Environmental Health[JOURNAL]
Sun
200 papers
Cross-sectional association of arsenic exposure with thyroid function in Bangladeshi children aged 5 to 7 years.
Ni Y, Balakumar P, Islam T … +12 more , Haque SE, Shahriar MH, Sarwar G, Ahmed A, Liu C, Pierce BL, Sargis RM, Jackson B, Jasmine F, Kibriya MG, Ahsan H, Argos M
Environ Health · 2026 Jan · PMID 41501906 · Full text
BACKGROUND: Arsenic is a pervasive environmental contaminant and a recognized global public health concern. Experimental evidence suggests that arsenic may disrupt endocrine signaling during critical developmental window...
BACKGROUND: Arsenic is a pervasive environmental contaminant and a recognized global public health concern. Experimental evidence suggests that arsenic may disrupt endocrine signaling during critical developmental windows, yet epidemiologic data on its effects on thyroid function in early childhood remain limited. METHODS: We investigated the cross-sectional association between arsenic exposure and free thyroxine (fT4) levels among 496 children aged 5 to 7 years enrolled in the Bangladesh Environmental Research in Children's Health (BiRCH) cohort. Arsenic exposure was assessed using urinary total arsenic and toenail arsenic concentrations. Serum fT4 levels were measured by an enzyme-linked immunosorbent assay (ELISA) kit. Associations with fT4 were estimated using multivariable linear regression models adjusted for child age, sex, body mass index, and environmental tobacco smoke exposure. RESULTS: The median urinary and toenail arsenic concentrations were 88.0 µg/L (interquartile range [IQR]: 127.4) and 1.7 µg/g (IQR: 2.0), respectively. Children in the highest quartile (Q4) of arsenic exposure had significantly higher fT4 levels compared to those in the lowest quartile (Q1), for both urinary (β = 0.09; 95% CI: 0.005-0.17) and toenail arsenic (β = 0.10; 95% CI: 0.03-0.17). A significant dose-response trend was observed across quartiles, suggesting a potential linear relationship. CONCLUSIONS: Our findings suggest that thyroid function may be a sensitive target of arsenic toxicity in early childhood. Longitudinal studies are necessary to assess the long-term effects of early-life arsenic exposure on thyroid function across the life course.
Metals in water used by artisanal and small-scale gold miners for gold-mercury amalgamation in Western Kenya.
Raoilimanantsoa N, Oremo J, Akello O … +5 more , Majanga W, Gunter S, Ayodo G, Torkmahalleh MA, Dorevitch S
Environ Health · 2026 Jan · PMID 41501896 · Full text
BACKGROUND: Workers in artisanal and small-scale gold mining (ASGM) are exposed to metals and metalloids (referred to here as "metals") while mixing milled ore and elemental mercury to produce a gold-mercury amalgam. Alt...
BACKGROUND: Workers in artisanal and small-scale gold mining (ASGM) are exposed to metals and metalloids (referred to here as "metals") while mixing milled ore and elemental mercury to produce a gold-mercury amalgam. Although concentrations of metals in surface waters near ASGM activities have been described, little is known about concentrations of metals in the water-ore-mercury slurry with which workers have extensive dermal contact. We sought to characterize those concentrations. METHODS: Water samples (n = 76) were collected from amalgamation basins and milled ore washing ponds at 13 ASGM sites in Western Kenya. Samples were filtered and metals in the filtrate and metals retained on filters were analyzed for trace elements by inductively coupled plasma mass spectrometry (ICP-MS). Based upon the volume filtered and ICP-MS results, total metal concentrations in the original samples (pre-filtration), were calculated. RESULTS: Concentrations of metals in the amalgamation basins were high. The median concentrations of arsenic (240.23 µg/L), chromium (312.97 µg/L) and total mercury (3.52 µg/L) all exceeded Kenya's drinking water standard by several fold. Only 3.38% of arsenic, 0.28% of chromium, 40.51% of manganese, 0.22% of mercury and 0.01% of lead mass were in filtrate, with the remainder of the metal mass retained on filters. CONCLUSIONS: Concentrations of arsenic, chromium, manganese and lead to which ASGM workers are exposed in the amalgamation process were approximately 5-100-fold higher concentrations than reported in prior studies of metals in surface waters near ASGM sites. These findings should be useful in assessments of exposure and health risk of the many thousands ASGM workers who amalgamate milled ore. The high concentrations of As, Mn and Hg put at risk the health of children who live near or work at ASGM sites. Policy measures and changes in occupational practices are urgently needed to reduce Hg use in ASGM and to protect individuals from metals present in milled ore.
Human biomonitoring in support of the Minamata Convention: a case of phasing out dental amalgam.
Usenik V, Alilović Osolin A, Snoj Tratnik J … +5 more , Jagodic Hudobivnik M, Mazej D, Kocman D, Kontić D, Horvat M
Environ Health · 2026 Jan · PMID 41491475 · Full text
This study analysed urinary mercury (U-Hg) concentrations in 1412 Slovenian children across four human biomonitoring campaigns conducted between 2007 and 2024. Median U-Hg levels declined from 0.76 ng mL−1 (0.72 µg g−1 c...
This study analysed urinary mercury (U-Hg) concentrations in 1412 Slovenian children across four human biomonitoring campaigns conducted between 2007 and 2024. Median U-Hg levels declined from 0.76 ng mL−1 (0.72 µg g−1 creatinine) in the 2007 PHIME cohort to 0.22 ng mL−1 (0.21 µg g−1 creatinine) in the 2018–2024 SLO-HBM-II cohort, paralleling a decrease in the prevalence (from 65 to 3%) and the average number of dental amalgam fillings in children. Multilevel mixed-effects models showed a consistent temporal decline in U-Hg that persisted after adjustment for demographic and environmental covariates. In contrast, the inclusion of the amalgam number substantially attenuated the time trend, indicating that reduced amalgam use likely contributed to the observed decrease. As amalgam prevalence fell, other sources of exposure, such as fish consumption, became relatively more prominent predictors of U-Hg, while children living in historically Hg-contaminated areas showed persistently higher levels. Although Slovenia had already phased down dental amalgam in children before ratifying the Minamata Convention, these long-term biomonitoring data illustrate how changes in exposure sources are reflected in internal Hg levels. The study demonstrates the value of repeated national HBM programmes for identifying dominant exposure pathways, investigating their evolution over time, and providing evidence relevant to effectiveness-evaluation frameworks under Article 22 of the Minamata Convention.
Association of oil spill cleanup-related hydrocarbon exposure with incident hypertension up to 11 years after exposure in the Gulf Long-term Follow-up Study.
Patel OP, Edwards JK, Kucharska-Newton AM … +8 more , Whitsel EA, Christenbury KE, Jackson Ii WB, Lawrence KG, Stewart PA, Stenzel MR, Engel LS, Sandler DP
Environ Health · 2025 Dec · PMID 41469699 · Full text
BACKGROUND: While several studies have found positive associations between exposure to oil spill cleanup-related chemicals and hypertension, no study has examined these associations longitudinally. OBJECTIVE: This study...
BACKGROUND: While several studies have found positive associations between exposure to oil spill cleanup-related chemicals and hypertension, no study has examined these associations longitudinally. OBJECTIVE: This study examined associations of oil spill-related benzene, toluene, ethylbenzene, xylene, and n-hexane (BTEX-H) exposures, individually and as both the aggregate sum (total) of BTEX-H and the BTEX-H mixture with incident hypertension among Gulf Long-term Follow-up (GuLF) Study participants. METHODS: Participants were 18,619 Deepwater Horizon (DWH) oil spill cleanup and response workers who enrolled in the GuLF Study (2011-2013). Cumulative exposures to each BTEX-H chemical were estimated with a job-exposure matrix linking detailed self-reported DWH participant work histories to exposure group estimates developed from air monitoring data. We defined incident hypertension as the first self-reported physician diagnosis of hypertension or high blood pressure after each worker's last date of cleanup work, as reported at enrollment or a follow-up interview (2013-2016 or 2017-2021). We used Cox proportional hazards regression to estimate hazard ratios (HR) and 95% confidence intervals (CI). We used quantile g-computation to estimate the joint effect of the BTEX-H mixture. RESULTS: Approximately 20% (n = 3,779) of workers reported an incident hypertension diagnosis. Exposures to the individual BTEX-H chemicals were highly correlated (r = 0.87-0.95). The HRs comparing the highest to lowest quartiles of individual BTEX-H and total BTEX-H exposures ranged from 1.27 to 1.35. We found evidence of exposure-response trends across increasing quartiles of exposure. Each one quartile increase in the BTEX-H mixture was positively associated with incident hypertension (HR: 1.10, 95% CI: 1.07, 1.14). DISCUSSION: Oil spill cleanup work-related BTEX-H exposures were associated with the risk of incident hypertension, extending prior findings of cross-sectional associations. Since BTEX-H exposures are common in occupational and population settings, these findings may have broader public health implications.
Dissecting the effect of long-term exposure to air pollution on risk of dementia in UK Biobank.
Palacios ER, Shapland CY, Wolf LJ … +8 more , Nordestgaard LT, Anderson E, Slaney C, Bernie D, Mitchell D, Kehoe PG, Griffith GJ, Tilling K
Environ Health · 2025 Dec · PMID 41462458 · Full text
Mounting evidence links air pollution to dementia, the most prevalent cause of cognitive impairment in older people. Here we investigated individual and compound effects of particulate matters (PM, PM, PM, PM) and nitric...
Mounting evidence links air pollution to dementia, the most prevalent cause of cognitive impairment in older people. Here we investigated individual and compound effects of particulate matters (PM, PM, PM, PM) and nitric oxides (NO, NO) on risk of all-cause dementia, and its most common subtypes, Alzheimer's disease (AD) and vascular dementia (VAD), using data from UK Biobank. We addressed factors that hinder causal interpretation of associations previously shown in the literature and their translation into clear public health policies. Specifically: 1) spatial confounding by area-level covariates, 2) collinearity among and identification of the most relevant air pollutants, and 3) the time window for pollution exposure. Furthermore, we used chronic obstructive pulmonary disease (COPD) and frequency of oily fish intake in positive and negative control analyses. We found NO to be the strongest risk factor for dementia, especially when considering participants with longer permanence at residential address as proxy for longer periods ([Formula: see text] years) of exposure (all-cause dementia hazard ratio HR=1.06, 1.02-1.11 per 9.86 [Formula: see text] interquartile range). There was stronger evidence of an effect on risk for AD than VAD. Positive control analysis did not provide any evidence against causality, although the analyses of spatial confounding and negative control analyses revealed the presence of some residual bias, thus warranting care in the interpretation of the results. Together, our results highlight that targeting air pollution, in particular NO levels, could inform preventive public health policies for dementia.
Biological monitoring of occupational exposure to inorganic lead: a comparison between salivary, blood and airborne lead levels.
Tobia L, Mastrantonio R, Muselli M … +8 more , De Rossi L, Tolli E, Cofini V, Grignani E, Gambelunghe A, Dell'Omo M, Necozione S, Fabiani L
Environ Health · 2025 Dec · PMID 41444959 · Full text
BACKGROUND: Inorganic lead exposure is a relevant occupational health issue in many industry sectors. European regulations set specific limits for time-weighted chemical airborne exposure and for biological exposure. Whi...
BACKGROUND: Inorganic lead exposure is a relevant occupational health issue in many industry sectors. European regulations set specific limits for time-weighted chemical airborne exposure and for biological exposure. While blood lead monitoring is the current standard, saliva sampling offers a less invasive alternative for biomonitoring. This study evaluates the potential of salivary lead assessment as an alternative biological matrix for occupational exposure monitoring. METHODS: An observational study was conducted at a lead-acid battery production facility in Central Italy from July to December 2024. Ninety-two male workers participated: 46 occupationally exposed and 46 non-exposed workers. Salivary lead levels were measured using ICP-MS in all participants. Blood lead levels and personal airborne lead assessments were performed in the exposed group. Socio-demographic data were collected through self-administered questionnaires. RESULTS: Mean salivary lead levels were significantly higher in exposed workers (23.3 ± 41.4 ng/swab) compared to non-exposed workers (0.3 ± 0.6 ng/swab, p < 0.001). A moderate positive correlation was found between environmental and salivary lead levels (ρ = 0.5587, p = 0.0003). No significant correlations were observed between blood and salivary lead levels or between environmental and blood lead levels. Occupational exposure and alcohol consumption were significant predictors of salivary lead levels. CONCLUSIONS: Saliva appears to be a promising alternative matrix for recent lead exposure monitoring, showing better correlation with environmental exposure than blood lead levels. Further research is needed to establish reference values and standardize salivary lead biomonitoring protocols.
Organophosphate ester exposure in pregnancy, gestational weight gain, and postpartum body composition in a U.S.-based longitudinal pregnancy cohort.
Barrett ES, Klus J, Pande A … +7 more , Love T, Thurston SW, Brunner J, Kannan K, Miller RK, Groth S, O'Connor TG
Environ Health · 2025 Dec · PMID 41419913 · Full text
BACKGROUND: Organophosphate esters (OPEs) are replacement flame retardants that have been implicated as metabolic disruptors and linked to birth size across a number of epidemiologic studies. Little is known about how OP...
BACKGROUND: Organophosphate esters (OPEs) are replacement flame retardants that have been implicated as metabolic disruptors and linked to birth size across a number of epidemiologic studies. Little is known about how OPEs impact maternal weight and body composition from pregnancy through the postpartum period. METHODS: We measured OPE metabolites in mid-pregnancy urine samples from participants in a pregnancy cohort study based in Rochester, NY, USA. We calculated total gestational weight gain (GWG) based on clinical records (n = 278) and additionally measured weight retention and body fat percentage through bioelectric impedance at 6 (n = 205) and 12 months postpartum (n = 167). We fitted adjusted linear and logistic regression models examining OPE concentrations in relation to the outcome measures and secondarily, fitted models stratified by earliest pregnancy BMI (< 25 kg/m versus ≥ 25 kg/m). RESULTS: In main models, most associations were null. Several highly prevalent OPEs such as bis(1,3-dichloro-2-propyl) phosphate (BDCPP; β: -1.02 lbs 95%CI: -2.00, -0.03) were associated with lower GWG, while detection of other, less prevalent OPEs like BMPP (bis(methylphenyl) phosphate; β: 2.86 lbs, 95%CI: -0.21, 5.94) was associated with greater GWG. In stratified analyses, associations tended to be stronger in women who started pregnancy overweight or obese, including findings that several OPEs were associated with higher fat percentage at 6 and 12 months postpartum. Few associations with postpartum weight retention were observed. DISCUSSION: Evidence linking gestational OPE exposure with GWG and body composition in the postpartum was limited and mixed, with the strongest associations observed for BDCPP. In light of the growing literature on OPEs' impacts on birth size and child outcomes, greater research into maternal metabolic disruption is warranted.
Residential proximity to nuclear power plants and cancer incidence in Massachusetts, USA (2000-2018).
Alwadi Y, Evans JS, Schwartz J … +4 more , Vieira CLZ, Christiani DC, Coull BA, Koutrakis P
Environ Health · 2025 Dec · PMID 41408632 · Full text
PURPOSE: To investigate the associations between residential proximity to nuclear power plants and ZIP code-level cancer incidence among Massachusetts residents. METHODS: We assessed proximity of Massachusetts ZIP codes...
PURPOSE: To investigate the associations between residential proximity to nuclear power plants and ZIP code-level cancer incidence among Massachusetts residents. METHODS: We assessed proximity of Massachusetts ZIP codes to nuclear power plants using an inverse-distance weighted metric. We obtained cancer incidence data (2000-2018) from the Massachusetts Cancer Registry. We applied two approaches: (1) longitudinal Generalized Estimating Equation (GEE) Poisson regression to evaluate yearly incidences for all cancers combined, and (2) cross-sectional log-linear Poisson regression for site-specific cancers. We adjusted models for PM2.5, demographic, socioeconomic, environmental, and healthcare covariates, and stratified analyses by sex and four age groups (45-54, 55-64, 65-74, 75 +). RESULTS: Proximity to plants significantly increased cancer incidence, with risk declining by distance. At 2 km, females showed RRs of 1.52 (95% CI: 1.20-1.94) for ages 55-64, 2.00 (1.59-2.52) for 65-74, and 2.53 (1.98-3.22) for 75 + . Males showed RRs of 1.97 (1.57-2.48), 1.75 (1.42-2.16), and 1.63 (1.29-2.06), respectively. Cancer site-specific analyses showed significant associations for lung, prostate, breast, colorectal, bladder, melanoma, leukemia, thyroid, uterine, kidney, laryngeal, pancreatic, oral, esophageal, and Hodgkin lymphoma, with variation by sex and age. We estimated 10,815 female and 9,803 male cancer cases attributable to proximity, corresponding to attributable fractions of 4.1% (95% CI: 2.4-5.7%) and 3.5% (95% CI: 1.8-5.2%). CONCLUSIONS: Residential proximity to nuclear plants in Massachusetts is associated with elevated cancer risks, particularly among older adults, underscoring the need for continued epidemiologic monitoring amid renewed interest in nuclear energy.
Couples exposure to neonicotinoid insecticides and its influence on in vitro fertilization/intracytoplasmic sperm injection outcomes.
Liu Z, Shi H, Li N … +5 more , Xu Z, Zhao X, Liu G, Liang X, Yang X
Environ Health · 2025 Dec · PMID 41408251 · Full text
Neonicotinoid insecticides (NEOs), recognized endocrine-disrupting compounds, are extensively utilized in agricultural and livestock practices, exhibiting global environmental persistence and bioaccumulation in human pop...
Neonicotinoid insecticides (NEOs), recognized endocrine-disrupting compounds, are extensively utilized in agricultural and livestock practices, exhibiting global environmental persistence and bioaccumulation in human populations and wildlife. Accumulating experimental and epidemiological evidence implicates NEO exposure in reproductive dysfunction. This study investigated paired NEO concentrations in serum, female follicular fluid, and male seminal plasma from 211 couples undergoing assisted reproductive technology (ART), evaluating associations with reproductive outcomes. NEO concentrations were quantified using liquid chromatography-tandem mass spectrometry (LC–MS/MS), and associations with ART parameters, considering partner exposure metrics, were examined utilizing covariate-adjusted generalized linear models. Results revealed N-demethyl-acetamiprid (N-dm-ACE) was commonly detected across all matrices. Female serum clothianidin (CLO) demonstrated a significant inverse correlation with fertilization potential and good-quality embryo yield, while elevated serum N-dm-ACE concentrations were linked to diminished biochemical pregnancy probability. Within follicular fluid, CLO presence impaired fertilization and cleavage rates, and higher N-dm-ACE levels compromised good-quality embryo developmental competence. Additionally, THX detection in seminal plasma was linked to reduced cleavage rates and lower biochemical and clinical pregnancy rates. Negative dose–response relationships were observed between N-dm-ACE exposure in female serum and both biochemical and clinical pregnancies, and between N-dm-ACE levels in follicular fluid and cleavage rate and biochemical pregnancy. These results demonstrate that partner NEO exposure detrimentally influences pivotal ART success metrics, highlighting the critical importance of dual parental biomonitoring in reproductive toxicology research for clinical risk assessment. Comprehensive longitudinal cohort studies are warranted to substantiate these associations and elucidate mechanistic pathways.
Burden of disease attributable to PM at low exposure levels: impact of methodological choices.
Lehtomäki H, Aasvang GM, Sulo G … +6 more , Denby BR, Hänninen OO, Brauer M, Pereira G, Dadras O, Bølling AK
Environ Health · 2025 Dec · PMID 41382282 · Full text
BACKGROUND: Exposure to fine particles (PM) has been associated with adverse health outcomes, even at low exposure levels (< 10 µg/m). Burden of disease assessments can quantify these associations; however, their sensiti...
BACKGROUND: Exposure to fine particles (PM) has been associated with adverse health outcomes, even at low exposure levels (< 10 µg/m). Burden of disease assessments can quantify these associations; however, their sensitivity to methodological choices limits comparability between studies. METHODS: This study aimed to quantify the impact of methodological choices on disease burden attributable to low levels of ambient PM, using Norway as a case study. Key methodological choices included (i) population exposure data, (ii) concentration-response curves, and (iii) population health data. Data from national and international sources were applied, including the global burden of disease (GBD) study. Attributable mortality and disability-adjusted life years (DALY) were estimated using burden of disease methodology. Additionally, the impact of choices related to concentration-response curves was assessed for higher exposure levels, using a scenario where exposure distributions were shifted to mean exposures up to 30 µg/m. RESULTS: Methodological choices related to the concentration-response curves had the largest impacts on the estimated attributable deaths, ranging from - 91% to 104% change relative to the reference estimate (1,448 deaths, 95% CI 502-1497). These choices had a smaller impact on higher exposure levels, varying from - 46% to 53%. The choice of exposure and population health data led to 40% differences in attributable death estimates. DALYs attributable to PM were predominantly driven by years of life lost (YLL: 74%). The choice of relative risk (RR) for the concentration response curve caused around 30% variation in DALY estimates relative to the reference (11,730 DALYs; 5,980 - 16,790), with larger differences for ischemic heart disease (-44 to 79%). CONCLUSION: Attributable burden estimates for PM are highly sensitive to key methodological choices, particularly at low exposure levels. Consequently, transparent reporting of the methodological choices and data sources in PM health risk assessments are required to improve comparability and facilitate interpretations of the burden estimates.
Wildfire smoke and pediatric asthma control in the Northeastern United States: a cross-sectional study.
Maassel AK, Brochu P, Harder VS … +3 more , Ricketts TH, Teach SJ, Robinson KJ
Environ Health · 2025 Dec · PMID 41372919 · Full text
BACKGROUND: Poor air quality due to smoke from distant wildfires is a growing risk for the Northeastern United States, a region largely unaffected by these events until recently. Despite this emerging threat, few studies...
BACKGROUND: Poor air quality due to smoke from distant wildfires is a growing risk for the Northeastern United States, a region largely unaffected by these events until recently. Despite this emerging threat, few studies have examined the effect of wildfire smoke on respiratory health in this region. We investigated the association between wildfire smoke exposure and pediatric asthma control in Vermont and upstate New York. METHODS: We extracted data from the electronic health records of youth aged 3-21 years diagnosed with asthma within a single regional healthcare system and included three clinical measures of asthma control: Test for Respiratory and Asthma Control in Kids (3-4 years), Asthma Therapy Assessment Questionnaire (5-21 years), and the National Heart, Lung and Blood Institute (NHLBI) asthma control guidelines (3-21 years). We first compared asthma control in the smoke-affected summer of 2023 to the largely unaffected summers of 2022 and 2024 using regression models, controlling for pollen exposure. We then obtained airborne particulate matter (PM) values within ZIP codes and used regression models to investigate the association between asthma control and PM during the smoke-affected summer of 2023. RESULTS: The study sample included 1,217 encounters (mean age 9.1 ± 4.4 years, 57% male). Asthma control was significantly worse in the severely smoke-affected summer of 2023 versus 2022 for two of the three clinical measures but was not different between 2023 and 2024 for any of the clinical measures. Within summer 2023, there were no significant associations between ZIP code-level PM and asthma control for any of the three clinical measures. CONCLUSIONS: Wildfire smoke exposure in the Northeast was associated with decreased asthma control in this pediatric population, though not consistently across years and all clinical measures. As climate change drives longer and more intense wildfire seasons, continued monitoring is needed to understand the impact on pediatric respiratory health in this historically low-exposed region.
Risk of hospitalization and mortality across US climate regions following extreme heat exposure in patients with end-stage kidney disease (ESKD) receiving in-center hemodialysis: a space-time-stratified case-crossover analysis.
Sieck NE, Liang M, Song H … +9 more , He H, Raimann JG, Cruz R, Salawitch RJ, Sapkota AR, Maddux FW, Usvyat LA, Kotanko P, Sapkota A
Environ Health · 2025 Dec · PMID 41350691 · Full text
BACKGROUND: The impact of heat exposure on patients with end-stage kidney disease (ESKD) is of growing concern in the context of climate change. In this study, we investigated the association of heat exposure with hospit...
BACKGROUND: The impact of heat exposure on patients with end-stage kidney disease (ESKD) is of growing concern in the context of climate change. In this study, we investigated the association of heat exposure with hospitalization and mortality, and how the risk of these adverse health outcomes varied by climate region in the US. METHODS: We obtained hospitalization and mortality data for patients with ESKD receiving in-center hemodialysis treatment between 2012 and 2018 at Fresenius Kidney Care facilities located within the contiguous US. We used the treatment facility location to assign heat exposure using maximum universal thermal climate index temperature data. We conducted a space-time-stratified case-crossover study using conditional Poisson regression with distributed lag nonlinear models to examine the effects of heat exposure at the 95th percentile of the region-specific temperature distribution for lags of three days. Stratified analyses were run to assess differences in associations across nine climate regions and three latitude bands. RESULTS: The cumulative lag 0-3 risk of hospitalization associated with heat exposure was highest in the West (rate ratio [RR]: 1.099; 95% confidence interval [CI]: 1.041, 1.160), whereas the highest risk of mortality was observed in the Northwest region (RR: 1.097; 95% CI: 1.007, 1.195). We observed significant increases in the risk of hospitalization at the low- and mid-latitude bands and a significant increase in the risk of mortality in the mid-latitude band. CONCLUSION: We observed spatial heterogeneity across US climate regions. The strongest effects of heat exposure were observed in the Ohio Valley, South, and West regions for hospitalization and the Upper Midwest, Southeast, and Northwest regions for mortality. Findings may be used to inform targeted interventions to patients with ESKD residing in areas with higher risks of adverse health outcomes following heat exposure.
A systematic review of exposure to endocrine disruptors and energy expenditure in mice.
Dos Santos Rodrigues Vaz ML, da Silva Sousa AB, Ribeiro CM … +2 more , Bellozi PMQ, Amato AA
Environ Health · 2025 Dec · PMID 41345655 · Full text
Exposure to endocrine disruptors (EDs) is associated with increased susceptibility to obesity and metabolic dysfunction in epidemiological and preclinical studies. Accumulating evidence supports that various EDs promote...
Exposure to endocrine disruptors (EDs) is associated with increased susceptibility to obesity and metabolic dysfunction in epidemiological and preclinical studies. Accumulating evidence supports that various EDs promote energy intake and fat storage, but little is known about how they affect energy expenditure (EE). This systematic review examined the effect of EDs on EE in murine models and on mitochondrial bioenergetics in cell-based studies. We included 12 in vivo studies, which assessed the effect of phytoestrogens, DDT, tolylfluanid, benzene, bisphenol A, bisphenol S, butyl-phthalate, deltamethrin, and the mixtures of 23 chemicals and of organophosphate flame retardants. DDT, tolylfluanid, benzene, and the mixtures of 23 chemicals and of flame retardants decreased; bisphenol A, bisphenol S, and butyl-phthalate had a neutral effect; and phytoestrogens and deltamethrin increased EE. The effects of some EDs were sexually dimorphic, dose-dependent, and interacted with diet. Nine cell-based studies were included and indicated that mitochondrial bioenergetics was impaired by tolylfluanid, bisphenol A, and DDT in muscle cells; by bisphenol AF, BDE-99, DDT, DDE, and the mixture of DDE, trans-nonachlor, and oxychlordane in adipocytes; by bisphenol A in hepatocytes; and by tributyltin in pluripotent cells. Our findings indicate that EDs affect EE in mice in a sexually dimorphic pattern and impair mitochondrial bioenergetics in cellular models which are representative of key tissues involved in energy balance. While further studies are needed to fully elucidate the impact of EDs on energy balance and mitochondrial function, this review underscores the plausibility of mitochondrial dysfunction and altered EE as key pathways linking ED exposure to metabolic diseases.
Chained mediation of interleukins linking fluoride exposure to frailty: a cohort study of skeletal fluorosis patients in China.
Lu Y, Tao F, Hu T … +9 more , Wang R, Shao Z, Ye H, Yang G, Li J, Jia Q, Hong F, Luo P, China Fluorosis Cohort (CFC) collaborative group
Environ Health · 2025 Dec · PMID 41327285 · Full text
BACKGROUND: Chronic fluorosis, characterized by excessive exposure to fluoride, is associated with a greater risk of frailty in endemic populations. While fluoride correlates with inflammation and frailty, the mediating...
BACKGROUND: Chronic fluorosis, characterized by excessive exposure to fluoride, is associated with a greater risk of frailty in endemic populations. While fluoride correlates with inflammation and frailty, the mediating role of interleukins (ILs) remains unclear. This study investigated the potential multiple mediation pathways of ILs on the relationship between fluoride exposure and frailty in skeletal fluorosis patients. METHODS: A multicenter cross-sectional cohort (N= 678; age: ≥40 years) from high-fluoride areas in China (2023-2024) was enrolled. Urine fluoride (uF) was used to assess exposure. Frailty was measured via the FRAIL scale, and serum ILs (IL-6, IL-8, IL-1β, and IFN-α) were measured via ELISA. Associations and potential mediating pathways were evaluated via chain mediation models (PROCESS macro, SPSS),which test IL-mediated pathways between uF and frailty and adjust for age/sex. Bootstrapping (5,000 resamples) was used to estimate 95% CIs. RESULTS: Frailty prevalence (5.9%) surpassed that of the general population (2.3%). A high uF value was directly associated with frailty risk (β = 0.2856, P < 0.001). Two potential pathways were identified: the inflammatory cascade: uF→IL-6↑ (β= 0.2947) → IL-1β↑ (β= 0.3936) →frailty (β= 0.0893), and the indirect association accounted for 3.6% of the total effect. Muscle-nutrition depletion: IL-1β↑ → sarcopenia↑ (β= 0.1137)→ increased undernutrition risk↑ (β=-0.2148)→ frailty (β=-0.1990); the indirect association accounted for 4.2% of the total effect. IFN-α attenuated the association of fluoride with IL-1β (P = 0.0113) and was linked to lower frailty risk (β = -0.086, P < 0.01). CONCLUSIONS : The"IL-6→IL-1β" pathway is a potential mechanism for inflammation-related frailty, and nutritional interventions could disrupt the "IL-1β→sarcopenia→malnutrition" cycle. IFN-α has a protective effect on fluoride-induced inflammation.
Children's environmental health, environmental justice and PM2.5 regulation in the US, 1997-2024.
Sullivan M, Kohl E
Environ Health · 2025 Nov · PMID 41318487 · Full text
INTRODUCTION: Children are uniquely susceptible to air pollution. US EPA is required to set National Ambient Air Quality standards that protect susceptible populations from air pollution within an “adequate margin.” Addi...
INTRODUCTION: Children are uniquely susceptible to air pollution. US EPA is required to set National Ambient Air Quality standards that protect susceptible populations from air pollution within an “adequate margin.” Additionally, environmental justice communities are often disproportionately exposed to air pollution, therefore children living in these communities may experience increased vulnerability. PM2.5 contributes significantly to air pollution attributable morbidity and mortality. This research analyzes each PM2.5 rulemaking starting with the first in 1997 to determine for how children and children living in environmental justice communities were considered at each stage of the rulemaking process. METHODS: We used content analysis to analyze all EPA PM 2.5 rulemakings. Publicly available rulemaking documents were searched to determine how EPA assessed the weight of evidence for Children’s Environmental Health (CEH) endpoints and how this evidence was used in later stages of rulemaking. We also analyzed EPA’s consideration of children in environmental justice analyses related to rulemaking. We used word count analysis to examine the relative emphasis on CEH and environmental justice in rulemaking over time. Finally, we examined if CEH evidenced was prioritized in EPA’s rulemaking rationales. RESULTS: The evidence base for CEH and PM 2.5 has expanded since 1997 but there are a limited number of CEH health endpoints designated as causal or likely causal in EPA’s weight of evidence assessments. CEH health effects in PM 2.5 benefits assessments have primarily been limited to respiratory effects and infant mortality. Consideration of environmental justice was limited until 2012 but expanded in 2024, however children have not been included in environmental justice health effects analyses. When CEH evidence was prioritized in rulemaking rationales, standards were strengthened. CONCLUSIONS AND RECOMMENDATIONS: We find conflicting treatment of CEH in PM 2.5 standard setting. In some rulemakings CEH was prioritized while in others it was not. There has been limited consideration of environmental justice in PM 2.5 rulemaking and no rulemaking has accounted for the potential risk of adverse health effects for children living in environmental justice communities. EPA’s strict adherence to causal criteria for CEH endpoints, which can be difficult to study, may slow the adoption of protective standards. Further, policymakers should have access to more comprehensive data and information on PM2.5’s impact on CEH. Finally, due to its importance for lifelong health, we advocate for a consistent precautionary approach to CEH in NAAQs standard setting.
Small extracellular vesicles: connecting early life exposure outcomes to air pollution during pregnancy to early childhood health.
Kahroba H, Krauskopf J, Briedé JJ … +2 more , Nawrot T, de Kok TM
Environ Health · 2025 Nov · PMID 41316269 · Full text
Exposure to air pollution poses a serious threat to maternal and child health, particularly during critical developmental periods. Extracellular vesicles (EVs), as key mediators of intercellular communication, have emerg...
Exposure to air pollution poses a serious threat to maternal and child health, particularly during critical developmental periods. Extracellular vesicles (EVs), as key mediators of intercellular communication, have emerged as a novel mechanism through which environmental exposures, including air pollutants, exert systemic effects. This review synthesizes current evidence on the role of small EVs (sEVs) in mediating the biological impacts of prenatal air pollution exposure, with a focus on their molecular profile, including the presence of signaling molecules like miRNAs and proteins, and their implications for childhood health outcomes. In this review, we explore mechanisms involving sEVs in transplacental exposure, signaling and epigenetic modifications, linking exposure to adverse developmental and health effects in early life. Furthermore, we highlight the potential of sEVs as biomarkers for exposure assessment and predictors of adverse health outcomes. Relevant studies were identified through a comprehensive literature search and systematic review of experimental and epidemiological evidence. By integrating insights from toxicology, epidemiology, and molecular biology, we identify specific needs for further research into sEVs, both as mechanistic mediators and diagnostic tools for air pollution-related health risks.
Cumulative childhood lead exposure estimation and school-age IQ in a prospective birth cohort.
Vester A, Xu Y, Newman NC … +9 more , MacDougall MC, Papandonatos GD, Parsons PJ, Palmer CD, Braun JM, Lanphear BP, Chen A, Cecil KM, Yolton K
Environ Health · 2025 Nov · PMID 41310752 · Full text
BACKGROUND: Lead is a well-known neurotoxicant with no identified safe level. Prior studies found that childhood lead exposure is associated with decreased intelligence quotient (IQ) scores. However, most studies rely on...
BACKGROUND: Lead is a well-known neurotoxicant with no identified safe level. Prior studies found that childhood lead exposure is associated with decreased intelligence quotient (IQ) scores. However, most studies rely on a limited number of blood lead measurements. In this prospective pregnancy and birth cohort, we estimated cumulative childhood lead exposure using repeated blood lead concentrations and regression calibration, allowing for more accurate assessment of lead burden over time and its association with IQ. METHODS: This prospective study included 262 mother-child dyads from Greater Cincinnati enrolled in the Health Outcomes and Measures of the Environment (HOME) Study from 2003 to 2006. We obtained serial blood lead measurements and estimated cumulative childhood lead exposure using a regression calibration method. Outcome was assessed via Wechsler-based IQ testing at ages 5-12 years. We examined the association between estimated cumulative childhood lead exposure and child IQ using linear regression models. RESULTS: Our cohort had low levels of estimated lifetime average lead exposure (geometric mean: 1.21 μg/dL). Overall, estimated lead exposure decreased from age 12 months to time of IQ test. Cumulative childhood lead exposure estimate was associated with decreased IQ at ages 5-12 years in unadjusted analyses, but not after adjusting for maternal IQ, household income, reported prenatal vitamin use, Home Observation for Measurement of the Environment score, and maternal serum cotinine. Sensitivity analyses additionally adjusting for prenatal total folate did not markedly change our results. We assessed early-life, school-age, or concurrent blood lead exposure estimate in place of cumulative childhood lead exposure estimate and observed a similar pattern of results. CONCLUSIONS: We used a regression calibration method to leverage robust, repeated lead exposure data in our prospective pregnancy and birth cohort. In this cohort with low levels of lead exposure, cumulative childhood lead exposure estimate was negatively associated with school-age IQ in unadjusted analyses but not adjusted analyses. We considered sociodemographic and maternal factors previously associated with cognitive development. Our results suggest these factors may confound the association between low-level child lead exposure and child IQ.
Evaluating urinary metabolic profiles with wildland-urban-interface (wui) fire exposure among male firefighters: a comparison with municipal structure fires (msf).
Liu T, Furlong MA, Snider JM … +13 more , Beitel S, Mullins CE, Walker DI, Goodrich JM, Urwin DJ, Gabriel J, Hughes J, Gulotta JJ, Calkins MM, Liu Y, von Hippel FA, Beamer P, Burgess JL
Environ Health · 2025 Nov · PMID 41250158 · Full text
BACKGROUND: Firefighters have frequent exposure to carcinogens and an increased risk of cancer. Wildland-urban interface (WUI) fires, which involve both structures and undeveloped wildland fuels, pose unique challenges t...
BACKGROUND: Firefighters have frequent exposure to carcinogens and an increased risk of cancer. Wildland-urban interface (WUI) fires, which involve both structures and undeveloped wildland fuels, pose unique challenges to the health of firefighters. However, the extent of health risks associated with these fires remains underexplored. OBJECTIVES: This study aims to identify altered urine metabolites and metabolic processes among male firefighters that were associated with WUI fires as compared with municipal structure fires (MSF). METHODS: Untargeted metabolomic profiling was applied to pre-exposure (baseline) and postfire urine samples collected from firefighters responding to WUI and MSF fires. Differential analysis was conducted by fitting linear mixed effects regression models on preprocessed ion intensity and exposure status while adjusting for demographic covariates. Differential metabolites by post-exposure status were identified using a false discovery rate (FDR) threshold of < 0.05. Pathway analysis was performed to identify pathways that were significantly perturbed at a Bonferroni adjusted p-value < 0.05 level. We conducted differential and pathway analyses in both the WUI and MSF cohorts and compared the two fire types in terms of the number of differentially expressed metabolites and patterns of metabolic pathway enrichment. RESULTS: Eighty-five firefighters contributed paired baseline and post-fire samples from WUI events, and 98 firefighters contributed paired baseline and post-fire samples from MSF events. We performed metabolic profiling on baseline and postfire urine samples from WUI and MSF using four modes: HILIC(-), HILIC(+), C18(-), and C18(+) and identified metabolites against an in-house library. We identified 244, 297, 320, and 266 level-1 metabolites from the four respective modes. In the statistical analysis, the main model identified a total of 176 differential metabolites from WUI fires. For MSF, the model identified a total of 652 differential metabolites from the four respective modes. Most metabolites with significant changes after a WUI fire also changed significantly after an MSF event. Two metabolic pathways were significantly enriched after WUI fires, while 7 pathways were significantly enriched after MSF exposure and 2 pathways overlapped between the two types of fires. CONCLUSION: Fire exposure induces numerous metabolic perturbations in firefighters responding to WUI fires, potentially contributing to their elevated cancer risk. Although individual metabolites changed in a similar fashion across both WUI and MSF, MSF were associated with an increased number of metabolite changes and some of the enriched pathways differed between exposures to WUI fires vs. MSF. These findings suggest that WUI and MSF exposures may share common biological responses while also posing unique health risks to firefighters.
Prenatal fluoride exposure and autistic behaviors in preschool-aged children: the Maternal-Infant Research on Environmental Chemicals (MIREC) cohort study.
Carty A, Green R, Goodman CV … +8 more , McLaughlin JR, Hu H, Lanphear B, Martinez-Mier EA, MacFarlane AJ, Muckle G, Brook JR, Till C
Environ Health · 2025 Nov · PMID 41220017 · Full text
BACKGROUND: The prevalence of autism spectrum disorder has risen in recent decades. Given the growing evidence that prenatal fluoride exposure may be neurotoxic, we examined associations between prenatal fluoride exposur...
BACKGROUND: The prevalence of autism spectrum disorder has risen in recent decades. Given the growing evidence that prenatal fluoride exposure may be neurotoxic, we examined associations between prenatal fluoride exposure and parent-reported autistic behaviors in preschool-aged children. METHODS: We studied 453 mother-child pairs using data from the Maternal-Infant Research on Environmental Chemicals (MIREC) study, a prospective Canadian birth cohort. Autistic behaviors were assessed in children at 3 to 4 years using the Social Responsiveness Scale-Second Edition (SRS-2) Preschool Form, where a higher score indicates more autistic behaviors. We estimated prenatal fluoride exposure using three methods: (i) maternal urinary fluoride adjusted for specific gravity (MUF), from spot urine samples collected at each trimester and the mean calculated across samples, (ii) daily maternal fluoride intake, based on self-reported consumption of tap water, coffee, and tea during the first and third trimesters, and (iii) water fluoride concentration in tap water. We used multivariable linear regression models to estimate associations between the SRS-2 scale T-scores and each fluoride exposure separately. We used multivariable logistic regression to estimate the association between each prenatal fluoride exposure and an elevated SRS-2 total T-score (i.e., 90th percentile or higher). Potential effect modification of MUF was examined by child sex, daily folic acid supplementation, and plasma total folate in pregnancy. RESULTS: The mean SRS-2 total T-score for children aged 3 to 4 years was 45.3 (SD = 6.1, range = 34 to 85). The median MUF concentration was 0.43 mg/L (interquartile range = 0.33 mg/L). MUF was not significantly associated with the SRS-2 total T-score in multivariable linear regression (β = -0.16; 95% CI, -1.70, 1.39) or logistic regression (OR = 0.76; 95% CI, 0.29, 1.96). Similarly, estimated daily fluoride intake and water fluoride concentration were not associated with the SRS-2 total T-score. No effect modification was observed. CONCLUSIONS: There was no evidence of an association between prenatal fluoride exposure and autistic behaviors in preschool-aged children, in contrast to previous MIREC research findings on lead and phthalates. Given that this cohort has relatively few children with high SRS-2 scores, further research is needed in other groups of children to more fully explore this association.
Combined glyphosate and chlorpyrifos-based pesticides impair innate and adaptive immune functions: an in vitro approach.
Friedrich AD, Gareis DB, Ordoñez ME … +9 more , Regge MV, Santilli MC, Rubinsztain MN, Gantov M, Amarilla MS, Gaillardou ME, Domaica CI, Fuertes MB, Zwirner NW
Environ Health · 2025 Nov · PMID 41199268 · Full text
BACKGROUND: The widespread use of pesticides, including glyphosate-based herbicides (e.g., Roundup®, R) and chlorpyrifos-based insecticides (e.g., Clorpi48®, C), has raised concerns about their environmental and human he...
BACKGROUND: The widespread use of pesticides, including glyphosate-based herbicides (e.g., Roundup®, R) and chlorpyrifos-based insecticides (e.g., Clorpi48®, C), has raised concerns about their environmental and human health impacts. Growing evidence links pesticide exposure to cancer development. Given the critical role of immune surveillance in tumor growth control, environmental pollutants such as pesticides should also be evaluated for immunotoxicity. Moreover, while individual pesticides have been extensively studied, the effects of pesticide mixtures on human immune cells remain poorly explored. Here, we assessed the impact of environmentally relevant doses of R, C, or their combination (R+C) on immune cell functions. METHODS: Peripheral blood mononuclear cells (PBMCs), NK cells, and T cells from healthy donors were exposed to environmentally relevant doses of R, C, or R+C. NK cell cytotoxicity, T-bet expression and IFN-g production were analyzed by flow cytometry, and immune synapse formation (LFA-1 localization) and perforin polarization were analyzed by confocal microscopy. T-cell proliferation, Th1 differentiation, and IL-2 signaling were also evaluated by flow cytometry. Oxidative stress was quantified using a fluorometric assay by measuring HO production in PBMCs exposed to R, C, or R+C. Also, the role of oxidative stress in T-cell dysfunction was assessed. RESULTS: The combination of R+C, but not the individual compounds, significantly impaired NK cell cytotoxicity, IFN-g production, and immune synapse formation, as evidenced by disrupted LFA-1 localization and defective perforin polarization. In T cells, R+C exposure inhibited proliferation, Th1 differentiation, IL-2 signaling, and IFN-g secretion by CD8⁺ T cells, all key functions for effective antitumor responses. Mechanistically, oxidative stress contributed to the antiproliferative effect, as scavenging of HO by catalase addition restored T cell proliferation. CONCLUSIONS: Environmentally relevant doses of glyphosate and chlorpyrifos-based pesticide mixtures disrupt innate and adaptive immune effector functions that are critical for the control of neoplastic cells and nascent tumor foci, suggesting that current risk assessments underestimate the immunotoxicity of combined formulations.
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