Environmental Health Research Articles

Occupational Hazards: The Impact of Streptococcus suis Infections in Portuguese Pig Farming

Abstract Background In Portugal, the commensal and opportunistic bacteria Streptococcus suis is prevalent among pigs. Recognizing its public health significance, this systematic review investigates the relationship between occupational exposure in pig farming and the incidence of S. suis infections among workers. The importance of this study is to identify high-risk occupational activities and formulate effective public health interventions. Methods This review analyzed 20 scientific studies from 1986 to 2023 on human infections with S. suis in Portugal. The primary sources included articles in Portuguese from databases like MedLine, Scopus, and Pubmed. Studies were selected based on their focus on occupational exposure and the details provided on epidemiological context, clinical presentations, and outcomes. Results The review found that 85% of infection cases occurred in occupational settings, particularly among butchers (53%) and pig breeders or handlers (29%). Clinical manifestations predominantly included acute bacterial meningitis, with significant occurrences of neurosensory hearing loss as a sequelae. The average age of affected individuals was 44, predominantly male. Conclusions The study confirms a significant correlation between occupational exposure in pig farming and S. suis infections in humans. The findings underscore the need for stringent occupational health measures and integrated approaches encompassing human, animal, and environmental health under the One Health initiative. Innovations in public health interventions recommended include enhanced surveillance, improved workplace hygiene, and targeted health education for at-risk populations. Key messages • Occupational exposure in pig farming is a significant risk factor for S. suis infections in humans. • Integrative One Health approaches are essential for preventing S. suis infections in occupational settings.

Greenwashing by the fossil fuel industry: impediments to SDGs

Abstract The fossil fuel industry, a major commercial determinant of public and environmental health, constitutes a central challenge to the achievement of the SDGs. Motivated by profit, the industry has contributed to establishing the current global reliance on fossil fuel as the primary energy source and essential raw material in global production. Major oil companies have purposefully hindered the research and transition towards renewable energy. This was achieved through an intricate web of interference and mechanisms that fall under the corporate playbook, such as political interference through lobbying to stagnate carbon emission reduction, influences on carbon pricing policies, and hinderances to environmental protection legislation. These practices known as ‘greenwashing’ have resulted in misinformation, interfered with climate action in an aim to increase demand for their products, to decrease the pressure from society on the industry, and portray a green image to consumers. Using the commercial determinants of health framework and focusing on the Middle East, this presentation will illustrate how fossil fuel companies falsely advertise their products as environmentally friendly, resulting in environmental degradation, and impede the achievement of most SDGs, especially SDG 3 (good health and wellbeing), SDG 7 (affordable and clean energy), and SDG 13 (climate action).

Unveiling mercury exposure sources in e-waste recycling with biomonitoring - A Portuguese case study

Abstract Background Mercury (Hg), a global pollutant, poses risks to both human and environmental health. The management and recycling of electrical and electronic waste (e-waste) is recognized as having the potential to promote workers’ exposure to this pollutant. Human biomonitoring (HBM) is a tool that can be used to evaluate exposure and monitor the health of workers. The objective of this study was to characterize exposure of workers from an e-waste recycling company and to analyze the relevance that HBM holds in the detailed characterization of exposure. Methods A cross-sectional observational study was conducted using data collected within the framework of the European Human Biomonitoring Initiative (HBM4EU). Data from environmental monitoring (settled dust) and biological monitoring (urine and hair) of 30 workers potentially exposed to Hg were analyzed in comparison with 12 unexposed workers from other occupational settings (controls). Results Exposed workers did not exhibit significantly higher concentrations of Hg in urine when compared to control workers. We found a significantly positive correlation between the concentration of Hg in urine (ρ = 0.688; p ≤ 0.001) and hair (ρ = 0.470; p ≤ 0.01) and the consumption of fish and shellfish. Conclusions Diet appears to be the most significant source of Hg in this context. These results suggest the importance of information and dietary habits to prevent mercury exposure. HBM stands out as an essential tool for identifying the most relevant exposure sources and risk management measures for workers and the general population. Key messages • Diet appears to be the most significant Hg source in workers from a Portuguese e-waste company. • HBM stands out as essential for identifying the most relevant exposure sources and risk management.

SustentAÇÃO: E-learning training on food sustainability for teachers in the Lisbon Metropolitan Area

Abstract Background It is essential to address food sustainability (FS) within the school community to enhance both public and environmental health. In Portugal, in the scope of AML Alimenta, teachers’ training on FS was identified as a priority. Therefore, local partners along with academia developed, implemented, monitored, and evaluated the SustentAÇÃO. Objectives SustentAÇÃO aimed to empower school teachers in the Lisbon Metropolitan Area to teach students between 6 and 14 years old on FS. The program consisted of 10 hours of asynchronous online learning (MoodleTM), structured in 4 modules, and 10 hours of autonomous learning (5 students’ educational sessions), offering autonomy and flexible time management. The contents were adapted for different age groups. The teacher’s performance was monitored and evaluated continuously. A process evaluation was conducted for both teachers and students. Results Of the 79 teachers enrolled, 47% completed the program. Teachers’ performance (0-20) on the 4 evaluation questionnaires was on average 17,9±3,13. Most teachers found the program benefited their work (94%) and considered it essential for enhancing student’s knowledge (98%). Considering overall satisfaction, 85% of teachers were satisfied or very satisfied with the training and 91% would recommend it to their colleagues. Additionally, 86% of students enjoyed the activities delivered, 76% considered that they were wasting less food, and 78% believed they had improved their ability to make healthier and more sustainable food choices. Conclusions Through a collaborative work between local partners and academia, an innovative e-learning training programme on FS was developed, implemented, monitored, and evaluated, responding to the local needs identified. SustentAÇÃO complies with national education guidelines and contributes to the sustainable development goals agenda. Key messages • SustentAÇÃO E-learning training highlights the importance of collaborative work, based on an initial assessment to target local needs. • SustentAÇÃO E-learning training improve teachers’ knowledge on FS and benefit their students.

One Health Perspectives on Food System Transformation: Insights from the InsectERA Agenda

Abstract Background One Health framework recognises the interconnectedness of human, animal, plant and environmental health. With this understanding, it becomes imperative to address challenges such as those posed by food systems through a One Health lens. Food systems pose significant public health challenges, particularly in terms of food safety and security. Pressures from factors such as population growth, changing consumption patterns and intensified production systems, particularly animal-based protein production, contribute to environmental pressures. In addition, environmental changes, including climate change, further threaten food safety and access to healthy food. Methods Through the InsectERA agenda, funded as part of the Recovery and Resilience Plan, stakeholders collaborated across sectors to explore the potential of insects as bioindustrial tools to address food system challenges. A structured, integrated approach combining health and sustainability considerations was matured and applied to pilot food products developed through this initiative. Recognising the potential health and sustainability impacts of these products, a comprehensive assessment was carried out. Results This study defined a structured, integrated approach to assessing the health and sustainability impacts of foods developed under the InsectERA agenda. Key steps included i) identifying critical issues and questions, ii) prioritising considerations, iii) defining methodologies, iv) collecting and analysing data, and v) integrating results for communication. Conclusions The study highlights the importance of integrated approaches in addressing food system transitions. Integrated approaches, guided by the One Health framework, play a critical role in informing policy decisions by providing policy makers with robust evidence. There is an urgent need for food system transformation based on decisions that holistically consider health and sustainability impacts, to ensure the protection of Public Health. Key messages • Integrating health and sustainability into the transition of food systems, within the One Health framework, is crucial for identifying options that safeguard Public Health. • A structured, integrated approach within a multi-stakeholder environment offers robust insights for policy decisions, advancing sustainable food systems.

Temporal Analysis of Sanitation and Water Development Indicators in Tunisia: 2012-2023

Abstract Background Access to sanitation and water resources is a cornerstone of the ‘One Health’ approach, which encompasses the holistic integration of human, animal and environmental health considerations. We aimed to elucidate the temporal trajectory of sanitation and water resource development in Tunisia across successive years. Methods Data from the Multiple Indicator Cluster Survey in Tunisia, a UNICEF-conducted repeated cross-sectional survey, was used to compare trends in access to improved water sources, utilization of improved sanitation facilities, and handwashing practices across 2012, 2018, and 2023. Results In 2023, we observed that 20.9% of households did not have access to drinking water on site, compared with 12.7% in 2018 (p = 0.15). The availability of drinking water in sufficient quantity was 69.8% in 2023 and 80.6% in 2018 (p = 0.37). In 2023, 78.1% of the population had access to an improved water source, compared with 86.3% in 2018 and 95.7% in 2012 (p = 0.4), 80% in urban areas and 73% in rural areas (p = 0.57). In 2023, 12.5% of the population consumed water from sources contaminated with Escherichia coli, compared with 20.5% in 2018 (p = 0.16). Disparities in Escherichia coli detection were observed between rural (21%) and urban (8.3%) areas (p = 0.01). In 2023, 92.1% of households had access to handwashing facilities equipped with soap and water, compared with 89.9% in 2018 and 91.5% in 2012 (p = 0.98). The breakdown between urban and rural areas was 95.1% and 86.4% respectively (p = 0.51). Conclusions Access to improved water sources, sanitation, and handwashing practices remains high over time, but regional disparities persist. Improved water quality directly reduces the transmission of waterborne pathogens, emphasizing the need to address regional disparities and socio-economic inequalities to promote public health nationwide. Key messages • Challenges persist in tunisia regarding sanitation and access to water. • Regional disparities threaten public health.

Scanning the horizon- environmental health indicator surveillance

Abstract Aim This work aimed to conduct a comprehensive literature review with narrative synthesis of evidence in relation to the surveillance of environmental health indicators by Public Health agencies internationally. This will strengthen the All-Hazards approach to Health Protection in Ireland. Methods The project proposal was registered on PROSPERO. Preferred Reporting Systems for Systematic Review and Meta-Analysis (PRISMA) guidelines were followed. A systematic search was conducted across five databases. In addition, relevant websites, reference lists and the grey literature were searched. Data were extracted following TIDieR-PHP guidelines. Risk of bias was considered and quality appraisal was performed using SANRA and AGREE-HS tools. A narrative synthesis of the evidence was completed. Results 12 papers were included in the final review. Four were narrative review articles describing European and worldwide initiatives and the remaining eight described a single health system. Only three papers were deemed high quality. The number of indicators monitored varied widely from one in Italy to over 400 in the USA. The most established programmes described the use of a framework such as Drivers-Pressures-States-Exposures-Effects-Actions (DPSEEA) and indicator selection criteria were applied. The papers described a variety of public health actions arising from the surveillance of environmental health indicators. The knowledge provided by this review can inform the implementation process. Establishment of a project team, and beginning with monitoring one domain is suggested. Air quality is the most frequently monitored domain internationally. The DPSEEA framework is recommended, and Briggs’ indicator selection criteria should be applied to any indicator under consideration. The system should measure both hazard and outcome measures. Finally, meaningful public health action should result from the monitoring. Key messages • Environmental health indicator surveillance is essential to all-hazards health protection. • Few public health agencies internationally are systematically monitoring environmental health outcomes.

4.F. Scientific session: Progress in assessing climate change risks to health and implementation in UK and Europe

Abstract Climate change poses one of the greatest threats to health security. Climate change is increasing the frequency and intensity of environmental health threats like flooding and heatwaves and is creating conditions which heighten the risks from infectious diseases. Whilst everyone will be at some risk from adverse health impacts from climate change, the impacts will vary at individual level and the most disadvantaged both here in the UK and around the world will be disproportionately affected. Many of the anticipated adverse health impacts of climate change in the UK are still avoidable through mitigation and adaptation and that there are other benefits to health to be gained, therefore rapid action is critical to avoid the most severe potential scenarios. The Health Protection Research Unit in Environmental Change and Health, funded by the National Institute of Health Research, provides multi-disciplinary research to support decision-making relating to the impacts and responses to environmental changes that affect human health and well-being in the UK and beyond. In this workshop we present the results of recent research on the progress in assessing climate change risk factors on health in the UK and review the evidence on implementation of mitigation and adaptation measures in Europe. The workshop aims to support evidence translation for climate action that prioritises health protection and equity. The workshop will include presentations on reviewing risk assessment methods for quantifying health impacts across Europe as well as analysing the effects of fuel poverty on cold-related mortality. We present results from an analysis of primary care data to identify individual level characteristics associated with increased risk of mortality during heatwaves. Furthermore, we review national food-based dietary guidelines across Europe and South America to determine how environmental sustainability is being integrated to benefit health. The workshop will comprise 4 -5 oral presentations and we will then open the floor to have a wider facilitated discussion about what are the evidence needs for UK and European policy to further address climate risks to health. Key messages • The progress in assessment and understanding of risks from climate change on health is improving. • The health risks we face from climate change will not be distributed equally across the UK and Europe.

A Multidisciplinary One Health Approach to Addressing Unsanitary Conditions: The Case of Cascais

Abstract Unsanitary conditions in domiciles often stem from complex social and health-related issues, involving the elderly and/or individuals with mental health problems. These situations typically lead to a decreased quality of life for those involved, directly and indirectly, and may pose a risk to public health depending on their magnitude. In Cascais municipality, identified cases of unsanitary conditions undergo a multidisciplinary analysis. It has been established a Local Technical Group for Domiciliary Unsanitary Situations, comprising various institutions such as local authorities, law enforcement agencies, civil protection, health and social security ministries, and the animal rescue center. This group operates under a One Health approach, encompassing human health, environmental health, and animal health. Interventions are determined by the working group, with the aim of promoting health and enhancing citizens’ quality of life. Cases of unsanitary conditions reported are subsequently discussed within the technical group, which has regular meetings, and may organize joint assessment visits and appropriate actions. This social and environmental initiative responds to the growing need to address unsanitary and cluttered living conditions, which significantly impact individuals’ physical, emotional, and social well-being. The objective is to restore housing conditions in homes by removing waste and unnecessary items, contributing to general individual well-being. While international studies suggest a correlation between unsanitary conditions and hoarding disorder, it’s crucial to differentiate between distinct and independent situations caused by various physical, psychological, and cognitive processes. The establishment of a Local Technical Group for Domiciliary Unsanitary Situations exemplifies a proactive approach to addressing complex health and social challenges, emphasizing collaboration, and holistic intervention strategies, always with a One Health approach. Key messages • Addressing unsanitary conditions is crucial for safeguarding public health, impacting physical, emotional, and social well-being. • The establishment of a Local Technical Group for Domiciliary Unsanitary Situations, under a One Health framework, reflects a collaborative approach to addressing complex health and social challenges.

Preparedness and Public Health: an Italian Local Health Authority plan for a mass gathering in 2023

Abstract Issue Mass gatherings represent an important Public Health challenge. The increased number of people present in a specific area puts local health systems under stress (i.e.workload of emergency services, environmental health and food safety) and at the same time it rises the risks of a potential mass casualty incident. Effective planning and disaster preparedness have to be achieved through collaboration among local health authorities(LHA) and other stakeholders (event planners, law enforcement, local transportation services). Problem Every year, for 3 days, the Italian Alpine troops gather in a different city to remember First World War fallen. During those days, the city centre transit is not allowed to car (in specific areas even to emergency vehicles).In May 2023 this event occurred in Udine, a city in the North East of Italy with almost 100.000 inhabitants. For that year at least 300.000 participants were expected. LHA had to reorganize preparing itself to manage a temporary quadrupled catchment area. Results In the previous months, local authorities met local health representatives and other stakeholders in order to define a single emergency response plan. For healthcare services it was decided to: institute first aid points within the city; reorganise patients’ emergency transport system; increase hospitals’ treatment capacity (beds, life support equipment); increase healthcare professional availability; empower drugstores (opening times, drugs procurement); strengthen human and animal health surveillances;activate alternative communication systems. During the event, LHA updated other authorities involved three times a day about hospital and emergency system situation. At the end of the event,a multiprofessional debriefing meeting was held and no critical situations were reported. Lessons Preparedness requires a great commitment in terms of resources and time, but it is confirmed to be essential to guarantee adequate assistance even in extraordinary conditions. Key messages • Mass gathering s events put under stress all the main areas of public health system. • Public health preparedness cannot be effective without a strong involvement of other public and private stakeholders.

Noise inequalities and cardiovascular diseases in Bulgaria

Abstract Background Social determinants of health in the physical environment are among the social determinants that greatly impact population health. At very high levels, noise can cause permanent changes in a person’s psyche but, even at lower levels, it can cause stress and disorders. Global burden of diseases studies arrange noise on the second position among the environmental risk factors, related to sleep disturbance, cardiovascular effects etc. The study aims to analyse noise pollution in Bulgaria and measure its association with cardiovascular diseases. Methods National Statistical Institute and Eurostat data were used to analyse the noise pollution in Bulgaria. The 28 regions were compared according to the proportion of surveyed points above permissible limits and the death rates due to CVD, /2022/. Data were statistically processed with SPSS v.26. To establish the correlation, the Pearson coefficient was used. Results Data provided by Eurostat reveal that 9% of the total population suffers from noise but there is a very positive trend - from 17.7% /in 2005/ to 8.7% /in 2023/. The share of surveyed points above permissible limits shows a continuing trend of maintaining a high percentage - 71.80% /2011/ and 68.62%/2022/. The district comparison shows significant variations - Blagoevgrad -17.65% and Silistra, Kyustendil and Razgrad with shares above 80%. The study found that almost all districts with the highest share of surveyed points above permissible limits have higher levels of death rate due to CVD. The results of statistical data analysis show that there is a positive moderate linear correlation between the share of surveyed points above permissible limits and the death rate due to CVD - Pearson coefficient 0.423 (p = 0.025). Conclusions The study found a moderate correlation between noise pollution and the death rate due to cardiovascular disease. CVD have a multifactorial genesis, but reducing noise in urban areas would help prevent these diseases. Key messages • As a result of the performed analysis, it can be concluded that the investigated indicators determining the degree of discomfort during the daily period remained high in Bulgaria. • The established health inequalities between regions and the increasing mortality from CVD are one of the factors for the deteriorating level of public health in Bulgaria.

Does air pollution impact myocardial infarction incidence even in a city with fair air quality? Results from the EPIC-MI (Environmental Pollution and IncidenCe of Myocardial Infarction) Study

Abstract Background In light of recent research highlighting the potential association between air pollution and cardiovascular diseases, there remains a gap in data, particularly in cities characterized by relatively low pollution levels. The EPIC-MI Study endeavors to explore whether, even in a city boasting fair air quality such as our city, there exists a discernible impact of air pollution on the risk of cardiovascular events within an urban setting. Methods We analyzed all consecutive acute myocardial infarction (MI) patients admitted to our city heart center from March 2013 to December 2022. Air pollution data were meticulously gathered from 5 strategically positioned monitoring stations. Utilizing Poisson regression, the associations between these pollutants and the incidence of MI was analyzed. We also investigated the impact of pollution exceedance days and COVID-19 lockdown periods on MI incidence. Results Over nearly a decade, 18.798 MI cases were analyzed. The Poisson regression model revealed a significant independent association between the monthly average MI incidence and pollutant concentrations within the same month. Statistically significant independent effects were observed for CO (p<0.01), O₃ (p=0.03), SO₂ (p<0.01), and relative humidity (p<0.01) on MI incidence (Figure 1). Exceedance days were associated with a significant upswing in daily MI incidence. The MI incidence increased by 3.3% when PM10 exceeded 25 µg/m³ on the same day (5.19 ± 2.49 vs. 5.36 ± 2.50, p=0.03) and remained elevated over three days (5.19 ± 1.42 vs. 5.34 ± 1.46, p<0.01). For PM2.5, there was a 4.2% increase when exceeding 20 µg/m³ on the same day (5.20 ± 2.49 vs. 5.42 ± 2.52, p=0.02) and still elevated over three days (5.20 ± 1.42 vs. 5.40 ± 1.47, p<0.01). During the COVID-19 lockdown periods, a significant decrease was observed in air pollutant levels compared to non-lockdown years within the same timeframe (Figure 2). PM2.5 (9.89 µg/m³ vs. 12.76 µg/m³, p=0.02), PM10 (15.26 µg/m³ vs. 18.7 µg/m³, p<0.01), SO2 (1.16 µg/m³ vs. 1.77 µg/m³, p<0.01), and NO2 (14.42 µg/m³ vs. 19.53 µg/m³, p<0.01) exhibited significant reductions. Concurrently, a 22.5% reduction in daily MI incidence was observed compared to non-lockdown years within the same timeframe (4.16 vs. 5.37, p<0.01). Conclusion The study demonstrates an enduring influence of air pollutants on cardiovascular events, even in a city with fair air quality, such as our city. Elevated concentrations of air pollutants, especially on days with excessive levels, were significantly associated with an increased incidence of MI. The reduction in MI cases observed during the COVID-19 lockdown period underscores the potential cardiovascular benefits associated with improved air quality. These findings emphasize the importance of sustained efforts to mitigate air pollution for the enhancement of cardiovascular health in urban environments.

Thermal indices for evaluating the impact of thermal conditions on human health: a systematic review

Abstract Background Thermal indices assess individuals’ perception of their ambient thermal surroundings (thermal comfort and heat/cold stress) considering several meteorological factors, such as temperature, humidity, wind, and radiation. As climate change progresses, there is an increased demand for accurately monitoring the association between thermal environment and human health. This study summarizes the available evidence on the association between thermal indices and health outcomes. Methods We conducted a systematic search in PubMed, Scopus, and Web of Science until December 31st, 2023, to identify all relevant studies examining the association between thermal indices and health outcomes in outdoor environments. Results A total of 5,034 electronic records were screened. Of these, 310 were considered eligible, examining 1,143 associations. Seventeen indices were identified, with 32 (10.3%) articles using more than one index. The most commonly employed index was Apparent Temperature (articles: n = 141, 38.2%; associations: n = 634, 55.5%). The specific-cause health outcomes examined spanned 18 categories of the International Classification of Diseases. Most associations (n = 304, 26.6%) pertained to mortality/morbidity related to diseases of the circulatory system, followed by all-cause morbidity/mortality (n = 288, 25.2%). The 48.6% (n = 556) of the associations suggested an increased risk of adverse health outcomes when indices increased while 32.5% (n = 372) of the associations were non-significant. The 14.2% (n = 162) of the associations suggested an increased risk of adverse outcomes when indices decreased while 16% (n = 183) of the associations were non-significant. Conclusions The relevant literature revealed associations between thermal indices and health outcomes. Therefore, thermal indices, considering several meteorological variables, could be a useful tool for public health planning. However, there is diversity in their methodologies and reporting. Key messages • Summarizing the published evidence regarding thermal indices is expected to attract the interest of public health professionals and policy makers, and enhance their use. • Implementing integrated methods to monitor the association between thermal conditions and health, including using thermal indices, could be valuable for developing and evaluating policies.

The Presence of Heavy Metals in Drinking Water and Its Possible Impact on the Development of Type 1 Diabetes in Children

This study aimed to determine the relationship between the concentration of heavy metals in drinking water and the number of type 1 diabetes mellitus (T1DM) cases in two regions of Poland. The number of births in 2015-16 in Pomeranian Voivodeship was 50,461, while the number of new T1DM cases was 219. In Lublin Voivodeship, the number of births in the same period reached 39,381, and the number of new T1DM cases was 221. The incidence of T1DM, calculated per 100 live births, amounted to 0.43 and 0.56 in Pomeranian and Lublin. The statistical analysis of collected data proved that the number of new T1DM cases in Pomeranian Voivodeship is correlated to the concentrations of selenium (Se; p < 0.0001), lead (Pb; p < 0.00001), cadmium (Cd; p < 0.00001), zinc (Zn; p < 0.00001) and arsenic (As; p = 0.00001). In the case of Lublin Voivodeship, the number of new T1DM cases was correlated to the concentrations of Se (p = 0.0000001), Pb (p < 0.000001), Cd (p = 0.0000001) and Zn (p < 0.00001) in drinking water. No correlation was found between the number of new T1DM cases and arsenic concentration in the drinking water samples from Lublin Voivodeship. The results indicated that environmental exposure to specific heavy metals may contribute to the risk of T1DM, underscoring the need for stringent environmental controls and public health policies to mitigate these risks.

Leishmaniasis in Humans and Animals: A One Health Approach for Surveillance, Prevention and Control in a Changing World

Leishmaniasis is classified as a neglected tropical disease (NTD), caused by protozoan parasites of the genus Leishmania, which are transmitted to humans and other animals through the bite of infected female phlebotomine sandflies. There are three forms of the disease: cutaneous leishmaniasis (CL) manifested by ulcers and scars; systemic or visceral leishmaniasis (VL), which can lead to life-threatening complications if left untreated; and mucocutaneous leishmaniasis (MCL), which can destroy the mucous membranes of the nose, mouth and throat. Human leishmaniasis is endemic in many countries across Africa, Asia, Southern Europe, the Middle East, and Central and South America. The interconnection of environmental, animal and human health underlies the spread of the Leishmania parasite. Environmental disruptions, such as climate change, deforestation or urbanisation, but also globalisation and migration, significantly affect the distribution and abundance of sand fly vectors and reservoir hosts. Climate change alters the breeding patterns of sandflies and expands their geographic range; deforestation and misuse of large areas disrupt ecosystems, leading to increased human-vector contact; and urbanisation increases the potential for contact between parties, particularly in densely populated areas. Migration of humans and animals, either through natural migration or, for example, the pet trade and breeding, can facilitate the spread of Leishmania parasites. In addition, socio-economic factors, including poverty and lack of access to healthcare, increase the burden of leishmaniasis in vulnerable populations. Due to this multitude of reasons, the geographic distribution of sandflies has expanded to higher latitudes and altitudes in recent years, with a consequent increase in disease burden. Indeed, despite ongoing challenges in the surveillance systems, data from the last available year have shown an increase in many cases in both humans and dogs. This perspective explores the interconnected factors influencing the spread of leishmaniasis worldwide and the epidemiology of the disease. In addition, it illustrates the importance of integrated strategies in a One Health approach: surveillance, prevention and control of vectors, animals and humans.

Light Absorption Properties of Brown Carbon Aerosol During Winter at a Polluted Rural Site in the North China Plain

Brown carbon aerosols (BrC), a subfraction of organic aerosols, significantly influence the atmospheric environment, climate and human health. The North China Plain (NCP) is a hotspot for BrC research in China, yet our understanding of the optical properties of BrC in rural regions is still very limited. In this study, we characterize the chemical components and light absorption of BrC at a rural site during winter in the NCP. The average mass concentration of PM1 is 135.1 ± 82.3 μg/m3; organics and nitrate are the main components of PM1. The absorption coefficient of BrC (babs,BrC) is 53.6 ± 45.7 Mm−1, accounting for 39.5 ± 10.2% of the total light absorption at 370 nm. Diurnal variations reveal that the babs,BrC and organics are lower in the afternoon, attributed to the evolution of planetary boundary layers. BrC is mainly emitted locally, and both the aqueous phase and the photooxidation reactions can increase babs,BrC. Notably, the babs,BrC is reduced when RH > 65%. During foggy conditions, reactions in the aqueous phase facilitate the formation of secondary components and contribute to the bleaching of BrC. This process ultimately causes a decrease in both the absorption Ångström exponent (AAE) and the mass absorption efficiency (MAE). In contrast, the babs,BrC, along with AAE and MAE, rise significantly due to substantial primary emissions. This study enhances our understanding of the light absorption of BrC in rural polluted regions of the NCP.

Climate Change, Air Pollution, African Dust Impacts on Public Health and Sustainability in Europe

Abstract Climate change poses a significant threat to environmental sustainability and public health, leading to extreme weather events, rising sea levels, and biodiversity loss. Research on air pollution from African dust adversely associated with climate change highlights its significant role in trapping heat in the atmosphere and causing heat-related illnesses, cardiovascular disorders, and respiratory ailments. Smog, dust, acid rain, and ozone depletion also negatively impact ecosystems. The methods of the study also include the dynamics of climate change-induced air pollution. The implications for public health and environmental sustainability through GWR modeling and MODIS-NDVI analysis of controlling air pollution are crucial for reducing the climate crisis, safeguarding public health, and maintaining ecosystem sustainability. Results from particulate matter (PM 2.5-10), which consists of tiny particles with varying diameters, can enter the respiratory system through inhalation. This can lead to a diameter of less than 10 μm (PM 2.5-10). According to the relevant legislation, the limit value refers to the daily average value and must not exceed 50 μg/m3. While ozone in the stratosphere serves a protective function against ultraviolet radiation, excessive levels at ground level can be harmful and have been recorded in atmospheric samples ranging from 146.6 μg/m3 up to 702.3 μg/m3. impacting the respiratory and cardiovascular systems. Policy leaders, businesses, and individuals need to be proactive in reducing air pollution, adopting clean energy technology, and implementing stricter pollution rules. Stricter pollution rules, environmentally friendly transportation choices, and the adoption of clean energy technology. The sustainability of the ecosystem and public health are significantly impacted by climate change linked to air pollution. To solve these global problems and move toward a healthier, cleaner future for future generations, we must act now on climate justice. Key messages • Examine the impact of African dust air pollution on public health and its significant impacts from climate change, provide solutions to mitigate its effects on environmental sustainability in Europe. • Public health workers, Policymakers and stakeholders must prioritize reducing emissions and enforcing strict air quality laws to mitigate the negative impact of African dust on European populations.

Climate change and health topics in pre-university education in Kosovo: A Content Analysis

Abstract Background Climate health literacy (CHL), recommended and recognized as vital for the global response to climate change and impacts on health, lacks comprehensive studies on its integration into primary and secondary school curricula. In Kosovo, where numerous environmental issues already exist and are expected to worsen due to climate change, the resulting health outcomes pose significant challenges. Moreover, the low environmental knowledge among youth further adds to the complexity of addressing these issues. This study addresses this gap by focusing on understanding and enhancing the inclusion of climate change and health topics in pre-university education. Methods A content analysis was conducted on: (1) core curricula, (2) subject curricula, and (3) textbooks for pre-university education (grades 0-12) in Kosovo. The outcomes of the content analysis were then juxtaposed with the CHL framework to identify alignment and gaps. Results We found that curricula in Grades 0-5, contained one topic on climate change and health topic out of 638 (0.16%) topics documented; however, textbooks did not elucidate this focus. Grades 6-9 had 2 out of 701 (0.28%) and the relevant textbook revealed that various environmental and health topics are covered, but that they lack exploration of the interrelatedness between environmental pollution, climate change, and health. Grades 9-12 had the highest integration with 4 out of 745 (0.54%). Textbook analysis of these grades revealed a more in-depth coverage of climate change and health linkages. In total, seven topics out of a pool of over 2000 topics encompassed learning outcomes related to climate and health in Kosovo’s pre-university education. Conclusions The current efforts to integrate climate change and health into Kosovo’s curriculum fails to meet the recommendations for achieving CHL levels. Localized and context relevant additions are needed to fulfil CHL among students in Kosovo and other countries interested in improving CHL. Key messages • This case serves as a testing ground for a framework assessing climate health literacy within curricula. The results identify gaps and areas of improvement, which inform the implications to attain CHL. • Results reveal shortcomings in the incorporation of climate change and health topics in schools, underscoring the necessity for tailored strategies to foster CHL among students.

Colorimetric aptasensing of microcystin-LR using DNA-conjugated polydiacetylene.

Polydiacetylene (PDA) holds promise as a versatile material for biosensing applications due to its unique optical properties and self-assembly capabilities. In this study, we developed a colorimetric detection biosensor system utilizing PDA and aptamer for the detection of microcystin-LR (MC-LR), a potent hepatotoxin found in cyanobacteria-contaminated environments. The biosensor was constructed by immobilizing MC-LR-specific aptamer on magnetic beads, where the aptamer was hybridized with a urease-labelled complementary DNA (cDNA-urease). Upon binding MC-LR, the aptamer undergoes a conformational change to release cDNA-urease. The released cDNA-urease is subsequently captured by PDA bearing a single-stranded DNA (ssDNA). The enzymatic reaction triggers a distinctive color transition of PDA from blue to red. The results demonstrate exceptional sensitivity, with a linear detection range of 5-100ng/mL and a limit of detection as low as 1ng/mL. The practicability of the colorimetric method was demonstrated by detecting different levels of MC-LR in spiked water samples. The recoveries ranged from 77.3 to 102% and the color change, visible to the naked eye, underscores the practical utility for on-site applications. Selectivity for MC-LR over other microcystin variants (MC-RR and MC-YR) was confirmed. The colorimetric detection platform capitalizes on the properties of PDA and nucleic acid, offering a robust method for detecting small molecules with potential applications in environmental monitoring and public health.

Assessing microplastic abundances in freshwater fishes in a subtropical African reservoir

Microplastics are emerging pollutants of global concern, and their presence in the aquatic environment poses a serious risk for aquatic biota. While many studies have been conducted on the presence of microplastics in marine habitats, little research has been done in freshwater African reservoirs on microplastic pollution and their impacts on fish within the subtropical regions. To bridge this gap, the current study investigated microplastic abundances and distribution in freshwater fish within Nandoni reservoir, South Africa, across two seasons (i.e., hot–wet, cool–dry). Fish were randomly sampled using seine and gill nets from seven sites within the reservoir. In the laboratory, fish were then sorted according to taxa before dissecting them to remove the gills and the gastrointestinal tract (GIT). The organs were digested using hot hydrochloric acid and hydrogen peroxide, and the microplastics were classified according to their colours and shapes. Among the 94 fishes (i.e., 8 species) examined, microplastics were detected in 86.6% of the eight species caught. Microplastics were dominant in the gills and GIT during the cool–dry and hot–wet seasons, respectively. High microplastic abundances were found in the gills of Micropterus salmoides and the GIT of Coptodon rendalli, where fibres and the transparent colour were the most dominant. The results further showed high microplastic abundances in benthopelagic feeders highlighting that habitat influences fish consumption of microplastics whether directly or indirectly. Significant differences were observed in the feeding zone and season for all microplastic types. Microplastic sources in the reservoirs could be due to anthropogenic activities such as illegal dumping, fishing, and agriculture. Thus, there is a need for further investigation into the relation of fish weight, fish sex and body in relation to microplastic pollution. The highlighted ecological factors should be taken into consideration for future research and management actions aimed at mitigating and protecting the negative impacts of microplastic pollution on environmental and human health.