International Journal of Environmental Research and Public Health

20 pages, 746 KiB

Open AccessReview

Protecting Repositories of Indigenous Traditional Ecological Knowledges: A Health-Focused Scoping Review

by Danya Carroll, Mélina Maureen Houndolo, Alia Big George and Nicole Redvers

Int. J. Environ. Res. Public Health 2025, 22(6), 886; https://doi.org/10.3390/ijerph22060886 (registering DOI) - 31 May 2025

Abstract

Indigenous Peoples have stewarded Indigenous traditional ecological knowledge (TEK) for millennia. Health-related TEK represents vital knowledge that promotes Indigenous health and wellbeing. Yet, the intergenerational protection of TEK continues to be threatened by various factors, including climate change, which underscores the importance of [...] Read more.

Indigenous Peoples have stewarded Indigenous traditional ecological knowledge (TEK) for millennia. Health-related TEK represents vital knowledge that promotes Indigenous health and wellbeing. Yet, the intergenerational protection of TEK continues to be threatened by various factors, including climate change, which underscores the importance of strengthening and supporting Indigenous-managed TEK repositories. Using a scoping review methodology, we aimed to identify documents for setting up health-related TEK repositories within Indigenous communities. A systematic search was completed in multiple databases—Medline, PubMed, CABI abstracts, Canadian Public Policy Collection, and JSTOR—with manual searches carried out on relevant Indigenous repositories and Google. Content analysis was then carried out with the nine documents meeting our inclusion criteria. We characterized six overarching categories and twelve sub-categories from the included documents. These categories covered impacts on Indigenous TEK repositories resulting from colonial processes, with TEK being seen as diverse, living knowledge protected by longstanding cultural protocols. Concerns surrounding TEK repository management included the need for platforming Indigenous data sovereignty and Indigenous Peoples’ access and ownership. Wise practices of Indigenous-led repository development demonstrated clear examples of data governance processes in action. Indigenous communities were seen to be vital in contributing to key policies and protocols that protect health-related TEK. Full article

(This article belongs to the Section Environmental Health)

15 pages, 295 KiB

Open AccessArticle

Predictors of Low Back Pain Risk Among Farmers in Rural Communities of Loja, Ecuador

by Isabel Masson Palacios, Israel Vinueza-Fernandez, Samuel-Olegario Iñiguez-Jiminez, Mario J. Grijalva and Benjamin R. Bates

Int. J. Environ. Res. Public Health 2025, 22(6), 885; https://doi.org/10.3390/ijerph22060885 (registering DOI) - 31 May 2025

Abstract

Background: Low back pain (LBP) and musculoskeletal disorders are highly prevalent among agricultural workers. However, there is limited epidemiological evidence from rural regions of Ecuador, where working and living conditions may differ substantially from those in other settings. This study aimed to identify [...] Read more.

Background: Low back pain (LBP) and musculoskeletal disorders are highly prevalent among agricultural workers. However, there is limited epidemiological evidence from rural regions of Ecuador, where working and living conditions may differ substantially from those in other settings. This study aimed to identify predictors of LBP among farmers in rural Ecuador to inform locally relevant prevention strategies. Methods: Participants aged 30 to 60 years (n = 103) were recruited through a traveling health clinic. Participants were assessed with behavioral and sociodemographic self-report questionnaires and anthropometric measurements. Low back pain (LBP) was assessed using the Standardized Nordic Musculoskeletal Questionnaire, which asked about symptoms experienced in the past 12 months. Bivariate (Chi-square and Fisher exact tests) and multivariate (binary logistic regression) analyses were conducted to explore associations between risk factors and LBP in individuals aged 30 to 60 years. Results: LBP was highly prevalent, affecting 78.6% of participants. Behavioral patterns were mixed, with low rates of smoking and moderate alcohol and coffee consumption associated with LBP. A normal body mass index (BMI) was observed in 66% of the sample, and over half reported stable mood and good self-perceived health. In the binary logistic regression analysis, only education level significantly predicted LBP, with secondary education acting as a protective factor. Conclusions: While lower back pain was widespread in the population studied, most risk factors that were analyzed were not significantly associated with its presence. Full article

11 pages, 1185 KiB

Open AccessArticle

Use of a Validated Risk Perception Questionnaire for the Inclusion of People with Hearing Impairments in a Productive Environment

by Aline Franchini, Antonio Xavier and André Soares

Int. J. Environ. Res. Public Health 2025, 22(6), 884; https://doi.org/10.3390/ijerph22060884 (registering DOI) - 31 May 2025

Abstract

The inclusion of people with hearing impairments in logistics environments is a topic of increasing importance, especially when considering the promotion of diversity and accessibility in the workplace. The use of a risk perception questionnaire can represent an effective tool to identify barriers [...] Read more.

The inclusion of people with hearing impairments in logistics environments is a topic of increasing importance, especially when considering the promotion of diversity and accessibility in the workplace. The use of a risk perception questionnaire can represent an effective tool to identify barriers and challenges faced by these workers. The questionnaire covers several aspects, including communication between employees, the adequacy of visual signage, workplace safety and the accessibility of tools and equipment. The responses collected help to understand how people with hearing impairments perceive the risks inherent in their work activities, as well as to identify possible deficiencies in the training and awareness of their coworkers. Analysis of the data collected by the questionnaire allows companies to develop specific strategies and actions to improve inclusion, such as inclusive training, adaptation of the physical environment and implementation of auxiliary technologies. In this way, these actions not only contribute to a safer and more productive work environment, but also value diversity and the unique contribution that each worker can make to the logistics sector. Full article

(This article belongs to the Special Issue Models and Approaches to Workplace Health Promotion and Well-Being with Diverse Population Groups)

► Show Figures

Figure 1

27 pages, 2655 KiB

Open AccessReview

Climate Change and Zoonotic Disease Outbreaks: Emerging Evidence from Epidemiology and Toxicology

by Abdallah Borham, Kadria Abdel Motaal, Nour ElSersawy, Yassmin F. Ahmed, Shuaib Mahmoud, Abobaker Salem Musaibah and Anwar Abdelnaser

Int. J. Environ. Res. Public Health 2025, 22(6), 883; https://doi.org/10.3390/ijerph22060883 (registering DOI) - 31 May 2025

Abstract

Background: Disruptions in the mesh of the ecosystem come with implications that severely harm the sustainability and the equilibrium of life. Interactions of humans, animals, and many other organisms, along with the whole ecological complex, have given birth to zoonotic diseases, which can [...] Read more.

Background: Disruptions in the mesh of the ecosystem come with implications that severely harm the sustainability and the equilibrium of life. Interactions of humans, animals, and many other organisms, along with the whole ecological complex, have given birth to zoonotic diseases, which can vary in type and burden. Collaborative efforts put into the prioritization of environmental, animal, and human health are envisioned as “One Health”. Understanding vector ecology and the varying mechanistic ways of transmission is crucial for constructing effective One Health surveillance tools and warning systems. Methods: We identified the literature available concerning the subject matter. We utilized scholarly databases to gather research for the last 10 years using predefined keywords. Objectives: This review aims to synthesize current knowledge on the interconnection between climate discrepancies, ecological alarms, and the emergence and spread of zoonotic diseases. We attempted to provide recommendations for future research and policy interventions. Results: Human activities have significantly impacted disease-carrying vectors and wildlife habitats, aiding their proliferation and the spillover of diseases. Global frameworks incorporating One Health principles enhance global preparedness for future health threats. Applying the integrated One Health Surveillance has strengthened early warning systems. Interdisciplinary collaborations and tools like OH-EpiCap, a comprehensive tool that assesses and enhances the capacities of One Health surveillance systems, have significantly contributed to responding to infectious disease outbreaks, as seen in the Netherlands, reducing the risk of tick-borne diseases. Conclusions: Strides have been made with comprehensive processes that identify and prioritize zoonotic diseases of most significant concern and burden, such as OHZDP, approaches like One Health, and other theories considered. A proactive and integrated approach will build resilience against potential outbreaks and ensure a healthier future for our planet and its inhabitants. Full article

(This article belongs to the Special Issue The Impact of Extreme Weather and Climate on Human Health)

► Show Figures

Figure 1

16 pages, 1020 KiB

Open AccessArticle

Beyond Isolation: Social Media as a Bridge to Well-Being in Old Age

by Renato Mendonça Ribeiro, João Daniel de Souza Menezes, Daniele Alcalá Pompeo, Maria Angélica Andreotti Diniz, Gabriella Santos Lima, Patrícia Cruz Pontífice Sousa Valente Ribeiro, Júlio César André, Rita de Cássia Helú Mendonça Ribeiro, Rosalina Aparecida Partezani Rodrigues and Luciana Kusumota

Int. J. Environ. Res. Public Health 2025, 22(6), 882; https://doi.org/10.3390/ijerph22060882 (registering DOI) - 31 May 2025

Abstract

Population aging and the digital revolution have converged, creating challenges and opportunities for the social inclusion of older adults. This study examined social media usage patterns among Brazilian older adults during the COVID-19 pandemic, exploring their associations with sociodemographic factors, health, and well-being. [...] Read more.

Population aging and the digital revolution have converged, creating challenges and opportunities for the social inclusion of older adults. This study examined social media usage patterns among Brazilian older adults during the COVID-19 pandemic, exploring their associations with sociodemographic factors, health, and well-being. Through an online survey with 441 participants aged 60 or older, we found that WhatsApp^® and Instagram^® were the most utilized platforms, with a significant increase in usage during the pandemic. Higher educational attainment and income were associated with more frequent and diverse social media use, while the presence of comorbidities positively correlated with seeking health information online. Notably, greater engagement in social media was associated with an improved perception of well-being. The results highlight the potential of social media as tools for digital inclusion, access to information, and promotion of well-being for older adults, especially in crisis contexts. However, they also reveal socioeconomic disparities in access to and use of these technologies. These findings have significant implications for public policies on digital inclusion and health promotion, suggesting the need for targeted interventions to reduce digital inequality among older adults and maximize the potential benefits of social media for active and connected aging. Full article

► Show Figures

Figure 1

30 pages, 13436 KiB

Open AccessSystematic Review

Interventions on Barriers to the Participation of Adolescents in Physical Activity: A Systematic Review

by Lauryane Fonseca Terra, Leonardo Mateus Teixeira de Rezende, Regina Márcia Ferreira Silva, Woska Pires da Costa, Vicente Miñana-Signes, Matias Noll and Priscilla Rayanne E. Silva

Int. J. Environ. Res. Public Health 2025, 22(6), 881; https://doi.org/10.3390/ijerph22060881 (registering DOI) - 31 May 2025

Abstract

This review aimed to assess the effectiveness of interventions used to minimize barriers to participation in physical activity (PA) among adolescents. This systematic literature review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines. Searches were conducted across five databases: [...] Read more.

This review aimed to assess the effectiveness of interventions used to minimize barriers to participation in physical activity (PA) among adolescents. This systematic literature review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines. Searches were conducted across five databases: PubMed, SPORTDiscus, Embase, Scopus, and Web of Science. Thirty-four studies evaluated interventions to overcome barriers to participation in PA, with a focus on lack of motivation, encouragement, and support, as well as intrapersonal, interpersonal, and environmental barriers. Most interventions were conducted in developed countries, with an emphasis on girls, reflecting efforts to address health inequities. The interventions, conducted in schools, included workshops, training programs, lectures, goal setting, and practical activities, lasting from four weeks to four years. Twenty-seven studies (79.4%) reported positive impacts on PA participation, particularly in interventions addressing psychosocial, psychological, and behavioral barriers. The most effective interventions combined theory (through educational approaches) and practice (practical PA activities). These findings contribute to understanding barriers leading to physical inactivity and provide insights for developing or replicating initiatives to improve PA levels among adolescents. Full article

► Show Figures

Figure 1

17 pages, 363 KiB

Open AccessArticle

Turning Points as a Catalyst for Escaping Partner Violence: A Shelter-Based Phenomenological Study Examining South African Women’s Experiences of Leaving Abusive Relationships

by Annah Mabunda, Mathildah Mpata Mokgatle and Sphiwe Madiba

Int. J. Environ. Res. Public Health 2025, 22(6), 880; https://doi.org/10.3390/ijerph22060880 (registering DOI) - 31 May 2025

Abstract

Even though South Africa is a signatory to international declarations that aim to eliminate violence against women, intimate partner violence (IPV) remains a significant problem. While many women eventually leave IPV relationships after enduring violence for a long period, the matter of why [...] Read more.

Even though South Africa is a signatory to international declarations that aim to eliminate violence against women, intimate partner violence (IPV) remains a significant problem. While many women eventually leave IPV relationships after enduring violence for a long period, the matter of why women leave IPV relationships is not adequately researched in South Africa. This study explored the turning points that trigger the decision to leave IPV relationships and examined the process of leaving in a sample of women who left their abusive partners. In-depth interviews with 11 women living in shelters of safety for women in Gauteng Province, South Africa, were analyzed using Giorgi’s phenomenological analysis method. Leaving IPV relationships was a complex process that involved multiple decisions and actions over time; thus, most women endured many years of abuse. Leaving was triggered by various turning points, resulting in the leaving process being either planned or unplanned. For some of the women, the turning point was a specific violent event, while, for others, it was a culmination of violent events. Severe or escalating violence and the desire to protect their children from the impact of violence were key turning points for most of the women, such that they feared for their lives and that of their children. Overall, turning points played a crucial role in the decisions to leave abusive partners, and the leaving process for women was characterized to a great extent by fear. Understanding the complexities of the process of leaving and the relevance of turning points is essential to informing the development of appropriate interventions to respond more appropriately to women experiencing IPV. Full article

(This article belongs to the Special Issue Factors Associated with Intimate Partner Violence Perpetration and Victimisation)

11 pages, 267 KiB

Open AccessArticle

Association of Individual and Contextual Factors with Chronic Spine Problems: An Analysis from the National Health Survey

by Aryostennes Miquéias da Silva Ferreira, Sanderson José Costa de Assis, Clécio Gabriel de Souza, Geronimo José Bouzas Sanchis, Rebeca Freitas de Oliveira Nunes, Marcello Barbosa Guedes Otoni Guedes, Johnnatas Mikael Lopes and Angelo Giuseppe Roncalli

Int. J. Environ. Res. Public Health 2025, 22(6), 879; https://doi.org/10.3390/ijerph22060879 (registering DOI) - 31 May 2025

Abstract

The spine is the most affected region, which compromises functionality and generates absenteeism, increased health care costs, and disability retirement rates. Based on the biopsychosocial model, it is believed that chronic back problems are the result of a complex network of factors, both [...] Read more.

The spine is the most affected region, which compromises functionality and generates absenteeism, increased health care costs, and disability retirement rates. Based on the biopsychosocial model, it is believed that chronic back problems are the result of a complex network of factors, both individual and contextual. A cross-sectional study was developed with data from the 2013 National Health Survey, the United Nations Development Programme, and the National Register of Health Establishments (state level) for the second and third levels of aggregation, respectively. Multilevel Poisson regression was performed at three levels. The prevalence of chronic back problems was 18.5% (95% CI 17.8; 19.1), with a higher prevalence in females (RP = 1.23; 95% CI 1.15; 1.30), those aged above 49 years (RP = 1.75; 95% CI 1.61; 1.90), those performing heavy activities at work (RP = 1.37; 95% CI 1.28; 1.46), those with depressive days (RP = 1.70; 95% CI 1.50; 1.94), those who were smokers (RP = 1.37; 95% CI 1.27; 1.48), and those in states with a higher coefficient of Family Health Support Team per 100,000 inhabitants (PR = 1.28; 95% CI 1.07; 1.54). Chronic spine problems were associated with biological and behavioral factors and were more strongly associated with the coefficient of Family Health Support Team in Brazilian municipalities. Full article

(This article belongs to the Special Issue System Approaches to Improving Latino Health)

21 pages, 867 KiB

Open AccessArticle

Bullying in Students with Attention Deficit/Hyperactivity Disorder (ADHD): Analyzing Students’ Social Status and Student–Teacher Relationship Quality

by Sofia Mastrokoukou, Martina Berchiatti, Laura Badenes-Ribera, Laura Galiana and Claudio Longobardi

Int. J. Environ. Res. Public Health 2025, 22(6), 878; https://doi.org/10.3390/ijerph22060878 (registering DOI) - 31 May 2025

Abstract

The present study investigated how the quality of teacher–student relationships and students’ social status among peers relate to bullying experiences in children with Attention Deficit/Hyperactivity Disorder (ADHD) and those with typical development (TD). A sample of 135 students (27 with ADHD and 108 [...] Read more.

The present study investigated how the quality of teacher–student relationships and students’ social status among peers relate to bullying experiences in children with Attention Deficit/Hyperactivity Disorder (ADHD) and those with typical development (TD). A sample of 135 students (27 with ADHD and 108 with TD; M = 11.37, SD = 1.25) participated. Using a structural equation model, we examined whether ADHD predicted students’ relationships with teachers and peers and whether these variables, in turn, predicted bullying victimization and perpetration. The model showed a good fit. Children with ADHD reported more conflictual relationships with teachers, lower peer preference, and higher social impact compared to their typically developing peers. These relationship characteristics were differentially associated with bullying outcomes, with teacher–student conflict and peer visibility emerging as social risk factors. Although preliminary, the results suggest that the relational context—particularly teacher attention and peer dynamics—may play a critical role in shaping the social experiences of students with ADHD and could have unintended consequences within peer groups. Full article

(This article belongs to the Special Issue Bullying and Cyberbullying Among Youths)

15 pages, 4317 KiB

Open AccessArticle

Food Environment Around Schools in a Capital City in Southern Brazil: Changes in the Availability of Commercial Food Establishments Between 2012 and 2019

by Lidiamara Dornelles de Souza, Elizabeth Nappi Corrêa, Adalberto Aparecido dos Santos Lopes, Cristine Garcia Gabriel and Francisco de Assis Guedes de Vasconcelos

Int. J. Environ. Res. Public Health 2025, 22(6), 877; https://doi.org/10.3390/ijerph22060877 (registering DOI) - 31 May 2025

Abstract

Objective: The objective of this article was to perform a comparative analysis of the changes in the availability of commercial food establishments around the schools in a Brazilian capital city. Methods: This is a comparative analysis between two cross-sectional panels performed in 2012 [...] Read more.

Objective: The objective of this article was to perform a comparative analysis of the changes in the availability of commercial food establishments around the schools in a Brazilian capital city. Methods: This is a comparative analysis between two cross-sectional panels performed in 2012 and 2019 in Florianópolis, Santa Catarina, Brazil. Secondary data from different sources were used. The location data of schools and establishments were georeferenced. For the analysis of the surroundings of schools, a network buffer of 800 m was considered. The establishments were classified based on the foods they primarily sold: fresh, mixed and ultra-processed foods. The chi-square and Wilcoxon tests were applied for the analyses, considering a significance level of 95% (p < 0.05). Results: The number of food establishments around schools increased by 63%. There was a statistically significant growth in mixed (p = 0.008) and ultra-processed (p = 0.024) food- selling establishments. Conclusion: We conclude that the increase in establishments selling ultra-processed foods around schools at the expense of establishments selling fresh food deserves attention. This condition requires public policies that help promote healthier environments, thus contributing to the health of schoolchildren. Full article

(This article belongs to the Special Issue Bridging the Gap in Studies on the Food Environment: The State-of-the-Art in Low- and Middle-Income Countries (LMICs))

► Show Figures

Figure 1

12 pages, 246 KiB

Open AccessArticle

Soil Eating as a Psychological Coping Strategy for Women in Rural African Patriarchal Contexts

by Libopuoa Notsi and Mamochana Anacletta Ramatea

Int. J. Environ. Res. Public Health 2025, 22(6), 876; https://doi.org/10.3390/ijerph22060876 (registering DOI) - 31 May 2025

Abstract

In African patriarchal contexts, women have borne the dual responsibilities of mental and physical caregiving for their households and communities. These responsibilities often contribute to significant emotional, social, and economic burdens imposed by deeply entrenched gender and power structures. Alternative psychological coping mechanisms [...] Read more.

In African patriarchal contexts, women have borne the dual responsibilities of mental and physical caregiving for their households and communities. These responsibilities often contribute to significant emotional, social, and economic burdens imposed by deeply entrenched gender and power structures. Alternative psychological coping mechanisms emerge to navigate these challenges, some deeply rooted in cultural and historical practices. One such practice is soil eating, which has been observed in various African communities. Historically linked to cultural and spiritual beliefs, soil eating has been largely unexplored from a psychological perspective. This paper examined soil eating as a coping strategy among women in Africa, investigating its role as a means of emotional relief, resistance, or a symbolic reclamation of agency in the face of oppression. Drawing on the indigenous knowledge systems (IKS) of eZiko siPheka siSophula as a psychological framework, this study engaged sixteen women aged 20 to 89 in Ha Makintane Lesotho to participate in focus group discussions and reveal their personal narratives, cultural traditions, and the intersections of gender, race, and class to understand how this practice helps them manage their mental and emotional toll of patriarchal dominance. This research contributes to discussions on resilience, survival, and the psychological strategies developed by marginalized communities, shedding light on the complex interplay between cultural practices, mental health, and gendered experiences of power. Full article

(This article belongs to the Special Issue Creating the Future We Expect: Enhancing Women’s Health, Well-Being, and Gender Equality)

25 pages, 3501 KiB

Open AccessArticle

Radical Imagination: An Afrofuturism and Creative Aging Program for Black Women’s Brain Health and Wellness

by Tanisha G. Hill-Jarrett, Ashley J. Jackson, Alinda Amuiri and Gloria A. Aguirre

Int. J. Environ. Res. Public Health 2025, 22(6), 875; https://doi.org/10.3390/ijerph22060875 (registering DOI) - 31 May 2025

Abstract

Intersectional oppression and invisibility are primary drivers of cognitive and mental health disparities that affect Black women’s wellness. Older Black women additionally experience compounding effects of ageism, which may place them at increased risk for a decline in cognitive functioning and mental wellness. [...] Read more.

Intersectional oppression and invisibility are primary drivers of cognitive and mental health disparities that affect Black women’s wellness. Older Black women additionally experience compounding effects of ageism, which may place them at increased risk for a decline in cognitive functioning and mental wellness. To date, limited strengths-based, culturally relevant programming has focused on aging Black women. Fewer have incorporated Black women elders into conversations on Black liberation and the transformational change needed to create possible futures rooted in equity, healing, and health. This manuscript describes the inception and development of Radical Imagination, a creative aging program for Black women in the San Francisco Bay Area. Over ten weeks, 42 Black women (M age = 73.6, SD = 6.20; range: 58–85 years old) participated in the program, which incorporated brain and mental health education, art-making, storytelling, and photography. Grounded in principles of Afrofuturism and radical healing, participants explored past narratives of Black women and created a collective vision for a future that centers on Black women’s needs. Approximately 54.8% of participants attended more than one workshop. Upon program completion, exit surveys indicated that participants reported a moderate level of hopefulness about their ability to shape the future. Respondents reported overall satisfaction with the workshop series. We conclude with reflections on our process and recommendations for ways to support aging Black women using Afrofuturism and the arts. Full article

(This article belongs to the Special Issue Creating the Future We Expect: Enhancing Women’s Health, Well-Being, and Gender Equality)

12 pages, 626 KiB

Open AccessArticle

Increased Risk of Hospitalization for Lower Respiratory Tract Illness (LRTI) in the Elderly Living in Communities near a Newly Established Industrial Estate in Central Thailand

by Pirawan Wangupadcha, Steven Ronsmans, Jeroen Vanoirbeek, Yuparat Limmongkon, Wipharat Phokee and Chananya Jirapornkul

Int. J. Environ. Res. Public Health 2025, 22(6), 874; https://doi.org/10.3390/ijerph22060874 (registering DOI) - 31 May 2025

Abstract

Air pollution and health effects in communities near industrial areas are matters of concern in Thailand. Elevated air pollution concentrations are associated with morbidity and mortality arising from lower respiratory tract illness. In this study, we aimed to assess whether living in a [...] Read more.

Air pollution and health effects in communities near industrial areas are matters of concern in Thailand. Elevated air pollution concentrations are associated with morbidity and mortality arising from lower respiratory tract illness. In this study, we aimed to assess whether living in a community near a new industrial estate in Central Thailand was associated with an elevated incidence of lower respiratory tract illness (LRTI) among the elderly. We used data on hospital admissions from a primary hospital and sub-district-level health-promoting hospitals in six sub-districts located within a radius of 5 km from the industrial estate, between 1 November 2023 and 31 March 2024, using a cross-sectional study design. There were 1311 elderly individuals living within a radius of 3 km and 1488 between 3 and 5 km. We found a statistically significant increased risk of hospitalization for LRTI in the elderly living within a radius of less than 3 km (odds ratio: 3.43 [95% CI: 1.61–7.36] compared to those living in a radius between 3 and 5 km. Our results provide strong support for an association between hospitalization for LRTI and living distance from a new industrial estate. Full article

(This article belongs to the Special Issue Respiratory Health Effects of Environmental and Occupational Exposures)

► Show Figures

Figure 1

18 pages, 1338 KiB

Open AccessArticle

Human Health Risk Assessment from the Tilapia Fish in Heavy Metal–Contaminated Landfill Reservoir

by Ni Yang, Pansa Monkheang, Lamyai Neeratanaphan, Somsak Intamat and Bundit Tengjaroensakul

Int. J. Environ. Res. Public Health 2025, 22(6), 873; https://doi.org/10.3390/ijerph22060873 (registering DOI) - 31 May 2025

Abstract

This study highlights the significant environmental and health risks associated with heavy metal contamination (As, Cd, Cr, and Pb) in Oreochromis niloticus (Nile tilapia) from two locations: the Khon Kaen municipal landfill (study site) and the Thapra commercial fish farm (reference site). It [...] Read more.

This study highlights the significant environmental and health risks associated with heavy metal contamination (As, Cd, Cr, and Pb) in Oreochromis niloticus (Nile tilapia) from two locations: the Khon Kaen municipal landfill (study site) and the Thapra commercial fish farm (reference site). It also evaluates potential human health risks and investigates genotoxicity and oxidative stress markers, including malondialdehyde, hydrogen peroxide (H₂O₂), catalase (CAT), and superoxide dismutase (SOD) in fish. Heavy metal concentrations were analyzed using inductively coupled plasma optical emission spectrometry. To determine genetic differentiation, inter-simple sequence repeats with dendrogram construction and genomic template stability (%GTS) were applied. The results showed that the average concentrations of As, Cd, Cr, and Pb in water samples were 0.0848, 0.536, 1.23, and 0.73 mg/L, respectively. These values exceeded safety limits, and the average Cd in sediment (1.162 mg/kg) was above regulatory thresholds. In fish muscle, the average metal concentrations (mg/kg) followed the order Cr (1.83) > Pb (0.69) > Cd (0.096) > As (0.0758), with Pb exceeding food quality standards. The bioaccumulation factor ranked as Cr > Pb > As > Cd. Health risk assessments, including health risk index and carcinogenic risk, suggested Pb contamination poses significant health risks through fish consumption. From dendrogram results, the %GTS of O. niloticus from the landfill and reference sites were 46.34 to 71.67% and 87.34 to 96.00%, respectively. This suggests that fish from the landfill site exhibited greater genetic diversity compared to those from the reference site. Specific oxidative stress markers revealed higher levels of H₂O₂ and significantly lower activities of CAT and SOD in landfill O. niloticus than in the reference site. These results emphasize the urgent need for environmental monitoring, stricter pollution controls, and improved waste management strategies to protect aquatic ecosystems and human health. Full article

► Show Figures

Figure 1

16 pages, 871 KiB

Open AccessArticle

Exposure to Air Pollution and Changes in Resting Blood Pressure from Morning to Evening: The MobiliSense Study

by Lisa Sekarimunda, Clelie Dureau, Basile Chaix and Sanjeev Bista

Int. J. Environ. Res. Public Health 2025, 22(6), 872; https://doi.org/10.3390/ijerph22060872 (registering DOI) - 31 May 2025

Abstract

Several epidemiological studies have documented associations between air pollution exposure and cardiovascular responses, including adverse effects of air pollutants on blood pressure (BP). However, previous studies only considered the effect of specific air pollutants on resting BP, and did not sufficiently consider the [...] Read more.

Several epidemiological studies have documented associations between air pollution exposure and cardiovascular responses, including adverse effects of air pollutants on blood pressure (BP). However, previous studies only considered the effect of specific air pollutants on resting BP, and did not sufficiently consider the independent effects of various air pollution species as well as their overall mixture effect. We addressed this gap in our MobiliSense sensor-based study among 273 participants living in the Grand Paris region. Participants wore personal monitors to assess personal exposure to particles [black carbon and particulate matter smaller than 2.5 μm in diameter (PM_2.5)] and gaseous pollutants [ozone (O₃), nitrogen monoxide (NO), carbon monoxide (CO), and nitrogen dioxide (NO₂)] along with noise exposure. Participants were asked to measure their blood pressure (BP) at rest in the mornings and evenings for three days. Multilevel models with a random intercept at the individual level explored the relationship between air pollution exposure (averaged over the day) and change in resting BP from morning to evening. We also used the quantile G-computation method to estimate the joint effect of the mixture of targeted air pollutants on resting BP. Sensitivity analyses examined the associations between air pollution exposure averaged at different temporal scales before evening BP measurements and the outcome. A quantile increase in the mixture of air pollutants (PM_2.5, NO₂, NO, CO, and O₃) over the day did not affect changes in systolic BP [−0.33 mmHg (95% CI: −3.31, 2.65)] and diastolic BP [−0.53 mmHg (95% CI: −2.66, 1.60)] from morning to evening. When shorter time exposure windows were considered (from a few minutes to a few hours), both NO and the mixture showed positive associations with the morning-to-evening DBP change in only some of the models. Future studies with sufficient repeated BP measurements for more participants should test the association at varying temporal scales (minutes to days) to better understand how air pollution exposure influences resting BP. Full article

► Show Figures

Figure 1

13 pages, 838 KiB

Open AccessArticle

The Impact of a Novel Transfer Process on Patient Bed Days and Length of Stay: A Five-Year Comparative Study at the Mayo Clinic in Rochester and Mankato Quaternary and Tertiary Care Centers

by Anwar Khedr, Esraa Hassan, Rida Asim, Muhammad Khuzzaim Khan, Nikhil Duseja, Noura Attallah, Jennifer Mueller, Jamie Newman, Erica Loomis, Jennifer Bartelt, Syed Anjum Khan and Brian Bartlett

Int. J. Environ. Res. Public Health 2025, 22(6), 871; https://doi.org/10.3390/ijerph22060871 (registering DOI) - 31 May 2025

Abstract

Introduction: This study evaluated the impact of parallel-level patient transfers on bed utilization efficiency within the Mayo Clinic Health System in Southern Minnesota, focusing on optimizing resources across tertiary and critical access hospitals. Methods: A retrospective analysis of 179,066 Emergency Department visits (2018–2022) [...] Read more.

Introduction: This study evaluated the impact of parallel-level patient transfers on bed utilization efficiency within the Mayo Clinic Health System in Southern Minnesota, focusing on optimizing resources across tertiary and critical access hospitals. Methods: A retrospective analysis of 179,066 Emergency Department visits (2018–2022) was conducted, with ~2% involving parallel-level transfers for observation or admission. Machine learning was utilized to identify patients suitable for parallel transfers based on demographics, comorbidities, and clinical factors. A Random Forest model with an AUROC of 0.87 guided transfer decisions. Saved patient days were calculated as the difference between the actual LOS and the benchmark LOS based on Diagnosis-Related Groups (DRGs). Generalized estimating equations analyzed length of stay (LOS) differences, adjusted for confounders, with 95% confidence intervals (CI). Statistical analyses were conducted using SPSS (v.26). Results: The mean patient age was 56 years (SD = 17.2), with 51.4% being female. Saved patient days increased from ~600 to 5200 days over the study period. Transferred patients had a 5.7% longer unadjusted LOS compared to non-transferred patients (95% CI: 2.9–8.6%, p < 0.001). After adjustment for demographics and comorbidities, the LOS difference was not significant (adjusted mean difference: 0.4%, 95% CI: −1.7–2.5%, p = 0.51). Conclusions: Parallel-level transfers increased saved patient days, reflecting enhanced resource utilization. However, the adjusted LOS differences were not significant, highlighting the need for robust transfer protocols and controlled studies to confirm these findings. Full article

(This article belongs to the Special Issue Innovations in Rural Health Services: Bridging Gaps and Enhancing Access)

16 pages, 2836 KiB

Open AccessArticle

The Value and Access of Urban Greenspace: A Comparison Study of User Perceptions of the Naval Cemetery Landscape, New York

by Shujuan Li, Alden Stoner, Angela Walseng, Neha Srinivasan, Esther M. Sternberg and Bo Yang

Int. J. Environ. Res. Public Health 2025, 22(6), 870; https://doi.org/10.3390/ijerph22060870 (registering DOI) - 31 May 2025

Abstract

In studying greenspace and people’s health and wellbeing, the self-report health perception survey method is broadly used. There is a consensus that people’s health and wellbeing are positively associated with greenspace exposure. Meanwhile, different conclusions on details related to greenspace exposure have also [...] Read more.

In studying greenspace and people’s health and wellbeing, the self-report health perception survey method is broadly used. There is a consensus that people’s health and wellbeing are positively associated with greenspace exposure. Meanwhile, different conclusions on details related to greenspace exposure have also been reported, e.g., the frequency and the stay time. Few studies have investigated and compared on-site greenspace exposure and off-site reflections with perspectives on greenspace (i.e., afterward greenspace exposure). Some self-report health perception surveys have been conducted on-site, especially for experimental studies. There are also surveys that have been conducted off-site, e.g., general association studies on greenspace and public health. On-site and off-site settings indicate different time dimensions of greenspace experiences (i.e., real time vs. afterward). To what extent do these survey settings impact the conclusions on greenspace exposure? This study compares visitors’ self-reported health and landscape perceptions of the Naval Cemetery Landscape, a contemplative greenspace for passive recreation activities in Brooklyn, New York. The results show that the on-site survey reached a broader audience, and the perception and valuing of the space captured by the on-site survey were more positive than those of the off-site survey. In addition, the on-site survey captured more details on the associations between greenspace access, perception, and values than the off-site survey did. Full article

(This article belongs to the Section Environmental Health)

► Show Figures

Figure 1

24 pages, 3214 KiB

Open AccessReview

Health Literacy in People with Type 1 Diabetes: A Scoping Review

by Ilaria Milani, Elisa Cipponeri, Paola Ripa, Arianna Magon, Stefano Terzoni, Silvia Cilluffo, Maura Lusignani and Rosario Caruso

Int. J. Environ. Res. Public Health 2025, 22(6), 869; https://doi.org/10.3390/ijerph22060869 (registering DOI) - 31 May 2025

Abstract

Health literacy (HL) plays a crucial role in the self-management and clinical outcomes of individuals with Type 1 Diabetes Mellitus (T1DM). Despite its significance, research on HL in this population remains fragmented. This scoping review aims to map the existing literature on HL [...] Read more.

Health literacy (HL) plays a crucial role in the self-management and clinical outcomes of individuals with Type 1 Diabetes Mellitus (T1DM). Despite its significance, research on HL in this population remains fragmented. This scoping review aims to map the existing literature on HL in T1DM and assess its impact on disease management. A systematic search was conducted in PubMed, Embase, Scopus, Web of Science, and Google Scholar, covering studies up to January 2025. The review included 55 studies, primarily focusing on adolescents and young adults, examining key HL dimensions such as numeracy, self-efficacy, nutrition literacy, and the use of digital health technologies. Findings highlight that adequate HL levels are associated with improved diabetes self-care, glycemic control, and quality of life, while barriers such as low numeracy, social anxiety, and socioeconomic disparities hinder disease management. Limited research exists on HL interventions tailored to T1DM, underscoring the need for targeted strategies to enhance patient education and engagement. Given the complex interplay between HL and diabetes outcomes, integrating HL assessments into routine care and developing tailored interventions may improve long-term disease management and quality of life for individuals with T1DM. Full article

14 pages, 727 KiB

Open AccessArticle

Knowledge, Attitude, and Practice Towards Antibiotic Use and Resistance Among Non-Medical University Students, Riyadh, Saudi Arabia

by Amen Bawazir, Abdullah Bohairi, Omar Badughaysh, Abdulmohsen Alhussain, Mohannad Abuobaid, Majd Abuobaid, Azzam Al Jabber, Yaman Mardini, Abdulaziz Alothman, Faris Alsomih, Abdullah AlMuzaini and Mohammed BaHamdan

Int. J. Environ. Res. Public Health 2025, 22(6), 868; https://doi.org/10.3390/ijerph22060868 (registering DOI) - 31 May 2025

Abstract

Background: Antibiotic resistance (AR) is a global public health crisis, largely driven by the misuse and overuse of antibiotics. This study aimed to assess the level of knowledge, attitude, and practice (KAP) toward AR among non-medical university students in Riyadh, Saudi Arabia and [...] Read more.

Background: Antibiotic resistance (AR) is a global public health crisis, largely driven by the misuse and overuse of antibiotics. This study aimed to assess the level of knowledge, attitude, and practice (KAP) toward AR among non-medical university students in Riyadh, Saudi Arabia and identify factors that influence antibiotic use. Methods: A cross-sectional survey was conducted with 672 students from both public and private universities in Riyadh. Data were collected using a self-administered questionnaire covering sociodemographic characteristics and KAP regarding antibiotics. Results: The findings indicated that 59.1% of students had sufficient knowledge of antibiotics, while 60% had positive attitudes, and 60.6% exhibited responsible practices. However, 40.9% of students demonstrated insufficient knowledge, and factors such as age, gender, and field of study significantly impacted KAP outcomes. Females had 65.8% higher odds of demonstrating a positive attitude toward AR prevention, compared to males, and 52% higher odds of adopting appropriate practices than males. The primary source of information on antibiotics was healthcare professionals, particularly doctors. Conclusions: These findings underscore the need for targeted educational interventions to enhance awareness and promote the responsible use of antibiotics among university students, helping to mitigate the threat of antibiotic resistance. Full article

(This article belongs to the Section Health Care Sciences)

► Show Figures

Figure 1

Journal Description

International Journal of Environmental Research and Public Health

Latest Articles

Journal Menu

Journal Browser

Highly Accessed Articles

Latest Books

E-Mail Alert

News

Topics

Conferences

Special Issues

Topical Collections

Further Information

Guidelines

MDPI Initiatives

Follow MDPI