Oil and gas production is one of the largest emitters of methane, a potent greenhouse gas and a significant contributor of air pollution emissions. While research on methane emissions from oil and gas production has grown rapidly, there is comparatively limited information on the distribution of impacts of this sector on air quality and associated health impacts. Understanding the contribution of air quality and health impacts of oil and gas can be useful for designing mitigation strategies. Here we assess air quality and human health impacts associated with ozone, fine particulate matter, and nitrogen dioxide from the oil and gas sector in the US in 2016, and compare this impact with that of the associated methane emissions. We find that air pollution in 2016 from the oil and gas sector in the US resulted in 410 000 asthma exacerbations, 2200 new cases of childhood asthma and 7500 excess deaths, with $77 billion in total health impacts. NO₂ was the highest contributor to health impacts (37%) followed by ozone (35%), and then PM_2.5 (28%). When monetized, these air quality health impacts of oil and gas production exceeded estimated climate impact costs from methane leakage by a factor of 3. These impacts add to the total life cycle impacts of oil and gas, and represent potential additional health benefits of strategies that reduce consumption of oil and gas. Policies to reduce oil and gas production emissions will lead to additional and significant health benefits from co-pollutant reductions that are not currently quantified or monetized.

Millions of students in Japan participate in school sports club activities, where thousands of heat illness cases occur every year. With future climate change, there is concern about the increased health risks posed to students in sports club activities by the worsening heat environment. However, few studies have quantitatively assessed the heat illness risks associated with school sports activities and the effectiveness of countermeasures under future climate change scenarios. Here, we evaluated the impact of heat and effectiveness of countermeasures based on hourly wet-bulb globe temperature (WBGT) projections under multiple climate scenarios. For the 2060s to 2080s, even under a stringent greenhouse gas (GHG) emission control scenario (SSP1-1.9), strenuous exercise will be restricted for one to four months in five out of eight WBGT zones defined for Japan and for one to six months in six zones under the scenario with little control of GHG emissions (SSP5-8.5). In all four scenarios, unlike in the past, all physical activity should be stopped at least once a week in one or more zones. While common countermeasures like early morning exercise and reducing outdoor activity frequency effectively reduce heat illness risks, under the most pessimistic scenario (SSP5-8.5), strenuous exercise would still need to be restricted for one to four months in warmer zones, even with these measures. Common heat illness countermeasures remain necessary for sports club activities at present. However, further measures—such as replacing outdoor activities with indoor sessions—and behavioral changes—such as moving tournaments concentrated during summer vacation to cooler times of the year—will be inevitable as global warming progresses.

Wildfires are impacting communities globally, with California wildfires often breaking records of size and destructiveness. Knowing how communities are affected by these wildfires is vital to understanding recovery. We sought to identify impacted communities' post-wildfire needs and characterize how those needs change over time. The WHAT-Now study deployed a survey that was made publicly available for communities affected by the October 2017 Northern California wildfires or the accompanying smoke at beginning approximately four months post-fire with the vast majority completed by nine months post-fire. Among other questions, the survey asked an adult household member to report on their households' greatest need both one-week post-fire and at the time of survey. A total of 1461 households responded to these questions. Households reported many types of needs, with 154 responses that did not directly name needs but rather described how their households had been affected, which we classified as impacts. Four major themes were identified: physical, health, air, and information, each representing an array of varied specific needs or impacts. Physical needs (e.g. housing, food) were the most common (cited by more than 50% during the fires and about a third at the time of survey). The need for clean air was strong during the fires, but not months later, at the time of survey. In contrast, health needs were reported by a quarter of households during the fires. Needs that were reported at both times were categorized as 'persistent', and there were more persistent mental health needs over time compared to other health themes. Understanding the needs and impacts that arise during wildfires, their diversity and duration, and how they change over time is crucial to identifying types of assistance that are most needed during recovery efforts and when they are needed. Results presented here along with other wildfire needs assessments can be utilized to improve disaster preparedness, including for wildfire recovery.

Future impacts of climate change-driven increases in extreme heat exposure on population health will be driven both by the frequency and intensity of future heat, as well as changes in the size and vulnerability of affected communities. Given indications of spatial persistence of social vulnerability across the US, we explore the implications for heat exposures of the most vulnerable populations due to mid-century climate change. Population heat exposure is estimated by combining heat hazard with population growth projections. Specifically, median projected acute (95% maximum temperature), extreme (hot days, daily maximum heat index >40 °C), and chronic (cooling degree days) heat hazard are assessed in contemporary (1995–2014) and projected (2041–2060) epochs across 25+ climate models under three climate scenarios against 2020 social vulnerability index (SVI). By mid-century, increases in both chronic and extreme heat will be concentrated in the South region. Population is expected to grow faster in census tracts at the high and low extrema of the SVI. The intersection of these projected future trends suggests that the intensity and exacerbation of heat exposures due to climate change will not be evenly distributed across the population. Individuals who are most vulnerable today will face disproportionately larger heat exposures circa mid-century. Populations in high SVI areas will both increase in size and experience the largest increases in extreme heat exposure. Spatial aggregation masks fine scale changes. While cities and counties with concentrations of vulnerable populations will face rightward shifts in the tails of their temperature across the US, extreme and especially chronic population heat exposures will be concentrated in a swath stretching across southern US states. The magnitude of population heat exposure changes and their intersection with underlying vulnerability require action to focus adaptation resources on resilience to extreme heat.

Extreme heat events present significant health risks, particularly for populations facing systemic marginalization. Through interviews and FGs with 63 (n = 60 residents; n = 3 service providers (SP)) participants, this paper explores the barriers and opportunities related to access and use of cooling centres from both user and provider perspectives, as well as broader implications for addressing vulnerability to extreme heat in the metro Vancouver region of British Columbia, Canada. Initially focused on cooling centres, our research expanded to include the complexities of individual and systemic responses to heat, highlighting the complex interplay between personal preferences and structural barriers. Key barriers to cooling centre usage reported by participants included concerns over safety, hygiene, stigma, lack of information, and infrastructural challenges such as transportation. SPs faced constraints with staffing, limited hours, and underutilization of additional services. Tensions emerged between individual, do-it-yourself (DIY) approaches and collective solutions, with participants seeking agency in their choices while acknowledging the need for improved, community-based interventions. The study also uncovered the unintended effects of inclusivity, as the presence of individuals who use substances or are unhoused in cooling spaces deterred some potential users, underscoring the challenges of designing universally accessible services. Broader systemic issues, such as housing security and the quality of indoor environments, further intersected with vulnerability to extreme heat, exacerbating risks for those opting to stay at home. The paper recommends leveraging existing public spaces, enhancing social networks, improving tenant protections, and fostering 'right to cool' initiatives to balance immediate relief with long-term systemic reform, particularly around the rental housing crisis and tenant insecurity. By addressing both individual and collective needs, this approach can mitigate the health impacts of extreme heat while promoting greater equity and resilience.

In this literature review, the critical role of coping strategies in enhancing mental health and resilience among disaster survivors is examined. Natural disasters, such as hurricanes, earthquakes, wildfires, tsunamis and floods, have been known to inflict significant psychological distress on affected populations. Similarly, man-made disasters, such as terrorist attacks, civil wars and industrial accidents, can lead to lasting mental health challenges for survivors. The focus of this paper is primarily on coping strategies and their impact on mental health and resilience among those affected by disasters. A comprehensive search was conducted using academic databases, including PubMed, PsycINFO, Web of Science, Scopus and Google Scholar, to gather peer-reviewed articles published in recent times. Search terms such as 'coping strategies,' 'mental health,' 'resilience,' 'disaster survivors,' 'natural disasters' and 'man-made disasters' were utilized to refine the search results. A total of 210 articles were initially identified, and 30 articles were retained for further review based on their methodological rigor, relevance to the topic and diversity of coping strategies examined. This study found that problem-focused, emotion-focused, social support and avoidance coping are crucial for understanding how to mitigate psychological distress and promote recovery after disasters. Additionally, it identified several other coping strategies, including mindfulness-based practices, cognitive-behavioral therapy, cultural coping and proactive coping. The novel contribution of this review lies in its emphasis on the intersection of coping strategies with diverse disaster experiences, offering implications for tailored public health interventions. This study is not only timely but also relevant given the increasing frequency of both natural and man-made disasters, and the growing recognition of the need for effective mental health strategies in disaster response and recovery.

Previous studies indicate that pollution exposure can increase risks of adverse birth outcomes, but Black communities are underrepresented in this research, and the potential moderating role of neighborhood context has not been explored. These issues are especially relevant in Louisiana, which has a high proportion of Black residents, an entrenched history of structural racism, the most pounds of toxic industrial emissions annually, and among the nation's highest rates of low birthweight (LBW), preterm birth (PTB), and infant mortality. We investigated whether air pollution and social polarization by race and income (measured via the index of concentration at the extremes [ICE]) were associated with LBW and PTB among Louisiana census tracts (n = 1101) using spatial lag models. Data sources included 2011–2020 birth records, U.S. Census Bureau 2017 demographic data, and 2017 respiratory hazard (RH) from the U.S. Environmental Protection Agency. Both RH and ICE were associated with LBW (z = 4.4, P < 0.0001; z = −27.0, P < 0.0001) and PTB (z = 2.3, P = 0.019; z = −16.7, P < 0.0001), with no interaction. Severely polluted tracts had 36% higher and 25% higher risks of LBW and PTB, respectively, versus unpolluted tracts. On average, 2166 low birthweight and 3583 preterm births annually were attributable to pollution exposure. Tracts with concentrated social deprivation (i.e. low ICE scores) had 53% higher and 34% higher risks of LBW and PTB, respectively, versus intermediate or mixed tracts. On average, 1171 low birthweight and 1739 preterm births annually were attributable to concentrated deprivation. Our ecological study found that a majority of adverse birth outcomes in Louisiana (i.e. 67% of LBW and PTB combined) are linked to air pollution exposure or disadvantage resulting from social polarization. These findings can inform research, policy, and advocacy to improve health equity in marginalized communities.

Increased electrification of the transportation sector promises to both decrease emissions from the largest sector source of greenhouse gases as well as improve health through better air quality. The objective of this study is to evaluate the distribution of air quality health benefits of Medium- and Heavy-Duty Electric Vehicle (MHDEV) policies in New York City (NYC), quantifying differences across neighborhoods (census tracts) and population subgroups (race, ethnicity). We ran an integrated model for a 2040 baseline/business-as-usual scenario and for two policy scenarios simulating different rates of MHDEV adoption, also for 2040. Changes in air quality (fine particulate matter (PM_2.5) and nitrogen dioxide (NO₂)) and health and economic benefits were calculated for the two policy scenarios. We used a modified version of our previously developed ZIP Code-Level Air Pollution Policy Assessment tool which integrates two reduced form models: the Community Air Quality Tools and the Co-Benefits Risk Assessment Health Impacts Screening and Mapping Tool. Our air quality modeling employed a novel receptor network to capture sharp gradients due to medium- and heavy-duty vehicle (MHDV) emissions in the densely populated NYC region. We find that electrification of MHDVs would have substantial air pollution and health benefits for NYC, with full on-road electrification of MHDVs saving $2.4 billion in health costs in 2040, including the prevention of 248 deaths and 173 childhood asthma emergency departments visits. We find that NO₂ benefits contributed between 85% and 97% of the total health benefits, emphasizing its importance for on-road health studies. We find that most health benefits would occur in neighborhoods with the highest percentage of historically marginalized populations, including substantial benefits to Hispanic populations.

With the widespread implementation of air pollution mitigation strategies for health and climate policy, there is an emerging interest in accountability studies to validate whether a reduction of air pollution exposure, in fact, produces the human health benefits estimated from past air pollution epidemiology. The closure of a coal coking plant provides an ideal 'natural' experiment opportunity to rigorously evaluate the health benefits of air pollution emissions reductions. In this study, we applied an interrupted time series model to test the hypothesis that the substantial reduction in air pollution induced by the closure of the Shenango, Inc. coke plant in Pittsburgh, PA during January, 2016 was followed by immediate and/or longer-term cumulative local cardiovascular health benefits. We observed a 90% decrease in nearby SO₂ levels, as well as significant reductions in coal-related fine particulate matter constituents (sulfate and arsenic), after the closure. Statistically significant cardiovascular health benefits were documented in the local population, including a 42% immediate drop (95% CI: 33%, 51%) in cardiovascular emergency department (ED) visits from the pre-closure mean. A longer-term downward trend was also observed for overall emergency visits at −0.14 (95% CI: −0.17, −0.11) visits per week rate of decrease after the closure, vs. a rise of 0.17 (95% CI: 0.14, 0.20) visits per week before. Similarly, inpatient cardiovascular hospitalizations per year showed a decrease after closure (−27.97 [95% CI: −46.90, −9.04], as compared with a 5.09 [95% CI: −13.84, 24.02] average increase in cases/year over the prior three years). Our study provides clear evidence that this intervention lowering fossil fuel-associated air pollution benefited public health in both the short and longer term, while also providing validation of the past use of observational air pollution epidemiology effect estimates in policy analyses.

In Malaysia, climate change typically manifests as frequent and extreme weather events. The effects on human health of such meteorological and ecological imbalances are multiple and diverse. Urgent attention is needed to address the health-related threats facing Malaysia as a result of climate change. This systematic review (SR) of available evidence adopted Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and identified and assessed a broad range of English language empirical, published research and excluded grey literature. Bias and quality of articles was assessed using Mixed Methods Assessment Tool. Using the search engines Scopus, PubMed, Ovid EMBASE, Web of Science, and EBSCO Host Medline, n = 374 results were yielded. Of these, after checking, n = 23 studies were examined. The studies can be grouped into three climatic themes Exposure, Outcomes and Planning. Our review confirms that urgent funding and investment is needed for larger-scale intervention studies on each of these themes. We observed a scarcity of high-quality empirical research, a preponderance of modelling studies to project and simulate scenarios, and a limited number of qualitative studies. Particular gaps in knowledge exist on climate change impacts on health in population groups in terms of demographic intersections to support these epidemiological data and simulation pathways. Furthermore, there was an absence of data on various topics concerning the effects of climate change on, for example, mental health, women, older people and/or the effects of displacement. The limitations of this work include accepting only English language publications and presenting only empirical studies. The study was not funded but was managed by the Monash Climate Change Communication Research node. This SR was registered on PROSPERO ID: CRD42023431868.

This article showcases the relevance and complementarity of commonly used bioethics theories and frameworks for thinking about the challenges and moral tensions that (may) arise in efforts to move toward a more sustainable and ecological healthcare sector. It presents critical insights from deontology, consequentialism, virtue ethics, contractualism, modern casuistry, justice theories, and feminist approaches to bioethics, and points to important lessons from each of these for a green healthcare ethics in which acknowledging and dealing with potential, real, or apparent trade-offs is central. While ideal moral theories and frameworks such as deontology, consequentialism and virtue ethics can offer relevant normative principles to guide change at individual, organizational, and societal levels, other approaches such as contractualism and casuistry can offer practical and procedural guidance for addressing trade-off situations. In addition, justice theories and feminist approaches can offer normative grounds, respectively, for determining how to appropriately and equitably distributing the benefits, risks and burdens of specific initiatives or policies that are envisioned for transitioning to green healthcare sector, and for better understanding the role of complex human–human and human–environment relations and interdependencies in these discussions. These lessons provide foundations for the development of a comprehensive ethical framework, and we advocate for their future integration into a trade-off ethics.

Energy emissions mitigation policies bring co-benefits for health and opportunities to drive sustainable development for rapidly transitioning economies in sub-Saharan Africa. Developing methods of quantifying these co-benefits in differing demographic groups is an area of interest for policymakers to support resource allocation efforts. Using synthetic populations of three municipalities in Kenya, we assessed the impact of policies to promote the use of clean cooking fuels on exposure to ambient and household air pollution and associated age- and gender-specific mortality. Exposure to household PM_2.5 for a range of cooking fuel types and informal and formal housing archetypes were simulated using the building physics software, EnergyPlus. A combined household and ambient PM_2.5 exposure was calculated for each individual by weighting PM_2.5 concentrations using national demographic-specific time-activity estimates. Exposure-response functions were applied to quantify the burden of mortality for six associated health outcomes. To compare the health impacts of energy policy implementation, a two-stage policy was tested through medium and long-term transitions towards successively cleaner cooking fuels prioritising liquid petroleum gas and ethanol. The resulting difference in mortality consecutively declined through the two-stage policy transition with the greatest impact after the first transition and an incremental but smaller impact after the second. The overall difference in mortality burden averted per 100 000 population relative to the baseline scenario was largest in Kisumu (males: 39.23; females: 18.09), with smaller decreases in Mombasa (males: 5.71; females: 3.03) and Nairobi (males: 1.82; females: 1.08). A sensitivity analysis showed reductions in PM_2.5 exposure under the policy scenarios may be overestimated in the presence of fuel stacking practices, where households rely on multiple fuels and stoves. This model provides a proof-of-concept for the use of individual-level modelling methods to estimate demographic-specific health impacts from environmental exposures and quantitatively compare health co-benefits of household fuel emission mitigation policies.

The healthcare sector's contribution to climate change and pollution more broadly is now widely recognised as problematic. Not only does it disrupt the ecosystems and the living environment, but it also paradoxically affects human health. In recent years, an increasing number of countries have committed to reducing the ecological footprint, or in other words, the 'environmental cost' of their healthcare system. Achieving a responsible transition toward a greener healthcare sector requires considering the perspectives and potential roles of various actors and stakeholders within the field. Thus far, very few studies have investigated the perspectives of (potential) healthcare consumers on challenges, ethical issues and social tensions that could arise during the transition to a greener healthcare system. To address this gap, we carried out five group interviews, exploring the views of 28 participants on climate change, healthcare pollution, and their sense of engagement in reducing healthcare pollution. Data were collected, coded and analysed using an inductive process. While most participants perceived climate change as a serious threat to human health, many were unaware of the healthcare sector's significant contribution to it. Pharmaceutical waste and plastic pollution were identified as the main problems. Two promising avenues for reducing healthcare pollution emerged from the findings: promoting healthcare sobriety and improving education for actors and stakeholders on the sector's contribution to global pollution. Participants defined healthcare sobriety through four key elements: adequate care, collective responsibility, ecological finance, and prevention. Regarding education, they underline that it should be done at the right time, by the right person and in an effective manner. Two important barriers to achieving these goals were identified: participants are less willing to accept trade-offs when it is health-related; and ethical concerns were raised about mobilizing vulnerable populations to achieve carbon neutrality in the healthcare sector.

Future impacts of climate change-driven increases in extreme heat exposure on population health will be driven both by the frequency and intensity of future heat, as well as changes in the size and vulnerability of affected communities. Given indications of spatial persistence of social vulnerability across the US, we explore the implications for heat exposures of the most vulnerable populations due to mid-century climate change. Population heat exposure is estimated by combining heat hazard with population growth projections. Specifically, median projected acute (95% maximum temperature), extreme (hot days, daily maximum heat index >40 °C), and chronic (cooling degree days) heat hazard are assessed in contemporary (1995–2014) and projected (2041–2060) epochs across 25+ climate models under three climate scenarios against 2020 social vulnerability index (SVI). By mid-century, increases in both chronic and extreme heat will be concentrated in the South region. Population is expected to grow faster in census tracts at the high and low extrema of the SVI. The intersection of these projected future trends suggests that the intensity and exacerbation of heat exposures due to climate change will not be evenly distributed across the population. Individuals who are most vulnerable today will face disproportionately larger heat exposures circa mid-century. Populations in high SVI areas will both increase in size and experience the largest increases in extreme heat exposure. Spatial aggregation masks fine scale changes. While cities and counties with concentrations of vulnerable populations will face rightward shifts in the tails of their temperature across the US, extreme and especially chronic population heat exposures will be concentrated in a swath stretching across southern US states. The magnitude of population heat exposure changes and their intersection with underlying vulnerability require action to focus adaptation resources on resilience to extreme heat.

Millions of students in Japan participate in school sports club activities, where thousands of heat illness cases occur every year. With future climate change, there is concern about the increased health risks posed to students in sports club activities by the worsening heat environment. However, few studies have quantitatively assessed the heat illness risks associated with school sports activities and the effectiveness of countermeasures under future climate change scenarios. Here, we evaluated the impact of heat and effectiveness of countermeasures based on hourly wet-bulb globe temperature (WBGT) projections under multiple climate scenarios. For the 2060s to 2080s, even under a stringent greenhouse gas (GHG) emission control scenario (SSP1-1.9), strenuous exercise will be restricted for one to four months in five out of eight WBGT zones defined for Japan and for one to six months in six zones under the scenario with little control of GHG emissions (SSP5-8.5). In all four scenarios, unlike in the past, all physical activity should be stopped at least once a week in one or more zones. While common countermeasures like early morning exercise and reducing outdoor activity frequency effectively reduce heat illness risks, under the most pessimistic scenario (SSP5-8.5), strenuous exercise would still need to be restricted for one to four months in warmer zones, even with these measures. Common heat illness countermeasures remain necessary for sports club activities at present. However, further measures—such as replacing outdoor activities with indoor sessions—and behavioral changes—such as moving tournaments concentrated during summer vacation to cooler times of the year—will be inevitable as global warming progresses.

This systematized literature review aims to assess reporting units used by hospital LCAs to communicate their environmental impact through life-cycle assessment (LCA). As the healthcare sector increasingly prioritizes sustainability, understanding the choice of reporting unit is crucial. This analysis aims to provide recommendations for effective communication of environmental performance. A systematized literature search was conducted for LCAs and carbon footprint studies of healthcare organizations or systems in the databases PubMed and Web of Science. The identified units were analyzed using seven criteria, including the differentiation between input and output flows, treatment complexities, quantity of provided services, quality of provided services, longevity of services, matching with system boundaries, and data availability. Seven reporting flows were identified: (i) floor area, (ii) number of beds, (iii) workforce, (iv) expenditure, (v) patient load, (vi) revenue, and (vii) the diagnosis-related groups case mix. Each flow has its own advantages and disadvantages; the best reporting flow for an assessment depends on the specific goals and objectives and should be meaningful to stakeholders. However, none of the reporting flows measure the actual function of healthcare organizations, i.e. the impact on the health of the patients. However, data on this flow, such as quality-adjusted life years, are not available in a meaningful quantity. In conclusion, this literature review highlights the importance of reporting unit selection in communicating the environmental impact of healthcare organizations through LCA. The present analysis identified seven reporting flows, each with its own advantages and disadvantages. These findings are of importance for decision makers to contextualize given data and to choose the most suitable reporting flow for their own assessment. Future research might evaluate the quantitative impact of the reporting flow decision.

The United States (U.S.) healthcare sector—a significant contributor to climate change through emissions, pollution, and waste—is beginning to integrate sustainability into operations. Sustainability science and accounting have been widely adopted across other industries to measure and communicate mitigation progress. Transparency, defined as ensuring accurate reporting and open disclosure of sustainability data, is critical. Without it, organizations risk 'greenwashing,' where misleading claims can erode public trust and undermine sustainability efforts. This scoping review evaluates the extent to which U.S. healthcare literature addresses transparency as a critical component of sustainability initiatives. This review identified peer-reviewed and non-peer-reviewed literature on environmental sustainability within U.S. healthcare from 1994 to 2024, with a focus on transparency and related concepts. Articles were excluded if they were not in English, corporate reports, advertisements, or irrelevant to U.S. healthcare sustainability. The following databases were searched: Ovid MEDLINE, Nexis Uni, Business Source Complete, Scopus, and Health Care Administration. Two independent reviewers screened and extracted the data, with a third resolving disagreements. Qualitative and thematic analyses were employed to assess if and how transparency was defined and operationalized in the context of healthcare sustainability. Of the 835 articles screened, 33 met inclusion criteria. Only 10 of the 33 articles both defined and operationalized transparency. Key focus areas included environmental sustainability practices in healthcare (n = 18, 55%); ESG or CSR and public health impact (n = 18, 55%); the business of healthcare (n = 8, 24%); and policy-driven sustainability initiatives (n = 7, 21%). Barriers included absence of mandates, standardization, and leadership. Despite a growing body of research on healthcare sustainability, studies addressing transparency are sparse. Limitations included a narrow keyword focus and limited databases searched. Transparent reporting could be considered the sixth 'R' in the 5 Rs of sustainability–refuse, reduce, reuse, recycle, repurpose, and report.

Despite recent interest in land-use and land-cover (LULC) change effects on emerging infectious diseases (EIDs), the debate on global potential health threats remains polarizing. These depend on diverse LULC changes, different types of infectious disease systems, and spatio-temporal scales of studies. Here, using both a bibliometric and scoping review method, we summarize the reliability and availability of published relevant studies on LULC effects on mycobacteria, an important group of infectious bacteria that affect humans and both wild and domestic animals. We make connections of LULC with environmental changes (e.g. soils) that likely lead to an increased risk of mycobacteria spillover to human and other animal populations. An important feature of our review is a focus on research from the richest countries of the world, though some studies have been done in Africa, Asia and South America. Geographically, regions experiencing important LULC transformations, such as many tropical regions of Meso- and South America and Southeast Asia, have been given little or no attention in this important topic. Research on Mycobacterium bovis, and to a larger extent on M. ulcerans, constitutes convincing illustrations of the importance of acknowledging shifts in spatio-temporal scales, from local to global and inter-annual to decadal ones, when evaluating responses of mycobacteria to LULC changes. However, studies on other pathogenic mycobacteria remain very much confined to local and dispersed scales. To date, the role of LULC change effects has not been adequately studied for many human and animal pathogens, and more research and attention to this issue is clearly needed. This review provides a comprehensive set of data on the updates of LULC change and their impact on animal and human mycobacterial infections. It also proposes several research recommendations, in particular to better understand the emergence of mycobacteria in context, by multiplying study sites in different regions of the world and in adopting an ecosystem-based perspective, in order to encourage interdisciplinary research better linking environmental microbiology, veterinary science and medical research.

Health professionals have a crucial role to play in educating the public and advocating with policymakers about the human health relevance of climate change. Here, we review 93 studies published between the years 2000–2023 on the roles health professionals can play in addressing climate change as a health issue, their knowledge of and concern about the issue, their willingness to engage with the issue, barriers they perceive to that engagement, and strategies to overcome these challenges. Overall, we found health professionals have a growing understanding of and concern about climate change's impacts on human health and are interested in communicating about the issue and advocating for climate and health solutions. Continued efforts are needed to develop effective programming and resources to help activate, train, and support health professionals as trusted voices on the issue.

The benefits of green and blue space (GBS) exposure on improving public health are accepted by a range of stakeholders, including policy makers. Extensive GBS research into health supports the theory that GBS promotes physical activity and has mental restorative and environmental mitigative properties. Studies exploring the impact of GBS exposure on maternal, prenatal, and/or neonatal health have mainly utilised cross-sectional methods. This does not allow for causal inference. Thus, our systematic review aimed to analyse the evidence of the impact of GBS on maternal, prenatal, and/or neonatal health. Our study adhered to PRISMA guidelines. We searched seven online databases (Medline, Scopus, Web of Science, PsycInfo, Embase, Environment Complete, and Maternity & Infant Care Database) and excluded cross-sectional studies without mediation analysis. Our risk of bias assessment framework was adapted from the ROBINS-E tool. We conducted narrative syntheses of studies examining maternal, prenatal, and/or neonatal outcomes. We carried out meta-analyses using random effects models for five birth outcomes (i.e. birthweight, low birthweight (LBW), gestational age, pre-term birth (PTB), and small-for-gestational-age (SGA)). Studies found to be high risk of bias, or very high risk of bias were excluded from our analyses. Initial searches yielded 1099 articles. Following full text screening, our review included 62 studies. Most studies were conducted in either Europe or North America (n = 41, 66%). All studies reported green space exposure as an independent variable while seven studies also included blue space exposure as an independent variable. The most reported green space variable was the Normalized Difference Vegetation Index (NDVI) (n = 46, 74%). Our meta-analyses results indicated that greater greenness is protective against LBW (OR = 0.95, 95% CI: 0.92–0.98, p = 0.002), SGA (OR = 0.95, 95% CI: 0.92–0.99, p = 0.01), PTB (OR = 0.92, 95% CI: 0.88–0.97, p = 0.001), and affects birthweight (β = 13.02 g, 95% CI: 9.99–16.05, p < 0.0001).

The effects of climate change are wide-reaching, impacting both natural ecosystems and human populations, with the increased exposure to ultraviolet (UV) radiation and high temperatures causing extensive health problems and disruptions in food and water supplies, exacerbating existing health issues. Climate change also aggravates extreme weather events, leading to environmental catastrophes related to cancer development and prevention. Although the impacts of climate change on human health have been widely studied, for example, regarding the effects of UV radiation and air pollution, it is an emerging area for its effects on chronic diseases like cancer, remaining a subject of ongoing research. This review found a strong link between environmental risk factors, such as UV radiation, ozone, high precipitation, air pollutants, food insecurity and chemical toxins, and the development of certain cancers, particularly evident in skin, lung, esophagus, and colorectal cancers. As the global climate continues to change, it is essential to comprehend and address the interactions between environmental factors and human health to mitigate its impacts on overall well-being.