Investigating the effectiveness of nanotechnologies in environmental health with an emphasis on environmental health journals

Guest Editorial: Global Perspective on Environmental Health

In this issue of Environmental Health Perspectives, Feingold et al. (2010) propose a unique step forward for toxicology: incorporating infectious disease agents and theory into the toxicological paradigm. The fields of infectious disease and toxicology intersect on many different levels. First, they can act concurrently, as when global bands of various tropical diseases widen due to increased atmospheric temperatures. For example, in A Human Health Perspective on Climate Change, the Interagency Working Group on Climate Change and Health (2010) identified health effects from climate change, as well as the health benefits from mitigating climate change. These various health effects range from respiratory and cardiovascular disease, to developmental and neurological disorders, to food- and waterborne illness, and vectorborne and zoonotic disease. It is increasingly clear that climate change—a marquee issue in the field of environmental health—and infectious disease are linked. Second, the two fields can also act antagonistically: For example, the newly renewed appeals for global use of DDT (dichlorodiphenyltrichloroethane) to combat malaria will pit the well-known hazardous effects of DDT against the scourge of malaria. In many countries DDT has been banned for agricultural use; it is considered a Class II or “moderately hazardous” pesticide by the World Health Organization (International Programme on Chemical Safety 2005), and its use is strictly limited by the 2001 Stockholm Convention. However, use of DDT is still permitted for vector control. This balance of risks and benefits is a conundrum for scientists and policy makers, but it reveals the serious issues raised when infectious disease and environmental health interests clash. Third, these two disciplines can act synergistically, as in the interactions between hepatitis B and aflatoxin in hepatic cancer. Both hepatitis B and aflatoxin are independent factors in liver cancer. However, when combined, they act powerfully to raise the risk of hepatic cancer up to 60 times that of unexposed individuals (Groopman et al. 2005). This National Institute of Environmental Health Sciences (NIEHS)-funded research is a primary example of the interaction between environmental health and infectious disease and can serve as a model for future research efforts. Supression of the immune response by polychlorinated biphenyls (PCBs) was first shown in mice and nonhuman primates. Recently, in another example of concurrent interaction, NIEHS-funded studies led by Philippe Grandjean have shown that perinatal and developmental exposure to PCBs adversely impact immune responses to childhood vaccinations (Heilmann et al. 2006, 2010). We have an opportunity at the NIEHS to embrace this new paradigm. As we have shown with our investment in research into the aflatoxin–hepatitis B and PCB–vaccine interactions, the NIEHS has a track record that could promote a wider interest in this field of inquiry. Ideas like these are supported not only at the institute level but also throughout the National Institutes of Health (NIH). Recently, NIH director Francis Collins (2010b) wrote, “NIH can play a major role in ramping up the discovery of novel targets in both pathogen and host and work to facilitate advances in prevention . . . .” Collins (2010a) also wrote, “the best outcomes are generally when you don’t have walls between parts of the organization that prevent people from learning from each other.” A recent presentation at the NIEHS outlined a vision for the institute that included the infectious disease and environmental health intersection within the context of the rapid evolution in the field of environmental health, specifically in epigenetics. As we recognize that our old assumptions about toxicants and how they affect our bodies are being changed by modern science (e.g., exposure effects are not only dose dependent but are also affected by both time and context), the field of environmental health is moving fast and the NIEHS needs to be at the front with innovative, bold ideas so we can participate and lead with the best science possible. The idea of incorporating infectious disease into the toxicological paradigm is exactly the kind of pioneering concept that can take environmental health to the next level. The NIEHS Office of the Director will be working with division leaders to develop an initiative on infectious disease and environmental health—to incorporate infectious disease into the toxicological paradigm. We look forward to the possibilities to strengthen the field of environmental health science.

BackgroundControl of leishmaniasis in the Mediterranean Basin relies on the active contributions from researchers in the fields of animal, human and environmental health. The application of knowledge, perceptions and practices (KPP) questionnaires to health students and professionals in Europe could be fundamental to identify and explore gaps in KPP, highlighting the diversity of conceptions related to this disease between students and professionals active in (One) Health. The objective of this study was to characterize and compare the current knowledge, perceptions and practices regarding leishmaniasis among subgroups of students and health professionals in Portugal through the application of an online questionnaire.MethodsA cross-sectional study targeted the population of health students and professionals in Portugal, including students in medicine, veterinary medicine and environmental health, physicians, veterinarians and environmental health technicians. Potential participants were approached by email via universities and professional societies and organizations and provided with the link to access the online questionnaire. Answers to the self-administered sociodemographic and KPP questionnaire were collected between July and December 2022. Individual KPP scores were calculated by summing grades defined for each question. Logistic regression models were used to search for potential associations, and the results were expressed at estimated crude and adjusted odds ratios with 95% confidence intervals.ResultsIn total, 486 participants were included in this study: 254 students and 232 professionals. Overall, 75% of the participants reported having heard of both human and animal leishmaniasis, and > 80% reported hearing about the disease during their course work (although this was significantly lower among those in the field of environmental health). Around 90% of participants identified the pathogenic agent as a parasite, and an arthropod bite was identified as the main route of transmission by > 95%. Animal leishmaniasis was considered to be diagnosed in Portugal by 87% of participants and human leishmaniasis by only 69%. The main barriers pointed out by professionals to the control of leishmaniasis were: lack of knowledge in the general population, failures in the early diagnosis and treatment of diseased animals, absence/inefficacy of vector control programs and lack of knowledge in human health professionals. Median knowledge and perception scores were higher among professionals in the animal health field and higher in professionals than in students. Median practice scores were not significantly different between groups and subgroups. The multivariate analysis revealed that a longer period of study (for students) and having seen cases of leishmaniasis (for physicians) were associated with above-mentioned median knowledge score.ConclusionsMost health students and professionals are knowledgeable about the cause and transmission route of leishmaniasis. However, recognition of the disease as autochthonous in humans is less common, highlighting the importance of promoting an approach to this infection through a One-Health lens. A national structured plan to control leishmaniasis could overcome some of the barriers pointed out by professionals, namely by implementing systematic phlebotomine surveillance and integrated reporting of animal and human cases of disease.Graphical abstract

Forty years has passed since the first issue of the Scandinavian Journal of Work, Environment & Health. Over these four decades of rapid change in scientific publishing, the Journal has stabilized its position as the top international periodical in Occupational and Environmental Health. Our latest (2014) impact factor is 3.454, with a 5-year impact factor of 4.060. The journal now ranks 21st of 160 journals in the Public, Environmental and Occupational Health category of the Journal Citation Report - and the best among more than a dozen occupational health journals on the list.Authors refer to that are important for their own new research. But what makes an important publication in occupational health research? At the very least, it should be an innovative and high-quality publication. One paper alone is rarely responsible for societal impact, but a good one can further catalyze, support, or enhance our understanding of the elements of good practical solutions and cost-effective interventions. The aim of Scand J Work Environ Health has always been to promote good and impactful research in the field of occupational and environmental health and safety and increase knowledge through scientific publication.Over the years, although the goals of the Journal have remained unchanged, scientific focus, research methods, and academic publishing itself have undergone a monumental change.Looking back, the first paper published in the Journal in 1975 was a review by Anna Maria Seppalainen (1) on the applications of neurophysiological methods in occupational medicine. At that time, neurophysiological methods were recommended for the research and diagnosis of vibration and exposure to, for example, insecticides, carbon monoxide, acrylamide, and lead. The first issues of the Journal were rich in exposure assessment methodology and toxicology. Likewise, there were many papers related to occupational medicine. In the third issue from the same year, however, a paper did emerge on sleep length and adaption to shift work among Swedish railroad workers (2), varying the content. A study of the distribution of the research topics of 85 (ie, papers with >100 citations) from 1950 to 1997 in five major occupational medicine journals (including Scand J Work Environ Health) revealed some interesting findings. While a few citations classics dealing with toxicology were published during each decade, classics concerning solvents appeared only during the 1970s and 1980s, and those dealing with work-related musculoskeletal disorders emerged in the 1980s and increased significantly in the decades thereafter (3).During the last ten years, the most popular topics in the Journal have been occupational epidemiology, musculoskeletal disorders, and psychosocial factors. These papers also performed better than average with respect to citations (especially psychosocial factors), while papers on, eg, toxicology and respiratory disorders have appeared less frequently and have also been less frequently cited (4). During the last two years (see the top-cited articles www.sjweh.fi/list_top_cited.php) , many well-cited papers have investigated key issues relating to present working life, factors predicting return-to-work (5, 6), decreased sickness absence (7, 8), longer work careers (9, 10), and higher productivity (7, 11) at work. The solutions studied were often practical interventions related to work modifications and working hours, but also changes in individual, social or lifestyle factors. The evolution of the Journal's contents seems to reflect the current trends in general occupational safety and health (OSH) research policies (see eg, http://www.perosh.eu/research-priorities/). The Journal has come a long way in updating its expertise and focus areas but is still open to all relevant topics in the area of occupational and environmental health. Also toxicology, which the Journal initially targeted, is still an issue in today's working life. …

Background: Even in the field of climate change and environmental health there is a need to for robust, systematic and transparent methods of research synthesis to define policy and support decision makers. Environmental and research agencies have started to translate methods from evidence-based medicine into environmental health. In the field of exposure to heatwaves, public health interventions have been implemented in several countries with a poor or lacking evidence-base. This systematic review is focused on public health interventions aimed to reduce, in the short or in the long-term, the adverse effects of high temperatures and heatwaves. Methods: We searched Pubmed, Embase and other bibliographic databases to identify relevant studies (inception-July 2015) using a detailed search strategies. Inclusion criteria were: RCT and observational studies with a control group and quantitative effect measures. Two reviewers extracted data independently and assessed risk of bias using a modified version of the Cochrane risk of bias tool. Results: We identified 6323 records of which 8 studies met all inclusion criteria. Included studies had a very high risk of selection bias, contamination and heterogeneity in study design prohibited a meta-analysis. They showed weak evidence on effectiveness for educational and home interventions (2 RCT); limited evidence on cooling measures (2 cohort studies), and urban interventions (4 CBA). Conclusions: Evidence on the effectiveness of interventions in the field of heat prevention is limited and not conclusive due to the exposure characteristics and the risk of bias associated to nonrandomized studies. Despite the uptake of systematic methods is promising in the field of environmental health, the process for the synthesis of evidence needs improvements and discussion.

This chapter provides a context for the practice of environmental health law. Public health law practitioners in the field of environmental health are faced with a complex legal landscape. Environmental health law spans portions of both the field of environmental protection and public health law. Public health laws traditionally have provided noncoercive authorities to state, local, and federal agencies and are useful in building an evidence base for change and fostering partnerships for cooperative ventures. In contrast, environmental protection laws are media-based and provide strong coercive authorities to federal and state agencies pursuing environmental health improvement. Attorneys pursuing environmental health improvement efforts have at their disposal a broad and extensive set of legal tools that, when deployed appropriately, are adaptable to address most of today's environmental health problems.

Food and population growth.

The article presents the main results of scientific investigations of the Northwest Public Health Research Center, obtained in 2000-2016 during the implementation of the international projects in the field of environmental health in the Arctic, local food-and-water security and diseases associated with food and water transmission routes, ecotoxicology of persistent toxic substances (PTS), evaluation of exposure of various Arctic populations (including the indigenous people) to PTS, assessment of PTS effects on the body and health risks for the population.

Aquaculture Effluent: Impacts and Remedies for Protecting the Environment and Human Health

Advancing Knowledge on the Environment and Its Impact on Health, and Meeting the Challenges of Global Environmental Change

Summit Discusses Public Health Implications of Fracking

On 25 June 2013 the Environmental Health Review (EHR) Award was presented to Dr. Eilish Cleary of the New Brunswick Office of the Chief Medical Officer of Health (N.B. OCMOH) at the Canadian Institute of Public Health Inspectors (CIPHI) 79th Annual National Educational Conference in Winnipeg. Chief Medical Officer of Health Dr. Cleary was recognized for her leadership in presenting the potential health effects associated with shale gas development. The EHR Award is a national award presented annually by CIPHI, to individuals or agencies for their outstanding contributions to the field of environmental health and (or) to the Institute. Awards are presented to individuals and agencies that have been deemed to have made a significant contribution to the professional association, the field of environmental health, and (or) the betterment of public health. The EHR Award is issued to a member, nonmember, individual, or organization for excellence in presenting an environmental health issue or topic to the public. Selection criteria for the award include: (i) leadership in effective utilization of communication to bring an issue of environmental health or public health significance to public attention and consideration; (ii) published works dealing with an issue of environmental health or public health significance; and (iii) innovative use of communication tools to enhance the association or the field of environmental health. The N.B. OCMOH, under the leadership of Dr. Cleary, was recognized for its contribution to the field of public health for the research, development, and communication of the shale gas report titled ‘‘Chief Medical Officer of Health’s Recommendations Concerning Shale Gas Development in New Brunswick’’. The report may be found at http://www2.gnb.ca/content/gnb/ en/departments/ocmoh.html. Dr. Cleary’s report has provided New Brunswickers with an enhanced understanding of the potential health and environmental impacts related to the shale gas industry. The report includes recommendations on how to protect the health of New Brunswickers and thereby has empowered citizens to engage in discussions and ask questions related to the protection of their own health. The comprehensiveness of its recommendations from a health perspective makes it the only report of its kind in Canada. The N.B. OCMOH has worked diligently over the last few years to devise sound public health advice and recommendations for the Government of N.B. (GNB), and ultimately the

Background: As the subject of environmental health knowledge trains specialized and dedicated human resources and offers the quality and quantity of human resources needed for environmental health, future research and foresight are particularly crucial. This study examines research and educational facilities in the field of environmental health in terms of the presence of expert human resources and the development of facilities. This study addressed educational and research centers in the field of environmental health in terms of its development and the presence of expert human resources. Methods: This descriptive cross-sectional research was conducted in 2018-2019. First, a description of the ten areas of higher education has been presented and information related to indicators such as the presence of health faculty, the number of professors and research centers has been presented in the form of tables and figures. The data were analyzed using SPSS 22 software. Results: The findings indicated that there are regional differences in the proportion of faculty members to the total population. This ratio was lower in regions 5 and 10, but was significantly higher in region 8 compared to the national average (4.5 persons per million people). Also, the eastern provinces had a high number of environmental health student training centers. There were differences in the number of environmental health research facilities across different regions, and some provinces had none at all. The highest number of people working with environmental health degrees was found in region 5, while the lowest number was found in region 7. Conclusion: The findings showed that the development of education should be based on related factors, including population, and the environmental health facilities and priorities of each of the regions should be the basis of educational-research center development, student admission, and attracting faculty members and expert staff in order to be more productive in the field of environmental health engineering.

Analytical quantitative studies focusing on health-related behaviours as the final outcomes are scarce, especially in the field of Environmental Health. They have mostly focused on behaviours as risk factors for disease and have rarely dealt with determinants of such behaviours. This study examines the relationship between socio-economic, psycho-social, demographic, and environmental factors and Environmental Health practices at the household level. It further explores, qualitatively, lay perceptions of such practices and illnesses associated with them. An analytical cross-sectional study, complemented by a qualitative study, was the approach chosen for this purpose. Fieldwork took place in Manhiqa, a rural district in Southern Mozambique, from October 2002 to November 2003. The cross-sectional study comprised the following data collection methods: a socio-economic and demographic questionnaire, spot-check observations, and a questionnaire on women's autonomy covering 405 households, and structured observations covering 102 households. The qualitative study comprised 12 focus group discussions (involving 134 people in total) namely with mothers, grandmothers and fathers of children under 5, and 25 semi-structured interviews with caretakers of children under 5. Using factor analysis, three dimensions of wealth (characterising households) and five autonomy constructs (characterising caretakers of children under-5) served as the main predicting factors that the study sought to explore in relation to Household Environmental Health (HHEH) practices. Other predicting factors of interest were type and domain of water source, child's age, and caretaker's age. Prevalence of latrine ownership was high (95%), and so was soap availability (86%). Sixty-two percent of households had access to water from taps (either private or public). However, hand-washing with soap was observed on 6% of occasions after potential faecal contact, and children's stools were disposed of in the latrine on 6% of occasions after open defecation events. In terms of access to hygiene and sanitation hardware, only caretaker's education predicted latrine ownership, and access to soap was associated with caretaker's education, caretaker's exposure to information and socio-economic status of the head of household. With regards to hygiene and sanitation practices, there was no strong evidence for the influence of any of the predicted factors on hand-washing. Socio-economic status of the head of household and type of water source were the only variables significantly associated with safe disposal of stools. Infants under 1 and children between 2 and 5 years of age were the most likely to contaminate the household environment with faeces. Regarding mosquito deterrence practices, it was found that the likelihood that children under 5 were protected by any deterrence method increased with increased caretaker's education and with caretakers decreased proximity to maiden family. Use of traditional fumigation in the child's bedroom was associated with decreased accumulation of modern assets, increased accumulation of traditional assets, and increased caretaker's age. Protecting children under 5 with commercially available products other than bednets was associated with caretaker's education and her financial independence. Bednet use by children was predicted by increased head of household socio-economic status, accumulation of modern assets, and decreased proximity of caretaker to her maiden family. It was also found that certain hygiene and sanitation practices are highly clustered and that there are greater psychosocial connotations carried by sanitation practices than by mosquito deterrence practices. The qualitative study revealed that, from the study participants' perspective, HHEH practices, in particular latrine possession status were associated with the following factors: authority, social commitment, value for self, self-reliance, self-organisation, and completeness. Good fortune was particularly related to bednet possession. Lack of initiative and modernism were personal attributes viewed to be associated with both not having bednets and not having latrines. Through its detailed examination of the associations between individual and household characteristics and behaviour outcomes this study makes an original contribution to our understandiing of how risk and protective practices are produced at household level. This is of interest to those who seek to understand human behaviour from an academic perspective and to those who seek to influence it in order to improve health outcomes. For example, the study adds a contribution to HHEH behaviour change initiatives, especially those that require criteria in order to carry out selective targeting of households according to their social, economic, demographic, or environmental characteristics.

The push for virtual education modes continues to grow and develop following unprecedented acceleration during the COVID-19 pandemic. Environmental and occupational health education echoes that demand, where programs are seeing the focus expand from lab-based bench work to include greater practice emphasis in areas such as environmental health equity, environmental justice, environmental policy, and environmental health literacy. Part of the educational foundation for Environmental and Occupational Health MPH programs includes a practicum designed to provide students with “real-world” experience beyond classroom applications. Given the expected increased demand for virtual educational models from students and virtual employees from the professional sector, higher education programs that require practicum experiences must seek innovative approaches that meet both student and employer needs. The University of Pittsburgh’s Department of Environmental and Occupational Health is a practicum host site for local universities. Recently, faculty have sought to co-create virtual environmental health practicums in response to requests for these types of opportunities. This article expands upon work on “virtual” or “remote” practicum placements and builds upon best practices to contribute to continuing research in this area. The article also shares insight into creating additional virtual opportunities in the environmental health field. This work presents a case study of the development of a virtual student practicum, documents the processes and procedures followed to develop work grounded in best practices, and shares lessons learned and recommendations for developing future virtual practicums for public health students. The student and practicum host provide reflections on the practicum design and experience.