Pub Date : 2025-09-01DOI: 10.1016/j.ijheh.2025.114667
Jonny Crocker , Jeffrey Walters , Jenala Chipungu , Jay Bhagwan , Michel Dione , Robert Dreibelbis , Maria Corazon Dumlao , A.S.G. Faruque , Meriel Flint-O'Kane , Om Prasad Gautam , Ndeye Aissatou Lakhe , Richard Muga , Arundati Muralidharan , Idrissa Ndiaye , Moussa Sarr , Matthew C. Freeman
Background
Hygienic toileting is associated with positive health outcomes; yet efforts to provide the necessary preconditions for this behavior, namely provision of anal cleansing materials, a well-maintained toilet facility, and handwashing, are often limited—especially in schools—by a complex set of determinants and upstream factors that hinder access to the materials and behavioral drivers required for effective practice. Systems thinking, and its associated tools, is one approach to understanding and developing interventions to address the complexity of an interconnected set of factors impacting hygiene program outcomes.
Methods
This study modeled the interconnected factors influencing preconditions for hygienic toileting in schools using expert-based participatory systems modeling. Two global hygiene meetings were utilized to recruit participants for hygiene systems modeling, and to compare results across two distinct groups of model participants. Participants identified and prioritized hygiene system factors, created systems models, and performed structural analyses using influence maps and causal loop diagrams to compare key leverage points driving hygienic toileting in schools.
Results
Participants prioritized nine factors. Three of the nine factors were found to be highly influential and to drive the core system dynamics across both groups of participants: WASH leadership, governance, and partnerships; resource mobilization; and human resource capacity.
Discussion
Our study identified leverage points for system strengthening to deliver the preconditions for hygienic toileting in schools. Systems thinking should precede system strengthening to ensure the efficient and effective use of resources and to enhance the sustainability of outcomes.
{"title":"Hygiene system modeling for toileting in schools","authors":"Jonny Crocker , Jeffrey Walters , Jenala Chipungu , Jay Bhagwan , Michel Dione , Robert Dreibelbis , Maria Corazon Dumlao , A.S.G. Faruque , Meriel Flint-O'Kane , Om Prasad Gautam , Ndeye Aissatou Lakhe , Richard Muga , Arundati Muralidharan , Idrissa Ndiaye , Moussa Sarr , Matthew C. Freeman","doi":"10.1016/j.ijheh.2025.114667","DOIUrl":"10.1016/j.ijheh.2025.114667","url":null,"abstract":"<div><h3>Background</h3><div>Hygienic toileting is associated with positive health outcomes; yet efforts to provide the necessary preconditions for this behavior, namely provision of anal cleansing materials, a well-maintained toilet facility, and handwashing, are often limited—especially in schools—by a complex set of determinants and upstream factors that hinder access to the materials and behavioral drivers required for effective practice. Systems thinking, and its associated tools, is one approach to understanding and developing interventions to address the complexity of an interconnected set of factors impacting hygiene program outcomes.</div></div><div><h3>Methods</h3><div>This study modeled the interconnected factors influencing preconditions for hygienic toileting in schools using expert-based participatory systems modeling. Two global hygiene meetings were utilized to recruit participants for hygiene systems modeling, and to compare results across two distinct groups of model participants. Participants identified and prioritized hygiene system factors, created systems models, and performed structural analyses using influence maps and causal loop diagrams to compare key leverage points driving hygienic toileting in schools.</div></div><div><h3>Results</h3><div>Participants prioritized nine factors. Three of the nine factors were found to be highly influential and to drive the core system dynamics across both groups of participants: WASH leadership, governance, and partnerships; resource mobilization; and human resource capacity.</div></div><div><h3>Discussion</h3><div>Our study identified leverage points for system strengthening to deliver the preconditions for hygienic toileting in schools. Systems thinking should precede system strengthening to ensure the efficient and effective use of resources and to enhance the sustainability of outcomes.</div></div>","PeriodicalId":13994,"journal":{"name":"International journal of hygiene and environmental health","volume":"270 ","pages":"Article 114667"},"PeriodicalIF":4.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145109021","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 : 2025-09-01DOI: 10.1016/j.ijheh.2025.114675
Le Yang , Qinfei Wei , Jianhui Guo , Xingyan Xu , Li Zhu , Zhiyu Zhang , Jungu Zhou , Yuting Dong , Donghong Wei , Yeying Wen , Liuyan Zheng , Shaowei Lin , XiaoXu Xie , Huangyuan Li , Siying Wu
Greenness has been linked to cardiovascular disease. However, the specific biological mechanisms through which greenness impacts coronary heart disease (CHD) remain unclear. We aim to explore the underlying epigenetic mechanisms linking greenness and CHD by using proteomics and miRNA microarray. A total of 2387 participants were included in the population study, 816 of whom were diagnosed with CHD. Residential greenness exposure was characterized using the normalized difference vegetation index (NDVI). Generalized additive models and restricted cubic splines investigated the association between greenness and CHD. Mediation analysis examined whether cardiovascular metabolic risk factors (blood pressure, inflammation indicators, and glucose) mediated the association. After proteomics and miRNA microarray screening, Elisa and qRT-PCR validated selected proteins (THBS1, FCN3, and LTBP1) and miRNAs (miR-671-5p, miR-124-3p, and miR-379-5p) in CHD. Among these, LTBP1 and miR-379-5p showed significant differential expression (P < 0.05) and were examined as potential molecular mediators. Higher greenness exposure within a 1000-m area was associated with a lower risk of CHD (OR: 0.86, 95 % CI: 0.81, 0.92). Systolic blood pressure (6.32 % [95 % CI: 1.49 %, 13.12 %]), lymphocyte (10.98 % [95 % CI: 3.76 %, 22.00 %]), monocyte (9.94 % [95 % CI: 3.42 %, 20.87 %]), and fasting blood glucose (3.41 % [95 % CI: 0.56 %, 7.84 %]) mediated this association. LTBP1 and miR-379-5p were differentially expressed in CHD and mediated 7.19 % [95 % CI: 0.01 %, 23.37 %] and 20.03 % [95 % CI: 2.85 %, 69.71 %] of greenness effect on CHD, respectively. Combining the population study and experiments, we found that miR-379-5p and LTBP1 may jointly modulate vascular constriction and immune inflammation in the association between greenness and CHD.
{"title":"Association between residential greenness and coronary heart disease: A proteomics and miRNA microarray analysis","authors":"Le Yang , Qinfei Wei , Jianhui Guo , Xingyan Xu , Li Zhu , Zhiyu Zhang , Jungu Zhou , Yuting Dong , Donghong Wei , Yeying Wen , Liuyan Zheng , Shaowei Lin , XiaoXu Xie , Huangyuan Li , Siying Wu","doi":"10.1016/j.ijheh.2025.114675","DOIUrl":"10.1016/j.ijheh.2025.114675","url":null,"abstract":"<div><div>Greenness has been linked to cardiovascular disease. However, the specific biological mechanisms through which greenness impacts coronary heart disease (CHD) remain unclear. We aim to explore the underlying epigenetic mechanisms linking greenness and CHD by using proteomics and miRNA microarray. A total of 2387 participants were included in the population study, 816 of whom were diagnosed with CHD. Residential greenness exposure was characterized using the normalized difference vegetation index (NDVI). Generalized additive models and restricted cubic splines investigated the association between greenness and CHD. Mediation analysis examined whether cardiovascular metabolic risk factors (blood pressure, inflammation indicators, and glucose) mediated the association. After proteomics and miRNA microarray screening, Elisa and qRT-PCR validated selected proteins (THBS1, FCN3, and LTBP1) and miRNAs (miR-671-5p, miR-124-3p, and miR-379-5p) in CHD. Among these, LTBP1 and miR-379-5p showed significant differential expression (<em>P</em> < 0.05) and were examined as potential molecular mediators. Higher greenness exposure within a 1000-m area was associated with a lower risk of CHD (<em>OR</em>: 0.86, 95 % <em>CI</em>: 0.81, 0.92). Systolic blood pressure (6.32 % [95 % <em>CI</em>: 1.49 %, 13.12 %]), lymphocyte (10.98 % [95 % <em>CI</em>: 3.76 %, 22.00 %]), monocyte (9.94 % [95 % <em>CI</em>: 3.42 %, 20.87 %]), and fasting blood glucose (3.41 % [95 % <em>CI</em>: 0.56 %, 7.84 %]) mediated this association. LTBP1 and miR-379-5p were differentially expressed in CHD and mediated 7.19 % [95 % <em>CI</em>: 0.01 %, 23.37 %] and 20.03 % [95 % <em>CI</em>: 2.85 %, 69.71 %] of greenness effect on CHD, respectively. Combining the population study and experiments, we found that miR-379-5p and LTBP1 may jointly modulate vascular constriction and immune inflammation in the association between greenness and CHD.</div></div>","PeriodicalId":13994,"journal":{"name":"International journal of hygiene and environmental health","volume":"270 ","pages":"Article 114675"},"PeriodicalIF":4.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145119020","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 : 2025-09-01DOI: 10.1016/j.ijheh.2025.114681
Nekane Sandoval-Diez , Danielle Vienneau , Martin Röösli
Background
Sleep is essential for adolescents’ health, yet research on transportation noise and adolescent sleep is limited. This study investigated the relationship between night-time road traffic noise exposure and self-reported sleep disturbances in adolescents, considering individual factors like noise annoyance and sensitivity.
Methods
A cohort of 887 adolescents (mean age 14.03 ± 0.86 years) was recruited in Switzerland, with follow-up after one year. Night-time road traffic noise exposure (Ln) was modelled at the most exposed façade of participants' residences using three-dimensional propagation models. Sleep disturbances, noise annoyance, and sensitivity were assessed via self-report questionnaires. Associations were examined using mixed logistic regression, adjusting for potential confounders and environmental co-exposures. Longitudinal changes were assessed using the interaction between Ln and follow-up time.
Results
Participants' average Ln exposure was 44.6 ± 7.7 dB (range: 25.0–67.4). At baseline, 267 adolescents (30.3 %) reported being at least slightly annoyed by road traffic noise, and 205 (24.3 %) were highly noise sensitive. Higher Ln was associated with increased sleep disturbances, particularly at Ln ≥ 55 dB (OR vs Ln ≤ 44 dB = 2.43, 95 % CI: 1.20–4.91), and with higher odds of reporting at least slight annoyance (OR per interquartile range increase in Ln = 2.27, 95 % CI: 1.77–2.92). No changes in sleep outcomes were observed after one year in relation to noise exposure.
Conclusions
Road traffic noise was associated with increased self-reported sleep disturbances and noise annoyance in adolescents. These findings add to the growing evidence linking transportation noise to non-auditory health effects in youth.
背景睡眠对青少年健康至关重要，但交通噪音与青少年睡眠之间的关系研究有限。本研究调查了夜间道路交通噪音暴露与青少年自我报告的睡眠障碍之间的关系，考虑了噪音烦恼和敏感性等个人因素。方法在瑞士招募887名青少年（平均年龄14.03±0.86岁），随访1年。夜间道路交通噪声暴露（Ln）采用三维传播模型在参与者住宅的最暴露面进行建模。通过自我报告问卷评估睡眠障碍、噪音烦恼和敏感性。使用混合逻辑回归检查关联，调整潜在混杂因素和环境共同暴露。利用Ln与随访时间的相互作用评估纵向变化。结果受试者的平均暴露量为44.6±7.7 dB（范围：25.0 ~ 67.4）。在基线时，267名青少年（30.3%）报告对道路交通噪音至少有轻微的烦恼，205名青少年（24.3%）对噪音高度敏感。较高的Ln与睡眠障碍增加有关，特别是在Ln≥55 dB时（OR vs Ln≤44 dB = 2.43, 95% CI: 1.20-4.91），并且报告至少轻微烦恼的几率较高（Ln每四分位数范围增加的OR = 2.27, 95% CI: 1.77-2.92）。一年后，没有观察到噪音对睡眠结果的影响。结论道路交通噪音与青少年自我报告的睡眠障碍和噪音烦恼增加有关。这些发现进一步证明了交通噪音对青少年非听觉健康的影响。
{"title":"Adolescent sleep disturbances and road traffic noise: a Swiss cohort study","authors":"Nekane Sandoval-Diez , Danielle Vienneau , Martin Röösli","doi":"10.1016/j.ijheh.2025.114681","DOIUrl":"10.1016/j.ijheh.2025.114681","url":null,"abstract":"<div><h3>Background</h3><div>Sleep is essential for adolescents’ health, yet research on transportation noise and adolescent sleep is limited. This study investigated the relationship between night-time road traffic noise exposure and self-reported sleep disturbances in adolescents, considering individual factors like noise annoyance and sensitivity.</div></div><div><h3>Methods</h3><div>A cohort of 887 adolescents (mean age 14.03 ± 0.86 years) was recruited in Switzerland, with follow-up after one year. Night-time road traffic noise exposure (L<sub>n</sub>) was modelled at the most exposed façade of participants' residences using three-dimensional propagation models. Sleep disturbances, noise annoyance, and sensitivity were assessed via self-report questionnaires. Associations were examined using mixed logistic regression, adjusting for potential confounders and environmental co-exposures. Longitudinal changes were assessed using the interaction between L<sub>n</sub> and follow-up time.</div></div><div><h3>Results</h3><div>Participants' average L<sub>n</sub> exposure was 44.6 ± 7.7 dB (range: 25.0–67.4). At baseline, 267 adolescents (30.3 %) reported being at least slightly annoyed by road traffic noise, and 205 (24.3 %) were highly noise sensitive. Higher L<sub>n</sub> was associated with increased sleep disturbances, particularly at L<sub>n</sub> ≥ 55 dB (OR vs Ln ≤ 44 dB = 2.43, 95 % CI: 1.20–4.91), and with higher odds of reporting at least slight annoyance (OR per interquartile range increase in L<sub>n</sub> = 2.27, 95 % CI: 1.77–2.92). No changes in sleep outcomes were observed after one year in relation to noise exposure.</div></div><div><h3>Conclusions</h3><div>Road traffic noise was associated with increased self-reported sleep disturbances and noise annoyance in adolescents. These findings add to the growing evidence linking transportation noise to non-auditory health effects in youth.</div></div>","PeriodicalId":13994,"journal":{"name":"International journal of hygiene and environmental health","volume":"270 ","pages":"Article 114681"},"PeriodicalIF":4.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145217561","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 : 2025-09-01DOI: 10.1016/j.ijheh.2025.114678
Hong Mei , Liqin Hu , Haoshuang Liu , Neng Li , Yunxia Li , Jiali Xu , Hailin Gu , Feiyan Xiang , Meng Yang , Pan Yang , Jianduan Zhang , Han Xiao , Aifen Zhou
Objectives
This study aimed to explore the associations between trimester-specific prenatal bisphenol analogues (BPs) exposures and offspring growth during infancy. Additionally, it sought to evaluate the mediating effect of breast milk metabolites on this relationship.
Methods
The research examined the associations among bisphenol A (BPA), bisphenol F (BPF), bisphenol S (BPS) levels collected from mothers during the 1st, 2nd and 3rd trimesters, breast milk metabolites when the offspring were 1 month old, and infant growth measurements at 1, 3, 6, 9 and 12 months of age. General linear models (GLM), multiple logistic regression models, and generalized estimating equations (GEE) were employed to assess the relationships between BPs, breast milk metabolites and offspring growth. The mediation package was utilized to evaluate the mediating effect of breast milk metabolites.
Results
Significant associations were observed between first-trimester BPA (BPA_1) and 369 breast milk metabolites, primarily influencing glycometabolism and lipid metabolism pathways. BPA_1 were positively associated with infants' growth and ZBMI trajectory. Breast milk metabolites were also correlated with growth measurements and trajectories, predominantly categorized as glycometabolites and lipids. A mediating role was identified for 10 breast milk metabolites in the relationship between prenatal BPA_1 and infants’ ZBMI at 12 months.
Conclusion
First-trimester BPA exposure may promote early growth and high ZBMI trajectory, which are risk factors for obesity in later life. This study highlights BPA_1's impact on breast milk metabolites and first reports breast milk metabolites as mediators on relationship between prenatal BPA exposure and offspring growth.
{"title":"Prenatal bisphenol analogues exposure, metabolites in breast milk and offspring anthropometric growth during infancy: The Wuhan twin birth cohort study","authors":"Hong Mei , Liqin Hu , Haoshuang Liu , Neng Li , Yunxia Li , Jiali Xu , Hailin Gu , Feiyan Xiang , Meng Yang , Pan Yang , Jianduan Zhang , Han Xiao , Aifen Zhou","doi":"10.1016/j.ijheh.2025.114678","DOIUrl":"10.1016/j.ijheh.2025.114678","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to explore the associations between trimester-specific prenatal bisphenol analogues (BPs) exposures and offspring growth during infancy. Additionally, it sought to evaluate the mediating effect of breast milk metabolites on this relationship.</div></div><div><h3>Methods</h3><div>The research examined the associations among bisphenol A (BPA), bisphenol F (BPF), bisphenol S (BPS) levels collected from mothers during the 1st, 2nd and 3rd trimesters, breast milk metabolites when the offspring were 1 month old, and infant growth measurements at 1, 3, 6, 9 and 12 months of age. General linear models (GLM), multiple logistic regression models, and generalized estimating equations (GEE) were employed to assess the relationships between BPs, breast milk metabolites and offspring growth. The mediation package was utilized to evaluate the mediating effect of breast milk metabolites.</div></div><div><h3>Results</h3><div>Significant associations were observed between first-trimester BPA (BPA_1) and 369 breast milk metabolites, primarily influencing glycometabolism and lipid metabolism pathways. BPA_1 were positively associated with infants' growth and ZBMI trajectory. Breast milk metabolites were also correlated with growth measurements and trajectories, predominantly categorized as glycometabolites and lipids. A mediating role was identified for 10 breast milk metabolites in the relationship between prenatal BPA_1 and infants’ ZBMI at 12 months.</div></div><div><h3>Conclusion</h3><div>First-trimester BPA exposure may promote early growth and high ZBMI trajectory, which are risk factors for obesity in later life. This study highlights BPA_1's impact on breast milk metabolites and first reports breast milk metabolites as mediators on relationship between prenatal BPA exposure and offspring growth.</div></div>","PeriodicalId":13994,"journal":{"name":"International journal of hygiene and environmental health","volume":"270 ","pages":"Article 114678"},"PeriodicalIF":4.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145215028","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}
The study aimed to investigate the association between glyphosate (GLY) exposure, using urinary GLY and its primary metabolite aminomethylphosphonic acid (AMPA), and the DNA damage biomarkers 8-hydroxy-2′-deoxyguanosine (8-OHdG) and N7-methylguanine (N7-MeG) in rural populations in Taiwan.
Methods
A cross-sectional study was conducted with 368 participants from a rural area in Taiwan characterized by extensive agricultural activity. Urinary concentrations of GLY, AMPA, and the DNA damage biomarkers 8-OHdG and N7-MeG were measured by liquid chromatography-tandem mass spectrometry (LC-MS/MS). GLY and AMPA concentrations were creatinine-adjusted (μg/g creatinine) and log2 transformed. Multivariable linear and logistic regression models were performed to evaluate the associations.
Results
Urinary GLY and AMPA were positively associated with the oxidative stress biomarker 8-OHdG and the DNA methylation biomarker N7-MeG. In linear regression models adjusted for age, gender, and occupation, the geometric mean ratios (GMR) per doubling of GLY and AMPA were 1.11 (95 % CI: 1.04–1.19) and 1.19 (95 % CI: 1.10–1.30) for 8-OHdG, and 1.10 (95 % CI: 1.03–1.18) and 1.16 (95 % CI: 1.08–1.26) for N7-MeG, respectively. The adjusted odds ratios (aORs) were 1.79 (95 % CI: 1.39–2.31) and 1.69 (95 % CI: 1.30–2.19) for high 8-OHdG, and 1.55 (95 % CI: 1.23–1.95) and 1.74 (95 % CI: 1.33–2.28) for high N7-MeG, per doubling of GLY and AMPA concentrations.
Conclusion
These findings indicate that urinary GLY and AMPA concentrations are positively associated with 8-OHdG and N7-MeG, implicating carcinogenic pathways of oxidative stress and DNA methylation. The results highlight the need for further research and regulatory considerations, particularly in agricultural communities.
{"title":"Association between urinary glyphosate and aminomethylphosphonic acid concentrations and DNA damage biomarkers among rural populations in Taiwan","authors":"Miku Kono , Wei-Hsiang Chang , Nien-Chia Chen , Jyun-Ming Chen , Wei-Te Wu","doi":"10.1016/j.ijheh.2025.114671","DOIUrl":"10.1016/j.ijheh.2025.114671","url":null,"abstract":"<div><h3>Objectives</h3><div>The study aimed to investigate the association between glyphosate (GLY) exposure, using urinary GLY and its primary metabolite aminomethylphosphonic acid (AMPA), and the DNA damage biomarkers 8-hydroxy-2′-deoxyguanosine (8-OHdG) and N7-methylguanine (N7-MeG) in rural populations in Taiwan.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted with 368 participants from a rural area in Taiwan characterized by extensive agricultural activity. Urinary concentrations of GLY, AMPA, and the DNA damage biomarkers 8-OHdG and N7-MeG were measured by liquid chromatography-tandem mass spectrometry (LC-MS/MS). GLY and AMPA concentrations were creatinine-adjusted (μg/g creatinine) and log<sub>2</sub> transformed. Multivariable linear and logistic regression models were performed to evaluate the associations.</div></div><div><h3>Results</h3><div>Urinary GLY and AMPA were positively associated with the oxidative stress biomarker 8-OHdG and the DNA methylation biomarker N7-MeG. In linear regression models adjusted for age, gender, and occupation, the geometric mean ratios (GMR) per doubling of GLY and AMPA were 1.11 (95 % CI: 1.04–1.19) and 1.19 (95 % CI: 1.10–1.30) for 8-OHdG, and 1.10 (95 % CI: 1.03–1.18) and 1.16 (95 % CI: 1.08–1.26) for N7-MeG, respectively. The adjusted odds ratios (aORs) were 1.79 (95 % CI: 1.39–2.31) and 1.69 (95 % CI: 1.30–2.19) for high 8-OHdG, and 1.55 (95 % CI: 1.23–1.95) and 1.74 (95 % CI: 1.33–2.28) for high N7-MeG, per doubling of GLY and AMPA concentrations.</div></div><div><h3>Conclusion</h3><div>These findings indicate that urinary GLY and AMPA concentrations are positively associated with 8-OHdG and N7-MeG, implicating carcinogenic pathways of oxidative stress and DNA methylation. The results highlight the need for further research and regulatory considerations, particularly in agricultural communities.</div></div>","PeriodicalId":13994,"journal":{"name":"International journal of hygiene and environmental health","volume":"270 ","pages":"Article 114671"},"PeriodicalIF":4.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145102681","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 : 2025-09-01DOI: 10.1016/j.ijheh.2025.114674
Hyung Doo Kim , Inho Hong , Hwan-Cheol Kim
Per- and polyfluoroalkyl substances (PFASs) are synthetic chemicals with high persistence in the environment and biological systems, raising significant public health concerns. This study developed and evaluated machine learning (ML) models to predict high PFAS exposure among participants in the fourth cycle of the Korean National Environmental Health Survey (KoNEHS). The study assessed the effectiveness of a Full model incorporating 64 variables and a Compact model incorporating 10 basic health metrics using six different ML algorithms: random forest (RF), gradient boosting machine (GBM), eXtreme gradient boosting (XGBoost), logistic regression (LR), support vector machine (SVM), and K-nearest neighbors (KNN). The study revealed a robust performance across all algorithms, achieving a balanced accuracy of 82 %. Age was the most significant predictor, particularly in individuals aged >45 years. Other critical predictors included serum mercury and serum lead levels in the Full model and hemoglobin levels, alanine aminotransferase, red blood cell counts, and platelet counts in the Compact model. Hence, these findings underscore the potential of ML in improving the identification and management of populations at risk for high PFAS exposure. Consequently, even minimal data sets can yield high predictive accuracy, as demonstrated by the Compact model.
{"title":"Predicting high exposure of per- and polyfluoroalkyl substances (PFASs) in Korean adults using machine learning","authors":"Hyung Doo Kim , Inho Hong , Hwan-Cheol Kim","doi":"10.1016/j.ijheh.2025.114674","DOIUrl":"10.1016/j.ijheh.2025.114674","url":null,"abstract":"<div><div>Per- and polyfluoroalkyl substances (PFASs) are synthetic chemicals with high persistence in the environment and biological systems, raising significant public health concerns. This study developed and evaluated machine learning (ML) models to predict high PFAS exposure among participants in the fourth cycle of the Korean National Environmental Health Survey (KoNEHS). The study assessed the effectiveness of a Full model incorporating 64 variables and a Compact model incorporating 10 basic health metrics using six different ML algorithms: random forest (RF), gradient boosting machine (GBM), eXtreme gradient boosting (XGBoost), logistic regression (LR), support vector machine (SVM), and K-nearest neighbors (KNN). The study revealed a robust performance across all algorithms, achieving a balanced accuracy of 82 %. Age was the most significant predictor, particularly in individuals aged >45 years. Other critical predictors included serum mercury and serum lead levels in the Full model and hemoglobin levels, alanine aminotransferase, red blood cell counts, and platelet counts in the Compact model. Hence, these findings underscore the potential of ML in improving the identification and management of populations at risk for high PFAS exposure. Consequently, even minimal data sets can yield high predictive accuracy, as demonstrated by the Compact model.</div></div>","PeriodicalId":13994,"journal":{"name":"International journal of hygiene and environmental health","volume":"270 ","pages":"Article 114674"},"PeriodicalIF":4.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145155098","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 : 2025-09-01DOI: 10.1016/j.ijheh.2025.114677
Anders Bekkelund, Petter Langlete, Carl Fredrik Nordheim, Tora Alexandra Ziesler, Elisabeth Henie Madslien, Susanne Hyllestad
Climate change is expected to increase the frequency of extreme weather events, challenging the provision of safe drinking water. In August 2023, the extreme flood event Hans severely affected infrastructure in south-eastern Norway. We assessed the impact on drinking water quality in 63 municipalities receiving red flood warnings, covering 138 water supply systems serving ∼845,000 people. Data on E. coli, Clostridium perfringens and intestinal enterococci were retrieved from 93 utilities that reported results before, during, and after the flood. In total, >7000 water samples were analysed. Positive samples were more frequent in raw water (14.6 % E. coli, 32.2 % Clostridiumperfringens, 9.6 % enterococci) than in treated water (≤1.2 %). Significant correlations were observed between river flow and faecal indicator exceedances in both raw and treated water, particularly in the Drammen river basin. These findings indicate increased public health risk during extreme flooding and underscore the vulnerability of drinking water systems to climate-sensitive hazards. The results provide baseline data directly relevant for hazard identification and risk assessment in climate-resilient water safety planning and for implementing the European Drinking Water Directive (EU, 2020/2184).
{"title":"Extreme weather and drinking water safety: impacts of the 2023 flood Hans in Norway","authors":"Anders Bekkelund, Petter Langlete, Carl Fredrik Nordheim, Tora Alexandra Ziesler, Elisabeth Henie Madslien, Susanne Hyllestad","doi":"10.1016/j.ijheh.2025.114677","DOIUrl":"10.1016/j.ijheh.2025.114677","url":null,"abstract":"<div><div>Climate change is expected to increase the frequency of extreme weather events, challenging the provision of safe drinking water. In August 2023, the extreme flood event <em>Hans</em> severely affected infrastructure in south-eastern Norway. We assessed the impact on drinking water quality in 63 municipalities receiving red flood warnings, covering 138 water supply systems serving ∼845,000 people. Data on <em>E. coli</em>, <em>Clostridium perfringens</em> and intestinal enterococci were retrieved from 93 utilities that reported results before, during, and after the flood. In total, >7000 water samples were analysed. Positive samples were more frequent in raw water (14.6 % <em>E. coli</em>, 32.2 % <em>C</em><em>lostridium</em> <em>perfringens</em>, 9.6 % enterococci) than in treated water (≤1.2 %). Significant correlations were observed between river flow and faecal indicator exceedances in both raw and treated water, particularly in the Drammen river basin. These findings indicate increased public health risk during extreme flooding and underscore the vulnerability of drinking water systems to climate-sensitive hazards. The results provide baseline data directly relevant for hazard identification and risk assessment in climate-resilient water safety planning and for implementing the European Drinking Water Directive (EU, 2020/2184).</div></div>","PeriodicalId":13994,"journal":{"name":"International journal of hygiene and environmental health","volume":"270 ","pages":"Article 114677"},"PeriodicalIF":4.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145155096","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 : 2025-09-01DOI: 10.1016/j.ijheh.2025.114649
Lindsay J. Underhill , Lisa de las Fuentes , Laura Nicolaou , Shakir Hossen , Anaite Diaz-Artiga , Ajay Pillarisetti , Aris T. Papageorghiou , Florien Ndagijimana , Ghislaine Rosa , Gurusamy Thangavel , John P. McCracken , Kalpana Balakrishnan , Krishnendu Mukhopadhyay , Kyle Steenland , Lisa M. Thompson , Lance A. Waller , Maggie L. Clark , Michael A. Johnson , Sarada Garg , Sankar Sambandam , Victor G. Davila-Roman
Background
Cardiovascular disease is the leading cause of global morbidity and mortality, disproportionately affecting people in low- and middle-income countries (LMICs). Biomass fuels used for cooking in LMICs contribute significantly to household air pollution (HAP), which has been associated with inflammation, oxidative stress, and other pathways linked to atherosclerosis. We evaluate the association between HAP exposure and atherosclerosis by use of carotid artery ultrasound.
Methods
An exposure-response analysis was conducted using cross-sectional baseline data from 397 women aged 40–79 years from the Household Air Pollution Intervention Network (HAPIN) trial in Guatemala, India, Peru, and Rwanda. Participants underwent ultrasound evaluation of their carotid arteries to measure intima-media thickness (CIMT) and atherosclerotic plaques. Additionally, 24-h personal exposures to particulate matter (PM2.5), carbon monoxide (CO), and black carbon (BC) were assessed.
Findings
Mean 24-h PM2.5 exposure was 119 μg/m3 (range 10–803), BC was 13 μg/m3 (range 1.1–72), and CO was 2.3 ppm (range 0–39). Mean and maximal unadjusted CIMT measurements were 0.64 ± 0.13 mm and 0.75 ± 0.14 mm, respectively. Prevalence of atherosclerotic plaques was 7.1 % (range: 0.8 %–11.6 % by country). In adjusted linear models, each 10 μg/m3 increase in PM2.5 was associated with a 0.001 mm increase in mean CIMT (95 % CI: 0 to 0.002) and a 0.002 mm increase in maximal CIMT (95 % CI: 0 to 0.003). For CO, each 10 ppm increase was associated with a 0.04 mm increase in maximal CIMT (95 % CI: 0 to 0.08), with the highest quartile of CO exposure having 0.036 mm and 0.05 mm greater mean and maximal CIMT (95 % CI: 0.002 to 0.07; 0.01, 0.09), respectively, than the lowest quartile. No significant associations were found between BC and CIMT or between any exposures and carotid atherosclerotic plaque.
Interpretation
In this cross-sectional study, higher personal exposures to PM2.5 and CO were associated with greater mean and maximal CIMT, a well-established biomarker of atherosclerosis, further supporting the association between HAP and cardiovascular disease.
背景：心血管疾病是全球发病率和死亡率的主要原因，对低收入和中等收入国家（LMICs）人群的影响尤为严重。在中低收入国家，用于烹饪的生物质燃料对家庭空气污染（HAP）有重大影响，而家庭空气污染与炎症、氧化应激和其他与动脉粥样硬化相关的途径有关。我们通过颈动脉超声评估HAP暴露与动脉粥样硬化之间的关系。方法使用来自危地马拉、印度、秘鲁和卢旺达家庭空气污染干预网络（HAPIN）试验的397名40-79岁妇女的横断面基线数据进行暴露反应分析。参与者接受了颈动脉超声评估，以测量内膜-中膜厚度（CIMT）和动脉粥样硬化斑块。此外，还评估了24小时个人暴露于颗粒物（PM2.5）、一氧化碳（CO）和黑碳（BC）的情况。平均24小时PM2.5暴露量为119 μg/m3（范围10-803），BC为13 μg/m3（范围1.1-72），CO为2.3 ppm（范围0-39）。未调整的平均和最大CIMT测量值分别为0.64±0.13 mm和0.75±0.14 mm。动脉粥样硬化斑块患病率为7.1%（各国范围：0.8% - 11.6%）。在调整后的线性模型中，PM2.5每增加10 μg/m3，平均CIMT增加0.001 mm (95% CI: 0 ~ 0.002)，最大CIMT增加0.002 mm （95% CI: 0 ~ 0.003）。对于CO，每增加10 ppm，最大CIMT增加0.04 mm (95% CI: 0至0.08)，CO暴露的最高四分位数的平均CIMT和最大CIMT分别比最低四分位数高0.036 mm和0.05 mm （95% CI: 0.002至0.07;0.01,0.09）。没有发现BC和CIMT之间或任何暴露与颈动脉粥样硬化斑块之间的显著关联。在这项横断面研究中，PM2.5和CO的个人暴露水平越高，平均和最大的CIMT（动脉粥样硬化的一个公认的生物标志物）越高，进一步支持HAP与心血管疾病之间的关联。
{"title":"Household air pollution exposure in adult women is associated with increased carotid intima-media thickness: A cross-sectional study of the Household Air Pollution Intervention Network trial.","authors":"Lindsay J. Underhill , Lisa de las Fuentes , Laura Nicolaou , Shakir Hossen , Anaite Diaz-Artiga , Ajay Pillarisetti , Aris T. Papageorghiou , Florien Ndagijimana , Ghislaine Rosa , Gurusamy Thangavel , John P. McCracken , Kalpana Balakrishnan , Krishnendu Mukhopadhyay , Kyle Steenland , Lisa M. Thompson , Lance A. Waller , Maggie L. Clark , Michael A. Johnson , Sarada Garg , Sankar Sambandam , Victor G. Davila-Roman","doi":"10.1016/j.ijheh.2025.114649","DOIUrl":"10.1016/j.ijheh.2025.114649","url":null,"abstract":"<div><h3>Background</h3><div>Cardiovascular disease is the leading cause of global morbidity and mortality, disproportionately affecting people in low- and middle-income countries (LMICs). Biomass fuels used for cooking in LMICs contribute significantly to household air pollution (HAP), which has been associated with inflammation, oxidative stress, and other pathways linked to atherosclerosis. We evaluate the association between HAP exposure and atherosclerosis by use of carotid artery ultrasound.</div></div><div><h3>Methods</h3><div>An exposure-response analysis was conducted using cross-sectional baseline data from 397 women aged 40–79 years from the Household Air Pollution Intervention Network (HAPIN) trial in Guatemala, India, Peru, and Rwanda. Participants underwent ultrasound evaluation of their carotid arteries to measure intima-media thickness (CIMT) and atherosclerotic plaques. Additionally, 24-h personal exposures to particulate matter (PM<sub>2.5</sub>), carbon monoxide (CO), and black carbon (BC) were assessed.</div></div><div><h3>Findings</h3><div>Mean 24-h PM<sub>2.5</sub> exposure was 119 μg/m<sup>3</sup> (range 10–803), BC was 13 μg/m<sup>3</sup> (range 1.1–72), and CO was 2.3 ppm (range 0–39). Mean and maximal unadjusted CIMT measurements were 0.64 ± 0.13 mm and 0.75 ± 0.14 mm, respectively. Prevalence of atherosclerotic plaques was 7.1 % (range: 0.8 %–11.6 % by country). In adjusted linear models, each 10 μg/m<sup>3</sup> increase in PM<sub>2.5</sub> was associated with a 0.001 mm increase in mean CIMT (95 % CI: 0 to 0.002) and a 0.002 mm increase in maximal CIMT (95 % CI: 0 to 0.003). For CO, each 10 ppm increase was associated with a 0.04 mm increase in maximal CIMT (95 % CI: 0 to 0.08), with the highest quartile of CO exposure having 0.036 mm and 0.05 mm greater mean and maximal CIMT (95 % CI: 0.002 to 0.07; 0.01, 0.09), respectively, than the lowest quartile. No significant associations were found between BC and CIMT or between any exposures and carotid atherosclerotic plaque.</div></div><div><h3>Interpretation</h3><div>In this cross-sectional study, higher personal exposures to PM<sub>2.5</sub> and CO were associated with greater mean and maximal CIMT, a well-established biomarker of atherosclerosis, further supporting the association between HAP and cardiovascular disease.</div></div>","PeriodicalId":13994,"journal":{"name":"International journal of hygiene and environmental health","volume":"270 ","pages":"Article 114649"},"PeriodicalIF":4.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144925885","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}
Bloodstream infections (BSIs) are a major cause of neonatal morbidity and mortality in low-resource settings, yet most are preventable. However, few studies evaluated the effectiveness of multimodal interventions in preventing healthcare-associated BSIs (HA-BSIs) in neonatal intensive care units (NICUs) in low- and middle-income countries (LMICs).
Methods
We conducted an implementation study in a NICU in Northern Ethiopia from January to June 2024, using a pre-and post-intervention design. Multimodal prevention strategies consisted of infection prevention and control (IPC) training, the appointment of an IPC expert, in-house production of alcohol-based hand rub (ABHR), HA-BSI surveillance, and online IPC meetings. Follow-up interventions were implemented based on feedback from these meetings. Logistic regression analysis was used to assess the associations between variables.
Results
Among 151 clinically suspected HA-BSI episodes, 58.3 % were culture-positive. The baseline rate of HA-BSI was 333 episodes per 1000 hospital admissions. This rate significantly declined to 74 within two months (p < 0.0001) and 96 episodes per 1000 by the end of the study (p < 0.0001). HA-BSI-associated mortality decreased by 80 % (p < 0.0001). Each additional hospital day increased HA-BSI risk by 10.5 % (odds ratio [OR]: 1.105, 95 % confidence interval [CI]: 1.018–1.200; p < 0.05), while a 100-g increase in birth weight improved the odds of successful antibiotic treatment by 15.2 % (OR: 1.152, 95 % CI: 1.055–1.257; p < 0.01).
Conclusion
Cost-effective, multimodal IPC interventions can significantly reduce HA-BSIs and associated mortality in NICUs in low-resource settings. Further research is needed to evaluate the long-term sustainability of these measures in LMICs.
血液感染（bsi）是低资源环境中新生儿发病和死亡的主要原因，但大多数是可以预防的。然而，很少有研究评估多模式干预措施在中低收入国家新生儿重症监护病房（nicu）预防医疗保健相关脑梗死（ha - bsi）的有效性。方法采用干预前和干预后设计，于2024年1月至6月在埃塞俄比亚北部的一所新生儿重症监护室进行实施研究。多模式预防战略包括感染预防和控制（IPC）培训、任命一名IPC专家、室内生产含酒精的洗手液（ABHR）、HA-BSI监测以及在线IPC会议。根据这些会议的反馈意见实施了后续干预措施。采用Logistic回归分析评估变量之间的相关性。结果151例临床怀疑HA-BSI发作中，58.3%为培养阳性。HA-BSI的基线发生率为每1000例住院患者333例。这一比率在两个月内显著下降到74例（p < 0.0001），在研究结束时每1000人发作96例（p < 0.0001）。ha - bsi相关死亡率降低了80% （p < 0.0001）。每增加一个住院日，HA-BSI风险增加10.5%（优势比[OR]: 1.105, 95%可信区间[CI]: 1.018-1.200; p < 0.05），而出生体重每增加100克，抗生素治疗成功的几率提高15.2% （OR: 1.152, 95% CI: 1.055-1.257; p < 0.01）。结论低成本、多模式IPC干预可显著降低低资源环境下nicu ha - bsi和相关死亡率。需要进一步研究来评估这些措施在中低收入国家的长期可持续性。
{"title":"Impact of infection prevention interventions on neonatal bloodstream infections and mortality in Ethiopia","authors":"Friederike Lemm , Hailemariam Gebrearegay Haileeyesus , Kiros Weldegerima Gezahegn , Simret Niguse Weldebirhan , Shishay Abay Nigusse , Amanuel Hadgu Berhe , Niguse Tsegay Gebre , Kibra Hailu Desta , Eden Kassahun Gebreegziabher , Kaleb Birhanu Bugudom , Meskelu Kidu Weldetensae , Mengistu Hagazi Tequare , Kibrom Gebreselassie Desta , Haileslassie Berhe , Hailemichael Embafrash Berhe , Monika Kasper-Sonnenberg , Mulugeta Naizgi Gebremicael","doi":"10.1016/j.ijheh.2025.114676","DOIUrl":"10.1016/j.ijheh.2025.114676","url":null,"abstract":"<div><h3>Introduction</h3><div>Bloodstream infections (BSIs) are a major cause of neonatal morbidity and mortality in low-resource settings, yet most are preventable. However, few studies evaluated the effectiveness of multimodal interventions in preventing healthcare-associated BSIs (HA-BSIs) in neonatal intensive care units (NICUs) in low- and middle-income countries (LMICs).</div></div><div><h3>Methods</h3><div>We conducted an implementation study in a NICU in Northern Ethiopia from January to June 2024, using a pre-and post-intervention design. Multimodal prevention strategies consisted of infection prevention and control (IPC) training, the appointment of an IPC expert, in-house production of alcohol-based hand rub (ABHR), HA-BSI surveillance, and online IPC meetings. Follow-up interventions were implemented based on feedback from these meetings. Logistic regression analysis was used to assess the associations between variables.</div></div><div><h3>Results</h3><div>Among 151 clinically suspected HA-BSI episodes, 58.3 % were culture-positive. The baseline rate of HA-BSI was 333 episodes per 1000 hospital admissions. This rate significantly declined to 74 within two months (p < 0.0001) and 96 episodes per 1000 by the end of the study (p < 0.0001). HA-BSI-associated mortality decreased by 80 % (p < 0.0001). Each additional hospital day increased HA-BSI risk by 10.5 % (odds ratio [OR]: 1.105, 95 % confidence interval [CI]: 1.018–1.200; p < 0.05), while a 100-g increase in birth weight improved the odds of successful antibiotic treatment by 15.2 % (OR: 1.152, 95 % CI: 1.055–1.257; p < 0.01).</div></div><div><h3>Conclusion</h3><div>Cost-effective, multimodal IPC interventions can significantly reduce HA-BSIs and associated mortality in NICUs in low-resource settings. Further research is needed to evaluate the long-term sustainability of these measures in LMICs.</div></div>","PeriodicalId":13994,"journal":{"name":"International journal of hygiene and environmental health","volume":"270 ","pages":"Article 114676"},"PeriodicalIF":4.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145155095","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 : 2025-09-01DOI: 10.1016/j.ijheh.2025.114590
Jennie Sotelo-Orozco , Antonia M. Calafat , Julianne Cook Botelho , Rebecca J. Schmidt , Irva Hertz-Picciotto , Deborah H. Bennett
{"title":"Corrigendum to “Exposure to endocrine disrupting chemicals including phthalates, phenols, and parabens in infancy: Associations with neurodevelopmental outcomes in the MARBLES study” [IJHEH 261 (2024) 114425]","authors":"Jennie Sotelo-Orozco , Antonia M. Calafat , Julianne Cook Botelho , Rebecca J. Schmidt , Irva Hertz-Picciotto , Deborah H. Bennett","doi":"10.1016/j.ijheh.2025.114590","DOIUrl":"10.1016/j.ijheh.2025.114590","url":null,"abstract":"","PeriodicalId":13994,"journal":{"name":"International journal of hygiene and environmental health","volume":"270 ","pages":"Article 114590"},"PeriodicalIF":4.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145088749","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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