According to the Food and Agriculture Organization of the United Nations (FAO), Mexico uses more than a quarter of Central America's agricultural pesticides. Furthermore, Mexican regulatory agencies still do not recognize the classification of highly hazardous pesticides (HHP) under the Regulations on Registrations, Import and Export Authorizations, and Export Certificates for Pesticides, Plant Nutrients, and Toxic or Hazardous Substances and Materials (PLAFEST) regulation; no explicit national HHP definition exists. The aim of this review was to identify active ingredients (a.i.) historically used in Nayarit that are classified as HHP by internationally accepted classification systems and highlight the differences between them. Seven bibliographic resources, identified through a literature search conducted between October 2024 and July 2025, reported the pesticide sales or use patterns in Nayarit between 1987 and 2021. One hundred and twenty-five different a.i. were observed, of which 44 (35.2%) are HHP according to criteria defined by the FAO and the World Health Organization (WHO). In comparison, 82 (65.6%) are HHP according to the Pesticide Action Network International (PAN). Although most pyrethroids are highly toxic to bees, most of them are not recognized as HHP by FAO/WHO. Organophosphorus and carbamates are the main chemical families of HHP used in Nayarit. Glyphosate, an individual a.i. rather than a chemical family, was also identified as HHP. Dicofol, an organochlorine listed in Annex A of the Stockholm Convention for the global elimination of its use, was reported in retailer sales records. This review demonstrates the differences in the selection of HHP at a state-level assessment revealing that the criteria proposed by PAN allow the inclusion of a greater number of pesticides, in terms of their environmental effects, and a broader understanding of the presence of multiple HHP identified across the available evidence, indicating the potential for mixed pesticide exposure. We consider that a transparent and nationally adopted HHP identification framework is the first step to develop risk prevention strategies and promotion of sustainable alternatives.
BackgroundEl Paso, Texas, a city uniquely situated along the US-Mexico border, faces increased exposure to environmental pollutants due to factors including the mountainous desert landscape, industrial pollution, and high rates of transborder mobility along the El Paso-Juarez binational region. These unique environmental conditions and community characteristics make the region an important setting for environmental exposure surveillance. The association between traffic-related air pollution and adverse health outcomes is well established; however, the magnitude of impact that poor air quality and other environmental stressors place on border populations remains underexplored. Therefore, this study aimed to identify the most frequently documented environmental exposure-related ICD-9/10 codes among emergency department (ED) visits in El Paso and to characterize documentation patterns, temporal and seasonal trends, and selected healthcare utilization outcomes.MethodsThe study retrospectively reviewed charts from ED visits at University Medical Center of El Paso (UMCEP) and El Paso Children's Hospital (EPCH) between January 2000 to December 2024, examining frequency, distribution, and longitudinal and seasonal trends of environmental exposure-related ED visits.ResultsSeven hundred and twenty-six charts met inclusion criteria for patients aged up to 89 years with at least one environmental exposure-related diagnostic code. The most frequently documented codes were Z77.098: Contact with and (suspected) exposure to other hazardous, chiefly nonmedicinal, chemicals, Z77.011: Contact with and (suspected) exposure to lead, and V15.89: Other specified personal history presenting hazards to health. Environmental exposure-coded ED visits increased notably between 2015 and 2016 and demonstrated seasonal variation, with higher counts in the summer months.DiscussionThese findings provide important insights to how environmental exposure-related ED visits are documented within the region, highlighting distinct temporal and seasonal patterns. However, the overwhelming use of non-specific exposure codes underscores a need for more granular documentation to better characterize environmental exposures and inform future surveillance strategies.
IntroductionDespite sustained investments in water and sanitation infrastructure, peri-urban communities in South Africa continue to experience unreliable access to water, sanitation, and hygiene (WASH) services, limiting the translation of sanitation aspirations into everyday practice. This study examines the existing gap between WASH aspirations and actual practices in Nompumelelo, a peri-urban settlement in East London.MethodsEmploying a mixed-methods approach that includes interviews with key informants and surveys of 264 residents, the research identifies behavioral, infrastructural, sociocultural, and systemic barriers to achieving sustainable WASH outcomes. Grounded in the Theory of Planned Behaviour and Social Practice Theory, the study explores the factors influencing the realisation of effective WASH practices.ResultsThe findings indicate that the realities of water access, sanitation behaviours, sanitation infrastructure, resource scarcity, inadequate hygiene practices, governmental inefficiencies, and imposed decisions are key factors that contribute to the challenges in the realisation of effective WASH practices, despite the existing enthusiasm for their implementation. Community feedback emphasizes the shortcomings of top-down interventions in addressing local realities, highlighting the necessity for participatory, context-sensitive approaches.DiscussionThe study advocates for co-designed solutions that incorporate local knowledge, adaptive infrastructure models, and responsive policy frameworks. These strategies are essential for transforming WASH aspirations into equitable, sustainable, and dignified public health outcomes in peri-urban areas.
BackgroundIn Somaliland, a region characterized by post-conflict recovery and rapid urbanization, a significant qualitative housing gap persists despite international mandates like Sustainable Development Goal 11. However, little empirical research has investigated the hierarchical factors shaping structural housing quality in this specific context.MethodsThis study used multilevel mixed-effects logistic regression to identify determinants of structural housing quality, by analyzing 6,074 households from the 2020 Somaliland Demographic and Health Survey. Quality was defined by the durability of floor, wall, and roof materials, while predictors included household socioeconomic factors and community-level geographic variables.ResultsOverall, 24.1% of households resided in improved housing, while 75.9% lived in unimproved housing. Household wealth was the strongest determinant of structural housing quality. Compared with households in the lowest wealth category, those in the middle (AOR = 26.61, 95% CI: 18.76–37.75), high (AOR = 95.72, 95% CI: 64.31–142.48), and very high wealth categories (AOR = 298.19, 95% CI: 191.29–464.84) had significantly greater odds of residing in improved housing. Households without livestock ownership were more likely to have improved housing (AOR = 1.38, 95% CI: 1.13–1.70). Significant regional disparities were observed, with households in Maroodi-jeex, Sahil, and Togdheer having lower odds of improved housing compared with those in Awdal. Rural households were significantly less likely to reside in improved housing than urban households.ConclusionStructural housing quality remains low in Somaliland and is strongly associated with household wealth, geographic location, place of residence, electricity access, and livelihood characteristics. The findings highlight persistent socioeconomic and regional inequalities in housing conditions and underscore the need for targeted housing, infrastructure, and rural development interventions to support equitable progress toward Sustainable Development Goal 11.
IntroductionAnthropogenic air pollution has declined substantially across the United States, but wildfire smoke may be offsetting these gains. PM2.5 exposure increases the risk of adverse birth outcomes, and wildfire-related PM2.5 may be more toxic than PM2.5 from other sources. Yet limited data exist on spatiotemporal changes in population-level prenatal wildfire PM2.5 exposure. Existing studies have characterized geographic patterns of wildfire contributions to ambient PM2.5 but have not estimated population-based prenatal exposure at the national scale, a perspective essential for allocating public-health resources to the people most affected.MethodsWe linked daily county-level PM2.5 data from 2,842 counties (2003–2019) to national birth certificate records covering 64.5 million live births. Using chemical transport modeling, we separated wildfire-related from non-fire PM2.5 and computed period-averaged exposure for baseline (2003–2005) and endline (2017–2019). We assessed trends across nine NOAA climate regions, demographic subgroups, and counties stratified by wildland-urban interface (WUI) status and perinatal healthcare availability, and quantified prenatal exceedance days above 35 µg/m³.ResultsPrenatal PM2.5 declined from 12.82 to 8.45 µg/m³ (−34.1%), but non-fire PM2.5 declined more steeply (−37.2%), indicating that wildfire offset a portion of these gains. Wildfire's share more than doubled (3.71% to 8.19%), with 0.22 µg/m³ of improvement foregone nationally. Fire-attributable exceedance days were essentially unchanged (∼14%–15% of infants) while non-fire exceedance fell 85%; wildfire now accounts for 65% of remaining events. WUI, low-income, and American Indian/Alaska Native infants bore disproportionate burdens, and maternity hospital shortage counties had wildfire contributions nearly double those of adequate-access counties by 2017–2019.DiscussionIncreasing wildfire activity is systematically offsetting prenatal air quality gains from anthropogenic emission reductions, disproportionately burdening low-income, rural, and Indigenous communities, with the potential to further erode progress as wildfire activity intensifies.
Air quality and its effects on public health have long been a serious global concern, with pollutant sources, levels, and transport increasingly becoming subjects of research and public interest. As the amount of multi-source air quality datasets grows, research efforts have also increased, showing varying degrees of success, challenges, and coverage across different regions worldwide. Therefore, a study that synthesises this knowledge is urgently required for multiple planning and monitoring purposes. Here, we present a systematic review of studies on air quality and their potential impact on public health, sourced from the Scopus, Web of Science and PubMed databases. Our search identified 123 peer-reviewed articles that met the search criteria between 2005 and 2026, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The review identified an increasing trend in articles, with most studies spatially concentrated in Asia (53), where China (23) and Iran (9) account for the highest numbers. Africa follows with 23 articles, with South Africa (9) having the most. North America has 20 articles, led by the United States (17). Europe has few articles (10), and South America (5), and no more than four articles for other countries. About half of these studies (50.4%) used ground-based stations, while almost one-fifth (20.7%) used MODIS satellite data, with growing studies using various sensors coupled with machine learning methods. The most studied pollutants include PM2.5 (66 articles), NO2 (38), PM10 (36), SO2 and O3 (28 each), CO (13), and relatively few examined NOX (4) and BC (1). The results revealed that relatively few articles were published within the Remote Sensing and Geoinformation journal category. This finding further underscores a significant research gap at the intersection of remote sensing and air quality studies. Air quality monitoring across sub-Saharan Africa continues to be constrained by sparse ground-based monitoring networks and a limited number of studies that integrate satellite-derived and in situ observations. Consequently, there is a pressing need for more region-specific research to enhance pollution assessment, improve exposure characterization, and advance understanding of air quality dynamics within the regional context. Overall, studies successfully associated poor indoor and outdoor air quality with adverse effects on human health such as respiratory disorders, hospital admission and mortality to both children and adults.
BackgroundInadequate household solid waste management remains a critical environmental health challenge in low- and middle- income countries, contributing to infectious disease transmission through vector breeding, water contamination, and unsafe disposal practices. Evidence linking quantified environmental risk practices to household morbidity remains limited, particularly in urban–rural comparative settings.MethodsA community- based mixed- methods descriptive study was conducted among 219 households across urban slums and rural villages in Odisha, India. Quantitative data were collected using interviewer- administered questionnaires, observational checklists, and waste quantification through colour- coded bag weighing. Eight waste categories were assessed for segregation and disposal practices. An environmental risk score (0–8) was developed based on the appropriateness of disposal. Infectious morbidity (gastrointestinal, respiratory, dermatological, and vector- borne diseases) reported within the preceding 3 months was recorded. Qualitative insights were obtained through focus group discussions and in- depth stakeholder interviews. Associations were analysed using chi- square tests, odds ratios, and thematic analysis.ResultsA total of 219 households participated (urban = 110; rural = 109). Appropriate waste segregation practices were significantly higher in urban households. Dustbin use for kitchen waste was reported by 75% (95% CI: 66.1–82.3) in urban areas compared to 65% (95% CI: 55.5–73.4) in rural areas (p < 0.001), while indiscriminate disposal was observed only in rural households (20%; 95% CI: 13.3–28.5). Safe thin- plastic collection was higher in urban settings (78%; 95% CI: 69.5–84.7) than rural (64%; 95% CI: 1.54.5–72.6) (p < 0.001). Mean daily kitchen waste generation was greater in rural households (2.38 ± 0.60 kg) than in urban households (1.38 ± 0.50 kg; p < 0.001). Skin infections were significantly higher in rural households (46%; 95% CI: 36.7–55.6) than in urban households (18%; 95% CI: 11.7–26.4), whereas vector- borne diseases were more prevalent in urban areas (21%; 95% CI: 14.2–29.7). Higher environmental risk scores were positively associated with increased reporting of infectious morbidity.ConclusionEnvironmental risk scoring provides an actionable household- level metric linking waste practices to infectious morbidity. Strengthening segregation behaviour, decentralised waste systems, and risk communication strategies is essential for infection prevention and environmental health equity.
IntroductionChronic low-level fluoride exposure has been associated with depressive symptoms in animals and child internalizing behaviors in the United States (US); however, this study is the first to examine whether excess early life fluoride exposure is associated with depressive symptoms in US adults.MethodsParticipants were 886 adults aged 18–29 years from the National Health and Nutrition Examination Survey (NHANES) 2015–2016. Dental fluorosis, a marker of excess fluoride exposure during tooth development, was assessed using the Dean's Fluorosis Index (DFI). Self-reported depression was measured using the Patient Health Questionnaire (PHQ-9). We classified participants as having depression if they scored ≥10 and satisfied certain clinical criteria. We also classified depression symptom severity. Survey-weighted and covariate-adjusted binomial and multinomial logistic regression examined associations of dental fluorosis with presence and severity of depression, respectively.ResultsParticipants were 24 years-old on average. Approximately 70% of participants had dental fluorosis that was mostly very mild or mild and 5% reported depression. Participants with dental fluorosis had 1.8 times the odds of reporting current depression compared to those without fluorosis (OR = 1.78; 95% CI: 1.03–3.07; p = 0.04). This association was significant for very mild/mild fluorosis and depression (OR = 1.82, 95% CI: 1.06–3.11, p = 0.031) but not moderate/severe fluorosis and depression (p = 0.814). Dental fluorosis was not associated with depressive symptom severity.DiscussionHaving very mild or mild dental fluorosis was associated with higher odds of young adults in the US reporting depressive symptoms; however, prospective studies are needed to further examine this association.
In this systematic literature review and meta-analysis, the association between air pollution exposure and depression was analyzed. This meta-analysis is based on 90 studies investigating the associations between both short- and long-term exposure to various air pollutants and depression, including post-partum depression. These studies were reported according to “The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)” guidelines. The studies included in the meta-analysis comprised of several different air pollutants including nitrogen dioxide (NO2), sulphur dioxide (SO2), carbon monoxide (CO), particulate matter (PM2.5 and PM10), ozone (O3), and black carbon (BC), examined through both measured data and modelled estimates. A total of 17 meta-coefficients were calculated, with statistically significant associations in ten of these, indicating a clear link between air pollution exposure and depression. The meta-coefficient for long-term exposure to PM2.5 was based on 25 studies with a risk increase of 1.044 (95%: 1.024–1.064) associated with a 1 µg m−3 increase. The meta-coefficient for long-term exposure to NO2 was based on 22 studies with a risk increase of 1.011 (95%: 1.003–1.018) associated with a 1 µg m−3 increase. However, a high degree of heterogeneity throughout almost all meta-analyses may restrict the generalizability of our findings.Systematic Review Registrationhttps://inplasy.com/inplasy-2024-8-0025/, INPLASY INPLASY202480025.
Glyphosate-based herbicides are the most widely used agricultural chemicals globally and have been widely regarded as safe due to their low acute toxicity. However, this safety paradigm has been shaped by regulatory frameworks that prioritize short-term endpoints and may overlook slower, systemic pathways to disease. In this perspective, we revisit glyphosate through a public health lens, drawing parallels with the historical trajectory of dichlorodiphenyltrichloroethane (DDT), where early assurances of safety preceded recognition of long-term ecological and human health harms. We highlight emerging evidence linking glyphosate exposure to metabolic, inflammatory, and neurological conditions, alongside ecological disruptions that may indirectly affect human health by altering soil systems, biodiversity, and food quality. We examine how safety assumptions have been challenged by reassessment of early toxicological data, raising concerns about biases in regulatory evidence selection and the exclusion of independent academic studies. Mechanistic insights from microbiome science, epigenetics, and non-monotonic dose response relationships suggest that glyphosate's effects may manifest across generations, pathways not captured in conventional risk assessment. Glyphosate exposure is not evenly distributed where populations with close connections to land-based food systems, including Indigenous communities, face disproportionate risks, highlighting an underexamined environmental injustice. We argue that current regulatory approaches are insufficient to address the chronic disease drivers embedded in modern food systems. A systems-based framework is needed, one that incorporates microbiome and epigenetic endpoints, prioritizes long-term studies, and evaluates cumulative effects. Reframing glyphosate within this broader context is essential to inform policy, protect population health, and prevent the repetition of historical failures in environmental health governance.
IntroductionWe investigated the impact of COVID-19 on presenteeism among healthcare workers (HCWs) in the Greater Accra Region of Ghana.MethodsThis longitudinal follow-up study employed a census approach to include 756 HCWs, comprising 252 COVID-19–exposed and 504 unexposed participants. Data were collected at baseline, month 3, and month 6. Statistical analyses were conducted using Stata LP version 15. Pearson's chi-square tests were used to assess differences in presenteeism between exposure groups at each time point. Variables showing significant associations were included in a multivariable generalized linear model with a proportional odds specification to estimate adjusted proportional odds ratios with 95% confidence intervals. Statistical significance was set at α = 0.05.ResultsHigh presenteeism was consistently observed over the six-month period, peaking at 91.7% at month 3. Presenteeism rates were significantly higher among COVID-19–exposed HCWs at all time points (p < 0.005). Factors associated with increased presenteeism included having five or more dependents, holding part-time jobs, and working as a nurse or laboratory scientist, whereas HCWs with 5–9 years of experience had lower odds. Moderate to severe depression and anxiety were associated with reduced odds of high presenteeism, although severe anxiety at baseline was linked to increased odds. Overall, presenteeism declined over time.ConclusionPresenteeism remains high among HCWs, particularly those experiencing psychological distress. Targeted interventions, including improved working conditions, mental health support, adequate personal protective equipment, and workforce strengthening, are essential to safeguard HCW well-being and health system resilience.
IntroductionFirefighters often work extended schedules, including 56-hour workweeks, that may contribute to fatigue, disrupted sleep, and negative physical and mental health outcomes. These concerns have increased interest in alternative shift models that allow for longer recovery periods. One emerging approach is the 24/72, or “D shift,” schedule, which consists of 24 hours on duty followed by 72 hours off. Although this model is becoming more common, limited empirical evidence exists regarding its impact, particularly from the organizational perspective of fire service administrators.MethodsA cross-sectional, mixed-methods survey was distributed to 39 fire department administrators in the United States who had implemented or were considering the 24/72 schedule. Fifteen administrators representing departments across seven states completed the survey. Quantitative data were analyzed using descriptive statistics, and qualitative responses were examined using thematic analysis.ResultsAdministrators reported high levels of satisfaction with the 24/72 schedule, with 100% indicating they were satisfied or very satisfied. Reported benefits included improved morale, recruitment, retention, shift coverage, and reductions in sick leave. Qualitative findings reinforced these outcomes, with themes related to organizational stability and workforce well-being. The most frequently reported challenge was increased overtime costs, which some agencies noted required proactive planning.DiscussionFindings suggest that the 24/72 schedule may offer meaningful workforce and organizational benefits for fire departments, particularly in areas related to morale, staffing stability, recruitment, retention, and recovery. However, financial sustainability, especially overtime costs, should be carefully considered during implementation. Broader, longitudinal research is needed to evaluate the long-term effects of the 24/72 schedule on firefighter health, safety, performance, and organizational outcomes.
Exposure to anthropogenic volatile organic compounds (VOCs) has been associated with preterm birth, yet the spatial distribution of VOC exposures within urban environments remains poorly characterized, particularly for vapor intrusion pathways. Plants have recently been used as a cost-effective, non-invasive tool to “phytoscreen” for belowground contaminants. Here, we evaluated the use of phytoscreening within a birth cohort in metro Detroit, Michigan, USA by (a) assessing participant willingness to allow sampling in residential front yards, (b) quantifying VOC concentrations across plant tissue types (leaves and twigs), and (c) testing whether VOC detections in plants are associated with proximity to brownfield sites. Of 20 pregnant participants, 18 agreed to phytoscreening and sampling was completed at 13 residences, indicating high feasibility. Across 15 plant species, five of six target VOCs (benzene, toluene, ethylbenzene, xylene, trichloroethylene, tetrachloroethylene) were detected. Specifically, toluene was detected at all 13 homes and in 68% of samples. While less common, ethylbenzene was detected in 12 samples across 3 homes and trichloroethylene was detected in one sample that exceeded Michigan's risk-based screening level for soil vapor intrusion. Additionally, VOCs were detected more frequently and at higher concentrations in leaves compared to twigs. However, VOC concentrations in plants were not associated with proximity to known or suspected brownfield sites in this small sample size. Overall, these findings demonstrate the feasibility of phytoscreening in epidemiological studies and highlight its utility for characterizing spatial patterns of VOC exposure. Incorporating plant-based sampling approaches may help identify localized hotspots of human exposure and inform targeted environmental remediation efforts.
India is among the world’s most heat-exposed nations, with hundreds of millions of people facing dangerous temperatures each summer and a mortality burden that remains poorly understood at the district level. We estimate that a single day of extreme heat causes approximately 3,400 excess deaths nationally; a five-day heatwave causes nearly 30,000. Although global studies highlight surging heat-related mortality, granular spatial-temporal data on how heatwaves affect mortality at the district level in India remain inaccessible to common researchers. District-level estimates of heatwave-induced excess mortality covering all of India have not previously been reported in the peer-reviewed literature; this paper provides such estimates using publicly available data and a climate zone-based risk transfer methodology. We adapt findings from a multi-city epidemiological analysis of heat-related mortality across 10 Indian cities to estimate excess deaths across all Indian districts. We integrate district-level mortality rates from the Civil Registration System and population projections for 2024 with city-specific risk coefficients based on the Köppen–Geiger climate classification. We obtain district-level excess death estimates under one-day and five-day heatwave scenarios. Our results suggest that even a single day of extreme heat yields thousands of excess deaths, and a multi-day heatwave results in tens of thousands of excess deaths. By mapping heat-induced mortality risk to individual districts, this study finds that Uttar Pradesh alone accounts for approximately 8,100 excess deaths during a five-day heatwave, and districts such as Ahmedabad, Jaipur, and Surat each exceed 250 excess deaths in a single event. It underscores the need for more localized heat action plans, improved and heat-relevant healthcare infrastructure, and robust early-warning systems. These findings have implications not only for India but also for other countries in South Asia and Sub Saharan Africa facing similar heat vulnerabilities, highlighting the global urgency of heat adaptation measures. With respect to heatwave frequency and temperature thresholds, these estimates are conservative lower bounds. The direction of bias introduced by applying urban-derived risk coefficients to rural populations is uncertain and is discussed in the Limitations section.
ObjectiveGreenhouse gas emissions are a phenomenon that has a significant impact on the environment and can pose a threat to various aspects of life if not curtailed or given adequate attention. The extent of these emissions differs by region, but the consequences are undeniable. This study aims to determine the effects and relationships of these emissions on economic and health factors.MethodsUsing Generalised Additive Models (GAMs), this study investigates the relationships among environmental stresses, economic growth, and health consequences. The analysis considers per capita emissions from gas, liquid, and solid fuels, together with economic indicators like GDP per capita and health expenditure, as well as health outcomes like mortality rates (death rates, DR) and disease prevalence, using data from 40 industrialised and developing nations.ResultsThe results show significant heterogeneity among income groups; they also partially corroborate the Environmental Kuznets Curve (EKC) theory. Greenhouse gas emissions are strongly correlated with economic growth, despite their connection to increased mortality. The health implications of solid fuels are the most severe, especially concerning chronic diseases and infant mortality, whereas the results for liquid fuels are more inconsistent and unpredictable. The quality of institutions and healthcare systems is an important variable, and a classification of countries based on their GAM profiles reveals that traditional development categories frequently fall short.ConclusionThis study demonstrates how crucial GAM modelling is for representing intricate, non-linear connections in environmental and health economics. Instead of using a single-variable approach that limits the analysis, a two-variable method is applied when the important factors affecting the results (GDP and DR) are clearly identified. These results demonstrate that economic expansion by itself does not ensure improved environmental or health outcomes. Proactive and situation-specific policies are still crucial, which in turn influences the form of the recommendations to address the negative effects. Furthermore, considering different geographic areas provides a broad perspective on the differences in their dynamics, establishing a framework for national and international collaborations that can leverage the expertise and experience of countries that have curtailed their effects to a reasonable level.
IntroductionLooking at the divisional distribution of crashes and casualties in the first half of 2022 in the Volta region of Ghana, the Hohoe division recorded just 7 crashes, accounting for 3.6% of all reported crashes, one of the lowest among the divisions in the region. Notably, no fatalities were reported, suggesting relatively better road safety performance during this period. Therefore, this study aimed to investigate the factors that contributed to compliance among commercial drivers at Hohoe in the Volta region of Ghana during the first half of 2022—a period when the area reportedly recorded comparatively better road safety outcomes than other regions.MethodsUsing cross–sectional survey design and the census sampling technique, 395 (100%response rate) commercial drivers were recruited for the study. A structured questionnaire was used to measure key variables. Data were analyzed using frequency distribution, Pearson's chi–square test, and binary logistic regression in SPSS version 27.ResultsThe study found that 89% of commercial drivers observed compliance. Significant positive associations were found between compliance and sociodemographic characteristics (p < .001), human factors (p < .001), vehicle factors (p < .001), environmental factors (p < .001), and road factors (p < .001).DiscussionThe study findings, therefore, suggest that a multi–pronged policy approach that addresses vehicles, roads, the environment, human factors, and driver skills is critical for improving road safety protocols compliance among commercial drivers at Hohoe. By targeting both structural and human dimensions of road safety, authorities can reduce traffic violations, prevent accidents, and promote safer transport operations in the Volta region.
The spread and intensity of chemicals in farming are ever-increasing, primarily driven by a policy focus addressing food security and self-sufficiency issues. This has had a profound impact on environmental health, especially in South Asia, where the intensification of chemical farming is among the highest in the world. Despite its alarming adverse impacts, chemical farming is yet to attract the deserved policy attention. This paper, based on a systematic review of research among the five selected South Asian countries, aims to enhance policy awareness about this growing threat to human and livestock health, lives, livelihoods, and the production base (soil and water). These threats continue to escalate, threatening the progress made so far in food security and self-sufficiency. Unchecked chemical intensification needs to be regulated by removing policy distortions and initiating appropriate interventions. Awareness building, ensuring access to and use of safety gear, regulating chemical supply, and strengthening extension services are critical for addressing the menace in the short to medium term. Establishing sustainable farm practices, such as precision/natural/organic farming, in a phased manner, is presented as a long-term policy objective.
Poor-quality housing is a major but under-recognised driver of health inequalities in the UK. This perspective article explores how housing conditions are shaped by tenure, regional disparity, ageing populations, and decades of political and economic decision-making. Drawing on contemporary policy developments and examples from towns such as Blackpool, we argue that housing should be treated as health infrastructure, not a market commodity. We examine the health consequences of poor housing, including respiratory and cardiovascular disease, mental illness, and premature ageing, and highlight interventions to address housing issues such as regeneration, Housing First, and selective licensing. As pressures on the NHS and local authorities mount, addressing housing as a root cause of ill health is both a moral and pragmatic imperative. Until we treat housing policy as health policy, we will continue to treat the symptoms while ignoring the cause.
ObjectiveTuberculosis (TB) is one of the most prevalent public health challenges, particularly in developing countries where poverty, lack of sanitation and improper housing exacerbate the spread of infectious diseases. This study aimed to determine the socio-demographic and environmental factors associated with TB infection among children in the Hhohho region of Eswatini.MethodsWe conducted a cross-sectional study among children under 15 years diagnosed with TB (2022–2023) in Eswatini's Hhohho region, identified through hospital records. Data were collected via a structured survey and medical record review to assess environmental and socio-demographic risk factors. A Social Vulnerability Index (SVI) was constructed using 13 binary indicators to quantify cumulative social and environmental disadvantage. Social Vulnerability Index (SVI) from the Centers for Disease Control and Prevention (CDC) was utilised to investigate whether higher vulnerability correlates with a greater prevalence of TB symptoms.ResultsA high proportion (64%) of children were socially vulnerable, indicating multidimensional disadvantage. Children who are socially vulnerable face a significantly higher burden of TB symptoms (94%) compared to their less vulnerable peers (78%). Thus, social disadvantage directly increases health risks in children. The Expanded SVI therefore serves as an important indicator of social determinants of TB risk in the study populationConclusionThese results strongly suggest a need for targeted public health interventions that prioritize children who are economically disadvantaged. There is an ever-increasing need for policies that address upstream social determinants such as poverty, overcrowding, and poor nutrition that heighten TB risk.
