentation. Conclusions: While UENs show significant potential to enhance biodiversity and urban resilience, their direct impacts on human health remain underexplored. Future interdisciplinary research should focus on quantifying these links and integrating UENs into urban planning to address ecological and Public Health challenges under a One Health framework. Full article

Safe and adequate water supply, sanitation, and hygiene (WASH) in schools are prerequisites within the right to basic education. WASH facilities across schools in developing nations, particularly in Africa, are unsatisfactory and expose children to risks of disease and infection. This study aims to gather insights into the WASH status of secondary schools in Ibadan, Nigeria, to develop a sustainable water management framework for schools. A concurrent mixed-method design (questionnaires and interviews) was adopted to benchmark water management in schools and inform the design of a framework. Results reveal a wealth of issues and concerns that include infrastructure challenges accessing reliable and safe water supplies, rundown and unhygienic toilet/urinal facilities, and dilapidated sinks/taps, plus resource challenges, such as an absence of tissue paper and soap. These issues are exposing schoolchildren to unnecessary health risks, further supported by reported illnesses and reduced school attendance. Based on these findings, and guided by the UN SDG#6 targets, a water improvement framework has been created and validated by school officials. The framework identifies both short-term and long-term guidance/actions to improve water management in schools across Sub-Saharan Africa. These form crucial steps toward better WASH, building healthier communities and enhancing educational environments and outcomes for schoolchildren. Full article

The relationship between natural environments and psychological well-being has gained increasing attention in environmental and health sciences. However, there is still a lack of robust quantitative instruments to assess the restorative potential of different environments. This study aimed to adapt and validate the Portuguese version of the Perceived Restorativeness Scale (PRS), an instrument based on Attention Restoration Theory that evaluates the perceived restorative qualities of environments. In Study 1, exploratory and confirmatory factor analyses were conducted on data from 410 participants. The results supported a refined 20-item version of the scale, comprising four factors—being away, fascination, compatibility, and legibility—with good internal consistency and acceptable model fit. Measurement invariance analysis confirmed configural, metric, and scalar invariance across gender. In Study 2, a separate sample of 212 participants completed the PRS along with additional validated measures: the Sublime Emotion toward Nature Scale (SEN), an aesthetic evaluation of landscapes, and the Positive and Negative Affect Schedule (PANAS). The PRS showed strong convergent and discriminant validity and significantly predicted restorative outcomes. These findings support the psychometric adequacy of the Portuguese PRS and its relevance as a valid tool for assessing perceived restorativeness in both natural and built environments. The scale may inform future research and public policies aimed at designing spaces that promote psychological restoration and mental well-being. Full article