Health Impact Assessment Research Articles

Health impact assessment of road traffic noise exposure based on different densification scenarios in Malmö, Sweden

While urbanization provides many opportunities to those arriving in thriving urban areas, a greater number of residents necessitates the expansion of housing and infrastructure. This is often achieved through densification, which can lead to increased noise, particularly through increased road traffic. A key challenge of promoting healthy urban planning is to understand potential health effects, especially on the local level. The aim of the present study is, therefore, to estimate and compare the health impacts of road traffic noise exposure for various urban densification scenarios within a neighborhood (Lorensborg) in Malmö, Sweden. The three scenarios include 1) Present-day, representing the study area as it is presently organized; 2) Planned municipal strategy (the city of Malmö’s own densification plans) and 3) Health-centred, which involves major structural alterations and reflects an effort prioritize a health-centred approach. Noise was modelled using the Nordic prediction method for road traffic. Health outcomes included noise annoyance, adverse sleep disturbance, ischemic heart disease (IHD) incidence and mortality. Within all scenarios, a large proportion of the study population was exposed above the WHO’s health-based guideline value (Lden 53 dB): >80% for Present-day and Planned municipal strategy scenarios, and almost 50% in the Health-centred scenario. Still, densifying Lorensborg (population ≈9,600) according to the Health-centred scenario could prevent 549 cases of highly annoyed, 193 cases of adverse sleep disturbance, 4.7 new cases of IHD (8.9% of total cases), and 1.5 deaths due to IHD (17.8% of IHD mortality) annually. The results demonstrated that it is possible to considerably lower the health impact with a more health-centred densification strategy. Important co-benefits for public and environmental health include air pollution reduction and green space creation, although their health effects were not quantified in the present study. Urban planning initiatives must be more ambitious in order to create healthy, sustainable cities.

A Health-Impact Assessment of an Ergonomic Measure to Reduce the Risk of Work-Related Lower Back Pain, Lumbosacral Radicular Syndrome and Knee Osteoarthritis among Floor Layers in The Netherlands

Sand-cement-bound screed floor layers are at risk of work-related lower back pain, lumbosacral radicular syndrome and knee osteoarthritis, given their working technique of levelling screed with their trunk bent while mainly supported by their hands and knees. To reduce the physical demands of bending of the trunk and kneeling, a manually movable screed-levelling machine was developed for floor layers in the Netherlands. The aim of this paper is to estimate the potential health gains of working with a manually movable screed-levelling machine on the risk of lower back pain (LBP), lumbosacral radicular syndrome (LRS) and knee osteoarthritis (KOA) compared to traditional working techniques. This potential health gain was assessed using the epidemiological population estimates of the Population Attributable Fraction (PAF) and the Potential Impact Fraction (PIF), combined with work-related risk estimates for these three disorders from systematic reviews. The percentage of workers exceeding these risk estimates was based on worksite observations among 28 floor layers. For LBP, 16/18 workers were at risk when using traditional working techniques, with a PAF = 38%, and for those using a manually movable screed-levelling machine, this was 6/10 with a PIF = 13%. For LRS, these data were 16/18 with a PAF = 55% and 14/18 with a PIF = 18%, and for KOA, 8/10 with a PAF = 35% and 2/10 with a PIF = 26%. A manually movable screed-levelling machine might have a significant impact on the prevention of LBP, LRS and KOA among floor layers in the Netherlands, and health-impact assessments are a feasible approach for assessing health gains in an efficient way.

High-resolution patterns and inequalities in ambient fine particle mass (PM2.5) and black carbon (BC) in the Greater Accra Metropolis, Ghana

Growing cities in sub-Saharan Africa (SSA) experience high levels of ambient air pollution. However, sparse long-term city-wide air pollution exposure data limits policy mitigation efforts and assessment of the health and climate effects. In the first study of its kind in West Africa, we developed high resolution spatiotemporal land use regression (LUR) models to map fine particulate matter (PM2.5) and black carbon (BC) concentrations in the Greater Accra Metropolitan Area (GAMA), one of the fastest sprawling metropolises in SSA. We conducted a one-year measurement campaign covering 146 sites and combined these data with geospatial and meteorological predictors to develop separate Harmattan and non-Harmattan season PM2.5 and BC models at 100 m resolution. The final models were selected with a forward stepwise procedure and performance was evaluated with 10-fold cross-validation. Model predictions were overlayed with the most recent census data to estimate the population distribution of exposure and socioeconomic inequalities in exposure at the census enumeration area level. The fixed effects components of the models explained 48–69 % and 63–71 % of the variance in PM2.5 and BC concentrations, respectively. Spatial variables related to road traffic and vegetation explained the most variability in the non-Harmattan models, while temporal variables were dominant in the Harmattan models. The entire GAMA population is exposed to PM2.5 levels above the World Health Organization guideline, including even the Interim Target 3 (15 μg/m3), with the highest exposures in poorer neighborhoods. The models can be used to support air pollution mitigation policies, health, and climate impact assessments. The measurement and modelling approach used in this study can be adapted to other African cities to bridge the air pollution data gap in the region.

ENVIRONMENTAL HEALTH OFFICERS IN NIGERIA IN THE 21ST CENTURY: ADVOCACY AND RAISING PUBLIC AWARENESS

Healthy environment is important for the well-being of mankind and environmental factors play a crucial role in the spread of diseases, especially in the 21st century. Environmental health officers are stakeholders in this regard and in the sustainable development goals. This paper discussed the interplay between the environment and health, the importance of environmental officers in Nigeria and factors that influence their activities. A narrative review was carried out using secondary data from various databases and organizational websites. In Nigeria, an environmental health officer must be registered with the Environmental Health Officers Registration Council of Nigeria (EHORECON) in line with Act 11, of 2002 and requires investigative, analytical, communicative and educational skills, among others to function effectively. They are important stakeholders in environmental issues with roles in sanitary inspection of premises, prevention and control of diseases, disasters, antimicrobial resistance, food hygiene and safety, ecological health, planetary health and environmental impact assessment, among others. The challenges they face during their work include lack of enabling laws to deter defaulters, shortage of manpower, poor knowledge and access to various standardized tools, among others. The role of environmental health officers cannot be over-emphasized, especially in this 21st century. However, these professionals need to think outside the ‘box’ to address arising challenges.

Association of Incident Cardiovascular Disease With Time Course and Cumulative Exposure to Multiple Risk Factors

BackgroundThe quantitative relationship of incident cardiovascular disease (CVD) to lifetime cumulative risk factor exposure is not well understood. ObjectivesUsing CARDIA (Coronary Artery Risk Development in Young Adults) study data, we examined the quantitative associations of cumulative exposure over time to multiple, simultaneously operating risk factors with CVD incidence and the incidence of its components. MethodsRegression models were developed quantifying the influence of the time course and severity of multiple CVD risk factors, operating simultaneously, on risk of incident CVD. The outcomes were incident CVD and the incidence of its components: coronary heart disease, stroke, and congestive heart failure. ResultsOur study included 4,958 asymptomatic adults enrolled in CARDIA from 1985 to 1986 (ages 18 to 30 years) who were followed for 30 years. Risk of incident CVD depends on the time course and severity of a series of independent risk factors, the impact of which is mediated by their effects on individual CVD components after age 40 years. Cumulative exposure (AUC vs time) to low-density lipoprotein cholesterol and triglycerides was independently associated with risk of incident CVD. Of the blood pressure variables, areas under the mean arterial pressure vs time curve and the pulse pressure vs time curve were strongly and independently associated with incident CVD risk. ConclusionsThe quantitative description of the link between risk factors and CVD informs the construction of individualized CVD mitigation strategies, design of primary prevention trials, and assessment of public health impact of risk factor-based interventions.

Occupational Exposure and Health Impact Assessment of Diisocyanates in Finland.

Diisocyanates are a group of chemicals widely used in different industrial applications. The critical health effects related to diisocyanate exposure are isocyanate sensitisation, occupational asthma and bronchial hyperresponsiveness (BHR). Industrial air measurements and human biomonitoring (HBM) samples were gathered in specific occupational sectors to examine MDI, TDI, HDI and IPDI and the respective metabolites from Finnish screening studies. HBM data can give a more accurate picture of diisocyanate exposure, especially if workers have been exposed dermally or used respiratory protection. The HBM data were used for conducting a health impact assessment (HIA) in specific Finnish occupational sectors. For this purpose, exposure reconstruction was performed on the basis of HBM measurements of TDI and MDI exposures using a PBPK model, and a correlation equation was made for HDI exposure. Subsequently, the exposure estimates were compared to a previously published dose-response curve for excess BHR risk. The results showed that the mean and median diisocyanate exposure levels and HBM concentrations were low for all diisocyanates. In HIA, the excess risk of BHR from MDI exposure over a working life period was highest in the construction and motor and vehicle industries and repair sectors, resulting in estimated excess risks of BHR of 2.0% and 2.6%, and 113 and 244 extra BHR cases in Finland, respectively. Occupational exposure to diisocyanates must be monitored because a clear threshold for DI sensitisation cannot be established.

Human health effects of recycling and reusing food sector consumer plastics: A systematic review and meta-analysis of life cycle assessments

Global transitions to circular economies of plastic could pose both risks and opportunities for human health. Life Cycle Assessment (LCA) can help to quantify possible health effects across plastic life cycles, syntheses of which could inform policy. This systematic review assessed LCA evidence for health effects of increased plastic recycling and reuse in the food sector. Scientific databases including Web of Science, Scopus, MEDLINE, Embase, Global Health, GreenFile and grey literature websites were searched for peer-reviewed LCA of consumer-level food sector plastics that compared virgin or single-use plastics with scenarios of increased recycling and reuse. Data on Human Health impacts and related midpoint impacts were extracted, converted to Disability-Adjusted Life Years (DALYs), and analysed using meta-regression. Forty-nine eligible LCAs were identified, only five of which related to low- and middle-income countries (China: n = 1 and Thailand: n = 4). Meta-regression showed strong evidence for a linear trend in reducing DALYs with increasing percentage recycled content compared to virgin plastic (Coefficient = −1.96E-5; 95% CI = −2.69E-5 to −1.24E-5; p < 0.0001) and increasing end-of-life recycling rate compared to landfill and/or incineration (Coefficient = −2.1E-5; 95% CI = −2.60E-5 to −1.63E-5; p < 0.0001), equating to almost a day of healthy life saved globally per tonne of plastic recycled. On average, reusable plastics reduced climate-related health impacts associated with single-use plastics after 30 uses. Global assessment was limited by data deficits, but meta-analyses suggested that health risks from linear economies of food sector plastics could be reduced by increasing recycling and reuse rates, though some reusable plastics would need to be used many more times than current norms. Encouraging greater geographical coverage in LCA, increasing uptake of health impact assessment methods, and incorporating emerging health data will strengthen future public health evaluations of circular economies.

Spatio-temporal patterns of tropospheric NO2 over India during 2005–2019

Air pollution is the leading environmental health risk factor globally. Nitrogen dioxide (NO2) is a criteria pollutant associated with adverse health effects. In India, the focus has been mostly on ambient PM2.5; hence understanding the space-time variability of NO2 and the potential role of different NO2 sources are required. This work aimed to address these two gaps by first examining a long-term spatial heterogeneity of NO2 and linking it to the major contributing sources (e.g., power plants and industries) over the Indian region, and secondly by examining the variability in land use patterns and its changes over the years 2005–2019. We analyzed tropospheric NO2 vertical columnar densities (VCDs) from the Ozone Monitoring Instrument (OMI) onboard the Aura satellite at a resolution of 0.1° × 0.1° for the period 2005 to 2019. We calculated linear trends in tropospheric NO2 VCDs and performed a significance test to ensure real changes. We also analyzed Global Human Settlement Layer (GHSL) data to identify the land use as ‘high-density urban,’ ‘low-density urban,’ ‘rural,’ and ‘no settlement.’ The spatial analysis found higher tropospheric NO2 VCDs (>5 × 1015 molecules/cm2) in eastern (coal belt with many power plants) and northern India, along with a few locations in central India. The change in tropospheric NO2 VCDs during the last 15 years showed an increasing trend (>2 × 1013 molecules/cm2) in most parts of India. Whereas during the last decade (2010–2019), the annual average trend over the country had reduced by up to ∼76% relative to 2005–2009. Tropospheric NO2 VCDs increased by 12.5%–29.6% from 2005 to 2019 across all levels of land settlement in India. Our study suggested considering NO2 as an important pollutant in addition to PM2.5 and developing a NO2 exposure model for further health impact assessment studies.

Sources of air pollution-related health impacts and benefits of radially applied transportation policies in 14 US cities

As the world becomes increasingly urbanized, growing populations are exposed to poor ambient air quality and at risk of the associated health outcomes. Urban air quality is affected both by local sources of air pollution and sources outside city borders. Policy-makers who develop air quality policies need to know whether it is most effective to focus on local policies or to spend resources fostering larger regional air quality management cooperation. Identifying the fraction of air pollution exposure from emissions as a function of distance from the city is a critical element of air quality management design. We estimate the health burden associated with exposure to fine particulate matter (PM2.5), ozone (O3), and nitrogen dioxide (NO2) from county-level anthropogenic sources in and around 14 US cities; this analysis is a test-bed to conduct future global analyses. We use adjoint sensitivities calculated from the chemical transport model GEOS-Chem, high resolution satellite-derived surface concentrations of PM2.5 and NO2, and health impact assessment methods. For the 70.2 million people living in these cities, we estimate that 27,740 PM2.5- and O3-related premature deaths and 126,600 NO2-related new asthma cases were attributable to air pollution exposure in 2011. Development within the GEOS-Chem adjoint framework enables sectoral attribution and policy analysis in addition to the rote assessment of impact. We find that 70% of deaths and nearly 100% of these asthma cases were attributable to anthropogenic emissions. There is great variability in the sources of the anthropogenically-related health impacts; within-urban emissions make up 5% in Austin to 56% in Los Angeles and Phoenix (median: 31%) of urban premature deaths and 18% in Austin to 82% in Los Angeles (median: 59.5%) of new asthma cases, with the remaining portions attributable to emissions from outside the urban area. For each city, we estimate the air quality related health benefits associated with the adoption of a vehicle-miles-traveled fee in that city and in multiple spatial regions surrounding the city. The findings suggest that the proportion of urban air pollution that is regional is greater for premature deaths than new asthma cases and for the eastern US than the western US.

Disability-adjusted life years (DALYs) based COVID-19 health impact assessment: a systematic review

BackgroundThe emergence of COVID-19 has resulted in health, socio-economic, and political crises. The overall health impact of this disease can be measured by disability-adjusted life years (DALYs) which is the sum of the life years lost due to disability (YLDs) and the years life lost due to premature death (YLLs). The overarching objective of this systematic review was to identify the health burdens of COVID-19 and summarise the literature that can aid health regulators to make evidence-based decisions on COVID-19 mitigation strategies.MethodsThis systematic review was conducted using the PRISMA 2020 guidelines. DALYs-based primary studies were collected from databases, manual searches, and included studies’ references. The primary studies published in English language, conducted since the emergence of COVID-19, and using DALYs or its subsets (years life lost due to disability and/or years life lost due to premature death) as health impact metrics, were the inclusion criteria. The combined disability and mortality health impact of COVID-19 was measured in DALYs. The risk of bias due to literature selection, identification, and reporting processes was assessed using the Joanna Bridges Institute critical appraisal tool for cross-sectional studies, and the certainty of evidence was assessed using the GRADE Pro tool.ResultOf the 1459 identified studies, twelve of them were eligible for inclusion in the review. The years life lost due to COVID-19 related mortality was dominant over the years life lost due to COVID-19 related disability (disability times from the onset of COVID-19 to recovery, from diseases occurrence to mortality, and the long-term consequences of COVID-19) in all included studies. The long-term consequence disability time and the pre-death disability time were not assessed by most of the reviewed articles.ConclusionThe impact of COVID-19 on both the length and quality of life has been substantial and has been causing considerable health crises worldwide. The health burden of COVID-19 was greater than other infectious diseases. Further studies focussing on issues examining increasing preparedness for future pandemics, public sensitization, and multi-sectorial integration are recommended.

A holistic assessment of indoor environmental quality perception in Australian high-rise social housing

The indoor environmental quality (IEQ) in social housing is commonly aggravated due to poor design and construction characteristics. Within Melbourne, a considerable proportion of social housing are high-rise buildings, for which no integrated IEQ studies have been conducted. This paper examines residents’ IEQ perception in high-rise social housing in Melbourne. Data from 94 apartment units were collected through a survey. Residents were least satisfied (33%) with the indoor temperature in summer, while they were most satisfied with daylight (72%). The most influential parameter over the overall IEQ satisfaction was “noise”, despite being rated the second least important. Sleep disturbances (61.8%) and not being able to open the windows for ventilation (43.4%) were identified as the most unfavourable effects of outdoor noise. Correlations were found between IEQ parameters and the frequency of building-related health issues. No clear relationship was found between perceived satisfaction and importance of IEQ parameters. There is an evident problem associated with overheating in summer, though winter underheating was not problematic. Differences in the share of IEQ parameters on the overall IEQ satisfaction question their equal weightage. The significance of this study is the integrated assessment of IEQ parameters and health impact in the Melbourne social housing context.

A health impact assessment of gender inequities associated with psychological distress during COVID19 in Australia’s most locked down state—Victoria

BackgroundSince March 2020, when the COVID19 pandemic hit Australia, Victoria has been in lockdown six times for 264 days, making it the world’s longest cumulative locked-down city. This Health Impact Assessment evaluated gender disparities, especially women’s mental health, represented by increased levels of psychological distress during the lockdowns.MethodsA desk-based, retrospective Health Impact Assessment was undertaken to explore the health impacts of the lockdown public health directive with an equity focus, on the Victorian population, through reviewing available qualitative and quantitative published studies and grey literature.ResultsFindings from the assessment suggest the lockdown policies generated and perpetuated avoidable inequities harming mental health demonstrated through increased psychological distress, particularly for women, through psychosocial determinants.ConclusionOngoing research is needed to elucidate these inequities further. Governments implementing policies to suppress and mitigate COVID19 need to consider how to reduce harmful consequences of these strategies to avoid further generating inequities towards vulnerable groups within the population and increasing inequalities in the broader society.

The role of ecotoxicology in the health impact assessment: an innovative ecosystem approach for the protection of human health in Italy.

The Health Impact Assessment (HIA) is a procedure with the aim to protect the populations exposed to the impacts deriving from the establishment or upgrading of large industrial enterprises, i.e. large combustion plants (>300 MWth). In Italy a guideline for the HIA procedure has been published in compliance with the 2014/52/EU Directive on the Environmental Impact Assessment (EIA) requirements. Italian HIA procedure. An ecotoxicological approach has been included for the first time in the HIA procedure with the aim to detect toxic effects caused by unknown not-monitored contaminants or mixtures in the ecosystem components affected by the potential emissions, discharges and releases of large industrial enterprises. Ecotoxicology plays an important bridge role between environment and human health in the scoping and monitoring step of the HIA procedure with a key function of early warning system and screening. The aim of this paper is to present the Italian experience in the first three years of the application of the new approach, proposing recommendations on specific case studies. Conclusion and future perspective. 80% of enterprises, that applied HIA, have delivered a robust, integrated and detailed documentation in relation to the ecotoxicological assessment, this positive feedback will generate environmental and human health benefits to the areas where the plants are established.

Reflections on burden of disease and health impact assessment methods for noise

Burden of Disease (BoD) assesses the noise impact on health at a given time and in a given population, whereas Health Impact Assessments (HIA) are conducted in the frame of decision-making to evaluate health effects of a policy, programme or project. In a 2020 report, the European Environmental Agency estimates transportation noise exposure in Europe annually results in 22 million highly annoyed, 6.5 million highly sleep disturbed, 48,000 cases of ischemic heart diseases and 12,000 deaths, and 12,400 children with cognitive impairments. These are based on END exposure assessment and exposure-response functions from the WHO noise guidelines 2018. Many more regional or national HIA and BoD studies have been conducted, and common methods across future assessments for consistent communication are needed. Given the rapid developments in noise research, current BoD and HIA are also partly outdated. Critical methodological issues will be discussed using national and regional examples with a focus on Switzerland. This includes the selection of noise sources, relevant health outcomes and corresponding exposure-response functions. Derivation of the lowest effect noise threshold, potential double-counting, and communication of results are also discussed with the aim toward a common understanding for the conduct of future BoD and HIA.

The mortality cost of carbon dioxide emissions from a steel plant in Southern Italy: a climate change health impact assessment

to quantify the temperature-related global health impacts of the Taranto steel plant CO2e emissions. using the risk functions available in the literature, a prospective global health impact assessment of the marginal CO2e emissions declared by the steel plant for 2020 was conducted. world population in the period 2020-2100. deaths in the period 2020-2100 attributable to the marginal CO2e emitted by the Taranto steel plant in 2020. considering the central estimates in the baseline emission scenario (4.1°C warming by 2100), the Taranto steel plant 2020 CO2e emissions will cause 1,876 deaths worldwide between 2020 and 2100. The largest part will be attributable to steelmaking processes, accounting for 1,093 deaths. The same emissions will cause 5.56 × 10-4 deaths worldwide between 2020 and 2100 per tonne of steel produced in 2020, i.e. one death for every 1,799 tonnes of steel. If the 2020 CO2e emissions of the steel plant had been reduced by 25%, 50% or 75%, the deaths avoided in the world in the period 2020-2100 would have been 469, 938 and 1,407 respectively. estimates predict a probably significant mortality impact worldwide by the end of the century associated with the greenhouse gases emissions of the Taranto steel plant. Just reducing emissions by 50% in a single year could maybe avoid over 900 deaths worldwide by the end of the century. This confirms the importance of implementing incisive policies to reduce greenhouse gases emissions in all sectors.

Systematic review and meta-analyses of association between transportation noise and Ischaemic heart disease based on studies published between 1994 - 2022

There is a growing body of evidence that exposure to transportation noise can increase the risk for ischaemic heart disease (IHD). However, there are significant variations in the pooled exposure-response relationships (ERRs) derived by recent meta-analyses. These discrepancies lead to uncertainties in health impact assessments and in public health policy decision-making. Updated analyses are needed to better understand this relationship. This paper presents an update to recent systematic reviews and meta-analyses investigating the effects of transportation noise exposure on IHD mortality and morbidity. Specific aims are to understand if studies published since 2019 affect pooled ERRs and assess if evidence for aircraft and railway noise exposure has strengthened. We included studies from two meta-analyses and one literature review covering the years 1994-2020. We then conducted an updated literature search in PubMed, Scopus, Web of Science and Medline for the period October 2020 and January 2022, following the same protocol as the WHO Environmental Noise Systemic Review Group. 30 studies were included from the previous reviews, and nine further studies were identified via the updated literature search. The studies present risk estimates for IHD incidence (n=36), prevalence (n=5) mortality (n=26). The updated evidence and exposure response analysis is presented for Lden.

Health and economic benefits of meeting WHO air quality guidelines, Western Pacific Region.

To quantify the number of avoidable annual deaths and associated economic benefits from meeting the World Health Organization (WHO) air quality guidelines for ambient concentrations for fine particulate matter (PM2.5) for Member States of the WHO Western Pacific Region. Using the AirQ+ software, we performed a quantitative health impact assessment comparing country-level PM2.5 concentrations with the 2005 and 2021 air quality guidelines recommended maximum concentrations of 10 and 5μg/m3, respectively. We obtained PM2.5 data from the WHO Global Health Observatory (latest available year 2016), and population and mortality estimates from the United Nations World Population Prospects database for the latest 5-year period available (2015-2019), which we averaged to 1-year estimates. A risk estimate for all-cause mortality, based on a meta-analysis, was embedded within AirQ+ software. Our economic assessment used World Bank value of a statistical life adjusted to country-specific gross domestic product (latest available year 2014). Data were complete for 21 of 27 Member States. If these countries achieved the 2021 guidelines for PM2.5, an estimated 3.1 million deaths would be avoided annually, which are 0.4 million more deaths avoided than meeting the 2005 guidelines. China would avoid the most deaths per 100 000 population (303 deaths) and Brunei Darussalam the least (5 deaths). The annual economic benefit per capita ranged from 5781 United States dollars (US$) in Singapore to US$143 in Solomon Islands. Implementing effective measures to reduce PM2.5 emissions would save a substantial number of lives and money across the Region.

English

Most often, patronage of open markets attracts huge populations of buyers in Nigeria. These markets are numerous in each state of the country but largely share similar characteristics in poor hygiene and sanitation. Health Impact Assessment (HIA) was conducted at Shasha market, Oba-Ile, Akure to assess the health implication of patronage of open markets, an emerging public health concern. Air, water and selected food samples were taken for microbial analysis while soil samples from different spots in the market, and faecal samples from residents of the market community were also taken for parasitology. The respective tests followed standard procedures to determine the coliform count and parasitic fauna in the collected samples. Out of 73 faecal samples that were examined, 69 (94.52%) were positive. Hookworm ova had the highest occurrence (40%) followed by Strongyloides. stercoralis and Ascaris lumbricoides ova which were 33 and 27% respectively. The result also revealed that 95.83% of the collected soil samples were contaminated with helminth eggs and larvae including Ascaris lumbricoides, Strongyloides stercoralis and Hookworm. Bacteria and fungi species found in the air, water and food samples include Staphylococcus aureus, Entamoeba. coli, Klebsiella pneumonia, Salmonella typhi, Rhizopus stolonifer, Penicillium digitatum and Aspergillus niger. The market environment was highly contaminated with various stages of pathogenic organisms of public health importance and this predisposes the buyers and sellers to different communicable diseases. The market requires urgent attention by the concerned government authority in its management and sanitation. Key words: Health impact assessment, open market, patronage, pathogens.

Cooling cities through urban green infrastructure: a health impact assessment of European cities

High ambient temperatures are associated with many health effects, including premature mortality. The combination of global warming due to climate change and the expansion of the global built environment mean that the intensification of urban heat islands (UHIs) is expected, accompanied by adverse effects on population health. Urban green infrastructure can reduce local temperatures. We aimed to estimate the mortality burden that could be attributed to UHIs and the mortality burden that would be prevented by increasing urban tree coverage in 93 European cities. We did a quantitative health impact assessment for summer (June 1-Aug 31), 2015, of the effect of UHIs on all-cause mortality for adults aged 20 years or older in 93 European cities. We also estimated the temperature reductions that would result from increasing tree coverage to 30% for each city and estimated the number of deaths that could be potentially prevented as a result. We did all analyses at a high-resolution grid-cell level (250 × 250 m). We propagated uncertainties in input analyses by using Monte Carlo simulations to obtain point estimates and 95% CIs. We also did sensitivity analyses to test the robustness of our estimates. The population-weighted mean city temperature increase due to UHI effects was 1·5°C (SD 0·5; range 0·5-3·0). Overall, 6700 (95% CI 5254-8162) premature deaths could be attributable to the effects of UHIs (corresponding to around 4·33% [95% CI 3·37-5·28] of all summer deaths). We estimated that increasing tree coverage to 30% would cool cities by a mean of 0·4°C (SD 0·2; range 0·0-1·3). We also estimated that 2644 (95% CI 2444-2824) premature deaths could be prevented by increasing city tree coverage to 30%, corresponding to 1·84% (1·69-1·97) of all summer deaths. Our results showed the deleterious effects of UHIs on mortality and highlighted the health benefits of increasing tree coverage to cool urban environments, which would also result in more sustainable and climate-resilient cities. GoGreenRoutes, Spanish Ministry of Science and Innovation, Institute for Global Health, UK Medical Research Council, European Union's Horizon 2020 Project Exhaustion.

Green and blue spaces: crucial for healthy, sustainable urban futures

Scientific knowledge of the health benefits of urban green and blue spaces is not being translated fast enough into practical and policy changes. Such changes are needed to improve the liveability of communities in large urban areas and to address the dual and growing challenges of climate change and biodiversity loss. A vast array of options can facilitate better design of urban settings to enhance natural environments and improve health. One is to increase tree coverage and green space to reduce the higher temperatures in cities and towns compared with rural areas. These green spaces can also provide respite during heatwaves, which are projected to increase in frequency and intensity because of climate change. 1 Intergovernmental Panel on Climate ChangeSummary for policymakers. in: Masson-Delmotte V Zhai P Pirani A Climate change 2021: the physical science basis. Cambridge University Press, Cambridge2021: 3-32 Google Scholar Urban greening could also address the inequities that arise because poor and marginalised populations generally live in hotter areas of cities. 2 Jay O Capon A Berry P et al. Reducing the health effects of hot weather and heat extremes: from personal cooling strategies to green cities. Lancet. 2021; 398: 709-724 Summary Full Text Full Text PDF PubMed Scopus (59) Google Scholar Access to green spaces, such as forests, parks, grasslands, and recreational areas, and blue spaces, such as rivers, oceans, seas, and lakes, improves health and wellbeing. 3 Cissé G McLeman R Adams H et al. Health, wellbeing, and the changing structure of communities. in: Pörtner H-O Roberts DC Tignor M Climate change 2022: impacts, adaptation and vulnerability. Cambridge University Press, Cambridge2022: 1041-1170 Google Scholar During the COVID-19 pandemic, green and blue spaces proved beneficial for mental 4 Pouso S Borja Á Fleming LE Gómez-Baggethun E White MP Uyarra MC Contact with blue–green spaces during the COVID-19 pandemic lockdown beneficial for mental health. Sci Total Environ. 2021; 756143984 Crossref PubMed Scopus (191) Google Scholar and physical health, 5 Yang Y Lu Y Yang L Gou Z Liu Y Urban greenery cushions the decrease in leisure-time physical activity during the COVID-19 pandemic: a natural experimental study. Urban For Urban Green. 2021; 62127136 Crossref PubMed Scopus (30) Google Scholar although it is important to note that these benefits were not felt equitably. In New York, for example, wealthy, White residents were more likely to use urban green space during the pandemic than people who self-identified as being part of non-exclusive, census-based race and ethnicity categories, (eg, Asian, Black, African American, Hispanic or Latinx, or Native American), 6 Bianca L Christopher K Christopher F Timon MP Who benefits from urban green spaces during times of crisis? Perception and use of urban green spaces in New York City during the COVID-19 pandemic. Urban For Urban Green. 2021; 65127354 Google Scholar raising important questions about how to increase equitable use. Cooling cities through urban green infrastructure: a health impact assessment of European citiesOur results showed the deleterious effects of UHIs on mortality and highlighted the health benefits of increasing tree coverage to cool urban environments, which would also result in more sustainable and climate-resilient cities. Full-Text PDF