{"title":"Airborne microplastics: a comprehensive analysis of indoor and outdoor pollution patterns.","authors":"Mina Rahmani, Fatemeh Yousefian, Fatameh Atoof, Sahar Gholipour, Zahra Batooli, Mansour Baziar, Nezam Mirzaei","doi":"10.1515/reveh-2025-0059","DOIUrl":"https://doi.org/10.1515/reveh-2025-0059","url":null,"abstract":"<p><p>In recent decades, airborne microplastics (MPs) and nano plastics have emerged as critical environmental pollutants, posing potential human health risks including respiratory issues such as asthma, alveolitis, and chronic bronchitis. This systematic review and meta-analysis investigated the distribution, characteristics and concentrations of airborne MPs in indoor and outdoor environments based on studies published up to October 2023. Following PRISMA guidelines, 27 eligible studies across 16 countries were selected, with 21 providing sufficient quantitative data for meta-analysis. Due to extreme, robust heterogeneity across the studies (I<sup>2</sup>>99 %), a random-effects model was applied. Sensitivity analyses confirmed these findings were stable and not driven by individual outliers. The results demonstrated that indoor environments were more polluted than outdoor settings. For example, moderately polluted indoor environments exhibited mean concentrations of 1,380.28 MP/m<sup>3</sup> compared to 102.45 MP/m<sup>3</sup> outdoors. However, these findings are presented as a descriptive summary of the literature to highlight methodological variability. Consistent with this, moderator analyses revealed that the most significant contributor to inter-study variability was the type of detection instrument used, with FTIR consistently reporting higher concentrations than microscopy or Raman spectroscopy. Sampling duration also significantly influenced the results. Additionally, indoor healthcare centers and outdoor urban areas were identified as the most heavily contaminated sub-environments. These findings highlight the urgent need for standardized sampling and detection protocols, while emphasizing the critical importance of monitoring and mitigating indoor air quality to reduce human exposure to airborne MPs.</p>","PeriodicalId":21165,"journal":{"name":"Reviews on Environmental Health","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148857717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Association between long-term exposure to air pollution and blood pressure in children: an updated systematic review and meta-analysis.","authors":"Hazal Cansu Çulpan, Yakup Gözderesi, Nur Canpolat, Günay Can, Seha Saygılı","doi":"10.1515/reveh-2026-0032","DOIUrl":"https://doi.org/10.1515/reveh-2026-0032","url":null,"abstract":"<p><strong>Introduction: </strong>Ambient air pollution is a modifiable environmental exposure that may contribute to early cardiovascular risk. Although long-term exposure has been linked to blood pressure (BP) dysregulation, research on its effects in children remains limited, despite their particular vulnerability during critical periods of cardiovascular development. This updated systematic review and meta-analysis aimed to estimate pollutant-specific associations of long-term air pollution exposure with BP and hypertension in children and adolescents.</p><p><strong>Content: </strong>Following PRISMA guidelines, studies were identified from prior systematic reviews and meta-analyses as well as an updated PubMed and Web of Science searches through March 27, 2025. Twenty-one studies, including 990,157 participants, were included in the systematic review evaluating air pollutants, including PM<sub>1</sub>, PM<sub>2.5</sub>, PM<sub>10</sub>, NO, NO<sub>2</sub>, NO<sub>x</sub>, SO<sub>2</sub>, O<sub>3</sub>, and CO. Meta-analysis was limited to PM<sub>2.5</sub>, PM<sub>10</sub>, and NO<sub>2</sub> because cohort data for other pollutants were limited, and exposure increments and hypertension definitions varied across studies.</p><p><strong>Summary: </strong>Long-term PM<sub>2.5</sub> exposure showed the most consistent association with higher systolic BP (0.59 mmHg per 10 μg/m<sup>3</sup>; 95 % CI: 0.28-0.90). PM<sub>10</sub> was initially associated with higher systolic (0.28 mmHg per 10 μg/m<sup>3</sup>; 95 % CI: 0.25-0.31) and diastolic (0.27 mmHg; 95 % CI: 0.24-0.30) BP, but these associations were not sustained in sensitivity analyses. NO<sub>2</sub> showed no significant association with systolic or diastolic BP. Several pollutants, including PM<sub>2.5</sub>, PM<sub>10</sub>, SO<sub>2</sub>, O<sub>3</sub>, and CO, were associated with increased odds of hypertension.</p><p><strong>Outlook: </strong>Current evidence suggests that exposure to fine particulate matter may contribute to early-life elevation in blood pressure; however, given the paucity of longitudinal data and the complexity of multipollutant exposures, further research employing standardized exposure metrics, harmonized outcome definitions, and multipollutant models are needed to clarify independent pollutant effects.</p>","PeriodicalId":21165,"journal":{"name":"Reviews on Environmental Health","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148689736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Carol Cusack, Tara C Serio, Noelle B Henderson, Kathryn B Egan, Zheng Li, Teresa W Wang
{"title":"Lead and cancer: a narrative review and risk of bias assessment (2003-2020).","authors":"Carol Cusack, Tara C Serio, Noelle B Henderson, Kathryn B Egan, Zheng Li, Teresa W Wang","doi":"10.1515/reveh-2025-0120","DOIUrl":"10.1515/reveh-2025-0120","url":null,"abstract":"<p><p>Lead exposure may contribute to harmful human health effects, but evidence of its carcinogenicity is limited. The International Agency for Research on Cancer (IARC) in 2006 classified lead as \"probably carcinogenic\" (Group 2A), based on limited evidence in humans and sufficient evidence in animals. To further synthesize evidence on lead's carcinogenicity, this review included a literature search and risk of bias assessment of 43 peer-reviewed epidemiological studies on lead exposure and cancer outcomes published between 2003 and 2020. Using the National Toxicology Program's Office of Health Assessment and Translation Risk of Bias approach, 13 Tier One studies (primarily low risk) and 30 Tier Two studies (low and high risk) were identified. These studies characterized lead exposure through biologic media (i.e., blood, urine, tissues, hair, nails), and/or work histories, and evaluated cancers of the biliary tract, brain and central nervous system, breast, digestive tract, head and neck, blood, mesothelium, reproductive organs, respiratory tract, skin, thyroid, and urinary tract. Notably, breast, thyroid, and head and neck cancers were not previously included in the IARC 2006 monograph. Across all site-specific cancers examined, at least one study reported an association with lead exposure except for skin cancer. Respiratory tract cancers had the most epidemiologic studies showing positive associations with lead exposure. Study limitations were commonly tied to risk of bias for confounding, exposure characterization, and outcome assessments. Taken together, future studies would benefit from robust experimental designs with thorough adjustments for confounders, large diverse populations, and standardized exposure assessments particularly for cancers with limited data.</p>","PeriodicalId":21165,"journal":{"name":"Reviews on Environmental Health","volume":" ","pages":"176-192"},"PeriodicalIF":5.2,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13130192/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147663087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Bérénice Schell, Camille Bourillon, Catherine Azoulay, Isabelle Baran, Julien Brunier, Aude Charbonnier, Laurence Chery, Isabelle Dangleterre, Isabelle De Cuniac, Patricia De Montdidier, Benedicte Denieul, Françoise Gay-Andrieu, Sylvain Girardot, Gwennaelle Guindeuil, Zahra Hassani, Quentin Le Masne, Benoit Vincent, Alice Baras, Guillaume Fond, Sonia Delaporte-Cerceau, Patrick Pessaux, Camille Schwab, Dominique Licaud, Romain Manet, Marie-Thérèse Charreyre, Gérard Lina, Yann Nguyen, Emmanuel Prothon, Florian Legrand, Florence Boissier, Marie Lecronier, David Grimaldi, Christian Clot, Olivier Decaux
{"title":"Initiating transformative medical practices to address environmental challenges - proceedings of \"Santé en 2050\", the French national conference on healthcare adaptation.","authors":"Bérénice Schell, Camille Bourillon, Catherine Azoulay, Isabelle Baran, Julien Brunier, Aude Charbonnier, Laurence Chery, Isabelle Dangleterre, Isabelle De Cuniac, Patricia De Montdidier, Benedicte Denieul, Françoise Gay-Andrieu, Sylvain Girardot, Gwennaelle Guindeuil, Zahra Hassani, Quentin Le Masne, Benoit Vincent, Alice Baras, Guillaume Fond, Sonia Delaporte-Cerceau, Patrick Pessaux, Camille Schwab, Dominique Licaud, Romain Manet, Marie-Thérèse Charreyre, Gérard Lina, Yann Nguyen, Emmanuel Prothon, Florian Legrand, Florence Boissier, Marie Lecronier, David Grimaldi, Christian Clot, Olivier Decaux","doi":"10.1515/reveh-2025-0134","DOIUrl":"10.1515/reveh-2025-0134","url":null,"abstract":"<p><p>\"Santé en 2050\" is the first medical conference in France dedicated to the adaptation of healthcare systems to environmental constraints. Organized in 2024 and 2025 by healthcare professionals within The Shifters, a non-profit association committed to raising public awareness of the dual carbon challenge, the conference provided both a scientific platform for research on mitigation and adaptation in health and a forum to enhance professional competencies on these cross-cutting issues. Over its two successful editions, the event mapped the emerging disease landscape driven by environmental exposures and climate change, affecting both communicable and non-communicable diseases due to shifting temperatures, precipitation patterns, mass population movements, unhealthy lifestyles, and increasing pollution. Climate change also poses indirect threats to health by straining infrastructure, disrupting supply chains, and triggering crises that practitioners must address with ever-scarcer resources. The conference underscored the urgent need for a systemic overhaul of healthcare to build resilient, sustainable care pathways. It provided attendees with practical tools to integrate ecodesigned care, integrative medical approaches, and non-pharmacological interventions into their daily practice. The conference further explored pressing ethical and philosophical dilemmas, examining how technology, research priorities, and innovation must evolve in response to environmental constraints and the broader responsibility of medicine at a population level. Here we summarize the topics discussed during the two editions of the conference. By equipping healthcare workers with skills in epidemiology, disease prevention, and continuity of care amid accelerating environmental change, \"Santé en 2050\" aims to prepare the medical community for the challenges of tomorrow.</p>","PeriodicalId":21165,"journal":{"name":"Reviews on Environmental Health","volume":"41 2","pages":"153-161"},"PeriodicalIF":5.2,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148259563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Editorial: A new chapter in the lasting legacy of <i>Reviews on Environmental Health</i>.","authors":"Kelly G Pennell","doi":"10.1515/reveh-2026-0005","DOIUrl":"10.1515/reveh-2026-0005","url":null,"abstract":"","PeriodicalId":21165,"journal":{"name":"Reviews on Environmental Health","volume":" ","pages":"1"},"PeriodicalIF":4.5,"publicationDate":"2026-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146207628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Andrea Gogos, Alicia Bjorksten, Wah Chin Boon, Anne-Louise Ponsonby
{"title":"The rising tide of plastic pollutants: implications for schizophrenia onset, a mini-review.","authors":"Andrea Gogos, Alicia Bjorksten, Wah Chin Boon, Anne-Louise Ponsonby","doi":"10.1515/reveh-2025-0106","DOIUrl":"10.1515/reveh-2025-0106","url":null,"abstract":"<p><p>The increasing exposure to manufactured environmental pollutants, especially plastics, is linked to adverse neurological effects. While prenatal exposure to plastics has been associated with neurodevelopmental disorders, particularly autism, the role of this exposure in schizophrenia remains under-investigated. This narrative mini-review examines the potential impact of endocrine-disrupting plastics, e.g. bisphenols and phthalates, on schizophrenia onset risk. These chemicals are ubiquitous and pervasive neurotoxicants, implicated in neuroinflammation - a key feature of schizophrenia. Additionally, microplastics have been detected in human brains, raising concerns about their potential long-term impact on neurological health. Despite the growing evidence of plastic-induced neurodevelopmental harm, this issue has been neglected for schizophrenia, with scarce human or valid animal model literature available. Limited studies indicate that plastic chemicals cause behavioural deficits, hormonal dysregulation and altered brain function relevant to schizophrenia. Cumulative exposure to multiple plastic chemicals over the life course necessitates carefully designed approaches. Future studies should investigate the mechanisms by which plastics contribute to schizophrenia risk. Epidemiological research with multi-omic approaches is needed to strengthen regulatory action and inform exposure prevention strategies particularly in high-risk populations. Given the increasing burden of environmental pollutants, urgent attention is required to address their role in neurodevelopmental disorders, particularly schizophrenia.</p>","PeriodicalId":21165,"journal":{"name":"Reviews on Environmental Health","volume":" ","pages":"2-11"},"PeriodicalIF":5.2,"publicationDate":"2026-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145934816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mohammed Alissa, Abdullah Alghamdi, Mohammed A Alshehri, Suad A Alghamdi, Ghadah S Abusalim, Abdulkarim S Binshaya, Ghada M Alnafesah
{"title":"Prevalence of Vancomycin-resistant <i>Enterococcus</i> in wild mammals: the first global systematic review and meta-analysis.","authors":"Mohammed Alissa, Abdullah Alghamdi, Mohammed A Alshehri, Suad A Alghamdi, Ghadah S Abusalim, Abdulkarim S Binshaya, Ghada M Alnafesah","doi":"10.1515/reveh-2025-0140","DOIUrl":"10.1515/reveh-2025-0140","url":null,"abstract":"<p><strong>Introduction: </strong>Vancomycin-resistant <i>Enterococcus</i> (VRE) represents a global public health threat due to its ability to disseminate antimicrobial resistance (AMR) genes across ecological boundaries. While the prevalence of VRE has been extensively studied in clinical and agricultural settings, its occurrence and dynamics in wildlife remain underexplored. This review aimed to systematically examine and analyze the global prevalence of VRE in wild mammals.</p><p><strong>Content: </strong>Following PRISMA guidelines, an extensive search of six databases yielded 25 studies that met predefined inclusion criteria. Data were extracted and synthesized using a random-effects model to estimate pooled prevalence rates, and subgroup analysis was also performed. Heterogeneity was quantified using the I² statistic, and publication bias was assessed through funnel plots and Egger's test. The overall pooled prevalence of VRE in wild mammals was 8.4 % (95 % CI: 4.9-14.0), with significant heterogeneity (I² = 87.63 %). Southern Europe recorded the highest prevalence, particularly in Spain (18.6 %) and Portugal (7.0 %), while lower rates were observed in England (3.3 %) and Italy (4.5 %). Species-specific prevalence was highest in Eurasian otters and roe deer (62.1 % and 48.6 %, respectively). Methodological variability also influenced prevalence rates, with disc diffusion reporting the highest prevalence (17.3 %) compared to PCR-based methods (3.9 %).</p><p><strong>Summary: </strong>The findings indicate a moderately significant prevalence of VRE in wild mammals, underscoring wildlife's critical role as reservoirs and vectors of AMR.</p><p><strong>Outlook: </strong>Anthropogenic factors such as agricultural activities and environmental pollution significantly shape the distribution and burden of VRE among wild animals.</p>","PeriodicalId":21165,"journal":{"name":"Reviews on Environmental Health","volume":" ","pages":"12-27"},"PeriodicalIF":4.5,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145715693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Xiaoqiang Shi, Yanlong Lu, Lianfeng Ren, Chunlong Mei
{"title":"Prevention strategies for organophosphate and pyrethroid pesticide poisoning: case studies of flucythrinate and dichlorvos.","authors":"Xiaoqiang Shi, Yanlong Lu, Lianfeng Ren, Chunlong Mei","doi":"10.1515/reveh-2025-0060","DOIUrl":"10.1515/reveh-2025-0060","url":null,"abstract":"<p><p>Organophosphate pesticides (e.g. dichlorvos) and pyrethroids (e.g. flucythrinate) are widely used in agriculture, yet their toxicity poses significant threats to human health. This study analyses risk factors for poisoning incidents involving these compounds and proposes targeted prevention strategies. Key risk factors encompass exposure pathways, high-risk populations, and socioeconomic determinants. Mitigation requires multi-level interventions, including technological innovation, public education, and personal protection. Case comparisons reveal commonalities and distinctions between flucythrinate and dichlorvos poisoning, underscoring the need for integrated prevention frameworks. The study concludes by identifying limitations in current measures and proposing future research directions and policy recommendations to advance sustainable agriculture and safeguard public health.</p>","PeriodicalId":21165,"journal":{"name":"Reviews on Environmental Health","volume":" ","pages":"56-65"},"PeriodicalIF":4.5,"publicationDate":"2025-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145669657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Exploring the presence of BTEX compounds in municipal solid waste management facilities as the toxic reality: a systematic review.","authors":"Mohammad Rezvani Ghalhari, Mahmood Alizadeh Sani, Elahe Noruzzade, Parnia Bashardoust, Masud Yunesian, Fatemeh Yousefian, Kamyar Yaghmaeian","doi":"10.1515/reveh-2025-0068","DOIUrl":"10.1515/reveh-2025-0068","url":null,"abstract":"<p><strong>Introduction: </strong>Exposure to BTEX (benzene, toluene, ethylbenzene, and xylene) can lead to various health issues. Despite the proven health effects, there are limited studies on the presence of BTEX compounds in municipal solid waste management facilities (MSWMFs). This study aims to evaluate the presence, sampling methods, and detection of BTEX in MSWMFs.</p><p><strong>Content: </strong>In the present study, the databases PubMed, Scopus, and Web of Science were combined by selected keywords using Boolean operators for published articles until March 30th, 2025. Finally, statistical analyses and comparisons were performed to make management decisions to reduce health impacts.</p><p><strong>Summary: </strong>After the systematic search, 2,794 articles were found that matched with search strategy; 20 of them were used for data extraction. Results show that the concentrations of benzene, toluene, ethylbenzene, and xylenes in MSWMFs were 0.479-271 μg/m<sup>3</sup>, 0.25-514 μg/m<sup>3</sup>, 0.13-565.9 μg/m<sup>3</sup> and 0.43-362.925 μg/m<sup>3</sup>, respectively.</p><p><strong>Outlook: </strong>The present study can provide crucial new insights for governments to make a management decision for environmental and occupational pollutions associated with BTEX emissions in MSWMFs. So, future research and monitoring will be essential to control and reduce the health issues that are related to BTEX exposure.</p>","PeriodicalId":21165,"journal":{"name":"Reviews on Environmental Health","volume":" ","pages":"28-42"},"PeriodicalIF":4.5,"publicationDate":"2025-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145597060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Association between serum levels of essential elements (copper, zinc, and iron) and major depressive disorder: a systematic review and meta-analysis.","authors":"Omran Davarinejad, Zahraalsadat Nasseri, Borhan Mansouri","doi":"10.1515/reveh-2025-0116","DOIUrl":"10.1515/reveh-2025-0116","url":null,"abstract":"<p><strong>Introduction: </strong>Trace elements such as zinc, iron, and copper are integral to neurochemical regulation, oxidative balance, and immune modulation. Their dysregulation has been increasingly implicated in the pathophysiology of Major Depressive Disorder (MDD). This systematic review and meta-analysis aimed to quantify differences in serum levels of zinc, iron, and copper between individuals with MDD and healthy controls.</p><p><strong>Content: </strong>Sixteen observational studies were included following a comprehensive search of major databases. Data on serum concentrations of zinc, iron, and copper were extracted and pooled using a random-effects model. Standardized mean differences (SMDs) with 95 % confidence intervals (CIs) were calculated. Heterogeneity was assessed using the I<sup>2</sup> statistic, and publication bias was evaluated via funnel plots and Egger's regression. Sensitivity analyses were conducted to test the robustness of findings.</p><p><strong>Summary: </strong>Meta-analysis revealed serum copper levels were significantly higher in patients with MDD compared to controls (SMD = +0.42; 95 % CI: +0.18 to +0.66; I<sup>2</sup>=67.4 %), while zinc (SMD = -0.62; 95 % CI: -0.78 to -0.46; I<sup>2</sup>=68.4 %) and iron (SMD = -0.36; 95 % CI: -0.52 to -0.20; I<sup>2</sup>=58.2 %) were lower in MDD patients. Evidence of publication bias was observed for zinc and copper, but adjusted estimates remained significant for zinc and iron.</p><p><strong>Outlook: </strong>This study demonstrates consistent reductions in serum zinc and iron among individuals with MDD, supporting their potential role in depressive pathophysiology. While copper findings were inconclusive, the stability of zinc and iron results highlights the clinical relevance of micronutrient assessment in depression. These findings provide a foundation for future research in nutritional psychiatry and adjunctive treatment strategies.</p>","PeriodicalId":21165,"journal":{"name":"Reviews on Environmental Health","volume":" ","pages":"43-55"},"PeriodicalIF":4.5,"publicationDate":"2025-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145565005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}