Heavy metal contamination in drinking water is a public health issue. This study conducted a probabilistic meta-analysis of health risk assessment for six commonly reported heavy metals (arsenic [As], lead [Pb], mercury [Hg], cadmium [Cd], chromium [Cr] and nickel [Ni]) in drinking water across six continents (Asia, Europe, Africa, North America, South America and Oceania) using the data from 2000 to 2024. Human exposure and risks were quantified in terms of cancer risks (CRs) and loss of disability-adjusted life years (DALYs). Monte Carlo simulation was employed to generate 5,000 random scenarios to incorporate uncertainty in risk assessment. Africa exhibited the average concentrations of As, Pb, Hg, Cd, Cr and Ni in drinking water of 176.7, 123.3, 93.7, 80.2, 91.0 and 35.1 μg/L respectively. The overall averages of CRs in Asia, Europe, North America, South America, Africa and Oceania were predicted to be 3.25 × 10[-4], 1.34 × 10[-4], 2.26 × 10[-4], 1.18 × 10[-3], 4.1 × 10[-3] and 5.83 × 10[-5] respectively while the DALYs were 1.48 × 10[5], 7.14 × 10[3], 1.20 × 10[4], 5.51 × 10[4], 8.63 × 10[5] and 2.68 × 10[2] respectively. Across six continents, inorganic fraction of arsenic (iAs) was the dominant carcinogen, contributing (45-91) % to total cancer risks in Asia, contributions of iAs and Cd were almost similar. The loss of DALYs were highest in Africa (8.63 × 10[5]), due mainly to arsenic-induced bladder and cadmium-induced lung cancers. The global economic burden was USD 29 billion, with Africa accounting for almost 52 %. Sensitivity analysis identified iAs as the key parameter. The heavy metal contamination is a public health issue that requires decisive actions in Africa, South America and Asia.

Herbal medicine products (HMPs) are widely consumed worldwide, yet contamination with toxicants such as heavy metals poses potential environmental health and consumer safety concerns. This study systematically reviewed studies measuring contamination levels of lead (Pb), cadmium (Cd), mercury (Hg), or arsenic (As) in crude herbal materials and formulated HMPs. PubMed, Scopus, Web of Science, and CINAHL were searched from inception to June 2026. Random-effects meta-analyses estimated metal-specific pooled mean concentrations; moderator analyses and meta-regression explored heterogeneity. Seventy studies from 27 countries or territories were included. Forty-eight, 45, 25, and 35 studies contributed to the Pb, Cd, Hg, and As meta-analyses, respectively. Pooled concentrations in HMPs were 1.930 mg/kg (95 % CI: 0.993-2.860) for Pb, 0.206 mg/kg (95 % CI: 0.142-0.270) for Cd, 0.122 mg/kg (95 % CI: 0.016-0.228) for Hg, and 0.501 mg/kg (95 % CI: 0.267-0.736) for As; heterogeneity was considerable for all metals. Pb concentrations differed by national income group (p=0.007), and Cd concentrations differed by product classification (p=0.002), with higher Cd concentrations in crude materials than formulated products. Higher gross national income per capita was associated with lower Pb and As concentrations. Reported exceedance of study-specific comparators was common but varied substantially because regulatory limits, product categories, and denominators differed across studies. Heavy metal contamination of HMPs varies between settings and products, which underscores the need for strengthened quality surveillance, improved monitoring, and harmonized regulatory standards.

The rising prevalence of cognitive decline and dementia imposes substantial burdens on individuals, families, and society. Air pollution has increasingly been linked to adverse cognitive outcomes, but findings vary across pollutants, study designs, and exposure-assessment methods. This review summarizes epidemiological evidence on ambient air pollution and cognitive outcomes among older adults, identifies research gaps, and outlines priorities for future investigation. PubMed was searched through February 2025 for peer-reviewed, English-language observational studies published from January 2000 onward that examined ambient air pollution and cognitive outcomes among adults aged 50 years and older. A total of 36 studies met the inclusion criteria. Fine particulate matter (PM2.5) was the most frequently studied pollutant, and most studies reported associations between higher PM2.5 exposure and poorer global or domain-specific cognitive function, faster cognitive decline, or increased risk of cognitive impairment and dementia. Evidence for other pollutants generally suggested adverse associations, although ozone (O3) findings were the most inconsistent. Differences in exposure assessment methods, cognitive assessment, study designs, confounding control, and population susceptibility likely contributed to heterogeneity. Overall, the accumulated evidence suggests that long-term ambient air pollution exposures may contribute to poorer cognitive outcomes in later life. These findings underscore the importance of strengthening air quality standards to protect brain health and developing targeted interventions for vulnerable older populations.

Healthcare associated infections (HAIs) lead to tens of thousands of deaths annually, with 21.6 % being caused by water, according to Collier S, Deng L, Adam E, Benedict K, Beshearse E, Blackstock A, et al. Estimate of burden and direct healthcare cost of infectious waterborne disease in the United States. Emerging Infect Disease J 2021;27:140. This is partially due to Opportunistic Premise Plumbing Pathogens (OPPPs); which may exhibit resistance to disinfection and thrive in pipe biofilms. Evidence found in literature indicates the rate of infections caused by OPPPs are going to increase with time, highlighting the need for better understanding of their detection and mitigation. The aim of this review is to provide insight on the latest status of OPPP research and highlight areas that need further investigation. It also emphasizes the importance of proactive surveillance, extensive water management protocols, and advanced detection technologies in reducing waterborne healthcare-associated infections. Ultimately, it was found there is still extensive research needed to fully mitigate and prevent pathogenic outbreaks.

In recent decades, airborne microplastics (MPs) and nano plastics have emerged as critical environmental pollutants, posing potential human health risks including respiratory issues such as asthma, alveolitis, and chronic bronchitis. This systematic review and meta-analysis investigated the distribution, characteristics and concentrations of airborne MPs in indoor and outdoor environments based on studies published up to October 2023. Following PRISMA guidelines, 27 eligible studies across 16 countries were selected, with 21 providing sufficient quantitative data for meta-analysis. Due to extreme, robust heterogeneity across the studies (I[2]>99 %), a random-effects model was applied. Sensitivity analyses confirmed these findings were stable and not driven by individual outliers. The results demonstrated that indoor environments were more polluted than outdoor settings. For example, moderately polluted indoor environments exhibited mean concentrations of 1,380.28 MP/m[3] compared to 102.45 MP/m[3] outdoors. However, these findings are presented as a descriptive summary of the literature to highlight methodological variability. Consistent with this, moderator analyses revealed that the most significant contributor to inter-study variability was the type of detection instrument used, with FTIR consistently reporting higher concentrations than microscopy or Raman spectroscopy. Sampling duration also significantly influenced the results. Additionally, indoor healthcare centers and outdoor urban areas were identified as the most heavily contaminated sub-environments. These findings highlight the urgent need for standardized sampling and detection protocols, while emphasizing the critical importance of monitoring and mitigating indoor air quality to reduce human exposure to airborne MPs.

Healthcare-associated infections (HAIs), also known as nosocomial infections, remain one of the most significant challenges facing healthcare systems worldwide. These infections affect hospitalized patients and may also pose a risk to healthcare workers and individuals exposed to healthcare environments. HAIs are associated with increased morbidity, mortality, prolonged hospitalization, and substantial healthcare costs. Although previous studies have investigated different aspects of HAIs, evidence remains fragmented, and few reviews have comprehensively integrated epidemiology, antimicrobial resistance, and infection prevention and control (IPC) challenges. To address this gap, this systematic review aimed to comprehensively synthesize the available evidence on the epidemiology of HAIs and the major challenges related to antimicrobial resistance, infection prevention, and infection control. This systematic review was conducted in accordance with the Preferred Reporting Items for PRISMA 2020 guidelines. A comprehensive literature search was performed, for studies published between 1980 and 2025. Search terms included HAIs, antimicrobial resistance, multidrug-resistant (MDR) pathogens, infection prevention, and infection control (IPC). Studies addressing at least two aspects of prevention, diagnosis, management, or infection-control challenges were considered eligible. After screening 190 records, 43 high-quality studies with a Newcastle-Ottawa Scale (NOS) score of ≥6 were included in the final review. All studies were independently assessed by two reviewers, and disagreements were resolved through consultation with a third reviewer. The reviewed evidence indicated that urinary tract infections, respiratory tract infections, bloodstream infections, and skin and soft tissue infections were among the most frequently reported HAIs. Intensive care units (ICUs) were identified as the highest-risk hospital settings for infection occurrence and transmission. Furthermore, the emergence and spread of MDR microorganisms have become a major obstacle to effective IPC. The findings consistently demonstrated that adherence to hand hygiene practices remains one of the most effective measures for reducing pathogen transmission and preventing HAIs. Nosocomial infections continue to represent a major threat to patient safety and healthcare quality. Improving awareness of HAIs, strengthening IPC programs, promoting compliance with evidence-based preventive measures, and enhancing healthcare workers' adherence to infection-control practices can substantially reduce the burden of these infections. The findings of this review provide evidence to support healthcare professionals, hospital administrators, and policymakers in developing evidence-based strategies to strengthen IPC programs, optimize antimicrobial stewardship, and improve patient safety.

Aspergillus fumigatus is a clinically important airborne fungal pathogen capable of causing a broad spectrum of respiratory disorders. Persistent exposure or airway colonization can provoke severe allergic diseases, particularly in patients with asthma or cystic fibrosis, whereas impaired immunity or pre-existing structural lung damage may allow the development of chronic or life-threatening invasive pulmonary aspergillosis. Accordingly, the aim of this review was to synthesize current evidence on the role of A. fumigatus in the development of allergic and non-allergic diseases, with particular emphasis on its pathogenic mechanisms, clinical manifestations, diagnostic approaches, treatment strategies, and preventive measures. A systematic search was conducted in PubMed, ResearchGate, Scopus, Web of Science, and Google Scholar, and data on disease course, diagnosis, and management were synthesized. A. fumigatus is a widespread fungus whose spores are abundant in the air and pose a particular risk to immunocompromised individuals. Its virulence factors include thermotolerance, toxin and allergen production, and resistance to oxidative stress. The fungus causes allergic diseases, such as allergic bronchopulmonary aspergillosis, hypersensitive pneumonitis, and severe asthma with fungal sensitivity, as well as non-allergic diseases, including invasive and chronic pulmonary aspergillosis. Infection primarily affects the respiratory system, presenting with cough, weakness, catarrhal symptoms, and haemoptysis. Disseminated infection can involve the brain (cerebral aspergillosis), eyes (endophthalmitis), bones (osteomyelitis), and skin (dermatitis). Diagnosis involves histological tissue examination for fungal hyphae, detection of fungal antigens in blood or respiratory samples, measurement of specific immunoglobulin E, skin tests, and imaging studies. Antifungal and antiallergic drugs are the mainstay of treatment; in case of complications, surgical treatment is performed. To prevent aspergillosis, it is necessary to identify and inform risk groups; control air humidity; and wear masks in places of high risk of infection. A. fumigatus is a dangerous mycosis that causes severe allergic and non-allergic diseases, mainly in people with weakened immune systems.

Inorganic arsenic (iAs) is a toxic environmental pollutant linked to serious health risks, prompting global regulatory efforts. This study identifies major health conditions associated with iAs exposure using text network analysis, and assesses health risk assessments through an umbrella review and dose-response analysis. It synthesizes previous systematic reviews to offer a broader perspective on iAs-related health effects. An optimized text network analysis-based search strategy was applied across multiple databases to identify relevant systematic reviews. An umbrella review framework was employed to synthesize and reinterpret findings across systematic reviews. The methodological quality of included systematic reviews was assessed using the A MeaSurement Tool to Assess systematic Reviews 2 tool. Extracted data on study characteristics, exposure levels, and risk estimates were analyzed to evaluate the dose-response relationship between iAs exposure and health outcomes. From 922 systematic reviews, 36 were included and categorized into 10 health condition groups. For example, seven SRs found a significant dose-response relationship between iAs and bladder cancer, with one systematic review reporting relative risks of 2.70, 4.20, and 5.80 at 10, 50, and 150 µg/L, respectively. Individual study analysis further showed that each 10 µg/L increase in iAs raised bladder cancer risk by 3.11 % (p=0.003). iAs exposure is associated with hypertension, diabetes, cardiovascular disease, and adverse fetal outcomes. Dose-dependent increases in bladder cancer, lung cancer, and hypertension risks were observed. These findings support more precise health risk assessments and regulatory strategies.

Water pollution caused by organic and inorganic contaminants, particularly dyes and pharmaceuticals, represents a major environmental challenge. Advanced oxidation processes based on photocatalysts have emerged as efficient and sustainable approaches for water and wastewater treatment. Copper ferrite (CuFe2O4) is considered a promising photocatalyst owing to its narrow bandgap, visible-light activity, chemical stability, and magnetic properties. Despite extensive experimental investigations, a comprehensive systematic comparison of CuFe2O4-based photocatalysts under diverse operational conditions has remained limited. In this study, a systematic review following PRISMA guidelines was conducted using studies published between January 2014 and November 2025 indexed in Scopus, PubMed, Web of Science, and ScienceDirect. From an initial pool of 397 studies, 98 articles met the inclusion criteria. Key parameters - including pollutant type, pH, catalyst dosage, initial pollutant concentration, irradiation time, light source, and degradation efficiency - were quantitatively compared to identify performance trends and operational optima. The results demonstrate that CuFe2O4-based nanocomposites, particularly heterojunction, Z-scheme, and S-scheme architectures combined with TiO2, g-C3N4, graphene, and metal oxides, achieve high degradation efficiencies (often >90 %) for a wide range of organic pollutants and selected inorganic contaminants (e.g., Cr(VI)). Enhanced charge separation and suppressed electron-hole recombination were identified as the primary factors contributing to improved photocatalytic activity. In addition, the intrinsic magnetic properties of these nanocomposites enable facile catalyst recovery and reuse. In conclusion, CuFe2O4-based nanocomposites, especially those incorporating advanced heterojunction architectures, emerge as highly efficient and magnetically recoverable photocatalytic platforms for sustainable water and wastewater treatment, with strong potential for scalable implementation and real-wastewater applications.

The global surge in Autism Spectrum Disorder (ASD) cases, coupled with evidence linking prenatal Particulate Matter (PM) exposure to developmental disruption, demands a comprehensive review to design targeted health interventions. This systematic review and meta-analysis aim to evaluate the strength and consistency of evidence linking prenatal PM exposure to ASD across studies, quantifying this relation to identify actionable environmental risk thresholds. This study employed PRISMA protocols to systematically extract and evaluate evidence from PubMed, Web of Science, Scopus, and ScienceDirect (2010-2024), and screened 4,013 articles to identify qualified case-control and cohort studies (n=29). Data synthesis employed random-effects modeling, accompanied by comprehensive assessment through I[2] statistics, Q-tests, funnel plots, Duval and Tweedie's trim-and-fill analysis, and Egger's regression, to ensure validity. A meta-analysis of 16 case-control studies revealed a 34 % increased risk of ASD associated with prenatal PM exposure (pooled OR=1.34; 95 % CI: 1.13-1.54), despite substantial between-study heterogeneity (I[2]=94.02 %, p<0.001). Publication bias was not significant (Egger's test p value=0.114). Critical trimester-specific analysis uncovered that third-trimester exposure significantly increased ASD risk (OR=1.17; 95 % CI: 1.01-1.34), while first-trimester (OR=1.02; 95 % CI: 0.92-1.11; I[2]=49.18 %, p<0.10) and second-trimester exposures (OR=1.13; 95 % CI: 0.88-1.38; I[2]=92.59 %, p<0.001) showed non-significant associations. This review identified prenatal and early life exposure to PM as a risk factor for ASD, indicating a trimester-specific vulnerability. It highlighted the necessity of focused air quality interventions and targeted guidance to reduce prenatal PM exposure to alleviate ASD risk during the critical-window.

The built environment, comprising homes, buildings, roads, public spaces, infrastructure, land use, civic design, and amenities, has a considerable influence on occupational health. In India's tea plantations, where women comprise majority of the workforce, the built environment plays a crucial role in determining occupational health. The aforementioned point can be explained by the co-occurrence of living and working conditions, which often coexist in tea plantations, further resulting in vulnerabilities to the health of women workers. Therefore, to understand the influence of built environment on the occupational health of women workers in tea plantations of India, the present paper employs a systematic review using the PRISMA 2020 framework. In the first search, 421 studies were identified, of which 21 studies met all the inclusion criteria. A quality appraisal and risk of bias of the included studies have been undertaken. The results identified that musculoskeletal disorders (MSDs) are the most prevalent occupational health consequence, affecting over 80 % of the women workers in Indian tea plantations, substantiated by a range of estimates in the studies reviewed. Gendered disparities in wage earning, self-autonomy, and dual responsibilities often lead to emotional distress, as delineated in minimal of the reviewed studies, grounded on self-disclosed or qualitative analysis. Further, deprived housing conditions and other facilities across the reviewed studies reflect institutional negligence. Therefore, by conducting a systematic synthesis of occupational health of women workers in the Indian tea plantation sector through the lens of the built environment, prior accounts have been extended. Addressing these issues is essential for safeguarding women workers, which will ensure the longevity of the Indian tea industry.