Pub Date : 2025-11-27DOI: 10.1016/j.ijheh.2025.114718
Tahvi Frank , Isabel J.B. Thompson , Solomon Aragie , Dionna M. Wittberg , Wondyifraw Tadesse , Adane Dagnew , Dagnachew Hailu , Jason S. Melo , Taye Zeru , Zerihun Tadesse , Benjamin F. Arnold , Matthew C. Freeman , Scott D. Nash , E Kelly Callahan , Travis C. Porco , Thomas M. Lietman , Jeremy D. Keenan
Background
Child growth faltering contributes significantly to global morbidity and mortality, with a disproportionate impact on low- and middle-income countries. Poor quality water, sanitation, and hygiene (WASH) has been identified as a risk factor, though prior studies have found mixed evidence for the effectiveness of WASH interventions.
Methods
The WASH Upgrades for Health in Amhara (WUHA) trial was a two-arm, parallel-group, cluster-randomized trial carried out in three districts of the Wag Hemra Zone of Amhara from 2016 to 2019 (ClinicalTrials.gov #NCT02754583). The intervention consisted of hygiene infrastructure improvements and hygiene promotion at the household, community, and school level. Height and weight were pre-specified secondary outcomes that were measured annually in the longitudinal cohort of children aged 0–5 years at baseline.
Results
Twenty communities were randomized to the WASH intervention and 20 to the control (delayed WASH) arm. Anthropometric measurements were done at baseline for a random sample of 613 children in the WASH intervention arm and 644 children in the control arm. There was no statistically significant difference over the 3-year study period for either height (0.1 cm lower in the WASH arm, 95 %CI -0.5 to 0.2, P = 0.45) or weight (0.02 kg higher in the WASH arm, 95 %CI -0.06 to 0.10, P = 0.64).
Conclusions
A comprehensive WASH intervention implemented for three years in rural Ethiopia did not improve growth among children 0–5 years old.
儿童生长迟缓是全球发病率和死亡率的重要因素，对低收入和中等收入国家的影响尤为严重。低质量的水、环境卫生和个人卫生（WASH）已被确定为一个风险因素，尽管先前的研究发现了关于WASH干预措施有效性的混合证据。方法：Amhara地区WASH健康升级（WUHA）试验是一项两组、平行组、集群随机试验，于2016 - 2019年在Amhara地区Wag Hemra区的三个地区进行（ClinicalTrials.gov #NCT02754583）。干预措施包括在家庭、社区和学校层面改善卫生基础设施和促进卫生。身高和体重是预先指定的次要结果，每年在0-5岁儿童的纵向队列中进行基线测量。结果20个社区随机分为WASH干预组和对照组（延迟WASH）。在基线时对WASH干预组的613名儿童和对照组的644名儿童进行了人体测量。在3年的研究期间，身高（WASH组低0.1 cm, 95% CI -0.5 ~ 0.2, P = 0.45）或体重（WASH组高0.02 kg, 95% CI -0.06 ~ 0.10, P = 0.64）均无统计学差异。结论在埃塞俄比亚农村实施3年的WASH综合干预并没有改善0-5岁儿童的生长。
{"title":"Effect of water, sanitation, and hygiene on childhood growth in Ethiopia: a cluster-randomized trial","authors":"Tahvi Frank , Isabel J.B. Thompson , Solomon Aragie , Dionna M. Wittberg , Wondyifraw Tadesse , Adane Dagnew , Dagnachew Hailu , Jason S. Melo , Taye Zeru , Zerihun Tadesse , Benjamin F. Arnold , Matthew C. Freeman , Scott D. Nash , E Kelly Callahan , Travis C. Porco , Thomas M. Lietman , Jeremy D. Keenan","doi":"10.1016/j.ijheh.2025.114718","DOIUrl":"10.1016/j.ijheh.2025.114718","url":null,"abstract":"<div><h3>Background</h3><div>Child growth faltering contributes significantly to global morbidity and mortality, with a disproportionate impact on low- and middle-income countries. Poor quality water, sanitation, and hygiene (WASH) has been identified as a risk factor, though prior studies have found mixed evidence for the effectiveness of WASH interventions.</div></div><div><h3>Methods</h3><div>The WASH Upgrades for Health in Amhara (WUHA) trial was a two-arm, parallel-group, cluster-randomized trial carried out in three districts of the Wag Hemra Zone of Amhara from 2016 to 2019 (<span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> #NCT02754583). The intervention consisted of hygiene infrastructure improvements and hygiene promotion at the household, community, and school level. Height and weight were pre-specified secondary outcomes that were measured annually in the longitudinal cohort of children aged 0–5 years at baseline.</div></div><div><h3>Results</h3><div>Twenty communities were randomized to the WASH intervention and 20 to the control (delayed WASH) arm. Anthropometric measurements were done at baseline for a random sample of 613 children in the WASH intervention arm and 644 children in the control arm. There was no statistically significant difference over the 3-year study period for either height (0.1 cm lower in the WASH arm, 95 %CI -0.5 to 0.2, <em>P</em> = 0.45) or weight (0.02 kg higher in the WASH arm, 95 %CI -0.06 to 0.10, <em>P</em> = 0.64).</div></div><div><h3>Conclusions</h3><div>A comprehensive WASH intervention implemented for three years in rural Ethiopia did not improve growth among children 0–5 years old.</div></div>","PeriodicalId":13994,"journal":{"name":"International journal of hygiene and environmental health","volume":"271 ","pages":"Article 114718"},"PeriodicalIF":4.4,"publicationDate":"2025-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145614508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-26DOI: 10.1016/j.ijheh.2025.114713
Sophia D. Steinbacher , Mats Leifels , Claudia Kolm , Gerhard Lindner , Katalin Demeter , Alexander K.T. Kirschner , Julia Derx , Rita B. Linke , Regina Sommer , Andreas H. Farnleitner
Comparative information on decay characteristics of genetic faecal markers including crAssphage is very limited for water resources, although PCR-based indicator-diagnostics are increasingly used worldwide. To our knowledge, we performed the first comparative microcosm experiments to assess the decay behaviour of commonly used qPCR-based genetic faecal markers (crAssphages, HF183/BacR287, BacHum) in a large European river. In addition, cultivation-based standards (E. coli, intestinal enterococci, Clostridium perfringens spores, somatic coliphages) were enumerated to allow for a cross-comparison between novel and established targets. River water was spiked with raw sewage from two combined municipal sewer systems and incubated at 8 °C and 20 °C for up to 66 days. The focus of the experimental work was put on genetic faecal markers. Two different filtration methods targeting either virus/phages and bacteria (using mixed cellulose esters, MCE) or solely bacteria (using polycarbonate filters, PC) were also evaluated. Results indicated biphasic decay for all targets (i.e., initial fast followed by secondary slow decay), with Bacteroides markers showing lower persistence under all conditions when compared to crAssphage. In addition, a tendency for higher long-term persistence of crAssphage based on MCE filtration as compared to PC filtration was observed. Finally, a meta-data analysis was conducted, comparing the results obtained here with those from recent case studies. This analysis further substantiated the comparatively higher persistence and lower decay of crAssphage relative to Bacteroides markers and established FIO, with the sole exception of C. perfringens spores.
{"title":"Comparative evaluation of decay characteristics of commonly used genetic faecal markers crAssphage and Bacteroides in complex river water microcosms","authors":"Sophia D. Steinbacher , Mats Leifels , Claudia Kolm , Gerhard Lindner , Katalin Demeter , Alexander K.T. Kirschner , Julia Derx , Rita B. Linke , Regina Sommer , Andreas H. Farnleitner","doi":"10.1016/j.ijheh.2025.114713","DOIUrl":"10.1016/j.ijheh.2025.114713","url":null,"abstract":"<div><div>Comparative information on decay characteristics of genetic faecal markers including crAssphage is very limited for water resources, although PCR-based indicator-diagnostics are increasingly used worldwide. To our knowledge, we performed the first comparative microcosm experiments to assess the decay behaviour of commonly used qPCR-based genetic faecal markers (crAssphages, HF183/BacR287, BacHum) in a large European river. In addition, cultivation-based standards (<em>E. coli</em>, intestinal enterococci, <em>Clostridium perfringens</em> spores, somatic coliphages) were enumerated to allow for a cross-comparison between novel and established targets. River water was spiked with raw sewage from two combined municipal sewer systems and incubated at 8 °C and 20 °C for up to 66 days. The focus of the experimental work was put on genetic faecal markers. Two different filtration methods targeting either virus/phages and bacteria (using mixed cellulose esters, MCE) or solely bacteria (using polycarbonate filters, PC) were also evaluated. Results indicated biphasic decay for all targets (<em>i.e.</em>, initial fast followed by secondary slow decay), with <em>Bacteroides</em> markers showing lower persistence under all conditions when compared to crAssphage. In addition, a tendency for higher long-term persistence of crAssphage based on MCE filtration as compared to PC filtration was observed. Finally, a meta-data analysis was conducted, comparing the results obtained here with those from recent case studies. This analysis further substantiated the comparatively higher persistence and lower decay of crAssphage relative to <em>Bacteroides</em> markers and established FIO, with the sole exception of <em>C. perfringens</em> spores.</div></div>","PeriodicalId":13994,"journal":{"name":"International journal of hygiene and environmental health","volume":"271 ","pages":"Article 114713"},"PeriodicalIF":4.4,"publicationDate":"2025-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145614506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-25DOI: 10.1016/j.ijheh.2025.114714
Ata Rafiee , David S. Wishart , Shelby S. Yamamoto , Lei Pei , Emily Quecke , Bernadette Quémerais
Welding fumes exposure is associated with various detrimental health consequences including cardiopulmonary diseases and cancer. We assessed welding fume exposure using biomonitoring, metalomics, and metabolomics. 38 professional welders (exposed) and 36 power line technicians (non-exposed) were recruited from various facilities in Alberta, Canada. Air sampling and urine collection were conducted. Metal levels were quantified using Inductively Coupled Plasma Mass Spectrometry (ICP-MS). Metabolites were quantified using Liquid Chromatography tandem Mass Spectrometry (LC-MS-MS). Receiver operating characteristic (ROC) curve analysis and linear mixed models (LMM) were performed using STATA 19.0 and MetaboAnalyst 5.0. Short-term and cumulative doses were calculated using air sampling data in the modified Environmental Protection Agency (EPA) method.
Elevated urinary levels of As, Cr, Fe, Mn, and Ni were observed in welders than in the non-exposed group (p˂0.05). Among the metabolites, beta-hydroxybutyric acid, arginine, asparagine, choline, and ornithine were proposed as potential biomarkers for welding fume exposure (AUC>0.7). ROC results identified metabolites associated with welding experience and smoking. LMM identified smoking as the main predictor of urinary Fe, Mn, and V, while short-term Cr and Sb doses predicted their urinary levels; welders' urinary metabolites were mainly influenced by welding experience and smoking.
Our study highlights the potential benefits of biomonitoring and metabolomics to assess the health effects of welding fume exposure. However, relatively small sample size and lacking biomarkers exploration by sex limit the generalizability of findings. Further investigation is recommended to explore the underlying mechanisms and the effects of other factors on the metabolomics profile in professional welders.
{"title":"Assessing welding fume exposure in professional welders: An exploratory study of biomarkers and metabolomic profiles","authors":"Ata Rafiee , David S. Wishart , Shelby S. Yamamoto , Lei Pei , Emily Quecke , Bernadette Quémerais","doi":"10.1016/j.ijheh.2025.114714","DOIUrl":"10.1016/j.ijheh.2025.114714","url":null,"abstract":"<div><div>Welding fumes exposure is associated with various detrimental health consequences including cardiopulmonary diseases and cancer. We assessed welding fume exposure using biomonitoring, metalomics, and metabolomics. 38 professional welders (exposed) and 36 power line technicians (non-exposed) were recruited from various facilities in Alberta, Canada. Air sampling and urine collection were conducted. Metal levels were quantified using Inductively Coupled Plasma Mass Spectrometry (ICP-MS). Metabolites were quantified using Liquid Chromatography tandem Mass Spectrometry (LC-MS-MS). Receiver operating characteristic (ROC) curve analysis and linear mixed models (LMM) were performed using STATA 19.0 and MetaboAnalyst 5.0. Short-term and cumulative doses were calculated using air sampling data in the modified Environmental Protection Agency (EPA) method.</div><div>Elevated urinary levels of As, Cr, Fe, Mn, and Ni were observed in welders than in the non-exposed group (p˂0.05). Among the metabolites, beta-hydroxybutyric acid, arginine, asparagine, choline, and ornithine were proposed as potential biomarkers for welding fume exposure (AUC>0.7). ROC results identified metabolites associated with welding experience and smoking. LMM identified smoking as the main predictor of urinary Fe, Mn, and V, while short-term Cr and Sb doses predicted their urinary levels; welders' urinary metabolites were mainly influenced by welding experience and smoking.</div><div>Our study highlights the potential benefits of biomonitoring and metabolomics to assess the health effects of welding fume exposure. However, relatively small sample size and lacking biomarkers exploration by sex limit the generalizability of findings. Further investigation is recommended to explore the underlying mechanisms and the effects of other factors on the metabolomics profile in professional welders.</div></div>","PeriodicalId":13994,"journal":{"name":"International journal of hygiene and environmental health","volume":"271 ","pages":"Article 114714"},"PeriodicalIF":4.4,"publicationDate":"2025-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145614505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-24DOI: 10.1016/j.ijheh.2025.114715
Kavita Singh , Tyler Pollock , Subramanian Karthikeyan , Gabrielle Sauvageau , Christine MacKinnon-Roy , Mike Walker , Chun Lei Liang , Pierre Dumas , Jean-François Bienvenu , Éric Gaudreau , Sébastien Gagné
Objective
The Canadian Health Measures Survey (CHMS) employed two laboratory methods to measure each of bisphenol A (BPA) and triclosan in urine. This analysis compares method performance.
Methods
Method E−475 used GC-MS/MS to measure BPA in recruitment cycles 1–6 and triclosan in recruitment cycles 2–4. Method E−505 used UPLC-MS/MS for BPA and triclosan in biobanked samples from recruitment cycles 4–6. Using unweighted concentrations for samples available from both methods, and removing observations < LOD (BPA Cycles 4–6, n = 3114 and triclosan Cycle 4, n = 651), we compared E−475 and E−505 with descriptive statistics, scatterplots, and Bland Altman analysis. An E−475 variation using isotope dilution (ID) was performed for triclosan. After applying a model to correct E−475 triclosan for ID (E−475m), we compared modeled results to E−505.
Results
The geometric mean (GM) for BPA from E−475 vs. E−505 was 1.2 vs. 1.1 μg/L. The E−475/E−505 GM ratio was 1.03, and the lower-upper limits of agreements (LOA) were 0.59–1.81. The GM for triclosan from E−475 vs. E−505 was 31 vs. 20 μg/L. E−475 concentrations were 1.56 times E−505, and the LOAs were 0.87–2.78. The GM for triclosan from E−475m vs. E−505 was 19 vs. 20 μg/L. E−475m concentrations were 0.93 times E−505, and the LOAs were 0.53–1.64.
Conclusions
BPA concentrations were comparable with E−475 and E−505. Triclosan concentrations were higher with E−475 than E−505. The E−475 triclosan concentrations became comparable to E−505 after correcting for ID. These results will have implications on whether BPA and triclosan data from the two methods can be combined and compared across CHMS recruitment cycles.
{"title":"A comparison of two laboratory methods to measure urinary bisphenol A and triclosan in the Canadian Health Measures Survey","authors":"Kavita Singh , Tyler Pollock , Subramanian Karthikeyan , Gabrielle Sauvageau , Christine MacKinnon-Roy , Mike Walker , Chun Lei Liang , Pierre Dumas , Jean-François Bienvenu , Éric Gaudreau , Sébastien Gagné","doi":"10.1016/j.ijheh.2025.114715","DOIUrl":"10.1016/j.ijheh.2025.114715","url":null,"abstract":"<div><h3>Objective</h3><div>The Canadian Health Measures Survey (CHMS) employed two laboratory methods to measure each of bisphenol A (BPA) and triclosan in urine. This analysis compares method performance.</div></div><div><h3>Methods</h3><div>Method E−475 used GC-MS/MS to measure BPA in recruitment cycles 1–6 and triclosan in recruitment cycles 2–4. Method E−505 used UPLC-MS/MS for BPA and triclosan in biobanked samples from recruitment cycles 4–6. Using unweighted concentrations for samples available from both methods, and removing observations < LOD (BPA Cycles 4–6, n = 3114 and triclosan Cycle 4, n = 651), we compared E−475 and E−505 with descriptive statistics, scatterplots, and Bland Altman analysis. An E−475 variation using isotope dilution (ID) was performed for triclosan. After applying a model to correct E−475 triclosan for ID (E−475m), we compared modeled results to E−505.</div></div><div><h3>Results</h3><div>The geometric mean (GM) for BPA from E−475 vs. E−505 was 1.2 vs. 1.1 μg/L. The E−475/E−505 GM ratio was 1.03, and the lower-upper limits of agreements (LOA) were 0.59–1.81. The GM for triclosan from E−475 vs. E−505 was 31 vs. 20 μg/L. E−475 concentrations were 1.56 times E−505, and the LOAs were 0.87–2.78. The GM for triclosan from E−475m vs. E−505 was 19 vs. 20 μg/L. E−475m concentrations were 0.93 times E−505, and the LOAs were 0.53–1.64.</div></div><div><h3>Conclusions</h3><div>BPA concentrations were comparable with E−475 and E−505. Triclosan concentrations were higher with E−475 than E−505. The E−475 triclosan concentrations became comparable to E−505 after correcting for ID. These results will have implications on whether BPA and triclosan data from the two methods can be combined and compared across CHMS recruitment cycles.</div></div>","PeriodicalId":13994,"journal":{"name":"International journal of hygiene and environmental health","volume":"271 ","pages":"Article 114715"},"PeriodicalIF":4.4,"publicationDate":"2025-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145608108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-17DOI: 10.1016/j.ijheh.2025.114710
Rosaria Tinnirello , Gioacchin Iannolo , Alberto Cagigi , Bruno Douradinha
Antimicrobial resistance (AMR) is widely recognized as the silent pandemic, leading the World Health Organization (WHO) to prioritize critical bacterial pathogens that demand urgent, innovative responses. Klebsiella pneumoniae, marked by extensive resistance to last-resort antibiotics and the absence of an effective vaccine, is among the most consequential of these threats. While high-profile sequence types (STs) such as ST258, ST512, ST101, ST307, ST147 and ST395 dominate interventions of healthcare-associated infections, other clinically important lineages remain underexplored. One such lineage is ST392, a member of clonal group 147 (CG147), increasingly reported in clinical settings worldwide.
Here, we describe what is currently known about nosocomial K. pneumoniae ST392 isolates and their impact within an environmental and One Health framework, examining how clinical reservoirs interface with hospital effluents and municipal wastewater treatment plants (WWTPs) that can carry antimicrobials, antimicrobial-resistance genes (ARGs) and resistant bacteria into broader ecosystems. We synthesize current evidence on the epidemiology, resistome/virulome features, and putative dissemination pathways of ST392 across clinical and environmental compartments and consider how wastewater-based epidemiology can act as a sentinel for emergence and spread. Finally, we outline priorities for integrated surveillance and control, linking clinical microbiology, environmental monitoring and genomics, and discuss implications for infection prevention and control, stewardship, and wastewater management. In conclusion, we show the need for targeted strategies that address the full spectrum of K. pneumoniae lineages, including underrecognized ST392, to mitigate AMR risk to population health.
{"title":"An overview of Klebsiella pneumoniae ST392 amid the AMR silent pandemic and consequent environmental dissemination and health risks","authors":"Rosaria Tinnirello , Gioacchin Iannolo , Alberto Cagigi , Bruno Douradinha","doi":"10.1016/j.ijheh.2025.114710","DOIUrl":"10.1016/j.ijheh.2025.114710","url":null,"abstract":"<div><div>Antimicrobial resistance (AMR) is widely recognized as the silent pandemic, leading the World Health Organization (WHO) to prioritize critical bacterial pathogens that demand urgent, innovative responses. <em>Klebsiella pneumoniae</em>, marked by extensive resistance to last-resort antibiotics and the absence of an effective vaccine, is among the most consequential of these threats. While high-profile sequence types (STs) such as ST258, ST512, ST101, ST307, ST147 and ST395 dominate interventions of healthcare-associated infections, other clinically important lineages remain underexplored. One such lineage is ST392, a member of clonal group 147 (CG147), increasingly reported in clinical settings worldwide.</div><div>Here, we describe what is currently known about nosocomial <em>K. pneumoniae</em> ST392 isolates and their impact within an environmental and One Health framework, examining how clinical reservoirs interface with hospital effluents and municipal wastewater treatment plants (WWTPs) that can carry antimicrobials, antimicrobial-resistance genes (ARGs) and resistant bacteria into broader ecosystems. We synthesize current evidence on the epidemiology, resistome/virulome features, and putative dissemination pathways of ST392 across clinical and environmental compartments and consider how wastewater-based epidemiology can act as a sentinel for emergence and spread. Finally, we outline priorities for integrated surveillance and control, linking clinical microbiology, environmental monitoring and genomics, and discuss implications for infection prevention and control, stewardship, and wastewater management. In conclusion, we show the need for targeted strategies that address the full spectrum of <em>K. pneumoniae</em> lineages, including underrecognized ST392, to mitigate AMR risk to population health.</div></div>","PeriodicalId":13994,"journal":{"name":"International journal of hygiene and environmental health","volume":"271 ","pages":"Article 114710"},"PeriodicalIF":4.4,"publicationDate":"2025-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145552527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-16DOI: 10.1016/j.ijheh.2025.114712
Leaf R. Kardol , Amina Rhaman , Erin Kelty , Shannon Morgan , Danielle J. Russell , Aster Gebremedhin , Sarah Bourke , Caitlin S. Wyrwoll
Nitrate and nitrite are present in drinking water, vegetables and processed meats. While they may offer health benefits in some contexts, high levels, especially during pregnancy, can be harmful. This scoping review investigates prenatal nitrate/nitrite exposure and maternal, child, pregnancy and birth outcomes, in animal models and humans. Six databases were searched systematically for peer-reviewed publications relating to nitrate and/or nitrite exposure in pregnancy. 3834 unique papers were identified, with 133 meeting inclusion criteria. In human studies (n = 66), high processed meat nitrite exposure was associated with congenital anomalies and childhood cancer, although primarily in conjunction with nitrosatable medication exposure. Fresh vegetable sources of nitrate/nitrite were associated with neutral or positive health outcomes. Prenatal drinking water nitrate exposure was moderately associated with preterm birth, while evidence for congenital anomalies, growth restriction, preeclampsia and early puberty was limited or inconsistent. Associations appeared at concentrations as low as 5 % of the WHO drinking water guideline. However, other water contaminants and exposures such as nitrosatable medications were only addressed in a minority of studies. Animal studies (n = 67) reported effects of nitrate/nitrite exposure on mortality and birthweights through pathways involving methemoglobinemia, inflammation, DNA-damage and endocrine disruption, however, dosing was often extreme. While vegetable sources of nitrate/nitrite show some health benefits, exposure to meat and drinking water sources should be limited, although safe limits and causal evidence are not fully established. Public health policy should prioritise decreasing nitrate exposure within the context of broader water quality concerns and barriers to perinatal health.
{"title":"Prenatal nitrate and nitrite intake in mammals: A scoping review of effects and associations with pregnancy and maternal and child health","authors":"Leaf R. Kardol , Amina Rhaman , Erin Kelty , Shannon Morgan , Danielle J. Russell , Aster Gebremedhin , Sarah Bourke , Caitlin S. Wyrwoll","doi":"10.1016/j.ijheh.2025.114712","DOIUrl":"10.1016/j.ijheh.2025.114712","url":null,"abstract":"<div><div>Nitrate and nitrite are present in drinking water, vegetables and processed meats. While they may offer health benefits in some contexts, high levels, especially during pregnancy, can be harmful. This scoping review investigates prenatal nitrate/nitrite exposure and maternal, child, pregnancy and birth outcomes, in animal models and humans. Six databases were searched systematically for peer-reviewed publications relating to nitrate and/or nitrite exposure in pregnancy. 3834 unique papers were identified, with 133 meeting inclusion criteria. In human studies (n = 66), high processed meat nitrite exposure was associated with congenital anomalies and childhood cancer, although primarily in conjunction with nitrosatable medication exposure. Fresh vegetable sources of nitrate/nitrite were associated with neutral or positive health outcomes. Prenatal drinking water nitrate exposure was moderately associated with preterm birth, while evidence for congenital anomalies, growth restriction, preeclampsia and early puberty was limited or inconsistent. Associations appeared at concentrations as low as 5 % of the WHO drinking water guideline. However, other water contaminants and exposures such as nitrosatable medications were only addressed in a minority of studies. Animal studies (n = 67) reported effects of nitrate/nitrite exposure on mortality and birthweights through pathways involving methemoglobinemia, inflammation, DNA-damage and endocrine disruption, however, dosing was often extreme. While vegetable sources of nitrate/nitrite show some health benefits, exposure to meat and drinking water sources should be limited, although safe limits and causal evidence are not fully established. Public health policy should prioritise decreasing nitrate exposure within the context of broader water quality concerns and barriers to perinatal health.</div></div>","PeriodicalId":13994,"journal":{"name":"International journal of hygiene and environmental health","volume":"271 ","pages":"Article 114712"},"PeriodicalIF":4.4,"publicationDate":"2025-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145544289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-14DOI: 10.1016/j.ijheh.2025.114711
Arash Derakhshan , Eva Tanner , Marlene Stratmann , Huan Shu , Robin P. Peeters , Barbara Demeneix , Chris Gennings , Tim I.M. Korevaar , Carl-Gustaf Bornehag
Background
Based on experimental and human studies, endocrine disrupting chemicals (EDCs) can disrupt the thyroid hormone system. However, their association with thyroid function tests when considered as part of a chemical mixture is unknown.
Methods
We used data of 1970 pregnant women from the Swedish Environmental Longitudinal Mother and Child, Asthma and Allergy (SELMA) study to investigate the cross-sectional association between exposure to 26 chemical compounds with maternal thyroid function tests in early pregnancy, using Weighted Quantile Sum (WQS) regression.
Results
Higher exposure to EDCs mixtures was associated with a lower FT3 [WQS Estimate per an IQR increase (95 % CI): −0.09 (−0.16 to −0.01), mostly driven by PCBs] and a lower TT3 [WQS Estimate per an IQR increase (95 % CI): −0.05 (−0.09 to −0.01), mostly driven by PFOS]. In addition, higher exposure to a mixture of short lived urinary based compounds was associated with a lower TT4/TT3 ratio while higher exposure to a mixture of persistent serum based compounds was associated with a higher TT4/TT3 ratio.
Conclusions
In this proof-of-principle analysis, we show that there could be an added benefit of analyzing thyroid hormone system disrupting EDCs using a mixture-based analysis approach. Our findings pave the way and provide hypotheses for future experimental and human studies to investigate the effects of EDCs as a mixture on the thyroid hormone system, revealing information on potential biological mechanisms explaining the associations from observational data.
{"title":"Exposure to a mixture of endocrine disrupting chemicals and thyroid function tests in pregnant women in the SELMA study","authors":"Arash Derakhshan , Eva Tanner , Marlene Stratmann , Huan Shu , Robin P. Peeters , Barbara Demeneix , Chris Gennings , Tim I.M. Korevaar , Carl-Gustaf Bornehag","doi":"10.1016/j.ijheh.2025.114711","DOIUrl":"10.1016/j.ijheh.2025.114711","url":null,"abstract":"<div><h3>Background</h3><div>Based on experimental and human studies, endocrine disrupting chemicals (EDCs) can disrupt the thyroid hormone system. However, their association with thyroid function tests when considered as part of a chemical mixture is unknown.</div></div><div><h3>Methods</h3><div>We used data of 1970 pregnant women from the Swedish Environmental Longitudinal Mother and Child, Asthma and Allergy (SELMA) study to investigate the cross-sectional association between exposure to 26 chemical compounds with maternal thyroid function tests in early pregnancy, using Weighted Quantile Sum (WQS) regression.</div></div><div><h3>Results</h3><div>Higher exposure to EDCs mixtures was associated with a lower FT3 [WQS Estimate per an IQR increase (95 % CI): −0.09 (−0.16 to −0.01), mostly driven by PCBs] and a lower TT3 [WQS Estimate per an IQR increase (95 % CI): −0.05 (−0.09 to −0.01), mostly driven by PFOS]. In addition, higher exposure to a mixture of short lived urinary based compounds was associated with a lower TT4/TT3 ratio while higher exposure to a mixture of persistent serum based compounds was associated with a higher TT4/TT3 ratio.</div></div><div><h3>Conclusions</h3><div>In this proof-of-principle analysis, we show that there could be an added benefit of analyzing thyroid hormone system disrupting EDCs using a mixture-based analysis approach. Our findings pave the way and provide hypotheses for future experimental and human studies to investigate the effects of EDCs as a mixture on the thyroid hormone system, revealing information on potential biological mechanisms explaining the associations from observational data.</div></div>","PeriodicalId":13994,"journal":{"name":"International journal of hygiene and environmental health","volume":"271 ","pages":"Article 114711"},"PeriodicalIF":4.4,"publicationDate":"2025-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145517227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-12DOI: 10.1016/j.ijheh.2025.114708
M.N. Maidana Kulesza , V.B. Rajal , D.G. Sanguino Jorquera , V.L. Romero , M. Aparicio González , S. Leonardi , E.E. Campos , M.E. Bracamonte , N.L. Reynaga , M.P. Zago , H.R. Poma
Salmonella Paratyphi B (SPB) has become endemic in the city of Salta, Argentina, with a staggering burden of bloodstream infections requiring hospitalization. This study unravels the underlying drivers of this endemicity through an integrated clinical-environmental approach. A novel duplex qPCR system was developed to accurately distinguish SPB from other Salmonella serotypes, enabling precise diagnosis and treatment. Clinical analysis revealed SPB in 98 % of positive blood cultures, confirming its strong association with severe infections.
Contrary to initial hypotheses, the public drinking water network -supported by deep wells and systematic chlorination-showed negligible microbial contamination, ruling it out as the primary transmission route. Instead, environmental investigations uncovered widespread SPB in untreated wastewater, river water used for crop irrigation, and in leafy vegetables sold in local markets. SPB was detected in 40 % of lettuce, arugula, and celery samples during the rainy season, with contamination levels exceeding international safety standards by several orders of magnitude.
This widespread presence of SPB in fresh produce, coupled with its uniform detection across city districts regardless of socioeconomic level, points to a foodborne route of transmission through contaminated vegetables. Based on these findings, we propose a strategic intervention plan that includes public education, routine screening for chronic carriers, strengthened monitoring of irrigation water, improved vegetable quality control, and upgrades to wastewater treatment infrastructure.
This study highlights the importance of targeted, multidisciplinary approaches to address human-restricted pathogens and provides a roadmap for interrupting SPB transmission in endemic urban contexts.
{"title":"Unraveling the causes of Salmonella paratyphi B endemicity in Salta: A clinical-environmental perspective","authors":"M.N. Maidana Kulesza , V.B. Rajal , D.G. Sanguino Jorquera , V.L. Romero , M. Aparicio González , S. Leonardi , E.E. Campos , M.E. Bracamonte , N.L. Reynaga , M.P. Zago , H.R. Poma","doi":"10.1016/j.ijheh.2025.114708","DOIUrl":"10.1016/j.ijheh.2025.114708","url":null,"abstract":"<div><div>Salmonella Paratyphi B (SPB) has become endemic in the city of Salta, Argentina, with a staggering burden of bloodstream infections requiring hospitalization. This study unravels the underlying drivers of this endemicity through an integrated clinical-environmental approach. A novel duplex qPCR system was developed to accurately distinguish SPB from other <em>Salmonella</em> serotypes, enabling precise diagnosis and treatment. Clinical analysis revealed SPB in 98 % of positive blood cultures, confirming its strong association with severe infections.</div><div>Contrary to initial hypotheses, the public drinking water network -supported by deep wells and systematic chlorination-showed negligible microbial contamination, ruling it out as the primary transmission route. Instead, environmental investigations uncovered widespread SPB in untreated wastewater, river water used for crop irrigation, and in leafy vegetables sold in local markets. SPB was detected in 40 % of lettuce, arugula, and celery samples during the rainy season, with contamination levels exceeding international safety standards by several orders of magnitude.</div><div>This widespread presence of SPB in fresh produce, coupled with its uniform detection across city districts regardless of socioeconomic level, points to a foodborne route of transmission through contaminated vegetables. Based on these findings, we propose a strategic intervention plan that includes public education, routine screening for chronic carriers, strengthened monitoring of irrigation water, improved vegetable quality control, and upgrades to wastewater treatment infrastructure.</div><div>This study highlights the importance of targeted, multidisciplinary approaches to address human-restricted pathogens and provides a roadmap for interrupting SPB transmission in endemic urban contexts.</div></div>","PeriodicalId":13994,"journal":{"name":"International journal of hygiene and environmental health","volume":"271 ","pages":"Article 114708"},"PeriodicalIF":4.4,"publicationDate":"2025-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145514775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Water contamination by arsenic is a serious public health concern due to its toxicity and long-term health effects, while the presence of pathogens poses immediate risks of waterborne diseases. Beyond these individual threats, their co-occurrence is particularly concerning, as arsenic has been linked to processes that can favor antimicrobial resistance by contributing to genetic mutations and activating bacterial defense mechanisms. Therefore, identifying regions where pathogens coexist with arsenic contamination is crucial. This study investigates simultaneous contamination by arsenic and pathogens in surface water bodies in Minas Gerais, Brazil, a state characterized by intensive mining activities and limited sanitation infrastructure. Data from 665 monitoring stations collected between 2000 and 2023 was used to analyze total arsenic, Escherichia coli, and other water quality parameters. Spatial and statistical analyses revealed critical contamination levels, with frequent violations of legal standards. In seven surface water monitoring points, arsenic and Escherichia coli levels exceeded limits in over 80 % of the samples. Conventional water treatment systems show difficulties to effectively remove arsenic, highlighting the need for region-specific solutions. The methods and protocols developed for Minas Gerais can be adapted to other regions facing similar challenges, offering a comprehensive model for water quality assessment and management that integrates rigorous monitoring, public policies, and practical guidance for water treatment. These findings underscore the importance of water treatment technologies and management strategies tailored to regional conditions to ensure water security and protect public health in scenarios of combined contamination.
{"title":"Integrated assessment of arsenic and pathogen contamination in surface waters impacted by mining activities and sewage discharge: challenges and strategies for water quality management and treatment","authors":"Marina Muniz de Queiroz , Carolina Cristiane Pinto , Victor Rezende Moreira , Dawber Batista Ferreira , Janaína Neres Barbosa , Larissa Guarany Ramalho Elias , Cristiano Christofaro , Míriam Cristina Santos Amaral , Sílvia Corrêa Oliveira","doi":"10.1016/j.ijheh.2025.114709","DOIUrl":"10.1016/j.ijheh.2025.114709","url":null,"abstract":"<div><div>Water contamination by arsenic is a serious public health concern due to its toxicity and long-term health effects, while the presence of pathogens poses immediate risks of waterborne diseases. Beyond these individual threats, their co-occurrence is particularly concerning, as arsenic has been linked to processes that can favor antimicrobial resistance by contributing to genetic mutations and activating bacterial defense mechanisms. Therefore, identifying regions where pathogens coexist with arsenic contamination is crucial. This study investigates simultaneous contamination by arsenic and pathogens in surface water bodies in Minas Gerais, Brazil, a state characterized by intensive mining activities and limited sanitation infrastructure. Data from 665 monitoring stations collected between 2000 and 2023 was used to analyze total arsenic, <em>Escherichia coli</em>, and other water quality parameters. Spatial and statistical analyses revealed critical contamination levels, with frequent violations of legal standards. In seven surface water monitoring points, arsenic and <em>Escherichia coli</em> levels exceeded limits in over 80 % of the samples. Conventional water treatment systems show difficulties to effectively remove arsenic, highlighting the need for region-specific solutions. The methods and protocols developed for Minas Gerais can be adapted to other regions facing similar challenges, offering a comprehensive model for water quality assessment and management that integrates rigorous monitoring, public policies, and practical guidance for water treatment. These findings underscore the importance of water treatment technologies and management strategies tailored to regional conditions to ensure water security and protect public health in scenarios of combined contamination.</div></div>","PeriodicalId":13994,"journal":{"name":"International journal of hygiene and environmental health","volume":"271 ","pages":"Article 114709"},"PeriodicalIF":4.4,"publicationDate":"2025-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145508700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Exposure to organic solvents can affect the central nervous system. Propylene glycol ethers such as propylene glycol methyl ether (PGME) and propylene glycol butyl ether (PGBE) are organic solvents widely used in commercial products including cleaning products. PGME has an established Swiss occupational exposure limit and a biomonitoring limit value while PGBE does not, which is probably due to the absence of toxicokinetic data. Our aim was to (1) Characterize PGBE elimination toxicokinetics in healthy human participants (N = 11) exposed under controlled conditions; (2) Provide urinary elimination kinetics of both conjugated and free PGBE and PGME following exposures to a mixture of PGME (35 ppm) and PGBE (15 ppm) for 6 h, and (3) Assess exposure among six professional cleaners. Urinary PGME and PGBE concentrations were quantified using head-space gas chromatography with flame ionization detection (HS-GC-FID) (LOQ 0.04 mg/L, LOD 0.01 mg/L). PGBE had an apparent elimination of ∼6 h and PGME ∼4 h. PGBE air concentration of 15 ppm corresponded to 1.2 mg/L in urine. Cleaners had low urinary concentrations (<0.5 mg/L). Intriguingly, post-shift concentrations were often lower than the next-day pre-shift values, suggesting skin exposure and possible non-occupational exposures. These findings support biomonitoring as the best approach to assess workers’ total PGBE exposures. Future studies should expand human biomonitoring efforts to better characterize exposure to glycol ethers.
{"title":"Urinary excretion of propylene glycol butyl ether (PGBE) and propylene glycol methyl ether (PGME) in healthy human participants and workers","authors":"Nancy B. Hopf , Susanne Kaspar , Aurélie Berthet , Julie Hechon , Jennifer Pache , Nicole Charriere , Myriam Borgatta","doi":"10.1016/j.ijheh.2025.114706","DOIUrl":"10.1016/j.ijheh.2025.114706","url":null,"abstract":"<div><div>Exposure to organic solvents can affect the central nervous system. Propylene glycol ethers such as propylene glycol methyl ether (PGME) and propylene glycol butyl ether (PGBE) are organic solvents widely used in commercial products including cleaning products. PGME has an established Swiss occupational exposure limit and a biomonitoring limit value while PGBE does not, which is probably due to the absence of toxicokinetic data. Our aim was to (1) Characterize PGBE elimination toxicokinetics in healthy human participants (N = 11) exposed under controlled conditions; (2) Provide urinary elimination kinetics of both conjugated and free PGBE and PGME following exposures to a mixture of PGME (35 ppm) and PGBE (15 ppm) for 6 h, and (3) Assess exposure among six professional cleaners. Urinary PGME and PGBE concentrations were quantified using head-space gas chromatography with flame ionization detection (HS-GC-FID) (LOQ 0.04 mg/L, LOD 0.01 mg/L). PGBE had an apparent elimination of ∼6 h and PGME ∼4 h. PGBE air concentration of 15 ppm corresponded to 1.2 mg/L in urine. Cleaners had low urinary concentrations (<0.5 mg/L). Intriguingly, post-shift concentrations were often lower than the next-day pre-shift values, suggesting skin exposure and possible non-occupational exposures. These findings support biomonitoring as the best approach to assess workers’ total PGBE exposures. Future studies should expand human biomonitoring efforts to better characterize exposure to glycol ethers.</div></div>","PeriodicalId":13994,"journal":{"name":"International journal of hygiene and environmental health","volume":"271 ","pages":"Article 114706"},"PeriodicalIF":4.4,"publicationDate":"2025-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145508750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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