International journal of hygiene and environmental health最新文献

{"title":"Psychosocial distress among individuals residing in a rural PFAS-contaminated community","authors":"Elizabeth Scharnetzki ,&nbsp;Lisa B. Rokoff ,&nbsp;Katherine Senechal ,&nbsp;Michelle Bosquet Enlow ,&nbsp;Abby F. Fleisch ,&nbsp;Rachel Criswell","doi":"10.1016/j.ijheh.2025.114736","DOIUrl":"10.1016/j.ijheh.2025.114736","url":null,"abstract":"<div><div>Few studies have evaluated how awareness of PFAS contamination impacts psychosocial distress. We sought to quantify psychosocial distress associated with awareness of drinking water PFAS contamination in the Maine Biosolids Study (<em>n</em>=146), a rural cohort affected by agricultural biosolids spreading. Participants had residential well water PFAS concentrations measured by the Department of Environmental Protection and were notified about concentrations above or below the Maine Interim Drinking Water Standard [∑6 PFAS (PFOA, PFOS, PFNA, PFHxS, PFHpA, PFDA) ≥20 ng/L]. We utilized negative binomial mixed effects regression to study associations of awareness of water PFAS above the Standard with PFAS-related psychosocial outcomes and state-dependent anxiety. We explored effect modification by pre-existing mental health diagnoses and resilience coping style. Fifty-eight percent of participants had drinking water PFAS above the Standard, and 35% had pre-existing mental health diagnoses. Affected participants with drinking water PFAS above the Standard had greater PFAS-related anxiety, worry and fears about health risk, and perceived stigma [for example, IRR_perceived _stigma (95% CI): 1.69 (1.32, 2.15)]. Knowledge of elevated water PFAS was associated with greater state-dependent anxiety, although confidence intervals included the null [IRR (95% CI): 1.21 (0.90, 1.61)]. Associations of awareness of water PFAS with worry about PFAS health risk and state-dependent anxiety were stronger among individuals without a prior mental health diagnosis [e.g., IRR_worry (95% CI): 2.30 (1.49, 3.57) versus 1.27 (0.80, 2.02)]. We found no effect modification by resilience coping style. Individuals with knowledge of elevated drinking water PFAS had greater PFAS-related psychosocial distress. Mental health support and community education are public health needs in PFAS-affected communities.</div></div>","PeriodicalId":13994,"journal":{"name":"International journal of hygiene and environmental health","volume":"272 ","pages":"Article 114736"},"PeriodicalIF":4.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145787320","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":"Per- and polyfluoroalkyl substances serum concentrations during pregnancy and gestational weight gain in the Healthy Start Study","authors":"Julia R. Kaplan ,&nbsp;Dana Dabelea ,&nbsp;Antonia M. Calafat ,&nbsp;John L. Adgate ,&nbsp;Anne P. Starling","doi":"10.1016/j.ijheh.2025.114735","DOIUrl":"10.1016/j.ijheh.2025.114735","url":null,"abstract":"<div><h3>Background</h3><div>Per- and polyfluoroalkyl substances (PFAS) are widespread and persistent contaminants detected in most humans. PFAS exposure has been linked to adverse health conditions, including excessive gestational weight gain (GWG), though results have been inconsistent.</div></div><div><h3>Methods</h3><div>Participants (n = 539) were enrolled in the Healthy Start Study, a Colorado-based cohort (2009–2014). Eleven PFAS were measured in serum collected during pregnancy (median 27 weeks of gestation). GWG was quantified in four ways: absolute change in weight during pregnancy; GWG adjusted for the duration of pregnancy (z-score); 3rd trimester rate of weight gain; and categories of recommended GWG according to Institute of Medicine (IOM) guidelines. PFAS detectable in &gt;60 % of samples (perfluorohexane sulfonate [PFHxS], perfluorooctane sulfonate [PFOS], perfluorooctanoate [PFOA], perfluorononanoate [PFNA], and perfluorodecanoate [PFDA]) were analyzed. We fit covariate-adjusted general linear models for continuous outcomes and multinomial logistic regression models for the categorical outcome. We evaluated effect modification by pre-pregnancy body mass index (BMI) categories.</div></div><div><h3>Results</h3><div>Serum concentrations of PFHxS and PFOS were positively associated with GWG, GWG z-score and greater odds of excessive weight gain. In stratified models, positive associations with GWG were stronger among women with pre-pregnancy BMI classified as overweight compared to those with BMI in the obesity or normal/underweight categories. Mixture analyses suggested that positive associations were largely due to PFOS.</div></div><div><h3>Discussion</h3><div>In a diverse population of pregnant women with PFAS serum concentrations typical of the U.S. general population, PFOS and PFHxS concentrations were associated with greater GWG. The influence of PFAS may differ by women's BMI status entering pregnancy.</div></div>","PeriodicalId":13994,"journal":{"name":"International journal of hygiene and environmental health","volume":"272 ","pages":"Article 114735"},"PeriodicalIF":4.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145787321","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":"Metal and dust exposure in workers from the metal recycling industry in Sweden: cross-sectional GreenMetalWaste study","authors":"Anja Stajnko ,&nbsp;Michael Levi ,&nbsp;Malin Engfeldt ,&nbsp;Robert Linder ,&nbsp;Mats Leeman ,&nbsp;Else Åkerberg Krook ,&nbsp;Eva Assarsson ,&nbsp;Henrik Enquist ,&nbsp;Camilla Dahlqvist ,&nbsp;Åsa Ek ,&nbsp;Karin Lovén ,&nbsp;Theo Bodin ,&nbsp;Anastasiia Snigireva ,&nbsp;Karin Grahn ,&nbsp;Maria Kippler ,&nbsp;Gunilla Rydenstrand ,&nbsp;Evana Amir Taher ,&nbsp;Gunilla Runström Eden ,&nbsp;Bodil Björ ,&nbsp;Helen Bertilsson ,&nbsp;Eva Dock","doi":"10.1016/j.ijheh.2025.114694","DOIUrl":"10.1016/j.ijheh.2025.114694","url":null,"abstract":"<div><div>The green transition relies on metals, requiring increased metal recovery from waste. However, exposure risks among metal recycling workers are poorly understood. We conducted a cross-sectional study to assess dust and metal exposure among 139 recycling workers from 13 Swedish metal recycling companies and 90 controls. We documented work practices through observations and questionnaires and assessed dust and metal exposures using a combination of individual air sampling (inhalable (ID) and respirable dust) and biomonitoring (blood and pre-/post-shift urine). ICP-MS was used to measure 39 metals in air, 47 in blood, and 42 in urine. Thirty-two % of the workers were involved in the recycling of e-waste. At most workplaces, dust control was insufficient, respiratory protective equipment was rarely or incorrectly used, and hygienic routines were inadequate. This was reflected in 6.2 times higher ID levels in recycling workers; 14 % exceeded the 5 mg/m³ exposure limit for ID, and some also exceeded limits for Pb, Cu, As, Cd, and Sb. Workers had elevated blood and/or urine levels of Pb, Hg, Al, Sb, Fe and Mn with known human toxicity, and of Y, Lu, In, Ga, W, and Te with limited or unknown toxicity. Furthermore, observed were also co-exposure patterns for those metals. Inhalation was the likely primary exposure route for Pb, Sb, Y, In, and Te. In conclusion, Swedish recycling workers were exposed to elevated levels of dust and metals, highlighting the need for ongoing monitoring of both known and emerging metals.</div></div>","PeriodicalId":13994,"journal":{"name":"International journal of hygiene and environmental health","volume":"271 ","pages":"Article 114694"},"PeriodicalIF":4.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145403335","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":"Evaluating environmental health communication: The readability of factsheets about per- and polyfluoroalkyl substances (PFAS)","authors":"Carla R. Magi-Prowse ,&nbsp;Kelly S. Fielding ,&nbsp;Kevin V. Thomas ,&nbsp;Kylie Morphett","doi":"10.1016/j.ijheh.2025.114680","DOIUrl":"10.1016/j.ijheh.2025.114680","url":null,"abstract":"<div><h3>Background</h3><div>It is important for environmental health professionals to inform the public about potential chemical risks. Factsheets are a common way to disseminate information to the public, however, there has been little evaluation of whether these materials are fit for purpose.</div></div><div><h3>Objectives</h3><div>This study evaluated the readability of factsheets about per- and polyfluoroalkyl substances (PFAS), contaminants of emerging concern that have impacted communities worldwide.</div></div><div><h3>Methods</h3><div>Using grey literature searches, we identified 36 PFAS fact sheets published by government agencies in countries where PFAS contamination events had occurred. Factsheets were evaluated using the Simple Measure of Gobbledygook (SMOG) readability formula, language complexity, and the Patient Education Materials Assessment Tool for Printable Materials (PEMAT-P).</div></div><div><h3>Results</h3><div>The factsheets had an average reading grade level of 15.1 with no factsheets meeting the recommended reading grade range of 5–8. On average, almost one quarter of the words used in the factsheets were complex or uncommon words. Only 8 of the factsheets scored above 70% on PEMAT-P, which is the threshold at which factsheets are categorised as understandable.</div></div><div><h3>Conclusion</h3><div>This study demonstrates that PFAS factsheets are typically not written at an appropriate reading level. We identify several areas for improvement such as using health literacy tools to reduce the complexity of language, incorporating infographics and pop out boxes, and providing concise summaries of information. To increase environmental health literacy, environmental health communicators should draw on the learnings of health communication and utilise existing tools to improve readability.</div></div>","PeriodicalId":13994,"journal":{"name":"International journal of hygiene and environmental health","volume":"271 ","pages":"Article 114680"},"PeriodicalIF":4.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145314266","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":"Does peer learning improve local government capacity to improve sanitation? A contribution analysis in rural Mozambique","authors":"Jamie Myers ,&nbsp;Énio Tembe ,&nbsp;Paul Hutchings ,&nbsp;Jamie Bartram ,&nbsp;Barbara Evans","doi":"10.1016/j.ijheh.2025.114701","DOIUrl":"10.1016/j.ijheh.2025.114701","url":null,"abstract":"<div><div>Strengthening local government capacity to improve sanitation and other basic services is a challenge in many low resource countries. There is growing interest in peer learning as a mechanism to spread successful practices and increase local government performance in the settings. However, few studies have investigated if peer learning leads to changes in practices and improved results. The study aims to identify and evaluate the causal linkages between peer learning activities and any changes to participants capacity, local government practices and increases in sanitation coverage in rural districts. Contribution Analysis, a theory-based evaluation approach, was used to design a longitudinal study investigating outputs, outcomes and impacts of two peer learning workshops between Open Defecation Free (ODF) Districts and non-ODF Districts in Mozambique alongside the enablers and barriers to change. The research draws on a survey of 66 participants directly after the workshops and 29 semi-structured follow-up interviews nine months later. We found that despite broader structural challenges that hinder progress in sanitation service provision, the workshops enabled the spread of knowledge of good practices (outputs) some of which were replicated (outcomes). There is evidence that these replicated practices accelerated progress towards ODF status (impact) in some districts. We demonstrate that under the right conditions peer learning can nurture local learning, improve knowledge, spread frugal practices and lead to incremental improvements in local government performance. We therefore recommend it be integrated into broader programmes to maximise benefits.</div></div>","PeriodicalId":13994,"journal":{"name":"International journal of hygiene and environmental health","volume":"271 ","pages":"Article 114701"},"PeriodicalIF":4.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145433673","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":"Racial differences in the associations between prenatal exposure to environmental phenol mixtures and preterm birth","authors":"Michael S. Bloom ,&nbsp;Meghana Varde ,&nbsp;Roy R. Gerona ,&nbsp;Karina Ky ,&nbsp;Radek Abarca ,&nbsp;Victor Y. Fujimoto ,&nbsp;Roger B. Newman","doi":"10.1016/j.ijheh.2025.114700","DOIUrl":"10.1016/j.ijheh.2025.114700","url":null,"abstract":"<div><div>We conducted a prospective study of differences in the associations between prenatal urinary environmental phenols (EPs) and preterm birth (PTB) among non-Hispanic white (NHW, n = 153) and non-Hispanic Black (n = 139) mothers. Pregnant participants provided a urine sample between 18 and 22 weeks gestation and self-reported race and ethnicity. We determined urinary levels of methyl- (MePb), ethyl-, propyl-, and butyl parabens, benzophenones 1 (BP-1) and 3, triclosan (TCS), and bisphenols A and S (BPS) using liquid chromatography-tandem mass spectrometry. Dose-response associations were characterized between the mixture of urinary EPs and PTB using Bayesian kernel machine regression (BKMR), adjusted for covariates. Logistic regression was used to estimate associations between individual EPs, log-transformed and scaled to the interquartile range, as predictors of PTB. We found a non-linear association between the mixture of urinary EPs and PTB using BKMR; a higher probability of PTB was associated with the 60th to 80th percentiles of a urinary EPs mixture relative to the 50th percentile among NHB participants, but not NHW participants. BP-3 and TCS were the most important mixture components. In contrast, higher urinary BP-1 (odds ratio (OR) = 0.62; 95 % confidence interval (CI): 0.38–1.01) and BPS (OR = 0.09; 95 %CI: 0.03–0.25), considered as individual predictors, were associated with lower odds of PTB, and the associations for urinary MePb and PTB differed among NHB (OR = 0.53; 95 %CI: 0.25–1.16) and NHW (OR = 0.97; 95 %CI: 0.66–1.42). Our results suggest that prenatal exposure to a mixture of EPs was associated with a higher risk of PTB among NHB participants, but not for individual EPs.</div></div>","PeriodicalId":13994,"journal":{"name":"International journal of hygiene and environmental health","volume":"271 ","pages":"Article 114700"},"PeriodicalIF":4.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145403332","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":"Unraveling the causes of Salmonella paratyphi B endemicity in Salta: A clinical-environmental perspective","authors":"M.N. Maidana Kulesza ,&nbsp;V.B. Rajal ,&nbsp;D.G. Sanguino Jorquera ,&nbsp;V.L. Romero ,&nbsp;M. Aparicio González ,&nbsp;S. Leonardi ,&nbsp;E.E. Campos ,&nbsp;M.E. Bracamonte ,&nbsp;N.L. Reynaga ,&nbsp;M.P. Zago ,&nbsp;H.R. Poma","doi":"10.1016/j.ijheh.2025.114708","DOIUrl":"10.1016/j.ijheh.2025.114708","url":null,"abstract":"<div><div>Salmonella Paratyphi B (SPB) has become endemic in the city of Salta, Argentina, with a staggering burden of bloodstream infections requiring hospitalization. This study unravels the underlying drivers of this endemicity through an integrated clinical-environmental approach. A novel duplex qPCR system was developed to accurately distinguish SPB from other <em>Salmonella</em> serotypes, enabling precise diagnosis and treatment. Clinical analysis revealed SPB in 98 % of positive blood cultures, confirming its strong association with severe infections.</div><div>Contrary to initial hypotheses, the public drinking water network -supported by deep wells and systematic chlorination-showed negligible microbial contamination, ruling it out as the primary transmission route. Instead, environmental investigations uncovered widespread SPB in untreated wastewater, river water used for crop irrigation, and in leafy vegetables sold in local markets. SPB was detected in 40 % of lettuce, arugula, and celery samples during the rainy season, with contamination levels exceeding international safety standards by several orders of magnitude.</div><div>This widespread presence of SPB in fresh produce, coupled with its uniform detection across city districts regardless of socioeconomic level, points to a foodborne route of transmission through contaminated vegetables. Based on these findings, we propose a strategic intervention plan that includes public education, routine screening for chronic carriers, strengthened monitoring of irrigation water, improved vegetable quality control, and upgrades to wastewater treatment infrastructure.</div><div>This study highlights the importance of targeted, multidisciplinary approaches to address human-restricted pathogens and provides a roadmap for interrupting SPB transmission in endemic urban contexts.</div></div>","PeriodicalId":13994,"journal":{"name":"International journal of hygiene and environmental health","volume":"271 ","pages":"Article 114708"},"PeriodicalIF":4.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145514775","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 value of selectivity in exposomics: Reflections on the Exposome Moonshot Forum","authors":"Caspar W. Safarlou","doi":"10.1016/j.ijheh.2025.114682","DOIUrl":"10.1016/j.ijheh.2025.114682","url":null,"abstract":"","PeriodicalId":13994,"journal":{"name":"International journal of hygiene and environmental health","volume":"271 ","pages":"Article 114682"},"PeriodicalIF":4.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145373544","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":"Assessing metal mixture effects on neuropsychological development: A trade-off between complexity and interpretability","authors":"Susana Diaz-Coto ,&nbsp;Leyre Notario-Barandiaran ,&nbsp;Pablo Martinez-Camblor ,&nbsp;Manuel Lozano ,&nbsp;Sabrina Llop ,&nbsp;Adonina Tardón ,&nbsp;Cristina Rodríguez-Dehli ,&nbsp;Amaia Irizar ,&nbsp;Nerea Lertxundi ,&nbsp;Mónica Guxens ,&nbsp;Jordi Julvez ,&nbsp;Antonio J. Signes-Pastor","doi":"10.1016/j.ijheh.2025.114697","DOIUrl":"10.1016/j.ijheh.2025.114697","url":null,"abstract":"<div><div>Several studies have explored the joint effect of mixtures of metals on health outcomes by using sophisticated statistical techniques such as Bayesian Kernel Machine Regression (BKMR). Although these appealing tools can detect complex relationships between metals, their interpretation is not straightforward. Indeed, BKMR is frequently used jointly with other methods, and final conclusions are simplified in terms of increase/decrease of the risk function at fixed values for individual metals. In this paper, we explore the feasibility and interpretability of such techniques to assess the effect of metal mixture exposures on neuropsychological development in early childhood. This is a cross-sectional study. Initially, we use Principal Components Analysis (PCA) to detect main latent neurodevelopment domains. The scores derived by the BKMR exposure-response function were computed and compared with those provided by traditional linear regression models (LRM). Pearson's correlation coefficients of the estimations obtained by BKMR and LRM accounting for pairwise interactions between metals (lead, molybdenum, and selenium) were 0.95, 0.95 and 0.92, for the three identified latent domains: executive functions, motor functions and visual and verbal functions, respectively. The observed differences between both estimations mainly occurred in participants having low concentrations of lead and low and high values of selenium, which suggest linearity in the associations and not high order interactions between metals. We concluded that, in this case, employing linear regression to model the impact of mixtures on targeted outcomes led to similar results than more complex statistical techniques allowing a better understanding of both individual and interaction effects between metals.</div></div>","PeriodicalId":13994,"journal":{"name":"International journal of hygiene and environmental health","volume":"271 ","pages":"Article 114697"},"PeriodicalIF":4.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145350680","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":"Parental stress, indoor environment and outdoor air pollution: A complex nexus and its impacts on childhood pneumonia","authors":"Chan Lu ,&nbsp;Yao Chen ,&nbsp;Wenying Sun ,&nbsp;Mengju Lan ,&nbsp;Zipeng Qiao","doi":"10.1016/j.ijheh.2025.114717","DOIUrl":"10.1016/j.ijheh.2025.114717","url":null,"abstract":"<div><h3>Background</h3><div>Childhood pneumonia is a major global health burden influenced by environmental and psychosocial factors, yet their potential interaction during critical developmental windows remains poorly understood.</div></div><div><h3>Objective</h3><div>To investigate the effects of parental socioeconomic and psychological stress, and interaction with indoor and outdoor environments to affect childhood pneumonia.</div></div><div><h3>Methods</h3><div>We conducted a combined retrospective cohort and cross-sectional study of 8689 preschool children in Changsha, China. Information on each child's health status, parental stress, and household environment exposure from one year before pregnancy to postnatal period were collected using a survey. Ambient air pollution and temperature data were obtained from local monitoring stations. Individual pollutant exposure at home during different time windows was estimated using the inverse distance weighted (IDW) method. Multivariate logistic regression was applied to assess the independent and interactive effects of parental stress with indoor and outdoor environments on childhood pneumonia.</div></div><div><h3>Results</h3><div>We found that childhood pneumonia was related with parental education level, fatigue, headache, and inattention. High parental social stress increased pneumonia risk of parental smoking and mould/damp clothing or bedding, while low parental social stress reduced pneumonia risk from indoor exposure to flowering plants. Children with high parental socioeconomic stress had a stronger association between air pollution and pneumonia. High parental psychological stress increased childhood pneumonia as a result of air pollution exposure, notably for particulate matter in early life.</div></div><div><h3>Conclusions</h3><div>Parental stress independently and interactively increases childhood pneumonia risk in relation to indoor (new furniture, mould/dampness) and outdoor (NO₂, SO₂) exposures during early life.</div></div>","PeriodicalId":13994,"journal":{"name":"International journal of hygiene and environmental health","volume":"271 ","pages":"Article 114717"},"PeriodicalIF":4.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145614507","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}