Aug 2026· Environmental Epidemiology· Vol 10· 0 citations· 55 references
Medicine
TL;DR
Environmental exposure was associated with self-perceived health and well-being, underscoring the need for integrated, system-based policies, such as One Health, to promote sustainable urban well-being.
Abstract
Background: Urban residents are exposed to multiple environmental stressors, but robust evidence on inequities in environmental exposure and associated health and well-being outcomes remains limited. Aim: To assess inequities in residential exposure to air pollution (PM2.5, PM10, and NO2), traffic noise (road, railway, and aircraft) and greenness (NDVI within 300 m), and to characterize associations with self-reported symptoms and annoyances. Methods: The study population comprised 46,282 adults (18–84 years) residing in Stockholm County, Sweden, who responded to the Swedish National Environmental Health Survey 2023. Residential exposure (dichotomized) was based on geocoded address coordinates and stratified by socioeconomic status (SES) and building type. Logistic regression estimated adjusted odds ratios (OR) with 95% confidence intervals (95% CI) and tested effect modification via interaction terms. Results: Apartment residents were more often exposed to air pollution and noise and had less surrounding greenness than house residents. SES-stratified analyses revealed exposure-specific patterns, but no consistent overall trends. Air pollution exposure was associated with perceived poor outdoor air quality (NO2: OR = 3.22; 95% CI = 2.75–3.79), traffic noise with, for example, high noise annoyance (road traffic: OR = 4.59; 95% CI = 4.02–5.26), and greenness, for example, with lower perceived indoor heat stress during summer (OR = 0.83; 95% CI = 0.79–0.88). Self-reported health and well-being varied by SES and building type. Conclusions: Our study reveals concentrated environmental stressors in dense residential areas and highlights multidimensional environmental inequities. Environmental exposure was associated with self-perceived health and well-being, underscoring the need for integrated, system-based policies, such as One Health, to promote sustainable urban well-being.
The results highlight fine-scale pollution variability not captured by regulatory monitors and underscore the need for spatially resolved assessments to guide public health interventions.
Abdulrahman N Alobireed, S. Totoni, L. Wigington et al.· Environmental science and po...· 0 citations
Differentials in exposure to air pollution across population subgroups is a source of environmental health inequality. An important question is the generalisability of the trends between air pollution exposure and demographic attributes across different populations: comparisons are often confounded by different study methodologies. A key challenge is that individual-level demographic data are not usually available. In this study, we apply identical methods to a single cohort of 56 734 individuals to compare trends between exposures to ambient NO2, PM2.5 and O3 and sex, age, ethnicity, and socioeconomic status (SES) in the cities of Glasgow and Edinburgh, UK. We also use individual-level information on place of work or study (where that applies) to derive more realistic estimates of exposures than studies using exposures at place of residence only. We find that whilst some broad trends in exposure-demographic relationships are similar between Glasgow and Edinburgh—for example that younger adults, those of lower SES and of non-White ethnicity are, on average, exposed to higher concentrations of NO2 and PM2.5 (and to lower concentrations of O3)—our results also confirm heterogeneities in these relationships between the two cities. Importantly, we show that this geographical specificity extends to between-city geographical distributions of places of work and study as well; for example, males and females have equal exposures to air pollutants in each city based on residence location only, but have different patterns of exposure in the two cities when place of work is included. The heterogeneities we observe presumably arise from the particular way in which the urban fabric of a given city develops over time. The policy message is that it is not appropriate to assume geographically transferable relationships between air pollution exposure and SES, ethnicity, age and sex, even when the population demographic profiles are broadly similar.
Tomáš Liška, Mathew R. Heal, Chun Lin et al.· Environmental Research: Heal...· 0 citations
Background: Urban ambient air pollution and various co-occurring environmental stressors during pregnancy contribute to systemic inflammation, oxidative stress, endothelial dysfunction, and impaired placental perfusion, thereby increasing the risk of adverse maternal and child health outcomes. Therefore, this study aims to systematically synthesize the evidence on the associations between ambient air pollution and co-occurring urban environmental exposures and pregnancy complications affecting maternal and child health, based on the available evidence.Methods: Following PRISMA 2020 guidelines and a defined PECO framework, comprehensive searches were executed on Scopus and ScienceDirect (April 23, 2026; updated May 06, 2026) for literature published between 2022 and 2025. Of 3,547 records identified, 20 articles met the inclusion criteria, comprising 16 empirical observational studies and 4 supporting conceptual articles. Study quality and risk of bias were assessed using the Newcastle-Ottawa Scale and JBI critical appraisal tools.Results: Moderate-certainty evidence indicated that exposure to PM2.5 and NO2 during the preconception and early-to-mid pregnancy periods increased the risks of gestational diabetes mellitus, hypertensive disorders of pregnancy, low birth weight, and preterm birth. Multi-pollutant models consistently provided stronger risk estimates than single-pollutant models. Evidence linking air pollution with gestational hypothyroidism, postpartum mental distress, and offspring neurodevelopmental outcomes remained limited and heterogeneous.Conclusion: Ambient air pollution and related urban environmental exposures are important determinants of maternal and child health. Integrating environmental exposure assessment into antenatal care and strengthening urban emission reduction policies are essential to reduce pregnancy-related health risks.
Siti Mardhatillah Musa, Muhammad Fachri, Nurmalia Lusida et al.· Jurnal Epidemiologi Kesehata...· 0 citations
The findings indicate that awareness and personal precautions cannot substitute for source-oriented emission control and an integrated intervention architecture is proposed, combining enforceable urban regulation, school- and community-based risk communication, real-time air-quality information and practical exposure-reduction measures.
Hai Binh Nguyen, Minh Chinh Pham· International Journal of Pub...· 0 citations
Air quality indices play a critical role in assessing and communicating the health risks associated with ambient air pollution. In Canada, the Air Quality Health Index is designed for real-time public communication, while the Air Health Trend Indicator monitors temporal trends in population-level health risks and supports policy evaluation. However, as air quality indices are primarily grounded in population-level biostatistics, there is a growing need to incorporate behavioural and social determinants, for which evidence remains fragmented across disciplines and geographical contexts. This umbrella review systematically examined how behavioural and social factors influence exposure to ambient air pollution, with the aim of informing the refinement of air quality indices in diverse local contexts, including Canada.
Five databases (PubMed, CINAHL, Scopus, GreenFILE, Environment Complete) were systematically searched in November 2024 to identify studies reporting human behaviours and social structures as either exogenous or endogenous variables associated with exposure to ambient air pollution. Quality assessment using the JBI tools, quantitative descriptive analysis, and qualitative thematic analysis were conducted.
Findings from 18 reviews included participants varying in age, region, race, behaviour type, and health conditions. Evidence synthesis identified two overarching categories—human behaviour, society—comprising three behavioural themes (physical activity, travel, protection), four societal themes (public health, urban planning, neighbourhood/housing, social identity), and 17 subthemes. Findings indicate that time spent outdoors is associated with increased individual exposure to air pollution, while social factors such as greenspace and public health advisories, as well as race and socio-economic status, influence community-level exposure.
The findings highlight the need to integrate behavioural and social factors into air quality assessment frameworks. A more nuanced understanding of behaviour-society-environment interactions is essential to underpin the development of equitable, evidence-based public health interventions that both mitigate health risks among vulnerable populations and promote overall public health in increasingly polluted urban environments.
Eun Jung, Eun-Young Lee, H. Shin· BMC Public Health· 0 citations
Emerging evidence links air pollution exposure to metabolic dysfunction; however, few studies have examined diabetes-related mortality in relation to ambient air pollutants using high-resolution exposure data at the population level. In the United States, particularly in large and geographically diverse states such as California, exposure contrasts and population heterogeneity provide an important setting to evaluate these associations.
We conducted a matched case–control analysis using California Department of Public Health (CDPH) Vital Records (2010–2021). Diabetes-related mortality events (ICD-10 E11) were identified as primary or contributory causes. Decedents (cases) were geocoded to residential addresses, and one-year rolling averages of fine particulate matter (PM
2.5
) before death were assigned as individual exposures. Each death record was matched to its selected controls based on month and year of birth and race-ethnicity. Controls were identified from the same statewide CDPH mortality database and were eligible because they had not died by the corresponding case’s date of death. Because the number of eligible controls varied across matched strata, controls were randomly sampled within each matched stratum to achieve an overall control-to-case ratio of approximately 2:1 for the study population. The final dataset included 60,824 diabetes-related deaths and 119,053 controls. Exposures were standardized by their interquartile range (IQR) and conditional logistic regression models estimated associations between 1 year rolling average fine particulate matter (PM
2.5
) exposure and odds of diabetes-related mortality, adjusting for age, sex, race-ethnicity, marital status, and education. Nitrogen dioxide (NO
2
) was included as a co-pollutant for confounding control.
PM
2.5
exposure (per 2.65 μg/m
3
IQR increase) was associated with a 18% higher odds of diabetes-related mortality (OR = 1.18; 95% CI: 1.15–1.22) before traffic indicator NO
2
adjustment and showed a stronger association with 21% higher odds (OR = 1.21; 95% CI: 1.17–1.25) after NO
2
adjustment. Health economics analysis estimated that reducing PM
2.5
exposure by its IQR could avoid losses of $31.2 million per 100,000 people.
Higher ambient PM
2.5
exposure was associated with increased odds of diabetes-related mortality in California even after adjustment for NO
2
and other impact factors. These findings support the need for continued strengthening of ambient air quality regulations.
Richy Zheng, Jason G. Su, E. Shahriary et al.· Frontiers in Public Health· 0 citations
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