research topics on environmental health

Research Topics & Ideas: Environment

100+ Environmental Science Research Topics & Ideas

Finding and choosing a strong research topic is the critical first step when it comes to crafting a high-quality dissertation, thesis or research project. Here, we’ll explore a variety research ideas and topic thought-starters related to various environmental science disciplines, including ecology, oceanography, hydrology, geology, soil science, environmental chemistry, environmental economics, and environmental ethics.

NB – This is just the start…

The topic ideation and evaluation process has multiple steps . In this post, we’ll kickstart the process by sharing some research topic ideas within the environmental sciences. This is the starting point though. To develop a well-defined research topic, you’ll need to identify a clear and convincing research gap , along with a well-justified plan of action to fill that gap.

If you’re new to the oftentimes perplexing world of research, or if this is your first time undertaking a formal academic research project, be sure to check out our free dissertation mini-course. Also be sure to also sign up for our free webinar that explores how to develop a high-quality research topic from scratch.

Overview: Environmental Topics

• Ecology /ecological science
• Atmospheric science
• Oceanography
• Soil science
• Environmental chemistry
• Environmental economics
• Environmental ethics
• Examples  of dissertations and theses

Topics & Ideas: Ecological Science

• The impact of land-use change on species diversity and ecosystem functioning in agricultural landscapes
• The role of disturbances such as fire and drought in shaping arid ecosystems
• The impact of climate change on the distribution of migratory marine species
• Investigating the role of mutualistic plant-insect relationships in maintaining ecosystem stability
• The effects of invasive plant species on ecosystem structure and function
• The impact of habitat fragmentation caused by road construction on species diversity and population dynamics in the tropics
• The role of ecosystem services in urban areas and their economic value to a developing nation
• The effectiveness of different grassland restoration techniques in degraded ecosystems
• The impact of land-use change through agriculture and urbanisation on soil microbial communities in a temperate environment
• The role of microbial diversity in ecosystem health and nutrient cycling in an African savannah

Topics & Ideas: Atmospheric Science

• The impact of climate change on atmospheric circulation patterns above tropical rainforests
• The role of atmospheric aerosols in cloud formation and precipitation above cities with high pollution levels
• The impact of agricultural land-use change on global atmospheric composition
• Investigating the role of atmospheric convection in severe weather events in the tropics
• The impact of urbanisation on regional and global atmospheric ozone levels
• The impact of sea surface temperature on atmospheric circulation and tropical cyclones
• The impact of solar flares on the Earth’s atmospheric composition
• The impact of climate change on atmospheric turbulence and air transportation safety
• The impact of stratospheric ozone depletion on atmospheric circulation and climate change
• The role of atmospheric rivers in global water supply and sea-ice formation

Topics & Ideas: Oceanography

• The impact of ocean acidification on kelp forests and biogeochemical cycles
• The role of ocean currents in distributing heat and regulating desert rain
• The impact of carbon monoxide pollution on ocean chemistry and biogeochemical cycles
• Investigating the role of ocean mixing in regulating coastal climates
• The impact of sea level rise on the resource availability of low-income coastal communities
• The impact of ocean warming on the distribution and migration patterns of marine mammals
• The impact of ocean deoxygenation on biogeochemical cycles in the arctic
• The role of ocean-atmosphere interactions in regulating rainfall in arid regions
• The impact of ocean eddies on global ocean circulation and plankton distribution
• The role of ocean-ice interactions in regulating the Earth’s climate and sea level

Tops & Ideas: Hydrology

• The impact of agricultural land-use change on water resources and hydrologic cycles in temperate regions
• The impact of agricultural groundwater availability on irrigation practices in the global south
• The impact of rising sea-surface temperatures on global precipitation patterns and water availability
• Investigating the role of wetlands in regulating water resources for riparian forests
• The impact of tropical ranches on river and stream ecosystems and water quality
• The impact of urbanisation on regional and local hydrologic cycles and water resources for agriculture
• The role of snow cover and mountain hydrology in regulating regional agricultural water resources
• The impact of drought on food security in arid and semi-arid regions
• The role of groundwater recharge in sustaining water resources in arid and semi-arid environments
• The impact of sea level rise on coastal hydrology and the quality of water resources

Topics & Ideas: Geology

• The impact of tectonic activity on the East African rift valley
• The role of mineral deposits in shaping ancient human societies
• The impact of sea-level rise on coastal geomorphology and shoreline evolution
• Investigating the role of erosion in shaping the landscape and impacting desertification
• The impact of mining on soil stability and landslide potential
• The impact of volcanic activity on incoming solar radiation and climate
• The role of geothermal energy in decarbonising the energy mix of megacities
• The impact of Earth’s magnetic field on geological processes and solar wind
• The impact of plate tectonics on the evolution of mammals
• The role of the distribution of mineral resources in shaping human societies and economies, with emphasis on sustainability

Topics & Ideas: Soil Science

• The impact of dam building on soil quality and fertility
• The role of soil organic matter in regulating nutrient cycles in agricultural land
• The impact of climate change on soil erosion and soil organic carbon storage in peatlands
• Investigating the role of above-below-ground interactions in nutrient cycling and soil health
• The impact of deforestation on soil degradation and soil fertility
• The role of soil texture and structure in regulating water and nutrient availability in boreal forests
• The impact of sustainable land management practices on soil health and soil organic matter
• The impact of wetland modification on soil structure and function
• The role of soil-atmosphere exchange and carbon sequestration in regulating regional and global climate
• The impact of salinization on soil health and crop productivity in coastal communities

Topics & Ideas: Environmental Chemistry

• The impact of cobalt mining on water quality and the fate of contaminants in the environment
• The role of atmospheric chemistry in shaping air quality and climate change
• The impact of soil chemistry on nutrient availability and plant growth in wheat monoculture
• Investigating the fate and transport of heavy metal contaminants in the environment
• The impact of climate change on biochemical cycling in tropical rainforests
• The impact of various types of land-use change on biochemical cycling
• The role of soil microbes in mediating contaminant degradation in the environment
• The impact of chemical and oil spills on freshwater and soil chemistry
• The role of atmospheric nitrogen deposition in shaping water and soil chemistry
• The impact of over-irrigation on the cycling and fate of persistent organic pollutants in the environment

Topics & Ideas: Environmental Economics

• The impact of climate change on the economies of developing nations
• The role of market-based mechanisms in promoting sustainable use of forest resources
• The impact of environmental regulations on economic growth and competitiveness
• Investigating the economic benefits and costs of ecosystem services for African countries
• The impact of renewable energy policies on regional and global energy markets
• The role of water markets in promoting sustainable water use in southern Africa
• The impact of land-use change in rural areas on regional and global economies
• The impact of environmental disasters on local and national economies
• The role of green technologies and innovation in shaping the zero-carbon transition and the knock-on effects for local economies
• The impact of environmental and natural resource policies on income distribution and poverty of rural communities

Topics & Ideas: Environmental Ethics

• The ethical foundations of environmentalism and the environmental movement regarding renewable energy
• The role of values and ethics in shaping environmental policy and decision-making in the mining industry
• The impact of cultural and religious beliefs on environmental attitudes and behaviours in first world countries
• Investigating the ethics of biodiversity conservation and the protection of endangered species in palm oil plantations
• The ethical implications of sea-level rise for future generations and vulnerable coastal populations
• The role of ethical considerations in shaping sustainable use of natural forest resources
• The impact of environmental justice on marginalized communities and environmental policies in Asia
• The ethical implications of environmental risks and decision-making under uncertainty
• The role of ethics in shaping the transition to a low-carbon, sustainable future for the construction industry
• The impact of environmental values on consumer behaviour and the marketplace: a case study of the ‘bring your own shopping bag’ policy

Examples: Real Dissertation & Thesis Topics

While the ideas we’ve presented above are a decent starting point for finding a research topic, they are fairly generic and non-specific. So, it helps to look at actual dissertations and theses to see how this all comes together.

Below, we’ve included a selection of research projects from various environmental science-related degree programs to help refine your thinking. These are actual dissertations and theses, written as part of Master’s and PhD-level programs, so they can provide some useful insight as to what a research topic looks like in practice.

• The physiology of microorganisms in enhanced biological phosphorous removal (Saunders, 2014)
• The influence of the coastal front on heavy rainfall events along the east coast (Henson, 2019)
• Forage production and diversification for climate-smart tropical and temperate silvopastures (Dibala, 2019)
• Advancing spectral induced polarization for near surface geophysical characterization (Wang, 2021)
• Assessment of Chromophoric Dissolved Organic Matter and Thamnocephalus platyurus as Tools to Monitor Cyanobacterial Bloom Development and Toxicity (Hipsher, 2019)
• Evaluating the Removal of Microcystin Variants with Powdered Activated Carbon (Juang, 2020)
• The effect of hydrological restoration on nutrient concentrations, macroinvertebrate communities, and amphibian populations in Lake Erie coastal wetlands (Berg, 2019)
• Utilizing hydrologic soil grouping to estimate corn nitrogen rate recommendations (Bean, 2019)
• Fungal Function in House Dust and Dust from the International Space Station (Bope, 2021)
• Assessing Vulnerability and the Potential for Ecosystem-based Adaptation (EbA) in Sudan’s Blue Nile Basin (Mohamed, 2022)
• A Microbial Water Quality Analysis of the Recreational Zones in the Los Angeles River of Elysian Valley, CA (Nguyen, 2019)
• Dry Season Water Quality Study on Three Recreational Sites in the San Gabriel Mountains (Vallejo, 2019)
• Wastewater Treatment Plan for Unix Packaging Adjustment of the Potential Hydrogen (PH) Evaluation of Enzymatic Activity After the Addition of Cycle Disgestase Enzyme (Miessi, 2020)
• Laying the Genetic Foundation for the Conservation of Longhorn Fairy Shrimp (Kyle, 2021).

Looking at these titles, you can probably pick up that the research topics here are quite specific and narrowly-focused , compared to the generic ones presented earlier. To create a top-notch research topic, you will need to be precise and target a specific context with specific variables of interest . In other words, you’ll need to identify a clear, well-justified research gap.

Need more help?

If you’re still feeling a bit unsure about how to find a research topic for your environmental science dissertation or research project, be sure to check out our private coaching services below, as well as our Research Topic Kickstarter .

Need a helping hand?

12 Comments

research topics on climate change and environment

Researched PhD topics on environmental chemistry involving dust and water

I wish to learn things in a more advanced but simple way and with the hopes that I am in the right place.

Thank so much for the research topics. It really helped

the guides were really helpful

Research topics on environmental geology

Thanks for the research topics….I need a research topic on Geography

hi I need research questions ideas

Implications of climate variability on wildlife conservation on the west coast of Cameroon

I want the research on environmental planning and management

I want a topic on environmental sustainability

It good coaching

Submit a Comment Cancel reply

Your email address will not be published. Required fields are marked *

Save my name, email, and website in this browser for the next time I comment.

• Print Friendly

• Privacy Policy

Home » 500+ Environmental Research Topics

500+ Environmental Research Topics

Environmental research is a crucial area of study in today’s world, as we face an increasing number of complex and pressing environmental challenges. From climate change to pollution, biodiversity loss to natural resource depletion, there is an urgent need for scientific inquiry and investigation to inform policy, decision-making, and action. Environmental research encompasses a broad range of disciplines, including ecology, biology , geology, chemistry , and physics , among others, and explores a diverse array of topics , from ocean acidification to sustainable agriculture. Through rigorous scientific inquiry and a commitment to generating evidence-based solutions, environmental research plays a vital role in promoting the health and well-being of our planet and its inhabitants. In this article, we will cover some trending Environmental Research Topics.

Environmental Research Topics

Environmental Research Topics are as follows:

• Climate change and its impacts on ecosystems and society
• The effectiveness of carbon capture and storage technology
• The role of biodiversity in maintaining healthy ecosystems
• The impact of human activity on soil quality
• The impact of plastic pollution on marine life
• The effectiveness of renewable energy sources
• The impact of deforestation on local communities and wildlife
• The relationship between air pollution and human health
• The impact of agricultural practices on soil erosion
• The effectiveness of conservation measures for endangered species
• The impact of overfishing on marine ecosystems
• The role of wetlands in mitigating climate change
• The impact of oil spills on marine ecosystems
• The impact of urbanization on local ecosystems
• The impact of climate change on global food security
• The effectiveness of water conservation measures
• The impact of pesticide use on pollinators
• The impact of acid rain on aquatic ecosystems
• The impact of sea level rise on coastal communities
• The effectiveness of carbon taxes in reducing greenhouse gas emissions
• The impact of habitat destruction on migratory species
• The impact of invasive species on native ecosystems
• The role of national parks in biodiversity conservation
• The impact of climate change on coral reefs
• The effectiveness of green roofs in reducing urban heat island effect
• The impact of noise pollution on wildlife behavior
• The impact of air pollution on crop yields
• The effectiveness of composting in reducing organic waste
• The impact of climate change on the Arctic ecosystem
• The impact of land use change on soil carbon sequestration
• The role of mangroves in coastal protection and carbon sequestration
• The impact of microplastics on marine ecosystems
• The impact of ocean acidification on marine organisms
• The effectiveness of carbon offsets in reducing greenhouse gas emissions
• The impact of deforestation on climate regulation
• The impact of groundwater depletion on agriculture
• The impact of climate change on migratory bird populations
• The effectiveness of wind turbines in reducing greenhouse gas emissions
• The impact of urbanization on bird diversity
• The impact of climate change on ocean currents
• The impact of drought on plant and animal populations
• The effectiveness of agroforestry in improving soil quality
• The impact of climate change on water availability
• The impact of wildfires on carbon storage in forests
• The impact of climate change on freshwater ecosystems
• The effectiveness of green energy subsidies
• The impact of nitrogen pollution on aquatic ecosystems
• The impact of climate change on forest ecosystems
• The effectiveness of community-based conservation initiatives
• The impact of climate change on the water cycle
• The impact of mining activities on local ecosystems
• The impact of wind energy on bird and bat populations
• The effectiveness of bioremediation in cleaning up contaminated soil and water
• The impact of deforestation on local climate patterns
• The impact of climate change on insect populations
• The impact of agricultural runoff on freshwater ecosystems
• The effectiveness of smart irrigation systems in reducing water use
• The impact of ocean currents on marine biodiversity
• The impact of climate change on wetland ecosystems
• The effectiveness of green buildings in reducing energy use
• The impact of climate change on glacier retreat and sea level rise
• The impact of light pollution on nocturnal wildlife behavior
• The impact of climate change on desert ecosystems
• The effectiveness of electric vehicles in reducing greenhouse gas emissions
• The impact of ocean pollution on human health
• The impact of land use change on water quality
• The impact of urbanization on bird populations
• The impact of oil spills on marine ecosystems and wildlife
• The effectiveness of green energy storage technologies in promoting renewable energy use
• The impact of climate change on freshwater availability and water management
• The impact of industrial pollution on air quality and human health
• The effectiveness of urban green spaces in promoting human health and well-being
• The impact of climate change on snow cover and winter tourism
• The impact of agricultural land use on biodiversity and ecosystem services
• The effectiveness of green incentives in promoting sustainable consumer behavior
• The impact of ocean acidification on shellfish and mollusk populations
• The impact of climate change on river flow and flooding
• The effectiveness of green supply chain management in promoting sustainable production
• The impact of noise pollution on avian communication and behavior
• The impact of climate change on arctic ecosystems and wildlife
• The effectiveness of green marketing in promoting sustainable tourism
• The impact of microplastics on marine food webs and human health
• The impact of climate change on invasive species distributions
• The effectiveness of green infrastructure in promoting sustainable urban development
• The impact of plastic pollution on human health and food safety
• The impact of climate change on soil microbial communities and nutrient cycling
• The effectiveness of green technologies in promoting sustainable industrial production
• The impact of climate change on permafrost thaw and methane emissions
• The impact of deforestation on water quality and quantity
• The effectiveness of green certification schemes in promoting sustainable production and consumption
• The impact of noise pollution on terrestrial ecosystems and wildlife
• The impact of climate change on bird migration patterns
• The effectiveness of green waste management in promoting sustainable resource use
• The impact of climate change on insect populations and ecosystem services
• The impact of plastic pollution on human society and culture
• The effectiveness of green finance in promoting sustainable development goals
• The impact of climate change on marine biodiversity hotspots
• The impact of climate change on natural disasters and disaster risk reduction
• The effectiveness of green urban planning in promoting sustainable cities and communities
• The impact of deforestation on soil carbon storage and climate change
• The impact of noise pollution on human communication and behavior
• The effectiveness of green energy policy in promoting renewable energy use
• The impact of climate change on Arctic sea ice and wildlife
• The impact of agricultural practices on soil quality and ecosystem health
• The effectiveness of green taxation in promoting sustainable behavior
• The impact of plastic pollution on freshwater ecosystems and wildlife
• The impact of climate change on plant-pollinator interactions and crop production
• The effectiveness of green innovation in promoting sustainable technological advancements
• The impact of climate change on ocean currents and marine heatwaves
• The impact of deforestation on indigenous communities and cultural practices
• The effectiveness of green governance in promoting sustainable development and environmental justice
• The effectiveness of wetland restoration in reducing flood risk
• The impact of climate change on the spread of vector-borne diseases
• The effectiveness of green marketing in promoting sustainable consumption
• The impact of plastic pollution on marine ecosystems
• The impact of renewable energy development on wildlife habitats
• The effectiveness of environmental education programs in promoting pro-environmental behavior
• The impact of deforestation on global climate change
• The impact of microplastics on freshwater ecosystems
• The effectiveness of eco-labeling in promoting sustainable seafood consumption
• The impact of climate change on coral reef ecosystems
• The impact of air pollution on human health and mortality rates
• The effectiveness of eco-tourism in promoting conservation and community development
• The impact of climate change on agricultural production and food security
• The impact of wind turbine noise on wildlife behavior and populations
• The impact of light pollution on nocturnal ecosystems and species
• The effectiveness of green energy subsidies in promoting renewable energy use
• The impact of invasive species on native ecosystems and biodiversity
• The impact of climate change on ocean acidification and marine ecosystems
• The effectiveness of green public procurement in promoting sustainable production
• The impact of deforestation on soil erosion and nutrient depletion
• The impact of noise pollution on human health and well-being
• The effectiveness of green building standards in promoting sustainable construction
• The impact of climate change on forest fires and wildfire risk
• The impact of e-waste on human health and environmental pollution
• The impact of climate change on polar ice caps and sea levels
• The impact of pharmaceutical pollution on freshwater ecosystems and wildlife
• The effectiveness of green transportation policies in reducing carbon emissions
• The impact of climate change on glacier retreat and water availability
• The impact of pesticide use on pollinator populations and ecosystems
• The effectiveness of circular economy models in reducing waste and promoting sustainability
• The impact of climate change on coastal ecosystems and biodiversity
• The impact of plastic waste on terrestrial ecosystems and wildlife
• The effectiveness of green chemistry in promoting sustainable manufacturing
• The impact of climate change on ocean currents and weather patterns
• The impact of agricultural runoff on freshwater ecosystems and water quality
• The effectiveness of green bonds in financing sustainable infrastructure projects
• The impact of climate change on soil moisture and desertification
• The impact of noise pollution on marine ecosystems and species
• The effectiveness of community-based conservation in promoting biodiversity and ecosystem health
• The impact of climate change on permafrost ecosystems and carbon storage
• The impact of urbanization on water pollution and quality
• The effectiveness of green jobs in promoting sustainable employment
• The impact of climate change on wetland ecosystems and biodiversity
• The impact of plastic pollution on terrestrial ecosystems and wildlife
• The effectiveness of sustainable fashion in promoting sustainable consumption
• The impact of climate change on phenology and seasonal cycles of plants and animals
• The impact of ocean pollution on human health and seafood safety
• The effectiveness of green procurement policies in promoting sustainable supply chains
• The impact of climate change on marine food webs and ecosystems
• The impact of agricultural practices on greenhouse gas emissions and climate change
• The effectiveness of green financing in promoting sustainable investment
• The effectiveness of rainwater harvesting systems in reducing water use
• The impact of climate change on permafrost ecosystems
• The impact of coastal erosion on shoreline ecosystems
• The effectiveness of green infrastructure in reducing urban heat island effect
• The impact of microorganisms on soil fertility and carbon sequestration
• The impact of climate change on snowpack and water availability
• The impact of oil and gas drilling on local ecosystems
• The effectiveness of carbon labeling in promoting sustainable consumer choices
• The impact of marine noise pollution on marine mammals
• The impact of climate change on alpine ecosystems
• The effectiveness of green supply chain management in reducing environmental impact
• The impact of climate change on river ecosystems
• The impact of urban sprawl on wildlife habitat fragmentation
• The effectiveness of carbon trading in reducing greenhouse gas emissions
• The impact of ocean warming on marine ecosystems
• The impact of agricultural practices on water quality and quantity
• The effectiveness of green roofs in improving urban air quality
• The impact of climate change on tropical rainforests
• The impact of water pollution on human health and livelihoods
• The effectiveness of green bonds in financing sustainable projects
• The impact of climate change on polar bear populations
• The impact of human activity on soil biodiversity
• The effectiveness of waste-to-energy systems in reducing waste and emissions
• The impact of climate change on Arctic sea ice and marine ecosystems
• The impact of sea level rise on low-lying coastal cities and communities
• The effectiveness of sustainable tourism in promoting conservation and community development
• The impact of deforestation on indigenous peoples and their livelihoods
• The impact of climate change on sea turtle populations
• The effectiveness of carbon-neutral and carbon-negative technologies
• The impact of urbanization on water resources and quality
• The impact of climate change on cold-water fish populations
• The effectiveness of green entrepreneurship in promoting sustainable innovation
• The impact of wildfires on air quality and public health
• The impact of climate change on human migration patterns and social systems
• The impact of noise pollution on bird communication and behavior in urban environments
• The impact of climate change on estuarine ecosystems and biodiversity
• The impact of deforestation on water availability and river basin management
• The impact of climate change on plant phenology and distribution
• The effectiveness of green marketing in promoting sustainable consumer behavior
• The impact of plastic pollution on freshwater ecosystems and biodiversity
• The impact of climate change on marine plastic debris accumulation and distribution
• The effectiveness of green innovation in promoting sustainable technology development
• The impact of climate change on crop yields and food security
• The impact of noise pollution on human health and well-being in urban environments
• The impact of climate change on Arctic marine ecosystems and biodiversity
• The effectiveness of green transportation infrastructure in promoting sustainable mobility
• The impact of deforestation on non-timber forest products and forest-dependent livelihoods
• The impact of climate change on wetland carbon sequestration and storage
• The impact of plastic pollution on sea turtle populations and nesting behavior
• The impact of climate change on marine biodiversity and ecosystem functioning in the Southern Ocean
• The effectiveness of green certification in promoting sustainable agriculture
• The impact of climate change on oceanographic processes and upwelling systems
• The impact of noise pollution on terrestrial wildlife communication and behavior
• The impact of climate change on coastal erosion and shoreline management
• The effectiveness of green finance in promoting sustainable investment
• The impact of deforestation on indigenous communities and traditional knowledge systems
• The impact of climate change on tropical cyclones and extreme weather events
• The effectiveness of green buildings in promoting energy efficiency and carbon reduction
• The impact of plastic pollution on marine food webs and trophic interactions
• The impact of climate change on algal blooms and harmful algal blooms in marine ecosystems
• The effectiveness of green business partnerships in promoting sustainable development goals
• The impact of climate change on ocean deoxygenation and its effects on marine life
• The impact of noise pollution on human sleep and rest patterns in urban environments
• The impact of climate change on freshwater availability and management
• The effectiveness of green entrepreneurship in promoting social and environmental justice
• The impact of deforestation on wildlife habitat and biodiversity conservation
• The impact of climate change on the migration patterns and behaviors of birds and mammals
• The effectiveness of green urban planning in promoting sustainable and livable cities
• The impact of plastic pollution on microplastics and nanoplastics in marine ecosystems
• The impact of climate change on marine ecosystem services and their value to society
• The effectiveness of green certification in promoting sustainable forestry
• The impact of climate change on ocean currents and their effects on marine biodiversity
• The impact of noise pollution on urban ecosystems and their ecological functions
• The impact of climate change on freshwater biodiversity and ecosystem functioning
• The effectiveness of green policy implementation in promoting sustainable development
• The impact of deforestation on soil carbon storage and greenhouse gas emissions
• The impact of climate change on marine mammals and their ecosystem roles
• The effectiveness of green product labeling in promoting sustainable consumer behavior
• The impact of plastic pollution on coral reefs and their resilience to climate change
• The impact of climate change on waterborne diseases and public health
• The effectiveness of green energy policies in promoting renewable energy adoption
• The impact of deforestation on carbon storage and sequestration in peatlands
• The impact of climate change on ocean acidification and its effects on marine life
• The effectiveness of green supply chain management in promoting circular economy principles
• The impact of noise pollution on urban birds and their vocal communication
• The impact of climate change on ecosystem services provided by mangrove forests
• The effectiveness of green marketing in promoting sustainable fashion and textiles
• The impact of plastic pollution on deep-sea ecosystems and biodiversity
• The impact of climate change on marine biodiversity hotspots and conservation priorities
• The effectiveness of green investment in promoting sustainable infrastructure development
• The impact of deforestation on ecosystem services provided by agroforestry systems
• The impact of climate change on snow and ice cover and their effects on freshwater ecosystems
• The effectiveness of green tourism in promoting sustainable tourism practices
• The impact of noise pollution on human cognitive performance and productivity
• The impact of climate change on forest fires and their effects on ecosystem services
• The effectiveness of green labeling in promoting sustainable seafood consumption
• The impact of climate change on insect populations and their ecosystem roles
• The impact of plastic pollution on seabird populations and their reproductive success
• The effectiveness of green procurement in promoting sustainable public sector spending
• The impact of deforestation on soil erosion and land degradation
• The impact of climate change on riverine ecosystems and their ecosystem services
• The effectiveness of green certification in promoting sustainable fisheries
• The impact of noise pollution on marine mammals and their acoustic communication
• The impact of climate change on terrestrial carbon sinks and sources
• The effectiveness of green technology transfer in promoting sustainable development
• The impact of deforestation on non-timber forest products and their sustainable use
• The impact of climate change on marine invasive species and their ecological impacts
• The effectiveness of green procurement in promoting sustainable private sector spending
• The impact of plastic pollution on zooplankton populations and their ecosystem roles
• The impact of climate change on wetland ecosystems and their services
• The effectiveness of green education in promoting sustainable behavior change
• The impact of deforestation on watershed management and water quality
• The impact of climate change on soil nutrient cycling and ecosystem functioning
• The effectiveness of green technology innovation in promoting sustainable development
• The impact of noise pollution on human health in outdoor recreational settings
• The impact of climate change on oceanic nutrient cycling and primary productivity
• The effectiveness of green urban design in promoting sustainable and resilient cities
• The impact of plastic pollution on marine microbial communities and their functions
• The impact of climate change on coral reef bleaching and recovery
• The impact of deforestation on ecosystem services provided by community-managed forests
• The impact of climate change on freshwater fish populations and their ecosystem roles
• The effectiveness of green certification in promoting sustainable tourism
• The impact of noise pollution on human stress and cardiovascular health
• The impact of climate change on glacier retreat and their effects on freshwater ecosystems
• The effectiveness of green technology diffusion in promoting sustainable development
• The impact of plastic pollution on sea grass beds and their ecosystem services
• The impact of climate change on forest phenology and productivity.
• The effectiveness of green transportation policies in promoting sustainable mobility
• The impact of deforestation on indigenous peoples’ livelihoods and traditional knowledge
• The impact of climate change on Arctic ecosystems and their biodiversity
• The effectiveness of green building standards in promoting sustainable architecture
• The impact of noise pollution on nocturnal animals and their behavior
• The impact of climate change on migratory bird populations and their breeding success
• The effectiveness of green taxation in promoting sustainable consumption and production
• The impact of deforestation on wildlife corridors and ecosystem connectivity
• The impact of climate change on urban heat islands and their effects on public health
• The effectiveness of green labeling in promoting sustainable forestry practices
• The impact of plastic pollution on sea turtle populations and their nesting success
• The impact of climate change on invasive plant species and their ecological impacts
• The effectiveness of green business practices in promoting sustainable entrepreneurship
• The impact of noise pollution on urban wildlife and their acoustic communication
• The impact of climate change on alpine ecosystems and their services
• The effectiveness of green procurement in promoting sustainable agriculture and food systems
• The impact of deforestation on soil carbon stocks and their effects on climate change
• The impact of climate change on wetland methane emissions and their contribution to greenhouse gas concentrations
• The effectiveness of green certification in promoting sustainable forestry and timber production
• The impact of plastic pollution on marine mammal populations and their health
• The impact of climate change on marine fisheries and their sustainable management
• The effectiveness of green investment in promoting sustainable entrepreneurship and innovation
• The impact of noise pollution on bat populations and their behavior
• The impact of climate change on permafrost thaw and its effects on Arctic ecosystems
• The impact of deforestation on ecosystem services provided by sacred groves
• The impact of climate change on tropical cyclones and their impacts on coastal ecosystems
• The effectiveness of green technology transfer in promoting sustainable agriculture and food systems
• The impact of plastic pollution on benthic macroinvertebrate populations and their ecosystem roles
• The impact of climate change on freshwater invertebrate populations and their ecosystem roles
• The effectiveness of green tourism in promoting sustainable wildlife tourism practices
• The impact of noise pollution on amphibian populations and their communication
• The impact of climate change on mountain ecosystems and their biodiversity
• The effectiveness of green certification in promoting sustainable agriculture and food systems
• The impact of deforestation on indigenous peoples’ food security and nutrition
• The impact of climate change on plant-pollinator interactions and their ecosystem roles
• The impact of plastic pollution on freshwater ecosystems and their services
• The impact of climate change on oceanic currents and their effects on marine ecosystems
• The effectiveness of green investment in promoting sustainable transportation infrastructure
• The impact of noise pollution on human sleep quality and mental health
• The impact of climate change on marine viruses and their effects on marine life
• The effectiveness of green labeling in promoting sustainable packaging and waste reduction
• The impact of deforestation on ecosystem services provided by riparian forests
• The impact of climate change on insect-pollinated crops and their yields
• The effectiveness of green procurement in promoting sustainable waste management
• The impact of plastic pollution on estuarine ecosystems and their services
• The impact of climate change on groundwater recharge and aquifer depletion
• The effectiveness of green education in promoting sustainable tourism practices
• The impact of climate change on coral reefs and their biodiversity
• The effectiveness of green labeling in promoting sustainable clothing and textile production
• The impact of deforestation on riverine fish populations and their fishery-dependent communities
• The impact of climate change on mountain water resources and their availability
• The effectiveness of green certification in promoting sustainable tourism accommodations
• The impact of plastic pollution on deep-sea ecosystems and their biodiversity
• The impact of climate change on sea-level rise and its effects on coastal ecosystems and communities
• The effectiveness of green energy policies in promoting renewable energy production
• The impact of noise pollution on human cardiovascular health
• The impact of climate change on biogeochemical cycles in marine ecosystems
• The effectiveness of green labeling in promoting sustainable personal care and cosmetic products
• The impact of deforestation on carbon sequestration and its effects on climate change
• The impact of climate change on wildfire frequency and severity
• The effectiveness of green procurement in promoting sustainable energy-efficient technologies
• The impact of plastic pollution on beach ecosystems and their tourism potential
• The impact of climate change on marine mammals and their habitat range shifts
• The effectiveness of green urban design in promoting sustainable and livable neighborhoods
• The impact of noise pollution on urban human and wildlife communities
• The impact of climate change on soil microorganisms and their roles in nutrient cycling
• The effectiveness of green labeling in promoting sustainable electronics and e-waste management
• The impact of deforestation on watershed services and their effects on downstream ecosystems and communities
• The impact of climate change on human migration patterns and their impacts on urbanization
• The effectiveness of green investment in promoting sustainable water management and infrastructure
• The impact of plastic pollution on seabird populations and their nesting success
• The impact of climate change on ocean acidification and its effects on marine ecosystems
• The effectiveness of green certification in promoting sustainable fisheries and aquaculture
• The impact of noise pollution on terrestrial carnivore populations and their communication
• The impact of climate change on snow and ice dynamics in polar regions
• The effectiveness of green tourism in promoting sustainable cultural heritage preservation
• The impact of deforestation on riverine water quality and their effects on aquatic life
• The impact of climate change on forest fires and their ecological effects
• The effectiveness of green labeling in promoting sustainable home appliances and energy use
• The impact of plastic pollution on marine invertebrate populations and their ecosystem roles
• The impact of climate change on soil erosion and its effects on agricultural productivity
• The effectiveness of green procurement in promoting sustainable construction materials and waste reduction
• The impact of noise pollution on marine mammal populations and their behavior
• The impact of climate change on ocean circulation and its effects on marine life
• The effectiveness of green investment in promoting sustainable forest management
• The impact of deforestation on medicinal plant populations and their traditional uses
• The impact of climate change on wetland ecosystems and their carbon storage capacity
• The effectiveness of green urban planning in promoting sustainable and resilient cities
• The impact of plastic pollution on seabed ecosystems and their biodiversity
• The effectiveness of green certification in promoting sustainable palm oil production
• The impact of noise pollution on bird populations and their communication
• The impact of climate change on freshwater quality and its effects on aquatic life
• The effectiveness of green labeling in promoting sustainable food packaging and waste reduction
• The impact of deforestation on streamflow and its effects on downstream

About the author

Muhammad Hassan

Researcher, Academic Writer, Web developer

You may also like

500+ Criminal Justice Research Topics

300+ Controversial Research Topics

1100+ Research Paper Topics

500+ Qualitative Research Titles and Topics

500+ Astronomy Research Topics

500+ Statistics Research Topics

• Fact sheets
• Facts in pictures
• Publications
• Questions and answers
• Tools and toolkits
• Endometriosis
• Excessive heat
• Mental disorders
• Polycystic ovary syndrome
• All countries
• Eastern Mediterranean
• South-East Asia
• Western Pacific
• Data by country
• Country presence 
• Country strengthening 
• Country cooperation strategies 
• News releases
• Feature stories
• Press conferences
• Commentaries
• Photo library
• Afghanistan
• Cholera 
• Coronavirus disease (COVID-19)
• Greater Horn of Africa
• Israel and occupied Palestinian territory
• Disease Outbreak News
• Situation reports
• Weekly Epidemiological Record
• Surveillance
• Health emergency appeal
• International Health Regulations
• Independent Oversight and Advisory Committee
• Classifications
• Data collections
• Global Health Estimates
• Mortality Database
• Sustainable Development Goals
• Health Inequality Monitor
• Global Progress
• World Health Statistics
• Partnerships
• Committees and advisory groups
• Collaborating centres
• Technical teams
• Organizational structure
• Initiatives
• General Programme of Work
• WHO Academy
• Investment in WHO
• WHO Foundation
• External audit
• Financial statements
• Internal audit and investigations 
• Programme Budget
• Results reports
• Governing bodies
• World Health Assembly
• Executive Board
• Member States Portal
• Health topics /

Environmental health

Healthier environments could prevent almost one quarter of the global burden of disease. The COVID-19 pandemic is a further reminder of the delicate relationship between people and our planet.

Clean air, stable climate, adequate water, sanitation and hygiene, safe use of chemicals, protection from radiation, healthy and safe workplaces, sound agricultural practices, health-supportive cities and built environments, and a preserved nature are all prerequisites for good health.

13.7 million of deaths per year in 2016, amounting to 24% of the global deaths, are due to modifiable environmental risks. This means that almost 1 in 4 of total global deaths are linked to environment conditions. 

Disease agents and exposure pathways are numerous and unhealthy environmental conditions are common, with the result that most disease and injury categories are being impacted. Noncommunicable diseases, including ischaemic heart disease, chronic respiratory diseases and cancers are the most frequent disease outcomes caused.  Injuries, respiratory infections and stroke follow closely.

Our activities to advance the global agenda for building healthier environments for healthier populations include:

• providing leadership on guiding important transitions such as in energy and transport, and stimulating good governance in health and environment;
• ensuring knowledge generation and dissemination for evidence-based norms and efficient solutions, steering research and monitoring change in risks to health and implementation of solutions;
• supporting capacity building and mechanisms for scaling up action in countries, and
• building capacity for emergency preparedness and response in case of environment-related incidents, and provide related guidance on environmental health services and occupational health and safety.
• Heat and health
• Electronic waste (e-waste)
• Estimations of attributable burden of disease due to a risk factor
• Public health and environment
• Monitoring health for the SDGs
• Ambient air pollution
• Household air pollution
• Water, sanitation and health
• Technical Advisory Group on Economics for Environment, Climate Change and Health (TAG-EconECH)
• Health environment and climate change (WHA72.15)
• Environment, Climate Change and Health

WHO announces the 2024 updated Compendium of interventions on environmental health

United Nations Secretary-General calls for global action on extreme heat

SunSmart Global UV App launches with new features to enhance sun protection

Health consequences of air pollution on populations

Latest publications

Enhancing radiation safety culture in health care: guidance for health care providers

Radiation safety culture in health care encompasses every action taken to improve the protection and safety of patients and personnel involved in medical...

Report of a scoping meeting for the selection of indicators to monitor the impact of extreme heat on...

This document summarizes the first meeting of an expert group convened in April 2023.The meeting had two key aims:1) to convene a group of multidisciplinary...

Compendium of WHO and other UN guidance in health and environment, 2024 update

This is the 2024 update of the Compendium of WHO and other UN guidance on health and environment. The Compendium is a comprehensive collection of available...

Universal water, sanitation, hygiene, waste and electricity services in all health care facilities to...

The Framework serves to guide efforts to deliver safe and sustainable water, sanitation and hygiene (WASH), health care waste management and reliable electricity...

Accelerating access to electricity in health-care facilities

Accelerating impact of innovations for health

Accelerating R&D processes

Accessing essential health services in fragile, conflict-affected and vulnerable settings

Features stories

Air pollution: The invisible health threat

The making of the health and environment scorecards

Protecting workers’ health and safety: Online training resources at your fingertips

Ensuring radiological imaging is ethically provided: new WHO policy brief

Dr Tedros video address on occupational and workplace health

Dr Tedros video address on healthy, safe, and resilient workplaces for all

Second global conference on air pollution and health

Cycle Path - 2024 Very Short Film Prize

Infographics

Main Heat Vulnerability Factors

Scale and nature of the health impacts of heat

1 in 4 adults works outdoors: these workers face health risks from pollution and climate change

4 in 5 work-related deaths are caused by diseases

Second Global Conference on Air Pollution and Health

Webinar: Accessing GCF Readiness funds with WHO as the Delivery Partner (TBC)

Webinar: Conducting a gender analysis for climate change and health vulnerability and adaptation assessments

Webinar: Developing a Health National Adaptation Plan: Quality criteria for HNAPs

Country profiles

Related health topics.

Air pollution

Chemical safety

Children's environmental health

Climate change

Health impact assessment

Occupational health

Sustainable development

Ultraviolet radiation

Urban health

Water, sanitation and hygiene (WASH)

• Subscribe to Our Newsletter

Environment

Addressing environmental exposures in air, water, soil, and food, as well as climate change and environmental justice

Environment Headlines

Explore the latest public health research and insights about environment.

The Visible and Unseen Dangers Lurking in Floodwater

As the climate continues to warm, flooding—and its associated health risks—is becoming more common. 

Public Health Prep for the 2024 Paris Olympics

Every four years, the Olympics brings athletes and spectators together from all over the world in one of the largest mass gathering events. Planning begins years in advance, and public health security is a major consideration.

‘Heat Poverty’: A Growing Threat in India

Increasingly extreme heatwaves are forcing India’s most impoverished people into heat poverty as they borrow large sums to buy air conditioners for their homes.

Extreme Heat Hazards

Increasingly frequent extreme heat days are putting more people’s health at risk.

Hurricane Preparedness Tips From Public Health Experts

How to stay safe and healthy before, during, and after a hurricane.

Embrace the Healing Power of Nature

• View more Headlines

Environment Faculty Experts

 Looking for prominent public health experts in the field of environment? They’re here at the Bloomberg School of Public Health.

Marsha Wills-Karp

Marsha Wills-Karp, PhD, researches the environmental determinants of allergic and immune diseases across the lifespan and chairs the Department of Environmental Health and Engineering.

Kellogg J. Schwab

Kellogg Schwab, PhD, integrates engineering, public health, and human behavior by researching water and wastewater contaminants of public health concern.

Alfred Sommer

Alfred Sommer, MD, MHS '73, studies the causes and prevention of childhood micronutrient malnutrition and mortality, and the causes and prevention of blinding diseases.

Brian Schwartz

Brian Schwartz, MD, MS, GME ’90, uses environmental epidemiology to evaluate the drivers of sustainability health impacts, such as energy, agriculture, and built environments.

Departments

Environmental Health and Engineering

Centers & Institutes

Bridging Research, Lung Health & the Environment

Johns Hopkins University Water Institute

Planetary Health Alliance

Upcoming Events

• Open access
• Published: 28 March 2022

Priorities for research on environment, climate and health, a European perspective

• Elina Drakvik 1 , 2 ,
• Manolis Kogevinas   ORCID: orcid.org/0000-0002-9605-0461 3 , 4 , 5 , 6 ,
• Åke Bergman 1 ,
• Anais Devouge 7 &
• Robert Barouki 7

on behalf of the HERA (Health and Environment Research Agenda) Consortium

Environmental Health volume  21 , Article number:  37 ( 2022 ) Cite this article

7525 Accesses

7 Citations

1 Altmetric

Metrics details

Climate change, urbanisation, chemical pollution and disruption of ecosystems, including biodiversity loss, affect our health and wellbeing. Research is crucial to be able to respond to the current and future challenges that are often complex and interconnected by nature. The HERA Agenda, summarised in this commentary, identifies six thematic research goals in the environment, climate and health fields. These include research to 1) reduce the effects of climate change and biodiversity loss on health and environment, 2) promote healthy lives in cities and communities, 3) eliminate harmful chemical exposures, 4) improve health impact assessment and implementation research, 5) develop infrastructures, technologies and human resources and 6) promote research on transformational change towards sustainability. Numerous specific recommendations for research topics, i.e., specific research goals, are presented under each major research goal. Several methods were used to define the priorities, including web-based surveys targeting researchers and stakeholder groups as well as a series of online and face-to-face workshops, involving hundreds of researchers and other stakeholders. The results call for an unprecedented effort to support a better understanding of the causes, interlinkages and impacts of environmental stressors on health and the environment. This will require breakdown of silos within policies, research, actors as well as in our institutional arrangements in order to enable more holistic approaches and solutions to emerge. The HERA project has developed a unique and exciting opportunity in Europe to consensuate priorities in research and strengthen research that has direct societal impact.

Peer Review reports

Climate change, urbanisation, chemical pollution and disruption of ecosystems, including biodiversity loss, impact our health and quality of life. Research is instrumental to be able to respond to the current and future environmental and health challenges that are so complex and interlinked by nature. The European Commission (EC), in line with policies of the European Union and the United Nations Sustainable Development Goals [ 1 ], launched a call for proposals to define priorities for research on environment, climate and health [ 2 ]. The Health and Environment Research Agenda (HERA) project, emerging from that call, was developed by a European consortium, and recently submitted its final report entitled “EU research agenda for the environment, climate & health, 2021–2030” [ 3 ], summarised in this commentary. The HERA Agenda highlights several key areas where further research is crucial for the next decade. This article provides a topical contribution to discussion of environmental health priorities and provides opportunities to reflect on future directions of research in this field, especially in the European context.

Process for developing the European research agenda

The approach that the project followed was based on principles of transparency, inclusiveness and mutual learning [ 4 ]. During the course of the project, the HERA Consortium performed extensive reviews of current knowledge, policies and research activities (Fig.  1 ). Web-based surveys targeting research communities and other stakeholder groups were carried out, along with online and face-to-face workshops, which taken together, involved hundreds of participants. Researchers primarily identified major current areas of concern, i.e. air pollution, chemicals, climate, cities, as priorities for research. Other stakeholders mostly identified implementation science and global issues (e.g. climate change, biodiversity loss) as priorities. The stakeholder process and results are described in detail in Paloniemi et al. [ 5 ]. Responses from the surveys and workshops were discussed by the HERA working group that further identified “Gaps in gaps”, namely research areas that are not well developed but that were not identified by the researchers’ survey. Research goals were prioritised by the HERA working group using the following criteria (modified from [ 6 ]): Novelty; Importance to People, Importance to the environment on a planetary scale; Impact on Policy; and, Innovation and Sustainable Development. A consensus-based approach was used for agreeing and refining the research goals along the process, based on the input and expertise of the HERA Consortium members, editorial group and independent scientific advisory board as well as input received through a public consultation.

HERA framework for engaging stakeholders and scientist in the definition of Research goals (RG) for the research agenda

The EU research agenda for the environment, climate & health, 2021–2030

The EU Research Agenda developed by the HERA project covers six major research goals on environment, climate and health. Within each of them, research areas were identified and research needs specified resulting in altogether 30 specific research goals (Table 1 ). Several of the research goals are interlinked e.g. air-pollution is identified as a priority in the global environment (Research Goal 1.6 Global pollution) and the local environment, cities and communities (Research Goal 2.2 Air pollutants in indoor and outdoor environments). Moreover, the Research Agenda addresses research that can contribute to relevant policy objectives promoting health and the environment, especially in the context of the European Green Deal [ 7 ]. The Green Deal aims at achieving climate neutrality, biodiversity preservation, a circular economy and a zero pollution/toxic-free ambition as well as providing a way forward for achieving sustainable food system. The HERA agenda and the identified research needs can hence strengthen the knowledge and evidence-base in these cross-cutting policy areas, directly supporting the implementation of the Green Deal.

The six overarching Research Goals

Research goal 1 “Climate change and biodiversity loss – reduce effects on health and the environment” focuses on global interconnected issues. The consequences of climate change, biodiversity loss, disruption of food chains, emerging infectious diseases and decreased ecosystem services on health are not well understood despite evidence that they have major and persistent effects on life and the environment globally that became evident from the COVID-19 pandemic. Furthermore, more attention is required for addressing pollution, including air pollution, at a global scale. The need to promote research for effective policies on mitigation and adaptation is identified as of paramount importance, as well as investigating co-benefits with air pollution mitigation policies. Overall, the research goal highlights the need for holistic approaches such as One Health and Planetary Health.

Research goal 2 “Cities and communities – promote healthy lives in sustainable and inclusive societies” focuses on problem-based research. Living conditions in urban environments are of key concern as they impact the health and wellbeing of most European citizens. The impacts of environmental factors (e.g. air pollution, noise, digitalisation), may vary in different contexts such as the urban environment workplace or contaminated land. Research should examine the complex relationships in these environments, and evaluate and promote positive interventions.

Research goal 3 “ Chemicals and physical stressors – prevent and eliminate harmful chemical exposures to health” focuses on chemicals, other stressors and environmental media. There are still many unknowns on the hazards and risks related to stressor families including chemicals and mixtures, physical stressors such as radiation (ranging from ionising to light exposure), and the role played by the various environmental media carrying these stressors such as water. Research should cover the tens of thousands of chemicals in daily usage that we have very little health information on and interactions of environmental exposures with other factors such as genes, occupation, political and socioeconomic determinants of health, a theme covered also in RG6 on interdisciplinary research. Regulatory decisions rely heavily on additional knowledge in these specific areas. Research should effectively address the challenges of a zero pollution paradigm and a sustainable future.

Research goal 4 “Improve health impact assessment of environmental factors and promote implementation research” focuses on the need to develop new harmonized methodologies to evaluate the burden of environmental and climate change on health and to identify and assess the health benefits of human environmental interaction. Moreover, research should promote optimal ways to implement science-based decisions and policies as this is a limiting factor in many fields.

Research goal 5 “Develop infrastructures, technologies and human resources for sustainable research on environment, climate change and health” focuses on the need of European research infrastructures to be strengthened and further developed. Infrastructures provide a basis for excellent research. Key proposals are establishing harmonized coordination of ongoing large cohort studies including tens of millions of participants, exposome characterization, laboratory infrastructure, data analysis using the latest data science tools, new methods for exposure assessment (e.g. sensors) and planetary monitoring tools.

Research goal 6 “Promote research on transformational change in environment, climate change and health” focuses on the need of transformational change to address the intertwined environmental, social and health issues and reach critical global goals towards sustainability and equity. Societies will need to adapt to the challenges elicited by environmental stressors and climate change and this will require significant transformation of individual and collective behaviour and of policy making across the sectors and silos. Development of research approaches directed to finding and promoting workable solutions together is necessary for achieving such transformations.

Conclusions—a vision for future research

It is striking how the HERA surveys and stakeholder consultations pointed out such a large number of knowledge gaps, even in areas such as climate change where relevant evidence-based policies are urgently needed. The ambitious political goals set in the UN Agenda for Sustainable Development and the European Green Deal, will need major investments in research and innovation. The HERA Agenda coincides with the reports highlighting the planetary boundaries [ 8 , 9 ], and intertwined environmental pressures, the triple planetary crisis: climate change, biodiversity loss and pollution, affecting the health of the planet and of the people [ 10 ]. The Agenda reinforces the opportunity to bring together human health and environment field to work together on integrated and transformative solutions. The focus is on Europe, hence putting less emphasis on major exposures, such as indoor air pollution from biomass, that are much more prevalent in low- and middle-income countries. In fact, there is an urgent need to also develop a global Agenda since most of the problems and solutions discussed in HERA are not limited to Europe. In recent years, increases in the EU allocation to environment and health projects through the Framework Programme budgets and rise in the interest and importance of the field ([ 11 ], see page 65), have not yet managed to close the long-term gap that exists between required research and funding. It is a positive signal that the HERA Agenda has already been applied by the European Commission in recent calls for funding, as for example calls for the indoor environment, or planned calls on planetary health or the interlink of infections and the environment. Nevertheless, the vision for future research underlying this Agenda calls for an unprecedented effort to support a better understanding of the causes, interlinkages and impacts of environmental determinants on health. Integrated and holistic research should support policies and practices to protect and promote human health and well-being while simultaneously improving the critical state of the environment, including climate change mitigation and ecosystem restoration, in Europe and globally. This requires transformational change at societal level to break down the silos in policymaking, research, and institutional arrangements, enabling cross-sectoral, interdisciplinary and holistic approaches and solutions to emerge.

Availability of data and materials

Not applicable.

UN (2016): UN Agenda for Sustainable Development https://www.un.org/sustainabledevelopment/development-agenda/ . Accessed 25 Nov 2021.

EC (2018): Setting the priorities for a European environment, climate and health research agenda SC1-HCO-13–2018: https://ec.europa.eu/info/funding-tenders/opportunities/portal/screen/opportunities/topic-details/sc1-hco-13-2018 . Accessed 25 Nov 2021.

HERA Agenda (2021): https://www.heraresearcheu.eu/hera-2030-agenda ) Accessed 25 Nov 2021.

HERA Agenda Annex (2020): Interim document. https://static1.squarespace.com/static/5d6d2b4f677cfc00014c7b53/t/5e8da0050340080865cbbe8e/1586339855357/Annex+1.pdf . Accessed 25 Nov 2021.

Paloniemi R. et al. (2022): A transformative research approach addressing the interface between health, environment and climate: the state of European policy and practice (Submitted for review)

Kogevinas M. Setting priorities in environmental health research. Environ Epidemiol. 2017;1: e001. https://doi.org/10.1097/EE9.0000000000000001 .

Article   Google Scholar  

EC (2019): The European Green Deal. https://ec.europa.eu/info/strategy/priorities-2019-2024/european-green-deal_en . Accessed 25 Nov 2021.

Steffen W, Richardson K, Rockstrom J, Cornell SE, Fetzer I, Bennett EM, Biggs R, Carpenter SR, de Vries W, de Wit CA, Folke C, Gerten D, Heinke J, Mace GM, Persson LM, Ramanathan V, Reyers B, Sorlin S. Planetary Boundaries: Guiding Human Development on a Changing Planet. Science. 2015;347(6223):1259855–1259855. https://doi.org/10.1126/science.1259855 .

Article   CAS   Google Scholar  

Persson L, Almroth C, Collins CD, Cornell S, de Wit C, et al. Outside the Safe Operating Space of the Planetary Boundary for Novel Entities. Environ Sci Technol. 2022. https://doi.org/10.1021/acs.est.1c04158 .

UNEP (2021): Making Peace with Nature: A scientific blueprint to tackle the climate, biodiversity and pollution emergencies. Nairobi. https://www.unep.org/resources/making-peace-nature . Accessed 11 Feb 2022.

Karjalainen T. (2021): European research on environment and health. Projects funded by Horizon 2020 (2014–2020). https://op.europa.eu/en/publication-detail/-/publication/03a2c022-9c01-11eb-b85c-01aa75ed71a1/language-en/format-PDF/source-199503195#document-info . Accessed 25 Nov 2021.

Download references

Acknowledgements

The HERA project was completed with the contributions of hundreds of researchers and stakeholders. HERA participants Robert Barouki (French National Institute of Health and Medical Research-INSERM), Manolis Kogevinas (Barcelona Institute for Global Health -ISGlobal), Åke Bergman (Stockholm University-SU), Elina Drakvik (SU) and Anaïs Devouge (INSERM)—drafted the HERA Agenda, 2021, with extensive contributions from Denis Sarigiannis (Aristotle University of Thessaloniki); Delphine Destoumieux-Garzón (The National Center for Scientific Research- CNRS); Franziska Matthies-Wiesler, Annette Peters (Helmholtz Zentrum München);Daniel Zalko (French National Institute for Agricultural Research-INRAE); Cristina Villanueva, Cathryn Tonne, Elisabeth Cardis, Elizabeth Diago-Navarro, Josep M. Antó, Maria Foraster, Mark Nieuwenhuijsen; Kurt Straif (ISGlobal); Karin van Veldhoven, Kristine Belesova, Neil Pearce, Andy Haines (London School of Hygiene & Tropical Medicine); Jana Klánová, Kateřina Šebková, Lukáš Pokorný, Klára Hilscherová (Masaryk University); Sandra Boekhold, Brigit Staatsen, Nina van der Vliet (National Institute for Public Health and The Environment-RIVM); Eeva Furman, Riikka Paloniemi, Aino Rekola, Marianne Aulake (Finnish Environment Institute-SYKE); Vivienne Byers, Alan Gilmer (Technological University of Dublin); Anke Huss, Roel Vermeulen (Utrecht University); Rémy Slama, Michel Samson (INSERM), (Sinaia Netanyahu, Julia Nowacki (WHO). Other contributors to the HERA agenda writing include Maria Albin (Karolinska Institutet), Åke Grönlund (Örebro University), and Jeanne Garric (French ministry of research)

The HERA project was funded from the European Union’s Horizon 2020 research and innovation programme under grant agreement No 825417.

Author information

Authors and affiliations.

Department of Environmental Science, Stockholm University, Stockholm, Sweden

Elina Drakvik & Åke Bergman

Department of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden

Elina Drakvik

ISGlobal, Barcelona, Spain

Manolis Kogevinas

CIBER Epidemiologia Y Salud Pública (CIBERESP), Madrid, Spain

Universitat Pompeu Fabra (UPF), Barcelona, Spain

IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain

Université de Paris, Inserm Unit, 1124, Paris, France

Anais Devouge & Robert Barouki

You can also search for this author in PubMed   Google Scholar

• Robert Barouki
• , Manolis Kogevinas
• , Åke Bergman
• , Elina Drakvik
• , Anaïs Devouge
• , Denis Sarigiannis
• , Delphine Destoumieux-Garzón
• , Franziska Matthies-Wiesler
• , Annette Peters
• , Daniel Zalko
• , Cristina Villanueva
• , Cathryn Tonne
• , Elisabeth Cardis
• , Elizabeth Diago-Navarro
• , Josep M. Antó
• , Maria Foraster
• , Mark Nieuwenhuijsen
• , Kurt Straif
• , Karin van Veldhoven
• , Kristine Belesova
• , Neil Pearce
• , Andy Haines
• , Jana Klánová
• , Kateřina Šebková
• , Lukáš Pokorný
• , Klára Hilscherová
• , Sandra Boekhold
• , Brigit Staatsen
• , Nina van der Vliet
• , Eeva Furman
• , Riikka Paloniemi
• , Aino Rekola
• , Marianne Aulake
• , Vivienne Byers
• , Alan Gilmer
• , Anke Huss
• , Roel Vermeulen
• , Rémy Slama
• , Michel Samson
• , Maria Albin
• , Åke Grönlund
•  & Jeanne Garric

Contributions

All authors contributed equally to the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Manolis Kogevinas .

Ethics declarations

Ethics approval and consent to participate, consent for publication, competing interests.

The authors declare that they have no competing interests.

Additional information

Publisher's note.

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ . The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/ ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and permissions

About this article

Cite this article.

Drakvik, E., Kogevinas, M., Bergman, Å. et al. Priorities for research on environment, climate and health, a European perspective. Environ Health 21 , 37 (2022). https://doi.org/10.1186/s12940-022-00848-w

Download citation

Received : 27 December 2021

Accepted : 10 March 2022

Published : 28 March 2022

DOI : https://doi.org/10.1186/s12940-022-00848-w

Share this article

Anyone you share the following link with will be able to read this content:

Sorry, a shareable link is not currently available for this article.

Provided by the Springer Nature SharedIt content-sharing initiative

• Research agenda
• Impact assessment
• Infrastructures
• Transformational change

Environmental Health

ISSN: 1476-069X

• General enquiries: [email protected]

Warning: The NCBI web site requires JavaScript to function. more...

An official website of the United States government

The .gov means it's official. Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you're on a federal government site.

The site is secure. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

• Publications
• Account settings
• Browse Titles

NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.

Toward a Future of Environmental Health Sciences

National Academies of Sciences, Engineering, and Medicine; Division on Earth and Life Studies; Board on Environmental Studies and Toxicology; Board on Life Sciences ; Anne Johnson , Rapporteur.

• Copyright and Permissions
• INTRODUCTION

What could the future of environmental health sciences hold, and what steps might be taken now to guide the field's trajectory? To envision a future research enterprise that integrates environmental health sciences, biomedical science, prevention research, and disease-specific research across the continuum from fundamental discovery research through the application of this research to population health, the National Academies of Sciences, Engineering, and Medicine hosted a workshop titled Towards a Future of Environmental Health Sciences on April 26–27, 2022.

In presentations and structured discussions, panelists explored expanding the mental model (a representation of how something works) and normalizing the language of environmental health, along with frameworks for identifying the breadth of stakeholder diversity needed. The panelists took a scenario-based approach to envision an integrated research enterprise, explore possible routes to reach this research future, and examine key scientific, technical, and policy gaps. The scenario-based exercises 1 were designed to facilitate a welcoming space for an open discussion across different perspectives. The virtual event convened speakers and panelists from government, academia, and community and nonprofit organizations with expertise in environmental health sciences, environmental justice, social and behavioral sciences, biomedical science, public health, and policy. This Proceedings of a Workshop—in Brief provides the rapporteur's high-level summary of the topics addressed in the workshop, including participants' suggestions for advancing research, improving models, and approaches to integrating environmental health across research areas and applications. Additional materials, including recordings from the workshop, are available online. 2 This proceedings highlights potential opportunities for action but these should not be viewed as consensus conclusions or recommendations of the National Academies of Sciences, Engineering, and Medicine.

Workshop Impetus and Organization

Kim Boekelheide (Brown University) set the stage for the discussions. The workshop was organized under the purview of the National Academies' Standing Committee on the Use of Emerging Science for Environmental Health Decisions, which examines issues regarding the use of new science, tools, and research methodologies for environmental health decisions. In addition to providing a venue for exchange among the scientific community, the Standing Committee's activities also help to inform government agencies on emerging issues and science in the area of environmental health. As part of a broader effort to gather input to envision the future of the environmental health sciences field, Boekelheide described the workshop's objective of exploring the 10-year horizon for environmental health sciences and the near-term research activities that can contribute to that future.

PART 1: SCANNING THE ENVIRONMENTAL HEALTH HORIZON

The first part of the workshop focused on envisioning examples of future priorities and directions for the field of environmental health sciences. Speakers discussed the 10-year horizon for the field overall and examined particular considerations for advancing knowledge and decision making in precision medicine, environmental justice and the exposome, 3 and climate change and health.

• EMERGING TRENDS AND PRIORITIES

To open the workshop and set the stage for the discussions to follow, Melissa Perry (George Washington University) moderated a panel focused on envisioning the 10-year horizon for redesigning environmental health sciences. Panelists Kristen Malecki (University of Wisconsin–Madison), Nicky Sheats (Kean University), Andrew Geller (U.S. Environmental Protection Agency [EPA]), and Kate Marvel (Columbia University and NASA Goddard Institute for Space Studies) highlighted key research questions and directions as well as technologies and methodologies needed to enable progress in these areas.

In outlining her vision for the future of environmental health sciences, Malecki emphasized systems thinking, translational research, and equity. While the traditional environmental health paradigm connects the dots between hazards exposures and the development of disease, Malecki said that emerging tools and technologies open opportunities to consider more upstream factors and understand the hallmarks of disease risk before disease starts. A broader, more systems-level paradigm suggests a need for enhanced tools to address the complex interplay among the chemical environment, the built environment, the social environment, and individual behaviors.

Pointing to the dramatic health disparities across U.S. populations—evident in patterns of expected lifespan at birth and exacerbated by the COVID-19 pandemic 4 —Malecki stressed the need to capture the unique drivers of disease susceptibility with an equity lens and identify what steps might be taken to protect groups with the highest vulnerability. She noted that emerging innovations present opportunities to advance predictive toxicology and reduce the reliance on animal models; to elucidate the role of the gut microbiome; and to continue to expand understanding of how multiple exposures interact. Highlighting the National Institute of Environmental Health Sciences (NIEHS) environmental health research translation framework, 5 she underscored the importance of translating environmental health sciences insights not only into clinical practice but also into communities. “Looking to the future of environmental health, we need to capitalize on past successes and strengths to advance new areas of environmental health sciences through innovation, translation, and equity,” she said.

Sheats outlined how focusing on cumulative impacts can form the basis for a community-centered, multidisciplinary approach to environmental health and environmental justice. “Cumulative impacts can be arguably thought of as the preeminent environmental justice issue in the country,” he said, defining cumulative impacts as the combined effects of multiple pollutants, usually from multiple sources, as they interact with social and other factors in the community. The current regulatory framework addresses individual pollutants, but communities can experience impacts from cumulative exposures even if no individual pollutant standard is violated. Compounding this challenge is the fact that the cumulative amount of pollution a person is exposed to in the United States is connected with race and income, leading to a disproportionate pollution load and contributing to persistent health disparities across groups. A focus on cumulative impacts captures this complexity by spanning not only the pollutants people are exposed to but also the social factors that may contribute to a community's vulnerability to adverse health impacts from those exposures, Sheats said.

Expanding further on the theme of social determinants of health, Geller outlined his vision for a future of environmental health sciences that more fully addresses groups' vulnerability to environmental stressors and health disparities. Because social determinants of health can exacerbate the impacts of environmental exposures, he stressed that reducing vulnerability is critical to reducing health disparities: “The challenge is not simply environmental health, but understanding and eliminating health disparities,” he said.

Noting that EPA defines cumulative impacts as the total burden of health-affecting conditions or circumstances on an individual or community, Geller said that there is a need for more data relevant to incorporating vulnerability into exposure and risk estimates, including through epidemiological studies that reflect the full diversity of the U.S. population. He said to move from the traditional chemical risk assessment paradigm toward a more complex view that incorporates non-chemical stressors, it will be useful to define the constellation of environmental and social factors relevant to identifying “vulnerable” phenotypes, which in turn helps to identify groups that experience accelerated aging and health disparities. In this way, the notion of cumulative social stress, operationalized as molecular biomarkers like epigenetics, provides a framework to move from a single-exposure, single-outcome approach to a more nuanced, context-sensitive perspective to inform decision making.

Climate change is causing a wide range of health impacts in communities around the world. To provide a basis for the workshop discussions on how the field of environmental health sciences can best contribute to knowledge and decision making around climate and health, Marvel outlined the physical science basis for climate change and its impacts. She emphasized the scientific consensus that humans are responsible for observed warming trends, largely through greenhouse gas emissions, and noted that the addition of aerosols, such as particulate matter pollutants, also plays an important role in the physical processes under way in the atmosphere, as well as having important health effects. She discussed how climate change is increasing the frequency and severity of extreme weather events, such as heat waves, downpours, and hurricanes, as well as contributing to sea-level rise and its subsequent impacts.

While she said it is too late to prevent the near-term impacts of climate change, Marvel stressed that the actions taken today do make a difference for the longer-term impacts of climate change. In addition, she highlighted that many climate mitigation strategies have co-benefits for health and other factors that communities can begin to reap in the near term. In the discussion, Sheats added that decision makers and communities should prioritize policies that have co-benefits for addressing climate change and curbing the disproportionate impacts of greenhouse gas emissions in environmental justice communities. To advance the science and inform decision making, Marvel added that it will be important to have effective dialogue between climate scientists and the environmental health community to help identify what questions physical scientists should focus on.

The panelists discussed the evolving conceptions of what defines environmental health sciences and cumulative impacts, as well as how existing and emerging knowledge and tools can be leveraged to move the needle on improving population health. Malecki said a critical shift for environmental health is an increasing focus on prevention—opening opportunities to be proactive, rather than reactive, in preventing harmful exposures before they occur. For example, she posited that –omics (e.g., genomics, transcriptomics, proteomics, metabolomics) technologies are posed to advance understanding of cumulative risk and could also be used to derive molecular signatures of the body burdens of emerging chemicals. Geller added that there is a growing emphasis on forms of knowledge beyond traditional data sources, recognizing the value of a community's knowledge and history, economic data, and other forms of information that are relevant to a community's own goals. As communities and scientists continue to improve the tools and amass knowledge, Sheats added that it is important to continue to make decisions even when the information is incomplete or the tools are not fully mature. “We don't have to have perfect knowledge before we act on the knowledge that we do have,” Sheats concluded.

• ENVIRONMENTAL HEALTH AND PRECISION MEDICINE

Building on the discussion of the 10-year horizon, panelists Julia Brody (Silent Spring Institute), Brandon Pierce (University of Chicago), Elena Rios (National Hispanic Medical Association), and Alicia Zhou (Color Health) discussed the frameworks, people, and approaches that may help to address opportunities and challenges in integrating environmental and exposures data into precision medicine. Weihsueh Chiu (Texas A&M University) moderated the session, which used the scenario of a patient's interaction with their primary care physician to envision how access to –omics data, environmental and exposures data, and lifestyle and behavioral information could inform a better understanding of health conditions within a family or neighborhood. In brief introductory remarks, Brody outlined her vision for a decision framework based on identifying relevant exposures, integrating exposure measurements into routine care, and using the results to enable personalized exposure reduction, targeted medical monitoring, and public health surveillance. She said that equity and community-engaged partnerships are critical to environmental health studies and interventions, highlighting examples of effective coalitions from studies of chemical exposures and breast cancer and fire retardant chemicals. To connect research with individual decision making, she added that it is vital for researchers to make results available to participants and offer contextual information about what is important and what individuals can do with the knowledge gained.

Pierce and Zhou described innovative approaches to tracing gene–environment linkages and feeding that information back to individuals to help inform decision making. Pierce highlighted his studies of arsenic exposure in Bangladesh, which are designed to help people determine whether they may face an increased risk of health effects from their personal level of arsenic exposure. Zhou described how her organization takes a genotype-first approach to predict how a person's genes might influence their phenotype and to identify opportunities to prevent certain health problems before they emerge. She said that by generating clinical-grade information that has value for patients and physicians that this approach can shed light on individual susceptibility and inform interventions to reduce the burden of key diseases, such as cancer and heart disease.

Precision medicine approaches have both benefits and potential pitfalls in the context of disparities in health and environmental health. Pointing to her work with Hispanic communities, Rios underscored the need for policies to reduce exposures and increase the involvement of underrepresented communities in research, including through thoughtful training for researchers aiming to work with communities that have a different social or ethnic background than their own. Brody noted that building trust with communities is essential; she said that researchers should attend to privacy risks in data collection and take steps to ensure that the data are used for the benefit of the individuals and avoid fueling stigmatization. Zhou added that it is important to collect data in an unbiased way, for example, by ensuring that the devices used to measure exposures are effectively deployed across all communities and not only concentrated in affluent areas. She said unconscious bias has contributed to major knowledge gaps, including a dearth of exposure data in many rural communities. Rios urged a focus on community-based research, and Pierce added that a community's goals and priorities should take a lead role in setting the research agenda itself.

Exploring the scenario posed to them and questions submitted by attendees throughout the discussion, the panelists considered how physicians could utilize a variety of data sources to provide actionable information for patients. Brody speculated that 10 years from now there will be more exposure monitoring devices in the environment, offering a clearer picture of the exposures that may be relevant to a particular patient. Rios said that one challenge for precision medicine tools of the future will be to not only identify likely exposures but also to correlate exposure times and locations.

Brody noted that some automated tools are being developed to help clinicians access relevant and meaningful exposure information, adding that there are also opportunities for researchers and clinicians to use wearables or other emerging technologies for personalized exposure monitoring. Despite the promise of these approaches, she said that it is important not to oversell what they can offer. “We need to share the information that we know—and also let people know what we do not know,” she said. Zhou added that inconsistencies in the terminology used for environmental exposures and health impacts can lead to confusion among clinicians and ultimately patients. She suggested that the research community should play a lead role in establishing a shared framework and nomenclature that is consistent and understandable.

To realize the promise of precision medicine for environmental health, the panelists pointed to several examples of priorities for research, funding, and collaboration. Pierce and Zhou underscored the value of leveraging large collections of data from diverse populations to extract meaningful information about exposures. Zhou added that this will require investments in data infrastructure, which can be costly but is critical to maintain. Rios suggested identifying which communities face the highest risks and prioritizing research funding and policy interventions accordingly. She also stressed the importance of building trust within the community and finding actionable solutions and clear messages to effect real change. “We have to think in terms of policies that can help with changing behavior,” she concluded.

• ENVIRONMENTAL JUSTICE AND THE EXPOSOME

How might information about the exposome be operationalized to address environmental justice issues? In this session, the panelists examined frameworks, stakeholders, and approaches needed to address challenges related to health disparities as well as to advance environmental justice over the next 10 years. The panelists included Aisha Dickerson (Johns Hopkins University), Sacoby Wilson (University of Maryland), Robert Wright (Icahn School of Medicine at Mount Sinai), and Ami Zota (George Washington University); Chandra Jackson (NIEHS) moderated the discussion. As a starting place, the panelists focused on the scenario of predominantly African American communities adversely affected by swine industrial livestock operations in Eastern North Carolina. Given the availability of comprehensive data on biomarkers of dietary, chemical, and pollution exposures, the panelists discussed how policy makers, environmental scientists, and community members might leverage this information to develop a plan for remediation and address environmental justice concerns in the affected community.

Emerging –omics tools offer opportunities to characterize the exposome and advance cumulative risk assessment. Wilson said that these technologies can help to close the gaps where knowledge of the health impacts of exposures is not keeping pace with the exposures people are experiencing. He posited that –omics data, which have proved instrumental in helping communities document harm in some cases, should be incorporated into cumulative risk assessment. Building on this point, Zota said that researchers need to focus on intersectionality and combine qualitative data with exposome measurements. Noting that risk assessments often focus on particular disease outcomes but fail to account for the ways disease outcomes influence each other, Wright suggested that risk assessment approaches should also take a cumulative approach to outcomes. “We think of the exposures as mixtures; in fact, the outcomes are also mixtures but we rarely think of them that way,” he said.

The panelists said that environmental justice communities are eager to shift from characterizing or drawing attention to problems to actually taking steps to address them. “Doing good science is not enough to actually move us toward justice and equity—we have to do something with the science,” Zota said. “That takes work; that takes innovation; that takes community engagement. It cannot be an afterthought.”

When the goal is to influence action, Dickerson pointed out that it is helpful to establish priorities, rather than simply creating lists of problems. Translating research into solutions requires disseminating evidence to politicians and community members who are in a position to take action, she said, and it requires that funding agencies support solutions-oriented research. Zota and Wilson added that coalition building and communication are essential to generating the political will to act. This could entail bringing together stakeholders who have an interest in the problem, as well as using traditional media, social media, and other channels to amplify the voices and concerns of those stakeholders. “We have to do better in increasing the accessibility of our information,” Zota said. She and Wright also noted that the approach to communication should be inclusive and appropriate for the intended audience, recognizing that some groups may be better reached through physical outreach in the community; others will be better reached through traditional media channels; and others can be effectively engaged via social media. Wilson added that metrics, such as environmental justice scorecards, can also resonate with politicians and community groups to help spur advocacy and track progress.

Panelists noted that listening to communities is essential. Wright cautioned that even when a problem seems clear-cut, listening to the community's concerns can surface important considerations. For example, designating an area as a Superfund site can influence property values and create a stigma; while residents may have an interest in having the site cleaned up, researchers should not assume they would be in favor of a Superfund designation. “Nothing is ever unanimous,” Wright said. “There are going to be competing voices, and we do need to listen to them.” Zota added that community input is also critical in informing what research questions to study, pointing to a need for more bidirectional communication between researchers and communities to elucidate how exposome research could fit with community priorities.

Looking forward, Wright speculated that low-cost, accessible sensors and mapping tools will help to enable more community-based research and allow many communities to take the lead role in gathering and using their own data. Dickerson added that it is important not only to develop these tools but also to disseminate them effectively; many people simply are not aware of resources such as free water testing kits available from health departments or EPA's environmental justice screening and mapping tool. 6 In addition to awareness, Zota and Wilson said that for communities to fully engage with researchers and public health organizations also requires building trust, which can pose special challenges for communities that have historically faced discrimination in science and health care. To build that trust, Wilson said that it is important for researchers to focus on solutions in areas communities care about. “You have to connect the issues you are working on … to the stuff that is important to folks: food, faith, family, health, and jobs,” said Wilson. “It just cannot be the discovery science. It has to be at the point where you have good investment in engagement and good investment in solutions.”

Zota noted that while there are good publicly accessible tools available for some types of exposures, actual exposome data such as biomarkers are not something most people can readily obtain, making cost and accessibility important barriers to translating these types of data to awareness and decision making. Wright added that researchers also face barriers in using these data to derive insights and suggested that federal agencies could fund databases and other tools to help toxicologists and epidemiologists better understand exposome data. “Until we make that investment so that we actually have the tools to actually interpret exposomic data, it is going to be really hard when you measure 10,000 things to know what is important and what is not,” he said.

• CLIMATE CHANGE AND HEALTH

Climate change has many impacts on the health of individuals and communities. Patrick McMullen (ScitoVation) moderated a discussion among Karen Bailey (University of Colorado Boulder), Christine K. Johnson (University of California, Davis), Patrick Kinney (Boston University), and Na'Taki Osborne Jelks (Spelman College) focused on new frameworks, people, and inclusive approaches that may be helpful to incorporate science into climate adaptation, policy planning, and public health in inclusive and equitable ways. Panelists considered the scenario of allocating a $1 billion budget for community-driven initiatives to help address climate change and related health issues nationwide, with particular attention to wildfires and their impact on air quality, severe drought and its impact on farmers and rural communities, and the impacts of other severe weather events such as flooding and extreme winter storms.

Health and climate intersect on a range of fronts. Johnson discussed how climate change and related shifts in land use are creating new opportunities for interaction between people and wild animals, raising the risk of zoonotic disease transmission. To track these impacts at the local scale and enable better surveillance for early detection of emerging infectious diseases, Johnson said it will be important to closely integrate animal, human, and environmental research, taking advantage of technological innovations such as precision medicine and remote data collection and emphasizing community-driven and citizen science approaches. In addition to infectious diseases, climate change brings health risks from extreme heat, exposure to contaminated floodwaters, increased pollen production, increased air pollution, severe weather events, and other pathways. Kinney said that the breadth of these impacts suggests a need to expand the scope of environmental health sciences beyond the traditional molecular-scale focus and forge stronger links with atmospheric scientists, social scientists, policy makers, and communities.

Intersectionality and interdisciplinarity will likely be critical to advancing solutions-oriented research surrounding climate and health. Bailey said that siloing can exacerbate challenges. An interdisciplinary team science approach in research studies can lead to solutions. Osborne Jelks added that the cumulative nature of many health impacts of climate change also elevates the importance of intersectionality. Climate change has the potential to exacerbate the negative health impacts that many people already experience from both chemical hazards and social factors over the course of their lifetimes, particularly for vulnerable communities such as those with preexisting health conditions.

Considering the scenario focused on resource allocation, the panelists stressed the important role of community-level research and action. Kinney noted that the pathways linking climate change to health are complex and place-specific. Given that there is no simple regulatory solution—governments do not set standards for temperatures or wildfires the way they do for toxic chemicals—Kinney said that partnerships among academic researchers, public health organizations, and community organizations are critical to developing tangible solutions to on-the-ground problems at the local scale. Osborne Jelks pointed to the value of community science models in which community organizations play a lead role in identifying the key questions to ask, collecting actionable data, and using that data to press for change. Drawing knowledge and data from the residents living in a community can help to fill gaps in understanding the impacts of climate and other stressors and inform solutions, she said.

In prioritizing what types of data to collect, Bailey said that the focus should be on data that will be usable, actionable, and empowering for individual and collective action in vulnerable communities. Osborne Jelks noted that it is important to recognize the social vulnerabilities that some communities experience as a result of policy structures: “We're all in the same storm,” she said, “but we're not in the same boat.” Bailey added that bringing a sense of humanity and a focus on healing is important to addressing past injustices while working toward future solutions.

The panelists suggested that successful community-based work requires time, investment, and the right mindset. There are already good models to draw from: Kinney pointed to NIEHS's programs in environmental justice 7 and community-based participatory research 8 as examples of successful investments that have not only advanced research but also helped to build capacity in many communities. Bailey noted that agencies have established useful frameworks for engaging with local communities, although they are not always adhered to well. Osborne Jelks stressed the importance of capacity building within communities, which requires sustained funding to support community organizations that work collaboratively with academic researchers and public health practitioners, not only through sub awards but also through sizeable and direct grants. In addition, she suggested that, where possible, funding structures should allow sufficient time for researchers and community organizations to cultivate relationships and co-develop projects, a process that can take longer than traditional academic funding cycles allow.

Kinney, Johnson, and Osborne Jelks added that issues at the intersection of climate and health span the missions of multiple agencies—EPA, the National Institutes of Health (NIH), and the National Science Foundation, for example—and suggested that a joint or cross-agency program to address both climate mitigation and adaptation with a focus on local-scale, community-based research could be an effective way to advance progress.

PART 2: CHARTING THE PATH AHEAD

The second part of the workshop focused on identifying funding and collaboration strategies to advance future directions and priorities for the field, with particular attention to opportunities in the areas of precision medicine, environmental justice and the exposome, and climate change and health.

Agency Perspectives and Opportunities

Gary Miller (Columbia University) moderated a session highlighting perspectives and opportunities from federal funding agencies that will likely play an active role in environmental health sciences as the field evolves over the coming decade. Panelists included Rick Woychik (NIEHS), Richard Hodes (National Institute on Aging [NIA]), Shannon Zenk (National Institute of Nursing Research [NINR]), and Gary Ellison (National Cancer Institute [NCI]).

Woychik provided an overview of NIEHS and cross-NIH priorities and initiatives. He said there are many opportunities for partnerships—including purposeful engagement with communities—to study the influence of the environment on the etiology of human disease, adding that this now extends beyond the “usual suspects” to include social determinants of health. The emerging concept of precision environmental health complements precision medicine by recognizing that individuals respond to environmental exposures in different ways as a result of genetic, epigenetic, and other factors, with a focus on preventing disease. The notion of the exposome, reflecting the totality of exposures over the lifespan points to the need to move beyond single exposures, he said. Although this concept is well established, Woychik noted that the scientific community is still grappling with how to operationalize exposomics in research methodology.

Climate change and health has been a major focus for the administration since President Biden took office in 2021. While NIEHS has been a leading institute funding research in this area over the past decade, Woychik said that a new Executive Committee for Climate Change and Health is now working to develop a strategic framework for transdisciplinary, transformative research in health effects, health equity, intervention science, and training and capacity building across the entire NIH. 9 Another growing area of interest is mechanistic and translational toxicology with a goal of translating research to predict health effects.

Hodes highlighted how NIA activities are helping to elucidate the impacts of environmental exposures on aging and older people. Two key areas of focus are extreme weather and air quality. Noting that older adults suffer disproportionate health impacts from climate change and extreme weather, Hodes said that observational studies of people affected by disasters such as 9/11 and the 2011 Japanese tsunami have provided insights into the health effects of such events for older people. In the area of air quality, he highlighted research in China and the United States aimed at tracing the relationships between air pollution and cognitive decline. As tools for monitoring exposures continue to improve, he said there will be opportunities to better understand how social determinants of health combine with environmental exposures—both at acute timescales and over the course of the lifespan—to affect health as people age.

Nurses were among the first in the health care field to recognize that how people live affects their health and incorporate environmental factors into care. Zenk said that what sets NINR apart is its focus on solutions that work in the context of people's lives. She continued, environmental health is crucial to health equity and closely linked to social determinants of health. “There are communities, through no fault of their own, [that] lack the resources to live their healthiest lives,” she said. NINR supports research focused on innovation, rigorous research methods, and health impact; advancing equity, diversity, and inclusion; and solutions to optimize health across settings and tackle pressing current and future challenges. Environmental factors cut across many key focal areas at NINR, including health equity, social determinants of health, population and community health, prevention and health promotion, and systems and models of care. As examples of this work, Zenk pointed to the Transformative Research to Address Health Disparities and Advance Health Equity initiative, 10 the Community Partnerships to Advance Science for Society program, 11 and the NIH-wide Social Determinants of Health Research Coordinating Committee, among others.

Ellison discussed how environmental health fits into the notion of the cancer control continuum, a framework for identifying research gaps and priorities relevant to reducing the burden from cancer at all stages from etiology to survivorship. Cancer is heterogeneous and complex, and the environment is also complex. Previous research on windows of susceptibility for cancer illustrates the key role of transdisciplinary science to accelerate the pace of scientific discovery. While advances in technology and research methods have enhanced the ability to understand how environmental exposures affect cancer susceptibility, Ellison said fully realizing the potential of this will require collaborative approaches to bridge genetics, phenotypes, and environment. As examples of key activities in this area, he highlighted the NCI Cancer Epidemiology Cohort, 12 the NCI Cohort Consortium, 13 and other initiatives to support research using data from established cohorts and to build the next generation of research cohorts. He argued that expertise in ethics, communications, and quality assessment is important.

Panelists discussed the need for continued dialogue and collaboration among federal research funding agencies, as well as other agencies, regulators, and advocacy groups, to translate findings from basic research into actionable solutions that account for the role of environmental exposures in health and disease. Woychik noted that the response to the COVID-19 pandemic demonstrated the value of cross-agency collaboration and said the NIH “All of Us” program 14 is a good example of how agencies are increasingly working together to effectively integrate research programs. Hodes noted that the onus is on NIH and its institutes (not researchers themselves) to lead the way on connecting and coordinating research activities across agencies and institutes. Ellison said that it is also important for funding agencies to remain attentive to the concerns and needs of the extramural research community. To realize the potential of exposomics and work toward a future vision for environmental health sciences, Woychik said that it will be valuable to elucidate what tools, methods, and data repositories are needed and to identify epigenetic markers that can shed light on developmental exposures. Ellison underscored the need for methods to measure exposures over time and incorporate them into large, longitudinal studies, and Zenk suggested focusing on opportunities to streamline data collection, such as through tools that can be used to assess exposures and behaviors simultaneously.

• NEW VOICES AND NEW COLLABORATIONS

For the workshop's final discussion session, Christina Park (NIH) moderated a conversation about how to achieve a research enterprise that fully integrates environmental health sciences into broader studies of human health and disease through building new collaborations and working across disciplines and sectors. The panelists included Jackson, Kim Fortun (University of California, Irvine), Jamaji Nwanaji-Enwerem (Emory University), and Martin Mulvihill (Safer Made).

Jackson outlined the fundamental principles and goals underlying environmental health sciences. Highlighting the linkage between overexploitation—of both people and resources—and the adverse social and physical environments that cause illness and health inequities, she said that disrupting exploitative practices will be critical to addressing environmental health problems. If the overall goal is for people to die of natural causes after reaching their optimal life (and health) potential, she noted, it is clear that clean air, water, soil, and food security are essential to that fundamental goal. She suggested that people should be viewed as a manifestation of the environment, rather than separate from it, and allocate most research funding toward preventing risk factors from developing, which involves collecting and integrating data along the full spectrum of exposures.

Different stakeholders have different levels of awareness and understanding of environmental hazards. Fortun discussed the role of communication and capacity building in generating knowledge and informing action on the part of individuals, communities, scientists, and governments. In many cases, she said, it cannot be assumed that people are aware of the hazards they face in their home communities; she pointed to creative approaches, such as using art to communicate about science and incorporating environmental health knowledge into K–12 education, as opportunities to increase the public's ability to access and use information about environmental exposures. She said that community-based organizations often have impressive capacity to build community knowledge infrastructure and suggested that these groups could benefit from greater collaboration with other communities facing similar issues. For their part, Fortun said that scientists are often willing to reach beyond their traditional sphere to make their work relevant to communities, though there are important barriers to this. Finally, she said there is a need to move toward shared governance approaches to facilitate effective government action at the right levels and agencies.

Adaptation can be an important part of making progress in environmental health and environmental justice. Nwanaji-Enwerem stressed the need to constantly reexamine and improve approaches to research and interventions. He outlined five facets of environmental health that are currently used mostly in the context of research but are also potentially relevant for clinical use. The first, timeframe, speaks to the timing and duration of the exposure and how the effects of the exposure evolve over time. The second, objective, refers to how a given marker will be used to inform decisions. The third is utility and understanding. Nwanaji-Enwerem said that researchers should not allow a lack of understanding of biomarkers to inhibit assessments of how to use them. The fourth facet, risk, speaks to what can be done to mitigate exposures and the level at which that mitigation is possible, such as through individual behavior change or through public policy. Finally, he noted that attention to equity is crucial for advancing health research and interventions in ways that work for everyone.

The products people use can be a source of exposure to chemicals, and the manufacture and disposal of products can release chemical pollutants into the environment. Mulvihill discussed opportunities and questions around the use of alternative materials and methods to prevent environmental exposures. As the petrochemical industry makes large investments in plastics and specialty chemicals, he said that there is an opportunity to influence what chemicals are made and incorporate a greater emphasis on green chemistry approaches; for example, to avoid producing certain classes of chemicals or designing chemicals that are less persistent in the environment. Bio-based chemicals have been touted as a key opportunity to make greener products, but Mulvihill cautioned that different stakeholders have different conceptions of what makes a product sustainable. For example, while a certain base material may be “greener,” properties such as health impacts and recyclability are often influenced heavily by the additive chemicals that are incorporated for particular functionalities. To address these challenges, Mulvihill stressed the need for transparency and a holistic view of all of the materials and additives that go into a product. Given that no amount of measurement will ever achieve complete knowledge, he said that it would be better to understand how to act in the absence of certainty.

Fortun, Mulvihill, and Nwanaji-Enwerem pointed to the important role of education throughout the lifespan in empowering people to evaluate and synthesize information—and counter disinformation—to support greater awareness and informed action and political engagement around environmental health issues. In addition, Jackson and Mulvihill emphasized identifying areas where the interests of communities, organizations, and governments overlap in order to better integrate efforts and increase impact.

• REFLECTIONS

Malecki closed the workshop with a brief synthesis of key themes that emerged in the course of the workshop presentations and discussions as participants considered the societal and health challenges that environmental health sciences can help address, key research topics for the next 5–10 years, and the barriers to achieving the articulated research goals.

One key theme was the potential benefit of more complex models and integration of knowledge. Several participants highlighted the importance of attending to cumulative exposures across the life course, including social determinants of health; identifying assets and resources that support resilience, especially in underserved communities; and advancing new biomarkers, bio-based chemistry, and prescriptive toxicology approaches. The integration of knowledge across disciplines, platforms, and communities from the local to global scale may help to achieve this.

Participants also highlighted the health impacts of climate change—with particular attention to environmental justice—as a key research area for environmental health sciences going forward. Many panelists suggested that work in this area should focus on empowering communities and building capacity for community-based programs, with particular emphasis on local solutions with co-benefits for health and climate. In climate and other areas of environmental health, participants underscored the critical importance of solution-oriented research with an emphasis on prevention.

Additional themes included a focus on collaborative, multidisciplinary teams; intersectionality, humanity, and healing; advancing the utility of innovation in environmental health sciences to address complexity and enable research translation; and advancing awareness and utility of environmental health insights through communication and education. With regard to funding models, several participants underscored the need for continued collaboration across NIH institutes; the importance of addressing barriers for both scientists and community partners; and the need to build in the appropriate amount of time and money to enable multidisciplinary and community-driven research.

Scenarios for the sessions are described in the agenda. See https://www ​.nationalacademies ​.org/event/04-26-2022 ​/towards-a-future-of-environmental-health-sciences-a-workshop (accessed July 19, 2022).

See https://www ​.nationalacademies ​.org/event/04-26-2022 ​/towards-a-future-of-environmental-health-sciences-a-workshop (accessed June 16, 2022).

Exposome can be defined as the totality of environmental exposures and corresponding biological responses over a lifespan. See https://factor ​.niehs ​.nih.gov/2021/7/feature ​/3-feature-niehs-council/index.htm (accessed July 15, 2022).

Masters, R.M., L.Y. Aron, and S.H. Woolf. 2022. Changes in life expectancy between 2019 and 2021: United States and 19 peer countries. medRxiv . https://doi ​.org/10.1101/2022 ​.04.05.22273393 .

See https://www ​.niehs.nih ​.gov/research/programs ​/translational/framework-details ​/index.cfm (accessed July 19, 2022).

See https://www ​.epa.gov/ejscreen (accessed June 17, 2022).

See https://www ​.niehs.nih ​.gov/research/programs/ehd-ej/index.cfm (accessed July 19, 2020).

See https://www ​.niehs.nih ​.gov/research/supported ​/translational/community/index.cfm (accessed July 19, 2020).

See https://www ​.nih.gov/climateandhealth (accessed June 17, 2022).

See https://commonfund ​.nih ​.gov/healthdisparitiestransformation (accessed June 17, 2022).

See https://dpcpsi ​.nih.gov ​/sites/default/files/2 ​.10PM-Cf-Concept-COMPASS-Zenk-Gordon-FINAL-508.pdf (accessed July 15, 2022).

See https://epi ​.grants.cancer.gov/cohorts (accessed July 15, 2022).

See https://epi ​.grants.cancer ​.gov/cohort-consortium (accessed July 15, 2022).

See https://allofus ​.nih.gov (accessed July 15, 2022).

This workshop was organized by the following experts: KRISTEN MALECKI ( Chair ), University of Wisconsin–Madison; KAREN BAILEY , University of Colorado Boulder; CHANDRA JACKSON , National Institute of Environmental Health Sciences; PATRICK MCMULLEN , ScitoVation; GARY MILLER , Columbia University; CHRISTINA PARK , National Institutes of Health.

The National Academies' Standing Committee on the Use of Emerging Science for Environmental Health Decisions (ESEHD) examines and discusses issues on the use of new science, tools, and research methodologies for environmental health decisions. The ESEHD is organized under the auspices of the Board on Life Sciences and the Board on Environmental Studies and Toxicology of the National Academies of Sciences, Engineering, and Medicine, and sponsored by the National Institute of Environmental Health Sciences.

To ensure that it meets institutional standards for quality and objectivity, this Proceedings of a Workshop—in Brief was reviewed by KAREN BAILEY , University of Colorado Boulder, and CRISEYDA MARTINEZ , Icahn School of Medicine at Mount Sinai. We also thank staff member LIDA BENINSON for reading and providing helpful comments on this manuscript.

LYLY LUHACHACK , Board on Life Sciences; NATALIE ARMSTRONG , Board on Environmental Studies and Toxicology; JESSICA DEMOUY , Board on Life Sciences; and DAISHA WALSTON , Board on Life Sciences.

This Proceedings of a Workshop—in Brief was prepared by ANNE JOHNSON as a factual summary of what occurred at the workshop. The statements made are those of the rapporteur or individual workshop participants and do not necessarily represent the views of all workshop participants; the planning committee; or the National Academies of Sciences, Engineering, and Medicine.

Division on Earth and Life Studies

National academies sciences engineering medicine.

The National Academies provide independent, trustworthy advice that advances solutions to society's most complex challenges.

www.nationalacademies.org

Suggested citation:

National Academies of Sciences, Engineering, and Medicine. 2022. Toward a Future of Environmental Health Sciences: Proceedings of a Workshop—in Brief. Washington, DC: The National Academies Press: https://doi.org/10.17226/26639 .

• Cite this Page National Academies of Sciences, Engineering, and Medicine; Division on Earth and Life Studies; Board on Environmental Studies and Toxicology; Board on Life Sciences; Johnson A, editor. Toward a Future of Environmental Health Sciences: Proceedings of a Workshop—in Brief. Washington (DC): National Academies Press (US); 2022 Aug 26. doi: 10.17226/26639
• PDF version of this title (266K)

In this Page

• SCANNING THE ENVIRONMENTAL HEALTH HORIZON
• CHARTING THE PATH AHEAD

Other titles in this collection

• The National Academies Collection: Reports funded by National Institutes of Health

Similar articles in PubMed

• Review Nutrigenomics and the Future of Nutrition: Proceedings of a Workshop [ 2018] Review Nutrigenomics and the Future of Nutrition: Proceedings of a Workshop National Academies of Sciences, Engineering, and Medicine, Health and Medicine Division, Food and Nutrition Board, Food Forum. 2018 Jul 25
• Review Advances in Multimodal Artificial Intelligence to Enhance Environmental and Biomedical Data Integration: Proceedings of a Workshop—in Brief [ 2023] Review Advances in Multimodal Artificial Intelligence to Enhance Environmental and Biomedical Data Integration: Proceedings of a Workshop—in Brief National Academies of Sciences, Engineering, and Medicine; Division on Engineering and Physical Sciences; Division on Earth and Life Studies; Board on Mathematical Sciences and Analytics; Board on Life Sciences; Board on Environmental Studies and Toxicology; Standing Committee on Emerging Science for Environmental Health Decisions, Armstrong N, Luhachack L. 2023 Aug 29
• Review Effective Health Communication Within the Current Information Environment and the Role of the Federal Government: Proceedings of a Workshop [ 2023] Review Effective Health Communication Within the Current Information Environment and the Role of the Federal Government: Proceedings of a Workshop National Academies of Sciences, Engineering, and Medicine; Division of Behavioral and Social Sciences and Education; Board on Science Education, Rhodes HG, Forstag EH. 2023 Sep 8
• Review Advancing the Science to Improve Population Health: Proceedings of a Workshop [ 2016] Review Advancing the Science to Improve Population Health: Proceedings of a Workshop National Academies of Sciences, Engineering, and Medicine, Health and Medicine Division, Board on Population Health and Public Health Practice, Roundtable on Population Health Improvement. 2016 Aug 11
• Review Violence and Mental Health: Opportunities for Prevention and Early Detection: Proceedings of a Workshop [ 2018] Review Violence and Mental Health: Opportunities for Prevention and Early Detection: Proceedings of a Workshop National Academies of Sciences, Engineering, and Medicine, Health and Medicine Division, Board on Global Health, Forum on Global Violence Prevention. 2018 Mar 22

Recent Activity

• Toward a Future of Environmental Health Sciences Toward a Future of Environmental Health Sciences

Your browsing activity is empty.

Activity recording is turned off.

Turn recording back on

Connect with NLM

National Library of Medicine 8600 Rockville Pike Bethesda, MD 20894

Web Policies FOIA HHS Vulnerability Disclosure

Help Accessibility Careers

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

• View all journals
• Explore content
• About the journal
• Publish with us
• Sign up for alerts
• Open access
• Published: 02 August 2024

Longitudinal study on the multifactorial public health risks associated with sewage reclamation

• Inés Girón-Guzmán 1 ,
• Santiago Sánchez-Alberola 1 , 2 ,
• Enric Cuevas-Ferrando   ORCID: orcid.org/0000-0002-0799-009X 1 ,
• Irene Falcó 1 , 3 ,
• Azahara Díaz-Reolid 1 ,
• Pablo Puchades-Colera   ORCID: orcid.org/0009-0009-5692-3406 1 ,
• Sandra Ballesteros 4 ,
• Alba Pérez-Cataluña 1 ,
• José María Coll 1 ,
• Eugenia Núñez   ORCID: orcid.org/0000-0002-1852-3374 1 , 2 ,
• María José Fabra 1 , 2 ,
• Amparo López-Rubio 1 , 2   na1 &
• Gloria Sánchez 1   na1  

npj Clean Water volume  7 , Article number:  72 ( 2024 ) Cite this article

403 Accesses

7 Altmetric

Metrics details

• Environmental sciences
• Water resources

This year-long research analyzed emerging risks in influent, effluent wastewaters and biosolids from six wastewater treatment plants in Spain’s Valencian Region. Specifically, it focused on human enteric and respiratory viruses, bacterial and viral faecal contamination indicators, extended-spectrum beta-lactamases-producing Escherichia coli , and antibiotic-resistance genes. Additionally, particles and microplastics in biosolid and wastewater samples were assessed. Human enteric viruses were prevalent in influent wastewater, with limited post-treatment reduction. Wastewater treatment effectively eliminated respiratory viruses, except for low levels of SARS-CoV-2 in effluent and biosolid samples, suggesting minimal public health risk. Antibiotic resistance genes and microplastics were persistently found in effluent and biosolids, thus indicating treatment inefficiencies and potential environmental dissemination. This multifaced research sheds light on diverse contaminants present after water reclamation, emphasizing the interconnectedness of human, animal, and environmental health in wastewater management. It underscores the need for a One Health approach to address the United Nations Sustainable Development Goals.

Similar content being viewed by others

Rethinking wastewater risks and monitoring in light of the COVID-19 pandemic

Realising a global One Health disease surveillance approach: insights from wastewater and beyond

Research progress on the origin, fate, impacts and harm of microplastics and antibiotic resistance genes in wastewater treatment plants

Introduction.

Water is a fundamental resource for human life, being also essential for crops and livestock production. However, the increasing global population and limited freshwater resources pose significant challenges to meeting the demands of various sectors, including agriculture. Water reuse has emerged as a sustainable solution to preserve freshwater resources and reduce environmental pressure. Reclaimed water, also known as recycled water or effluent from wastewater treatment plants (WWTPs), refers to the treated wastewater that undergoes a series of physical, chemical, and biological processes to remove contaminants and pathogens. The reclaimed water is then suitable for non-potable uses, such as irrigation, industrial processes, and groundwater recharge according to national regulations 1 .

Water reuse has become increasingly important in agriculture due to the limited freshwater resources and the growing demand for food production. Agriculture accounts for approximately 70% of global freshwater withdrawals and the water demand for crops and livestock is projected to increase in the coming decades 2 . Reclaimed water offers a sustainable solution to reduce the demand for freshwater resources and ensure the availability of water for irrigation while reducing the discharge of treated wastewater into the environment and the cost of water supply. However, water reuse also poses several challenges, particularly in terms of microbiological and chemical safety. Reclaimed water may contain a variety of contaminants, including bacteria, viruses, protozoa, and emerging pollutants, such as microplastics (MPs), antibiotic resistant genes (ARGs), and pharmaceuticals 3 .

In particular, human enteric viruses are responsible for causing viral gastroenteritis, hepatitis, and various illnesses primarily transmitted through the faecal-oral route 4 . The spread of these viruses is primarily linked to person-to-person contact and the consumption of contaminated food and water. Enteric viruses are excreted in substantial quantities, up to 10 13 particles per gram of stool, by both symptomatic and asymptomatic individuals 5 , 6 . Major causative agents of waterborne viral gastroenteritis and hepatitis outbreaks worldwide include rotaviruses (RVs), norovirus genogroups I (HuNoV GI) and II (HuNoV GII), hepatitis A and E viruses (HAV and HEV), and human astroviruses 5 (HAstVs). In this context, and related to microbiological risks dissemination, a new European regulation (EC, 2020/741) on minimum quality criteria (MQR) for water reuse is in place since June 2023, outlining the guidelines for the use of reclaimed water for agricultural irrigation 7 . However, questions have arisen concerning potential non-compliance scenarios in European water reuse systems 8 , 9 , 10 , 11 , 12 . According to EC 2020/741 regulation, validation monitoring needs to assess whether the performance targets reductions are met. Monitoring of pathogen elimination in the water reclamation process is necessary to assess the suitability of reclaimed water in its secondary uses. In this respect, the WHO has suggested that another problem to be tackled in the framework of “One Health” is the rise of antibiotic resistance (AR) 13 . AR is frequent in places where antibiotics are employed, but antibiotic resistant bacteria (ARB) and ARGs are also widely prevalent in water environments 14 , 15 . According to several reports, surface water and reclaimed wastewater used for irrigation are significant sources of ARBs and ARGs 16 . Due to inadequate removal of ARGs, which are crucial in the growth of extremely unfavourable drug-resistant superbugs, reuse of WWTP effluents may be harmful to human health 17 .

On the other hand, plastic pollution is currently one of the most important environmental problems that humanity must face. The exponential growth of plastic production since 1950s (up to 368 million of tons were produced in 2019) and the massive use of plastics, together with insufficient/inadequate waste management/disposal strategies, are the main causes of the global presence of plastics in every environmental compartment 18 . The European Commission has recently published an amending Annex to Regulation (EC) No 1907/2006 concerning the Registration, Evaluation, Authorization, and Restriction of Chemicals (REACH) as regards synthetic polymer microparticles, where the intentional use of microplastics in commercial products is prohibited 19 .

Current research is showing that one of the main concerns about plastics, apart from the fact that they persist in the environment for an extremely long time, is their constant fragmentation into even smaller particles called microplastics (MPs, 1 μm–5 mm) or nanoplastics (< 1 μm), depending on their final dimensions, though they are also released as such 20 .

MPs are emerging global threats as they can end up in our bodies through water and food ingestion or by air inhalation 21 . The larger MPs can cause mechanical damage to the intestinal epithelium, while the smaller particles can cross the epithelial barrier 22 and end up in the lung 23 , colon 24 , placenta 25 , and even blood 26 .

MPs can transport pathogens over long distances, due to their ability to harbor biofilms on the surface, which can lead to the spread of pathogenic viruses and bacteria to new areas where they were not previously found 27 . Another of the main risks associated with MPs is that plastic materials include approximately 4% by weight of additives 28 , some of them declared as possible human carcinogens, and most of them considered endocrine disruptors 29 . In addition, MPs also contain traces of persistent organic pollutants (COPs), such as polychlorinated biphenyls (PCBs), polycyclic aromatic hydrocarbons (PAHs), and organochlorine pesticides 22 .

It is important to highlight that depending on the performance of WWTPs high amounts of pathogens, MPs and ARGs can be released on a daily basis into rivers, lakes, and oceans 9 , 14 , 30 . On the other hand, the sludge generated as well as the effluent water from the WWTPs are generally used in agriculture as a fertilizer and for irrigation respectively, and, therefore, the presence of emerging contaminants in these biosolids and reclaimed waters can favour the propagation of plastic particles, emerging pathogens, and ARGs through agricultural soils which could reach cultivated vegetables and ultimately the human body through the trophic chain.

In overall terms, understanding the distinct risk factors involved in the water reclamation process is critical to ensuring the safety of water reuse in agriculture and other sectors, and the analysis of the water reclamation process can serve as an important risk assessment tool. Moreover, by analysing wastewater, we gain valuable insights into the collective health of a community, as it contains traces of chemical pollutants, pathogens, and biomarkers from human and animal sources. Thus, monitoring wastewater helps identifying trends in the prevalence of diseases, antibiotic resistance patterns, zoonotic pathogens, and exposure to environmental pollutants as MPs, providing early warning and valuable data for public health interventions. This integration of environmental, human, and animal health data underscores the significance of wastewater analysis in promoting a comprehensive and proactive “One Health” approach to public health and the well-being of both the planet and its inhabitants.

Incidence of human enteric viruses, respiratory viruses, and viral faecal indicators in influent and effluent wastewater samples

The presence of human enteric viruses, including HuNoV GI, HuNoV GII, HAstV, HAV, HEV, and RV, was analysed, along with novel viral faecal contamination indicators pepper mild mottle virus (PMMoV), crAssphage and somatic coliphages in influent, effluent and biosolid samples from six different WWTPs in the Valencian region of Spain (Figs. 1 and 2 ).

HEV hepatitis E virus, HAV hepatitis A virus, HAstV human astrovirus, RV rotavirus, PMMoV pepper mild mottle virus.

Whiskers in box are drawn min. to max., box extends from the 25th to 75th percentiles, and line within the box represents the median. Coloured circles above a box indicate significant differences between that box and the box with that same colour ( p  < 0.05). GC genome copies, PFU plate forming units, RV rotavirus, HuNoV human norovirus, HAstV human astrovirus, HAV hepatitis A virus, HEV hepatitis E virus, PMMoV pepper mild mottle virus.

In influent wastewater samples, the mean highest levels of viruses were observed for RV (8.55 log genome copies, GC/L), followed by HuNoV GII (7.80 log GC/L) and HAstV (7.72 log GC/L). The lowest concentration levels were detected for HuNoV GI (4.46 log GC/L), HEV (4.13 log GC/L), and HAV (3.47 log GC/L) (Fig. 2 ). HAV was only detected in 4 out of 72 influent wastewater samples (Fig. 1 ). PMMoV and crAssphage were detected in all influent samples, with mean levels of 5.95 log GC/L and 8.44 log GC/L, respectively.

In the effluent wastewater samples, the titres of all viruses decreased after the water reclamation process. HuNoV GI, HuNoV GII, HAstV, and RV showed mean concentrations titers of 3.51, 6.25, 6.35, and 7.69 Log GC/L when detected, respectively (Fig. 2 ). On the contrary, HEV was not detected in any of the effluent samples. In the case of faecal viral indicators, PMMoV (4.72 Log GC/L) and crAssphage (6.23 Log GC/L) were present in all effluent samples. The highest reduction in virus levels were observed for HEV, with a reduction of 4 Log GC/L, even though the vast majority of viruses’ reduction levels were below 2 Logs GC/L (Supplementary Fig. 1 ). Interestingly, viable somatic coliphages were found at levels of 4.73 Log plaque forming units (PFU)/100 mL in effluent waters, with a mean reduction of 1.83 Log PFU/100 mL compared to the influent waters (6.54 Log PFU/100 mL) when testing positive.

As for biosolid samples, HuNoV GI, HuNoV GII, HAstV, and RV showed the highest mean concentrations, with titers ranging from 5.37 (HuNoV GI) to 7.27 Log GC/L (RV) when detected (Fig. 2 ). HAV and HEV rendered lower mean concentrations of 3.24 and 3.91 Log GC/L, respectively. Besides, proposed viral faecal indicators yielded mean concentrations levels of 7.06 Log GC/L for crAssphage, 4.85 Log GC/L for PMMoV. and 5.63 Log PFU/100 mL for somatic coliphages (Fig. 2 ).

Regarding respiratory viruses, respiratory syncytial virus (RSV) showed a remarkable seasonality, with almost all positive samples being collected on November and December 2022 (Fig. 3 ). Influenza A virus (IAV) was intermittently detected over the year, with the most noteworthy peaks taking place in spring and winter (Fig. 3 ). Finally, SARS-CoV-2 was present in 99% and 32% of the influent and effluent samples, respectively. When testing positive, mean concentration values for RSV, IAV, and SARS-CoV-2 were 4.57, 6.20, and 5.27 Log GC/L, respectively. Notably, any of the analysed effluent wastewater samples tested positive for either RSV or IAV.

Nd not detected, GC genome copies, SARS-CoV-2 severe acute respiratory syndrome coronavirus 2, RSV respiratory syncytial virus, IA Influenza A virus.

Regarding biosolid samples, SARS-CoV-2 was found positive in 71% of the samples at a mean concentration of 4.44 Log GC/L, while RSV and IAV only tested positive in three biosolid samples.

In general, no significant differences were found among the six different WWTPs analysed neither for enteric or respiratory viruses.

Quantification of Escherichia coli , Extended Spectrum Beta-Lactamases-producing E. coli , and ARGs in wastewater and biosolids samples

In influent wastewater samples, the mean concentration of E. coli and ESBL- E. coli were 7.08 Log colony forming units (CFU)/100 mL and 6.19 Log CFU/100 mL, respectively (Fig. 4 ). After the wastewater treatment process, the mean concentrations of E. coli , and ESBL- E. coli in the effluent wastewater samples were significantly reduced, with mean concentrations of 5.43 Log CFU/100 mL, and 4.76 Log CFU/100 mL, respectively.

Whiskers in box are drawn min. to max., box extends from the 25th to 75th percentiles, and the line within the box represents the median. Coloured circles above a box indicate significant differences between that box and the box with that same colour ( p  < 0.05). CFU colony forming unit ESBL- E. coli extended spectrum beta-lactamases producing Escherichia coli .

Regarding biosolid samples, the mean concentration of E. coli was 5.64 Log CFU/100 mL, while ESBL- E. coli yielded a mean concentration of 4.89 Log CFU/100 mL.

Furthermore, a deeper analysis of the ARGs present in effluent and biosolids samples was performed due to the high levels of ESBL- E. coli in biosolids and the observed low performance of the water reclamation process (less than 2 log reduction; Fig. 4 ). ARGs including tetPB_3 , tetA_1 , and qacA_1 were not detected in effluent wastewater and biosolids. ARG sul1_1 , sul2_1 , pbp2b , bla CTX-M , cmlA_2 , nimE , and ermB were detected in effluent samples at mean concentrations of 9.20, 8.78, 8.57, 8.42, 8.31, 8,24, and 8.39 Log GC/100 mL, respectively (Fig. 5 ).

Each different symbol type represents a different WWTP. ND Not detected, MLSB Macrolide-lincosamide-streptogramin B group antibiotics, GC genome copies.

ARGs were identified in biosolids, with the following values: 9.87, 9.25, 8.58, 8.42, 8.50, 8.64, 8.28 Log GC/100 mL for sul1_1 , sul2_1 , pbp2b , bla CTX-M , cmlA_2 , erm B, and ermA , respectively. Notably, nimE was not found in any of analysed biosolids.

Quantification of particles and microplastics present in biosolids and reclaimed water samples

The presence of solid particles and microplastics was bi-monthly analysed in both influent and effluent wastewater samples. In general, a great reduction in both the number of particles between 1 μm and 5 mm or (T)-P and particles larger than 300 µm or (S)-P was observed after the wastewater treatment process (Fig. 6 ). Although there was not a clear effect derived from seasonality, WWTPs were slightly less efficient in removing (T)-P in January and March.

Concentration (log P/L) of total particles (T)-P and sieved particles (>300 μm, (S)-P) in influent and effluent wastewater samples in even months over a one-year period in six different WWTPs (P1-P6).

The efficiency of each WWTPs regarding the reduction of (T)-P and (S)-P particles was determined considering the average number of particles in the influent and effluent wastewater samples (Fig. 7 ). At the WWTP level, the calculated efficiency in (T)-P reduction was approximately 84, 68, 69, 46, 80 and 71%, for the different WWTPs (P1-P6) samples analysed. Notably, the efficiency in removing (S)-P was higher than in removing (T)-P, with the most noteworthy reduction taking place for P2 and P6 wastewater samples (91 and 93% approximately, and respectively), while the lowest efficiency in (T)-P reduction was approximately 40% for P5.

Removal efficiency (%) of all solid particles (P) and microplastics (MPs) between influent and effluent samples collected from six different WWTPs (P1-P6) after both pre-treatment protocols. Total Particles (T) and Sieved > 300 µm (S).

Once (T)-P and (S)-P particles were quantified, all samples were spectroscopically characterized in order to identify the presence of MPs derived from synthetic polymer particles, fibres, and films. In general terms, the highest reduction was observed in (S)-MPs as compared to (T)-MPs, thus suggesting the lower efficiency of wastewater treatments in removing microplastics smaller than 300 μm (Fig. 7 ). It should be highlighted that the efficiency of WWTPs for removing MPs of smaller particle size or (T)-MPs was lower than for removing all solid particles or (T)-P, being 59% the highest (T)-MPs efficiency (sample P6). In general, a higher efficiency in reducing (S)-MPs was observed (around 98-100%) in all samples, except in P2 (77%) (Fig. 7 ).

Considering the pre-treatment (T), the annual average MPs concentration in influent samples was around 1816 MPs/L which was slightly reduced in effluent samples (1724 MPs/L). In contrast, the annual average concentration of (S)-MPs (larger than 300 µm) in influent samples was 198 MPs/L and it was significantly reduced in effluent wastewater samples until 11 MPs/L in average (Fig. 8 ).

Average concentration (mean + standard deviation) of MPs in influent (I) and effluent (E) after (T) (left) and (S) (right) protocols collected from six different WWTPs. T total particles, S Sieved > 300 µm.

The annual average percentage of MPs with respect to all solid particles in influent and effluent wastewater samples and biosolids was also determined (Supplementary Fig. 2 ). It is worth mentioning that, regarding the particles larger than 300 μm, the MPs/all solid particles ratio in biosolid samples was similar to the MPs/all solid particles ratio in influent wastewater samples, reaching values up to 35 in some of the WWTPs (Supplementary Fig. 2 ).

In all the analysed biosolid samples a significant number of (S)-P was also detected, and no significant effects due to seasonality were found (Fig. 9 ). The average highest concentration of (S)-MPs was 122 MPs/g and 99 MPs/g for P1 and P2, respectively. In contrast, the lowest level of MPs was detected for P3 (23 MPs/g) (Supplementary Fig. 3 ).

Concentration (in log/g) of (S)-P and (S)-MPs in biosolids in even months over a one-year period in six different WWTPs (P1-P6).

Analysing the morphology and type of MPs identified in the WWTPs samples may help to understand the origin of water pollution (Supplementary Figs. 5 and 6 ). As depicted in Fig. 10 , the majority of MPs existing in influent wastewater samples had the shape of fragments ( ∼ 86%), percentage that was further increased in effluent wastewater samples. The percentage of particles identified as films was negligible both in influent or effluent samples. Most of the MPs found in influent samples were between 0 and 100 µm ( ∼ 61%) in size, percentage that was increased in effluents (up to 73%), and a small fraction of MPs ( ∼ 3-5%) were larger than 300 µm in size, in agreement with the results commented above (Fig. 8 ). It is hypothesized that, during sieving, particles smaller than 300 µm may aggregate and become retained, but following oxidative digestion, they break down into smaller particles. The composition of the MPs was dominated by common polymers, whereas the PS, PA, PVC, and PET were greatly decreased in effluent samples (Fig. 10 ). It is worth mentioning that the distribution of polymer type was quite different when comparing wastewater and biosolids samples. PE was dominant in all samples, accounting for 56, 46 and 57% of the total MPs, for wastewater (T)-MPs and (S)-MPs, and for biosolids (S)-MPs, respectively (Supplementary Fig. 4 ). The amount of PA was more than two-fold higher in (T)-MPs samples from wastewater than in (S)-MPs from biosolids (31% vs. 12%, respectively). PET represented around 21–28% of the (S)-MPs in wastewater and biosolid samples. Other polymers such as PS, polytetrafluoroethylene PTFE, PVC, and PS were detected in lower amounts.

PE polyethylene, PET polyethylene terephthalate, PA polyamide, PP polypropylene, PS polystyrene, PVC polyvinyl chloride, PTFE polytetrafluoroethylene, PAM polyacrylamide.

Reuse of effluent wastewater and biosolids in agriculture is essential to face the increasing demand of water and agricultural products in combination with global warming and water scarcity 31 . Effluent wastewater and biosolids, however, are sources of emerging contaminants of concern such as viral pathogens, antibiotic resistance genes, and microplastics. The reuse of water and the release of reclaimed water into the environment may compromise public health due to the combination of several risk factors. In recent years, several publications have pointed out the low efficiency of WWTPs in removing viral pathogens 9 . While decay rates of human enteric viruses in effluents wastewater samples are frequently studied, very few studies have reported the incidence of respiratory viruses, MPs, and ARGs in effluent wastewater and biosolids, with the potential of being used in agriculture.

The present study investigated the presence of human enteric viruses, including HuNoV GI and GII, HAstV, HEV, and RV, as well as ARBs, ARGs, MPs and two novel viral faecal contamination indicators (PMMoV and crAssphage) in influent, effluent and biosolids samples. Consistent with findings from earlier research, influent wastewater samples exhibited elevated concentrations of human enteric viruses, MPs and ARBs 14 , 32 (Figs. 1 , 2 , 4 , 6 , and 8 ).

Following the water reclamation process, the concentrations of all analysed viruses decreased in the effluent samples. However, it is worth noting that the reductions for HuNoV GI, HuNoV GII, HAstV, and RV (when detected in effluent) were below 2 Logs, suggesting the persistence of these viruses to a relevant extent after being exposed to either UV or chlorination treatments. Only HEV was not detected in any of the analysed effluent samples thus resulting in higher reductions (> 4 Log GC). The reductions observed for human enteric viruses along the year substantially differ from current European legislation (Regulation (EU) 2020/741, 2020) on water reuse, which indicates the need for ≥ 6 Log decreases on the presence of these pathogens 7 . Even though enteric viruses’ presence detected by RT-qPCR in this study might not correspond with infectious particles, several publications have pointed out the presence of infectious enteric viruses in reclaimed waters by capsid-integrity or cell culture approaches 8 , 9 , 10 , 11 , 33 .

Owing to the microbiological risk that the presence of enteric viruses in these waters could entail, this study also aimed to assess the levels of somatic coliphages and E. coli in influent and effluent wastewater samples, as well as biosolid samples. Coliphages have been found in locations where faecal contamination is present 34 , 35 , and numerous studies have suggested utilizing coliphages as markers for enteric viruses’ presence 34 , 35 , 36 , 37 , 38 , 39 . Following the water treatment process, reductions of 1.83 Log PFU and 1.65 Log CFU were observed for somatic coliphages and E. coli , respectively. These reductions, which are far from those stipulated by the legislation EU 2020/741, 2020, highlight the low performance of the investigated WWTPs in decreasing the microbial load and mitigating the potential risks associated with these pathogens (pathogenicity and antibiotic resistance transmission) 7 . The high prevalence of viruses in reclaimed waters and biosolids, attributed to their high stability, poses a significant risk when applied to agricultural fields, particularly for products such as leafy greens and berries, which are often consumed raw and are unlikely to undergo extensive processing 40 . Shellfish are highly susceptible to viral contamination due to their efficient water filtration capacity, and they are commonly consumed raw or with minimal processing, making them a potential source of viral outbreak.

For somatic coliphages and E. coli , obtained counts in biosolids were similar to those obtained in effluent wastewater samples, pointing out the risk of using biosolids without any further treatment in agriculture. Besides, in recent years, both crAssphage and PMMoV have been proposed as viral indicators of faecal contamination in water bodies and as a virus model to assess the performance of WWTPs 41 , 42 , 43 , 44 , 45 , 46 , 47 . Regarding effluent samples, the mean concentration of crAssphage detected in reclaimed waters was 6.25 Log GC/L, which consistently matches the reported mean concentrations of 6.5 Log GC/L in high-income countries as reviewed by Adnan et al. 48 . PMMoV concentrations in effluent wastewater samples are in line with existing bibliography, which reports mean concentration values of ~ 4 Log GC/L 49 , 50 , 51 . Notably, obtained mean concentrations of PMMoV in influent wastewaters (5.95 Log GC/L) are slightly under-average when compared with previously reported data, as the common concentration values of PMMoV published in influent wastewater samples range from 6 to 10 Log GC/L 49 , 50 , 51 , 52 , 53 , 54 , 55 . Interestingly, to our knowledge, this study includes the first report on PMMoV levels in biosolid samples. This finding suggests a potential risk for the dissemination of this plant pathogen, which can infect solanaceous plants, ultimately leading to reduced productivity.

As for respiratory viruses, SARS-CoV-2, and IAV were detected at mean titres similar to those reported in the US, Canada, Australia, and other regions in Spain covering the same time period, while RSV levels were at least one Log GC/L over the reported in the aforementioned studies 56 , 57 , 58 , 59 , 60 , 61 . In recent years, the possibility of transmission of various respiratory viruses through food and water consumption has been discussed 62 . The absence of RSV and IAV in all effluent samples analysed in this study indicates an almost non-existent risk of transmissibility caused by ineffective water treatment, a finding of significant relevance, especially given the current situation where IAV H5N1 has been detected in sewage 63 . Nevertheless, the high presence of SARS-CoV-2 in effluent samples, together with the presence of these respiratory viruses in several of the analysed biosolids samples and the lack of studies regarding non-respiratory routes of transmission, warrant the need for further studies to assess public health risks.

Recently, a new proposal by The Urban Wastewater Treatment Directive (UWWTD), requested that member states should monitor antibiotic resistance at WWTPs serving over 100,000 individuals 19 . As this monitoring has been proposed to be performed for both influent and effluent wastewater samples, it should tackle both environmental transmission risks arising from WWTPs and provide insights into resistance patterns within specific regional areas.

In this study, ESBL- E. coli levels in influent samples were very high, with 6.63 Log CFU /100 mL on average, with no statistical differences among the different WWTPs and along the year. When analysing the reclamation treatment applied by the WWTPs, only mean reductions of 1.43 Log were observed for ESBL- E. coli , with 4.30 Log counts on average in effluent samples, which surpasses by 3 Logs the levels reported in other studies, suggesting the important role of effluent water in the dissemination of ARB in the food chain if used for irrigation and the need to improve water reclamation processes 14 , 64 , 65 . Similarly, the high levels of ESBL- E. coli in biosolids, suggest the need for further treatments before application in agriculture.

As well as resistant bacteria, the spread of ARGs needs to be addressed worldwide 13 . Thus, it is important to understand and mitigate their occurrence in different ecological systems. This study has shown the prevalence of 11 different ARGs belonging to 7 of the most widely used antibiotic groups in effluent water and biosolids 66 . Our study revealed that sulfonamide ARGs ( sul1 and sul2 ) were the genes with higher concentrations in effluents and biosolid samples. In line with previous studies, levels of sulfonamide resistance genes in effluent samples were higher than macrolide, tetracycline, and quinolone resistance genes 66 , 67 . Furthermore, sulfonamide gene levels were higher in biosolids than effluents (Fig. 5 ) as in the Mao et al. 2015 aforementioned study, highlighting the risk of biosolids as carriers of ARGs 64 . Levels of bla CTX-M , ARG that confer resistance to beta-lactamase, were 4 Log higher than levels of viable ESBL- E. coli , which could be explained by the longer persistence of DNA 68 , the presence of extracellular genetic material with bacterial surfaces, colloids, and bacteriophages, which shields it from nucleases 69 , 70 , 71 , 72 . This fact supports the idea that the dissemination of ARGs is not only carried out by viable bacteria but also by being found free in the environment or carried by other microorganisms such as bacteriophages 73 .

ARGs profiles were comparable in effluents and biosolids despite gene concentration differences except for cmlA_2 and ermB_1 . The cmlA_2 gene, which confer resistance to phenicol, was not found in any effluent samples indicating that environmental conditions, microbial populations, or the presence of contaminants in water treatment facilities may have impacted effluents but not biosolids. In March–May 2022, the ermB_1 gene was only detected in effluent samples, whereas the ermA gene, conferring resistance to macrolide-lincosamide-streptogramin B group antibiotic, was only detected in biosolid samples collected in January, consistent with previously reported data, whereas erm genes were only detected in biosolids 74 . Cold stress, which is linked with low temperatures, may increase horizontal gene transfer of ARGs, explaining this fluctuation along the year 75 . The significant presence of the ARGs and ESBL- E. coli supports assertions that land application of biosolids may disseminate ARGs to soil bacteria and demonstrate their potential introduction to food products via both irrigation and amendment 76 . Furthermore, from a One Health perspective, the dissemination of ARGs in aquatic environments may have implications for both animal and human health, underscoring the importance of enhancing reclamation processes through innovative strategies such as membrane bioreactors.

The extensive presence of MPs in wastewater sources significantly contributes to environmental contamination and poses considerable risks. In this sense, WWTPs play an important role in hindering MPs from entering water environments 77 . As observed in this work, the concentration of MPs in wastewater decreased in effluent samples as compared to influent samples, being the water treatment more efficient in removing higher size particles. The number of MPs found in the different samples agreed with those reported in the literature. Previous works investigated the abundance of MPs in urban WWTPs, with ranges of 0.28 to 3.14 × 10 4 particles/L in the influent, which significant differed from 0.01 to 2.97 × 10 2 particles/L in the effluent 78 . However, they did not refer to the removal efficiency depending on the particle size. In this work, a higher efficiency in reducing MPs (between 77-100%) of higher particle size (S)-MPs has been observed, which was similar to the 88–94% efficiency of municipal WWTPs previously reported 79 . However, this value was significantly reduced for MPs with smaller particle size (S)-MPs and presented a great variability depending on the WWTP studied (4-59%). Deng et al. (2023) reported that the removal efficiency of MPs in a petrochemical WWTPs reached ̴ 92% and highlighted that the primary treatment removed most of the MPs 80 (87.5%). Talvitie et al. (2015) also stated that the primary treatment could remove most of the MPs, although they did not refer to their particle size 81 . They reported that the major part of the fibers can be removed already in primary sedimentation process, which agreed with the lower proportion of fibers (as compared to fragments) found in these samples. While some authors have indicated that removing MPs from wastewater is technically feasible and cost-effective, suggesting that membrane bioreactors and sludge incineration are the best options, further research is necessary to enhance processes within a circular economy framework 82 .

Concerning the type of polymers detected, there is a higher prevalence of PE, PET, PS, and PA, as it has been previously reported for drinking water and petrochemical and urban WWTPs 80 , 83 , 84 , 85 . Furthermore, WWTPs were more efficient in removing polymers with higher density such as PA and PET, probably during the density separation step, favouring a significant reduction of these polymers in the effluent wastewater. Furthermore, the size of more than 90% of microplastic particles detected in WWTPs ranged between 1 and 300 μm and fragments were found to be the most prevalent shape of microplastics, in agreement with other works 86 .

Within this context, MPs release into the environment through sludge and effluent wastewater can also pose another risk, since MPs can accumulate/transport harmful pollutants, posing concerns about their role in treatment resistance and disease spread 87 . Bacteria and viruses have been reported to adsorb onto MPs, forming plastispheres 88 . Pathogenic bacteria, including those harmful to humans and fish, have also been found in communities of MPs 89 , 90 , 91 . Regarding viruses, the primary interaction with MPs involves electrostatic adhesion, increasing the risk of waterborne viral transmission. These viral or bacterial plastispheres not only resist UV treatment but can also promote infections, as shown for polystyrene MPs, which have been observed to facilitate IAV infection of host cells 91 , 92 . Additionally, the persistence of pathogen-carrying MPs in aquatic environments raises concerns about reverse zoonosis, where these plastispheres might be ingested by aquatic organisms, potentially endangering human populations through the food chain 93 . In summary, MPs can act as carriers for pathogenic bacteria and viruses in municipal sewage, intensifying concerns about public health and the environment.

The wide distribution of MPs in wastewater sources and the capability of some viruses to remain intact after traditional tertiary treatment disinfection processes (UV and chlorination) undoubtedly bring about environmental pollution and risk. Regarding MPs, their removal before reaching environmental water courses is highly recommended. To overcome these problems, several researchers are focused on finding cutting-edge methods to improve the efficiency of microplastic removal rates in WWTPs, although the literature is still scarce. Nasir et al. 2024, have recently reviewed innovative technologies for the removal of microplastics, highlighting the use of a membrane bioreactor system which combines biological treatments (aerobic, anaerobic) with membrane technology, thus improving sludge separation and effluent quality as compared to traditional methods 94 . Al-Amir et al., 2024 proposed the use of ultrafiltration in WWTP. It consists on a low-pressure (1–10 bar) method that removes particles using perforated asymmetric membranes up to 1–100 μm 95 . In the case of viruses, over the past few decades, as reviewed by Ibrahim et al. 2021 and Al-Hazmi et al. 2022, several efforts have been made to employ membrane-based and other hybrid technologies to effectively eliminate waterborne enteric viruses 96 , 97 . Technologies such as microfiltration (MF), ultrafiltration (UF), and membrane bioreactors (MBR) have been widely applied. The major concerns with these technologies are the factors impacting membrane performance regarding virus removal efficiency and sustainable operation, including physical sieving, adsorption, cake layer formation, and changes in membrane fouling. Additionally, microalgae-based approaches have emerged as a biological alternative to energy-intensive and expensive disinfection techniques 98 . Utilising microalgal processes, in conjunction with natural temperature, pH, or light conditions in treatment systems, may facilitate the complete removal of viruses from wastewater. Also, enhancing systems to filter out particles of extremely small sizes, such as MPs or viruses, from reclaimed water increases protection against other potentially harmful contaminants, including pathogenic bacteria. Finally, despite these treatment methods having various advantages and disadvantages, combining these systems aims to overcome their known technical and economic limitations

Overall, the findings of this research underscore the potential threats to public health associated with the reuse and release of reclaimed water, particularly concerning microbiological pathogens and environmental pollutants like microplastics, as well as the release of emerging contaminants into the environment and food chain through the use of biosolids in agriculture. These risk factors, including the persistence of enteric viruses, the inadequate reduction of microbial load and antibiotic resistance genes, and the prevalent presence of microplastics, emphasize the need for a holistic approach in addressing health concerns. Integrating these insights from wastewater analysis as well as human epidemic respiratory viruses monitoring into the broader One Health framework is crucial for devising effective policies, improving water treatment processes, and safeguarding both human and ecosystem health in a sustainable manner.

Methods for viruses and ARGs in wastewater and biosolid samples

Grab influent ( n  = 72) and effluent ( n  = 72) wastewater samples were collected monthly along with dehydrated biosolid samples ( n  = 72) from 6 different urban WWTPs over a one-year period (January 2022–December 2022). Samples were grabbed early in the morning (8 am) by collecting ~500 mL of wastewater in sterile HDPE plastic containers (Labbox Labware, Spain). Collected samples were transferred on ice to the laboratory, kept refrigerated at 4 °C, and concentrated within 24 h. Samples were artificially contaminated with 10 6 PCR units (PCRU) of porcine epidemic diarrhea virus (PEDV) strain CV777, serving as a coronavirus model. Additionally, 10 6 PCRU of mengovirus (MgV) vMC 0 (CECT 100,000) were used as a non-enveloped counterpart for recovery efficiency assessment. Effluent wastewater samples were concentrated through a previously validated aluminium-based adsorption-precipitation method 11 , 99 . Briefly, 200 mL of sample was adjusted to pH 6.0 and Al(OH) 3 precipitate formed by adding 1 part 0.9 N AlCl 3 solution to 100 parts of sample. Then, pH was readjusted to 6.0 and sample mixed using an orbital shaker at 150 rpm for 15 min at room temperature. Next, viruses and ARGs were collected by centrifugation at 1700 × g for 20 min. The pellet was resuspended in 10 mL of 3% beef extract pH 7.4, and samples were shaken for 10 min at 150 rpm. Finally, the concentrate was recovered by centrifugation at 1900 × g for 30 min and the pellet was resuspended in 1 ml of phosphate buffer saline (PBS) and stored at −80 °C. Alternatively, 40 mL of influent wastewater samples were processed with the Enviro Wastewater TNA Kit (Promega Corp., Spain) vacuum concentration system following the manufacturer’s instructions 100 . For biosolid samples, 0.1 g of biosolid were resuspended in 900 µL PBS for nucleic acid extraction prior to PCR analyses.

Nucleic acid extraction from influent and effluent wastewater concentrates and biosolid suspensions was performed by using the Maxwell® RSC Instrument (Promega, Spain) with the Maxwell RSC Pure Food GMO for viral and ARG extraction. Specific programs, namely ‘Maxwell RSC Viral Total Nucleic Acid’ and ‘PureFood GMO and Authentication,’ were employed for viral and ARG extractions, respectively.

Virus detection and quantification

The detection of process control viruses, PEDV and MgV, was carried out through RT-qPCR using the One Step PrimeScript™ RT-PCR Kit (Perfect Real Time) (Takara Bio Inc., USA) as detailed elsewhere 101 . Levels of HuNoV GI and GII, HAstV, RV, HAV, and HEV were determined using the RNA UltraSense One-Step kit (Invitrogen, USA), following previously described procedures 9 , 11 . The occurrence of crAssphage was established using the qPCR Premix Ex Taq™ kit (Takara Bio Inc) 102 . PMMoV detection was determined using the PMMoV Fecal Indicator RT-qPCR Kit (Promega, Spain) following the manufacturer’s instructions. SARS-CoV-2 detection was performed by targeting the N1 region of the nucleocapsid gene. The One Step PrimeScript™ RT-PCR Kit (Perfect Real Time) was used with N1 primers and conditions described by CDC 103 . IAV detection followed the protocol described by CDC (2009) using primers from CDC (2020) and the One Step PrimeScript™ RT-PCR Kit (Perfect Real Time) 104 .

Different controls were used in all assays: negative process control consisting of PBS; whole process control to monitor the process efficiency of each sample (spiked with PEDV and MgV); and positive (targeted gene reference material) and negative (RNase-free water) RT-qPCR controls. The recoveries of PEDV and MgV, spiked as enveloped and non-enveloped viral process controls, respectively, ranged between 6.31 and 59.65% (data not included). The validation of results for targeted viruses adhered the criteria specified in ISO 15216-1:2017, where a recovery of the process control of ≥1% is required 105 .

Commercially available gBlock synthetic gene fragments (Integrated DNA Technologies, Inc., USA) of HuNoVs GI and GII, HAstV, RV, HAV, HEV, and crAssphage were used to prepare standard curves for quantification. For IAV and RSV quantification, Twist Synthetic InfluenzaV H1N1 RNA control (Twist BioScience, South San Francisco, CA, USA), and purified RNA of RSV (Vircell, S.L., Spain) were used. The PMMoV Fecal Indicator RT-qPCR Kit (Promega) provided PMMoV RNA for generating a standard curve. A table, featuring primers, probes, PCR conditions, limit of quantification (LOQ/L), and limit of detection (LOD/L) for all targeted viruses in this work is available in the Supplementary materials (Supplementary Table 1 ).

Quantification of viable somatic coliphages, E. coli , and Extended Spectrum Beta-Lactamases producing E. coli

One mL of influent and effluent samples was filtered through sterile 0.45 μm pore syringe filters (Labbox Labware, S.L., Spain) to remove bacteria and fungus 106 . Phage enumeration was performed by plaque counting using the commercial Bluephage Easy Kit for Enumeration of Somatic Coliphages (Bluephage S.L., Spain), following manufacturer’s instructions. For biosolid samples, 1 g of biosolid was resuspended in 100 mL PBS for both somatic coliphages and E. coli enumeration.

For all water and biosolid samples, E. coli and ESBL- E. coli enumeration was assessed by using selective culture media Chromocult coliform agar (Merck, Darmstadt, Germany) and CHROMagar ESBL (CHROMagar, Paris, France), respectively. Spread plating (0.1 mL) or membrane filtration (200 mL) was used depending on the anticipated bacterial concentration. Influent wastewater samples were diluted serially, and 0.1 mL aliquots were spread-plated. Effluent samples were filtered through a 0.45 μm cellulose nitrate membrane filter (Sartorius, Madrid, Spain). Following incubation at 37 °C for 24 hours, results were interpreted, with. dark blue-violet colonies considered positive for E. coli and dark pink-reddish colonies considered positive for ESBL- E. coli . The analysis was performed in duplicate, and the results were expressed as CFU/100 mL. The detection limit (LOD) for E. coli and ESBL- E. coli counts in the influent and biosolid samples was 2.0 Log CFU/100 mL (100 CFU/100 mL), while in the effluents, the LOD was 0 Log CFU/100 mL (1 CFU/100 mL).

Detection and quantification of antimicrobial resistance genes in effluent waters and biosolids

In this study, 11 ARGs that confer resistance to Sulfonamides ( sul1 , sul2_ 1), beta-lactamase ( pbp2b , bla CTX- M ), phenicols ( cmlA_2 ), nitroimidazoles ( nimE ), MLSB ( ermB_ 1, ermA ), tetracyclines ( tetPB_3 , tetA_1 ) and fluoroquinolones ( qacA_1 ), were only detected in effluent waters and biosolids. The 16 S rRNA gene was used as positive control for qPCR measurement. Quantification of the 12 selected genes was performed by high-throughput quantitative PCR (HT-qPCR) using the SmartChip™ Real-Time PCR system (TakaraBio, CA, USA) by Resistomap Oy (Helsinki, Finland). qPCR cycling conditions and processing of raw data were described elsewhere 107 , 108 , 109 , 110 . Each DNA sample was analysed in duplicate. Data processing and analysis were performed by using a python-based script by Resistomap Oy (Helsinki, Finland) 100 , 111 .

Digestion of organic material and isolation of MPs

Initial steps consisted on optimizing the protocol for the removal of organic material and the isolation of the maximum number of MPs from wastewater and biosolid samples. Different volumes of water, amounts of biosolids and digestion strategies for organic biomass removal were tested to remove the greatest amount of organic material without compromising the integrity of the MPs. Avoiding filter clogging was a requirement during the methodology development, to facilitate further identification of MPs. To reduce the risk of external contamination by MPs, laboratory consumables made of glass were used, the reagents were purified by filtering through a 0.2 µm pore size nitrocellulose filter (Whatman, Maidstone, UK), 100% cotton lab aprons were used, samples were processed in a laminar flow cabinet, the beakers were covered with a watch glass, disposable nitrile gloves were used and, before and after using the material, all used materials were rinsed thoroughly with deionized water. In order to assure that the isolation of MPs was effective and external contamination did not occur, a negative control (NC) was included every month and a positive control (PC) was carried out every 3 months. The positive control was made with fluorescent polystyrene microspheres (Invitrogen, Waltham, USA) of 1 µm in diameter. Specifically, a solution of 1000 beads/20 µL was prepared and 20 µL of this solution was incorporated before the pre-treatment and, the number of remaining microbeads after the digestion protocol was determined to calculate the percentage of recovery. The average value of particle recovery was 93.9%.

Two different pre-treatment protocols were finally defined:

(1) Sieved > 300 µm or (S): With this pre-treatment, all solid particles (including MPs) larger than 300 µm were isolated from 2 L of wastewater or 5 g of biosolid samples after sieving, oxidative digestion, and filtration steps.

(2) Total Particles or (T): With this pre-treatment all solid particles (including MPs) with a size between 1 µm and 5 mm were isolated from a 10 mL aliquot of wastewater after oxidative digestion, density separation, and filtration steps.

Through protocol (S), a larger and more representative amount of wastewater was treated, but particles smaller than 300 µm were lost. In the other hand, protocol (T) allowed the analysis of particles down to 1 µm in size, but the amount of analysed wastewater was much smaller to avoid filter clogging.

In both protocols (S) and (T), oxidative digestion was performed to remove organic material, adapting the method described by the National Oceanic and Atmospheric Administration (NOAA) 112 .

In the case of the Sieved 300 µm or (S) protocol (Figs. 11 ), 2L of wastewater or 5 g of biosolids were treated. The 5 g of biosolids were previously dispersed in 100 mL of ultrapure MilliQ water by applying stirring and heat during 30 minutes at 30 °C. The wastewater or biosolid dispersion were subsequently poured through a 300 µm mesh stainless steel sieve. The retained particles were collected by washing with MilliQ water into a beaker and digested by adding an equivalent volume of NaClO (14%, VWR chemical, USA). After heating at 75 °C for 3 h under stirring, the sample was sieved again to remove the disaggregated smallest particles. The particles retained on the sieve were collected by washing with MilliQ water on a 0.8 µm pore size nitrocellulose filter (Whatman, USA). The filter was protected from external contamination between a microscope glass slide and a glass cover, and finally dried at 40 °C for 24 h in a convection oven.

Scheme summary of the methodology used for the isolation, quantification, and identification of microplastics (MPs).

In the case of the Total Particles or (T) protocol, an oxidative digestion (Fenton reaction) was performed on a 10 mL wastewater sample by adding 20 mL of a H 2 O 2 (30%, Sigma- Aldrich, USA) solution and 20 mL of a 0.05 M Fe (II) solution prepared by mixing FeSO 4 (Sigma- Aldrich, USA), H 2 SO 4 (96%, PanReac AppliChem, ITW Reagents, USA) and deionized water. The sample was then heated at 75 °C for 30 min under stirring. The digestion step was repeated if any remaining organic material was visually. Thereafter, a density separation was performed after adding NaCl (99.5%, Sigma- Aldrich, USA) until saturation. Subsequently, the sample was left to sediment for 30 min in a separatory funnel and the supernatant was filtered through a 0.8 µm pore size nitrocellulose filter (Whatman, USA) under vacuum. The filter was also protected between glass slide and coverslip and dried at 40 °C for 24 hours.

Characterization of particles present in biosolid and wastewater samples

Filters obtained after pre-treatment protocols (S) and (T) were photographed using an EVOCAM II macrophotography equipment (Vision Engineering, Woking, UK) and the ViPlus software (2018, Vision Engineering). Two partially overlapping 2MPx color photos were taken for each filter, always at 20x magnification, with half of the filter appearing in each photo. These images were fused by digital stitching techniques using the mosaic J command of the FIJI software (ImageJ 1.49q Software, National Institutes of Health, USA). Each image showed a 25*15 mm field of view. The pixel size was 13.3 microns, obtaining an image to calibrate in each photo session to have precise external calibration data. A rough quantification was performed, and all particles, including MPs, were characterized using the Nis Elements BR 3.2 software (Nikon Corporation, Japan). To achieve this, a macro of programmed actions was designed in which, firstly, the pixel size was calibrated in the complete image of the filter, then a matrix-iterative detection tool for particles less bright than the filter was applied, which facilitated a binary segmentation by brightness levels and achieve the selection of the particles of each filter in an automated way, only in the filtration zone. Finally, the data of all the particles were exported to obtain the count and the different morphological values of numerous parameters and perform the statistical calculations.

For the characterization, the particles were classified into 3 size ranges of 1–100 µm, 100–300 µm and 300-5000 µm. The particles were also classified according to their circularity, calculated from the measured perimeter and area of each particle according to Eq. 1 , in 3 ranges: 0-0.4, 0.4–0.8, and 0.8-1. A circularity value of 1.0 indicates a perfect circle. As the value approaches 0.0, it indicates an increasingly elongated polygon. Particles with a circularity less than 0.4 were considered as fibers.

In addition, the efficiency of WWTPs in removing particles was calculated according to the following equation:

Where: Efficiency = particle removal efficiency (%); influent = number of particles detected at the WWTP influent; effluent = number of particles detected at the WWTP effluent.

Quantification of microplastics present in biosolid and wastewater samples

Quantification, identification, and characterization of MPs was carried out only on samples from the odd months. The analysis was performed using an automated Raman microscope Alpha300 apyron (Witec, Ulm, Germany). First, each filter was mapped by acquiring a total of 1089 images, which after reconstruction represented a 27% of the filter area or 1 cm 2 . The present particles were detected and selected by performing image analysis using the ParticleScout 6.0 software in automatic mode.

After particle selection, analysis on each particle by Raman spectroscopy and subsequent identification were carried out. The optimal conditions for Raman spectra acquisition were as follows: 785 nm laser which facilitates to identify fluorescent particles, 300 lines/mm diffraction grating opening, spectral range between 0 and 3000 cm –1 , 10 accumulations, 0.2 second acquisition time, and 40 mW laser power. The spectrum of each particle was registered and compared with an in-house build spectral library of polymers. The reference polymer materials included in the spectral library were polyethylene (PE), polyethylene terephthalate (PET), polyamide (PA), polypropylene (PP), polystyrene (PS), polyvinyl chloride (PVC), polytetrafluoroethylene (PTFE), polyacrylamide (PAM), Polyarylsulfones (PSU), Polymethylmethacrylate (PMMA), nitrile rubber (NBR), Cellophane and Melamine. Particles that had a 75% or better match (HQI) between the sample and reference spectra were identified as composed of the same material or of a similar chemical nature. In addition, a visual inspection was carried out and the spectrum acquisition was repeated on the particles where a clear identification was not initially possible. Three rules were considered to discriminate between plastics and non-plastics and to prioritize the particles to be analysed: (i) the object must not show cellular or natural organic structures; (ii) the fibre thickness must be uniform along the entire length; (iii) the colour of the particles must be clear and homogeneous 113 . The MPs already identified were classified based on material type, size, morphology, and area.

Statistical analysis

Results were statistically analysed and significance of differences was determined on the ranks with a one-way analysis of variance (ANOVA) and Tukey’s multiple comparison tests. In all cases, a value of p  < 0.05 (confidence interval 95%) was deemed significant.

Data availability

The datasets used and/or analysed during the current study available from the corresponding author on reasonable request.

Barcelo, D., & Petrovic, M. The Handbook of Environmental Chemistry (D. Barcel & Andrey G. Kostianoy, Eds.; Springer) (2011).

FAO. Water for Sustainable Food and Agriculture A report produced for the G20 Presidency of Germany. Retrieved 17 October 2023, from www.fao.org/publications (2017).

K Mishra, R., Mentha, S. S., Misra, Y., & Dwivedi, N. Emerging pollutants of severe environmental concern in water and wastewater: A comprehensive review on current developments and future research. https://doi.org/10.1016/j.wen.2023.08.002 (2023).

Oude Munnink, B. B., & van der Hoek, L. Viruses causing gastroenteritis: the known, the new and those beyond. Viruses, 8 . https://doi.org/10.3390/v8020042 (2016).

Bosch, A., Guix, S., Sano, D. & Pintó, R. M. New tools for the study and direct surveillance of viral pathogens in water. Curr. Opin. Biotechnol. 19 , 295–301 (2008).

Article   CAS   Google Scholar  

Okoh, A. I., Sibanda, T. & Gusha, S. S. Inadequately treated wastewater as a source of human enteric viruses in the environment. Int. J. Environ. Res. Public Health 7 , 2620–2637 (2010).

EC, E. C. Regulation (EU) 2020/741 of The European Parliament and of the Council of 25 May 2020 on minimum requirements for water reuse (Text with EEA relevance). Off. J. Eur. Union , L, 177 , 32–55(63) (2020).

Canh, V. D., Torii, S., Furumai, H. & Katayama, H. Application of Capsid Integrity (RT-)qPCR to assessing occurrence of intact viruses in surface water and tap water in Japan. Water Res. 189 , 116674 (2021).

Cuevas-Ferrando, E., Pérez-Cataluña, A., Falcó, I., Randazzo, W., & Sánchez, G. Monitoring human viral pathogens reveals potential hazard for treated wastewater discharge or reuse. Front. Microbiol., 13 . https://doi.org/10.3389/FMICB.2022.836193 (2022).

Gyawali, P. & Hewitt, J. Detection of infectious noroviruses from wastewater and seawater using PEMAXTM treatment combined with RT-qPCR. Water 10 , 841 (2018).

Article   Google Scholar  

Randazzo, W. et al. Interlaboratory comparative study to detect potentially infectious human enteric viruses in influent and effluent waters. Food Environ. Virol. 11 , 350–363 (2019).

Truchado, P. et al. Monitoring of human enteric virus and coliphages throughout water reuse system of wastewater treatment plants to irrigation endpoint of leafy greens. Sci. Total Environ. 782 , 146837 (2021).

One Health Initiative (n.d.). Retrieved 17 October 2023, from www.archive.onehealthinitiative.com/index.php .

Oliveira, M. et al. Surveillance on ESBL- Escherichia coli and Indicator ARG in wastewater and reclaimed water of four regions of Spain: Impact of different disinfection treatments. Antibiotics , 12. https://doi.org/10.3390/ANTIBIOTICS12020400 (2023).

Schwartz, T., Kohnen, W., Jansen, B. & Obst, U. Detection of antibiotic-resistant bacteria and their resistance genes in wastewater, surface water, and drinking water biofilms. FEMS Microbiol. Ecol. 43 , 325–335 (2003).

Koutsoumanis, K. et al. Role played by the environment in the emergence and spread of antimicrobial resistance (AMR) through the food chain. EFSA J. 19 , e06651 (2021).

CAS   Google Scholar  

Gajdoš, S. et al. Synergistic removal of pharmaceuticals and antibiotic resistance from ultrafiltered WWTP effluent: Free-floating ARGs exceptionally susceptible to degradation. J. Environ. Manag. 340 , 117861 (2023).

PlasticsEurope. Plastics-the Facts 2020. An analysis of European plastics production, demand, and waste data. Retrieved 12 September 2023. https://plasticseurope.org/wp-content/uploads/2021/09/Plastics_the_facts-WEB-2020_versionJun21_final.pdf (2020).

EC. Proposal for a revised Urban Wastewater Treatment Directive. Retrieved 10 November 2023, from https://environment.ec.europa.eu/publications/proposal-revised-urban-wastewater-treatment-directive_en (2022).

Wang, L. et al. Environmental fate, toxicity and risk management strategies of nanoplastics in the environment: Current status and future perspectives. J. Hazard. Mater. 401 , 123415 (2021).

Pironti, C., et al. Microplastics in the environment: intake through the food web, human exposure and toxicological effects. Toxics , 9 . https://doi.org/10.3390/TOXICS9090224 (2021).

Fackelmann, G. & Sommer, S. Microplastics and the gut microbiome: How chronically exposed species may suffer from gut dysbiosis. Mar. Pollut. Bull. 143 , 193–203 (2019).

Jenner, L. C. et al. Detection of microplastics in human lung tissue using μFTIR spectroscopy. Sci. Total Environ. 831 , 154907 (2022).

Ibrahim, Y. S. et al. Detection of microplastics in human colectomy specimens. JGH Open 5 , 116–121 (2021).

Zhu, L. et al. Identification of microplastics in human placenta using laser direct infrared spectroscopy. Sci. Total Environ. 856 , 159060 (2023).

Leslie, H. A. et al. Discovery and quantification of plastic particle pollution in human blood. Environ. Int. 163 , 107199 (2022).

Bowley, J., Baker-Austin, C., Porter, A., Hartnell, R. & Lewis, C. Oceanic Hitchhikers – assessing pathogen risks from marine microplastic. Trends Microbiol. 29 , 107–116 (2021).

Bouwmeester, H., Hollman, P. C. & Peters, R. J. Potential health impact of environmentally released micro- and nanoplastics in the human food production chain: experiences from nanotoxicology. Environ. Sci. Technol. 49 , 8932–8947 (2015).

Grindler, N. M. et al. Exposure to Phthalate, an endocrine disrupting chemical, alters the first trimester placental methylome and transcriptome in women. Sci. Rep 8 , 1–9 (2018).

Sadia, M. et al. Microplastics pollution from wastewater treatment plants: A critical review on challenges, detection, sustainable removal techniques and circular economy. Environ. Technol. Innov. 28 , 102946 (2022).

Zhu, L. et al. Quantifying health risks of plastisphere antibiotic resistome and deciphering driving mechanisms in an urbanizing watershed. Water Res. 245 , 120574 (2023).

Vermi, M., et al. Viruses in wastewater: occurrence, abundance and detection methods. https://doi.org/10.1016/j.scitotenv.2020.140910 (2020).

Simmons, F. J. & Xagoraraki, I. Release of infectious human enteric viruses by full-scale wastewater utilities. Water Res. 45 , 3590–3598 (2011).

AWPRC. Bacteriophages as model viruses in water quality controlag. Water Res. 25 , 529–545 (1991).

Grabow, W. O. K. Bacteriophages: update on application as models for viruses in water. Water SA 27 , 251–268 (2001).

Google Scholar  

Funderburg, S. W. & Sorber, C. A. Coliphages as indicators of enteric viruses in activated sludge. Water Res. 19 , 547–555 (1985).

Kott1, Y. Estimation of low numbers of Escherichia coli bacteriophage by use of the most probable number method. Appl. Microbiol . https://journals.asm.org/journal/am (1966).

Lucena, F. et al. Reduction of bacterial indicators and bacteriophages infecting faecal bacteria in primary and secondary wastewater treatments. J. Appl. Microbiol. 97 , 1069–1076 (2004).

Ueda, T. & Horan, N. J. Fate of indigenous bacteriophage in a membrane bioreactor. Water Res. 34 , 2151–2159 (2000).

Sánchez G., Bosch A. Survival of enteric viruses in the environment and food. Viruses Foods . 26 :367–392. https://doi.org/10.1007/978-3-319-30723-7_13 (2016).

Bivins, A. et al. Cross-assembly phage and pepper mild mottle virus as viral water quality monitoring tools—potential, research gaps, and way forward. Curr. Opin. Environ. Sci. Health 16 , 54–61 (2020).

Farkas, K. et al. Critical evaluation of CrAssphage as a molecular marker for human-derived wastewater contamination in the aquatic environment. Food Environ. Virol. 11 , 113–119 (2019).

García-Aljaro, C., Ballesté, E., Muniesa, M. & Jofre, J. Determination of crAssphage in water samples and applicability for tracking human faecal pollution. Microb. Biotechnol. 10 , 1775–1780 (2017).

Kitajima, M., Iker, B. C., Pepper, I. L. & Gerba, C. P. Relative abundance and treatment reduction of viruses during wastewater treatment processes - Identification of potential viral indicators. Sci. Total Environ. 488–489 , 290–296 (2014).

Symonds, E. M., Rosario, K. & Breitbart, M. Pepper mild mottle virus: Agricultural menace turned effective tool for microbial water quality monitoring and assessing (waste)water treatment technologies. PLOS Pathog. 15 , e1007639 (2019).

Tandukar, S., Sherchan, S. P. & Haramoto, E. Applicability of crAssphage, pepper mild mottle virus, and tobacco mosaic virus as indicators of reduction of enteric viruses during wastewater treatment. Sci. Rep. 10 , 3616 (2020).

Wu, Z., Greaves, J., Arp, L., Stone, D. & Bibby, K. Comparative fate of CrAssphage with culturable and molecular fecal pollution indicators during activated sludge wastewater treatment. Environ. Int. 136 , 105452 (2020).

Sabar, M. A., Honda, R. & Haramoto, E. CrAssphage as an indicator of human-fecal contamination in water environment and virus reduction in wastewater treatment. Water Res 221 , 118827 (2022).

Kitajima, M., Sassi, H. P. & Torrey, J. R. Pepper mild mottle virus as a water quality indicator. Npj Clean. Water 2018 1 , 1–9 (2018).

Rosario, K., Symonds, E. M., Sinigalliano, C., Stewart, J., & Breitbart, M. Pepper Mild Mottle Virus as an indicator of fecal pollution. Appl. Environ. Microbiol. , 75 , 7261. https://doi.org/10.1128/AEM.00410-09 (2009a).

Symonds, E. M., Nguyen, K. H., Harwood, V. J. & Breitbart, M. Pepper mild mottle virus: A plant pathogen with a greater purpose in (waste)water treatment development and public health management. Water Res. 144 , 1–12 (2018).

Hamza, I. A., Jurzik, L., Überla, K. & Wilhelm, M. Evaluation of pepper mild mottle virus, human picobirnavirus and Torque teno virus as indicators of fecal contamination in river water. Water Res. 45 , 1358–1368 (2011).

Gyawali, P., Croucher, D., Ahmed, W., Devane, M. & Hewitt, J. Evaluation of pepper mild mottle virus as an indicator of human faecal pollution in shellfish and growing waters. Water Res. 154 , 370–376 (2019).

Kuroda, K. et al. Pepper mild mottle virus as an indicator and a tracer of fecal pollution in water environments: Comparative evaluation with wastewater-tracer pharmaceuticals in Hanoi, Vietnam. Sci. Total Environ. 506–507 , 287–298 (2015).

Schmitz, B. W., Kitajima, M., Campillo, M. E., Gerba, C. P. & Pepper, I. L. Virus Reduction during Advanced Bardenpho and Conventional Wastewater Treatment Processes. Environ. Sci. Technol. 50 , 9524–9532 (2016) .

Ando, H. et al. Impact of the COVID-19 pandemic on the prevalence of influenza A and respiratory syncytial viruses elucidated by wastewater-based epidemiology. Sci. Total Environ. , 880 . https://doi.org/10.1016/J.SCITOTENV.2023.162694 (2023).

Boehm, A. B. et al. More than a Tripledemic: Influenza A Virus, Respiratory Syncytial Virus, SARS-CoV-2, and human metapneumovirus in wastewater during winter 2022-2023. Environ. Sci. Technol. Lett. 10 , 622–627 (2023).

Hughes, B. et al. Respiratory Syncytial Virus (RSV) RNA in Wastewater Settled Solids Reflects RSV Clinical Positivity Rates. Environ. Sci. Technol. Lett. 9 , 173–178 (2022).

Mercier, E. et al. (123 C.E.). Municipal and neighbourhood level wastewater surveillance and subtyping of an influenza virus outbreak. Sci. Rep. , 12 , 15777.

Toribio-Avedillo, D. et al. Monitoring influenza and respiratory syncytial virus in wastewater. Beyond COVID-19. Sci. Total Environ. 892 , 164495 (2023).

Wolfe, M. K. et al. Wastewater-based detection of two influenza outbreaks. Environ. Sci. Technol. Lett. 2022 , 687–692 (2022).

Guo, M., Tao, W., Flavell, R. A. & Zhu, S. Potential intestinal infection and faecal-oral transmission of SARS-CoV-2. Nat. Rev. Gastroenterol. Hepatol. 18 , 269–283 (2021).

Detection of hemagglutinin H5 influenza A virus sequence in municipal wastewater solids at wastewater treatment plants with increases in influenza A in spring, 2024. Marlene K. Wolfe, Dorothea Duong, Bridgette Shelden, View ORCID ProfileElana M. G. Chan, Vikram Chan-Herur, Stephen Hilton, Abigail Harvey Paulos, Alessandro Zulli, Bradley J. White, View ORCID ProfileAlexandria B. Boehm. https://doi.org/10.1101/2024.04.26.24306409 .

Nzima, B. et al. Resistotyping and extended-spectrum beta-lactamase genes among Escherichia coli from wastewater treatment plants and recipient surface water for reuse in South Africa. https://doi.org/10.1016/j.nmni.2020.100803 (2020).

Raven, K. E., et al. Genomic surveillance of Escherichia coli in municipal wastewater treatment plants as an indicator of clinically relevant pathogens and their resistance genes. Microb. Genomics , 5. https://doi.org/10.1099/mgen.0.000267 (2019).

Mao, D. et al. Prevalence and proliferation of antibiotic resistance genes in two municipal wastewater treatment plants. Water Res. 85 , 458–466 (2015).

Christgen, B. et al. Metagenomics shows that low-energy anaerobic−aerobic treatment reactors reduce antibiotic resistance gene levels from domestic wastewater. https://doi.org/10.1021/es505521w (2015).

Gekenidis, M. T., Rigotti, S., Hummerjohann, J., Walsh, F. & Drissner, D. Long-term persistence of blaCTX-M-15 in soil and lettuce after introducing extended-Spectrum β-Lactamase (ESBL)-producing Escherichia coli via manure or water. Microorganisms 2020 8 , 1646 (2020).

Bryzgunova, O. E. et al. Redistribution of free- and cell-surface-bound DNA in blood of benign and malignant prostate tumor patients. Acta Nat. 7 , 115 (2015). /pmc/articles/PMC4463421/.

Laktionov, P. P. et al. Cell-surface-bound nucleic acids: Free and cell-surface-bound nucleic acids in blood of healthy donors and breast cancer patients. Ann. N. Y. Acad. Sci. 1022 , 221–227 (2004).

Nagler, M., Insam, H., Pietramellara, G. & Ascher-Jenull, J. Extracellular DNA in natural environments: features, relevance and applications. Appl. Microbiol. Biotechnol. 2018 102 , 6343–6356 (2018).

Zhang, Y., Snow, D. D., Parker, D., Zhou, Z. & Li, X. Intracellular and extracellular antimicrobial resistance genes in the sludge of livestock waste management structures. Environ. Sci. Technol. 47 , 10206–10213 (2013).

Muniesa, M., Colomer-Lluch, M. & Jofre, J. Potential impact of environmental bacteriophages in spreading antibiotic resistance genes. Future Microbiol 8 , 739–751 (2013).

Szczepanowski, R. et al. Detection of 140 clinically relevant antibiotic-resistance genes in the plasmid metagenome of wastewater treatment plant bacteria showing reduced susceptibility to selected antibiotics. Microbiology 155 , 2306–2319 (2009).

Miller, J. H., Novak, J. T., Knocke, W. R. & Pruden, A. Elevation of antibiotic resistance genes at cold temperatures: implications for winter storage of sludge and biosolids. Lett. Appl. Microbiol. 59 , 587–593 (2014).

Xu, S., Liu, Y., Wang, R., Zhang, T. & Lu, W. Behaviors of antibiotic resistance genes (ARGs) and metal resistance genes (MRGs) during the pilot-scale biophysical drying treatment of sewage sludge: Reduction of ARGs and enrichment of MRGs. Sci. Total Environ. 809 , 152221 (2022).

Enfrin, M., Dumée, L. F. & Lee, J. Nano/microplastics in water and wastewater treatment processes – Origin, impact and potential solutions. Water Res. 161 , 621–638 (2019).

Liu, W. et al. A review of the removal of microplastics in global wastewater treatment plants: Characteristics and mechanisms. Environ. Int. 146 , 106277 (2021).

Iyare, P. U., Ouki, S. K. & Bond, T. Microplastics removal in wastewater treatment plants: a critical review. Environ. Sci.: Water Res. Technol. 6 , 2664–2675 (2020).

Deng, L. et al. The destiny of microplastics in one typical petrochemical wastewater treatment plant. Sci. Total Environ. 896 , 165274 (2023).

Talvitie, J. et al. Do wastewater treatment plants act as a potential point source of microplastics? Preliminary study in the coastal Gulf of Finland, Baltic Sea. Water Sci. Technol. 72 , 1495–1504 (2015).

Larissa VuoriMarkku Ollikainen How to remove microplastics in wastewater? A cost-effectiveness analysis. Ecol. Econ. 192 , 107246 (2022).

Koelmans, A. A. et al. Microplastics in freshwaters and drinking water: Critical review and assessment of data quality. Water Res. 155 , 410–422 (2019).

Schymanski, D., Goldbeck, C., Humpf, H. U. & Fürst, P. Analysis of microplastics in water by micro-Raman spectroscopy: Release of plastic particles from different packaging into mineral water. Water Res. 129 , 154–162 (2018).

Senathirajah, K. et al. Estimation of the mass of microplastics ingested – A pivotal first step towards human health risk assessment. J. Hazard. Mater. 404 , 124004 (2021).

Lee, J. H. et al. Detection of microplastic traces in four different types of municipal wastewater treatment plants through FT-IR and TED-GC-MS. Environ. Pollut. 333 , 122017 (2023).

Issac, M. N. & Kandasubramanian, B. Effect of microplastics in water and aquatic systems. Environ. Sci. Pollut. Res. 2021 28 , 19544–19562 (2021).

Reeves, A. et al. Potential transmission of SARS-CoV-2 through microplastics in sewage: A wastewater-based epidemiological review ☆ . https://doi.org/10.1016/j.envpol.2023.122171 (2023).

Kruglova, A. et al. The dangerous transporters: A study of microplastic-associated bacteria passing through municipal wastewater treatment. https://doi.org/10.1016/j.envpol.2022.120316 (2023).

Lai, K. P. et al. Microplastics act as a carrier for wastewater-borne pathogenic bacteria in sewage. https://doi.org/10.1016/j.chemosphere.2022.134692 (2022).

Manoli, K. et al. Investigation of the effect of microplastics on the UV inactivation of antibiotic-resistant bacteria in water. Water Res. 222 , 43–1354 (2022).

Wang, C., et al. Polystyrene microplastics significantly facilitate influenza A virus infection of host cells. https://doi.org/10.1016/j.jhazmat.2022.130617 (2022).

Zhong, H. et al. The hidden risk of microplastic-associated pathogens in aquatic environments. Ecol. Environ. Health 2 , 142–151 (2023).

Nasir, M. S. et al. Innovative technologies for removal of micro plastic: A review of recent advances. Heliyon 10 , e25883 (2024).

Amri, A., Yavari, Z., Reza Nikoo, M. & Karimi, M. Microplastics removal efficiency and risk analysis of wastewater treatment plants in Oman. Chemosphere 359 , 142206 (2024).

Ibrahim, Y. et al. Detection and removal of waterborne enteric viruses from wastewater: A comprehensive review. J. Environ. Chem. Eng. 9 , 105613 (2021).

Al-Hazmi, H. E. et al. Recent advances in aqueous virus removal technologies. Chemosphere 305 , 135441 (2022).

Bhatt, A., Arora, P. & Prajapati, S. K. Occurrence, fates and potential treatment approaches for removal of viruses from wastewater: A review with emphasis on SARS-CoV-2. J. Environ. Chem. Eng. 8 , 104429 (2020) .

Pérez-Cataluña, A. et al. Comparing analytical methods to detect SARS-CoV-2 in wastewater. Sci. Total Environ. 758 , 143870 (2021).

Girón-Guzmán, I. et al. Evaluation of two different concentration methods for surveillance of human viruses in sewage and their effects on SARS-CoV-2 sequencing. Sci. Total Environ. 862 , 160914 (2023).

Puente, H., Randazzo, W., Falcó, I., Carvajal, A. & Sánchez, G. Rapid selective detection of potentially infectious porcine epidemic diarrhea coronavirus exposed to heat treatments using viability RT-qPCR. Front. Microbiol. 11 , 1911 (2020).

Stachler, E. et al. Quantitative CrAssphage PCR Assays for Human Fecal Pollution Measurement. Environ. Sci. Technol. 51 , 9146–9154 (2017).

CDC. CDC 2019-novel coronavirus (2019-nCoV) real-time RT-PCR diagnostic panel. https://www.Fda.Gov/Media/134922/Download . Accessed October 2020.

Sanghavi, S. K., Bullotta, A., Husain, S. & Rinaldo, C. R. Clinical evaluation of multiplex real-time PCR panels for rapid detection of respiratory viral infections. J. Med. Virol. 84 , 162–169 (2012).

Haramoto, E. et al. A review on recent progress in the detection methods and prevalence of human enteric viruses in water. Water Res 135 , 168–186 (2018).

Girón-Guzmán, I. et al. Urban wastewater-based epidemiology for multi-viral pathogen surveillance in the Valencian region, Spain. Water Res 255 , 121463 (2024).

Muurinen, J., et al. Influence of manure application on the environmental resistome under finnish agricultural practice with restricted antibiotic use. https://doi.org/10.1021/acs.est.7b00551 (2017).

Muziasari, W. I., et al. Aquaculture changes the profile of antibiotic resistance and mobile genetic element associated genes in Baltic Sea sediments. FEMS Microbiol. Ecol. , 92 . https://doi.org/10.1093/FEMSEC/FIW052 (2016).

Muziasari, W.I., et al. The resistome of farmed fish feces contributes to the enrichment of antibiotic resistance genes in sediments below baltic sea fish farms. Front. Microbiol. , 7 , 229367. https://doi.org/10.3389/FMICB.2016.02137/BIBTEX (2017).

Wang, F. H. et al. High throughput profiling of antibiotic resistance genes in urban park soils with reclaimed water irrigation. Environ. Sci. Technol. 48 , 9079–9085 (2014).

Yin Lai, F., Muziasari, W., Virta, M., Wiberg, K., & Ahrens, L. Profiles of environmental antibiotic resistomes in the urban aquatic recipients of Sweden using high-throughput quantitative PCR analysis ☆ . https://doi.org/10.1016/j.envpol.2021.117651 (2021).

Masura, J., Baker, J. E., 1959-, Foster, G. D. (Gregory D., Arthur, C., & Herring, C). Laboratory methods for the analysis of microplastics in the marine environment: recommendations for quantifying synthetic particles in waters and sediments. https://doi.org/10.25923/4X5W-8Z02 (2015).

Hidalgo-Ruz, V., Gutow, L., Thompson, R. F. & Thiel, M. Microplastics in the marine environment: A review of the methods used for identification and quantification. Environ. Sci. Technol. 46 , 3060–3075 (2012).

Download references

Acknowledgements

This research was supported by project the Lagoon project (PROMETEO/2021/044) and MCEC WATER (PID 2020 116789 RB C 42 AEI/FEDER, UE). IATA-CSIC is a Centre of Excellence Severo Ochoa (CEX2021-001189-S MCIN/AEI / 10.13039/ 501100011033). IF (MS21-006) and SB were supported by a postdoctoral contract grant for the requalification of the Spanish university system from the Ministry of Universities of the Government of Spain, financed by the European Union (NextGeneration EU).IG-G is recipient of a predoctoral contract from the Generalitat Valenciana (ACIF/2021/181), EC-F is recipient of a postdoctoral contract from the MICINN Call 2018 (PRE2018-083753) and AP-C is recipient of the contract Juan de la Cierva – Incorporación (IJC2020-045382-I) which is financed by MCIN/AEI/10.13039/501100011033 and the European Union “NextGenerationEU/PRTR”. The authors thank Andrea López de Mota, Arianna Pérez, Agustín Garrido Fernández, Mercedes Reyes Sanz, José Miguel Pedra Tellols, and Alcira Reyes Rovatti for their technical support.

Author information

These authors jointly supervised this work: Amparo López-Rubio, Gloria Sánchez.

Authors and Affiliations

Institute of Agrochemistry and Food Technology, IATA-CSIC, Paterna, Valencia, Spain

Inés Girón-Guzmán, Santiago Sánchez-Alberola, Enric Cuevas-Ferrando, Irene Falcó, Azahara Díaz-Reolid, Pablo Puchades-Colera, Alba Pérez-Cataluña, José María Coll, Eugenia Núñez, María José Fabra, Amparo López-Rubio & Gloria Sánchez

Interdisciplinary Platform for Sustainable Plastics towards a Circular Economy—Spanish National Research Council (SusPlast), CSIC, Madrid, Spain

Santiago Sánchez-Alberola, Eugenia Núñez, María José Fabra & Amparo López-Rubio

Department of Microbiology and Ecology, University of Valencia, Burjassot, Valencia, Spain

Irene Falcó

Department of Genetics and Microbiology, Faculty of Biosciences, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Barcelona, Spain

Sandra Ballesteros

You can also search for this author in PubMed   Google Scholar

Contributions

All authors have provided substantial contributions to the conception or design of the work or the acquisition, analysis, or interpretation of the data, drafted the work or revised it critically for important intellectual content, have approved of the completed version, and are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Corresponding author

Correspondence to Enric Cuevas-Ferrando .

Ethics declarations

Competing interests.

The authors declare no competing interests.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary information

Supplementary material, rights and permissions.

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ .

Reprints and permissions

About this article

Cite this article.

Girón-Guzmán, I., Sánchez-Alberola, S., Cuevas-Ferrando, E. et al. Longitudinal study on the multifactorial public health risks associated with sewage reclamation. npj Clean Water 7 , 72 (2024). https://doi.org/10.1038/s41545-024-00365-y

Download citation

Received : 20 February 2024

Accepted : 23 July 2024

Published : 02 August 2024

DOI : https://doi.org/10.1038/s41545-024-00365-y

Share this article

Anyone you share the following link with will be able to read this content:

Sorry, a shareable link is not currently available for this article.

Provided by the Springer Nature SharedIt content-sharing initiative

Quick links

• Explore articles by subject
• Guide to authors
• Editorial policies

Sign up for the Nature Briefing: Anthropocene newsletter — what matters in anthropocene research, free to your inbox weekly.

Research in the Department of Environmental Health can be defined broadly within the following topic areas. Explore each page to learn more.

• Air Pollution
• Built Environment
• Climate Change
• Exposure Assessment
• Nano-Materials
• Occupational Health
• Sustainability
• Toxic Chemicals
• Water Pollution

News from the School

U.S. bird flu response builds on lessons learned from COVID

Experiencing gratitude associated with greater longevity among older adults

Insurance coverage disruptions, challenges accessing care common amid Medicaid unwinding

‘Linear urban forest’ project aims to mitigate heat, improve health in cities

Environmental Health Topics

Air quality.

Air quality is defined in terms of both ambient air (outdoor air) and indoor air. According to the EPA, ambient air refers to the atmosphere that is external to buildings where the general public has access. Indoor air quality (IAQ) refers to the “air quality within and around buildings and structures, especially as it relates to the health and comfort of building occupants.”  Learn more about Air Quality >

Water Quality

Water quality impacts every aspect of our interaction with the element.  From the water we drink, to the water we swim in, the water that is used to grow our food and replenish our aquifers, water quality has a direct impact on our health and wellbeing.  Learn more about Water Quality >

Food Safety

Food-related diseases affect tens of millions of people and kill thousands each year. A foodborne illness is caused by eating or drinking a contaminated food or beverage. NEHA’s Food Safety programs are dedicated to educating food safety and environmental health professionals.  Through the varied food safety related resources available through NEHA, we aim to help inform, educate and improve preparedness, response, and prevention of foodborne diseases within both the regulatory and industry workforce.  Learn more about Food Safety >

Healthy Homes

Healthy homes & communities.

Both natural and man-made environments can have an impact on human health. Environmental health applies to both healthy homes and healthy communities - inside and out.  Learn more about Healthy Homes & Communities >

Preparedness

Preparedness & Response involves awareness, planning and action in emergency situations due to natural disaster, terrorism event, or disease outbreak. Preparedness assists in building community resiliency in both health and economics.  Learn more about Preparedness > 

Climate Change

According to EPA, “climate change refers to any significant change in the measures of climate lasting for an extended period of time,” such as changes in temperature, precipitation, or wind patterns.  Learn more about Climate Change >

Vectors & Pests

According to the World Health Organization, “Vectors are living organisms that transmit infectious diseases between humans or from animal to human”. The most common and impactful vectors for humans are mosquitos and ticks.  Public Health Pests are organisms that are a nuisance to the general public but do not transmit disease. The most common public health pest is the bedbug though recent research has shown that they may have the ability to transmit disease.  Learn more about Vectors and Pests >

Tracking & Informatics

Health tracking & informatics.

Health Tracking and Informatics involves the collection, standardization and distribution of data from environmental indicator and health outcome monitoring. While many individuals track their own health via personal health trackers such as Fitbit or Jawbone, environmental public health tracking involves the collection and presentation of data for a community, county, state or country.  Tracking and Informatics can help leaders make more informed decisions on spending and focusing efforts and allow for citizens to better understand the effects of the environment on their health.  Learn more about Health Tracking & Informatics >

Looking for other Environmental Health Topics?

MPH 625: Environmental Health Issues in Public Health: Selecting a Topic in Public Health

• Selecting a Topic in Public Health
• Find Articles
• Search Strategies
• 3a. Evaluate Sources
• 3b. Primary vs. Secondary Sources
• 3c. Types of Periodicals
• 4a. Paraphrasing
• 4b. Notetaking
• Supplemental Reading
• MPH 625 Syllabus & Assignments

Tip! Keeping up in Public Health

Choose a topic that interests you and will hold your attention. If you do, the research will be more enjoyable! You can also subscribe to receive updates on the topic.  

Some resource suggestions:

• Select the Health Topic Environmental Health in  Medlineplus.gov  to get a general overview of environmental health issues, the latest news, and current research
• Select the Environmental Health Topics page on the  PHPartners.org web site 

Why You Should Stay Informed as a Public Health Professional: see these tips and resources offered by the University of Michigan School of Public Health

Topic Ideas

 Can’t think of a topic to research? 

• Scan your textbook for broad topic ideas.
• Peruse  current magazines and newspapers  to see what catches your eye .
• Browse print and electronic encyclopedias.
• Look at "hot topic" databases, such as Points of View Reference Center , which feature articles on current events and controversial issues.
• Discuss potential topics with your instructor, your librarian or a classmate.

The Research Assignment

Before selecting a topic or starting your research, make sure you understand your assignment and its requirements. Consider the following:

• How many pages/words do you need to write?
• Do you need to include specific types of sources? (e.g. scholarly journal, book, etc.)
• When is the assignment due? How much time do you have to research?
• Is currency of information important?

When in doubt, consult with your instructor!

Getting Topic Ideas from the Subject List and Thesauri of Online Databases

Consider looking at the Subject List tab available in many online databases. Some suggested keywords/terms: public health , environmental health , pollution , radiation exposure , global warming , climate change , and environmental justice .   

• Browse the Subject List for main  terms  in Academic Search Premier
• Browse by subject in JSTOR  
• Browse through the Thesauri in the advanced search page of ProQuest Database for the terms
• Browse for relevant  MeSH - Medical Subject Headings - in  Medline
• You may find some controversial topics that deal with public health issues in the database Points of View Reference Center

Subject Guide

• << Previous: Home
• Next: Find Books >>
• Last Updated: Sep 20, 2021 3:04 PM
• URL: https://liu.brooklyn.libguides.com/MPH625

• Annual Meeting

• Generation Public Health
• Public Health Thank You Day
• Who is public health?
• Climate, Health and Equity
• Racial Equity

Environmental Health

• Gun Violence
• Health Equity
• All Topics and Issues
• Advocacy for Public Health
• Policy Statements
• American Journal of Public Health
• The Nation's Health
• Fact Sheets
• Reports and Issue Briefs
• Advertising
• Public Health Buyers Guide
• Publications Contacts
• Continuing Education
• Public Health CareerMart
• Internships & Fellowships
• Careers at APHA
• Policy Action Institute
• National Public Health Week
• APHA Calendar
• News Releases
• Social Media
• Brand Guidelines
• Member Sections
• Student Assembly
• Member Perks
• Membership Rates
• Agency Membership
• School-Sponsored Student Membership
• Special Member Savings
• Early-Career Professionals
• Gift Membership
• APHA Your Way
• Member Directory
• Topics & Issues >
• Topics & Issues
• Children's Environmental Health
• Environmental Justice
• Lead Contamination

APHA brings national attention to environmental health issues, with a focus on environmental justice, lead contamination, water equity and climate change.

Join us in promoting sensible environmental health policies that foster safe, thriving communities.

Latest Updates

• Learn strategies, insights and best practices for funding and donor development by reviewing our recently released Funding and Donor Development Strategies for Small Nonprofits .
• Check out how five different organizations are working to advance environmental justice  in their communities.

What is environmental health?

Environmental health centers on the relationships between people and their environment.

When people are exposed to hazards like polluted air and lead in their drinking water, they can develop serious conditions, such as asthma, heart disease, cancer and dementia.

Black, Indigenous and People of Color and low-wealth communities are disproportionately burdened by environmental health hazards, systemic and structural racism and disinvestment, negatively impacting their health and well-being.

The environmental health field advances policies and programs that reduce chemical and other environmental exposures in air, water, soil and food.

A key part of any comprehensive public health system, environmental health ensures everyone has a safe place to live, learn, work and play.

How does environment affect our health?

We collaborate with partners and members, including APHA's Environment Section , to center equity and environmental justice to support, engage and lift up evidence-based solutions and best practices to creating environments where all communities can live, play, learn and thrive.

Learn more and get involved on these key topics: 

Children's Environmental Health Climate Change

Environmental Justice Lead Contamination

National Council for Environmental Health & Equity

For more information about our environmental health work, contact  Kate Robb or @EH_4_ALL .

Additional Resources

This communications toolkit, funded by CDC's National Center for Environmental Health, addresses the need for effective outreach and advocacy and aims to redefine and reinvigorate the public conversation around environmental health.

Building Understanding of Environmental Health: A Communications Toolkit

Conversation guides (PDF) highlighting successful cross-disciplinary collaborations across the country for healthy, equitable communities 

Creating the Healthiest Nation: Health & Housing Equity (PDF)

• What is public health
• Topics and Issues
• Policies and Advocacy
• Publications
• Professional Development
• Events and Meetings
• News and Media
• APHA Communities
• Privacy Policy

2024 © American Public Health Association

A .gov website belongs to an official government organization in the United States.

A lock ( ) or https:// means you've safely connected to the .gov website. Share sensitive information only on official, secure websites.

• Cyanotoxins in Air Study
• Outbreak Investigation of Diamond Shruumz TM Products
• Health Studies Publications
• Outbreak Investigation Course and Toolkit

About Environmental Health Studies

At a glance.

CDC conducts epidemiologic studies to better understand the relationship between human health and environmental exposures. Additionally, CDC investigates outbreaks and disease clusters believed to have environmental causes.

CDC assesses human exposure to emerging environmental threats and identifies potential adverse health effects. CDC also conducts rapid epidemiologic investigations in response to outbreaks and disease clusters (for example, unusual patterns of cancer ) related to environmental exposures. In addition, CDC conducts extended research studies to learn about the relationship between environmental threats and human health.

When requested, CDC provides technical assistance and expertise related to conducting environmental health studies to state, tribal, local, territorial, and international public health agencies.

Featured topics

Outbreaks and Disease Clusters Related to Environmental Exposures

Epidemiologic Studies of Emerging Environmental Hazards

Environmental Health Studies

CDC conducts epidemiologic studies to better understand the relationship between human health and environmental exposures.

For Everyone

Public health.

• Frontiers in Plant Science
• Plant Abiotic Stress
• Research Topics

Biological Responses of Plants to Antimony Pollution

Total Downloads

Total Views and Downloads

About this Research Topic

The responses of plants to a constantly changing environment due to anthropogenic pressures have garnered significant interest within the scientific community. Among the pollutants now prevalent due to increased emissions and human activities is antimony (Sb), a ubiquitous metalloid found in water and soil. The growing concern about antimony stems from its latent toxicity and carcinogenicity. The chemical speciation of antimony as Sb(III) or Sb(V) influences its environmental behavior and subsequent toxicity in organisms. Although antimony is a non-essential element for plants, it can still be absorbed, leading to varying levels of bioaccumulation, translocation to aerial parts of the plant, and influencing physiological and metabolic processes. Given its significant impact on plant health and ecosystem dynamics, it is crucial to explore how antimony toxicity affects plant organisms and to investigate the molecular responses activated in the presence of this metal. Plants are capable of responding to environmental imbalances such as contaminant presence by activating a series of tolerance and defense signals. Understanding the link between antimony (Sb) accumulation and plant metabolism has become increasingly necessary. This involves elucidating the biochemical, physiological, and molecular changes that occur in plants due to antimony exposure. The objectives include understanding how antimony's deleterious effects can affect electron transfer, suppress photosynthetic activity, and influence growth and metabolite synthesis. Additionally, the research aims to assess the defense mechanisms activated by plants, investigate the molecular profile, and analyze structural and ultrastructural changes induced by antimony toxicity. The results will also provide insights into plants' bioaccumulation levels and tolerance to antimony for potential applications in environmental remediation projects. We accept various types of articles for this research topic, including hypothesis and theory, methods, mini-reviews, opinions, original research, perspectives, reviews, and systematic reviews. Submitted manuscripts should not have been published previously nor be under consideration for publication elsewhere (excluding conference proceedings papers). We invite researchers to submit manuscripts addressing the following topics: • Effects of antimony pollution on plant growth, metabolism, and production • Multilevel regulation of metal stress responses in plants in the context of antimony exposure • Biochemical parameters of plants as indicators of antimony pollution in air, soil, and water • Expression and regulation of genes and proteins in response to antimony stress • Analysis of ultrastructural damage due to antimony exposure Investigation of oxidative and genotoxic damages in plants caused by antimony • Modulation of enzyme activities involved in defense mechanisms against antimony stress

Keywords : Antimony, Plant metabolism, Pollution, Molecular mechanisms, Defense mechanisms

Important Note : All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.

Topic Editors

Topic coordinators, submission deadlines.

Participating Journals

Manuscripts can be submitted to this Research Topic via the following journals:

total views

• Demographics

No records found

total views article views downloads topic views

Top countries

Top referring sites, about frontiers research topics.

With their unique mixes of varied contributions from Original Research to Review Articles, Research Topics unify the most influential researchers, the latest key findings and historical advances in a hot research area! Find out more on how to host your own Frontiers Research Topic or contribute to one as an author.

Information

• Author Services

Initiatives

You are accessing a machine-readable page. In order to be human-readable, please install an RSS reader.

All articles published by MDPI are made immediately available worldwide under an open access license. No special permission is required to reuse all or part of the article published by MDPI, including figures and tables. For articles published under an open access Creative Common CC BY license, any part of the article may be reused without permission provided that the original article is clearly cited. For more information, please refer to https://www.mdpi.com/openaccess .

Feature papers represent the most advanced research with significant potential for high impact in the field. A Feature Paper should be a substantial original Article that involves several techniques or approaches, provides an outlook for future research directions and describes possible research applications.

Feature papers are submitted upon individual invitation or recommendation by the scientific editors and must receive positive feedback from the reviewers.

Editor’s Choice articles are based on recommendations by the scientific editors of MDPI journals from around the world. Editors select a small number of articles recently published in the journal that they believe will be particularly interesting to readers, or important in the respective research area. The aim is to provide a snapshot of some of the most exciting work published in the various research areas of the journal.

Original Submission Date Received: .

• Active Journals
• Find a Journal
• Proceedings Series
• For Authors
• For Reviewers
• For Editors
• For Librarians
• For Publishers
• For Societies
• For Conference Organizers
• Open Access Policy
• Institutional Open Access Program
• Special Issues Guidelines
• Editorial Process
• Research and Publication Ethics
• Article Processing Charges
• Testimonials
• Preprints.org
• SciProfiles
• Encyclopedia

Article Menu

• Subscribe SciFeed
• Recommended Articles
• Google Scholar
• on Google Scholar
• Table of Contents

Find support for a specific problem in the support section of our website.

Please let us know what you think of our products and services.

Visit our dedicated information section to learn more about MDPI.

JSmol Viewer

Research on urban community street environment evaluation and optimization strategy under the concept of a healthy city: a case study of the dingwangtai area of changsha city, 1. introduction, 2. materials and methods, 2.1. study area, 2.2. data source and processing, 2.2.1. data source, 2.2.2. data processing, 2.3. research methods, 2.3.1. selection of indicators, 2.3.2. entropy-weighting topsis method, 3.1. topsis method results, 3.2. the dingwangtai area spatial health evaluation results, 4. strategy and suggestion, 4.1. healthy streets space design strategy, 4.1.1. optimize the design of streets to improve human perception, 4.1.2. adjusting the functional structure to enhance the vitality of the population, 4.1.3. optimize traffic organization and improve travel experience, 5. discussion, 5.1. in terms of research evaluation, 5.2. in terms of optimization strategies, 5.3. insufficiency of research, 5.4. future prospects, 6. conclusions, author contributions, data availability statement, acknowledgments, conflicts of interest.

• Li, X.; Zhao, M.W. Formation, Declination and Rebuilding of City Features. Adv. Mater. Res. 2011 , 1279 , 1527–1531. [ Google Scholar ] [ CrossRef ]
• Zheng, B.H.; Guo, R.; Komi, B.B.; Xiang, Y.F. Quantitative Evaluation of Urban Style at Street Level: A Case Study of Hengyang County, China. Land 2022 , 11 , 453. [ Google Scholar ] [ CrossRef ]
• Yang, Y.J.; Lei, H.C. Latest Development of Healthy Cities in Foreign Countries and Its Implications for China. Med. Soc. 2016 , 29 , 33–36. [ Google Scholar ] [ CrossRef ]
• Hirsch, J.A.; Roux, A.V.D.; Moore, K.A.; Evenson, K.R.; Rodriguez, D.A. Change in walking and body mass index following residential relocation: The multi-ethnic study of atherosclerosis. Am. J. Public Health 2014 , 104 , 49–56. [ Google Scholar ] [ CrossRef ] [ PubMed ]
• Saelens, B.E.; Handy, S.L. Built environment correlates of walking: A review. Med. Sci. Sports Exerc. 2008 , 40 , S550–S566. [ Google Scholar ] [ CrossRef ]
• Girling, L.C. The Sustainable Street: The Environmental, Human and Economic Aspects of Street Design and Management. Landsc. Urban Plan. 2003 , 62 , 117–118. [ Google Scholar ] [ CrossRef ]
• Ge, Y.; Shen, X.; Cai, C.T. Theory, Method and Practice of Healthy Street Design. Shanghai Urban Plan. Rev. 2020 , 2 , 49–56. [ Google Scholar ] [ CrossRef ]
• Bai, M.; Liu, Y.; Zhang, J.J.; Zhang, X.L. Research on Healthy City and Street Space Renewal. Urban. Archit. 2020 , 17 , 11–13. [ Google Scholar ] [ CrossRef ]
• Liang, H.N. Homo-urbanicus: Basic logic and operational procedure. City Plan. Rev. 2020 , 44 , 68–76. [ Google Scholar ]
• Gallagher, M.R.; Wang, Z.Y. To Pursue Delicate Street Design-Discussion on Streetscape Guidance: A Guide to Better London Streets. Urban Transp. China 2015 , 13 , 56–64. [ Google Scholar ] [ CrossRef ]
• He, H.; Fang, Y.X.; Zhang, T.; Zhang, Q.H.; Li, M.K.; Su, C. The Present and Future of Street Space Quality Research: Quantitative Analysis Based on the Visualization Literature at Home and Abroad in the Past Ten Years. Shanghai Urban Plan. Rev. 2022 , 6 , 73–81. [ Google Scholar ]
• Badland, H.; Mavoa, S.; Boulangé, C.; Eagleson, S.; Gunn, L.; Stewart, J.; David, S.; Giles-Corti, B. Identifying, creating, and testing urban planning measures for transport walking: Findings from the Australian national live ability study. J. Transp. Health 2017 , 5 , 151–162. [ Google Scholar ] [ CrossRef ]
• Deng, Y.L.; Guo, X.C.; Ye, M.; Guo, L.C.; Gong, X.L. The Experience and Inspiration from the Seattle Pedestrian Master Plan. Mod. Urban Res. 2012 , 9 , 17–22. [ Google Scholar ] [ CrossRef ]
• Dai, J. Overview of International Urban Street Design Guidelines. Urban Rural Dev. 2020 , 2 , 76–79. [ Google Scholar ]
• Jiang, Y.; Wang, Y.; Xie, J.H.; Liu, Y.; Zhao, J. Returning to Human-Centered Streets: Recent Developments of Street Design Guidelines in World Cities and Implications for Chinese Cities. Urban Plan. Int. 2012 , 27 , 65–72. [ Google Scholar ]
• Carmona, M.; Gabrieli, T.; Hickman, R.; Laopoulou, T.; Livingstone, N. Street appeal: The value of street improvements. Prog. Plan. 2017 , 126 , 1–51. [ Google Scholar ] [ CrossRef ]
• Prelovskaya, E.; Levashev, A. Modern Approach of Street Space Design. Transp. Res. Procedia 2017 , 20 , 523–528. [ Google Scholar ] [ CrossRef ]
• Jones, P.; Marshall, S.; Boujenko, N. Creating more people-friendly urban streets through ‘link and place’ street planning and design. IATSS Res. 2008 , 32 , 14–25. [ Google Scholar ] [ CrossRef ]
• Harvey, C.; Aultman-Hall, L. Measuring Urban Streetscapes for Livability: A Review of Approaches. Prof. Geogr. 2016 , 68 , 149–158. [ Google Scholar ] [ CrossRef ]
• Kaczynski, A.T.; Besenyi, G.M.; Child, S.; Hughey, S.M.; Colabianchi, N.; McIver, K.L.; Dowda, M.; Pate, R.R.; Healthy Communities Study Team. Relationship of objective street quality attributes with youth physical activity: Findings from the Healthy Communities Study. Pediatr. Obes. 2018 , 13 , 7–13. [ Google Scholar ] [ CrossRef ]
• Curl, A.; Thompson, W.C.; Aspinall, P. The effectiveness of ‘shared space’ residential street interventions on self-reported activity levels and quality of life for older people. Landsc. Urban Plan. 2015 , 139 , 117–125. [ Google Scholar ] [ CrossRef ]
• Hao, X.H.; Long, Y.; Shi, M.; Wang, P. Beijing’s Street Vitality: Measurement, Influencing Factors, and Implications for Planning and Design. Shanghai Urban Plan. Rev. 2016 , 3 , 37–45. [ Google Scholar ] [ CrossRef ]
• Ye, Y.; Zhang, Z.X.; Zhang, X.H.; Zeng, W. Measuring Spatial Quality of Streets at the Human Scale—A Large-Scale, High-Precision Evaluation Framework Combining Streetscape Data and New Analytical Techniques. Urban Plan. Int. 2019 , 34 , 18–27. [ Google Scholar ] [ CrossRef ]
• Wang, L.; Jia, Y.H.; Sun, W.Y.; Jiang, F.F. Quantitative Health Impact Assessment Study for Urban Planning Programs. Planners 2021 , 37 , 72–77. [ Google Scholar ] [ CrossRef ]
• Long, Y.; Shen, Y. Street Urbanism and Data Enhanced Design. 2015. Available online: https://sc802d58b85de2333.jimcontent.com/download/version/1608969944/module/10814319899/name/%E9%BE%99%E7%80%9BDAD.pdf (accessed on 4 January 2024).
• Long, Y.; Li, P.; Hou, J.X. Three-dimensional Urban Form at the Street Block Level for Major Cities in China. Shanghai Urban Plan. Rev. 2019 , 3 , 10–15. [ Google Scholar ]
• Long, Y. Street Urbanism a New Perspective for Urban Studies and City Planning in the New Data Environment. Time Archit. 2016 , 2 , 128–132. [ Google Scholar ] [ CrossRef ]
• Long, Y.; Tang, J.X. Large-scale quantitative measurement of the quality of urban street space: The research progress. City Plan. Rev. 2019 , 43 , 107–114. [ Google Scholar ]
• Gao, Y.B. A Study of Supportive Environments for Walking with Proactive Interventions for Resident Health ; Chongqing University: Chongqing, China, 2022. [ Google Scholar ] [ CrossRef ]
• Wang, L.; Li, X.T.; Yang, X.M. Health in 15-minute Life Sphere: Community Response to Public Health Emergency. Planners 2020 , 36 , 102–106+120. [ Google Scholar ]
• Bao, H.J.; Li, L.L. Evaluation indicator system for Healthy City Planning from the Perspective of Territorial Spatial Planning. Acta Ecol. Sin. 2024 , 10 , 1–11. [ Google Scholar ] [ CrossRef ]
• Dong, X.F.; Yin, H.G.; Chen, L.; Zhang, Y.J. Healthy Cities Seek Solutions from the Community—Taking a Typical Community in Shang Di Street, Beijing as an Example. Urban Dev. Stud. 2023 , 30 , 97–103. [ Google Scholar ] [ CrossRef ]
• Tang, J.X.; Long, Y. Metropolitan Street Space Quality Evaluation: Second and Third Ring of Beijing, Inner Ring of Shanghai. Planners 2017 , 33 , 68–73. [ Google Scholar ] [ CrossRef ]
• Wu, W.S.; Niu, X.Y. Impact of Built Environmental Functional Diversity on Street Vitality: A Case Study of West Nanjing Road in Shanghai. South Archit. 2019 , 2 , 81–86. [ Google Scholar ] [ CrossRef ]
• Fang, R.; Liu, B.Y. A Study on the Morphological Patterns of Living Streets and Their Motivation—Taking Nanjing as an Example. Urban Dev. Stud. 2022 , 29 , 129–136. [ Google Scholar ]
• Si, R.; Lin, Y.Y.; Xiao, Z.P.; Ye, Y. Spatio-temporal Analysis of Built Environment and Street Vitality Relationship Based on Street-level Imagery: A Case Study of Futian District, Shenzhen. Sci. Geogr. Sin. 2021 , 41 , 1536–1545. [ Google Scholar ] [ CrossRef ]
• Ewing, R.; Tian, G.; Goates, J. Varying influences of the built environment on household travel in 15 diverse regions of the United States. Urban Stud. 2015 , 52 , 2330–2348. [ Google Scholar ] [ CrossRef ]
• Yang, T.T.; Peng, H.Y.; Tan, S.H.; Zeng, M.Y. From Urban Stress to Neuro-Urbanization: Review and Framing of Healthy Street Research from an Interdisciplinary Perspective. Urban Plan. Int. 2023 , 38 , 29–38. [ Google Scholar ] [ CrossRef ]
• Dong, Y.; Li, Z.; Dong, W. The Influence of Perceived Living Street Environmental Characteristics on Mental Health of Residents: The Empirical Evidence from Old District in Harbin. Chin. Landsc. Archit. 2021 , 37 , 45–50. [ Google Scholar ] [ CrossRef ]
• Wu, W.S.; Ma, Z.Y.; Guo, J.H.; Niu, X.Y.; Zhao, K. Evaluating the Effects of Built Environment on Street Vitality at the City Level: An Empirical Research Based on Spatial Panel Durbin Model. Int. J. Environ. Res. Public Health 2022 , 19 , 1664. [ Google Scholar ] [ CrossRef ]
• Fumagalli, N.; Maccarini, M.; Rovelli, R.; Berto, R.; Senes, G. An Exploratory Study of Users’ Preference for Different Planting Combinations along Rural Greenways. Sustainability 2020 , 12 , 2120. [ Google Scholar ] [ CrossRef ]
• Xu, L.Q.; Meng, R.X.; Huang, S.Q.; Chen, Z. Healing Oriented Street Design: Experimental Explorations via Virtual Reality. Urban Plan. Int. 2019 , 34 , 38–45. [ Google Scholar ] [ CrossRef ]
• Hao, X.H.; Long, Y. Street Greenery: A New Indicator for Evaluating Walkability. Shanghai Urban Plan. Rev. 2017 , 1 , 32–36+49. [ Google Scholar ] [ CrossRef ]
• Zhao, M.N.; Zhen, F.; Jiang, Y.P. Study on Comprehensive Evaluation and Optimization Strategy of Urban Community Pedestrian Environment: A Case Study of Main Urban Area of Nanjing. Mod. Urban Res. 2021 , 2 , 41–48. [ Google Scholar ] [ CrossRef ]
• Gao, K.; Chen, M.Y.; Liu, Y.; Wu, Z.H. Typical Case Study on the Street Which Takes The Height-Width Ratio and the Near-Line Rate As The Evaluation Indexes—Case Study: Qing Dao. Intell. Build. Smart City 2020 , 130–131+134. [ Google Scholar ] [ CrossRef ]
• Yang, J.Y.; Wu, H.; Zheng, Y. Research on Characteristics and Interactive Mechanism of Street Walkability Through Multisource Big Data: Nanjing Central District as a Case Study. Urban Plan. Int. 2019 , 34 , 33–42. [ Google Scholar ] [ CrossRef ]
• Yang, C.; Tan, S.H.; Li, M.M.; Dong, M.J. Research on active planning intervention strategies for healthy cities. City Plan. Rev. 2022 , 46 , 61–76. [ Google Scholar ]
• Guo, L.L.; Tang, X.M. Evaluation of Walking Comfort of Community Roads under the Background of City Betterment and Ecological Restoration—A Case of Shanghai Cao Yang New Village. Chin. Landsc. Archit. 2020 , 36 , 70–75. [ Google Scholar ] [ CrossRef ]
• Shen, J.; Chun, T.; Niu, Q.; Wei, W.; Peng, Y. Evaluation and Difference Analysis of Built Environment Walking Demands in Urban Residential Areas: A Case Study of Five Types of Residential Areas in Wuhan. Planners 2020 , 36 , 38–44. [ Google Scholar ]
• Tang, X.T. Research on Health Service Function of Urban Public Space Based on Linear Physical Activity VGI ; Harbin Institute of Technology: Harbin, China, 2020. [ Google Scholar ] [ CrossRef ]
• Cao, Z.; Ren, S.B. Urban Street Space Walkability Measurement and Design Application by Conducting Street Design Guidelines: Taking Shanghai as an Example. Urban Rural Plan. 2022 , 1 , 1–12. [ Google Scholar ]
• Jiang, G.Y.; Xia, Z.W.; Sun, X.D.; Wang, X.X.; Luo, S.X. Social Infrastructure and Street Networks as Critical Infrastructure for Aging Friendly Community Design: Mediating the Effect of Physical Activity. Int. J. Environ. Res. Public Health 2022 , 19 , 11842. [ Google Scholar ] [ CrossRef ]
• Xie, Y.W.; Chen, S.Y.; Yan, Y.; Chen, N.P.; Zeng, Z.; Li, X.H. Classification of Urban Community Jogging Environment based on Multi-source Data: A Case Study based on Jinshan Street in Fuzhou City. South Archit. 2024 , 3 , 15. [ Google Scholar ]
• Li, H.X. Research on Neighborhood Scale and Road Patterns Based on Walking Principles of Compact City Concepts ; Nanjing University: Nanjing, China, 2016. [ Google Scholar ]
• Chen, Y.; Huo, K.C.; Tang, H.; Tang, J.F. Study on health assessment system of old city street spaces in Ziyang District, China. Proc. Inst. Civ. Eng. Smart Infrastruct. Constr. 2023 , 40 , 1–19. [ Google Scholar ] [ CrossRef ]
• Zhang, K.X.; Tan, Y. Research on the Spatial Form and Design Strategies of Street Corners Based on the Behavior Characteristics of Pedestrians. Urban. Archit. 2023 , 20 , 72–75. [ Google Scholar ] [ CrossRef ]
• Yu, Y.F.; Hu, Y.T. Progress of International Research on Health Impact of the Built Environment of Communities Literature Review and Ref lections from a Perspective of Physical Activities. Archit. J. 2017 , 2 , 33–38. [ Google Scholar ] [ CrossRef ]
• U.S. Department of Transportation. Pedestrian Road Safety Audit Guidelines and Prompt Lists. 2012. Available online: http://www.doc88.com/p-843810330614.html (accessed on 14 August 2015).
• Shi, C.; Yuan, Q.; Pan, H.X.; Ye, Y. Measuring Walkability of Street Space and Its Design Control in the Context of New Analytical Techniques: A Case Study of Shanghai Jingan Temple Area. Shanghai Urban Plan. Rev. 2020 , 5 , 71–79. [ Google Scholar ]
• Yu, F.; Sun, L.M.; Wang, S.F. Research on Optimization Strategy of Qingdao Coastal Pedestrian Path Based on Post Occupancy Evaluation. Urban. Archit. 2023 , 20 , 69–72. [ Google Scholar ] [ CrossRef ]
• Deelen, I.; Janssen, M.; Vos, S.; Kamphuis, C.; Ettema, D. Attractive running environments for all? A cross-sectional study on physical environmental characteristics and runners’ motives and attitudes, in relation to the experience of the running environment. BMC Public Health 2019 , 19 , 366. [ Google Scholar ] [ CrossRef ]
• Li, M.Y.; Pan, J.H. Assessment of Influence Mechanisms of Built Environment on Street Vitality Using Multisource Spatial Data: A Case Study in Qingdao, China. Sustainability 2023 , 15 , 1518. [ Google Scholar ] [ CrossRef ]

Click here to enlarge figure

Share and Cite

Zhang, Y.; Tang, H.; Huo, K.; Tang, J. Research on Urban Community Street Environment Evaluation and Optimization Strategy under the Concept of a Healthy City: A Case Study of the Dingwangtai Area of Changsha City. Buildings 2024 , 14 , 2449. https://doi.org/10.3390/buildings14082449

Zhang Y, Tang H, Huo K, Tang J. Research on Urban Community Street Environment Evaluation and Optimization Strategy under the Concept of a Healthy City: A Case Study of the Dingwangtai Area of Changsha City. Buildings . 2024; 14(8):2449. https://doi.org/10.3390/buildings14082449

Zhang, Yichi, Hui Tang, Kecheng Huo, and Jiangfan Tang. 2024. "Research on Urban Community Street Environment Evaluation and Optimization Strategy under the Concept of a Healthy City: A Case Study of the Dingwangtai Area of Changsha City" Buildings 14, no. 8: 2449. https://doi.org/10.3390/buildings14082449

Article Metrics

Article access statistics, further information, mdpi initiatives, follow mdpi.

Subscribe to receive issue release notifications and newsletters from MDPI journals

Transforming the understanding and treatment of mental illnesses.

Información en español

Celebrating 75 Years! Learn More >>

• Health Topics
• Brochures and Fact Sheets
• Help for Mental Illnesses
• Clinical Trials

Borderline Personality Disorder

What is borderline personality disorder.

Borderline personality disorder is a mental illness that severely impacts a person’s ability to manage their emotions. This loss of emotional control can increase impulsivity, affect how a person feels about themselves, and negatively impact their relationships with others. Effective treatments are available that can help people manage the symptoms of borderline personality disorder.

What are the signs and symptoms of borderline personality disorder?

People with borderline personality disorder may experience intense mood swings and feel uncertainty about how they see themselves. Their feelings for others can change quickly, and swing from extreme closeness to extreme dislike. These changing feelings can lead to unstable relationships and emotional pain.

People with borderline personality disorder also tend to view things in extremes, such as all good or all bad. Their interests and values can change quickly, and they may act impulsively or recklessly.

Other signs or symptoms may include:

• Efforts to avoid real or perceived abandonment, such as plunging headfirst into relationships—or ending them just as quickly.
• A pattern of intense and unstable relationships with family, friends, and loved ones.
• A distorted and unstable self-image or sense of self.
• Impulsive and often dangerous behaviors, such as spending sprees, unsafe sex, substance misuse, reckless driving, and binge eating. However, if these behaviors happen mostly during times of elevated mood or energy, they may be symptoms of a mood disorder and not borderline personality disorder.
• Self-harming behavior, such as cutting.
• Recurring thoughts of suicidal behaviors or threats.
• Intense and highly variable moods, with episodes lasting from a few hours to a few days.
• Chronic feelings of emptiness.
• Inappropriate, intense anger or problems controlling anger.
• Feelings of dissociation, such as feeling cut off from oneself, observing oneself from outside one’s body, or feelings of unreality.

Not everyone with borderline personality disorder will experience all of these symptoms. The severity, frequency, and duration of symptoms depend on the person and their illness.

People with borderline personality disorder have a significantly higher rate of self-harming and suicidal behavior than the general population.

If you or someone you know is struggling or having thoughts of suicide, call or text the 988 Suicide and Crisis Lifeline   at 988 or chat at 988lifeline.org   . In life-threatening situations, call 911 .

What are the risk factors for borderline personality disorder?

Studies suggest that genetic, environmental, and social factors may increase the likelihood of developing borderline personality disorder. These factors may include:

• Family history: People who have a close family member (such as a parent or sibling) with the illness may be more likely to develop borderline personality disorder due to shared genetic factors.
• Brain structure and function: Research shows that people with borderline personality disorder may have structural and functional changes in the brain, especially in areas that control impulses and emotion regulation. However, it is not clear whether these changes led to the disorder or were caused by the disorder.
• Environmental, cultural, and social factors: Many people with borderline personality disorder report having experienced traumatic life events, such as abuse, abandonment, or hardship, during childhood. Others may have experienced unstable, invalidating relationships or conflicts.

How is borderline personality disorder diagnosed?

A licensed mental health professional—such as a psychiatrist, psychologist, or clinical social worker—can diagnose borderline personality disorder based on a thorough evaluation of a person’s symptoms, experiences, and family medical history. A careful and thorough medical exam can help rule out other possible causes of symptoms.

Borderline personality disorder is usually diagnosed in late adolescence or early adulthood. Occasionally, people younger than age 18 may be diagnosed with borderline personality disorder if their symptoms are significant and last at least 1 year.

What other illnesses can co-occur with borderline personality disorder?

Borderline personality disorder often occurs with other mental illnesses, such as post-traumatic stress disorder (PTSD). These co-occurring disorders can make it harder to correctly diagnose and treat borderline personality disorder, especially when the disorders have overlapping symptoms. For example, a person with borderline personality disorder also may be more likely to experience symptoms of major  depression , PTSD , bipolar disorder , anxiety disorders , substance use disorder , or eating disorders .

How is borderline personality disorder treated?

With evidence-based treatment, many people with borderline personality disorder experience fewer and less severe symptoms, improved functioning, and better quality of life. It is important for people with borderline personality disorder to receive treatment from a licensed mental health professional.

It can take time for symptoms to improve after treatment begins. It is important for people with borderline personality disorder and their loved ones to be patient, stick with the treatment plan, and seek support during treatment.

Some people with borderline personality disorder may need intensive, often inpatient, care to manage severe symptoms, while others may be able to manage their symptoms with outpatient care.

Psychotherapy

Psychotherapy  (sometimes called talk therapy) is the main treatment for people with borderline personality disorder. Most psychotherapy occurs with a licensed, trained mental health professional in one-on-one sessions or with other people in group settings. Group sessions can help people with borderline personality disorder learn how to interact with others and express themselves effectively.

• Dialectical behavior therapy (DBT) was developed specifically for people with borderline personality disorder. DBT uses concepts of mindfulness or awareness of one’s present situation and emotional state. DBT also teaches skills to help people manage intense emotions, reduce self-destructive behaviors, and improve relationships.
• Cognitive behavioral therapy (CBT) can help people with borderline personality disorder identify and change core beliefs and behaviors that come from inaccurate perceptions and problems interacting with others. CBT may help people reduce mood swings and anxiety symptoms and may reduce the number of self-harming or suicidal behaviors.

Medications

The benefits of mental health medications for borderline personality disorder are unclear and medications aren’t typically used as the main treatment for the illness. In some cases, a psychiatrist may recommend medications to treat specific symptoms or co-occurring mental disorders such as mood swings or depression. Treatment with medications may require coordinated care among several health care providers.

Medications can sometimes cause side effects in some people. Talk to your health care provider about what to expect from a particular medication. To find the latest information about medications, talk to a health care provider and visit the Food and Drug Administration website  .

Therapy for caregivers and family members

More research is needed to determine how well family therapy helps with borderline personality disorder. Studies on other mental disorders show that including family members can help support a person’s treatment. Families and caregivers also can benefit from therapy.

Family therapy helps by:

• Allowing people to develop skills to understand and support a loved one with borderline personality disorder
• Focusing on the needs of family members to help them understand the obstacles and strategies for caring for their loved one

How can I find help for borderline personality disorder?

If you’re not sure where to get help, a health care provider can refer you to a licensed mental health professional, such as a psychiatrist or psychologist with experience treating borderline personality disorder. Find tips to help prepare for and get the most out of your visit and information about getting help .

The Substance Abuse and Mental Health Services Administration has an online treatment locator  to help you find mental health services in your area.

Here are some ways to help a friend or family member with borderline personality disorder:

• Take time to learn about the illness to understand what your friend or relative is experiencing.
• Offer emotional support, understanding, patience, and encouragement. Change can be difficult and frightening to people with borderline personality disorder, but things can improve over time.
• Encourage your loved one in treatment for borderline personality disorder to ask about family therapy.
• Seek counseling for yourself. Choose a different therapist than the one your relative is seeing.

How can I find a clinical trial for borderline personality disorder?

Clinical trials are research studies that look at new ways to prevent, detect, or treat diseases and conditions. The goal of clinical trials is to determine if a new test or treatment works and is safe. Although individuals may benefit from being part of a clinical trial, participants should be aware that the primary purpose of a clinical trial is to gain new scientific knowledge so that others may be better helped in the future.

Researchers at NIMH and around the country conduct many studies with patients and healthy volunteers. We have new and better treatment options today because of what clinical trials uncovered years ago. Talk to your health care provider about clinical trials, their benefits and risks, and whether one is right for you.

To learn more or find a study, visit:

• NIMH’s Clinical Trials webpage : Information about participating in clinical trials
• Clinicaltrials.gov: Current Studies on Borderline Personality Disorders  : List of clinical trials funded by the National Institutes of Health (NIH) being conducted across the country

Where can I learn more about borderline personality disorder?

Free brochures and shareable resources.

• Borderline Personality Disorder : This brochure offers basic information about borderline personality disorder, including signs and symptoms, treatment, and finding help. Also available en español .
• 5 Action Steps for Helping Someone in Emotional Pain : This infographic presents five steps for helping someone in emotional pain to prevent suicide. Also available en español .
• Frequently Asked Questions About Suicide :  This fact sheet can help you, or a friend or family member, learn about the signs and symptoms, risk factors and warning signs, and ongoing research about suicide and suicide prevention. Also available en español .
• Warning Signs of Suicide : This infographic presents behaviors and feelings that may be warnings signs that someone is thinking about suicide. Also available en español .
• Digital Shareables on Borderline Personality Disorder : These digital resources, including graphics and messages, can be used to spread the word about borderline personality disorder and help promote awareness and education in your community.

Federal resources

• Borderline Personality Disorder   (MedlinePlus Medical Encyclopedia)
• Borderline Personality Disorder   (Substance Abuse and Mental Health Services Administration)
• Personality Disorders   (MedlinePlus - also en español  )

Research and statistics

• Journal Articles   : This webpage provides articles and abstracts on borderline personality disorder from MEDLINE/PubMed (National Library of Medicine).
• Statistics: Personality Disorders :  This webpage provides the statistics currently available on the prevalence of personality disorder among people in the United States.
• Experts Discuss Borderline Personality Disorder : Learn the signs, symptoms, diagnosis, treatments, and the latest research on borderline personality disorder.

Last Reviewed: April 2024

Unless otherwise specified, the information on our website and in our publications is in the public domain and may be reused or copied without permission. However, you may not reuse or copy images. Please cite the National Institute of Mental Health as the source. Read our copyright policy to learn more about our guidelines for reusing NIMH content.

Create an account

Create a free IEA account to download our reports or subcribe to a paid service.

Global Energy Crisis

How the energy crisis started, how global energy markets are impacting our daily life, and what governments are doing about it

• English English

What is the energy crisis?

Record prices, fuel shortages, rising poverty, slowing economies: the first energy crisis that's truly global.

Energy markets began to tighten in 2021 because of a variety of factors, including the extraordinarily rapid economic rebound following the pandemic. But the situation escalated dramatically into a full-blown global energy crisis following Russia’s invasion of Ukraine in February 2022. The price of natural gas reached record highs, and as a result so did electricity in some markets. Oil prices hit their highest level since 2008. 

Higher energy prices have contributed to painfully high inflation, pushed families into poverty, forced some factories to curtail output or even shut down, and slowed economic growth to the point that some countries are heading towards severe recession. Europe, whose gas supply is uniquely vulnerable because of its historic reliance on Russia, could face gas rationing this winter, while many emerging economies are seeing sharply higher energy import bills and fuel shortages. While today’s energy crisis shares some parallels with the oil shocks of the 1970s, there are important differences. Today’s crisis involves all fossil fuels, while the 1970s price shocks were largely limited to oil at a time when the global economy was much more dependent on oil, and less dependent on gas. The entire word economy is much more interlinked than it was 50 years ago, magnifying the impact. That’s why we can refer to this as the first truly global energy crisis.

Some gas-intensive manufacturing plants in Europe have curtailed output because they can’t afford to keep operating, while in China some have simply had their power supply cut. In emerging and developing economies, where the share of household budgets spent on energy and food is already large, higher energy bills have increased extreme poverty and set back progress towards achieving universal and affordable energy access. Even in advanced economies, rising prices have impacted vulnerable households and caused significant economic, social and political strains.

Climate policies have been blamed in some quarters for contributing to the recent run-up in energy prices, but there is no evidence. In fact, a greater supply of clean energy sources and technologies would have protected consumers and mitigated some of the upward pressure on fuel prices.

Russia's invasion of Ukraine drove European and Asian gas prices to record highs

Evolution of key regional natural gas prices, june 2021-october 2022, what is causing it, disrupted supply chains, bad weather, low investment, and then came russia's invasion of ukraine.

Energy prices have been rising since 2021 because of the rapid economic recovery, weather conditions in various parts of the world, maintenance work that had been delayed by the pandemic, and earlier decisions by oil and gas companies and exporting countries to reduce investments. Russia began withholding gas supplies to Europe in 2021, months ahead of its invasion of Ukraine. All that led to already tight supplies. Russia’s attack on Ukraine greatly exacerbated the situation . The United States and the EU imposed a series of sanctions on Russia and many European countries declared their intention to phase out Russian gas imports completely. Meanwhile, Russia has increasingly curtailed or even turned off its export pipelines. Russia is by far the world’s largest exporter of fossil fuels, and a particularly important supplier to Europe. In 2021, a quarter of all energy consumed in the EU came from Russia. As Europe sought to replace Russian gas, it bid up prices of US, Australian and Qatari ship-borne liquefied natural gas (LNG), raising prices and diverting supply away from traditional LNG customers in Asia. Because gas frequently sets the price at which electricity is sold, power prices soared as well. Both LNG producers and importers are rushing to build new infrastructure to increase how much LNG can be traded internationally, but these costly projects take years to come online. Oil prices also initially soared as international trade routes were reconfigured after the United States, many European countries and some of their Asian allies said they would no longer buy Russian oil. Some shippers have declined to carry Russian oil because of sanctions and insurance risk. Many large oil producers were unable to boost supply to meet rising demand – even with the incentive of sky-high prices – because of a lack of investment in recent years. While prices have come down from their peaks, the outlook is uncertain with new rounds of European sanctions on Russia kicking in later this year.

What is being done?

Pandemic hangovers and rising interest rates limit public responses, while some countries turn to coal.

Some governments are looking to cushion the blow for customers and businesses, either through direct assistance, or by limiting prices for consumers and then paying energy providers the difference. But with inflation in many countries well above target and budget deficits already large because of emergency spending during the Covid-19 pandemic, the scope for cushioning the impact is more limited than in early 2020. Rising inflation has triggered increases in short-term interest rates in many countries, slowing down economic growth. Europeans have rushed to increase gas imports from alternative producers such as Algeria, Norway and Azerbaijan. Several countries have resumed or expanded the use of coal for power generation, and some are extending the lives of nuclear plants slated for de-commissioning. EU members have also introduced gas storage obligations, and agreed on voluntary targets to cut gas and electricity demand by 15% this winter through efficiency measures, greater use of renewables, and support for efficiency improvements. To ensure adequate oil supplies, the IEA and its members responded with the two largest ever releases of emergency oil stocks. With two decisions – on 1 March 2022 and 1 April – the IEA coordinated the release of some 182 million barrels of emergency oil from public stocks or obligated stocks held by industry. Some IEA member countries independently released additional public stocks, resulting in a total of over 240 million barrels being released between March and November 2022.

The IEA has also published action plans to cut oil use with immediate impact, as well as plans for how Europe can reduce its reliance on Russian gas and how common citizens can reduce their energy consumption . The invasion has sparked a reappraisal of energy policies and priorities, calling into question the viability of decades of infrastructure and investment decisions, and profoundly reorientating international energy trade. Gas had been expected to play a key role in many countries as a lower-emitting "bridge" between dirtier fossil fuels and renewable energies. But today’s crisis has called into question natural gas’ reliability.

The current crisis could accelerate the rollout of cleaner, sustainable renewable energy such as wind and solar, just as the 1970s oil shocks spurred major advances in energy efficiency, as well as in nuclear, solar and wind power. The crisis has also underscored the importance of investing in robust gas and power network infrastructure to better integrate regional markets. The EU’s RePowerEU, presented in May 2022 and the United States’ Inflation Reduction Act , passed in August 2022, both contain major initiatives to develop energy efficiency and promote renewable energies. 

The global energy crisis can be a historic turning point

Energy saving tips

1. Heating: turn it down

Lower your thermostat by just 1°C to save around 7% of your heating energy and cut an average bill by EUR 50-70 a year. Always set your thermostat as low as feels comfortable, and wear warm clothes indoors. Use a programmable thermostat to set the temperature to 15°C while you sleep and 10°C when the house is unoccupied. This cuts up to 10% a year off heating bills. Try to only heat the room you’re in or the rooms you use regularly.

The same idea applies in hot weather. Turn off air-conditioning when you’re out. Set the overall temperature 1 °C warmer to cut bills by up to 10%. And only cool the room you’re in.

2. Boiler: adjust the settings

Default boiler settings are often higher than you need. Lower the hot water temperature to save 8% of your heating energy and cut EUR 100 off an average bill.  You may have to have the plumber come once if you have a complex modern combi boiler and can’t figure out the manual. Make sure you follow local recommendations or consult your boiler manual. Swap a bath for a shower to spend less energy heating water. And if you already use a shower, take a shorter one. Hot water tanks and pipes should be insulated to stop heat escaping. Clean wood- and pellet-burning heaters regularly with a wire brush to keep them working efficiently.

3. Warm air: seal it in

Close windows and doors, insulate pipes and draught-proof around windows, chimneys and other gaps to keep the warm air inside. Unless your home is very new, you will lose heat through draughty doors and windows, gaps in the floor, or up the chimney. Draught-proof these gaps with sealant or weather stripping to save up to EUR 100 a year. Install tight-fitting curtains or shades on windows to retain even more heat. Close fireplace and chimney openings (unless a fire is burning) to stop warm air escaping straight up the chimney. And if you never use your fireplace, seal the chimney to stop heat escaping.

4. Lightbulbs: swap them out

Replace old lightbulbs with new LED ones, and only keep on the lights you need. LED bulbs are more efficient than incandescent and halogen lights, they burn out less frequently, and save around EUR 10 a year per bulb. Check the energy label when buying bulbs, and aim for A (the most efficient) rather than G (the least efficient). The simplest and easiest way to save energy is to turn lights off when you leave a room.

5. Grab a bike

Walking or cycling are great alternatives to driving for short journeys, and they help save money, cut emissions and reduce congestion. If you can, leave your car at home for shorter journeys; especially if it’s a larger car. Share your ride with neighbours, friends and colleagues to save energy and money. You’ll also see big savings and health benefits if you travel by bike. Many governments also offer incentives for electric bikes.

6. Use public transport

For longer distances where walking or cycling is impractical, public transport still reduces energy use, congestion and air pollution. If you’re going on a longer trip, consider leaving your car at home and taking the train. Buy a season ticket to save money over time. Your workplace or local government might also offer incentives for travel passes. Plan your trip in advance to save on tickets and find the best route.

7. Drive smarter

Optimise your driving style to reduce fuel consumption: drive smoothly and at lower speeds on motorways, close windows at high speeds and make sure your tires are properly inflated. Try to take routes that avoid heavy traffic and turn off the engine when you’re not moving. Drive 10 km/h slower on motorways to cut your fuel bill by around EUR 60 per year. Driving steadily between 50-90 km/h can also save fuel. When driving faster than 80 km/h, it’s more efficient to use A/C, rather than opening your windows. And service your engine regularly to maintain energy efficiency.

Analysis and forecast to 2026

Fuel report — December 2023

Europe’s energy crisis: Understanding the drivers of the fall in electricity demand

Commentary — 09 May 2023

Where things stand in the global energy crisis one year on

Commentary — 23 February 2023

The global energy crisis pushed fossil fuel consumption subsidies to an all-time high in 2022

Commentary — 16 February 2023

Fossil Fuels Consumption Subsidies 2022

Policy report — February 2023

Background note on the natural gas supply-demand balance of the European Union in 2023

Report — February 2023

Analysis and forecast to 2025

Fuel report — December 2022

How to Avoid Gas Shortages in the European Union in 2023

A practical set of actions to close a potential supply-demand gap

Flagship report — December 2022

Subscription successful

Thank you for subscribing. You can unsubscribe at any time by clicking the link at the bottom of any IEA newsletter.

An official website of the United States government

The .gov means it’s official. Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

The site is secure. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

National Institute of Environmental Health Sciences

Your environment. your health., environmental health topics, in the spotlight.

Asthma is a chronic lung disease. Common symptoms are wheezing, coughing, chest tightness, and shortness of breath. During an asthma attack, the sides of the airways in lungs swell and the airways shrink, making it harder to breathe.

Below is a list of popular health topics at NIEHS.

• Air Pollution and Your Health
• Endocrine Disruptors
• Perfluoroalkyl and Polyfluoroalkyl Substances (PFAS)
• Autoimmune Diseases
• Inflammation
• Electric & Magnetic Fields

Environmental Health Topics A-Z

• Agricultural Health
• Algal Blooms
• Alternatives to Animal Testing
• Bisphenol A (BPA)
• Breast Cancer
• Cell Phone Radio Frequency Radiation
• Chemical Mixtures
• Children's Environmental Health
• Climate Change
• Cosmetics and Your Health
• Dust Mites and Cockroaches
• Emergency Response
• Epigenetics
• Essential Oils
• Exposure Science
• Flame Retardants
• Formaldehyde
• Gene and Environment Interaction
• Hazardous Material/Waste
• Hexavalent Chromium
• Hydraulic Fracturing & Health
• Indoor Air Quality
• Kidney Disease
• Lung Diseases
• Nanomaterials
• Native American Health and the Environment
• Nutrition, Health, and Your Environment
• Parkinson's Disease
• Pet Allergens
• Reproductive Health
• Safe Water and Your Health
• Smoking and Vaping
• Weather Extremes
• Women's Health and the Environment
• Workers' Health