Search Results (68)

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

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

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

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

Exposure to PM_2.5 pollution poses substantial health risks, with the precise quantification of exposure being fundamental to understanding the environmental inequalities therein. However, the absence of high-resolution spatiotemporal ambient population data, coupled with an insufficiency of attribute data, impedes a comprehension of the environmental inequality of exposure risks at a fine scale. Within the purview of a conceptual framework that interlinks social strata and citizenship identity with environmental inequality, this study examines the environmental inequality of PM_2.5 exposure with a focus on the city of Xi’an. Quantitative metrics of the social strata and citizenship identities of the ambient population are derived from housing price data and mobile phone big data. The fine-scale estimation of PM_2.5 concentrations is predicated on the kriging interpolation method and refined by leveraging an advanced dataset. Employing geographically weighted regression models, we examine the environmental inequality pattern at a fine spatial scale. The key findings are threefold: (1) the manifestation of environmental inequality in PM_2.5 exposure is pronounced among individuals of varying social strata and citizenship identities within our study area, Xi’an; (2) nonlocal residents situated in the northwestern precincts of Xi’an are subject to the most pronounced PM_2.5 exposure; and (3) an elevated socioeconomic status is identified as an attenuating factor, capable of averting the deleterious impacts of PM_2.5 exposure among nonlocal residents. These findings proffer substantial practical implications for the orchestration of air pollution mitigation strategies and urban planning initiatives. They suggest that addressing the wellbeing of the marginalized underprivileged cohorts, who are environmentally and politically segregated under the extant urban planning policies in China, is of critical importance. Full article

Syndemics, the adverse interaction of two or more coterminous diseases or other negative health conditions, have probably existed since human settlement, plant and animal domestication, urbanization, and the growth of social inequality beginning about 10–12,000 years ago. These dramatic changes in human social evolution significantly increased opportunities for the spread of zoonotic infectious diseases in denser human communities with increased sanitation challenges. In light of a growing body of research that indicates that anthropogenic air pollution causes numerous threats to health and is taking a far greater toll on human life and wellbeing than had been reported, this paper proposes the possibility that air pollution is now the primary driver of infectious disease syndemics. In support of this assertion, this paper reviews the growth and health impacts of air pollution, the relationship of air pollution to the development and spread of infectious diseases, and reported cases of air pollution-driven infectious disease syndemics, and presents public health recommendations for leveraging the biosocial insight of syndemic theory in responding to infectious disease. Full article

Environmental justice research has focused on the distribution of environmental inequalities, such as proximity to landfills, across the U.S. and globally. Background: Public health research and environmental health research, specifically, have focused on toxic exposure—encompassing individuals or communities that are disproportionately exposed to contaminants that are harmful or potentially harmful to them. Yet, little research has applied critical environmental justice theory—characterized by the idea that marginalized communities need to be treated as indispensable rather than disposable—to the study of toxic exposure. To fill this gap, the current paper offers a case study approach applying critical environmental justice theory to the study of disproportionate and unequal exposure to toxic contaminants. Methods: This case study is of Kettleman City, a rural, unincorporated community in the heart of California’s Central Valley (USA). This community experiences the co-location of environmental hazards, including residing at the intersection of two major highways and hosting a class I hazardous-waste landfill, which is one of the few licensed to accept PCBs. PCBs are a contaminant that has been linked with several adverse health outcomes, including cancers and low birthweight. Residents may also experience poor air quality from proximity to the highways. Results: This case highlights the uneven distribution of pollution and environmental degradation that may be shouldered by the community, along with their experiences of adverse health and social impacts. This analysis reveals the importance of incorporating a critical environmental justice perspective to unpack experiences of not only disproportionate exposure but also disproportionate procedural and recognitional inequality. Conclusions: This research highlights the untapped potential of environmental justice to catalyze exposure science in challenging the unequal distribution of contaminants. Full article

Increased land use as a result of urbanization is one of the most rapid human-driven causes of biodiversity loss. Urbanization negatively affects human health because of poor nutrition, non-communicable diseases (NCDs) and health problems related to air pollution. Nature-based solutions (NbSs) for sustainable food production in combination with reduced land and water use are essential for the reduction in biodiversity loss, human health and nutrition. This systematic review aims to assess the effects of NbSs that positively contribute to biodiversity on human health and wellbeing in urban settings worldwide. Secondarily, other factors, such as safety, attractiveness, inequity and accessibility, that may have a potential role in the use of NbSs will be evaluated. For the purpose of the FENS conference, only results related to nutrition and food security will be presented. The PRISMA guidelines will be followed. Full-length articles in English language conducted in 2000 and published in 2010 will be included. Both quantitative and qualitative studies are eligible. Due to the diversity of studies, the quality assessment with diverse studies (QuADS) tool will be used for the quality assessment of the studies included. The statistical analysis will depend on the heterogeneity and the feasibility of harmonization of the data. PubMed, Web of Science and Scopus were searched. The initial search yielded 14386 publications. After the removal of duplicates, 8730 titles and abstracts were screened. Currently, 881 full texts out of 2928 have been screened, from which 69 (8%) studies reported outcomes related to human nutrition and food security. Most of the studies took place in urban gardens (61%). Urban farming (25%) and farmers’ markets followed (25%). Vegetation/greenness in cities was considered as an NbS by 6% of the studies. Less studied NbSs were green roofs, general green spaces, urban foraging and urban blue spaces (3% each). Gardening has been shown to be beneficial for the wellbeing and nutrition of various populations. Due to the high land use for the feeding of urban populations, alternative food production techniques without soil use are important. Soil-free rooftop farms and vertical farming could increase the vegetable and fruit production in cities and improve the diet quality of citizens. Full article