International journal of hygiene and environmental health最新文献

{"title":"Derivation of a dose descriptor for the internal exposure to benzene","authors":"T. Schettgen,&nbsp;K.-M. Wollin,&nbsp;M. Schümann,&nbsp;T. Göen,&nbsp;Y. Chovolou,&nbsp;P. Apel,&nbsp;M. Kolossa-Gehring,&nbsp;H.M. Koch,&nbsp;C. Röhl,&nbsp;Human Biomonitoring Commission of the German Environment Agency","doi":"10.1016/j.ijheh.2026.114908","DOIUrl":"10.1016/j.ijheh.2026.114908","url":null,"abstract":"<div><div>In 2022, the Human Biomonitoring (HBM) Commission of the German Environment Agency developed a concept for the risk assessment of carcinogenic substances in HBM studies, focusing on the internal exposure to genotoxic carcinogens. This concept involves deriving a dose descriptor for the internal exposure based on the concentration of specific biomarkers. In this study, the HBM Commission applies this new concept to benzene as a model substance, using urinary S-phenylmercapturic acid (S-PMA) as specific urinary exposure biomarker for benzene in HBM studies. The HBM Commission estimates additional lifetime cancer risks from benzene exposure using S-PMA HBM data from the German Environmental Specimen Bank and the German Environmental Survey (GerES V). Results indicate that there are considerable cancer risks for benzene in the general population for both adults and children. These findings highlight the importance of considering cumulative environmental exposures in public health risk management and demonstrate the applicability of HBM concepts for risk assessment of carcinogenic substances. Future studies should expand this approach to other environmental carcinogens to better inform mitigation strategies.</div></div>","PeriodicalId":13994,"journal":{"name":"International journal of hygiene and environmental health","volume":"278 ","pages":"Article 114908"},"PeriodicalIF":4.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149019236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serum legacy and emerging PFAS and lipid biomarkers in patients with chronic coronary syndrome: a cross-sectional human biomonitoring study","authors":"Chenyang Wang,&nbsp;Sheng Liu,&nbsp;Siyao Ni,&nbsp;Kexin Yang,&nbsp;Ludan Bi,&nbsp;Wenxuan Chen,&nbsp;Liwei Hang,&nbsp;Yunxiao Yang,&nbsp;Chengqian Yin,&nbsp;Ming Zhang","doi":"10.1016/j.ijheh.2026.114913","DOIUrl":"10.1016/j.ijheh.2026.114913","url":null,"abstract":"<div><div>Per- and polyfluoroalkyl substances (PFAS) have been associated with altered lipid metabolism in general populations, but evidence remains limited among patients with established coronary artery disease, particularly for emerging PFAS replacement compounds. We conducted a cross-sectional study of 155 patients with chronic coronary syndrome from Beijing Anzhen Hospital to examine associations between serum legacy and emerging PFAS and lipid biomarkers. Serum concentrations of 33 PFAS were measured by liquid chromatography-tandem mass spectrometry, and 10 compounds with detection rates &gt;80% were included in the primary analyses. Lipid outcomes included total cholesterol, triglycerides, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol (HDL-C), non-HDL cholesterol, remnant cholesterol, and lipoprotein(a). PFAS concentrations were log₂-transformed, lipid outcomes were ln-transformed. Associations were estimated using multivariable linear regression, with Benjamini–Hochberg false discovery rate correction applied separately within each lipid outcome-specific family of 10 PFAS tests. In fully adjusted models, each doubling of serum PFOS and 6:2 Cl-PFESA concentrations was associated with higher HDL-C levels after outcome-specific BH-FDR correction within the family of 10 PFAS–HDL-C tests (PFOS: β = 0.040, 95% CI: 0.011 to 0.070, q = 0.038; 6:2 Cl-PFESA: β = 0.048, 95% CI: 0.019 to 0.077, q = 0.012). However, neither association remained statistically significant after BH-FDR correction across all 70 individual PFAS–lipid tests. Effect estimates were similar in robust regression and after excluding influential observations, but were attenuated after excluding the highest 5% of exposure values. These findings should not be interpreted as indicating a favorable lipid effect and require confirmation in larger prospective studies.</div></div>","PeriodicalId":13994,"journal":{"name":"International journal of hygiene and environmental health","volume":"278 ","pages":"Article 114913"},"PeriodicalIF":4.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149070731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prenatal exposure to organophosphate esters and child cognitive development in the MARBLES prospective cohort","authors":"Luke Calder,&nbsp;Hyuna Jang,&nbsp;Jiwon Oh,&nbsp;Deborah H. Bennett,&nbsp;Kurunthachalam Kannan,&nbsp;Daniel J. Tancredi,&nbsp;Rebecca J. Schmidt,&nbsp;Hyeong-Moo Shin","doi":"10.1016/j.ijheh.2026.114910","DOIUrl":"10.1016/j.ijheh.2026.114910","url":null,"abstract":"<div><h3>Background</h3><div>Epidemiological studies on prenatal exposure to organophosphate esters (OPEs) and child cognitive development remain inconclusive. We examined associations between prenatal maternal urinary OPE biomarker concentrations and child cognitive development assessed at multiple time points.</div></div><div><h3>Methods</h3><div>The study included 311 mother–child pairs from MARBLES, a prospective cohort of children with elevated familial likelihood of autism and at least one available cognitive assessment. We quantified nine OPE biomarkers in one maternal urine sample per participant, collected predominantly during the third trimester. Cognitive development was assessed at 6, 12, 24, and 36 months, with observations at each time point included in the primary analyses. We examined associations between specific gravity-adjusted urinary OPE biomarker concentrations, both individually and as a mixture, and MSEL Composite and subscale scores at each time point. We also evaluated child sex as an effect modifier and assessed longitudinal changes in scores across assessments.</div></div><div><h3>Results</h3><div>Associations between individual prenatal OPE biomarkers and child cognitive outcomes were largely null after correction for multiple comparisons. Associations between bis(2-chloroethyl) phosphate (BCETP) concentrations and Composite and Visual Reception scores differed by age across assessments, with scores appearing higher at 36 months. Trajectory analyses identified no associations. Effect modification by child sex was not observed.</div></div><div><h3>Conclusions</h3><div>We did not observe that prenatal OPE exposure was associated with cognitive development across infancy and toddlerhood; however, we observed that associations differed by age at assessment, highlighting the importance of repeated outcome measurements. Larger studies in general-population cohorts with repeated exposure measurements throughout pregnancy are warranted.</div></div>","PeriodicalId":13994,"journal":{"name":"International journal of hygiene and environmental health","volume":"278 ","pages":"Article 114910"},"PeriodicalIF":4.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149044826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Household-specific indoor PM2.5 and PM10–2.5 concentrations and Kawasaki disease onset by age six: the Japan Environment and Children's Study","authors":"Kenta Matsumura,&nbsp;Hidekuni Inadera,&nbsp;Megumi Kushima,&nbsp;Akiko Tsuchida,&nbsp;Chiharu Ota,&nbsp;Eiji Yoshioka,&nbsp;The Japan Environment and Children's Study (JECS) Group","doi":"10.1016/j.ijheh.2026.114893","DOIUrl":"10.1016/j.ijheh.2026.114893","url":null,"abstract":"<div><h3>Background</h3><div>Onset of Kawasaki disease has been linked to atmospheric dust and various everyday environmental exposures, including immune stimulation; however, its association with household-specific indoor particulate matter (PM) concentrations remains unclear. Therefore, we examined the associations of indoor PM_2.5 and PM_10–2.5 concentrations with the onset of Kawasaki disease by 6 years of age.</div></div><div><h3>Methods</h3><div>We analyzed 3846 mother–child pairs from the Sub-Cohort Study of the Japan Environment and Children's Study. Indoor PM_2.5 and PM_10–2.5 concentrations were measured over 1-week periods at ages 1.5 and 3.0 years, log-transformed to address their skewed distributions, and then averaged. The outcome was onset of Kawasaki disease by 6 years of age. Logistic regression models were used to estimate odds ratios across exposure categories, and generalized additive models assessed nonlinear associations, adjusted for <em>a priori</em> selected potential confounders.</div></div><div><h3>Results</h3><div>The cumulative incidence of Kawasaki disease by 6 years of age was 15.34 per 1000. Intraclass correlation coefficients for averaged log-transformed indoor PM_2.5 and PM_10–2.5 concentrations at 1.5 and 3.0 years of age were 0.52 and 0.55, respectively. Higher PM_10–2.5 concentrations were associated with lower odds ratios of Kawasaki disease, with a consistent inverse pattern across exposure levels. A similar consistent trend was observed for PM_2.5, although it was weaker than that for PM_10–2.5.</div></div><div><h3>Conclusions</h3><div>Higher household-specific indoor PM concentrations, particularly PM_10–2.5, were associated with a lower risk of Kawasaki disease onset by 6 years of age. Further in-depth studies with larger sample sizes are needed.</div></div>","PeriodicalId":13994,"journal":{"name":"International journal of hygiene and environmental health","volume":"278 ","pages":"Article 114893"},"PeriodicalIF":4.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148938898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outdoor light at night, sleep disorder, and atopic diseases among children and adolescents: a cross-sectional study","authors":"Si-Han Wu,&nbsp;Le-Bing Wang,&nbsp;Xiao-Fan Lu,&nbsp;Yang-Yang Li,&nbsp;Joachim Heinrich,&nbsp;Lidia Morawska,&nbsp;Steve Hung Lam Yim,&nbsp;Shao Lin,&nbsp;Bin Jalaludin,&nbsp;Yi-Ran Chen,&nbsp;Xiao-Yi Liu,&nbsp;Yuan-Yuan Fan,&nbsp;Muhammad Amjad,&nbsp;Wen-Wen Bao,&nbsp;Li-Zi Lin,&nbsp;Yang Zhou,&nbsp;Guang-Hui Dong,&nbsp;Li-Wen Hu","doi":"10.1016/j.ijheh.2026.114891","DOIUrl":"10.1016/j.ijheh.2026.114891","url":null,"abstract":"<div><h3>Background</h3><div>Limited evidence exists regarding the association between outdoor light at night (LAN) and atopic diseases in children and adolescents. We aim to identify the relationship of outdoor LAN exposure with atopic diseases in children and adolescents and to conduct an exploratory statistical mediation analysis involving sleep disorder.</div></div><div><h3>Methods</h3><div>This study collected data from 2012 to 2018 in China, recruiting 176,968 children and adolescents (6-18 years). LAN exposure was assessed using VIIRS/DNB data based on individual addresses. Atopic diseases were determined by self-reported doctor-diagnosed asthma, rhinitis, eczema and conjunctivitis during the past two years. We fitted generalized linear mixed-effects regression models to assess the association between LAN and atopic diseases and conducted mediation analysis to explore the role of sleep disorders in LAN exposure and atopic diseases.</div></div><div><h3>Results</h3><div>Higher quartiles of outdoor LAN were associated with higher odds of having atopic diseases (quartile 2, OR = 1.08 [95% CI: 1.05-1.12]; quartile 3, OR = 1.12 [95% CI: 1.08-1.16]; quartile 4, OR = 1.13 [95% CI: 1.08-1.17]) compared to quartile 1. Increased outdoor LAN exposure was also associated with increased odds for asthma, rhinitis, and eczema. Furthermore, greater ORs were found among children aged &lt;12 years, boys, and higher per capita GDP. The proportion of the total association statistically explained by sleep disorder was 3.18% (95% CI: 0.27%-6.65%) for atopic diseases, 4.52% (95% CI: 0.23%-18.23%) for asthma, 2.38% (95% CI: 0.14%-4.88%) for rhinitis, and 4.07% (95% CI: 0.56%-14.88%) for eczema.</div></div><div><h3>Conclusion</h3><div>Higher outdoor LAN was associated with higher odds of atopic diseases among school-aged children and adolescents. Exploratory analyses suggested a statistical contribution of sleep disorder to some of these associations.</div></div>","PeriodicalId":13994,"journal":{"name":"International journal of hygiene and environmental health","volume":"278 ","pages":"Article 114891"},"PeriodicalIF":4.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148861841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of short-term exposure to volatile hydrocarbons on fertility: Findings from the Gulf Long-term Follow-up Study","authors":"Rebecca N. Noga,&nbsp;Jake E. Thistle,&nbsp;Elizabeth M. Kamai,&nbsp;Patricia A. Stewart,&nbsp;Mark R. Stenzel,&nbsp;W. Braxton Jackson II,&nbsp;Kate E. Christenbury,&nbsp;Richard K. Kwok,&nbsp;Kaitlyn G. Lawrence,&nbsp;Dale P. Sandler,&nbsp;Lawrence S. Engel,&nbsp;Stephanie M. Engel","doi":"10.1016/j.ijheh.2026.114906","DOIUrl":"10.1016/j.ijheh.2026.114906","url":null,"abstract":"<div><div>Petrochemicals benzene, toluene, ethylbenzene, xylene, n-hexane (BTEX-H) and total hydrocarbons (THC) have been linked to adverse reproductive health outcomes, yet few studies have examined their impact on fertility, particularly among oil spill response and clean-up (OSRC) workers. Using data from the Gulf Long-Term Follow-Up (GuLF) Study, a prospective cohort of OSRC workers and non-workers associated with the 2010 <em>Deepwater Horizon</em> disaster clean-up, we evaluated associations between BTEX-H and THC inhalation exposures and post-spill subfertility among 2671 male and 618 female OSRC workers Subfertility was defined as a self-reported infertility diagnosis and/or failure to conceive after 12 months of attempts. Cumulative and maximum daily average exposures to each BTEX-H constituent (ppb-days) and THC (ppm-days) were estimated via job-exposure matrixes combining air monitoring data with detailed <em>Deepwater Horizon</em> disaster-related work histories. Modified Poisson regression models estimated multivariable adjusted risk ratios for subfertility in relation to BTEX-H components, total BTEX, non-BTEX THC, and THC. Among male workers, higher cumulative daily average BTEX-H (RR = 1.14, 95% CI 0.98, 1.32) and THC (RR = 1.18, 95% CI 1.06, 1.31) exposures were associated with monotonically increasing subfertility risk. Among females, associations were less evident; however, increased risk was present for maximum daily average exposures to toluene and total BTEX. Overall, BTEX-H and THC exposures were associated with increased risk of subfertility among male workers, with suggestive evidence of similar associations in female workers. These findings highlight potential reproductive risks linked with OSRC work.</div></div>","PeriodicalId":13994,"journal":{"name":"International journal of hygiene and environmental health","volume":"278 ","pages":"Article 114906"},"PeriodicalIF":4.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149019010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Marine microplastic pollution and cancer incidence from 2013 to 2021 in US coastal counties: an ecological analysis","authors":"Nicolas E. Gentile,&nbsp;Jonathan Y. Huang,&nbsp;Eryn Uemori,&nbsp;Jesse A. Goodrich,&nbsp;Loïc Le Marchand,&nbsp;Max T. Aung,&nbsp;Lida Chatzi,&nbsp;Shiwen Li","doi":"10.1016/j.ijheh.2026.114903","DOIUrl":"10.1016/j.ijheh.2026.114903","url":null,"abstract":"<div><h3>Background</h3><div>Microplastics (MPs) are pervasive environmental contaminants detected in human tissue samples, including the lungs, liver, placenta, gastrointestinal tract, and tumors. Previous studies suggest carcinogenic mechanisms, including oxidative stress, DNA damage, metabolic disruption, and chronic inflammation. However, population-level evidence linking environmental MP contamination to cancer incidence remains limited.</div></div><div><h3>Objective</h3><div>Evaluate ecological associations between environmental MP contamination and site-specific cancer incidence across U.S. coastal counties.</div></div><div><h3>Methods</h3><div>Ecological analysis of U.S. coastal counties was conducted using 2013-2021 Surveillance, Epidemiology, and End Results (SEER) Program data. Applying 20 km buffers, National Oceanic and Atmospheric Administration (NOAA) MP data was spatially linked with counties to generate exposure scores (ranges 1–5). Annual county-level cancer incidence was merged with sociodemographic, behavioral, and environmental covariates. Association estimates using Poisson regression models applied fixed year effects, population offsets, and county-clustered robust standard errors. Incidence rate ratios (IRRs) were reported per 1-unit MP score increase, with false discovery rate controlled at 5%.</div></div><div><h3>Results</h3><div>MP data was linked to 89 coastal counties comprising a mean annual population of ∼54 million residents. 1-unit MP score increases were associated with moderate increases in overall cancer incidence (IRR = 1.01; 95% CI: 1.01–1.02; q = 0.004). Each cancer site was modeled separately. After false discovery rate correction, positive associations were observed for digestive, endocrine, oral cavity and pharynx, respiratory, and male genital cancers (site-specific IRRs 1.02–1.05). Subsite analyses showed heterogeneity, with associations for several digestive cancers, thyroid, prostate, lung and bronchus cancer, and acute myeloid leukemia. Sensitivity analyses found all findings consistent.</div></div>","PeriodicalId":13994,"journal":{"name":"International journal of hygiene and environmental health","volume":"278 ","pages":"Article 114903"},"PeriodicalIF":4.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148938897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patterns of pesticide use and potential health risks among men and women farmers in Rwanda: Practices, behaviors, and knowledge in Eastern Province","authors":"Cynthia L. Curl,&nbsp;Emmanuel Irimaso,&nbsp;Concorde Rwibutso,&nbsp;Therese Nyirahabimana,&nbsp;Liberata Mukamana,&nbsp;Stephanie Mitchell,&nbsp;Dawn Zimmerman,&nbsp;Sabrina B. Sholts","doi":"10.1016/j.ijheh.2026.114892","DOIUrl":"10.1016/j.ijheh.2026.114892","url":null,"abstract":"<div><div>Rapid increases in pesticide use among smallholder farmers in Rwanda raise concerns about associated health impacts in human, animal and environmental systems. Women farmers warrant particular attention due to their substantial participation in agricultural labor and potential for distinct exposure patterns and health risks. We aimed to characterize pesticide use practices, safety knowledge, health effects and health concerns among Rwandan smallholder farmers using a gender-balanced, One Health-informed survey, which we administered to 109 male and 90 female smallholder farmers across 10 sectors of Rwanda's Eastern Province. Based on these self-reported data, we found pesticide use to be widespread and increasing, with more than 80% of participants reporting increased use within the past five years. The most used products were profenofos + cypermethrin insecticidal formulations and mancozeb-based fungicides, with 95% and 83% of participants reporting often or sometimes using these products, respectively. Self-reported symptoms potentially consistent with acute pesticides poisoning were also common, with 89% of participants reporting experiencing eye irritation, 83% rash, 73% headache and 67% breathing problems following pesticide use. Pesticide-related knowledge, concern, and safety behaviors were largely similar between men and women, including high levels of concern about health risks. Rwandan smallholder farmers increasingly rely on pesticides for crop protection, yet few receive formal training on safe application practices or protective behaviors. Our research identifies a consistent desire for additional pesticide health and safety training and important gaps in protective behaviors among the respondents, generating actionable insights for targeted interventions and safer agricultural practices.</div></div>","PeriodicalId":13994,"journal":{"name":"International journal of hygiene and environmental health","volume":"278 ","pages":"Article 114892"},"PeriodicalIF":4.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148881985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High-quality shared sanitation is protective against excreta-related health outcomes: Evidence from India, Kenya, and Uganda","authors":"Lauren Sprouse,&nbsp;Sarah Lebu,&nbsp;Huijoo Shon,&nbsp;Chimdi Muoghalu,&nbsp;Herbert Kaboggoza,&nbsp;Yaoska Reyes,&nbsp;Richard K. Mugambe,&nbsp;Najib Lukooya Batenganya,&nbsp;Barbra Mary Aine,&nbsp;Gloria Mirembe,&nbsp;Aminah Nalukenge,&nbsp;Hakim Sendagire,&nbsp;Swaib Semiyaga,&nbsp;Faridah Nansubuga,&nbsp;Johnson Jeyaseelan,&nbsp;Susan Dundon,&nbsp;John Apambilla Akudago,&nbsp;Musa Manga","doi":"10.1016/j.ijheh.2026.114911","DOIUrl":"10.1016/j.ijheh.2026.114911","url":null,"abstract":"<div><div>Shared sanitation is widely used in rapidly growing informal settlements globally, but is classified as “limited” by current global monitoring standards due to concerns over hygiene, safety, and health risks. While previous studies have identified key features of high-quality shared sanitation, it remains unclear which aspects most strongly influence health outcomes. This study aimed to: (1) identify shared sanitation quality factors associated with diarrhea, stomach pain, and urinary tract infection (UTI); (2) construct a composite indicator of high-quality shared sanitation; and (3) assess whether associations vary across countries. We conducted a cross-sectional study of 5700 households using shared sanitation in informal settlements in Delhi (India), Nairobi (Kenya), and Kampala (Uganda) between June 2025 and January 2026. We assessed five sanitation quality domains — sharing intensity, cleanliness, hygiene, privacy/safety, and accessibility — and examined associations with health outcomes using multilevel logistic regression models. Overall, 14.5% of households reported diarrhea, 13.0% stomach pain, and 10.3% UTI. Sharing intensity was modestly associated with diarrhea (aOR: 1.04 per additional household [95% CI: 1.02–1.07]), while visible fecal contamination in the facility was strongly associated with all outcomes. In composite analyses, facilities meeting ≥4 quality criteria among 6 primary indicators (no visible feces/urine; water available for flushing/cleaning; functional handwashing station; lighting availability; lockable from inside; 24-h access) were consistently protective against diarrhea (aOR: 0.50 [0.41–0.62]), stomach pain (aOR: 0.45 [0.35–0.58]), and UTI (aOR: 0.36 [0.29–0.46]). These findings suggest that incremental improvements in shared sanitation quality may reduce health risks, and moving toward quality-based metrics may better inform investment priorities.</div></div>","PeriodicalId":13994,"journal":{"name":"International journal of hygiene and environmental health","volume":"278 ","pages":"Article 114911"},"PeriodicalIF":4.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149044827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting basic sanitation service achievement among rural households in Ethiopia: An integrated logistic regression and explainable machine learning approach","authors":"Argaw Ambelu,&nbsp;Seblework Mekonen,&nbsp;Taffere Addis,&nbsp;Abayneh Melaku,&nbsp;Alemu Kejela,&nbsp;Ziyad Ahmed Abdo,&nbsp;Ashrafedin Youya,&nbsp;Claudio Valsangiacomo","doi":"10.1016/j.ijheh.2026.114912","DOIUrl":"10.1016/j.ijheh.2026.114912","url":null,"abstract":"<div><div>Access to basic sanitation remains a major public health challenge in rural sub-Saharan Africa, where open defecation and unimproved facilities sustain preventable morbidity and mortality. Despite government-led initiatives, rural sanitation coverage in Ethiopia remains critically below the Sustainable Development Goal 6 target. This community-based cross-sectional study among 842 rural households across seven Ethiopian regions aimed to identify determinants of basic sanitation service achievement and to develop predictive models using multivariable logistic regression and explainable machine learning algorithms. Only 20.9% of households achieved at least basic sanitation service, while 55.8% used unimproved facilities and 17.1% practiced open defecation. Logistic regression identified privacy motivation (AOR = 1.59, 95% CI: 1.10–2.33, p = 0.015), perception of sanitation as a constitutional right (AOR = 1.51, 95% CI: 1.03–2.20, p = 0.034), and access to professional guidance (AOR = 1.49, 95% CI: 1.02–2.19, p = 0.039) as the strongest positive predictors, while households motivated primarily by peer observation had significantly lower odds of service achievement (AOR = 0.48, 95% CI: 0.28–0.81, p = 0.007). Among machine learning models, Categorical Boosting outperformed Extreme Gradient Boosting in accuracy (72.6% versus 60.1%) and balanced accuracy (74.7% versus 68.8%). Shapley Additive Explanations analysis confirmed that rights-based perception and professional consultation were the leading protective factors, while peer-driven motivation and absence of household toilet prioritization were the most influential predictors of non-achievement. Non-achievement of basic sanitation in rural Ethiopia reflects perceptual and behavioral barriers beyond infrastructure gaps. Sanitation programs should strengthen rights awareness, extension-worker engagement, and household prioritization alongside infrastructure investment.</div></div>","PeriodicalId":13994,"journal":{"name":"International journal of hygiene and environmental health","volume":"278 ","pages":"Article 114912"},"PeriodicalIF":4.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149045281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}