International Journal of Environmental Research and Public Health最新文献

The COVID-19 pandemic created a natural experiment to assess air quality responses to emission reductions, yet evidence from Latin American coastal industrial cities remains scarce. This study examined how meteorological variability modulated the effects of COVID-19 restrictions on air quality in Ilo, a medium-sized coastal industrial city in southern Peru (~67,000 inhabitants). We analyzed daily concentrations of PM₁₀, PM_2.5, NO₂, O₃, and SO₂ across six pandemic phases (January-December 2020) using multiple linear regression, variance decomposition, and Random Forest models. A health impact assessment translated PM_2.5 changes into cardiovascular mortality estimates using Global Burden of Disease 2021 coefficients. Despite reduced anthropogenic activity, PM_2.5 increased by 34% during early reopening (May-June: 16.9 vs. 12.6 µg/m³ baseline), whereas NO₂ decreased consistently (13-19%), SO₂ declined up to 65%, and O₃ more than doubled (+108%) in austral winter. Variance decomposition revealed that O₃ variability was almost entirely meteorology-driven (98%), while PM_2.5 and NO₂ showed balanced contributions from meteorology and restrictions (~50% each). The PM_2.5 increase corresponded to approximately 3 additional cardiovascular deaths per 100,000 population annually. Coastal meteorology can counteract emission reductions, generating counterintuitive air quality responses and underscoring the need for meteorological normalization in policy evaluation.

Women in resource-scarce communities navigate daily scarcity, structural neglect, and gendered violence, leaving profound but often invisible impacts on mental and reproductive health. Women play an active role in the Water-Energy-Food (WEF) space; they provide water, food, and household security daily. This study investigates how chronic deprivation across the WEF nexus shapes experiences of psychological distress, reproductive vulnerability, and social marginalization in South African settings: Lorentzville, a migrant urban informal settlement, and Mqanduli, a peri-urban Eastern Cape community. Using ethnographic methods, including in-depth interviews, focus group discussions, and participatory observation, and an analytical framework combining structural violence and feminist political ecology, we show that insecurity over water, energy, and food constrains reproductive autonomy, amplifies self-reported symptoms of anxiety and depression, and drives coping and adaptation strategies such as informal work, transactional sex, and fragile social support networks. These strategies, while mitigating immediate risks, cannot fully offset systemic harms. By foregrounding women's lived experiences, this study extends the WEF nexus framework to include embodied, emotional, and reproductive dimensions, linking historical legacies of colonial and apartheid neglect to contemporary inequities. The findings offer critical insights for integrated health, social, and resource policy interventions that center on gender, care, and justice within environmental, wellbeing, and livelihood.

Sorghum-based porridges are a key component of breakfast meals in South African school feeding programmes. While these meals support learner nutrition and educational outcomes, their effectiveness depends on learner acceptance and the extent of plate waste. This study assessed acceptance and plate waste of two sorghum-based porridges-Mabele (100% sorghum) and Morvite (pre-cooked sorghum, 75-100% depending on flavour, with possible inclusion of soya, cow's milk, and wheat/gluten)-compared with instant maize meal, Jungle Oats (100% wholegrain oats), within the Tiger Brands Foundation breakfast programme. Patterns of waste and underlying reasons were examined across five provinces. A mixed-methods approach was used in 25 primary schools across Gauteng, KwaZulu-Natal, Limpopo, North West, and Northern Cape. Quantitative data were collected through 10-day food waste diaries completed by Volunteer Food Handlers and analysed using descriptive statistics, ANOVA, and regression models. Qualitative data were obtained from 75 semi-structured staff interviews and 25 learner focus groups, analysed thematically using ATLAS.ti version 22. Overall, food waste was low, with "no food waste" reported in over half of the observations. Acceptance of sorghum-based products varied. Morvite was generally well accepted, whereas Mabele was frequently disliked in some provinces. Key drivers of waste included food dislike, poor preparation, bland flavour, and learner absenteeism, with serving conditions and a lack of utensils as secondary factors. Although waste was modest, variability in acceptance of sorghum-based porridges suggests the need to improve preparation quality, flavour, and serving conditions to enhance programme effectiveness.

Young caregivers, defined as individuals under 25 years of age who provide unpaid care to a family member(s) with illness, disability, or age-related needs, remain significantly underrecognized in Canada despite their valuable contributions to the healthcare system. Limited awareness, fragmented services, and adult-centred caregiving infrastructures leave them vulnerable to social isolation, disrupted education, and poor mental health. Unlike the United Kingdom and Australia, Canada lacks a coordinated national strategy to identify and support young caregivers. This qualitative study examines caregiving organizations across multiple Canadian provinces, exploring current practices, barriers, and future visions for supporting young caregivers. Group interviews were conducted with 18 service providers from caregiving organizations in Alberta, BC and Nova Scotia. Four themes emerged through analysis: (1) The Landscape of Existing Caregiving Organizations, (2) Barriers and Challenges to Supporting Young Caregivers, (3) Navigating a Pandemic, and (4) a Journey and Vision Worth Supporting. Organizations reported a strong interest in expanding support for young caregivers with a vision for cross-sector collaboration and school-based outreach. However, challenges such as inadequate funding and a lack of formal recognition limits their capacity in building youth programs. Findings from the study highlight the need for systemic reform, including early intervention models, sustainable funding, and formal recognition of young caregivers within policy frameworks. Addressing these gaps will not only uplift young caregivers, but also strengthen Canada's broader caregiving and healthcare ecosystem.

Background/Objectives: Whole food, plant-based (WFPB) diets have been associated with reduced cardiovascular risk and enhanced overall health. However, nutrition education in medical training remains limited. This study evaluated an experiential WFPB intervention known as the "Plant Plunge." Methods: A total of 64 medical student participants attended weekly one-hour nutrition seminars on campus led by a local nonprofit, received complimentary WFPB lunches, and were encouraged to eat a WFPB diet for four weeks. Semi-structured interviews explored program perceptions. Pre- and post-intervention assessments measured nutrition knowledge, and a post-program survey assessed attitudes toward the intervention. Results: We analyzed a total of 14 interviews, 25 pre- and post-intervention knowledge assessments, and 49 post-intervention surveys. Qualitative analysis identified seven major themes: (1) improved physical health outcomes; (2) increased awareness of nutrition's role in medicine; (3) concerns about feasibility and accessibility of WFPB diets; (4) personal empowerment and behavioral change; (5) educational value of seminars; (6) social engagement and peer support; and (7) relevance to future clinical practice. Mean scores on the knowledge assessment significantly improved from 73.3% to 87.0% (p = 0.045) following the Plant Plunge. Survey responses revealed that 65% of participants agreed that they increased knowledge of food ingredients, 54% indicated increased likelihood of selecting plant-based options, and 43% agreed that finding WFPB foods was easy, with 16% disagreeing. Conclusions: The Plant Plunge improved medical students' nutrition knowledge, dietary attitudes, and perceived readiness for lifestyle counseling while offering an experiential model of nutrition education. Short, experiential nutrition programs may serve as scalable approaches to strengthen nutrition training and support chronic disease prevention.

COVID-19 exposed longstanding racial and ethnic inequities among underserved populations. This retrospective cohort study examined inequities across stages of the hospitalization continuum-from COVID-19 diagnosis at admission to in-hospital mortality, including mortality patterns among COVID-19 hospitalizations-among Medicaid beneficiaries in Kentucky during 2020-2021. Statewide hospitalizations were analyzed using multivariable regression models, with propensity score matching (PSM) used as a confirmatory approach. Non-Hispanic Black patients were more likely than non-Hispanic White patients to be hospitalized with COVID-19 (adjusted odds ratio [aOR] = 1.41; 95% confidence interval [CI] = 1.26-1.59). Across the full cohort, COVID-19 hospitalizations were associated with substantially higher in-hospital mortality compared with non-COVID-19 hospitalizations (adjusted hazard ratio [aHR] = 2.38; 95% CI = 2.09-2.70). Additionally, hospitalizations among non-Hispanic Black patients had a modestly lower hazard of in-hospital mortality compared with non-Hispanic White patients (aHR = 0.81; 95% CI = 0.70-0.94). However, in analyses restricted to COVID-19 hospitalizations, adjusted estimates showed no Black-White differences in in-hospital mortality, with consistent findings from PSM analyses. These results indicate that racial inequities were more pronounced at hospital admission than during inpatient care, underscoring the importance of prevention, early diagnosis, and timely outpatient care as COVID-19 enters an endemic phase.

Background: This study aimed to determine the prevalence of atopic dermatitis (AD), as well as the determinants that contribute to its development, particularly household and environmental determinants, in young children residing in a rural area in South Africa. There is a lack of scientific evidence regarding the determinants, particularly environmental factors, of AD among children living in rural areas. Therefore, this study aimed to identify the household and environmental determinants influencing atopic dermatitis in young rural children in the Ehlanzeni District Municipality.

Methods: A cross-sectional analytical study was conducted, wherein mothers/caregivers and their children were purposefully recruited as participants. Data collection involved the utilization of an adapted version of the International Study of Asthma and Allergies in Childhood questionnaire (ISAAC), which was then analyzed using Stata MP version 18.

Result: The study included a total of 881 mothers/caregivers, with a majority of the child participants being boys (n = 477, 54.14%). The prevalence rates of historical and current AD were found to be 13.96% and 18.62%, respectively. Natural birth was found to be a protective factor for both history (Adjusted Odds Ratio [AOR]: 0.094; p < 0.001) and current (AOR: 0.261: <0.001) AD. The use of a traditional broom for sweeping the floor, exposure to household environmental tobacco smoking, and residing in a household that has ongoing renovations were associated with both history and current AD.

Conclusions: These findings demonstrate that the prevalence of AD in rural areas is high among children. Consequently, there is a need to provide primary health care services, particularly for skin diseases, which are currently limited in rural areas. Additionally, environmental health services could play a crucial role in the management and control (especially proactive programs such as educational campaigns) of AD and similar conditions in rural areas.

Background: Primary school teachers are experiencing unprecedented occupational stress due to technological demands, varied student needs, and the enduring psychological effects of the COVID-19 pandemic. Although burnout research is extensive globally, evidence regarding Greek primary educators remains scarce, particularly in post-pandemic contexts where Mediterranean cultural values, economic constraints, and centralized governance may yield unique patterns.

Methods: This cross-sectional study examined professional burnout among 102 primary school teachers in Achaia prefecture, Greece, during autumn 2022. The Greek-validated Maslach Burnout Inventory-Educators Survey assessed emotional exhaustion, depersonalization, and personal accomplishment. The psychological impact of COVID-19 was evaluated alongside demographic and occupational factors. Analyses included descriptive statistics, nonparametric tests, correlation analyses, hierarchical clustering, and multiple regression models.

Results: The sample exhibited mixed burnout profiles, with 42.2% indicating low emotional exhaustion (while 35.3% showed high levels) and 67.6% showing minimal depersonalization. Bivariate analysis revealed that the psychological burden of COVID-19 was significantly correlated with depersonalization (r = 0.339, p < 0.001) but not with emotional exhaustion (r = 0.078, ns) or personal achievement. However, multivariate regression controlling for demographic factors revealed a suppression effect: pandemic burden emerged as the strongest predictor of emotional exhaustion (β = 0.52, p < 0.001), while its association with depersonalization became non-significant. Cluster analysis identified four distinct profiles: Emotionally Strained (49.0%), Resilient (32.4%), Detached (15.7%), and At-Risk (2.9%). Gender significantly predicted emotional exhaustion (model R² = 0.136), while rural location and years of service predicted depersonalization (model R² = 0.225).

Conclusions: Greek primary school teachers demonstrated remarkable resilience after the pandemic, maintaining professional effectiveness despite emotional challenges. The suppression effect observed for COVID-19 burden-significantly associated with depersonalization bivariately but with emotional exhaustion multivariately-highlights the importance of examining both direct and demographically mediated stress pathways. The dimensional independence observed, particularly personal achievement's resilience to external stressors, contests unified burnout models and indicates that targeted interventions addressing specific burnout dimensions may be more effective than holistic approaches.

This study analyzed baseline data from a six-month longitudinal cohort to describe the demographic, occupational, and symptom profiles of Japanese working women and to examine associations between menopausal symptoms, workplace openness, and work productivity. A total of 4000 women aged 40-60 years completed the Simplified Menopause Index (SMI), a commonly used measure in Japan to assess menopausal symptoms, and the validated Health and Work Performance Questionnaire (HPQ) to assess self-rated work productivity. Multiple regression analyses were conducted, adjusting for demographic and occupational covariates. Psychological symptoms showed the strongest negative association with work productivity (β = -0.186, p < 0.001), while vasomotor symptoms showed a small positive coefficient (β = 0.054, p = 0.007). Somatic symptoms were not significant (β = -0.033, p = 0.121). Lower perceived workplace openness was associated with lower productivity (β = -0.149, p < 0.001), such that employees who felt uncomfortable or unsure about discussing health concerns reported lower productivity. Higher educational attainment, longer working hours, and longer years of service were also associated with higher productivity. These findings indicate that psychological and physical symptoms are associated with lower work functioning during midlife, while supportive organizational environments appear to be relevant in this context. These cross-sectional findings provide a foundation for future longitudinal analyses and highlight the potential relevance of workplaces that promote open health communication.

Municipally provided water is low-cost, considered safe in most communities, and usually fluoridated to improve oral health. Yet, many Chicago region families report relying on other water sources. We investigated if safety and quality concerns were associated with these decisions; we also investigated whether there were spatial trends related to lead risk associated with water choice preferences. We used self-reported water consumption behavior data from the Coordinated Oral Health Promotion (CO-OP) Study, a longitudinal cohort of young children and their families. Respondents' residences (N = 331) were geolocated at the census tract level. We evaluated associations between parent demographics, estimated lead risk and water preferences. Among those who "Never" gave their children tap water, we investigated demographic characteristics associated with viewing tap water as "Not safe". Sixty-five percent (n = 216) of caregivers report that their child "Never" drinks tap water. Ordinal logistic regression indicates that parents aged <30 years are more likely to respond "Never" relative to "Sometimes" or "Always" (OR = 1.89; CI = 1.04, 3.40). Among those in the "Never" category, we grouped reasons into safety concerns (n = 114), observed quality concerns (n = 48), and preference (n = 40). We found that the decision not to give children municipal water is not aligned with the estimated lead risk. Understanding water consumption choice mechanisms is important for communities seeking safe and quality drinking water.