Green Health

Corporate Social Responsibility (CSR) has evolved into a strategic corporate function; however, most reviews continue to frame it primarily through competitiveness and core-business alignment, offering limited analytical differentiation regarding its integration with environmental governance and public health. This study provides a conceptual synthesis of CSR evolution between 2015 and 2024, emphasizing environmental–health integration and emerging hybrid models, particularly in Latin America. A Narrative Systematic Review following PRISMA guidelines was conducted across Scopus, Web of Science, and Google Scholar, resulting in the analysis of 96 publications. Findings are structured into three ideal-typical configurations: Instrumental Competitive CSR, Adaptive Hybrid CSR, and Transformative Health-Centric CSR. The study proposes a complementary environmental health prevention framework in which companies, stakeholders, and governance actors interact to address structural determinants of health. By conceptualizing CSR as a preventive co-governance mechanism rather than a solely competitive strategy, this study advances a more theoretically grounded understanding of corporate responsibility in sustainable and healthy communities. Full article

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

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