Introduction: The escalating incidence and mortality rates of diabetes, coupled with the growing threat of air pollution, pose a substantial threat to public health in Iran. This study seeks to examine the geographical distribution and temporal trends of diabetes-related deaths specifically linked to air pollution across the country. Methods: Utilizing data from the Global Burden of Disease (GBD) study, we employed Joinpoint regression analysis to identify significant shifts in the mortality trends of type 2 diabetes mellitus (T2DM) linked to air pollution. Furthermore, spatial distribution patterns for the year 2021 were mapped and analyzed using ArcMap GIS v.10. Results: The mortality rate of T2DM attributable to air pollution in Iran exhibited an upward trend between 1990 and 2019, after which a subsequent decline was observed from 2019 to 2021. The highest annual percentage change in females occurred between 2011 and 2016 (5.134, 95% UI: 4.704–5.563), whereas in males, it occurred between 2012 and 2015 (6.275, 95% UI: 4.867–6.934). The highest average annual percentage change in females was observed in Gilan (4.427, 95% UI: 4.305–4.535), and in males, it was observed in Bushehr (4.125, 95% UI: 3.873–4.320). Geographical analysis revealed that in 2021, Tehran and Khuzestan had the highest mortality rates, whereas the lowest rates were recorded in Zanjan, Kohgiluyeh, and Boyer-Ahmad for females and Kohgiluyeh, Boyer-Ahmad, and Hamadan for males. Conclusion: These findings highlight the continued need for stronger environmental control measures, especially in high-risk areas, to further reduce the burden of air pollution-related diabetes mortality in Iran.
Introduction: Hospital wastewater is a key source of antibiotic-resistant bacteria and genes, driving the spread of environmental antimicrobial resistance (AMR). This review assessed the effectiveness of advanced treatment technologies in removing these resistance determinants from wastewater. Materials and Methods: This study adhered to the PRISMA guidelines and the PECOS framework. A comprehensive systematic search of six major databases (PubMed, Scopus, Web of Science, Google Scholar, ProQuest, and ScienceDirect) was conducted between April and June 2025. Of the 412 records initially identified, 89 studies met the predefined inclusion criteria. Relevant data on treatment technologies, antibiotic-resistant bacteria (ARB), resistance gene (ARG), and geographical–economic contexts were extracted and synthesized qualitatively. Results: Conventional treatment methods (e.g., activated sludge and chlorination) fail to fully remove ARB/ARGs and may even promote horizontal gene transfer via oxidative stress. In contrast, advanced technologies, such as MBR, advanced oxidation process (AOPs), and hybrid systems (MBR+ozone, MBR+GAC), achieve much higher removal efficiencies (>95%). Numerous critical ARGs (blaNDM, blaCTX-M, sul1, tetM, mcr-1, and vanA) have been detected in major pathogens (E. coli, P. aeruginosa, and Enterococcus spp.) in hospital wastewater worldwide. Research is largely focused on China, India, and Europe, while neglecting sludge and biofilms as important secondary reservoirs of ARGs, limiting accurate risk assessment. Conclusion: Effective AMR control in hospital wastewater requires integrated treatment technologies, molecular monitoring, and a One Health approach. Smart, sustainable solutions are essential to reduce risks to public health and ecosystems.
Introduction: Healthcare waste management poses significant environmental and public health challenges in Qazvin Province, Iran, particularly following increased infectious waste during the 2020–2022 COVID-19 pandemic. This study characterized HCW production patterns across hospital types and seasons and projected future trends using time-series modeling. Methods: A descriptive-epidemiological design was used to analyze 108 monthly records (2013–2022) from all 16 hospitals in Qazvin Province. Waste was categorized into general, infectious, chemical, and pathological categories. Descriptive statistics, one-way ANOVA, and independent t-tests were used for the analysis. An ARIMA model forecasted waste volumes through 2024, while an Interrupted Time Series analysis assessed the pandemic impact with March 2020 as the intervention point. Results: The ARIMA (4,1,1) model predicted an increase in total HCW, from 8,500 kg/day in 2022 to 12,000 kg/day by 2024, driven by rising infectious and chemical waste. ITS analysis revealed a significant surge in infectious waste (β=+153.29, p<0.001) and a decline in general waste (β=-3571.59, p=0.001) post-pandemic. Seasonal variation was significant only for pathological waste (p=0.000), peaking in summer and autumn. Conclusion: HCW generation in Qazvin is dynamic and influenced by institutional, seasonal, and epidemiological factors. This projected upward trend necessitates the implementation of adaptive, data-driven waste management strategies. Proactive policies must incorporate flexible capacity planning and enhanced segregation protocols to ensure environmental protection and public health safety, while accommodating healthcare expansion and future pandemic preparedness. These interventions should align with Sustainable Development Goals 3 and 12, respectively.
Introduction: Microplastic pollution has become a global environmental concern that threatens both marine ecosystems and human health, particularly in coastal regions with high fish consumption rates. This study aimed to analyze microplastic contamination in bullet tuna (Auxis rochei) consumed by coastal communities in the Muncar District, Banyuwangi Regency, Indonesia, and to evaluate its potential health risks using the Hazard Quotient (HQ) approach. Methods: Fish samples were collected from local fish auction sites and analyzed in both raw and fried forms using FTIR spectroscopy and microscopy. Results: The results revealed microplastic contamination in all samples, with a total concentration of 0.05 particles per gram, predominantly composed of polyethylene (PE) polymer. Frying reduced the microplastic abundance by 75%, although complete elimination was not achieved. Risk assessment indicated an average HQ of 0.47985, with a maximum value of 30.660, exceeding the safe threshold (HQ > 1) in extreme consumption scenarios. Statistical analysis showed a significant correlation (p < 0.05) between microplastic concentration and carcinogenic intake, indirectly increasing the HQ. Conclusion: These findings suggest that the consumption of Auxis rochei contributes to carcinogenic exposure and poses long-term health risks, especially among coastal populations with high consumption. This study underscores the urgent need for effective plastic waste management, food safety monitoring, and public education to safeguard marine food security and community health.
Introduction: Perfluorooctanoic acid (PFOA) is a persistent and toxic contaminant that requires effective degradation and defluorination strategies. Although several UV-based advanced oxidation and reduction processes have been investigated, direct comparisons under identical conditions are limited. In this study, we compared the degradation efficiency, mechanisms, and defluorination potential of three UV-based systems: UV/persulfate (UV/PDS), UV/peroxymonosulfate (UV/PMS), and UV/sulfite (UV/SS). Materials and Methods: PFOA degradation experiments were conducted under 254 nm UV irradiation with an initial PFOA concentration of 0.24 mM and oxidant/reductant dosages of 1.0 mM. Reaction kinetics, transformation products, and fluoride generation were analyzed using LC‑MS/MS and ion chromatography over a 6‑hour treatment period. Results: Direct UV photolysis was ineffective, achieving only 4% removal. Among the tested systems, UV/SS exhibited the highest performance, achieving 47% PFOA removal, compared with 24% and 31% for UV/PDS and UV/PMS, respectively. UV/PDS and UV/PMS primarily proceeded through oxidative radical pathways (sulfate and hydroxyl radicals), resulting in chain shortening and accumulation of shorter-chain perfluorinated carboxylic acids (PFHpA, PFHxA, PFPeA, PFBA, and TFA). In contrast, UV/SS operated through reductive pathways mediated by hydrated electrons, promoting sequential C–F bond cleavage and enhanced defluorination. Conclusion: The UV/SS process demonstrated the greatest potential for PFOA pretreatment due to its ability to achieve true defluorination, whereas oxidative systems mainly transformed PFOA into persistent short-chain intermediates.
Introduction: Over the years, some municipal dumpsites have been found to exhibit ionizing radiation due to indiscriminate dumping of hazardous refuse. Materials and Methods: An ionizing radiation survey of five municipal dumpsites in Akwa Ibom State was conducted to measure elevated radiation levels. The five dumpsites were Uyo Village Road, Nung Udoe, Nwaniba Road, Abak Road, and Udo Street. Radiation exposure at each dumpsite was measured using a Digilert 200 radiation survey meter. Results: For the Uyo Village Road dumpsite, the mean Absorbed Dose Rate (D), mean Annual Effective Dose Rate (AEDR), and mean Excess Lifetime Cancer Rate (ELCR) were 8.2 x 10-5 nGy/hr, 0.10 mSv/yr, and 0.35 x 10-3 respectively. For the Nung Udoe dumpsite, the mean D, AEDR, and ELCR were 1.0 x 10-4 nGy/hr, 0.12 mSv/yr, and 0.43 x 10-3 respectively. For the Nwaniba Road dumpsite, the mean D, AEDR, and ELCR were 9.9 x 10-5 nGy/hr, 0.12 mSv/yr, and 0.43 x 10-3 respectively. For the Abak Road dumpsite, the mean D, AEDR, and ELCR were 8.9 x 10-5 nGy/hr, 0.11 mSv/yr, and 0.38 x 10-3 respectively. For the Udo Street dumpsite, the mean D, AEDR, and ELCR were 8.2 x 10-5 nGy/hr, 0.10 mSv/yr, and 0.35 x 10-3 respectively. The mean Ds and AEDRs were far below the world average limit of 59 nGy/hr and 1 mSv/yr for the public, respectively. Conclusion: The reported values do not have any immediate radiological health hazards; however, residents and workers should reduce the hours spent at the dumpsites.
Introduction: Rapid urbanization and improving living standards have increased domestic wastewater generation, placing additional pressure on water resources in arid regions. This study investigated the knowledge, practices, and perceived barriers related to household wastewater management among women in Yazd, Iran, a water-scarce city with limited sewerage infrastructure. Material and Methods: A cross-sectional survey was conducted among 491 participants using a validated questionnaire covering demographic characteristics, wastewater management knowledge, self-reported behaviors, and perceived barriers. Descriptive statistics and Pearson ’s correlation analysis were applied to analyze the data. Results: The findings revealed moderate levels of knowledge (6.92 ± 2.27 out of 11) and suboptimal wastewater management behavior (35.8 ± 7.8 out of 60). Although participants demonstrated relatively high awareness of the environmental impact of wastewater, important gaps were identified in practical water conservation knowledge and greywater reuse concepts. The most frequently reported barriers were the high cost of water-saving equipment (60.7%), insufficient water pressure (46.0%), and limited public awareness of water conservation methods (43.6%). Perceived barriers showed a strong negative association with household wastewater management behaviors (r = −0.625, p < 0.001), whereas knowledge alone was not significantly associated with behavior. Conclusion: Improving household wastewater management in arid urban areas requires integrated behavioral and infrastructural interventions. Public education, financial incentives, and expanded sewerage infrastructure could promote sustainable practices and advance Sustainable Development Goal 6 (SDG 6) in water-stressed regions.
Introduction: This study aimed to assess the environmental health risks of heavy metal pollution in groundwater around non-engineered landfills in Botshabelo, South Africa. Materials and Methods: Inductively coupled plasma mass spectrometry and ion chromatography were used to analyze heavy metals in groundwater collected during the dry and wet seasons. Ecological risk factors and potential ecological risk indices were used to assess ecological risks. A human health risk assessment method was used to assess potential public health risks. Results: The mean concentrations of heavy metals were as F(0.29) > Mn(0.24) > Al(0.08) > Ba(0.06) = U(0.06) > Mo(0.04) > Fe(0.03) = B(0.03) > Cr(0.02) = Cu(0.02) > Zn(0.01) mg/l and F(0.21) > Mn(0.12) > B(0.06) > Fe(0.02) > Al(0.01) mg/l in wet and dry season respectively. Generally, only Mn, Mo, and U were above the acceptable standards for drinking water. It was only Mo that posed a high potential ecological risk during the wet season, whereas in the dry season, all heavy metals showed low ecological risk. The potential ecological risk index revealed a significantly high and low ecological risks during wet and dry season respectively. There was a potential non-carcinogenic risk of Mo, U, and Cr during the wet season for all population groups. The study also revealed that Cr has an acceptable carcinogenic risk and no possibility of carcinogenic risks during the wet season for children and adults. Conclusion: It can be concluded that there is potential heavy metal pollution of groundwater migrating from Botshabelo non-landfill.
Introduction: This study investigates the connection between sustainable supply chain practices and Health, Safety, and Environment (HSE) outcomes in the alloy steel industry using Structural Equation Modeling (SEM). Materials and Methods: A cross-sectional survey was conducted among 120 industry professionals, selected through purposive, non-random sampling to ensure their expertise in HSE and supply chain management. Data were collected using validated questionnaires measuring four dimensions of sustainable supply chain practices—supplier management, customer relationships, internal processes, and organizational learning—alongside HSE outcomes. Results: The data were analyzed using Partial Least Squares Structural Equation Modeling (PLS-SEM) with SmartPLS software, selected for its suitability in modeling complex constructs with moderate sample sizes. The measurement model demonstrated acceptable reliability (Cronbach's alpha > 0.7) and satisfactory convergent and discriminant validity. The findings from the structural model indicated that all four dimensions of sustainable supply chain practices had a significant and positive impact on HSE outcomes (path coefficients = 0.131–0.325, p < 0.05), with internal processes showing the strongest influence. The model exhibited high explanatory power (R² = 0.854). Conclusion: These findings suggest that aligning sustainable supply chain practices—particularly internal process optimization—with HSE objectives can substantially enhance the sustainable performance of the alloy steel industry. However, the findings should be interpreted with caution due to the cross-sectional design, and depended on self-reported data, and use of purposive, non-random sampling, which may limit causal inference and generalizability.
Introduction: Occupational exposure to the BTEX compounds (Benzene, Toluene, Ethylbenzene, and Xylene) in the printing industry is a major health concern due to their established carcinogenic and non-carcinogenic toxicity. This study aimed to quantify respiratory exposure, assess the internal biological dose, and determine the associated carcinogenic and non-carcinogenic health risks using the US-EPA methodology. Methods: This cross-sectional study monitored 23 occupationally exposed printing workers and 23 unexposed administrative staff (control group). Personal respiratory air sampling was conducted for BTEX (NIOSH 1501/GC), and end-of-shift urine samples were collected for biological monitoring of t,t-MA (Benzene metabolite) and Hippuric Acid (Toluene metabolite) using HPLC. Health risks were calculated using the EPA guidelines for the Hazard Quotient (HQ) and Lifetime Cancer Risk (LCR). Results: The Mean BTEX concentrations were high, notably toluene (47.17±52.03 ppm) and xylene (45.12±68.41 ppm) were markedly elevated. Biological monitoring revealed statistically significant differences between the groups (p < 0.001); the mean t,t-MA level in the exposed group was 51,809.37 µg/g creatinine compared to 265.75 µg/g creatinine in the control group. Risk assessment indicated critical non-carcinogenic risks, with HQs for Xylene (230.06), Benzene (16.43), and Toluene (8.35) far exceeding the safety threshold of 1. The mean LCR for Benzene was 7.8×10−3, significantly surpassing the EPA acceptable limit of 10-6. Conclusion: Chronic BTEX exposure in this printing facility significantly exceeded the permissible occupational limits, resulting in substantial non-carcinogenic and carcinogenic risks. Immediate intervention through engineering controls and comprehensive revision of safety standards is urgently required to protect worker health.
Introduction: Air pollution remains the leading environmental risk factor for human health. Although artificial intelligence (AI) has demonstrated strong technical potential for air quality monitoring and prediction, its integration into environmental policy and governance remains unclear. This study examines how AI is currently addressed in policy-oriented literature on air pollution management. Methods: A scoping review was conducted following Arksey and O’Malley’s framework and its extension by Levac et al. Systematic searches of major scientific databases and policy sources identified English-language documents published between 2015 and 2025 that addressed the use of AI in air pollution control from a policy, governance, or strategic perspective. Thematic analysis was used to synthesize the findings. Results: Eight policy-relevant documents met the inclusion criteria of this review. The analysis identified four core themes: applications of AI, perceived benefits, governance and ethical concerns, and policy strategies. AI applications have primarily been framed around real-time monitoring, predictive modeling, and data-driven policymaking. The reported benefits included improved accuracy, responsiveness, and decision support, whereas the key concerns were related to data quality, privacy, energy use, transparency, and institutional capacity. Policy strategies emphasized regulatory frameworks, digital infrastructure, capacity building, cross-sector collaboration, and international coordination. Conclusions: The limited number of policy-oriented studies highlights a significant governance gap between technical AI development and environmental policy-making. Integrating AI into air pollution management requires evidence-based, transparent, and accountable governance. Future research should focus on policy design, implementation, and evaluation to support the responsible and sustainable adoption of AI in environmental governance.
Introduction: Freshwater fish inhabiting polluted rivers are capable of bio-accumulating microplastics (plastic fragments measuring less than 5 mm, and nanoplastics (particles with dimensions below 1 µm) in their gastrointestinal tracts and occasionally in edible tissues, depending on species, size, and feeding ecology. Consumption of MNP-contaminated fish therefore represents a potential pathway of human exposure. Although dietary intake estimates vary by region and consumption patterns, aquatic bio-resources are recognized exposure routes alongside inhalation and other food sources. This study assessed the human health risks associated with consuming Clarias gariepinus and Oreochromis niloticus contaminated with micro- and nanoplastics (MNPs) from the Ngadda River, Borno State, Nigeria. Materials and Methods: C. gariepinus and O. niloticus were collected monthly from 6 stations over eight months. Samples were processed and analyzed for MNPs using Fourier Transform Infrared (FTIR) Spectroscopy and Gas Chromatography–Mass Spectrometry (GC–MS) at Yobe State University, Damaturu. Results: Mean MNP abundance in C. gariepinus ranged from 0.24–0.39 pp/kg (Stations B–C), while O. niloticus ranged from 0.47–0.79 pp/kg. Estimated ingestion for children was 70.38–117.97 pp/week and 844.50–1415.65 pp/year. Adult exposure ranged from 211.13–353.91 pp/week and 2533.51–42426.95 pp/year. Conclusion: O. niloticus exhibited higher bioaccumulation than C. gariepinus. Spatial variability reflected localized pollution sources. Dietary exposure levels for both children and adults were notable, highlighting the need for further studies on MNP retention and elimination in humans.
Introduction: Solid waste from healthcare centers is a major health and environmental challenge that imposes significant costs on the healthcare system. Methods: This systematic review was conducted following the PRISMA guidelines. A comprehensive search was conducted in the PubMed, Scopus, and Web of Science databases using keywords related to healthcare waste reduction, and Google Scholar was used as a supplementary source. Original quantitative, qualitative, and mixed-method studies examining waste reduction interventions in healthcare settings were included. The quality of the studies was assessed using the Newcastle Ottawa scale, and only studies with moderate to high quality were included in the final synthesis of results. The data were analyzed narratively and descriptively. Results: Twelve studies were included in the review. The results showed that educational and management interventions, such as implementing comprehensive quality management models, pharmaceutical interventions, such as prescription review, use of multi-dose vials, and rounding of drug doses, as well as redesigning hospital nutrition services and employing safe technologies and alternatives, resulted in significant waste reduction and cost savings. Among these, pharmacy bundles and targeted staff training were the most effective interventions. Conclusion: This review found that various strategies have been used to reduce healthcare waste in different countries, with pharmaceutical packaging optimization and educational programs showing the greatest effectiveness. However, there is still a need for larger intervention studies and evaluations of long-term clinical and economic outcomes.
Introduction: Classroom-based education alone is insufficient for developing practical skills in medical students. Structured field-based learning opportunities are scarce in Iran, limiting students’ exposure to real-world industrial and environmental processes. This descriptive-analytical study employed an educational evaluation approach to evaluate the effectiveness of the first environmental health field school to assess its impact on participants’ satisfaction, learning, behavior, and professional outcomes. Materials and Methods: This descriptive-analytical study employed an educational evaluation approach. A researcher-made questionnaire was designed according to the four levels of the Kirkpatrick model and distributed among 19 participants Results: The overall weighted mean of participant satisfaction at the reaction level was 4.52 out of five. At the learning level, the weighted mean was 4.19, indicating a significant improvement in practical knowledge, particularly in waste management, air pollution control, and irradiation technology. At the behavior level, the weighted mean was 3.84, reflecting the partial application of acquired knowledge in research and operational activities. Finally, at the results level, the weighted mean was 4.44, demonstrating the program’s lasting impact on the participants’ professional attitudes, motivation, and willingness to participate in future programs. Conclusion: The first environmental health field school showed high effectiveness across all four levels of the Kirkpatrick model. The program significantly improved satisfaction, learning, and professional attitudes. Follow-up programs and real internship opportunities are recommended to enhance the transfer of learning into practical behavior. Expanding such field schools can strengthen students’ practical skills and reinforce the university-industry links in environmental health.
Introduction: Wastewater-based epidemiology (WBE) has emerged as a valuable approach for environmental management and public health surveillance. By detecting viral RNA and biomarkers in wastewater, WBE provides community-level early warning signals that can support outbreak preparedness and guide policy-making. Methods: We conducted a systematic review and meta-analysis according to the PRISMA 2020 guidelines. Eligible studies published until March 2025 were screened from PubMed, Web of Science, and Scopus. Data on study design, sample type, detection methods, positivity rates, and temporal associations with clinical indicators were extracted. Pooled positivity rates were calculated using random-effects models, heterogeneity was assessed, and subgroup analyses were conducted. Results: Twenty-nine studies on SARS-CoV-2 wastewater surveillance were included in this review. The pooled positivity rate was 59.5% (95% CI: 49.6–68.7), with signals detected earliest in the sludge samples (98.8%). Wastewater indicators preceded reported clinical cases by a median of six days. Evidence has also demonstrated WBE’s applicability of WBE for influenza, RSV, norovirus, polio, and antimicrobial resistance, reinforcing its value beyond COVID-19.
Introduction: Exposure to air pollutants is a serious concern that leads to numerous health issues. Power plants are one of the main sources of pollutant emissions, including sulfur dioxide and nitrogen dioxide. This study aimed to estimate the non-carcinogenic risk associated with exposure to SO2 and NO2 at a power plant in northwestern Iran. Materials and Methods: SO2 and NO2 concentrations in the power plant exhaust gas and the power plant area were collected from official data recorded during regular monitoring. The health risk of exposure to the detected concentrations of SO2 and NO2 was assessed by calculating the hazard quotient based on the estimated chronic daily intake. Results: The analysis showed that the concentrations of SO2 and NO2 in the studied area were 12.60 and 20.18 μg/m3, respectively. However, the concentrations of the total studied pollutants in winter were 45.10% higher than those in summer. In addition, the mean hazard quotient of exposure to SO2 and NO2 was calculated as 0.0369 and 0.0905, respectively. But, the use of diesel for energy production in a power plant resulted in a 65.07% higher non-carcinogenic risk than the use of gas as a power plant fuel. Conclusion: Although the health risk of exposure to the studied pollutants was not significant (HI = 0.127) in the current situation, the use of diesel significantly increased the health risk owing to increased pollutant emissions.
Introduction: Metformin, an extremely prescribed antidiabetic medication, is discharged with minimal or no processing and remains during the usual wastewater treatment procedures. Advanced oxidation processes (AOP), especially ultrasound-enabled oxidation, are catalyst- and sludge-free reaction pathways for degrading recalcitrant pharmaceuticals. This study aimed to (i) determine the ultrasound-assisted degradation of metformin using hydrogen peroxide, (ii) determine the effect of the main operation parameters, and (iii) optimize the chemical oxygen demand (COD) and total organic carbon (TOC) using Response Surface Methodology (RSM). Materials and Methods: Five process parameters were optimized: pH (3-9), ultrasonic power (60-150 W), sonication time (10-60 min), H₂O₂ concentration (0-1.0 mL/L), and initial metformin concentration (5-50 mg/L). Dual response variables, including COD and TOC removal, were analyzed via quadratic polynomial regression. Metformin concentration was quantified using high-performance liquid chromatography at a detection wavelength of 240 nm. Results: Optimal operating conditions were identified as pH 3.5, ultrasonic power 110 W, sonication time 40 min, and H₂O₂ concentration 0.65 mL/L, achieving 94.5% COD removal, 88.3% TOC removal, and 97.2% metformin degradation. Both statistical models demonstrated high significance (p < 0.0001) with a coefficient of determination R² > 0.96 and a composite desirability of 0.9845 (98.45%), confirming excellent multi-response optimization. Conclusion: Metformin significantly reduced the organic load, and the drug was significantly degraded by ultrasonic-assisted oxidation. The optimization method based on RSM offers predictive models that can be used to design the process or the performers.
Introduction: Dental amalgam, a mercury-based restorative material, is a significant point source of environmental mercury contamination in clinical wastewater. Mercury and other heavy metals from dental clinics enter wastewater systems untreated, posing risks to ecosystems and human health. This review uniquely bridges the critical gap between dental practice effluent pathways, quantitative environmental risk assessment, and practical evaluation of mitigation technologies. Methods and Methods: A comprehensive literature search was conducted using Scopus, Web of Science, PubMed/MEDLINE, and Embase for publications from 2000 to 2024. This review focused on studies quantifying mercury in dental wastewater and evaluated the effectiveness of containment, treatment, and policy measures. Results: The findings confirmed that dental clinics contribute substantially to mercury loads in wastewater, with a single chair releasing as much as 4.5 g/day. Reported mercury concentrations in dental effluent vary widely, ranging from 0.90 µg/L to 39 mg/L, reflecting differences in clinical practices and control measures. The primary mitigation technology is amalgam separators, which can remove more than 90% of amalgam particles and are increasingly required by regulations, such as the U.S. Environmental Protection Agency 2017. A multi-faceted approach combining separators, optimized chairside practices, waste segregation, and staff education is essential for effective management. Conclusion: Despite the declining use of dental amalgam, it remains an important environmental concern. Effective mitigation requires a combination of stringent policies, proven technologies, and professional stewardship. Future efforts should prioritize standardized monitoring, long-term performance data on control measures, and robust cost-benefit analyses to guide sustainable dental practices.
