Eco-Environment & HealthPub Date : 2026-06-01Epub Date: 2026-05-20DOI: 10.1016/j.eehl.2026.100248
Yajie Shu , Tian Hu , Ming Zhou
{"title":"Policy and advanced monitoring synergies to tackle ammonia emission impacts","authors":"Yajie Shu , Tian Hu , Ming Zhou","doi":"10.1016/j.eehl.2026.100248","DOIUrl":"10.1016/j.eehl.2026.100248","url":null,"abstract":"","PeriodicalId":29813,"journal":{"name":"Eco-Environment & Health","volume":"5 2","pages":"Article 100248"},"PeriodicalIF":17.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148184925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Eco-Environment & HealthPub Date : 2026-06-01Epub Date: 2026-05-23DOI: 10.1016/j.eehl.2026.100251
Bo Shao , Zhengyu Wu , Haoran Peng , Qing Yang , Meiqi Huang , Qirui Wang , Yiwen Liu , Wei He , Yingxin Zhao , Xiaoyu Cui , Hongyang Cui , Yindong Tong
{"title":"Shaping of microbial community structure and function by effluent-derived dissolved organic matter in a receiving river across seasons","authors":"Bo Shao , Zhengyu Wu , Haoran Peng , Qing Yang , Meiqi Huang , Qirui Wang , Yiwen Liu , Wei He , Yingxin Zhao , Xiaoyu Cui , Hongyang Cui , Yindong Tong","doi":"10.1016/j.eehl.2026.100251","DOIUrl":"10.1016/j.eehl.2026.100251","url":null,"abstract":"<div><div>Wastewater treatment plant (WWTP) effluent is a significant source of environmental impacts, introducing substantial dissolved organic matter (DOM) and nutrients into receiving waters. However, the specific role of effluent-derived DOM (EDOM) in shaping microbial community structure and key metabolic functions remains insufficiently understood. We systematically explored the effects of EDOM on the seasonal dynamics of bacterial communities in effluent-receiving waters in a typical water-scarce region of North China. Our results revealed that WWTP effluent input significantly altered DOM characteristics, shifting them toward greater humification, increased recalcitrance, lower molecular mass, and simpler structure, against a background of elevated nutrient levels. The interplay between transformed EDOM and resident microorganisms collectively restructured the bacterial community and its potential metabolic functions. These changes included (i) increased taxonomic richness and a more specialized community composition; (ii) enhanced microbial network complexity with a polycentric architecture dominated by DOM components; (iii) seasonal convergence of microbial network structure, as strong EDOM-driven interactions in the dry season were attenuated by wet season hydrology; and (iv) strengthened coupling between DOM molecular traits and biogeochemical cycling potential. Crucially, EDOM was identified as the key driver controlling microbial richness and core metabolic processes, with its influence exhibiting significant seasonal dynamics across the carbon, nitrogen, and sulfur cycles. While current Chinese wastewater discharge standards regulate nutrient inputs, they lack consideration of ecological risks posed by EDOM fractions and their dynamic interactions with microorganisms. Our findings highlight the need to integrate EDOM characteristics into effluent risk assessments to improve WWTP discharge standards.</div></div>","PeriodicalId":29813,"journal":{"name":"Eco-Environment & Health","volume":"5 2","pages":"Article 100251"},"PeriodicalIF":17.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148184924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Eco-Environment & HealthPub Date : 2026-03-01Epub Date: 2025-12-24DOI: 10.1016/j.eehl.2025.100213
Chuyan Lai , Shaochen Yang , Ruolan Li , Huifang Jiang , Rasheed Mohammed Abdul , Ping Li , Bo Wang , Xinbin Feng
{"title":"Distinct demethylation pathways of rice- and fish-derived methylmercury in pregnant women revealed by compound-specific isotope analysis","authors":"Chuyan Lai , Shaochen Yang , Ruolan Li , Huifang Jiang , Rasheed Mohammed Abdul , Ping Li , Bo Wang , Xinbin Feng","doi":"10.1016/j.eehl.2025.100213","DOIUrl":"10.1016/j.eehl.2025.100213","url":null,"abstract":"<div><div>Understanding mercury (Hg) metabolism and exposure pathways in pregnant women is essential for protecting fetal health. However, most previous studies have relied primarily on Hg concentrations in single biomarkers, limiting insight into <em>in vivo</em> metabolic differences and maternal–fetal transfer, especially regarding source-specific MeHg metabolism. This study applies compound-specific stable isotope analysis to investigate total Hg (THg) and methylmercury (MeHg) concentrations and isotopic signatures in rice and maternal biomarkers from the Wanshan Hg mining area, China. Even after remediation, THg in all cord blood samples still exceeded the U.S. EPA recommended limit. Widespread mass-dependent fractionation (MDF) was observed across different biomarkers. The MDF of THg was driven by internal redistribution and demethylation of MeHg, while the MDF of MeHg specifically reflected metabolic demethylation processes in the gut and brain. In contrast, no mass-independent fractionation (MIF) was observed during maternal or transplacental THg transfer, suggesting that Δ<sup>199</sup>Hg values in maternal biomarkers reflect food-source signals. This study identifies the biomarker-specific contribution of dietary sources: MeHg isotope mixing models revealed that rice contributed a higher proportion of Hg in maternal blood than in hair, comparable to that in placenta and cord blood. Comparisons with previously reported fish-derived MeHg isotopes suggest that rice-derived MeHg undergoes preferential demethylation and elimination, highlighting the complexity of <em>in vivo</em> Hg dynamics. The use of both THg and MeHg isotopes in biomarkers enables more precise tracing of dietary Hg sources. These findings highlight the value of multi-biomarker isotope analysis for tracing Hg sources and improving exposure assessments.</div></div>","PeriodicalId":29813,"journal":{"name":"Eco-Environment & Health","volume":"5 1","pages":"Article 100213"},"PeriodicalIF":17.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145925997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Eco-Environment & HealthPub Date : 2026-03-01Epub Date: 2026-01-30DOI: 10.1016/j.eehl.2026.100217
Hualong Zhu , Yongwei Xiong , Zhi Yuan , Yexin Luo , Kongwen Ouyang , Tiantian Wang , Hua Wang , Yufeng Zhang , Wei Chang , Jin Zhang , Hao Li , Lan Gao , Dexiang Xu , Hua Wang
{"title":"Prenatal cadmium exposure and male infertility in mice: A multi-generational mechanistic study","authors":"Hualong Zhu , Yongwei Xiong , Zhi Yuan , Yexin Luo , Kongwen Ouyang , Tiantian Wang , Hua Wang , Yufeng Zhang , Wei Chang , Jin Zhang , Hao Li , Lan Gao , Dexiang Xu , Hua Wang","doi":"10.1016/j.eehl.2026.100217","DOIUrl":"10.1016/j.eehl.2026.100217","url":null,"abstract":"<div><div>Male infertility affects approximately one in seven couples worldwide. Prenatal cadmium (Cd) exposure has been shown to affect offspring phenotypes and increase susceptibility to diseases later in life. However, the effects of prenatal Cd exposure on multi-generational offspring fertility and the mechanisms remain unknown. A novel murine multi-generational (F1–F3 offspring) male subfertility model induced by prenatal Cd exposure was developed. The levels of testosterone and steroidogenic enzymes were also lower in these offspring’s testes. The ubiquitin-dependent degradation of NR4A1, the upstream transcription factor regulating steroidogenic enzymes, was enhanced across generations upon prenatal Cd exposure. After treatment with MG132, an inhibitor of the ubiquitin-proteasome system, the levels of NR4A1 and steroidogenic enzymes were higher in offspring testes with prenatal Cd exposure. Based on the analysis of the UbiBrowser database and testicular global transcriptome, RAPSN was identified as a novel ubiquitin E3 ligase containing the RING-H2_Rapsyn domain that mediates multi-generational testicular NR4A1 ubiquitination. m<sup>6</sup>A epitranscriptome analysis revealed that prenatal Cd exposure upregulated RAPSN expression in multi-generational offspring testes, and was attributed to a higher level of m<sup>6</sup>A modification of <em>Rapsn</em> mRNA. Furthermore, there was a lower level of YTHDC2, a m<sup>6</sup>A reader, in the multi-generational offspring testes with prenatal Cd exposure. Prenatal and postnatal testicular YTHDC2 overexpression reduced the stability of m<sup>6</sup>A-methylated <em>Rapsn</em> mRNA to downregulate RAPSN expression in F1–F3 testes. Overall, YTHDC2 reduction-mediated increment in m<sup>6</sup>A-methylated <em>Rapsn</em> mRNA contributed to prenatal Cd-enhanced multi-generational susceptibility to male subfertility.</div></div>","PeriodicalId":29813,"journal":{"name":"Eco-Environment & Health","volume":"5 1","pages":"Article 100217"},"PeriodicalIF":17.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146173436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Eco-Environment & HealthPub Date : 2026-03-01Epub Date: 2026-02-11DOI: 10.1016/j.eehl.2026.100221
Li He , Ce Liu , Baofeng Zhou , Hao Zhao , Zhaoru Yang , Erkai Zhou , Huan Chen , Huanhuan Wei , Ququmo Guoji , Yuxin He , Bin Luo
{"title":"PM2.5 and its chemical components interact with hypoxia to increase the risk of hospitalization for peripheral arterial disease","authors":"Li He , Ce Liu , Baofeng Zhou , Hao Zhao , Zhaoru Yang , Erkai Zhou , Huan Chen , Huanhuan Wei , Ququmo Guoji , Yuxin He , Bin Luo","doi":"10.1016/j.eehl.2026.100221","DOIUrl":"10.1016/j.eehl.2026.100221","url":null,"abstract":"<div><div>This study investigated the combined effects of fine particulate matter (PM<sub>2.5</sub>) exposure and ambient oxygen (O<sub>2</sub>) availability on peripheral artery disease (PAD) hospitalizations in Gansu Province, China, from 2018 to 2022 (N = 38,514). A time-series case-crossover design with conditional logistic regression assessed short-term exposure to daily PM<sub>2.5</sub> and its major chemical components (black carbon [BC], organic carbon [OC], sulfate [SO<sub>4</sub><sup>2−</sup>], nitrate [NO<sub>3</sub><sup>−</sup>], ammonium [NH<sub>4</sub><sup>+</sup>], and chloride [Cl<sup>−</sup>]). Atmospheric O<sub>2</sub> levels were estimated based on altitude, temperature, and humidity. Short-term exposure to PM<sub>2.5</sub> was associated with an increased risk of PAD hospitalization, notably at lag 1 (odds ratio [OR] = 1.003; 95% confidence interval [CI]: 1.002–1.004). Carbonaceous pollutants exhibited delayed effects, with peak associations at lag 6 for BC (OR = 1.069; 95% CI: 1.035–1.105) and OC (OR = 1.028; 95% CI: 1.011–1.050), per 1 μg/m<sup>3</sup> increase. Secondary inorganic aerosols showed acute effects at lag 1: Cl<sup>−</sup> (OR = 1.107; 95% CI: 1.063–1.150), NH<sub>4</sub><sup>+</sup> (OR = 1.040; 95% CI: 1.022–1.060), SO<sub>4</sub><sup>2−</sup> (OR = 1.025; 95% CI: 1.015–1.036), and NO<sub>3</sub><sup>−</sup> (OR = 1.030; 95% CI: 1.018–1.042), per 1 μg/m<sup>3</sup> increase. Nonlinear exposure–response curves revealed a stronger PAD risk under lower O<sub>2</sub> conditions (<18%). The PM<sub>2.5</sub>-related risk was amplified in high-altitude residents (>1500 m), older adults (>60 years), females, emergency admissions, and during the cold season. These findings suggest that ambient PM<sub>2.5</sub> and lower O<sub>2</sub> levels interact synergistically to elevate PAD hospitalization risk, emphasizing the urgent need for region-specific air quality controls and targeted health protection strategies.</div></div>","PeriodicalId":29813,"journal":{"name":"Eco-Environment & Health","volume":"5 1","pages":"Article 100221"},"PeriodicalIF":17.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147285288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Association between nocturnal ozone enhancement and daily cardiovascular mortality: A multi-city study in China","authors":"Zhihan Jian , Peng Yin , Renjie Chen , Lijun Wang , Yixiang Zhu , Xia Meng , Haidong Kan , Yue Niu , Maigeng Zhou","doi":"10.1016/j.eehl.2025.100211","DOIUrl":"10.1016/j.eehl.2025.100211","url":null,"abstract":"<div><div>The health effects of ambient ozone (O<sub>3</sub>) pollution have been well documented, but most studies have focused on daytime exposure, with limited research on nighttime O<sub>3</sub>. Nocturnal O<sub>3</sub> enhancement (NOE) refers to unexpected increases in nighttime O<sub>3</sub> concentrations over a few hours, yet the health effects of this phenomenon remain unknown. This study evaluated the short-term association between NOE days and cardiovascular mortality by conducting a multi-city time-series analysis in China (2013–2015). Nine definitions were adopted to identify site-level NOE events, considering both average O<sub>3</sub> levels and peak increments at night. A city-level NOE day was defined as a day when over 60% of the monitoring stations within a city recorded at least one site-level NOE event. City-level associations were analyzed using over-dispersed generalized additive models, and national estimates were pooled using meta-analysis. We also conducted stratified analyses by age, sex, season, and region. We found significant associations between NOE days and increased mortality due to total cardiovascular disease (CVD) and coronary heart disease (CHD). Under the strictest NOE definition, mortality risk increased by 1.7% (95% CI: 0.8%, 2.5%) for total CVD and 2.1% (95% CI: 0.9%, 3.3%) for CHD on the day after NOE. Relatively higher risk estimates were found in individuals aged 5–64 years, females, the warm season, and the southern region. No stable associations were found with stroke mortality. These findings offer new insights into the health impacts of NOE and underscore the need for time-phased actions to control both daytime and nighttime O<sub>3</sub> air pollution.</div></div>","PeriodicalId":29813,"journal":{"name":"Eco-Environment & Health","volume":"5 1","pages":"Article 100211"},"PeriodicalIF":17.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145925998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Eco-Environment & HealthPub Date : 2026-03-01Epub Date: 2025-12-24DOI: 10.1016/j.eehl.2025.100212
Jie Hou , Ye Li , Qinglin Chen , Mengqi Liu , Yi An , Fengxia Yang , Yanpo Yao
{"title":"Cross-regional dynamics of antibiotic resistance (AR): Genomic evidence of transmission for Escherichia coli carrying last-resort AR gene between food animals and humans in China","authors":"Jie Hou , Ye Li , Qinglin Chen , Mengqi Liu , Yi An , Fengxia Yang , Yanpo Yao","doi":"10.1016/j.eehl.2025.100212","DOIUrl":"10.1016/j.eehl.2025.100212","url":null,"abstract":"<div><div>The rapidly increasing dissemination of antibiotic-resistant bacteria (ARB) among food animals and humans is a burgeoning public health crisis. Yet, our understanding of ARB transmission is largely constrained to regional studies, with a dearth of insights into cross-regional dynamics. In this study, the whole-genome sequences of >800 <em>E. coli</em> strains harboring last-resort antibiotic resistance genes (LARGs) across 20 regions of China were retrieved from the NCBI RefSeq database. Our analysis uncovered that 1767 human–animal isolate pairs exhibited high homology, with the pairwise average nucleotide identity (ANI) values exceeding 99.5%. By employing phylogenetic analysis, transmission cluster identification, ANI, and single-nucleotide polymorphism (SNP) analysis, 42 human–animal transmission clusters and 306 recent transmission events were identified. Strikingly, more than 90% of these human–animal transmission events (284 out of 306) spanned different regions. Counterfactual analysis indicated that the cross-regional transmission significantly contributes to the prevalence of these ARBs in humans (21.62%), while its role in the food-animal epidemic is less pronounced (3.47%). Our findings underscore the urgency of a more integrated, nationwide approach to address the spread of LARG-harboring bacteria, which is essential to preserving the efficacy of our remaining antibiotic arsenal and safeguarding public health on a global scale.</div></div>","PeriodicalId":29813,"journal":{"name":"Eco-Environment & Health","volume":"5 1","pages":"Article 100212"},"PeriodicalIF":17.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145925999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Eco-Environment & HealthPub Date : 2026-03-01Epub Date: 2026-01-29DOI: 10.1016/j.eehl.2026.100218
Yiou Zhu , Quang Tri Ho , James P.W. Robinson , Marian Kjellevold , Ruirong Chang , Edvin Fuglebakk , Jianmin Ma , Shijie Song , Lisbeth Dahl , Ole Jakob Nøstbakken , Maria W. Markhus , Bente M. Nilsen , Tanja Kögel , Anne-Katrine Lundebye , Atabak M. Azad , Abimbola Uzomah , Jeppe Kolding , Vidar S. Lien , Martin Wiech , Yanxu Zhang , Michael S. Bank
{"title":"Global marine fish trade networks track international pathways of nutrients and contaminants","authors":"Yiou Zhu , Quang Tri Ho , James P.W. Robinson , Marian Kjellevold , Ruirong Chang , Edvin Fuglebakk , Jianmin Ma , Shijie Song , Lisbeth Dahl , Ole Jakob Nøstbakken , Maria W. Markhus , Bente M. Nilsen , Tanja Kögel , Anne-Katrine Lundebye , Atabak M. Azad , Abimbola Uzomah , Jeppe Kolding , Vidar S. Lien , Martin Wiech , Yanxu Zhang , Michael S. Bank","doi":"10.1016/j.eehl.2026.100218","DOIUrl":"10.1016/j.eehl.2026.100218","url":null,"abstract":"<div><div>Marine fish trade globalizes nutrients and contaminants. Using trade data, human demographic information, and nutrient and contaminant exposure data, the estimated direct consumption of traded fish from Northeast Atlantic Ocean (NEAO) catches varied among 155 importer countries/regions. The associated trade pathways globalised high amounts of important nutrients including iodine, selenium, and eicosapentaenoic acid and docosahexaenoic acid (EPA + DHA) and contributed greatly to annual domestic EPA + DHA requirements for small-population importers (e.g., Lithuania: 62.8%) but not for high-population importers (e.g., Chinese mainland). Traded amounts of mercury, dioxin, and dioxin-like polychlorinated biphenyls (dl-PCBs) from the NEAO fish were low, and associated pathway contributions to total domestic mercury exposures were <4%. Changes in fish body size affected nutrient and contaminant fillet concentrations and subsequently trade dynamics of nutrients and contaminants. Our study provides valuable insights regarding seafood globalization and marine fish trade that can be used to support adaptive management strategies for contaminants and nutrition-sensitive policies.</div></div>","PeriodicalId":29813,"journal":{"name":"Eco-Environment & Health","volume":"5 1","pages":"Article 100218"},"PeriodicalIF":17.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146173431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Eco-Environment & HealthPub Date : 2026-03-01Epub Date: 2026-02-03DOI: 10.1016/j.eehl.2026.100220
Ning Chen , Feipeng Cui , Yudiyang Ma , Jianing Wang , Linxi Tang , Lei Zheng , Meiqi Xing , Xinru Zhao , Yaohua Tian
{"title":"Association between residential greenness and risks of diabetic complications among individuals with type 2 diabetes and the roles of healthy lifestyle behaviors","authors":"Ning Chen , Feipeng Cui , Yudiyang Ma , Jianing Wang , Linxi Tang , Lei Zheng , Meiqi Xing , Xinru Zhao , Yaohua Tian","doi":"10.1016/j.eehl.2026.100220","DOIUrl":"10.1016/j.eehl.2026.100220","url":null,"abstract":"<div><div>Prospective evidence on the associations between residential greenness and risks of major diabetic complications remains limited. We explored the associations of residential greenness with incident diabetic macrovascular and microvascular complications among individuals with type 2 diabetes (T2D), and further assessed the roles of lifestyle factors in these associations. Our study included 13,848 patients with T2D. The Normalised Difference Vegetation Index (NDVI) within a 300-m buffer was used as the indicator of residential greenness. Eight lifestyle factors were included to construct a weighted healthy lifestyle score. Cox proportional hazard models were performed to assess the links between residential greenness and diabetic complication risks. We found that each interquartile range increase of NDVI within 300-m buffer was significantly associated with decreased diabetic complication risks, with hazard ratios (95% confidence intervals) of 0.921 (0.881, 0.964) for composite macrovascular complications, 0.886 (0.805, 0.975) for stroke, 0.901 (0.825, 0.985) for heart failure, 0.914 (0.866, 0.965) for coronary artery disease, 0.909 (0.865, 0.956) for composite microvascular complications, 0.842 (0.757, 0.937) for diabetic neuropathy, and 0.899 (0.841, 0.961) for diabetic nephropathy. Air pollutants and physical activity partly mediated these associations. Lifestyle factors modified some residential greenness-complications associations, and no significant associations between residential greenness and diabetic complications were observed among participants with poor lifestyles. Higher residential greenness levels were linked with lower risks of diabetic complications, and lifestyle factors might modify these associations.</div></div>","PeriodicalId":29813,"journal":{"name":"Eco-Environment & Health","volume":"5 1","pages":"Article 100220"},"PeriodicalIF":17.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146173437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}