Volume 39, Issue 1

Tobacco is the only consumer product that kills half its users yearly. The challenges posed by tobacco control are limitless especially in a country like India where in addition to smoked forms, other smokeless forms of tobacco are also highly prevalent. Apart from being a health hazard tobacco is also a great environmental hazard. Policies for controlling tobacco use also include policy to prevent people from second hand smoke, which is aimed at improvement of air quality. According to the National Non-Communicable Disease Monitoring Survey, 2017–18, daily tobacco use was 32.8% in adults (18–69 years) and 3.1% in adolescents (15–17 years). Overall reduction in tobacco users by 8.1 Million was seen from GATS-1 to GATS-2, and prevalence amongst youth decreased from 18.4 to 12.4%. GYTS-4 (2019) revealed that 8.5% of students, 9.6% of boys and 7.4% of girls-currently used any tobacco products. This makes tobacco control a priority in India. Tobacco control consists of different approaches such as educational, healthcare, legislative, regulatory and fiscal. In the present article we traverse nearly five decades and decode the evolution of legislative, regulatory and fiscal approaches to Tobacco Control in India. A critical evaluation of all these approaches is described in the format of the MPOWER strategy for Tobacco Control which stands for Monitoring Tobacco use, Preventing people from Second Hand Smoke, Offering help to quit, Waring regarding ill effects of tobacco, Enforcing bans and Raising taxes on tobacco products.

Objectives Previous literature has shown that heavy metals (HMs) in cigarette smoke have been overestimated, and second-hand smoke (SHS) has recently raised public concern. This study aimed to review the effects of passive tobacco exposure on lead (Pb) and cadmium (Cd) concentrations of children and women in different biological samples. Content In this systematic review, two independent researchers assessed different databases/search engines including PubMed, Web of Science, Scopus, and Google Scholar using Mesh terms and Text Words. Studies between January 2000 and May 2022 were included. After quality assessment, studies with sufficient data were included in the meta-analysis. A fixed or random model was used to pool the results in a meta-analysis. Heterogeneity between the studies was assessed by using I -square and Q tests. Forest plots demonstrating the point and pooled estimates were provided. Summary A total of 976 studies were obtained from different databases and finally 17 studies meet our criteria and were included in our systematic review. Out of 17 studies, six studies had sufficient data for analysis and were included in the meta-analysis. The results of the meta-analysis showed a significant difference in blood lead concentrations (BLC) between the children with SHS exposure and the control group (Hedges’ g: 2.44, 95% CI: 1.01–3.86, p<0.05). Also, there were significant differences in hair levels of Cd (Hedges’ g: 0.66, 95% CI: 0.04, 1.28, p<0.05) and Pb (Hedges’ g: 0.94, 95% CI: 0.05, 1.83, p<0.05) between children with SHS exposure compared to the control group. Outlook The results of the present meta-analysis showed that passive smokers had higher Pb and Cd concentrations than those who were not exposed to cigarette smoke.

In high-altitude environments, the oxygen and air density are decreased, and the temperature and humidity are low. When individuals enter high-altitude areas, they are prone to suffering from acute mountain sickness (AMS) because they cannot tolerate hypoxia. Headache, fatigue, dizziness, and gastrointestinal reactions are the main symptoms of AMS. When these symptoms cannot be effectively alleviated, they can progress to life-threatening high-altitude pulmonary edema or high-altitude cerebral edema. If the risk of AMS can be effectively assessed before people enter high-altitude areas, then the high-risk population can be promptly discouraged from entering the area, or drug intervention can be established in advance to prevent AMS occurrence and avoid serious outcomes. This article reviews recent studies related to the early-warning biological indicators of AMS to provide a new perspective on the prevention of AMS.

Phthalates are a kind of synthetic plasticizers, which extensively used as plastic productions to improve their plasticity and flexibility. However, exposure to phthalates has been proved an increased risk of respiratory disease, because by they affect the development and functions of the lung and immune system. Here, we attempt to review respiratory health of phthalate exposure. Firstly, we describe the relationship between phthalates and lung function and airway inflammation. Then, the role of phthalates in asthma, lung cancer, rhinitis, and respiratory tract infections and the possible mechanisms of action are discussed. Finally, possible effective measures to reduce exposure to phthalates are proposed, and health care workers are called upon to provide educational resources and advocate for informed public health policies. Overall, the evidence for association between phthalate exposure and respiratory disease is weak and inconsistent. Therefore, thorough implementation in large populations is needed to produce more consistent and robust results and to enhance the overall understanding of the potential respiratory health risks of phthalate in long-term exposure.

The fifth generation of radiofrequency communication, 5G, is currently being rolled out worldwide. Since September 2017, the EU 5G Appeal has been sent six times to the EU, requesting a moratorium on the rollout of 5G. This article reviews the 5G Appeal and the EU’s subsequent replies, including the extensive cover letter sent to the EU in September 2021, requesting stricter guidelines for exposures to radiofrequency radiation (RFR). The Appeal notes the EU’s internal conflict between its approach to a wireless technology-led future, and the need to protect the health and safety of its citizens. It critiques the reliance of the EU on the current guidelines given by the International Commission on Non-Ionizing Radiation Protection (ICNIRP), that consider only heating and no other health relevant biological effects from RFR. To counteract the ICNIRP position, the 2021 cover letter briefly presented recent research from the EU’s own expert groups, from a large collection of European and other international studies, and from previous reviews of the effects of RFR on humans and the environment. The 5G Appeal asserts that the majority of scientific evidence points to biological effects, many with the potential for harm, occurring below the ICNIRP public limits. Evidence to establish this position is drawn from studies showing changes to neurotransmitters and receptors, damage to cells, proteins, DNA, sperm, the immune system, and human health, including cancer. The 2021 Appeal goes on to warn that 5G signals are likely to additionally alter the behaviour of oxygen and water molecules at the quantum level, unfold proteins, damage skin, and cause harm to insects, birds, frogs, plants and animals. Altogether, this evidence establishes a high priority for the European Union towards (i) replacing the current flawed guidelines with protective thresholds, and (ii) placing a moratorium on 5G deployment so as to (iii) allow industry-independent scientists the time needed to propose new health-protective guidelines. This 2021 Appeal’s relevance becomes even more pressing in the context of the EU plans to roll out the sixth generation of wireless technologies, 6G, further adding to the known risks of RFR technology for humans and the environment. This all leads to an important question: Do EU decision makers have the right to ignore EU´s own directives by prioritising economic gain over human and environmental health?

Dust storms expose people suspended particles, microorganisms and potential allergens that have been absorbed by dust particles during airborne transport. The purpose of this study was investigation effect of microorganisms (bacteria and fungi) in dust storm on human health. Databases used to for searched were the PubMed, Google Scholar, Web of Science, Springer and Science Direct (Scopus). 58 papers based on abstract and article text filtered. In the end after sieve we selected 10 papers. Identify all relevant studies published 1978-2022. The literature showed that green spaces created by city officials in different areas include a set of trees and shrubs in accordance with the effect of microorganisms (bacteria and fungi) in dust storm on human health. Based on the result the many studies are conducted every year on the characteristics and different sources of dust, one of the most important of which is the ability of these storms to carry pathogenic microorganisms. the purpose of this study is the effect of bacteria and fungi in dust storms on human health. The findings of this study showed that the evaluation of various studies showed that with the occurrence of dust storms that originate from different sources, in addition to transporting suspended solids, pathogenic bacteria and fungi are also transmitted by dust storms from near and far places and cause various diseases of these include respiratory and pulmonary problems, upper respiratory tract infections, and cardiovascular disease.

Heavy metals are chemical elements with unique properties that are toxic even in low concentrations and affect human health with different functions. Agricultural and industrial activities, improper disposal of household solid waste and residues related to industrial producers, discharge of household wastewater and agricultural fertilizers are the most important ways in which toxic heavy metals enter the environment, which harms human health and life. A narrative review of the literature was done from 2000 to 2022 based on searched databases included Google Scholar, PubMed, Springer, Web of Science, and Science Direct (Scopus). All relevant studies published 2000 until 2022 gathered. According to the databases, 820 articles were retrieved. 186 and 50 articles were found and selected based on records identified through database searching and additional records identified through other sources. In the next stage, 97 studies were screened after review and 64 full-text articles entered into the analysis process. Finally, 45 articles were selected in this study. Adverse effects of heavy metals on various conditions in the body depend on a number of factors, including dose, route of exposure and chemical species, as well as age, sex, genetics, nutritional status, and duration of exposure to the heavy metal. The existence of significant relationships between long-term and short-term exposure to toxic heavy metals and their adverse effects, including carcinogenicity, has been extensively studied and proven through numerous experiments. However, the mechanisms associated with this complication have not been properly identified, so in future research, there is a great need for comprehensive studies on the carcinogenicity of heavy metals.

The contamination of water due to heavy metals (HMs) is a big concern for humankind; particularly in developing countries. This research is a systematic review, conducted by searching google scholar, Web of Science, Science Direct, PubMed, Springer, and Scopus databases for related published papers from 2010 to July 2021, resulting in including 40 articles. Among the analyzed HMs in the presented review, the average content of Cr, Pb, Ba, Al, As, Zn, and Cd exceeded the permissible limits suggested by the World Health Organization (WHO) and 1,053 Iranian standards. Also, the rank order of Hazard Quotient (HQ) of HMs was defined as Cd>As>Cr>Pb>Li for children which means Cd has the highest non-carcinogenic risk and Li has the least. This verifies to the current order As>Cr>Pb>Fe=Zn=Cu>Cd for adults. The corresponded values of HQ and Hazard Index (HI) in most cities and villages were investigated and the results indicated a lower than 1 value, which means consumers are not at non-carcinogenic risk (HQ). Carcinogenic risk (CR) of As in the adult and children consumers in most of the samples (58.82% of samples for both groups) were investigated too, and it was more than>1.00E-04 value, which determines that consumers are at significant CR.

Natural radioactivity is a public health issue that affects people all around the world. Environmental radioactivity accounts for approximately 87% of the radiation dose received by human beings. The primary external source of irradiation to the human body is gamma radiation emitted by naturally occurring radioisotopes such as 40 K and radionuclides from the 232 Th and 238 U families, as well as their decay products, which exist at trace amounts in all ground formations. The establishment of baseline data for environmental radiological studies is of great importance for the assessment of environmental radiological levels in Uzbekistan and related studies on human health risks. The current study aimed to describe the research state of the art on natural radioactivity in Uzbekistan with emphasis on results obtained during the last 20 years. NaI (Tl) and High Purity Germanium HPGe detectors were employed in most conducted studies. The results showed that data for natural radionuclide activity were below international standards in all but a few areas. The research results of this paper can play a good guidance and reference role in the planning of such research in the future.

Lead in the environment remains a matter of grave concern for public health. Lead has been associated with some traditional medicines and has been linked to cases of lead poisoning. A comprehensive compilation of these reports has not previously been conducted. The objective of this review is to explore how common is lead exposure after traditional medicine use, and which countries, systems and/or products are of most concern when it comes to lead contamination. A systematic search was conducted on PubMed, Ovid and EMBASE for studies published between 2005 and 2020. A grey literature search was conducted. Search terms related to lead and traditional medicine were developed for each database, and there were no limitations on language. Studies were included if they examined elevated lead in humans resulting from the use of traditional medicines reported in case reports, case-series, or observational studies. Of the papers discussing lead exposure, 85 case reports were identified and synthesized for the current review. Several themes were identified in the included studies. Traditional medicine has been used in the many parts of the world, however use is more common in South and Southeast Asian countries. The level of detectable lead in products varied widely by region and product types. Consumers of traditional medicines sought products for a wide variety of symptoms and ailments. The symptoms of lead poisoning from traditional medicine use reflected the typical symptom profile of lead poisoning, highlighting the need for awareness of traditional medicine products as a source of lead exposure. Traditional medicine usage remains an important part of health care in many regions, however there is a risk of lead exposure from several products. Health care practitioners in all regions of the world should be aware of the risk and explore the potential for traditional medicine use for patients presenting with elevated blood lead levels. Countries with a strong traditional medicine culture should explore policies for reducing lead exposure from traditional medicine products. JG, LO and MNBD are staff members of the World Health Organization. The authors alone are responsible for the views expressed in this publication and they do not necessarily represent the decisions, policy, or views of the World Health Organization.

There is a growing awareness that spending time in nature is associated with improvement of well-being; nevertheless, the prescription of forest bathing is still limited. The aim of this systematic review was to explore the physiological and psychological benefits of different forest therapies on healthy and pathological elderly populations (>60 years) to identify the most-effective type, duration, and frequency of these interventions. A search for literature was carried out in December 2021 using PubMed, EMBASE, ResearchGate, Google Scholar and Web of Science. Grey literature was searched as well. After removal of the duplicates, within the 214 articles identified, ten met the inclusion criteria. The methodological quality of the selected studies was rated. Forest walking, alone and in combination with other activities is the most effective intervention. The selected studies reported a positive impact on physical components, including reduction in blood pressure and heart rate and improvements in cardiopulmonary and neurochemical parameters. Favorable modifications have also been noted in the psychological field, with improvements in depression, stress levels and in quality of life perception. In conclusion, forest walking may play an important role in promoting physical and mental health in healthy and pathological elderly populations. However, the lack of high-quality studies limits the strength of the results, calling for more trials.

The Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA) is a landmark environmental policy. It broadly empowers the federal government to manage hazardous waste sites to ensure the protection of human and environmental health. In many ways, CERCLA is the result of the environmental justice movement, and public concern about hazardous sites. Because the goal of CERCLA is explicitly managing risk from hazardous sites, it is central to the regulatory structure for management of environmental injustice in the United States of America. However, CERCLA does not fully consider the full scope of environmental justice, and may fail to fully ensure environmental justice for communities impacted directly by proximity to hazardous sites. Specifically, the use of institutional controls such as fish consumption advisories as long terms risk management strategies may prolong and compound environmental injustice as a matter of policy.

One of the main factors that causes health effects in humans such as hospital admissions for cardiovascular disease (HACVD), respiratory disease (RD), lung function, cardiovascular mortality (MCVD), lung cancer, and increased mortality is air pollution especially particulate matter (PM). This a systematic review and meta-analysis aims to investigate the effects of particulate matter on the occurrence of cardiovascular disease and mortality. A systematic review and meta-analysis of the literature was done from 2011 to 2021 based on various databases. Based on the result of this study, subgroup analysis based on temperature conditions showed a different estimation in cold cities (6.24, UR (4.36–8.12)), moderate cities (4.86, UR (3.57–6.15)) and warm cities (8.96, UR (7.06–10.86)). Test of group differences showed a significant difference (Q=12.22, p-value<0.001). There was publication bias among the studies (the Egger’s test; (Z=14.18, p<0.001)). According result study pooled estimation of AP% for MCVD from the random-effect meta-analysis based on DerSimonian-Laird model, overall is 5.04, UR (3.65–6.43) (Figure 4). Subgroup analysis based on temperature conditions showed the estimation in cold cities (5.47, UR (3.97–6.97)) and moderate cities (4.65, UR (0.54–8.77)). Test of group differences showed a non-significant difference (Q=0.13, p-value=0.71). There was no publication bias among the studies (the Egger’s test; (Z=0.82, p=0.376)). Exposed to air pollutants and particulate matter can be increase the risk of cardiovascular disease, respiratory disease, and cardiovascular mortality.

Objectives Merchant ships represent a peculiar working environment with several challenges and risks. The specific situation on board of ships may affect the mental health of seafarers more remarkably than ashore workers. Content A systematic review of the literature has been carried out to identify the main causes of mood disorders among seafarers and the impact that these disorders have on their health. This review has analyzed the scientific literature published between January 2006 and December 2021 using the search engines PubMed, Web of Science (WoS) and Cumulative Index to Nursing and Allied Health Literature (CINAHL). Summary Social isolation, distance from families, fatigue, stress and long work shifts represent the main causes of mood disorders among seafarers. Outlook Strategies aimed at improving conditions of cohabitation on board, and a greater consideration of these problems are key for improving the mental health of workers at sea.