Exposure Patterns Research Articles

A critical review of public health policies for radiation protection and safety

The increasing use of radiation in various sectors, including medicine, industry, and research, underscores the need for robust public health policies to ensure radiation protection and safety. This critical review examines the effectiveness of current public health policies aimed at mitigating the risks associated with radiation exposure. The review synthesizes findings from peer-reviewed literature and official reports to evaluate the strengths and weaknesses of existing frameworks. Public health policies for radiation protection are designed to safeguard individuals and communities from the potential hazards of radiation exposure. These policies include regulatory standards for radiation use, safety protocols in medical and industrial settings, and public education programs. The review explores the evolution of these policies over time, highlighting significant regulatory milestones and their impact on radiation safety. Key areas of focus include the effectiveness of international guidelines and national regulations, such as those established by the International Atomic Energy Agency (IAEA) and national bodies like the U.S. Environmental Protection Agency (EPA) and the European Commission. The review assesses how well these guidelines are implemented and adhered to in practice, identifying gaps in enforcement and areas where policies may fall short. The review also examines the role of risk communication and public awareness in shaping effective radiation protection policies. It discusses how well current policies address the needs of vulnerable populations and how they balance the benefits of radiation use with potential health risks. Challenges such as emerging technologies, changes in radiation exposure patterns, and the need for ongoing policy adaptation are also considered. The review concludes with recommendations for strengthening public health policies, including enhancing regulatory oversight, improving risk communication strategies, and investing in research to address new and evolving radiation safety issues. Overall, this review underscores the importance of continuous evaluation and adaptation of public health policies to ensure effective radiation protection and safety in an ever-changing technological landscape.

Diet quality and blood lead levels in Uruguayan first graders

ObjectiveFoods are a potential source of lead but also contain nutrients that counteract the intestinal absorption of lead. Translatable evidence is needed to better understand the relationship between whole diets and blood lead levels (BLLs) in children. In this cross-sectional study we investigated the association between dietary variety, adequacy, moderation, and overall diet quality with children's BLLs. MethodsFirst graders (~ 7 years) from Montevideo, Uruguay were evaluated in years 2009–13 (Phase I, n = 303) and 2015–19 (Phase II, n = 443). Lead was measured in fasting blood via atomic absorption spectrometry and primary caregivers completed two non-consecutive 24-h recalls. Indices of dietary variety (maximum score of 20), adequacy (maximum 40), moderation (maximum 30), and overall diet quality were calculated from food and nutrient intakes averaged over two recall days. The indices were adapted from the Diet Quality Index-International based on dietary recommendations for children. Missing covariate data were imputed. The associations between diet quality measures and BLLs were modeled separately in Phase I and II with multivariable linear models, testing for sex differences via interaction terms and stratified models. ResultsThe median[IQR] BLLs were 3.8[2.6, 4.9] and 1.3[0.7, 3.6] μg/dL in study Phases I and II, respectively. All diet quality scores were <60 % of the maximum values and daily intakes of key food groups fell below recommended levels. There was little evidence of an association between measures of diet quality and children's BLLs overall. On the other hand, higher diet variety, adequacy, and overall diet quality were associated with slightly higher BLLs among girls in Phase I only. ConclusionsIn the context of low lead exposure and food consumption patterns that fall short of recommended levels, the relation of diet quality to children's BLLs may depend on lead exposure levels.

A cross-linguistic examination of young children's everyday language experiences.

We present an exploratory cross-linguistic analysis of the quantity of target-child-directed speech and adult-directed speech in North American English (US & Canadian), United Kingdom English, Argentinian Spanish, Tseltal (Tenejapa, Mayan), and Yélî Dnye (Rossel Island, Papuan), using annotations from 69 children aged 2-36 months. Using a novel methodological approach, our cross-linguistic and cross-cultural findings support prior work suggesting that target-child-directed speech quantities are stable across early development, while adult-directed speech decreases. A preponderance of speech from women was found to a similar degree across groups, with less target-child-directed speech from men and children in the North American samples than elsewhere. Consistently across groups, children also heard more adult-directed than target-child-directed speech. Finally, the numbers of talkers present in any given clip strongly impacted children's moment-to-moment input quantities. These findings illustrate how the structure of home life impacts patterns of early language exposure across diverse developmental contexts.

Racial/Ethnic Differences in Adverse Childhood Experiences and Health-Related Outcomes: A Scoping Review.

Racial and ethnic differences have been observed across patterns of substance use and exposure to adverse childhood experiences (ACEs). The goal of this review was to summarize the current evidence on ACE and health outcomes across racial and ethnic groups in the United States. A scoping review of the literature following the Preferred Reporting Items for Systematic Reviews and Meta- Analysis for Scoping Review (PRISMA-ScR) guideline was performed. Using predetermined search terms and parameters, an electronic database search of peer-reviewed literature between 1997 and 2022 was performed. Forty-five articles met the inclusion and exclusion criteria. Thirteen articles focused on health behavior and education outcomes, fifteen reported on physical health outcomes, and eighteen reported on mental health outcomes. Relatively to mental health outcomes, race/ethnicity appeared to play a less significant role in the relationship between ACE and behavioral outcomes or physical health outcomes. There was stronger evidence that race/ethnicity may moderate relationships between ACE exposure and mental health outcomes. Across health behavior, physical health, and mental health domains, the evidence suggests that the relationship between ACE exposure and health outcomes is not uniform across different racial and ethnic groups. These findings highlight the need for future research to uncover how cultural, societal, and developmental factors interact to shape health in the context following exposure to childhood adversity.

An ultraviolet light data logger for studies of organismal ecology and physiology

Abstract Monitoring environmental conditions over time is essential for understanding how species regulate those conditions to satisfy their physiological needs. Variation in ultraviolet (UV) light exposure, for instance, is crucial for numerous taxa, influencing behaviour as well as essential physiological processes like vitamin D3 synthesis. Yet, despite these considerations, no commercially available data loggers exist to record UV exposures over time, preventing inquiry into this important but neglected fitness demand. To overcome this challenge, I designed the first UV data logger, custom built on the open‐source Arduino platform. This device logs UV exposures (in voltage or converted to UV index) and date‐time information for each UV reading, at user‐defined intervals. The integration of a low‐power timer into the assembly, and its weather‐resistant housing, enables long‐term use (at least several months). The cost of one device (including housing) is under £45/$55 USD. Calibration and performance tests reveal that this device is reliable under various weather conditions and produces accurate UV readings under both artificial lighting and sunlight. Both the device and its customised housing can be easily replicated and expanded upon (e.g. inclusion of additional sensors). Overall, this device represents a crucial first step in our ability to better characterise UV exposure patterns in habitats for physiological ecology studies. Exposure to UV light is adaptive for many types of organisms, both in the wild and in captivity (e.g. zoos and private hobbyists), and so I expect a broad array of scientific and public users alike to benefit from using this device.

Longitudinal study and predictive modelling of urinary pesticide metabolite concentrations in residents of Guangzhou, China

Continuous human biomonitoring and predictive modelling of urinary pesticide metabolites are critical for evaluating pesticide exposure trends and associated health risks. We conducted repeat cross-sectional surveys to determine the urinary concentrations of eight pesticide metabolites in the residents of Guangzhou, China, from 2018 to 2022. We longitudinally analyzed the changes in these metabolite concentrations over the years and assessed the potential non-carcinogenic risks by calculating the hazard quotient and hazard index. No significant differences were observed in the total urinary pesticide metabolite concentrations over the 5 years (9.16–12.99 μg/L). The urinary concentrations of 3,5,6-trichloro-2-pyridinol and 2,4-dichlorophenoxyacetic acid reached their lowest levels in 2020 (1.47 and 0.11 μg/L). Conversely, urinary para-nitrophenol concentrations exhibited an inverse trend, peaking in 2020 (6.16 μg/L). The composition profiles of urinary pesticide metabolites showed that para-nitrophenol consistently constituted the largest proportion each year. Males consistently showed higher median concentrations of total urinary pesticide metabolites and individual metabolites of 3,5,6-trichloro-2-pyridinol, trans-3-(2,2-dichlorovinyl)-2,2-dimethylcyclopropane-1-carboxylic acid, and para-nitrophenol than females. The concentrations of cis-3-(2,2-dichlorovinyl)-2,2-dimethylcyclopropane-1-carboxylic acid in adults' urine were significantly higher than those in minors' urine each year. The total pesticide metabolite concentrations in adults' urine were significantly higher than those in minors' urine in 2018 and 2020, whereas no significant differences were observed in other years. No significant differences in urinary pesticide metabolite concentrations were observed among different BMI groups. Results showed that 14.17% of the population had hazard index values above 1, indicating a higher risk of health hazards. Three predictive models were employed to predict urinary pesticide metabolite concentrations for 2023–2024, revealing an increasing trend in 3,5,6-trichloro-2-pyridinol concentrations while other metabolites are expected to decrease. The study showed the concentration of para-nitrophenol peaked in 2020 while 3,5,6-trichloro-2-pyridinol and 2,4-dichlorophenoxyacetic acid reached their lowest levels, suggests that the COVID-19 pandemic may have influenced pesticide exposure patterns.

Exposure patterns and the risk factors of Crimean Congo hemorrhagic fever virus amongst humans, livestock and selected wild animals at the human/livestock/wildlife interface in Isiolo County, upper eastern Kenya.

Crimean Congo hemorrhagic fever (CCHF) is a tick-borne zoonotic disease caused by CCHF virus (CCHFV). The disease has a complex transmission cycle that involves a wide range of hosts including mammalian and some species of birds. We implemented a sero-epidemiological study in Isiolo County, Kenya, to determine relative seroprevalences of CCHFV in humans, livestock and in wild animals. In addition, we identified subject and environment level factors that could promote exposure to CCHFV. Humans (n = 580) and livestock (n = 2,137) were recruited into the study through a multistage random sampling technique, and in addition, various species of wild animals (n = 87) were also sampled conveniently. Serum samples from all recruited humans and animals were collected and screened for CCHFV antibodies using ID Screen multispecies, double-antigen IgG enzyme-linked immunosorbent assay (ELISA). The overall anti-CCHFV IgG seroprevalences in humans, cattle, goats, sheep and camels were 7.2% [95% CI: 3.1-15.8%], 53.9% [95% CI: 30.7-50.9%], 11.6% [95% CI: 7.2-22.5%], 8.6% [95% CI: 3-14%] and 89.7% [95% CI: 78-94%], respectively. On average, the sampled wild animals had CCHFV seroprevalence of 41.0% [95% CI: 29.1-49.4%]; giraffes had the highest mean CCHF seroprevalence followed by buffaloes, while impala had very low exposure levels. Statistical analyses using mixed effects logistic regression models showed that CCHFV exposure in humans was significantly associated with male gender, being over 30 years of age and belonging to a household with a seropositive herd. In livestock, a combination of animal- and environment level factors including older animals, being in an area with high normalized difference vegetation index (NDVI) and high vapour pressure deficit were significantly associated with CCHFV infection. Age, sex and species of wild animals were considered as the key risk factors in the analysis, but none of these variables was significant (P-value = 0.891, 0.401 and 0.664, respectively). Additionally, RT-qPCR analysis revealed the presence of CCHFV RNA in camels (30%), cattle (14.3%), and goats (3.8%), but not in humans, sheep, or wild animals. This study demonstrates that environmental factors, such as NDVI and vapor pressure deficit, affect CCHFV exposure in livestock, while the presence of infected livestock is the key determinant of human exposure at the household level. These findings underscore the importance of using One Health approaches to control the disease in human-livestock-wildlife interfaces. For instance, the existing CCHF surveillance measures could be enhanced by incorporating algorithms that simulate disease risk based on the environmental factors identified in the study. Additionally, tick control in livestock, such as the use of acaricides, could reduce CCHFV exposure in livestock and, consequently, in humans.

Associations between real-life light exposure patterns and sleep behaviour in adolescents.

One of the most striking changes in the regulation of sleep-wake behaviour during adolescence is circadian phase delay. Light exposure synchronises circadian rhythms, impacting sleep regulation, however, the influence of real-life light exposure on sleep variations remains less clear. We aimed to describe the sleep and light exposure patterns of high school students with comparable schedules and socio-economic backgrounds, and to evaluate whether there was any association between them, considering chronotype. We analysed five school days and two free days of actigraphy records, from 35 adolescents (24 female, mean age: 16.23 ± 0.60). The sample was described using the Sleep Regularity Index (SRI), chronotype (actigraphy MSFsc), and self-reported diurnal preference (Morning/Evening Scale). Regression models were constructed to assess the impact of light exposure (daytime and nighttime) on subsequent sleep episodes; and to confirm whether the associations could be an indirect consequence of chronotype. Despite following similar routines, the SRI varied considerably (48.25 to 88.28). There was compatibility between the actigraphy proxy for chronotype and the self-reported diurnal preference, extracted using the circadian rhythm scale for adolescents. Less light exposure during the day was associated with later sleep onset and shorter sleep duration. An increase of 100 lux in average daytime light exposure advance of 8.08 minutes in sleep onset and 7.16 min in sleep offset. When the regressions were controlled for chronotype, these associations persisted. These findings facilitate discussions regarding the behavioural aspect of the impact of real-life light exposure on sleep and its potential as a target for interventions aiming to enhance adolescents' sleep quality.

Association of Plastic Exposure with Cognitive Function Among Chinese Older Adults.

The widespread exposure to plastic products and the increasing number of individuals with cognitive impairments have imposed a heavy burden on society. This study aims to investigate the relationship between plastic product exposure in daily life and cognitive function in older Chinese individuals. Data were obtained from the 2023 Ningxia Older Psychological Health Cohort, comprising 4045 participants aged 60 and above. Cognitive function was assessed using the Mini-Mental State Examination scale. A population-based plastic exposure questionnaire was used to calculate plastic exposure scores (PES). Binary logistic regression was employed to analyze the relationship between PES and cognitive function, while restricted cubic splines were used to examine the dose-response relationship between PES and cognitive function. Latent profile analysis (LPA) was employed to explore the potential patterns of plastic exposure, and logistic regression was used to investigate the relationship between different exposure patterns and cognitive function. A linear regression model was utilized to investigate the relationship between PES and different dimensions of cognitive function. Among the 4045 participants, 1915 individuals were assessed with mild cognitive impairment (MCI). After adjusting for all covariates, PES (OR = 1.04, 95% CI 1.02-1.06) was significantly associated with the risk of MCI and exhibited a dose-response relationship. LPA identified two potential categories of plastic exposure, with a higher risk of MCI observed in the group using plastic utensils. This study indicates a positive correlation between plastic exposure levels and MCI risk, particularly among individuals who frequently use plastic tableware.

Spatiotemporal Facility-Level Patterns of Summer Heat Exposure, Vulnerability, and Risk in United States Prison Landscapes.

Heat is associated with increased risk of morbidity and mortality. People who are incarcerated are especially vulnerable to heat exposure due to demographic characteristics and their conditions of confinement. Evaluating heat exposure in prisons, and the characteristics of exposed populations and prisons, can elucidate prison-level risk to heat exposure. We leveraged a high-resolution air temperature data set to evaluate short and long-term patterns of heat metrics for 1,614 prisons in the United States from 1990 to 2023. We found that the most heat-exposed facilities and states were mostly in the Southwestern United States, while the prisons with the highest temperature anomalies from the historical record were in the Pacific Northwest, the Northeast, Texas, and parts of the Midwest. Prisons in the Pacific Northwest, the Northeast, and upper Midwest had the highest occurrences of days associated with an increased risk of heat-related mortality. We also estimated differences in heat exposure at prisons by facility and individual-level characteristics. We found higher proportions of non-white and Hispanic populations in the prisons with higher heat exposure. Lastly, we found that heat exposure was higher in prisons with any of nine facility-level characteristics that may modify risk to heat. This study brings together distinct measures of exposure, vulnerability, and risk, which would each inform unique strategies for heat-interventions. Community leaders and policymakers should carefully consider which measures they want to apply, and include the voices of directly impacted people, as the differing metrics and perspectives will have implications for who is included in fights for environmental justice.

Temporal trends in the visual impairment burden attributable to high fasting plasma glucose levels: a population-based study.

Elevated fasting plasma glucose (FPG) levels have been associated with visual impairment. Recognising global patterns of high FPG level exposure can facilitate the prevention and treatment of related visual impairment. We aimed to assessthe trendsof the visual impairmentburden attributable to high FPG levels globally, regionally, nationally, and by income level. We obtained data on the visual impairment burden attributable to high FPG levels from the Global Burden of Disease Study 2019. We evaluated the trends of related disability-adjusted life-years (DALYs) from 1990 to 2019 through joinpoint regression analysis and calculated the annual percentage change (APC) and average APC (AAPC). Countries/territories were categorised into high-, upper-middle-, lower-middle-, and low-income groups based on the 2019 World Bank criteria. The age-standardised rate of DALYs due to visual impairment attributable to high FPG levels significantly increased globally, from 6.75 (95% uncertainty interval [UI], 1.55-15.79) in 1990 to 8.44 per 100,000 population (95% UI, 2.00-19.63) in 2019 (AAPC, 0.79; 95% confidence interval [CI], 0.69-0.89; p < 0.001). The largest increases were observed in high-income (AAPC, 0.73; 95% CI, 0.60-0.85) and lower-middle-income countries/territories (AAPC, 0.68; 95% CI, 0.62-0.73). In 2019, lower-middle-income countries/territories had the highest age-standardised DALY rate (18.94 per 100,000 population; 95% UI, 4.39-43.98), whereas high-income countries/territories had the lowest (2.97 per 100,000 population; 95% UI, 0.75-6.74). The visual impairment burden associated with elevated FPG levels has increased significantly, necessitating enhanced public health prevention measures, clinical management, and treatment to mitigate adverse outcomes.

Vitamin D Deficiency-A Public Health Issue in Children.

25-hydroxyvitamin D [25(OH)D] deficiency is a global health concern, particularly in pediatric populations, with implications for musculoskeletal health and overall well-being. This study aimed to evaluate serum 25(OH)D levels in a pediatric population and assess the prevalence of deficiency and insufficiency. A retrospective analysis was conducted on data from 741 pediatric patients (2-17 years old) who visited an urban hospital for children for acute respiratory and gastrointestinal conditions in the span of 2 years. Serum 25(OH)D levels were measured using chemiluminescent microparticle immunoassay. Statistical analyses were performed to assess the prevalence of deficiency and insufficiency, seasonal variations, and correlations with age and daylight exposure. Of the 739 pediatric patients analyzed, a substantial proportion exhibited insufficient (31.80%) or deficient (36.54%) serum 25(OH)D levels. While younger age groups generally had higher mean 25(OH)D levels, a negative correlation was observed between 25(OH)D levels and age. Sunlight exposure variations did not significantly impact serum 25(OH)D levels. Despite diverse daylight exposure patterns, there were no significant differences between longer and shorter daylight periods. This study highlights the high prevalence of 25(OH)D deficiency and insufficiency in the pediatric population, emphasizing the need for public health monitoring and targeted supplementation strategies. Findings underscore the importance of regular consultations with healthcare providers to ensure optimal 25(OH)D levels in children, with potential implications for revising current sufficiency thresholds. Addressing 25(OH)D deficiency is crucial for promoting musculoskeletal health and overall well-being in children.

Italian urban tourism predictions using the holiday Climate Index

The tourism sector is a source of sustenance for local communities, a driver of fiscal revenues and a way to connect local sites to international guests. Its dependence on climate change exposes it to chronic risks such as slowly varying climate patterns. In this paper, we predicted tourism intensity (as the number of beds per square kilometres) according to three Representative Concentration Pathways (RCP) at the municipal level in Italy: 2.6, 4.5 and 8.5. We first estimated a statistical model of tourism intensity using the Holiday Climate Index (HCI) and other drivers. Then, we used the prediction of beds per Km2 to infer changes between 2004 and 2050 according to each RCP scenario of the HCI. We find complex heterogeneous patterns in exposure and a moderate positive effect in the RCP2.6 scenario. However, delayed (RCP4.5) or no climate policy at all (RCP8.5) scenarios present dire consequences for the tourism sector.

Progress and gaps in climate change adaptation in coastal cities across the globe

Coastal cities are at the frontlines of climate change impacts, resulting in an urgent need for substantial adaptation. To understand whether, and to what extent, cities are on track to prepare for climate risks, this paper systematically assesses the academic literature to evaluate evidence on climate change adaptation in 199 coastal cities worldwide. Results show that adaptation in coastal cities is rather slow, of narrow scope and not transformative. Adaptation measures are predominantly designed based on past and current—rather than future—patterns in hazards, exposure and vulnerability. City governments, particularly in high-income countries, are more likely to implement institutional and infrastructural responses, whereas coastal cities in lower-middle-income countries often rely on households to implement behavioral adaptation. There is comparatively little published knowledge on coastal urban adaptation in low- and middle-income countries, and regarding particular adaptation types such as ecosystem-based adaptation. These insights make an important contribution for tracking adaptation progress globally and help to identify entry points for improving adaptation of coastal cities in the future.

Exposure pattern of triclosan and tetracycline change their impacts on methanogenic digestion microbiomes

Triclosan (TCS) and tetracycline (TC) as common antibacterial agents are frequently detected in the influent of wastewater treatment plants. The TCS and TC exposure patterns may determine their impacts on wastewater treatment microbiomes, on which information remains unknown. In this study, the impacts of sequential exposure of TCS and TC on methanogenic digestion microbiomes in upflow anaerobic sludge blanket (UASB) reactors were analyzed and compared with that of the same microbiomes being simultaneously exposed to TCS and TC. Results indicated that the UASB reactor 2 (MD2) with sequential TCS-TC exposure consistently demonstrated higher chemical oxygen demand (COD) removal efficiency (94.7 %). In contrast, in the MD1 reactor, COD removal efficiency decreased from 94.4 % to 82.7 % upon simultaneous exposure to TCS and TC. Accordingly, a 1.8 times higher enrichment of total antibiotic resistance genes (ARGs) was observed in MD1 relative to MD2. Using a dissimilarity-overlap approach, the MD2 microbiome with sequential exposure was predominantly mediated by deterministic factors in their community assembly (largely contributed by abundant and intermediate biospheres), resulting in microbial interaction networks with higher average clustering coefficients and shorter average path lengths, compared to the MD1 microbiomes. Our results could support sustainable management of TCS and TC contamination in wastewater treatment plants.

Sensing noise exposure and its inequality based on noise complaint data through vision-language hybrid method

This study seeks to reveal urban noise exposure patterns and inequalities using noise complaint data and vision-language hybrid method. By applying a natural language processing model to 17,243 noise complaint records, we uncovered distinct patterns of traffic, industrial, and living noise exposures across residential communities. Our analysis of street view images near complaint locations, utilizing a Residual Network (ResNet) model and Class Activation Mapping (CAM), identified the key environmental elements of different noise sources. Notably, our assessment of noise exposure inequality across 9791 communities yielded a counterintuitive finding: contrary to previous studies in Western contexts, rich communities in China experience higher and more unequal noise exposure compared to average communities, with Gini coefficients exceeding 0.8. This unexpected result likely stems from China's unique rapid urbanization process. Our use of crowdsourced complaint data aligns more closely with human subjective perceptions of noise, offering a novel perspective on noise exposure inequality. These findings challenge existing assumptions about the relationship between socioeconomic status and environmental quality in urban China, and have significant implications for urban planning and noise management strategies in rapidly developing cities.

Co-occurrence of wildfire smoke and extreme heat events in British Columbia, 2010-2022: Spatiotemporal patterns in population-level exposure

Co-occurrence of wildfire smoke and extreme heat events in British Columbia, 2010-2022: Spatiotemporal patterns in population-level exposure

Spatial patterns of heat exposure and child hospital admissions in Aotearoa New Zealand

Spatial patterns of heat exposure and child hospital admissions in Aotearoa New Zealand

Blood levels of metal exposure patterns and associated factors in a population living in an Industrial District in Brazil

Blood levels of metal exposure patterns and associated factors in a population living in an Industrial District in Brazil

Spatial-temporal assessment of future population exposure to compound extreme precipitation-high temperature events across China.

Global warming has increased the probability of extreme climate events, with compound extreme events having more severe impacts on socioeconomics and the environment than individual extremes. Utilizing the Coupled Model Intercomparison Project Phase 6 (CMIP6), we predicted the spatiotemporal variations of compound extreme precipitation-high temperature events in China under three Shared Socioeconomic Pathways (SSPs) across two future periods, and analyzed the changes in exposed populations and identified influencing factors. From the result, we can see that, the CMIP6 effectively reproduces precipitation patterns but exhibits biases. The frequency of compound event rises across SSPs, especially under high radiative forcing, with a stronger long-term upward trend. Furthermore, the economically developed areas, notably China's southeastern coast and North China Plain, will be hotspots for frequent and intense compound extreme events, while other regions will see reduced exposure. Finally, in the long-term future (2070-2100), there is a noteworthy shift in population exposure to compound events, emphasizing the increasing influence of population factors over climate factors. This highlights the growing importance of interactions between population and climate in shaping exposure patterns.