Search Results (2,042)

Background: Human exposure to environmental endocrine-disrupting chemicals (EDCs) rarely occurs in isolation, yet most epidemiological research has assessed chemicals individually. PFASs, toxic metals, phthalates, and VOCs are ubiquitous contaminants with well-documented reproductive toxicity. Objective: The aim of this study was to investigate the joint and individual effects of 28 EDCs spanning four chemical classes on six reproductive hormone biomarkers in a nationally representative U.S. population—using an innovative approach that simultaneously characterizes nonlinear mixture effects and chemical interactions across multiple exposure domains. Methods: This cross-sectional study used NHANES 2017–2018 data (n = 9254). Multivariable linear regression and Bayesian Kernel Machine Regression (BKMR) characterized individual and mixture associations, respectively. Missing data were handled using multiple imputations by chained equations. Survey design weights were applied in linear regression models. Results: Linear regression revealed heterogeneous associations across chemical classes and hormones. PFOA was positively associated with SHBG (β = 12.35; 95% CI: 8.33, 16.38) and LH (β = 6.91; 95% CI: 1.44, 12.38), while mercury was inversely associated with estradiol (β = −3.38; 95% CI: −5.12, −1.65). BKMR analyses identified pronounced non-monotonic dose–response relationships and emergent mixture effects not predictable from single-chemical analyses for all six hormones. Posterior inclusion probabilities identified cadmium, PFOA, MEHP, and MBzP as the most influential predictors across hormone endpoints. Conclusions: Concurrent real-world exposure to PFASs, toxic metals, phthalates, and VOCs is associated with measurable, nonlinear alterations in reproductive hormone profiles. Chemical mixture effects cannot be reliably predicted from single-pollutant analyses, underscoring the necessity of mixture-based methodologies in environmental reproductive epidemiology. Prospective studies are needed to establish causal temporality and identify critical windows of susceptibility. Full article

Background/Objectives: Acute lymphoblastic leukemia (ALL) is the most common childhood malignancy. Understanding its epidemiological characteristics is essential for guiding public health strategies. In this study, we characterized the epidemiological profiles that may contribute to the risk of ALL in children in southern Brazil. Methods: Clinical and epidemiological data from 71 children (1–15 years old) admitted and newly diagnosed with ALL at four hospitals in Curitiba, Paraná, Brazil, were retrieved and analyzed. Results: Among the 71 children with ALL, the majority were male (n = 43, 60.6%), with an age range of 1–3 years (n = 26, 36.6%), self-identified as White (n = 47, 66.2%), and were born in Paraná state (n = 61, 85.9%). Nearly half had a family history of cancer (n = 33, 46.5%), primarily among grandparents (n = 36, 61%). Parental environmental exposures included smoking (n = 30, 42.3%) and occupational exposure to chemicals or radiation (n = 17, 23.9%). At diagnosis, most patients (n = 43, 60.5%) had a bone marrow blast count > 70%, and 27 patients (38%) had a peripheral blood blast count > 70%. B-cell ALL was the predominant subtype (n = 61, 85.9%). In B-cell ALL cases, the most frequent molecular subtype was high hyperdiploidy (n = 17, 23.9%). White blood cell counts differed significantly between the B-cell ALL and T-cell ALL groups (p = 0.029). Conclusions: Our findings provide insights into ALL epidemiology in southern Brazil and highlight regional differences across the country. Full article

Orthohantavirus infections are classically associated with hemorrhagic fever with renal syndrome (HFRS) in Eurasia and hantavirus cardiopulmonary syndrome (HCPS) in the Americas. However, accumulating evidence indicates that the clinical spectrum is considerably broader, with frequent involvement of organ systems beyond the kidney and lung. Hepatic manifestations, in particular, may mimic acute viral hepatitis, leading to diagnostic challenges and underrecognition. This paper synthesizes published evidence on hepatic involvement in orthohantavirus infection, with a focus on clinical presentation, pathogenic mechanisms, differential diagnosis, biomarkers, and public health implications. Relevant literature was identified through searches of peer-reviewed articles, with emphasis on studies reporting hypertransaminasemia, hepatitis-like illness, and liver injury in confirmed hantavirus infections. Mild to moderate elevations in aminotransferases are common during acute orthohantavirus infection, and in some patients the clinical picture may be dominated by fever, thrombocytopenia, and hepatitis-like abnormalities, closely resembling dengue, leptospirosis, or classical viral hepatitis. Hepatic injury appears to result primarily from systemic endothelial dysfunction, immune-mediated inflammation, and microvascular leakage rather than direct hepatocytopathic effects. Emerging biomarkers of severity, including thrombocytopenia, neutrophil-to-lymphocyte ratio, soluble thrombomodulin, and IL-6 trans-signaling, reflect widespread vascular and inflammatory activation. Diagnostic delays are frequent, particularly in non-endemic regions, due to low clinical awareness and overlapping features with more common febrile hepatotropic syndromes. Orthohantavirus infection should be considered in the differential diagnosis of acute febrile illness with unexplained hypertransaminasemia and thrombocytopenia, especially when epidemiological clues suggest rodent exposure or compatible environmental contexts. Recognizing hepatic involvement as part of a systemic endothelial syndrome may improve diagnostic accuracy, reduce underreporting, and facilitate earlier supportive management. Increased awareness among hepatologists, infectious disease specialists, and emergency physicians is warranted. Full article

Hantaviruses are emerging rodent-borne pathogens that pose increasing global public health concerns due to their association with hemorrhagic fever with renal syndrome (HFRS) and hantavirus cardiopulmonary syndrome (HCPS), both of which can result in substantial morbidity and mortality. Environmental change, climate variability, urbanization, and land-use transformation are increasingly recognized as critical drivers of hantavirus emergence and transmission. This review summarizes current evidence regarding hantavirus virology, epidemiology, pathogenesis, clinical manifestations, diagnostics, surveillance systems, prevention strategies, and One Health preparedness approaches. Emphasis is placed on the influence of climate change and ecological disruption on rodent reservoir dynamics and spillover risk, as well as major surveillance and diagnostic gaps in tropical and Caribbean regions where hantavirus circulation may be underrecognized. Advances in molecular diagnostics, genomic surveillance, vaccine development, monoclonal antibody therapies, and climate-based early warning systems are also discussed. Existing evidence highlights the importance of integrated One Health surveillance systems that combine human, animal, and environmental monitoring to improve early detection and outbreak preparedness. Strengthening laboratory capacity, ecological surveillance, regional collaboration, and public health infrastructure will be essential for reducing the global burden of hantavirus infections and improving preparedness for future zoonotic disease threats. Full article

Arboviral diseases are emerging as important public health threats in Saudi Arabia, driven by rapid urbanization, climate variability, the expansion of Aedes aegypti populations, international travel, and large-scale religious mass gatherings. Dengue virus remains the most established arboviral infection in the Kingdom, particularly in the southwestern regions such as Jazan and the western urban centers of Makkah and Jeddah, where ecological and climatic conditions are conducive to sustained vector survival and transmission. This review synthesizes current evidence on the epidemiology, vector ecology, climatic determinants, diagnostics, and prevention strategies of arboviral diseases in Saudi Arabia. Particular attention is paid to the impacts of rising temperatures, changes in rainfall patterns, urban heat island effects, population mobility, and cross-border movement on vector expansion and disease emergence. The review also identifies gaps in surveillance, diagnostics, insecticide resistance monitoring, and integrated vector management programs. Emerging preparedness strategies include climate-informed early warning systems, Geographic Information System-based risk mapping, multiplex molecular diagnostics, genomic surveillance, and community-based vector control. The review emphasizes the importance of implementing a One Health approach that combines data on humans, the environment, entomology, and climate. Currently, sustained endemic transmission of chikungunya and Zika viruses has not been conclusively demonstrated in Saudi Arabia, but increased environmental suitability and connectivity with other areas highlight the need for proactive surveillance and preparedness. Full article

Military burn pits used during post-9/11 U.S. military deployments functioned as uncontrolled combustion systems and were widely utilized to dispose of large volumes of outdoor waste by burning. Burn pits involved heterogeneous waste materials burned under variable temperature and oxygen conditions. These combustion environments generated complex, toxic, multipollutant airborne emission mixtures that included particulate matter (PM_2.5), polycyclic aromatic hydrocarbons (PAHs), and volatile organic compounds (VOCs). This narrative review synthesizes epidemiologic, experimental, and mechanistic evidence linking burn pit emissions to disruption of the lung–brain axis and adverse neurological outcomes. We specifically aim to address a critical gap in understanding how combustion-derived toxicants impact brain health and are associated with unfavorable neuropsychiatric outcomes, including increased risk of post-traumatic stress disorder (PTSD) and depression. Combustion-related exposures promote pulmonary inflammation and system-wide immune signaling that propagate to the central nervous system, contributing to neuroinflammation and dysregulation of the hypothalamic–pituitary–adrenal (HPA) axis. These interconnected mechanisms are associated with toxic encephalopathy and related cognitive and mood disturbances, underscoring the need to integrate fire science with military and environmental health services research to better define the systemic and neurological consequences of acute and chronic fire-derived inhalation exposures. Full article

Industrial settlements of the East Kazakhstan Region face a persistent technogenic burden driven by the dense concentration of non-ferrous metallurgy and heat-and-power enterprises, further compounded by unfavorable pollutant dispersion conditions inherent to the region’s mountain–basin topography. This study evaluated spatiotemporal associations between annual mean concentrations of NO₂, SO₂, H₂S, and CO, the integrated air pollution index (API₅), and primary neoplasm morbidity across five settlements over the period 2014–2024. A retrospective ecological analysis was carried out for Ust-Kamenogorsk, Ridder, Altai, Shemonaikha, and the settlement of Glubokoe, incorporating Spearman’s rank correlation, lag analysis (1–3 years), and the Mann–Kendall trend test. Throughout the study period, neoplasm morbidity in the region consistently exceeded the national average by a factor of 1.3 to 2.0. In Ust-Kamenogorsk—where metallurgical SO₂ and NO₂ emissions are most heavily concentrated—strong positive associations were found in children for SO₂ (ρ = 0.791, p < 0.05) and in adolescents for NO₂ and CO, reflecting elevated inhalation exposure under conditions of chronic pollution. The negative associations with API₅ observed in Ridder and Altai, where the index showed a statistically significant downward trend, are interpreted as evidence of the inertial character of oncological processes and the lasting influence of cumulative past exposure. Across all studied settlements, SO₂ emerged as the most consistent predictor of morbidity variation. These findings support prioritizing stricter emission controls for SO₂ and NO₂ from metallurgical and energy facilities, establishing oncological screening programs for children and adolescents in chronically polluted areas, and strengthening ambient air monitoring—measures whose effective implementation will require coordinated action between public health authorities and environmental regulators. Full article

The Barbary partridge (Alectoris barbara), an endemic game bird in Algeria, has not been systematically investigated for parasitic infections despite its ecological, economic, and conservation importance. This study provides the first eco-epidemiological and histopathological assessment of Capillaria contorta infection in birds from a semi-captive breeding center in Zeralda, Algeria. Between 2021 and 2024, 1085 pooled fecal samples and 138 postmortem examinations were analyzed using standard parasitological and histopathological methods. C. contorta showed an aviary-level overall prevalence of 32.94% and was involved in 42.02% of parasite-related mortalities, underscoring its marked pathological significance. Aviary-level prevalence varied significantly across seasons and years (p < 0.05), with higher levels recorded during environmentally favorable periods. Mixed infections with helminths, protozoa, cestodes, and ectoparasites were recorded for the first time in this host species at the aviary level, highlighting complex parasite interactions. Morphological characteristics were consistent with C. contorta. Gross examination revealed marked thickening of the esophagus and crop. Histologically, the adult nematodes were embedded within hyperplastic epithelium, with characteristic bipolar-plugged eggs and associated epithelial tunnels, accompanied by chronic inflammation and granulomatous reactions. These findings demonstrate the clinical relevance of C. contorta and emphasize the need for strengthened surveillance and control programs to reduce infection pressure and prevent potential spillover to wild populations. Full article

Background: Dementia and Type 2 diabetes (T2D) represent two of the most pressing global public health challenges of our time, both exacerbated by physical inactivity. These conditions disproportionately affect Global Majority populations, who experience earlier onset, higher prevalence, and poorer access to culturally appropriate preventive care. However, conventional research and interventions often overlook the sociocultural and structural factors that underpin this disparity. This study synthesises current evidence to understand how these three conditions intersect and to identify equitable pathways for prevention and support. Methods: A meta-narrative review approach was employed to integrate evidence from diverse biomedical, public health, sociocultural and intervention science traditions. Searches were undertaken across MEDLINE/PubMed-adapted searches, CINAHL, PsycINFO, Web of Science Core Collection, AMED and ASSIA, supplemented by grey literature searching and citation chasing. Five meta-narratives were identified: biomedical and epidemiological, public health, health disparities, sociocultural and behavioural, and intervention science. Cross-narrative synthesis produced a conceptual framework linking upstream determinants, lifestyle factors, and disease outcomes. Results: The review revealed that structural inequities such as deprivation, environmental barriers and sociocultural factors including stigma, gendered norms, limited access to culturally appropriate facilities that restrict physical activity (PA) opportunities within Global Majority communities. These constraints elevate T2D and dementia risk through biological pathways involving insulin resistance, vascular injury, and neuroinflammation. Community-based participatory research (CBPR) interventions particularly those delivered in trusted cultural or faith settings emerged as effective strategies to improve PA, glycaemic control, and cognitive well-being. Conclusions: This synthesis reframes dementia and diabetes as interlinked within a wider syndemic driven by structural and sociocultural inequities. The proposed framework underscores the importance of culturally grounded, community-led approaches to promote brain health, reduce risk, and achieve equitable healthy ageing among Global Majority populations. Full article

Metabolic dysfunction-associated fatty liver disease (MAFLD) is now recognized as a leading form of chronic liver disease globally and is strongly associated with metabolic abnormalities. Traditionally, the pathogenesis of MAFLD has mainly been attributed to genetic susceptibility and unhealthy lifestyles (such as high-calorie diets and sedentary behavior). However, in recent years, environmental factors, especially air pollution, have been confirmed as independent risk factors and important promoting factors for MAFLD development and further disease progression. This review summarizes current epidemiological findings on the link between air pollution exposure and MAFLD, while exploring its potential biological mechanisms involving systemic inflammation, oxidative stress, immune alteration, genetic risk, and epigenetic regulation underlying the relationship between air pollution and hepatic steatosis. It also reviews the additive interaction between air pollution and lifestyle or socioeconomic factors in MAFLD. Finally, we also discuss multilevel strategies spanning individual-, community-, national-, and global-level cooperation to address the increasing public health burden caused by air pollution. Therefore, incorporating the assessment and control of air pollution into the comprehensive strategies for MAFLD prevention and treatment has important scientific value and public health significance. Full article

Mosquito-borne diseases pose a significant public health concern globally; however, data on mosquito population dynamics in Taipei, Taiwan are limited and outdated. Updated information on species composition and seasonal abundance is crucial for enhancing vector surveillance and informing effective control strategies. In this study, to investigate the seasonal dynamics of mosquito populations in Taipei, Taiwan, adult females were collected biweekly from June 2023 to May 2025 using CDC light traps baited with ultraviolet light and dry ice. Species identification was performed based on morphological characteristics, and morphologically challenging Culex mosquito species were further confirmed using cytochrome c oxidase I barcoding. Mosquito surveillance from June 2023 to May 2025 yielded 1926 females representing 31 species. Of these, Culex quinquefasciatus, Culex pipiens molestus, Aedes albopictus, and Culex tritaeniorhynchus accounted for over 90% of all specimens. These dominant species exhibited distinct seasonal patterns: Cx. quinquefasciatus occurred year-round, Cx. pipiens molestus predominated during winter and spring, while Ae. albopictus and Cx. tritaeniorhynchus populations peaked in summer. Furthermore, spatial heterogeneity in both mosquito abundance and species composition was noted among the study sites. Monitoring the composition and seasonal dynamics of mosquito species is essential for understanding the epidemiology of mosquito-borne pathogens. These insights can inform more effective and targeted vector control strategies for reducing disease transmission. Such ecological insights can also support One Health approaches by linking human, animal, and environmental factors that influence the transmission of mosquito-borne diseases. Full article

Ischemic heart disease (IHD) is a chronic and progressive condition characterized by reduced blood flow, mainly due to atherosclerosis. It is currently the leading cause of mortality among cardiovascular diseases. In recent years, per- and polyfluoroalkyl substances (PFAS), a group of ubiquitous and highly persistent environmental contaminants, have emerged as potential risk factors for IHD. PFAS are well-established endocrine disruptors and have been associated with hypercholesterolemia, hypertriglyceridemia, and insulin resistance. Despite the limited number of epidemiological studies and inconsistent findings from occupational settings, accumulating evidence suggests that elevated exposure to certain PFAS compounds may increase the risk of IHD and vascular dysfunction, including processes related to atherosclerosis development, sometimes with dose–response relationships and sex-specific patterns. Mechanistic evidence supports this link, indicating that PFAS exposure induces molecular and cellular alterations relevant to cardiovascular pathophysiology, including increased oxidative stress and vascular inflammation, and disruption of lipid metabolism. In addition, PFAS may affect epigenetic regulation, telomere length, and mitochondrial DNA copy number, which are emerging biomarkers associated with atherosclerosis and IHD and may indicate early cardiovascular vulnerability. Future research integrating innovative approaches and advanced analytical techniques may help address current knowledge gaps and clarify the mechanistic pathways linking PFAS exposure to clinical cardiovascular outcomes. Full article

Background/Objectives: Plant-based dietary patterns like the Dietary Approaches to Stop Hypertension (DASH) reduce cardiovascular risk, which is a leading cause of mortality globally and in Spain. Diet is also a major environmental determinant, highlighting the need to evaluate public health alongside environmental sustainability. The aim of this study was to analyze the evolution of adherence to the DASH dietary pattern in Spain between 2006 and 2023 and evaluate its relationship with environmental sustainability indicators. Methods: This was an ecological epidemiological study. Food consumption data were harmonized into daily servings to calculate annual DASH scores using a standard 80-point methodology. Environmental impact was assessed by calculating the comprehensive Ecological Footprint (EF) using the Agribalyse^® 3.2 database. The study utilized open data from the Spanish Household Budget Surveys, capturing the consumption habits of approximately 24,000 randomly selected Spanish households annually from 2006 to 2023. The primary measures evaluated were the annual DASH adherence index score and the overall environmental Ecological Footprint. Temporal trends were evaluated using segmented regression models selected via the Akaike Information Criterion and Davies test. Pareto analysis determined individual food group environmental contributions, and correlations assessed the relationship between DASH scores and the EF. Results: DASH adherence increased by 8.26% over the study period, peaking in 2020. The EF demonstrated an overall decrease over time, largely driven by reduced consumption of meat, fish, and eggs. A strong inverse correlation was found between the DASH score and the EF (r = −0.8237 (95% CI: −0.932 to −0.580; p < 0.001)). Conclusions: A shift toward the DASH dietary pattern in Spain demonstrates potentially convergent health and environmental associations, promoting population cardiovascular health potential while simultaneously mitigating environmental impacts. Full article

The rising incidence of early-onset colorectal cancer (CRC) remains incompletely explained despite extensive investigation into genetic, environmental and metabolic factors. Emerging evidence suggests that infectious agents may contribute to colorectal carcinogenesis. A recent study by Tehrani et al. demonstrated the presence of Mycobacterium avium subspecies paratuberculosis (MAP) in a majority of colorectal cancer lesions and in approximately half of precancerous lesions, providing a critical epidemiologic anchor. MAP, a zoonotic intracellular pathogen long associated with Crohn’s disease, exhibits biological features consistent with inflammation-driven carcinogenesis, including persistence, immune modulation and systemic dissemination. Mechanistically, MAP infection may promote tumorigenesis through chronic mucosal inflammation, epithelial barrier disruption and activation of human endogenous retroviruses (HERVs) linking persistent infection to genomic instability. Detection of MAP in early lesions argues against secondary colonization and supports a potential initiating or promoting role. Within a One Health framework, MAP represents a plausible, pleiotropic and potentially modifiable contributor to CRC. While causality remains unproven, the convergence of epidemiologic association, mechanistic plausibility and early lesion involvement warrants rigorous investigation. Full article

Wastewater surveillance (WWS) has quickly emerged as an invaluable tool for public health surveillance, particularly in the wake of the COVID-19 pandemic. Its long-term utility is constrained, however, by fragmented data systems, inconsistent metadata practices, and poor interoperability. The Public Health and Environmental Surveillance Open Data Model (PHES-ODM) was developed as an open, collaborative framework to standardize WWS data and support transparent, ethical data use aligned with FAIR principles in response to these challenges. Building on the success and global adoption of earlier versions, this paper introduces version 3 of the model, expanding to address persistent barriers to interoperability and data utility. Key enhancements include improved metadata capture, support for complex relational linkages across sites, samples, measures, and populations, and new tables for public health actions, external data linkages, and analytical workflows. Tools for mapping across existing standards and supporting long and wide data formats are also introduced. Balancing robustness with usability, PHES-ODM v3 provides a scalable, modular infrastructure adaptable to diverse WWS programmes. The model offers comprehensive solutions for improving data quality, accessibility, and integration, supporting more effective public health decision-making in an increasingly complex global surveillance landscape. Full article