Lancet Planetary Health最新文献

{"title":"Is growth in consumption occurring where it is most needed? An empirical analysis of current energy and material trends","authors":"Joel Millward-Hopkins PhD ,&nbsp;Prof Jason Hickel PhD ,&nbsp;Suryadeepto Nag MS","doi":"10.1016/S2542-5196(25)00115-9","DOIUrl":"10.1016/S2542-5196(25)00115-9","url":null,"abstract":"<div><h3>Background</h3><div>Increasing global use of energy and materials is breaching planetary boundaries, but large inequalities mean that billions of people still cannot meet basic needs. Researchers have estimated minimum energy and material requirements to secure human wellbeing. However, it remains unclear whether countries with shortfalls in energy and material use are increasing their consumption towards sufficient levels, and whether countries with surplus consumption are reducing theirs to sustainable levels.</div></div><div><h3>Methods</h3><div>In this empirical modelling study, we compared large datasets of national energy and material footprints with estimates of the energy and material required for each country to bring its poorest populations up to decent living standards (DLS). We then estimated the share of countries that are in shortfall and in surplus, for both energy and material consumption, and assessed to what degree countries are moving in the right direction, given existing growth rates. For countries with consumption shortfalls, we calculated the time it will take, at current growth rates, to reach energy and material use sufficient for DLS.</div></div><div><h3>Findings</h3><div>The world currently uses more energy and materials than is required to achieve DLS for all (approximately 2·5 times more), even with existing within-country distributions (approximately 1·5 times more). However, 50% of nations currently have energy shortfall, and 46% have material shortfall. For most of these countries, growth in energy and material use is too slow to achieve DLS by 2050. Indeed, with current growth rates and national inequalities, at least one in five countries will remain in shortfall in 2100. By contrast, the growth rates of countries in surplus are four times higher than the growth rates of countries in shortfall, exacerbating ecological pressures.</div></div><div><h3>Interpretation</h3><div>Currently, the world is not moving towards a just and ecological future for all. Growth in energy and material use is occurring primarily in countries that do not need it and is not occurring fast enough (or is declining) in countries that do need it. A substantial redistribution of energy and material use is needed—both within countries and between them—to achieve faster progress on DLS with less ecological pressure. Indeed, this redistribution is imperative if we are to achieve DLS for all while also achieving the Paris Agreement objectives. Convergence between the Global North and South is necessary but is not occurring fast enough. At current rates, convergence will not occur within the next 100 years.</div></div><div><h3>Funding</h3><div>European Research Council.</div></div>","PeriodicalId":48548,"journal":{"name":"Lancet Planetary Health","volume":"9 6","pages":"Pages e503-e510"},"PeriodicalIF":24.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144262039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Building a Healthy Urban Design Index (HUDI): how to promote health and sustainability in European cities","authors":"Federica Montana PhD ,&nbsp;Natalie Mueller PhD ,&nbsp;Evelise Pereira Barboza PhD ,&nbsp;Sasha Khomenko PhD ,&nbsp;Tamara Iungman PhD ,&nbsp;Marta Cirach MSc ,&nbsp;Carolyn Daher MPH ,&nbsp;TC Chakraborty PhD ,&nbsp;Kees de Hoogh PhD ,&nbsp;Alice Battiston PhD ,&nbsp;Rossano Schifanella PhD ,&nbsp;Prof Mark Nieuwenhuijsen PhD","doi":"10.1016/S2542-5196(25)00109-3","DOIUrl":"10.1016/S2542-5196(25)00109-3","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;As global urbanisation accelerates, alongside declining environmental quality and increasing climate challenges, it is increasingly vital for urban planners and policy makers to integrate health and wellbeing considerations into urban planning. This study introduces the Healthy Urban Design Index (HUDI), a high-resolution spatial index developed for European cities. HUDI combines policy-relevant indicators related to urban design, sustainable transportation, environmental quality, and greenspace accessibility—key factors influencing human health and well-being. Unlike existing indices, which often focus on few or large metropolitan cities and lack spatial granularity, HUDI offers high resolution and extends its scope to small-sized and medium-sized cities, home to over 50% of Europe's population.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;We analysed 917 European cities in total, 916 cities and one larger city, on the basis of the 2018 Urban Audit database. Using open-source spatial data, we mapped cities at a fine 250 m grid cell scale. To compare cities effectively, we grouped them into five city clusters on the basis of population size, following the definition of the Organisation for Economic Co-operation and Development: large metropolitan (11), metropolitan (53), medium-sized (177) and small (638) cities, and small towns (38). A set of 13 indicators, across four overarching domains of urban design, sustainable transportation, environmental quality, and green space accessibility was calculated spatially at the 250 m grid cell scale and then aggregated to the city level. The 13 indicators were optimal dwelling density, compactness, mid-rise development, permeability, opportunity to walk, opportunity to cycle, public transport stops, air quality (PM&lt;sub&gt;2·5&lt;/sub&gt; and NO&lt;sub&gt;2&lt;/sub&gt;), surrounding greenness (Normalized Difference Vegetation Index), lower urban heat islands, universal access to green spaces, and access to large green spaces. To ensure comparability, all indicators were standardised on a scale from 0 to 10, considering data quality, indicator target levels, and specific evaluation criteria. The HUDI was then calculated by applying different weights to these indicators, allowing us to rank cities within their respective city size cluster. We visualised overall city performance using spider plots and did Local Moran's &lt;em&gt;I&lt;/em&gt; and Local Indicators of Spatial Association analyses to pinpoint areas with poor urban planning. We did sensitivity tests and correlation analyses, incorporating external datasets where available, to validate our findings.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;div&gt;HUDI scores ranged from 2·9 to nearly 7 of 10, showing that there is still room for improvement in creating healthier urban environments across European cities. Larger metropolitan cities, particularly in northern Europe and parts of Spain, tended to score well in the urban design and sustainable transportation domains. In contra","PeriodicalId":48548,"journal":{"name":"Lancet Planetary Health","volume":"9 6","pages":"Pages e511-e526"},"PeriodicalIF":24.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144262040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biodiversity, health science, and the human right to a healthy environment","authors":"Liz Willetts MEM ,&nbsp;Prof Lora E Fleming MD ,&nbsp;Prof Elisa Morgera PhD","doi":"10.1016/S2542-5196(25)00092-0","DOIUrl":"10.1016/S2542-5196(25)00092-0","url":null,"abstract":"<div><div>Planetary health agendas need a strong human rights focus. Both public health and the human right to a clean, healthy, and sustainable environment depend on biodiversity, ecosystems, and a healthy biosphere. Targeted transdisciplinary health research, action, and communication on biodiversity–health linkages can clarify and reinforce the human rights obligations of public authorities whose decisions might negatively affect the environment. However, our observations across law, policy, science, and advocacy show that there is a void of transdisciplinary guidance on how to apply the human right to a healthy environment to impact policy and law. We introduce a biodiversity–health roadmap to the UN <em>Framework Principles on Human Rights and the Environment</em>. This roadmap is only a starting point to co-develop and mobilise knowledge and policy-driven research and action agendas across the health–environment nexus, and among science, policy, and law professionals. In this Personal View, we invite knowledge co-development among health and environmental sciences, environmental law, human rights, and policy advisors to steer, mobilise, and focus the health–environment nexus on human rights to support more effective and coherent public decisions.</div></div>","PeriodicalId":48548,"journal":{"name":"Lancet Planetary Health","volume":"9 6","pages":"Pages e553-e565"},"PeriodicalIF":24.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144261392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Property insurance bluelining as a social determinant of health","authors":"Jerel M Ezell","doi":"10.1016/S2542-5196(25)00113-5","DOIUrl":"10.1016/S2542-5196(25)00113-5","url":null,"abstract":"","PeriodicalId":48548,"journal":{"name":"Lancet Planetary Health","volume":"9 6","pages":"Pages e449-e450"},"PeriodicalIF":24.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to Lancet Planet Health 2025; 9: e62–78","authors":"","doi":"10.1016/S2542-5196(25)00133-0","DOIUrl":"10.1016/S2542-5196(25)00133-0","url":null,"abstract":"","PeriodicalId":48548,"journal":{"name":"Lancet Planetary Health","volume":"9 6","pages":"Page e455"},"PeriodicalIF":24.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"City planning for the future","authors":"The Lancet Planetary Health","doi":"10.1016/j.lanplh.2025.05.005","DOIUrl":"10.1016/j.lanplh.2025.05.005","url":null,"abstract":"","PeriodicalId":48548,"journal":{"name":"Lancet Planetary Health","volume":"9 6","pages":"Page e448"},"PeriodicalIF":24.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144261393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Air pollution and fetal brain morphological development: a prospective cohort study","authors":"Laura Gómez-Herrera MD ,&nbsp;Yu Zhao MPH ,&nbsp;Ioar Rivas PhD ,&nbsp;Elisenda Eixarch PhD ,&nbsp;Carla Domínguez-Gallardo MD PhD ,&nbsp;Toni Galmes MSc ,&nbsp;Marta Muniesa MD ,&nbsp;Maria Julia Zanini MD ,&nbsp;Alan Domínguez MPH ,&nbsp;Marta Cirach MSc ,&nbsp;Prof Mark Nieuwenhuijsen PhD ,&nbsp;Xavier Basagaña PhD ,&nbsp;Xavier Querol PhD ,&nbsp;Maria Foraster PhD ,&nbsp;Mariona Bustamante PhD ,&nbsp;Jesus Pujol MD ,&nbsp;Mireia Gascon PhD ,&nbsp;Elisa Llurba MD PhD ,&nbsp;María Dolores Gómez-Roig MD PhD ,&nbsp;Payam Dadvand PhD ,&nbsp;Prof Jordi Sunyer PhD","doi":"10.1016/S2542-5196(25)00093-2","DOIUrl":"10.1016/S2542-5196(25)00093-2","url":null,"abstract":"<div><h3>Background</h3><div>There is a scarcity of evidence of the influence of exposure to air pollution during pregnancy on the human fetal brain characterised prenatally. We aimed to evaluate the association of exposure to air pollution with fetal brain morphology.</div></div><div><h3>Methods</h3><div>In this prospective cohort study, we used data from the Barcelona Life Study Cohort, Spain, which recruited 1080 pregnant women at 8–14 weeks of gestation between Oct 16, 2018, and April 14, 2021, from three major university hospitals in Barcelona. Eligible participants were aged 18–45 years, had a singleton pregnancy, and had a fetus without major congenital anomalies. Third-trimester transvaginal neurosonography was applied to evaluate fetal brain morphological development. We integrated comprehensive data on time–activity patterns with land use regression, dispersion, and hybrid models to estimate exposure to NO₂, PM_2·5, and black carbon at home, workplace, and commuting routes during pregnancy until the neurosonography date. Single-pollutant linear mixed regression models and multipollutant ridge regression models were applied to estimate the associations between air pollutants and fetal brain outcomes, controlled for confounders. Distributed lag linear models were used to identify the vulnerable windows.</div></div><div><h3>Findings</h3><div>Among 1080 participants recruited at baseline, 954 attended the follow-up for the neurosonographic examination, 754 of whom were included in this study. In single-pollutant models, we found that prenatal exposure to NO₂, PM_2·5, and black carbon was associated with a wider anterior horn of lateral ventricles, wider cisterna magna, and larger cerebellar vermis. We also observed that higher exposure to black carbon was related to a shallower Sylvian fissure. No clear pattern or associations were observed between air pollution and other structures of brain morphology. Multipollutant models showed that these associations with black carbon remained significant, whereas associations with PM_2·5 and NO₂ lost significance for some indicators. A potential vulnerability window in mid-to-late pregnancy was identified for these associations.</div></div><div><h3>Interpretation</h3><div>Exposure to air pollution might affect brain morphological development as early as the fetal stage. Our findings could have important policy implications as they highlight the need to mitigate exposure of pregnant individuals to air pollution in urban areas to protect fetal brain development.</div></div><div><h3>Funding</h3><div>European Research Council.</div></div>","PeriodicalId":48548,"journal":{"name":"Lancet Planetary Health","volume":"9 6","pages":"Pages e480-e490"},"PeriodicalIF":24.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144262037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of tree canopy cover on air pollution-related mortality in European cities: an integrated approach","authors":"Pierre Sicard PhD ,&nbsp;Ionuţ-Silviu Pascu PhD ,&nbsp;Stefan Petrea PhD ,&nbsp;Stefan Leca PhD ,&nbsp;Alessandra De Marco PhD ,&nbsp;Prof Elena Paoletti PhD ,&nbsp;Prof Evgenios Agathokleous PhD ,&nbsp;Vicent Calatayud PhD","doi":"10.1016/S2542-5196(25)00112-3","DOIUrl":"10.1016/S2542-5196(25)00112-3","url":null,"abstract":"<div><h3>Background</h3><div>In urban areas, fine particles (PM_2·5), nitrogen dioxide (NO₂), and tropospheric ozone (O₃) are the most harmful air pollutants for human health. Urban greening is seen as a strategy for co-benefitting air quality, climate, and citizens’ wellbeing. We aimed to estimate the changes in tree cover, the mortality burden attributable to air pollution, and the mortality that could be potentially prevented by increasing tree coverage in European cities.</div></div><div><h3>Methods</h3><div>We did a quantitative health impact assessment to estimate the effect of mean tree cover on air pollutants levels and PM_2·5-related, NO₂-related, and O₃-related mortality (all ages) in 744 European urban centres, with more than 50 000 inhabitants, across 36 countries. We did all analyses at the city-wide scale.</div></div><div><h3>Findings</h3><div>Between 2000 and 2019, the mean tree coverage increased by 0·76 percentage points, with 73·5% of the urban centres showing greener coverage, whereas mortality burdens declined by on average 3·39% (SD 0·28) in all urban centres. In 2019, about 25% of the total population lived in areas with a mean tree canopy coverage over 30%. Compared with the current tree cover, each five percentage point increase in tree canopy cover could facilitate an air quality improvement of 2·8% for annual PM_2·5 mean concentrations, 1·4% for annual NO₂ mean concentrations, and 1·2% for summertime mean of the daily maximum 8-h O₃ concentrations.</div></div><div><h3>Interpretation</h3><div>We estimated that each five percentage point increase in tree canopy would potentially prevent 4727 premature deaths (95% CI 2067–7475) related to air pollution annually across the 744 European urban centres. We also estimated that reaching a canopy cover of 30% within each city could potentially prevent 11974 premature deaths (95% CI 7775–14 390) each year. Our results highlighted the potential public health benefits of increasing tree coverage in urban environments, contributing to sustainable, liveable, and healthier cities.</div></div><div><h3>Funding</h3><div>LIFE financial instrument of the EU; Romanian National Research Authority; Agencia Estatal de Investigación, Ministerio de Ciencia e Innovación; Generalitat Valenciana; The European Regional Development Fund; and National Natural Science Foundation of China.</div></div>","PeriodicalId":48548,"journal":{"name":"Lancet Planetary Health","volume":"9 6","pages":"Pages e527-e537"},"PeriodicalIF":24.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144262041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acceptability of health-only versus climate-and-health framings in lifestyle-related climate-sensitive health counselling: results of a randomised survey experiment in Germany","authors":"Alina Herrmann MD ,&nbsp;Nicola Krippl BA ,&nbsp;Helen Fischer PhD ,&nbsp;Jessica Nieder MSc ,&nbsp;Silvan Griesel MD ,&nbsp;Prof Till Bärnighausen MD ScD ,&nbsp;Prof Jan Schildmann MA MD ,&nbsp;Prof Rafael Mikolajczyk MD MSc ,&nbsp;Prof Ina Danquah PhD MSc ,&nbsp;Nikolaus C S Mezger MD MSc ,&nbsp;Prof Eva J Kantelhardt MD","doi":"10.1016/S2542-5196(25)00110-X","DOIUrl":"10.1016/S2542-5196(25)00110-X","url":null,"abstract":"<div><h3>Background</h3><div>Climate-sensitive health counselling (CSHC) delivered by health professionals could promote individual patients and planetary health, particularly within lifestyle counselling. However, health professionals’ uncertainty about the acceptability of CSHC remains a barrier to implementation. This study aimed to establish the effects of different topics and framings on patients’ acceptability of lifestyle-related CSHC.</div></div><div><h3>Methods</h3><div>We conducted a randomised survey experiment with a 2 × 3 mixed factorial design embedded in a larger survey in the Health-Related Beliefs and Health Care Experiences (HeReCa) panel study in Germany, an online panel of the general adult population from five of the 16 federal states across Germany. Participants were randomly assigned in a 1:1 ratio to one of two topics (either diet or physical activity) and were presented with three vignettes in a random order (framing A framed the given advice in health terms only; framing B presented the advice in terms of health and climate co-benefits; and framing C emphasised health, climate co-benefits, and climate risks). Topic served as the between-subject factor, and framing served as the within-subject factor. We hypothesised that the acceptability of CSHC would differ according to framing, but not according to topic. The primary outcome variable was the acceptability of the CSHC vignettes, measured using an acceptability score based on four items (affective attitude, burden, ethicality, and perceived effectiveness), rated on a five-point Likert scale (1–5 score: 1=not acceptable, 5=very acceptable). We refined our hypotheses based on subpopulations generated from a Left–Right Self-Placement for political orientation and climate change attitude test. We applied descriptive statistics, <em>t</em> tests, and a mixed ANOVA to the full and stratified samples.</div></div><div><h3>Findings</h3><div>Of 3346 individuals who signed up for the HeRaCa panel between November, 2019, and June, 2020, 3163 participants of the panel (94·5%) were given the survey and 1516 (47·9%) submitted responses between April and June, 2022. 25 participants with incomplete data were excluded, and 1491 participants were included in the mixed ANOVA primary analysis. 748 participants were allocated to the diet group and 743 to the physical activity group. The mean age of the full sample was 55·6 years (SD 14·2). Excluding 62 participants with missing values, 814 (57·0%) were female and 613 (49·2%) were male; two participants (0·1%) self-identified as a diverse gender. In the whole cohort, the mean acceptability score of framing A was 4·09 (SD 0·71), was 3·67 (0·91) for framing B; and was 3·55 (0·97) for framing C. Mixed ANOVA revealed a significant and large effect of framing (partial η=0·18, p&lt;0·001), and a significant but negligible effect of topic (partial η=0·004, p=0·021) on CSHC acceptability. Stratified analysis revealed that framing effects were less pr","PeriodicalId":48548,"journal":{"name":"Lancet Planetary Health","volume":"9 6","pages":"Pages e456-e466"},"PeriodicalIF":24.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144261388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of global treaties on commercial chemicals widely used as additives: a meta-analysis of historical measurements of polybrominated diphenyl ethers","authors":"Guangbin Zhong MS ,&nbsp;Zengwei Li PhD ,&nbsp;Prof Kevin C Jones PhD ,&nbsp;Ying Zhu PhD","doi":"10.1016/S2542-5196(25)00114-7","DOIUrl":"10.1016/S2542-5196(25)00114-7","url":null,"abstract":"<div><h3>Background</h3><div>Commercial organic additives, many of which possess persistent, bioaccumulative, and toxic (PBT) features, are widely used in various products. Although some PBT chemicals have been restricted, the risks associated with long-term exposure remain. Polybrominated diphenyl ethers (PBDEs) are flame retardants in electronics, textiles, and many everyday products. They are a typical class of ubiquitous additive chemicals with PBT characteristics. PBDEs include three commercial formulations: penta-BDE, octa-BDE, and deca-BDE. Penta-BDE and octa-BDE were banned in most countries in the early 2000s and listed under the Stockholm Convention in 2009 with recycling exemptions. Deca-BDE was banned later, with the USA starting to phase it out in 2009, and was added to the Convention in 2017 only with exemption for inclusion in vehicle parts until 2036. We conducted a meta-analysis and systematic regression analysis to explore the impact of global policies and treaties on both internal (human) and external (environmental) exposure to PBDEs.</div></div><div><h3>Methods</h3><div>On Jan 4, 2023, we conducted a search of electronic databases including Web of Science, Scopus, Embase, and PubMed, along with grey literature. The search results were updated on March 21, 2025. The inclusion criteria focused on studies reporting PBDE concentrations in indoor dust (a major source of external exposure) and in the human body (internal exposure). We collated concentration data of major PBDE congeners, which are present in different formulations of flame retardants used in different products, including BDE-47, BDE-99, BDE-153, BDE-183, and BDE-209. We used a breakpoint regression model to analyse the temporal trends of PBDEs and compared these trends with the timeline of national and regional policies.</div></div><div><h3>Findings</h3><div>We identified 9782 studies, of which 343 were included, covering data from 94 countries worldwide. Marked differences were observed in PBDE internal and external exposure across countries. Using the EU, China, and the USA as examples, we summarised the general temporal patterns of large-scale indoor emissions (which dominate exposures of the general population) of different PBDE congeners and their effects on human exposure, correlating with treaty, production, and usage schedules. The results indicate that PBDE emissions in indoor environments have decreased following policy interventions, but reductions in human PBDE levels have been delayed and slow. Using breakpoint regression modelling, we identified a significant turning point in the concentrations of low-brominated PBDEs (BDE-47: 1996 [95% CI 1991–2001], p&lt;0·0001; and BDE-99: 1997 [1992–2003], p&lt;0·0001) in human milk in the EU. Significant decreases were observed in both China (BDE-47, p=0·0008; BDE-99, p=0·011) and the USA (BDE-47, p=0·0023; BDE-99, p=0·041). However, no decreasing trend over time was evident for BDE-153, nor for the higher-bromina","PeriodicalId":48548,"journal":{"name":"Lancet Planetary Health","volume":"9 6","pages":"Pages e538-e552"},"PeriodicalIF":24.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144262042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}