Environmental Health Perspectives[JOURNAL]
Sun
200 papers
Association between Perfluorooctanoic Acid-Related Poor Embryo Quality and Metabolite Alterations in Human Follicular Fluid during IVF: A Cohort Study.
Xu J, Wang Q, Jiao X … +7 more , Kong P, Chen S, Yang W, Liu W, Li K, Teng X, Guo Y
Environ Health Perspect · 2025 Jun · PMID 40334213 · Full text
BACKGROUND: Perfluoroalkyl and polyfluoroalkyl substances (PFAS) have been shown to disrupt normal follicular development and ovulation. However, it is unknown which specific PFAS in follicular fluid negatively impact oo...
BACKGROUND: Perfluoroalkyl and polyfluoroalkyl substances (PFAS) have been shown to disrupt normal follicular development and ovulation. However, it is unknown which specific PFAS in follicular fluid negatively impact oocyte development and embryo quality or whether any of the metabolites present in the follicular fluid contribute to these adverse effects. OBJECTIVES: We conducted a cross-sectional and cohort study to identify specific PFAS with significant adverse effects on embryo quality and their associated modes of action. METHODS: We enrolled 378 women undergoing assisted reproductive technology (ART) and collected follicular fluid samples during oocyte retrieval. We performed PFAS detection and untargeted metabolomics on the follicular fluid. The associations of individual PFAS with high-quality embryo rates and clinical pregnancy outcomes were assessed using beta regression and logistic regression, respectively, and the potential joint effect of mixtures of PFAS was assessed using Bayesian kernel machine regression (BKMR) and quantile g-computation models. A causal mediation effect model was performed to estimate the average indirect impact of PFAS, mediated by high-quality embryo rates, on clinical pregnancy outcomes, as well as its direct impact representing all other causal effects. Spearman's rank correlation coefficient was used to identify the associations between the differentially expressed metabolites and the high-quality embryo rates. RESULTS: The detection frequencies of 15 PFAS exceeded 85%, and perfluorooctanoic acid (PFOA) had the highest median concentration (). The PFAS mixture was negatively associated with the high-quality embryo rate, and PFOA was the major contributor (conditional posterior inclusion ). PFAS was also negatively associated with clinical pregnancy outcome, and the causal mediation analysis revealed that the embryo quality potentially mediated the relationship between the clinical pregnancy outcome with PFOA [proportion mediated: 0.181; 95% confidence interval (CI): 0.024, 0.755], perfluoro--nonanoic acid (PFNA) (proportion mediated: 0.148; 95% CI: 0.022, 0.656), or perfluoro--tridecanoic acid (PFTrDA) (proportion mediated: 0.130; 95% CI: 0.005, 0.693). The decreased organonitrogens (Pro-Trp and lauryldimethylamine oxide) and sphingolipids metabolites (phytosphingosine, -myristoylsphinganine, and -lauroyl-d-erythro-sphinganine) in the follicular fluid were associated with PFOA-related poor embryo quality. CONCLUSIONS: High exposure to follicular fluid PFAS was negatively correlated with embryo quality during ART, with PFOA likely to be the major contributor. PFOA-related poor embryo quality was associated with the reduction of organonitrogens and sphingolipids metabolites that are crucial for the maintenance of normal cell growth and metabolism. https://doi.org/10.1289/EHP15422.
Comparing the Role of Relative and Absolute Humidity in Heat-Related Mortality: A Case Time-Series Study in South Korea.
Min J, Lee W, Oh J … +2 more , Kang C, Ha E
Environ Health Perspect · 2025 Jun · PMID 40333434 · Full text
BACKGROUND: Epidemiology studies have reported inconsistent associations of humidity with heat-related health outcomes, despite strong plausibility of such physiological associations. In this regard, there has been a hea...
BACKGROUND: Epidemiology studies have reported inconsistent associations of humidity with heat-related health outcomes, despite strong plausibility of such physiological associations. In this regard, there has been a heated debate on which humidity metric to use in epidemiological research. OBJECTIVES: This study aimed to compare the role of two common humidity metrics, relative and absolute humidity, in heat-related mortality in summer using a nationwide mortality dataset. METHODS: We applied a case time-series design for summer (June-September) mortality across the entire 229 districts of South Korea from 2011 to 2019. The temperature was fitted using a distributed lag nonlinear model (DLNM) with 10 lag days. A linear interaction between the cross-basis of temperature and humidity was included in each model to examine the different patterns of association between heat and mortality by humidity level (low and high humidity defined by fifth and 95th percentile of each humidity distribution). RESULTS: A total of 780,102 deaths were recorded in the summer from 2011 to 2019 in South Korea. The association between extreme heat (temperature approximately above the 99th percentile of the temperature distribution) and mortality was modified more by absolute humidity than by relative humidity, although the effect modification of both humidity indicators was not statistically significant. The relative risks at the 99.Ninth percentile temperature in comparison with the minimum mortality temperature were 1.21 [95% confidence interval (CI): 1.11, 1.31] and 1.22 (95% CI: 1.03, 1.44) for low and high relative humidity, respectively, and 1.11 (95% CI: 0.89, 1.37) and 1.25 (95% CI: 1.15, 1.34) for low and high absolute humidity, respectively. DISCUSSION: Our findings provide epidemiological evidence on the role of relative and absolute humidity in heat-related mortality and suggest that absolute humidity may be a more appropriate metric than relative humidity when assessing health impact. https://doi.org/10.1289/EHP15827.
Effect Modification of Serum Omega-3 Fatty Acids on the Associations between Urinary Phthalate Biomarkers Mixture and Pregnancy Outcomes among Women Seeking Fertility Care.
Shen X, Génard-Walton M, Williams PL … +9 more , Ford JB, Souter I, Allan Y, Calafat AM, Zhang D, Chavarro JE, Hauser R, Mínguez-Alarcón L, Earth Study Team
Environ Health Perspect · 2025 Jun · PMID 40326889 · Full text
BACKGROUND: Phthalate exposures are ubiquitous and have been associated with pregnancy complications. Interaction between serum long-chain n-3 polyunsaturated fatty acids (n3PUFA) and phthalate biomarkers is biologically...
BACKGROUND: Phthalate exposures are ubiquitous and have been associated with pregnancy complications. Interaction between serum long-chain n-3 polyunsaturated fatty acids (n3PUFA) and phthalate biomarkers is biologically plausible because both can bind to human peroxisome proliferator-activated receptors (PPARs), which are involved in placenta development. However, evidence of this interaction in humans is lacking. OBJECTIVE: This study evaluated whether serum n3PUFA modifies the associations of biomarkers of phthalate exposure on pregnancy outcomes. METHODS: Among 351 women undergoing fertilization in the Environment and Reproductive Health study (2004-2017), we evaluated the effect modification of eicosapentaenoic acid (EPA) and serum docosahexaenoic acid (DHA) on the association of pregnancy outcomes with the mixture of urinary concentrations of phthalate biomarkers by quantile g-computation. All models were adjusted for age, body mass index, prior smoking, infertility diagnosis, treatment year, and urinary specific gravity. RESULTS: Concentrations of the phthalate biomarkers mixture were associated with higher adjusted probabilities of pregnancy loss and lower estimated probabilities of live birth among women with serum in the lowest tertile ( of total fatty acids), but not among women with middle-to-high serum ( and 0.15, respectively). Among women in the lowest tertile of serum , the adjusted probability [95% confidence interval (CI)] of pregnancy loss for women in the lowest and highest quartile of phthalates mixtures was 5% (95% CI: 2%, 16%) and 44% (95% CI: 23%, 85%), respectively (). The corresponding estimates were 14% (95% CI: 5%, 41%) and 11% (95% CI: 3%, 42%) among women with serum in the highest tertile ( of total fatty acids) (). Similar trends were observed for live birth but not for implantation and clinical pregnancy. CONCLUSIONS: This study suggests adverse effects of phthalate exposure on pregnancy loss and live birth may be attenuated by intakes of n3PUFA. These results, if replicated, could inform clinical practice reducing the burden of infertility by phthalate exposure among the general population and improving pregnancy outcomes among subfertile couples. https://doi.org/10.1289/EHP15942.
Air Pollution and Autism Spectrum Disorder: Unveiling Multipollutant Risks and Sociodemographic Influences in California.
O'Sharkey K, Mitra S, Chow T … +4 more , Thompson L, Su J, Cockburn M, Ritz B
Environ Health Perspect · 2025 Jun · PMID 40324144 · Full text
BACKGROUND: Autism spectrum disorder (ASD) is a neurodevelopmental condition with increasing prevalence worldwide. Air pollution may be a major contributor to the rise in ASD cases. This study investigated how the risk o...
BACKGROUND: Autism spectrum disorder (ASD) is a neurodevelopmental condition with increasing prevalence worldwide. Air pollution may be a major contributor to the rise in ASD cases. This study investigated how the risk of ASD associated with prenatal and early postnatal exposure to specific air pollutants is modified by key sociodemographic factors, exploring vulnerable exposure periods. METHODS: We conducted a California population-based cohort study of 44,173 ASD cases among 2,371,379 children born between 2013 and 2018 (California birth registry), linked to California Department of Developmental Services (DDS) records to extract ASD diagnoses prior to the end of 2022. Prenatal and 1-year postnatal air pollution exposures [fine particulate matter with aerodynamic diameter (), nitrogen dioxide (), and ozone ()] were estimated using an advanced land-use regression (LUR) spatiotemporal model with machine learning. Logistic regression was used to estimate odds ratios and 95% confidence intervals for four models: single pollutant at a single period (prenatal or postnatal), multi-pollutant at a single period, single pollutant with dual periods (prenatal and postnatal), and multi-pollutant with dual time period co-adjustment, adjusting for relevant individual and regional covariates. RESULTS: Prenatal and postnatal exposures increased ASD odds in all models. was associated with ASD pre- and postnatally in single and multi-pollutant models but only postnatally in dual time period models. In contrast, showed the opposite pattern of with slightly negative associations in single and multi-pollutant models that turned positive for the prenatal period in dual time period models. The postnatal effect was strongest among Black and Hispanic children, suggesting higher contributions from traffic-related exposures. CONCLUSIONS: Exposure to specific air pollutants during pregnancy and in the postnatal periods is associated with an increased risk of ASD, with sociodemographic differences potentially highlighting exposure hot spots and sources as well as subpopulation vulnerabilities. https://doi.org/10.1289/EHP15573.
A State of the Science Review of Wildfire-Specific Fine Particulate Matter Data Sources, Methods, and Models.
Orr A, Adam CE, Graham J … +11 more , Holden ZA, Hu L, Jaffar Z, Leary C, Migliaccio CT, Mullan K, Noonan C, Semmens EO, Urbanski S, Walker E, Landguth EL
Environ Health Perspect · 2025 Jun · PMID 40324008 · Full text
BACKGROUND: Despite progress in reducing industrial air pollution, rising wildfire frequency and intensity, driven in part by climate change, pose significant health risks. Accurate estimates of wildfire-generated fine p...
BACKGROUND: Despite progress in reducing industrial air pollution, rising wildfire frequency and intensity, driven in part by climate change, pose significant health risks. Accurate estimates of wildfire-generated fine particulate matter with an aerodynamic diameter () are needed for advancing health research, policymaking, and environmental protection. OBJECTIVE: This review evaluates existing methodologies and data sources for estimating wildfire-generated , aiming to improving accuracy and accessibility for health research, policy development, and environmental management strategies. METHODS: We conducted a systematic literature search across Medline, Scopus, Web of Science, Google Scholar, and Embase (January 2018 to March 2024) using keywords such as " exposure," and "wildfire ." Studies were included if they were publicly available, focused on North America (primarily the US), and provided wildfire-attributable data. Of 2,757 articles identified, 418 full texts were screened, and 33 met inclusion criteria. Four studies offered wildfire-specific estimates of , and one dataset was excluded due to accessibility issues, leaving three for analysis. We processed data using R (version R 4.3.1; R Development Core Team) at the ZIP code level for consistency and examined total and wildfire-specific estimates for California in 2010 (low fire activity) and 2018 (high fire activity), focusing on Los Angeles (densely monitored) and Modoc (no monitors) counties. Analyses included Pearson correlation, cross-correlation, and Granger causality to assess temporal relationships and consistency. RESULTS: From the 33 studies included, three main estimation approaches emerged: chemical extraction, thresholding, and integration of satellite and fire-specific data (e.g., smoke plumes and fire perimeters). Most studies combined ground-based monitor data, satellite-derived aerosol optical depth, and explanatory data like meteorology and land use. The three public datasets indicated that in California, wildfire-specific contributed 11.2%-36.9% of total in 2010 and 13.7%-21.2% in 2018 with stronger agreement in 2018. Correlations were stronger in Modoc County (no monitors) (0.44-0.51 in 2010; 0.79-0.88 in 2018) than in Los Angeles County (densely populated area, 20 EPA monitors, where correlations ranged from 0.19-0.21 in 2010 and 0.54-0.79 in 2018). Overall, the datasets estimating total were more consistent than wildfire-specific estimates. CONCLUSIONS: We offer a review of current data sources used for wildfire-specific estimation and compare publicly available datasets. As expected, the contribution of wildfire smoke to overall increased with wildfire activity. However, limited publicly available datasets hinder comprehensive comparisons and generalizations for health research and outcomes. https://doi.org/10.1289/EHP15672.
Perinatal Exposure to Lead or Diethylhexyl Phthalate in Mice: Sex-Specific Effects on Cardiac DNA Methylation and Gene Expression across Time.
Wang K, Li M, Sartor MA … +3 more , Colacino JA, Dolinoy DC, Svoboda LK
Environ Health Perspect · 2025 Jun · PMID 40315424 · Full text
BACKGROUND: Global and site-specific changes in DNA methylation and gene expression are associated with cardiovascular development, aging, and disease, but how the transcriptome and epigenome of the heart change across t...
BACKGROUND: Global and site-specific changes in DNA methylation and gene expression are associated with cardiovascular development, aging, and disease, but how the transcriptome and epigenome of the heart change across the life course in males vs. females and how chemical exposures early in life influence this programming have not yet been investigated. OBJECTIVES: We used an established mouse model of developmental exposures to investigate the effects of perinatal exposure to either lead (Pb) or diethylhexyl phthalate (DEHP), two ubiquitous environmental contaminants that are both strongly associated with cardiovascular diseases (CVDs), on DNA methylation and gene expression across the life course in whole hearts. METHODS: Dams were randomly assigned to receive human physiologically relevant levels of Pb ( in water), DEHP ( chow), or control water and chow. Exposures started 2 weeks prior to mating and continued until weaning at postnatal day 21 (3 wk of age). Approximately 1 male and 1 female offspring per litter were followed to 3 wk, 5 months, or 10 months of age, at which time whole hearts were collected ( per sex per exposure). Enhanced reduced representation bisulfite sequencing (ERRBS) was used to assess the cardiac DNA methylome at 3 wk and 10 months, and RNA-Seq was conducted at all three time points. MethylSig and edgeR were used to identify age-related differentially methylated regions (DMRs) and differentially expressed genes (DEGs), respectively, within each sex and exposure group. Cell type deconvolution of bulk RNA-Seq data was conducted using the MuSiC algorithm and publicly available single-cell RNA-Seq data. RESULTS: Thousands of DMRs and hundreds of DEGs were identified in control, DEHP, and Pb-exposed hearts across time between 3 wk and 10 months of age. A closer look at the genes and pathways showing differential DNA methylation revealed that the majority were unique to each sex and exposure group. Overall, pathways governing development and differentiation changed across time in all conditions. A small number of genes in each group showed significant differences in DNA methylation and gene expression with life stage, including several that were different in toxicant-exposed but not control mice. We also observed subtle but significant differences in the proportion of several cell types that were associated with life stage, sex, or developmental exposure. DISCUSSION: Together these data suggest that gene expression and DNA methylation programs, as well as cellular composition, may differ across the life course long after cessation of exposure in perinatal Pb- or DEHP-exposed mice compared to controls and highlight potential biomarkers of developmental toxicant exposures; however, additional studies are required for confirmation. Further studies are also needed to investigate how epigenetic and transcriptional differences impact cardiovascular health across the life course, particularly in old age when the risk of cardiovascular diseases is markedly increased. https://doi.org/10.1289/EHP15503.
Erratum: "Long-Term Air Pollution Exposure and Mitochondrial DNA Copy Number: An Analysis of UK Biobank Data".
Hong YS, Battle SL, Puiu D … +5 more , Shi W, Pankratz N, Zhao D, Arking DE, Guallar E
Environ Health Perspect · 2025 May · PMID 40315346 · Full text
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Long-Term Exposure to Air Pollution and Incidence of Type 2 Diabetes in the Nurses' Health Study and Nurses' Health Study II.
Fiffer MR, Chen J, Silva EL … +8 more , Nethery RC, Sun Q, James P, Grady ST, Yanosky JD, Kaufman JD, Laden F, Hart JE
Environ Health Perspect · 2025 Jun · PMID 40314697 · Full text
BACKGROUND: Research has detected associations between air pollution exposure and type 2 diabetes (T2DM), but findings from large cohort studies are needed to ascertain the most influential pollutants, susceptible subpop...
BACKGROUND: Research has detected associations between air pollution exposure and type 2 diabetes (T2DM), but findings from large cohort studies are needed to ascertain the most influential pollutants, susceptible subpopulations, and low-level exposure associations. Our aim was to prospectively evaluate the association between long-term exposure to fine particulate matter in aerodynamic diameter () and nitrogen dioxide () and T2DM incidence in the Nurses' Health Study (NHS) and Nurses' Health Study II (NHSII) cohorts of US women. METHODS: Monthly and exposures were predicted from spatiotemporal models and linked to participants' residential addresses. We used Cox proportional hazards models to assess the association between 24-month moving average and exposure and self-reported, clinician-diagnosed T2DM from 1992-2019. We adjusted for time-varying lifestyle factors, reproductive hormonal factors, and individual and neighborhood socioeconomic status (SES). Results were meta-analyzed. We evaluated whether relationships persisted at levels below the current US EPA National Ambient Air Quality Standards (NAAQS). Lastly, we examined multiplicative and additive interactions by body mass index (BMI), smoking status, physical activity, neighborhood SES, and region. RESULTS: Over follow-up, there were 19,083 incident T2DM cases among the 208,733 women in NHS and NHSII. In fully adjusted single-pollutant models, the hazard ratio (HR) for an interquartile range (IQR) () higher 24-month average exposure was 1.05 [95% confidence interval (CI): 1.02, 1.08] for incident T2DM. The HR for an IQR () higher exposure was 1.05 (95% CI: 1.01, 1.09). Both associations were robust to co-adjustment. Associations remained stable when restricting to levels below the NAAQS as compared to the full dataset. Stronger associations were observed in individuals who had a BMI , were physically active, and resided in the Northeast. CONCLUSIONS: Our results showed a positive association between T2DM and long-term exposure to and , persisting even at levels below the current EPA NAAQS. https://doi.org/10.1289/EHP15673.
Causal Concentration-Response Modeling with Continuous Curves and Exposure Error Correction: and Mortality in the Medicare Cohort.
Schwartz J, Feng Y, Castro E … +1 more , Wei Y
Environ Health Perspect · 2025 Jun · PMID 40310753 · Full text
BACKGROUND: Many studies have reported associations of fine particulate matter with aerodynamic diameter ()with mortality but fewer at low concentrations and even fewer using causal modeling or correcting for exposure e...
BACKGROUND: Many studies have reported associations of fine particulate matter with aerodynamic diameter ()with mortality but fewer at low concentrations and even fewer using causal modeling or correcting for exposure error bias. None have corrected for the nonrepresentativeness of monitoring locations. OBJECTIVES: We examined the association of with all-cause mortality in the Medicare cohort using a combination of causal modeling, flexible concentration-response modeling, and bias correction for exposure error, while controlling for and as well as standard confounders. METHODS: Using monitors not used to fit our model, we fitted 72 regression calibration models stratified by season, region, and elevation in the US. We fitted a B-spline with 4 degrees of freedom to the calibrated and fitted separate generalized propensity score models for each spline component using gradient boosting. We also used inverse probability weights to account for the nonrepresentativeness of monitoring locations. Using the generalized propensity scores and the B-splines, we fitted quasi-Poisson models to counts of deaths in each ZIP code-year stratified by race, Medicaid status, and gender. Separate models were fit for participants identifying as black and as white and for ZIP codes with higher and lower poverty rates. We fit a model using the original exposure to estimate the extent of exposure error bias. RESULTS: The propensity score analysis achieved good balance for all covariates. Controlling for the propensity scores, we found a concentration-response curve with no evidence of a threshold and whose confidence interval did not include the null from and upward. There were 223,666,531 person-years of follow-up between the current US Environmental Protection Agency (EPA) standard of and the World Health Organization (WHO) guideline of , and the rate ratio between them was 1.088 [95% confidence interval (CI): 1.064, 1.113]. Using the original exposure, the rate ratio was 1.076 (95% CI: 1.070, 1.083). Hence, effects continue below the EPA standard, and calibrated estimates of effect were 16% higher. Effects were larger from among participants identifying as black. DISCUSSION: The concentration-response curve between air pollution and mortality remains after adjustment for exposure error and using causal models and continues to concentrations below current US EPA and EU standards and even below WHO guidelines. Exposure error in the original exposure resulted in noticeable downward bias at low concentrations. Persons identifying as black are more susceptible. https://doi.org/10.1289/EHP15238.
A State-of-the-Science Review of Long-Term Predictions of Climate Change Impacts on Dengue Transmission Risk.
Islam J, Frentiu FD, Devine GJ … +2 more , Bambrick H, Hu W
Environ Health Perspect · 2025 May · PMID 40310699 · Full text
BACKGROUND: Climate change is predicted to profoundly impact dengue transmission risk, yet a thorough review of evidence is necessary to refine understanding of climate scenarios, projection periods, spatial resolutions,...
BACKGROUND: Climate change is predicted to profoundly impact dengue transmission risk, yet a thorough review of evidence is necessary to refine understanding of climate scenarios, projection periods, spatial resolutions, and modeling approaches. OBJECTIVES: We conducted a state-of-the-science review to comprehensively understand long-term dengue risk predictions under climate change, identify research gaps, and provide evidence-based guidelines for future studies. METHODS: We searched three medical databases (PubMed, Embase, and Web of Science) up to 5 December 2024 to extract relevant modeling studies. An a search strategy, predefined eligibility criteria, and systematic data extraction procedures were implemented to identify and evaluate studies. RESULTS: Of 5,035 studies retrieved, 57 met inclusion criteria. Prediction for dengue risk ranged from 1950 to 2115, and 52.63% () of all studies used Representative Concentration Pathways (RCPs). Specifically, RCP 8.5 (34.94%; ), Shared Socioeconomic Pathways (SSPs) 2 (32.35%; ), and the Special Report on Emissions Scenarios (SRES) A1 (58.33%; ) were utilized the most among all the RCPs, SSPs, and SRES climate change scenarios. Most studies (57.89%; ) used only climatic variables for the prediction, and 21.05% () of studies employed fine spatial resolution () for the climate data. We identified that correlative approach was used mostly across the studies for modeling the future risk (61.40%; ). Among mechanistic models, 35% () lacked outcome validation, and 75% () did not report model evaluation metrics. DISCUSSION: We identified the urgent need to strengthen dengue databases, use finer spatial resolutions to integrate big data, and incorporate potential socioenvironmental factors such as human movement, vegetation, microclimate, and vector control efficacy in modeling. Utilizing appropriate spatiotemporal models and validation techniques will be crucial for developing functional climate-driven early warning systems for dengue fever. https://doi.org/10.1289/EHP14463.
Cumulative Human Health Risk Assessment of Regional Ozone and Volatile Organic Compounds from Unconventional Oil and Gas Sites in Colorado's Front Range.
Weisner ML, Varner PM, Ku IT … +3 more , Collett JL, Buck B, McKenzie LM
Environ Health Perspect · 2025 May · PMID 40305737 · Full text
BACKGROUND: Most unconventional oil and gas (UOG) extraction in Colorado occurs within the Denver Metro/North Front Range (DMNFR) ozone Nonattainment Area (NAA). Previous UOG human health risk assessments do not consider...
BACKGROUND: Most unconventional oil and gas (UOG) extraction in Colorado occurs within the Denver Metro/North Front Range (DMNFR) ozone Nonattainment Area (NAA). Previous UOG human health risk assessments do not consider cumulative risk from both volatile organic compounds (VOCs) and criteria air pollutants like ozone. METHODS: We conducted a cumulative human health risk assessment (CHHRA) using regulatory-grade 1- and 8-h ozone measurements from a DMNFR US Environmental Protection Agency (US EPA) monitoring station and weekly and short-term (15 s-1 min) VOC air quality monitoring data collected between 2018-2023 from 10 near-pad air monitoring sites, three community sites, and one background site. Acute and chronic noncancer hazard indices (HIs) for multiple health end points, as well as cancer risks, were calculated during well drilling, well completions, and production activity periods and compared between sites. VOC concentrations were compared between operations that used a petroleum-based drilling fluid vs. a synthetic drill fluid. Differences in weekly chemical concentrations between sites, UOG phases, and drill muds were analyzed using repeated measures analysis of variance with post hoc pairwise comparisons with Bonferroni adjustment. RESULTS: Acute HIs of VOCs and ozone ranged from to 31.33 at the 95th percentile concentrations at all sites. One of the three community monitoring sites, Anthem, exceeded US EPA thresholds for respiratory, immunological, and developmental end points during production and for the immunological end point during well completions. At the near-pad sites, acute hazards exceeded US EPA thresholds during well completions for immunological, respiratory, reproductive, developmental, and neurological end points. Neurological and immunological HIs were above thresholds for the drilling phase at near-pad sites. Chronic HIs ranged from to 0.47 at 95th percentile concentrations and, therefore, were below the HI threshold for all near-pad and community sites for all health end points. Cancer risks ranging from 209 to 335 in a million at 95th percentile concentrations were above US EPA thresholds for all sites, including the background site, which is more heavily influenced by Denver Metro traffic emissions. CONCLUSIONS: Our results suggest that for communities located near UOG well pads in the DMNFR ozone NAA, acute health risks persist after the implementation of best management practices to reduce emissions. Greater protection to public health could be afforded by establishing policies that require drilling and well completions to be conducted outside the summer ozone season. Further research is needed to address potential health risks from the use of synthetic drilling fluid. https://doi.org/10.1289/EHP16272.
Exploring Environmental and Cardiometabolic Impacts Associated with Adherence to the Sustainable EAT-Lancet Reference Diet: Findings from the China Health and Nutrition Survey.
Wu M, Lv Y, Liu W … +4 more , Liu K, Wang Y, Cui Z, Meng H
Environ Health Perspect · 2025 May · PMID 40305654 · Full text
BACKGROUND: To contribute to the growing evidence on the potential co-benefits of the EAT-Lancet reference diet for cardiometabolic health and sustainability, we investigated this topic in a nationwide prospective cohort...
BACKGROUND: To contribute to the growing evidence on the potential co-benefits of the EAT-Lancet reference diet for cardiometabolic health and sustainability, we investigated this topic in a nationwide prospective cohort of Chinese adults. Adherence to this diet has been measured using several indices, including the World Index for Sustainability and Health (WISH) and the Planetary Health Diet Index (PHDI). OBJECTIVES: We aimed to investigate the associations between adherence to the EAT-Lancet reference diet, as evaluated by WISH and PHDI, with risk of new-onset cardiometabolic diseases (CMDs), risk of all-cause mortality, and greenhouse gas (GHG) emissions. METHODS: We included adults ( for CMDs and 15,318 for all-cause mortality) from the China Health and Nutrition Survey (1997-2015) in the analysis. Dietary intake data were collected, and WISH and PHDI scores were computed with established methods. CMDs included myocardial infarction (MI), type 2 diabetes mellitus (T2DM), and stroke. We used Cox proportional hazard regression models to analyze data with a mean of 10 years of follow-up from the date of baseline to the end of study or until the occurrence of the event of interest, whichever came first. We adjusted for sociodemographic, anthropometric, lifestyle, and dietary characteristics of participants as confounders. RESULTS: Greater adherence to the EAT-Lancet reference diet, as reflected by higher WISH or PHDI scores, was inversely associated with risk of MI {Q4 vs. Q1: [95% confidence interval (CI): 0.48, 0.96] for WISH and 0.14 (95% CI: 0.07, 0.29) for PHDI}, T2DM [Q4 vs. Q1: (95% CI: 0.67, 0.96) for WISH and 0.68 (95% CI: 0.57, 0.82) for PHDI], and all-cause mortality [Q4 vs. Q1: (95% CI: 0.68, 0.95) for WISH and 0.60 (95% CI: 0.46, 0.80) for PHDI] in fully adjusted models (all -trend ). Both WISH and PHDI were inversely associated with GHG emissions in fully adjusted models (all -trend ). WISH and PHDI were not significantly associated with risk of stroke. CONCLUSIONS: Our findings supported the co-benefits of the EAT-Lancet reference diet for both cardiometabolic health and environmental sustainability. Long-term adherence to this reference diet as effectively indicated by either higher WISH or PHDI scores may reduce the risk and burden of CMDs and all-cause mortality in Chinese adults. https://doi.org/10.1289/EHP15006.
Pavements to Longevity: The Influence of Neighborhood Walkability on Mortality in Taiwan.
Zeng Y, Rudge G, Yu T … +5 more , Chen W, Chong KC, Huang Y, Thomas GN, Lao XQ
Environ Health Perspect · 2025 May · PMID 40305004 · Full text
BACKGROUND: There is limited information on the association between walkability and health in Asian countries. OBJECTIVE: Our study aimed to investigate the association between neighborhood walkability and mortality in T...
BACKGROUND: There is limited information on the association between walkability and health in Asian countries. OBJECTIVE: Our study aimed to investigate the association between neighborhood walkability and mortality in Taiwanese adults. METHODS: We selected 457,874 participants ( y of age) from Taiwan who joined a standard medical examination program between 1998 and 2016 and followed them until 31 July 2021. Three walkability measures were estimated within a walking distance of of participant's addresses: points of interest (POI), transit stations, and impedance (restrictions to walking due to absence of intersections and physical barriers). Walkability measures were applied as continuous and categorical (tertiles) variables in data analyses. Mortality data were obtained from the National Death Registry maintained by the Ministry of Health and Welfare in Taiwan. A time-varying Cox regression model was used to investigate the association of neighborhood walkability with deaths from natural causes and specific causes. RESULTS: This study identified 24,744 deaths over a median follow-up of 16.9 y. In comparison with participants living with the first tertile for numbers of POI and transit stations, those living with higher numbers of POI and transit stations were associated with a lower risk of natural-cause mortality, with hazard ratios (HRs) of 0.97 [95% confidence intervals (CIs): 0.94, 1.00] and 0.93 (95% CI: 0.90, 0.96) for second and third tertiles of numbers of POI, and 0.99 (95% CI: 0.96, 1.02) and 0.94 (95% CI: 0.92, 0.98) for second and third tertiles of numbers of transit stations, respectively. Each unit increase in POI and transit stations was associated with a 3% ( 0.97; 95% CI: 0.96, 0.99) and 2% ( 0.98; 95% CI: 0.97, 0.99) reduced risk of natural-cause mortality, respectively. In addition, in comparison with living in areas with the first tertile of impedance, living with the third tertile of impedance was associated a higher risk of natural-cause mortality, with HRs of 1.01 (95% CI: 1.00, 1.03). One unit increase in impedance was associated with a 1% ( 1.01; 95% CI: 1.00, 1.03) increased risk of natural-cause mortality. We also found significantly inverse associations between three walkability measures with deaths from cardiovascular diseases and between POI and death from chronic respiratory diseases. CONCLUSION: Our findings indicate that a higher level of neighborhood walkability was associated with a lower risk of mortality. Our data suggest that it is important to take into account neighborhood walkability in urban planning and health guideline development. https://doi.org/10.1289/EHP15209.
Impact of the Wood-Burning Cookstove on Glycated Hemoglobin (HbA1c): A Stepped-Wedge Randomized Trial in Rural Honduras.
Young BN, Peel JL, Rajkumar S … +12 more , Keller KP, Benka-Coker ML, Good N, Walker ES, Brook RD, Nelson TL, Volckens J, L'Orange C, Quinn C, Africano S, Osorto Pinel AB, Clark ML
Environ Health Perspect · 2025 May · PMID 40300153 · Full text
BACKGROUND: Type 2 diabetes is a rapidly growing global health challenge in low- and middle-income countries (LMICs), and evidence suggests that air pollution exposure contributes. Household air pollution from burning so...
BACKGROUND: Type 2 diabetes is a rapidly growing global health challenge in low- and middle-income countries (LMICs), and evidence suggests that air pollution exposure contributes. Household air pollution from burning solid fuels for cooking is a major burden in LMICs, but studies demonstrating associations between reductions in household air pollution and improvements in HbA1c, a biomarker of diabetes risk, are lacking. We previously reported substantial reductions in fine particulate matter with an aerodynamic diameter () and black carbon concentrations following an intervention in rural Honduras with the cookstove, a wood-burning stove with an engineered combustion chamber and chimney. OBJECTIVE: In a stepped-wedge randomized controlled trial among 230 Honduran women using traditional wood-burning stoves at baseline, we evaluated the effect of the intervention on HbA1c and characterized the longitudinal associations between air pollution exposures and HbA1c. METHODS: At each of six visits over 3 y, we measured 24-h and black carbon concentrations, and finger-stick HbA1c levels. We used linear mixed models in intent-to-treat (condition by assigned stove type), exposure-response (using 24-h measures and modeled estimates of long-term exposures), and "per protocol" self-reported stove use analyses. RESULTS: HbA1c was reduced for the condition in comparison with the traditional stove condition, but estimates were small and not statistically significant [ percentage points, 95% confidence interval (CI): , 0.07, observations]. A slightly stronger effect was observed when using self-reported stove use in per protocol analyses. Exposure-response analyses demonstrated positive associations between HbA1c and air pollution [e.g., HbA1c was 0.22 percentage points higher (95% CI: 0.13, 0.30) per log-unit higher long-term average personal ]. DISCUSSION: Our study provides novel evidence of exposure-response associations between household air pollution and HbA1c within a randomized cookstove trial, contributing to the evidence base necessary to support clean cooking policy initiatives. https://doi.org/10.1289/EHP15095.
A State of the Science Review of Human Health Effects of the Michigan Polybrominated Biphenyl Contamination after Five Decades.
Hoffman SS, Kaufman JA, Hood RB … +6 more , Wainstock T, Hartnett K, Barton H, Pearson MA, Terrell ML, Marcus M
Environ Health Perspect · 2025 Jun · PMID 40293296 · Full text
BACKGROUND: The Michigan Polybrominated Biphenyl (PBB) Registry, followed since 1976, was created after a 1973 chemical manufacturing mistake. The flame retardant PBB was accidentally mixed into animal feed and distribut...
BACKGROUND: The Michigan Polybrominated Biphenyl (PBB) Registry, followed since 1976, was created after a 1973 chemical manufacturing mistake. The flame retardant PBB was accidentally mixed into animal feed and distributed to Michigan farms for nearly a year, exposing farm residents and animal product consumers. OBJECTIVE: We synthesized knowledge to date on health effects of PBB exposure within the Michigan PBB Registry and describe research findings in the context of literature on other persistent organic pollutants (POPs) and endocrine-disrupting chemicals (EDCs). METHODS: We reviewed literature published from 1973 to 2025 on human health effects of PBB following the Michigan contamination, using PubMed and Thompson Reuters (ISI) Web of Science databases. We excluded studies not in English; studies on exposures besides PBB; animal studies; reviews, abstracts, or letters to the editor; studies without a health outcome; and studies outside of Michigan or unrelated to the 1973 contamination. For each article, two researchers performed title and abstract screening, full article review, and data extraction. RESULTS: We included 79 publications out of 601 identified and screened. Early studies did not find many health outcomes associated with PBB, possibly because of methodological limitations. More recent studies on long-term and multigenerational impacts found an increased breast cancer risk, accelerated pubertal development and earlier menarche for girls exposed , urogenital problems and slower pubertal development in boys exposed , lower estrone 3-glucuronide and follicle-stimulating hormone among women exposed in childhood, and increased miscarriage risk among daughters of exposed women. Epigenetic and metabolomic research reported altered pathways related to estrogenic effects and immune function as well as the epigenetic alterations of spermatogenic cells. DISCUSSION: This unique community-academic partnership has produced insights into multigenerational consequences of EDC/POP exposures across the life course. The findings from this cohort underscore the broader relevance of critical windows of vulnerability, particularly during fetal development and childhood. https://doi.org/10.1289/EHP15012.
Are NHANES Data Representative of the US Population for Chemicals with Seasonal and Regional Use?
Naiman J, Naiman DQ, LaKind JS … +1 more , Barr DB
Environ Health Perspect · 2025 May · PMID 40279270 · Full text
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Effects of Long-Term Air Pollution Exposure on Disease Outcomes and Hybrid Immune Responses in SARS-CoV-2 Breakthrough Infections: A Study of the Yichang COVID-19 Antibody Longitudinal Survey (YC-CALS) in China.
Yan X, Du Y, Li K … +6 more , Zhao X, Wang H, Liu L, Wang Q, Liu J, Wei S
Environ Health Perspect · 2025 May · PMID 40273424 · Full text
BACKGROUND: As immunity wanes and viral mutations continue, the risk of endemic SARS-CoV-2 breakthrough infections (BTIs) remains. Air pollution is considered a risk factor for respiratory infection, but evidence of its...
BACKGROUND: As immunity wanes and viral mutations continue, the risk of endemic SARS-CoV-2 breakthrough infections (BTIs) remains. Air pollution is considered a risk factor for respiratory infection, but evidence of its association with SARS-CoV-2 BTIs is limited. OBJECTIVES: We aimed to examine the effects of long-term exposure to air pollution on disease outcomes, immune responses, and antibody dynamics of SARS-CoV-2 BTIs. METHODS: We gathered data on self-reported SARS-CoV-2 infections through questionnaires and measured IgG antibody levels using serological assays from a total of 6,875 participants from the Yichang COVID-19 Antibody Longitudinal Survey cohort in China. Air pollutant exposure [particulate matter (PM) with an aerodynamic diameter (), PM with an aerodynamic diameter (), PM with an aerodynamic diameter (), , , , and CO] was quantified using validated models for the past 5 y (2018-2022). Logistic and linear regression models were applied to analyze the associations between air pollutant levels and SARS-CoV-2 BTIs, Long COVID, COVID-19 hospitalization, and antibody responses. Quantile g-computation was used to assess the combined effects of pollutant mixtures. A linear mixed model was used to evaluate the effect of air pollution on antibody dynamics. RESULTS: Per interquartile range (IQR) increase in , , , and CO, the adjusted odds ratios (ORs) for SARS-CoV-2 BTIs were 1.65 [95% confidence interval (CI): 1.30, 2.08], 1.30 (95% CI: 1.12, 1.50), 1.63 (95% CI: 1.20, 2.20), and 1.24 (95% CI: 1.06, 1.45). The ORs for were 1.78 (95% CI: 1.07, 3.02) and 2.02 (95% CI: 1.18, 3.54) for Long COVID and hospitalization. Per IQR increase in and , IgG antibody percentages decreased by (95% CI: , ) and (95% CI: , ). Effects were stronger in older adults, those with comorbidities, and the undervaccinated. The combined effect on SARS-CoV-2 BTIs was mainly driven by (59.4%), and the impact on IgG response was largely attributed to (63.7%). Exposure to the highest levels of (), (), and () was associated with a faster IgG decline than the lowest. DISCUSSION: Long-term exposure to air pollution increases the risk of SARS-CoV-2 BTIs and disease severity while weakening the immune response, particularly for vulnerable populations. https://doi.org/10.1289/EHP15660.
Health Effects and Water Quality Following Low Pressure Events in Drinking Water Distribution Systems in the United States.
Mattioli MC, Benedict KM, Miko S … +13 more , Barrett CE, Roundtree A, Kim S, Collier SA, Adam E, Gargano JW, Yoder JS, Vacs Renwick DA, Rotert K, Sullivan M, Sweeney S, Beach M, Hill VR
Environ Health Perspect · 2025 Jun · PMID 40267339 · Full text
BACKGROUND: Low pressure events (LPEs), defined as a water service disruption that presumably lowers system water pressure, can cause drinking water contamination, resulting in increased illness risk to consumers. OBJECT...
BACKGROUND: Low pressure events (LPEs), defined as a water service disruption that presumably lowers system water pressure, can cause drinking water contamination, resulting in increased illness risk to consumers. OBJECTIVES: This study sought to examine whether LPEs increase the risk for highly credible acute gastrointestinal illness (HCGI) and acute respiratory illness (ARI) and to compare water quality in exposed and unexposed areas in the United States. METHODS: A matched cohort study was conducted during the period 2015-2019. For each LPE, household survey exposed areas were matched 1:2 with unexposed areas based on water-main size and material at the point of repair, as well as the housing type and demographic characteristics of the local population from the most recent census tract data. Water samples were collected to monitor physicochemical and microbiological water quality parameters. Households (HHs) were surveyed about water use and illness during the 2 wk after the LPE. Multivariable log-binomial models clustered on utility and LPE number were used to investigate associations between LPE exposure and HCGI and ARI. RESULTS: Five water utilities reported 58 LPEs, including planned maintenance (76%) and emergency (24%) events. Controlling for livestock near home, private well presence, number of people in HH, and travel away from home, exposed HHs were at higher risk of HCGI in comparison with unexposed HHs (; 95% confidence interval: 1.05, 1.37). No associations between LPE and ARI were detected. Certain LPEs characteristics like pipe material, size, and depth were associated with an increased HH HCGI risk. HHs experiencing LPEs where low disinfectant residual, high adenosine triphosphate, or general were detected in water following an LPE repair were also at a higher risk for HCGI. CONCLUSIONS: LPEs were associated with 20% higher risk of HCGI in HHs. Planned improvements to water distribution system infrastructure, adherence to industry standard distribution repair practices, and water monitoring following pipe repairs could supplement community alert systems to reduce illnesses from LPEs. https://doi.org/10.1289/EHP15564.
Evaluating Metabolic Signatures in the Serum of South Korean Patients with Humidifier Disinfectant-Associated Lung Injury Identified through Untargeted Metabolomics.
Kim J, Kang MJ, Lee SY … +4 more , Hong SB, Kim HC, Nam MH, Hong SJ
Environ Health Perspect · 2025 May · PMID 40266912 · Full text
BACKGROUND: The South Korean humidifier disinfectant-associated lung injury case was one of the worst disasters involving household chemical products, resulting in over 5,800 casualties. Despite the strong association be...
BACKGROUND: The South Korean humidifier disinfectant-associated lung injury case was one of the worst disasters involving household chemical products, resulting in over 5,800 casualties. Despite the strong association between lung injury and humidifier disinfectants, the underlying pathogenic mechanisms remain unclear. OBJECTIVES: We investigated patients with humidifier disinfectant-associated lung injury to identify key metabolic signatures, aiming to gain insights into the underlying pathogenic mechanisms based on the characteristics of these metabolites. METHODS: We employed untargeted metabolomics to assess the differential enrichment of plasma metabolites in 80 South Korean children with lung injuries caused by exposure to humidifier disinfectant containing polyhexamethylene guanidine. The key metabolites identified were subsequently validated in an independent cohort of 132 South Korean adults. RESULTS: In the plasma of patients with humidifier disinfectant-associated lung injuries, we observed significantly higher levels of oxidized lipids in comparison with healthy controls, with these levels negatively correlating with lung function. These metabolic signatures differentiated humidifier disinfectant-associated lung injury from other respiratory diseases in children, such as asthma and bronchiolitis obliterans. The 47 key metabolites identified in children were validated in an independent adult cohort. Furthermore, the classification performance of these metabolic signatures for humidifier disinfectant-associated lung injury achieved an accuracy of 0.97, a precision of 0.95, an F1 score of 0.97, and a recall of 1.00. DISCUSSION: These findings suggest a connection between humidifier disinfectant-associated lung injury and oxidative stress-induced lipid peroxidation. The oxidative stress signatures provide valuable insights into the underlying pathogenesis of humidifier disinfectant-associated lung injury and may serve as potential targets for biomarker development. https://doi.org/10.1289/EHP14984.
Prediagnostic Serum Concentrations of Per- and Polyfluoroalkyl Substances and Risk of Endometrial Cancer in a US Cohort.
Madrigal JM, Trabert B, Medgyesi DN … +8 more , Fisher JA, Calafat AM, Cook Botelho J, Kato K, Albert PS, Silverman DT, Hofmann JN, Jones RR
Environ Health Perspect · 2025 Jun · PMID 40262115 · Full text
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