The introduction of pasteurization, antibiotics, and vaccinations, as well as improved sanitation, hygiene, and education, were critical in reducing the burden of infectious diseases and associated mortality during the 19th and 20th centuries and were driven by an improved understanding of disease transmission. This advance has led to longer average lifespans and the expectation that, at least in the developed world, infectious diseases were a problem of the past. Unfortunately this is not the case; infectious diseases still have a significant impact on morbidity and mortality worldwide. Moreover, the world is witnessing the emergence of new pathogens, the reemergence of old ones, and the spread of antibiotic resistance. Furthermore, effective control of infectious diseases is challenged by many factors, including natural disasters, extreme weather, poverty, international trade and travel, mass and seasonal migration, rural–urban encroachment, human demographics and behavior, deforestation and replacement with farming, and climate change.
The importance of environmental factors as drivers of disease has been hypothesized since ancient times; and until the late 19th century, miasma theory (i.e., the belief that diseases were caused by evil exhalations from unhealthy environments originating from decaying organic matter) was a dominant scientific paradigm. This thinking changed with the microbiology era, when scientists correctly identified microscopic living organisms as the pathogenic agents and developed evidence for transmission routes. Still, many complex patterns of diseases cannot be explained by the microbiological argument alone, and it is becoming increasingly clear that an understanding of the ecology of the pathogen, host, and potential vectors is required.
There is increasing evidence that the environment, including climate, can affect pathogen abundance, survival, and virulence, as well as host susceptibility to infection. Measuring and predicting the impact of the environment on infectious diseases, however, can be extremely challenging. Mathematical modeling is a powerful tool to elucidate the mechanisms linking environmental factors and infectious diseases, and to disentangle their individual effects. A common mathematical approach used in epidemiology consists in partitioning the population of interest into relevant epidemiological compartments, typically individuals unexposed to the disease (susceptible), infected individuals, and individuals who have cleared the infection and become immune (recovered). The typical task is to model the transitions from one compartment to another and to estimate how these populations change in time. There are different ways to incorporate the impact of the environment into this class of models. Two interesting examples are water-borne diseases and vector-borne diseases. For water-borne diseases, the environment can be represented by an additional compartment describing the dynamics of the pathogen population in the environment—for example, by modeling the concentration of bacteria in a water reservoir (with potential dependence on temperature, pH, etc.). For vector-borne diseases, the impact of the environment can be incorporated by using explicit relationships between temperature and key vector parameters (such as mortality, developmental rates, biting rate, as well as the time required for the development of the pathogen in the vector).
Despite the tremendous advancements, understanding and mapping the impact of the environment on infectious diseases is still a work in progress. Some fundamental aspects, for instance, the impact of biodiversity on disease prevalence, are still a matter of (occasionally fierce) debate. There are other important challenges ahead for the research exploring the potential connections between infectious diseases and the environment. Examples of these challenges are studying the evolution of pathogens in response to climate and other environmental changes; disentangling multiple transmission pathways and the associated temporal lags; developing quantitative frameworks to study the potential effect on infectious diseases due to anthropogenic climate change; and investigating the effect of seasonality. Ultimately, there is an increasing need to develop models for a truly “One Health” approach, that is, an integrated, holistic approach to understand intersections between disease dynamics, environmental drivers, economic systems, and veterinary, ecological, and public health responses.
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Article
Modeling the Impact of Environment on Infectious Diseases
Giovanni Lo Iacono and Gordon L. Nichols
Article
Monitoring and Modeling of Outdoor Air Pollution
Stefan Reis
Air pollution has been a major threat to human health, ecosystems, and agricultural crops ever since the onset of widespread use of fossil fuel combustion and emissions of harmful substances into ambient air. As a basis for the development, implementation, and compliance assessment of air pollution control policies, monitoring networks for priority air pollutants were established, primarily for regulatory purposes. With increasing understanding of emission sources and the release and environmental fate of chemicals and toxic substances into ambient air, as well as atmospheric transport and chemical conversion processes, increasingly complex air pollution models have entered the scene. Today, highly accurate equipment is available to measure trace gases and aerosols in the atmosphere. In addition, sophisticated atmospheric chemistry transport models—which are routinely compared to and validated and assessed against measurements—are used to model dispersion and chemical processes affecting the composition of the atmosphere, and the resulting ambient concentrations of harmful pollutants. The models also provide methods to quantify the deposition of pollutants, such as acidifying and eutrophying substances, in vegetation, soils, and freshwater ecosystems. This article provides a general overview of the underlying concepts and key features of monitoring and modeling systems for outdoor air pollution.
Article
Natural Environments, Health, and Well-Being
Matilda van den Bosch
Human beings are part of natural ecosystems and depend on them for their survival. In a rapidly changing environment and with increasing urbanization, this dependence is challenged. Natural environments affect human health and well-being both directly and indirectly. Urban green and blue areas provide opportunities for stress recovery and physical activity. They offer spaces for social interactions in the neighborhood and places for children’s play. Chronic stress, physical inactivity, and lack of social cohesion are three major risk factors for noncommunicable diseases, and therefore abundant urban greenery is an important asset for health promotion.
Through numerous ecosystem services natural environments play a fundamental role in protecting health. Various populations depend on nature for basic material, such as fresh water, wood, fuel, and nutritious food. Biodiverse natural areas are also necessary for regulating the environment and for mitigating and adapting to climate change. For example, tree canopy cover can reduce the urban heat island effect substantially, preventing excess morbidity during heat waves. This natural heat-reducing effect also lessens the need for air conditioning systems and as a consequence decreases energy spending. Urban trees also support storm-water management, preventing flooding and related health issues. Air pollution is a major threat to population health. Urban trees sequester pollutants and, even though the effect may be relatively small, given the severity of the problem it may still have some public-health implications.
The evidence around the effects of natural environments on health and well-being is steadily increasing. Several pathways and mechanisms are suggested, such as health services through functional ecosystems, early life exposure to biodiverse microbiota, which is important for the immune-system development, and sensory exposure, which has direct neurobiological impact supporting cognitive development and stress resilience. Support for several pathways is at hand that shows lower mortality rates and prevalence of cardiovascular and respiratory diseases, healthier pregnancy outcomes, reduced health inequalities, and improved mental health in urban areas with greater amounts of green and blue space.
Altogether, the interactions between healthy natural environments and healthy people are multiple and complex, and require interdisciplinary attention and action for full understanding and resilient development of both nature and human beings.
Article
The Oceans and Human Health
Lora Fleming, Michael Depledge, Niall McDonough, Mathew White, Sabine Pahl, Melanie Austen, Anders Goksoyr, Helena Solo-Gabriele, and John Stegeman
The interdisciplinary study of oceans and human health is an area of increasing global importance. There is a growing body of evidence that the health of the oceans and that of humans are inextricably linked and that how we interact with and affect our oceans and seas will significantly influence our future on earth. Since the emergence of modern humans, the oceans have served as a source of culture, livelihood, expansion, trade, food, and other resources. However, the rapidly rising global population and the continuing alterations of the coastal environment are placing greater pressure on coastal seas and oceans. Negative human impacts, including pollution (chemical, microbial, material), habitat destruction (e.g., bottom trawling, dredging), and overfishing, affect not only ecosystem health, but also human health. Conversely, there is potential to promote human health and well-being through sustainable interactions with the coasts and oceans, such as the restoration and preservation of coastal and marine ecosystems.
The study of oceans and human health is inherently interdisciplinary, bringing together the natural and social sciences as well as diverse stakeholder communities (including fishers, recreational users, private enterprise, and policymakers). Reviewing history and policy with regard to oceans and human health, in addition to known and potential risks and benefits, provides insights into new areas and avenues of global cooperation, with the possibility for collaboratively addressing the local and global challenges of our interactions with the oceans, both now and in the future.
Article
Pesticides and Human Health
Pierluigi Cocco
The fight against agricultural and household pests accompanies the history of humanity, and a total ban on the use of pesticides seems unlikely to happen in the foreseeable future. Currently, about 100,000 different chemicals, inorganic and organic, are currently in the market, grouped according to their function as insecticides, herbicides, fungicides, fumigants, rodenticides, fertilizers, growth regulators, etc. against specific pests, such as snails or human parasites, or their chemical structure—organochlorines, organophosphates, pyrethroids, carbamates, dithiocarbamates, organotin compounds, phthalimides, phenoxy acids, heterocyclic azole compounds, coumarins, etc. Runoff from agricultural land and rain precipitation and dry deposition from the atmosphere can extend exposure to the general environment through the transport of pesticides to streams and ground-water. Also, the prolonged bio-persistence of organochlorines generates their accumulation in the food chain, and their atmospheric drift toward remote geographical areas is mentioned as the cause of elevated fat contents in Arctic mammals. Current regulation in the developed world and the phasing out of more toxic pesticides have greatly reduced the frequency of acute intoxications, although less stringent regulations in the developing world contribute to a complex pattern of exposure circumstances worldwide. Nonetheless, evidence is growing about long-term health effects following high-level, long-lasting exposure to specific pesticides, including asthma and other allergic diseases, immunotoxicity, endocrine disruption, cancer, and central and peripheral nervous system effects. Major reasons for uncertainty in interpreting epidemiological findings of pesticide effects include the complex pattern of overlapping exposure due to multiple treatments applied to different crops and their frequent changes over time to overcome pest resistance. Further research will have to address specific agrochemicals with well-characterized exposure patterns.
Article
Pollen, Allergens, and Human Health
Rachel N. McInnes
Allergenic pollen is produced by the flowers of a number of trees, grasses, and weeds found throughout the world. Human exposure to such pollen grains can exacerbate pollen-related asthma and allergenic conditions such as allergic rhinitis (hay fever). While allergenic pollen comes from three main groups of plants—certain trees, grasses, and weeds—many people are sensitive to pollen from one or a few taxa only. Weather, climate, and environmental conditions have a significant impact on the levels and varieties of pollen grains present in the air. These allergenic conditions significantly reduce the quality of life of affected individuals and have been shown to have a major economic impact.
Pollen production depends on both the current meteorological conditions (including day length, temperature, irradiation, precipitation, and wind speed/direction), and the water availability and other environmental and meteorological conditions experienced in the previous year. The climate affects the types of vegetation and taxa that can grow in a particular location through availability of different habitats. Land-use or land management is also crucial, and so this field of study has implications for vegetation management practices and policy.
Given the influential effects of weather and climate on pollen, and the significant health impacts globally, the total effect of any future environmental and climatic changes on aeroallergen production and spread will be significant. The overall impact of climate change on pollen production and spread remains highly uncertain, and there is a need for further understanding of pollen-related health impact information. There are a number of ways air quality interacts with the impact of pollen. Further understanding of the risks of co-exposure to both pollen and air pollutants is needed to better inform public health policy. Furthermore, thunderstorms have been linked to asthma epidemics, especially during the grass pollen seasons. It is thought that allergenic pollen plays a role in this “thunderstorm asthma.”
To reduce the exposure to, or impact from, pollen grains in the air, a number of adaptation and mitigation options may be adopted. Many of these would need to be done either through policy changes, or at a local or regional level, although some can be done by individuals to minimize their exposure to pollen they are sensitive to. Improved aeroallergen forecast models could be developed to provide detailed taxon-specific, localized information to the public. One challenge will be combining the many different sources of aeroallergen data that are likely to become available in future into numerical forecast systems. Examples of these potential inputs are automated observations of aeroallergens, real-time phenological observations and remote sensing of vegetation, social sensing, DNA analysis of specific aeroallergens, and data from symptom trackers or personal monitors. All of these have the potential to improve the forecasts and information available to the public.
Article
Radiation and the Environment
E. Jerry Jessee
The “Atomic Age” has long been recognized as a signal moment in modern history. In popular memory, images of mushroom clouds from atmospheric nuclear weapons tests recall a period when militaries and highly secretive atomic energy agencies poisoned the global environment and threatened human health. Historical scholarship has painted a more complicated picture of this era by showing how nuclear technologies and radioactive releases transformed the environment sciences and helped set the stage for the scientific construction of the very idea of the “global environment.”
Radioactivity presented scientists with a double-edged sword almost as soon as scientists explained how certain unstable chemical elements emit energic particles and rays in the process of radioactive decay at the turn of the 20th century. Throughout the 1920s and 1930s, scientists hailed radioactivity as a transformative discovery that promised to transform atomic theory and biomedicine by using radioisotopes—radioactive versions of stable chemical elements—which were used to tag and trace physiological processes in living systems. At the same time, the perils of overexposure to radioactivity were becoming more apparent as researchers and industrial workers laboring in new radium-laced luminescent paint industries began suffering from radiation-induced illnesses.
The advent of a second “Atomic Age” in wake of the bombing of Japan was characterized by increased access to radiotracer technologies for science and widespread anxiety about the health effects of radioactive fallout in the environment. Powerful new atomic agencies and military institutions created new research opportunities for scientists to study the atmospheric, oceanic, and ecological pathways through which bomb test radiation could make their way to human bodies. Although these studies were driven by concerns about health effects, the presence of energy-emitting radioactivity in the environment also meant that researchers could utilize it as a tracer to visualize basic environmental processes. Throughout the 1950s and early 1960s, as a result, ecologists pioneered the use of radiotracers to investigate energy flows and the metabolism of ecosystem units. Oceanographers similarly used bomb blast radiation to trace the physical processes in oceans and the uptake of radioactivity in aquatic food chains. Meteorologists meanwhile tracked bomb debris as high as the stratosphere to predict fallout patterns and trace large-scale atmospheric phenomenon. By the early 1960s, these studies documented how radioactive fallout produced by distant nuclear tests spread across the globe and infiltrated the entire planet’s air, water, biosphere, and human bodies.
In 1963, the major nuclear powers agreed to end above-ground nuclear testing with the Limited Test Ban Treaty, the first international treaty to recognize a global environmental hazard of planetary proportions. Throughout the 1960s and into the 1980s, research on the global effects of nuclear weapons continued to shape global environmental thinking and concern as debates about nuclear winter directed professional and public attention toward humanity’s ability to alter the climate.
Article
Risks for Occupational Health Hazards Among Solid Waste Workers
Mehrad Bastani, Nurcin Celik, and Danielle Coogan
This is an advance summary of a forthcoming article in the Oxford Research Encyclopedia of Environmental Science. Please check back later for the full article.
The volume of municipal solid waste produced in the United States has increased by 68% since 1980, up from 151 million to over 254 million tons per year. As the output of municipal waste has grown, more attention has been placed on the occupations associated with waste management. In 2014, the occupation of refuse and recyclable material collection was ranked as the 6th most dangerous job in the United States, with a rate of 27.1 deaths per 100,000 workers. With the revelation of reported exposure statistics among solid waste workers in the United States, the problem of the identification and assessment of occupational health risks among solid waste workers is receiving more consideration.
From the generation of waste to its disposal, solid waste workers are exposed to substantial levels of physical, chemical, and biological toxins. Current waste management systems in the United States involve significant risk of contact with waste hazards, highlighting that prevention methods such as monitoring exposures, personal protection, engineering controls, job education and training, and other interventions are under-utilized. To recognize and address occupational hazards encountered by solid waste workers, it is necessary to discern potential safety concerns and their causes, as well as their direct and/or indirect impacts on the various types of workers. In solid waste management, the major industries processing solid waste are introduced as recycling, incineration, landfill, and composting. Thus, the reported exposures and potential occupational health risks need to be identified for workers in each of the aforementioned industries. Then, by acquiring data on reported exposure among solid waste workers, multiple county-level and state-level quantitative assessments for major occupational risks can be conducted using statistical assessment methods. To assess health risks among solid waste workers, the following questions must be answered: How can the methods of solid waste management be categorized? Which are the predominant occupational health risks among solid waste workers, and how can they be identified? Which practical and robust assessment methods are useful for evaluating occupational health risks among solid waste workers? What are possible solutions that can be implemented to reduce the occupational health hazard rates among solid waste workers?
Article
Sentinel Species of Marine Ecosystems
Maria Cristina Fossi and Cristina Panti
A vigorous effort to identify and study sentinel species of marine ecosystem in the world’s oceans has developed over the past 50 years. The One Health concept recognizes that the health of humans is connected to the health of animals and the environment. Species ranging from invertebrate to large marine vertebrates have acted as “sentinels” of the exposure to environmental stressors and health impacts on the environment that may also affect human health. Sentinel species can signal warnings, at different levels, about the potential impacts on a specific ecosystem. These warnings can help manage the abiotic and anthropogenic stressors (e.g., climate change, chemical and microbial pollutants, marine litter) affecting ecosystems, biota, and human health.
The effects of exposure to multiple stressors, including pollutants, in the marine environment may be seen at multiple trophic levels of the ecosystem. Attention has focused on the large marine vertebrates, for several reasons. In the past, the use of large marine vertebrates in monitoring and assessing the marine ecosystem has been criticized. The fact that these species are pelagic and highly mobile has led to the suggestion that they are not useful indicators or sentinel species. In recent years, however, an alternative view has emerged: when we have a sufficient understanding of differences in species distribution and behavior in space and time, these species can be extremely valuable sentinels of environmental quality.
Knowledge of the status of large vertebrate populations is crucial for understanding the health of the ecosystem and instigating mitigation measures for the conservation of large vertebrates. For example, it is well known that the various cetacean species exhibit different home ranges and occupy different habitats. This knowledge can be used in “hot spot” areas, such as the Mediterranean Basin, where different species can serve as sentinels of marine environmental quality. Organisms that have relatively long life spans (such as cetaceans) allow for the study of chronic diseases, including reproductive alterations, abnormalities in growth and development, and cancer. As apex predators, marine mammals feed at or near the top of the food chain. As the result of biomagnification, the levels of anthropogenic contaminants found in the tissues of top predators and long-living species are typically high. Finally, the application of consistent examination procedures and biochemical, immunological, and microbiological techniques, combined with pathological examination and behavioral analysis, has led to the development of health assessment methods at the individual and population levels in wild marine mammals. With these tools in hand, investigators have begun to explore and understand the relationships between exposures to environmental stressors and a range of disease end points in sentinel species (ranging from invertebrates to marine mammals) as an indicator of ecosystem health and a harbinger of human health and well-being.
Article
Urban Heat Islands and Their Associated Impacts on Health
Clare Heaviside
Towns and cities generally exhibit higher temperatures than rural areas for a number of reasons, including the effect that urban materials have on the natural balance of incoming and outgoing energy at the surface level, the shape and geometry of buildings, and the impact of anthropogenic heating. This localized heating means that towns and cities are often described as urban heat islands (UHIs). Urbanized areas modify local temperatures, but also other meteorological variables such as wind speed and direction and rainfall patterns. The magnitude of the UHI for a given town or city tends to scale with the size of population, although smaller towns of just thousands of inhabitants can have an appreciable UHI effect. The UHI “intensity” (the difference in temperature between a city center and a rural reference point outside the city) is on the order of a few degrees Celsius on average, but can peak at as much as 10°C in larger cities, given the right conditions. UHIs tend to be enhanced during heatwaves, when there is lots of sunshine and a lack of wind to provide ventilation and disperse the warm air. The UHI is most pronounced at night, when rural areas tend to be cooler than cities and urban materials radiate the energy they have stored during the day into the local atmosphere.
As well as affecting local weather patterns and interacting with local air pollution, the UHI can directly affect health through heat exposure, which can exacerbate minor illnesses, affect occupational performance, or increase the risk of hospitalization and even death. Urban populations can face serious risks to health during heatwaves whereby the heat associated with the UHI contributes additional warming. Heat-related health risks are likely to increase in future against a background of climate change and increasing urbanization throughout much of the world. However, there are ways to reduce urban temperatures and avoid some of the health impacts of the UHI through behavioral changes, modification of buildings, or by urban scale interventions. It is important to understand the physical properties of the UHI and its impact on health to evaluate the potential for interventions to reduce heat-related impacts.
Article
Urban Landscapes and Green Infrastructure
Stephan Pauleit, Rieke Hansen, Emily Lorance Rall, Teresa Zölch, Erik Andersson, Ana Catarina Luz, Luca Szaraz, Ivan Tosics, and Kati Vierikko
Urban green infrastructure (GI) has been promoted as an approach to respond to major urban environmental and social challenges such as reducing the ecological footprint, improving human health and well-being, and adapting to climate change. Various definitions of GI have been proposed since its emergence more than two decades ago. This article aims to provide an overview of the concept of GI as a strategic planning approach that is based on certain principles.
A variety of green space types exist in urban areas, including remnants of natural areas, farmland on the fringe, designed green spaces, and derelict land where successional vegetation has established itself. These green spaces, and especially components such as trees, can cover significant proportions of urban areas. However, their uneven distribution raises issues of social and environmental justice. Moreover, the diverse range of public, institutional, and private landowners of urban green spaces poses particular challenges to GI planning. Urban GI planning must consider processes of urban change, especially pressures on green spaces from urban sprawl and infill development, while derelict land may offer opportunities for creating new, biodiverse green spaces within densely built areas.
Based on ample evidence from the research literature, it is suggested that urban GI planning can make a major contribution to conserving and enhancing biodiversity, improving environmental quality and reducing the ecological footprint, adapting cities to climate change, and promoting social cohesion. In addition, GI planning may support the shift toward a green economy.
The benefits derived from urban green spaces via the provision of ecosystem services are key to meeting these challenges. The text argues that urban GI planning should build on seven principles to unlock its full potential. Four of these are treated in more detail: green-gray integration, multifunctionality, connectivity, and socially inclusive planning. Considering these principles in concert is what makes GI planning a distinct planning approach. Results from a major European research project indicate that the principles of urban GI planning have been applied to different degrees. In particular, green-gray integration and approaches to socially inclusive planning offer scope for further improvement
In conclusion, urban GI is considered to hold much potential for the transition toward more sustainable and resilient pathways of urban development. While the approach has developed in the context of the Western world, its application to the rapidly developing cities of the Global South should be a priority.
Article
Valuing the Benefits of Green Stormwater Infrastructure
Amy W. Ando and Noelwah R. Netusil
Green stormwater infrastructure (GSI), a decentralized approach for managing stormwater that uses natural systems or engineered systems mimicking the natural environment, is being adopted by cities around the world to manage stormwater runoff. The primary benefits of such systems include reduced flooding and improved water quality. GSI projects, such as green roofs, urban tree planting, rain gardens and bioswales, rain barrels, and green streets may also generate cobenefits such as aesthetic improvement, reduced net CO2 emissions, reduced air pollution, and habitat improvement. GSI adoption has been fueled by the promise of environmental benefits along with evidence that GSI is a cost-effective stormwater management strategy, and methods have been developed by economists to quantify those benefits to support GSI planning and policy efforts. A body of multidisciplinary research has quantified significant net benefits from GSI, with particularly robust evidence regarding green roofs, urban trees, and green streets. While many GSI projects generate positive benefits through ecosystem service provision, those benefits can vary with details of the location and the type and scale of GSI installation. Previous work reveals several pitfalls in estimating the benefits of GSI that scientists should avoid, such as double counting values, counting transfer payments as benefits, and using values for benefits like avoided carbon emissions that are biased. Important gaps remain in current knowledge regarding the benefits of GSI, including benefit estimates for some types of GSI elements and outcomes, understanding how GSI benefits last over time, and the distribution of GSI benefits among different groups in urban areas.
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