Search Results (103)

Cancer disparities in low- and middle-income countries (LMICs) arise from multifaceted interactions between environmental exposures, infectious agents, and systemic inequities, such as limited access to care. The exposome, a framework encompassing the totality of non-genetic exposures throughout life, offers a powerful lens for understanding these disparities. In LMICs, populations are disproportionately affected by air and water pollution, occupational hazards, and oncogenic infections, including human papillomavirus (HPV), hepatitis B virus (HBV), Helicobacter pylori (H. pylori), human immunodeficiency virus (HIV), and neglected tropical diseases, such as schistosomiasis. These infectious agents contribute to increased cancer susceptibility and poor outcomes, particularly in immunocompromised individuals. Moreover, climate change, food insecurity, and barriers to healthcare access exacerbate these risks. This review adopts a population-level exposome approach to explore how environmental and infectious exposures intersect with genetic, epigenetic, and immune mechanisms to influence cancer incidence and progression in LMICs. We highlight the critical pathways linking chronic exposure and inflammation to tumor development and evaluate strategies such as HPV and HBV vaccination, antiretroviral therapy, and environmental regulation. Special attention is given to tools such as exposome-wide association studies (ExWASs), which offer promise for exposure surveillance, early detection, and public health policy. By integrating exposomic insights into national health systems, especially in regions such as sub-Saharan Africa (SSA) and South Asia, LMICs can advance equitable cancer prevention and control strategies. A holistic, exposome-informed strategy is essential for reducing global cancer disparities and improving outcomes in vulnerable populations. Full article

The Latin American and Caribbean (LAC) region faces persistent challenges of inequality, climate change vulnerability, and deteriorating air quality. The Aburrá Valley, where Medellín is located, is a narrow tropical valley with complex topography, strong thermal inversions, and unstable atmospheric conditions, all of which exacerbate the accumulation of pollutants. In Medellín, ${\mathrm{NO}}_2$ concentrations have remained nearly unchanged over the past eight years, consistently approaching critical thresholds, despite the implementation of air quality control strategies. These persistent high concentrations are closely linked to the variability of the atmospheric boundary layer (ABL) and are often intensified by prolonged dry periods. This study focuses on a representative street canyon in Medellín that has undergone recent urban interventions, including the construction of new public spaces and pedestrian areas, without explicitly considering their impact on ${\mathrm{NO}}_x$ dispersion. Using Computational Fluid Dynamics (CFD) simulations, this work evaluates the influence of urban morphology on ${\mathrm{NO}}_x$ accumulation. The results reveal that areas with high Aspect Ratios (AR > 0.65) and dense vegetation exhibit reduced wind speeds at the pedestrian level—up to 40% lower compared to open zones—and higher ${\mathrm{NO}}_2$ concentrations, with maximum simulated values exceeding 50 μg/m³. This study demonstrates that the design of pedestrian corridors in complex urban environments like Medellín can unintentionally create pollutant accumulation zones, underscoring the importance of integrating air quality considerations into urban planning. The findings provide actionable insights for policymakers, emphasizing the need for comprehensive modeling and field validation to ensure healthier urban spaces in cities affected by persistent air quality issues. Full article

Despite spending a substantial proportion of their time indoors, the mental health effects of indoor air pollution on children and adolescents remain inadequately explored. This study aimed to elucidate the spatiotemporal variations and sociodemographic inequalities in exposure to multiple indoor pollutants and to assess their potential associations with depressive symptoms among school-aged children in Beijing. Using real-time portable monitors, concentrations of fine particulate matter (PM_2.5), coarse particulate matter (PM₁₀), carbon dioxide (CO₂), formaldehyde (HCHO), total volatile organic compounds (TVOC), temperature, and humidity in classrooms and bedrooms were measured during both weekdays and weekends. Moreover, substantial spatiotemporal heterogeneity was observed. It was found that concentrations of PM_2.5, PM₁₀, and TVOC peaked in classrooms during weekday daytime, while CO₂ levels were highest in bedrooms on weekend nights. Exposure levels were notably higher among children whose mothers had lower educational attainment and those living in recently renovated homes, indicating marked socio-demographic disparities. In multivariable logistic regression models, indoor exposure to CO₂ and TVOC was significantly associated with increased odds of depressive symptoms. These findings highlight the critical need to improve indoor air quality through enhanced ventilation and the mitigation of emissions from indoor sources, particularly within school and residential settings. The results offer valuable empirical evidence to guide the development of targeted environmental interventions and public health policies designed to support and enhance the psychological well-being of children. Full article

Air pollution is a growing environmental and public health concern, particularly in urban areas where vehicular emissions, industrial activities, and public events contribute to deteriorating air quality. This study examines air pollution concentrations in two districts of Cusco, Peru, using an interdisciplinary approach that integrates environmental monitoring and social risk perception analysis. Air quality measurements revealed elevated levels of PM2.5 and NO₂, with 40–60% of data falling within “Moderate” or “Unhealthy for sensitive groups” categories according to international standards. Notably, major cultural events such as Inti Raymi were associated with a threefold increase in pollutant concentrations, highlighting their impact on urban air quality. Simultaneously, surveys and interviews assessed public perception, revealing a varied understanding of pollution risks and a general concern for health impacts, especially in more polluted and densely populated areas. However, trust in scientists remains limited, which poses challenges for the implementation of evidence-based environmental strategies. This study highlights significant environmental inequality within the city, with central districts facing greater pollution burdens than peripheral zones. These findings underscore the need for holistic air quality management strategies that combine scientific assessments with community engagement. Strengthening trust between scientists and local populations is essential to develop inclusive and effective interventions that align with both technical and social priorities, particularly in rapidly urbanizing contexts such as Cusco. Full article

Among the challenges the human population needs to address are threats of global pandemics, increasing socioeconomic inequality, especially in developing countries, and anthropogenic climate change. The latter’s effect has been amplified with the arrival of 2023/24 El Niño, causing an exceptional drought in the Amazon basin, significantly affecting fire conditions and hydroelectric power production in several South American countries, including Ecuador. This study analyzes five criteria pollutants—carbon monoxide (CO), nitrogen dioxide (NO₂), sulfur dioxide (SO₂), ozone (O₃), and particulate matter ≤ 2.5 µm (PM_2.5)—during 2019–2024 in Quito, Ecuador, a high-elevation tropical metropolis. Despite long-term efforts to regulate emissions, air pollution levels continue to rise, driven by overlapping crises, including energy shortages, political unrest, and extreme weather events. The persistent failure to improve air quality underscores the vulnerability of developing nations to climate change-induced energy instability and the urgent need for adaptive, diversified, and resilient future energy planning. Without immediate shifts in climate adaptation policies, cities like Quito will continue to experience worsening air quality, with severe implications for public health and environmental sustainability. Full article

The intersection of environmental justice and urban accessibility presents a critical challenge in sustainable city planning. While the “15-minute city” concept has emerged as a prominent framework for promoting walkable neighborhoods, its implications for environmental exposure inequalities remain underexplored. This study introduces an innovative methodology for assessing air pollution exposure disparities within the context of 15-minute activity zones in New York City. By integrating street-level PM2.5 predictions with spatial network analysis, this research evaluates exposure patterns that more accurately reflect residents’ daily mobility experiences. The results reveal significant socioeconomic and racial disparities in air pollution exposure, with lower-income areas and Black communities experiencing consistently higher PM2.5 levels within their 15-minute walking ranges. A borough-level analysis further underscores the influence of localized urban development patterns and demographic distributions on environmental justice outcomes. A comparative analysis demonstrates that traditional census tract-based approaches may underestimate these disparities by failing to account for actual pedestrian mobility patterns. These findings highlight the necessity of integrating high-resolution environmental justice assessments into urban planning initiatives to foster more equitable and sustainable urban development. Full article

Multiple studies have found an association between ambient air quality, noise pollution, green spaces and health. The underlying mechanisms of this association remain partly unknown. In this study, we focus on subjective perception as a potential underlying factor. We assess (I) the association between objective and subjective indicators of the living environment and all-cause mortality, as well as (II) the potential modification of the relationship between objective exposures and all-cause mortality by subjective perception: The data consisted of a linkage between the 2001 census, mortality register data from 1 October 2001 to 31 December 2016 and objective indicators of the residential living environment (air and noise pollution and green spaces). We used Cox regression to investigate the impact of objective and subjective indicators of the living environment and their potential interaction effect on all-cause mortality in the Brussels Capital Region: A negative subjective perception of the residential living environment is associated with an increased risk of mortality, even when controlling for socio-demographic parameters. Similarly, objective indicators of air pollutants and green spaces are also related to mortality. When studying the interaction effect, the beneficial effect of a neutral subjective perception stands out. Subjectively satisfied individuals living in the worst objective conditions showed the highest level of mortality hazard. Noise pollution was the only exception, characterized by the lack of an interaction effect: This study showed that besides objective indicators, the subjective perception of the residential environment also matters, and both interact to influence life chances. Subjective indicators not only have a genuine independent impact but also act as an underlying factor in the relationship between the objective residential environment and health. Full article

Over the past decade, China has enacted forward-looking environmental policies that have significantly reduced air pollution. However, while there appears to be a synergy between economic development and improvements in air quality, regional imbalances in development and disparities in health risks underscore systemic challenges in environmental governance. This study employed a population-weighted exposure index to evaluate disparities in PM_2.5 exposure and its temporal and spatial trends, considering multidimensional socio-economic factors such as education, age, gender, occupation, and urban/rural backgrounds across 32 provinces and regions in China. The findings reveal that despite a notable decline in overall PM_2.5 concentrations between 2013 and 2020, improvements in air quality are uneven across regions, with less developed areas bearing a disproportionate burden of emission reductions. Urban centers exhibit lower exposure levels due to resource and industrial advantages, whereas towns experience higher risks of air pollution. Socio-economic disparities are evident, with increased exposure observed in high-pollution industries and among groups with lower educational attainment. Women are more likely to be exposed than men, and both the elderly and children face higher risks. To address these challenges, policies should focus on the economic development of underdeveloped regions, balance environmental protection with growth, prioritize heavily polluted areas and vulnerable populations, and promote the adoption of clean energy to mitigate pollution inequality. Full article

Differences in exposures and resources to manage personal health contribute to persistent inequities in air pollution burden despite vast air quality improvements over the past 2–3 decades in the United States. These factors are, partly, linked to historic racist practices, such as redlining, a discriminatory housing policy that was practiced legally between 1935 and 1968. Using 100 m × 100 m resolution land-use regression predicted surfaces of PM_2.5 constituents (black carbon, nickel, vanadium, and copper) as pollution source indicators, we fit Bayesian generalized linear mixed-effects models to examine differences in source exposures over two study periods, 2008–2015 and 2016–2019, comparing (1) redlined to not redlined and (2) high-asthma to low-asthma neighborhoods. We examine redlining as an indicator of historical, and structural racism and asthma rates as an indicator of present-day community burden. Redlined areas saw near elimination of disparities in exposure to residual oil boilers and marine residual oil but persistent disparities in traffic. High-asthma neighborhoods continue to have disproportionately high exposures to both residual oil boilers and traffic, with no discernable disparities related to marine residual oil emissions. Overall exposure disparities are small, with PM_2.5 disparities by both asthma morbidity and redlining amounting to less than 1 µg/m³ and NO₂ disparities by asthma and redlining amounting to less than 2 ppb in the post-2016 period. For context, 2019 NYC average PM_2.5 and NO₂ were 8.5 µg/m³ and 20 ppb, respectively. Our findings suggest that local pollution policy should focus on reducing traffic and building boiler emissions in high-asthma neighborhoods to reduce exacerbations. Full article

A growing literature within the field of air pollution exposure assessment addresses the issue of environmental justice. Leveraging the increasing availability of exposure datasets with broad spatial coverage and high spatial resolution, a number of works have assessed inequalities in exposure across racial/ethnic and other socioeconomic groupings. However, environmental justice research presents the additional need to evaluate exposure inequity—inequality that is systematic, unfair, and avoidable—which may be framed in several ways. We discuss these framings and describe inequality and inequity conclusions provided from several contrasting approaches drawn from recent work. We recommend that future work addressing environmental justice interventions include complementary “Exposure-driven” and “Socially weighted” metrics, taking an intersectional view of areas and social groups that are both disproportionately impacted by pollution and are impacted by additional health risks resulting from structural racism and consider implications for environmental justice beyond distributional equity. Full article

Background: Ambient air pollution remains a major risk factor for population health worldwide. The impact of PM_2.5 air pollution is underestimated in sub-Saharan Africa due to a lack of epidemiological studies. AirQ+ is proposed to reduce these inequalities in research. The aim of this study is to assess, by AirQ+, the impact of prolonged exposure to PM_2.5 on respiratory health in Kinshasa in 2019, and to estimate the health benefits of reducing this air pollution. Methods: Population and mortality data were obtained from the Institut National de la Statistique and the Institut de Métrologie et d’Évaluation en santé, respectively. PM_2.5 concentrations were measured using PurpleAir PA-II-SD sensors, and average annual concentration was 43.5 µg/m³ in 2019. AirQ+ was used to estimate the health effect attributable to PM_2.5 in adults aged over 25 in Kinshasa. Results: In 2019, the proportion of deaths attributable to PM_2.5 air pollution was 30.72% for ALRI, 26.55% for COPD and 24.32% for lung cancers. Each 10% reduction in current PM_2.5 levels would prevent 1093 deaths (from all causes) per year in Kinshasa. Life expectancy would increase by 4.7 years (CI 3.5–5.3) if the WHO threshold of 5 mg/m³ were respected. Conclusions: The results of this study highlight the major respiratory public health problem associated with air pollution by fine particles in Kinshasa. AirQ+ was used to assess the impact of prolonged exposure to PM_2.5 and respiratory deaths among adults in Kinshasa and revealed that this number of deaths could be avoided by improving air quality. Full article

Simple indicators are often used to summarize the complexity of systems or products, commonly through color-coded labels paired with letters. These labels, like those indicating energy efficiency or nutritional ratings, help users quickly understand essential characteristics. Building on this approach, the Quality Urban Label (QUL) has been developed to assess public space adaptation to urban climate change. The QUL utilizes four key indicators, called quality components: air quality (pollutants), noise pollution, thermal comfort, and visual comfort. It ranges from 0 to 25 and is represented by a color and letter code (green, A, ranging from 0 to 2; blue, B, ranging from 6 to 11; orange, C, ranging from 15 to 19; and red, D, ranging from 22 to 25), with green representing better quality and red poorer quality. The QUL aims to evaluate public spaces based on energy consumption reduction, greenhouse gas emissions reduction, and progress toward carbon neutrality. This article explores some ecological and climate benefits of the QUL, especially in warm Mediterranean cities. An objective label that quantifies the alignment of urban public space with climate neutrality has numerous advantages, which are discussed in the article. In addition, it is a key tool for urban project planning, focused on reducing urban social inequalities and promoting a just energy transition of urban public space. Full article

Air pollution, greenspace and noise are interrelated environmental factors with the potential to influence human health outcomes. Research has measured these exposures in diverse ways across the globe, but no study has yet performed a country-wide analysis of air pollution, greenspace, and noise in England. This study examined cross-sectional PM_2.5, NO₂, greenness, accessible greenspace, road noise, and rail noise exposure data at all residential postcodes in England (n = 1,227,681). Restricted cubic spline models were fitted between each environmental exposure and a measure of socioeconomic status, the Index of Multiple Deprivation (IMD) rank. Population-weighted exposures by IMD deciles, urbanicity, and region were subsequently estimated. Restricted cubic spline models were also fitted between greenness and each other environmental exposure in the study. The results show some evidence of inequalities in exposure to air pollutants, greenspace, and noise across England. Notably, there is a socioeconomic gradient in greenness, NO₂, PM_2.5, and road noise in London. In addition, NO₂, PM_2.5, and road noise exposure decrease as greenness increases in urban areas. Concerningly, almost all air pollution estimates in our study exceed international health guidelines. Further research is needed to elucidate the socioeconomic patterns and health impacts of air pollution, greenspace, and noise over time. Full article

In the 21st century, climate change has emerged as a critical global public health challenge. Women experience the most severe impacts of climate change, intensifying pre-existing gender inequalities. This scoping review aims to explore the intersection of climate change, health, and gender, considering the social determinants of health. The methods for this review follow the Arksey and O’Malley framework for a scoping review and the PRISMA-ScR checklist. The review, covering January 2019 to February 2024, included PubMed, LILACS, and SciELO databases. We identified 71 studies with 19 meeting the inclusion criteria. The results revealed the differential effects of climate change on health according to gender in areas such as mental health, reproductive health, gender-based violence, occupational health, and health issues associated with heat and air pollution. Our findings also elucidated how socio-economic and gender inequities intersect, exacerbating the risk of experiencing these effects. In conclusion, the study highlights a clear need for gender-sensitive climate policies and interventions to address these disparities and protect vulnerable populations from the health impacts of climate change. Full article

Air pollution exposure has been linked to detrimental health outcomes. While cross-sectional studies have demonstrated socioeconomic disparities in air pollution exposure, longitudinal evidence on these disparities remains limited. The current study investigates trends in residential air pollution exposure across socioeconomic groups in the Netherlands from 2014 to 2019. Our dataset includes over 12.5 million individuals, aged 18 years and above, who resided in the Netherlands between 2014 and 2019, using Statistics Netherlands data. The address-level air pollution concentrations were estimated by dispersion models of the National Institute of Public Health and the Environment. We linked the exposure estimations of particulate matter < 10 or <2.5 μm (PM₁₀, PM_2.5) and nitrogen dioxide (NO₂) to household-level socioeconomic data. In highly urbanized areas, individuals from both the lowest and highest socioeconomic groups were exposed to higher air pollution concentrations. Individuals from the lowest socioeconomic group were disproportionally located in highly urbanized and more polluted areas. The air pollution concentrations of PM₁₀, PM_2.5, and NO₂ decreased between 2014 and 2019 for all the socioeconomic groups. The decrease in the annual average air pollution concentrations was the strongest for the lowest socioeconomic group, although differences in exposure between the socioeconomic groups remain. Further research is needed to define the health and equity implications. Full article