Hygiene and environmental health advances最新文献

{"title":"Blood cadmium and lead concentrations in association with homocysteine and all-cause and cardiovascular mortality","authors":"Shaohui Liu ,&nbsp;Ziqi Zeng ,&nbsp;Quanhong Chen ,&nbsp;Anan Zhou ,&nbsp;Yunan Xu ,&nbsp;Hao Chen ,&nbsp;Yunfeng Zou","doi":"10.1016/j.heha.2025.100148","DOIUrl":"10.1016/j.heha.2025.100148","url":null,"abstract":"<div><div>Cadmium and lead exposure are reported to associate with elevated plasma homocysteine concentrations. However, whether homocysteine plays a role in the associations of cadmium and lead with all-cause and cardiovascular mortality is unclear. We conducted a cohort study using data from 6456 participants in the National Health and Nutrition Examination Survey (NHANES) (2003–2006). Cox regression models and restricted cubic splines (RCS) were used to examine the associations between cadmium, lead, and homocysteine and all-cause and cardiovascular mortality. Mediation analysis was conducted to evaluate the indirect effect of homocysteine in the associations between cadmium, lead and all-cause and cardiovascular mortality. During a median of 14.33 years of follow-up, 1642 (25.43 %) all-cause deaths and 575 (8.91 %) cardiovascular deaths were observed. When compared with the first quartile, cadmium, lead, and homocysteine levels in the fourth quartile were associated with increased all-cause mortality risk [hazard ratios (HRs) with 95 % confidence interval (CI) 1.91 (1.60, 2.29), 1.38 (1.16, 1.64), and 1.74 (1.42, 2.14), respectively] and cardiovascular mortality [1.85 (1.37, 2.50), 1.55 (1.15, 2.09), 1.67 (1.17, 2.37), respectively]. RCS analysis suggested nonlinear associations of cadmium, lead, and homocysteine with all-cause mortality, nonlinear relationships between cadmium and cardiovascular mortality, and linear associations between lead, homocysteine and cardiovascular mortality. Changes in homocysteine levels accounted for approximately 4.11 % and 5.81 % of the observed associations between cadmium exposure and all-cause and cardiovascular mortality, respectively. Similar observations were made for homocysteine on the associations of lead exposure and all-cause (11.05 %) and cardiovascular (7.69 %) mortality. Furthermore, lead concentrations modified the associations of cadmium and homocysteine with cardiovascular and all-cause mortality. Our findings suggested that plasma homocysteine was associated with the observed relationships between cadmium and lead exposure and increased all-cause and cardiovascular mortality, potentially reflecting underlying pathways relevant to heavy metal-related cardiovascular risk.</div></div>","PeriodicalId":73269,"journal":{"name":"Hygiene and environmental health advances","volume":"16 ","pages":"Article 100148"},"PeriodicalIF":2.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145416428","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":"Air pollution mixtures and stillbirth: k-means cluster analysis","authors":"Naomi O. Riches ,&nbsp;Ramkiran Gouripeddi ,&nbsp;Robert M. Silver ,&nbsp;Julio C. Facelli","doi":"10.1016/j.heha.2025.100153","DOIUrl":"10.1016/j.heha.2025.100153","url":null,"abstract":"<div><h3>Background</h3><div>Preventing stillbirths starts with identifying modifiable risk factors, such as air pollution (AP). Most research has focused on individual components of AP (e.g. PM_2.5) to assess the linear relationship between air pollutant concentration and stillbirth, with mixed results. However, the air we breathe is a mixture of gases and particles. The purpose of this study was to assess how mixtures of criteria air pollutants are associated with stillbirth in the United States.</div></div><div><h3>Materials and Methods</h3><div>Air pollution data from the US Environmental Protection Agency and individual US birth and fetal death data from the CDC National Vital Statistics System were used. Air pollutant exposures were clustered using k-means clustering. A categorical variable linking each patient to one of these clusters was used in a regression analysis.</div></div><div><h3>Results</h3><div>Four AP clusters were identified through k-means. Exposure to air pollution mixtures included in Clusters 1, 2, and 4 during pregnancy was associated with a 40%, 13%, and 43% increase in the odds of stillbirth, compared to Cluster 3 (reference), (OR = 1.40, 95% CI: 1.36-1.44, p&lt;0.001; OR = 1.13, 95% CI: 1.09-1.16, p&lt;0.001; OR = 1.43, 95% CI: 1.38-1.49, p&lt;0.001), respectively.</div></div><div><h3>Discussion</h3><div>The air pollution cluster associated with the greatest odds of stillbirth was high in PM_2.5 and SO₂, which may indicate industrial sources. To our knowledge, this is the first study to assess the impact of air pollution mixtures on stillbirth using k-means clustering. This method can be used to identify non-linear relationships between mixtures of air pollution and a health outcome.</div></div>","PeriodicalId":73269,"journal":{"name":"Hygiene and environmental health advances","volume":"16 ","pages":"Article 100153"},"PeriodicalIF":2.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145159073","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":"Effects of occupational exposure factors interacting with NLRP3 gene polymorphisms on mild cognitive impairment: A cross-sectional study of workers in an aluminum electrolysis production environment","authors":"Youxing Li ,&nbsp;Yaqin Pang ,&nbsp;Wenxue Li ,&nbsp;Dongshun Chen ,&nbsp;Caiping Zhang ,&nbsp;Yufang Cen ,&nbsp;Junhong Wei ,&nbsp;Rongqing Xiao ,&nbsp;Wenlian Rao ,&nbsp;Yinxia Lin ,&nbsp;Ahmad Razali Ishak ,&nbsp;Mohd Shukri Bin Mohd Aris ,&nbsp;Guangzi Qi","doi":"10.1016/j.heha.2025.100144","DOIUrl":"10.1016/j.heha.2025.100144","url":null,"abstract":"<div><div>Mild cognitive impairment (MCI) is an early stage of Alzheimer's disease and is the result of interactions between environmental and genetic factors. However, their impact on aluminum workers is not yet clear. This study aimed to explore the interaction between occupational exposure and NLRP3 gene polymorphisms on the odds of MCI among aluminum production workers. We assessed the cognitive function of 478 workers in a factory in Guangxi, China, and identified two main occupational exposure factors: principal component 1 (PC1: noise, high temperature, carbon monoxide, sulfur dioxide, nitrogen oxides) and principal component 2 (PC2: aluminum oxide dust, magnetic field, fluoride, manganese dioxide). Genotyping of polymorphisms in the NLRP3 gene (rs10754558, rs10925027, rs3806265, rs4612666) was performed. The results of the analysis showed that high PC2 exposure significantly increased the odds of MCI [OR (95 % CI): 1.99 (1.36, 2.91)], and the rs10754558 G/C genotype was independently associated with MCI [OR (95 % CI): 1.56 (1.05, 2.33)]. PC2 interacted with rs3806265 C/T [OR (95 % CI):2.13 (1.16, 3.92)] and rs4612666 C/T [OR (95 % CI): 2.84 (1.19,6.81)], further increasing the odds of MCI. These findings suggest that alumina dust, magnetic fields, fluoride, and manganese dioxide are the main occupational hazards factors for MCI. rs10754558 G/C is an independent susceptibility genotype for MCI, while rs3806265 C/T and rs4612666 C/T are environmental susceptibility genotypes for MCI. This study emphasizes that reducing occupational exposure and screening for susceptibility genes can provide a basis for targeted interventions to reduce the odds of MCI in this population.</div></div>","PeriodicalId":73269,"journal":{"name":"Hygiene and environmental health advances","volume":"16 ","pages":"Article 100144"},"PeriodicalIF":2.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145693001","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":"Assessment of particulate matter exposure associated with biomass storage in urban heating plant","authors":"Daniel Tomčík ,&nbsp;Miloš Gejdoš","doi":"10.1016/j.heha.2025.100154","DOIUrl":"10.1016/j.heha.2025.100154","url":null,"abstract":"<div><div>This study assessed the airborne particulate matter (PM) in urban heating plants, potentially affecting respiratory health in workers and nearby residents. The objectives of this study were to characterize occupational exposure during chip-loading activities and to evaluate ambient PM concentrations in the surrounding environment. Occupational exposure was assessed in accordance with the relevant standards using the Temtop M2000C, while continuous ambient monitoring was conducted with the AirNote device. The results indicate a significant increase in PM concentrations during woodchip loading activities. Mean PM2.5 concentrations were 24.03 µg/m³ during loading and 8.07 µg/m³ during non-loading, while PM10 levels were 38.75 µg/m³ and 12.80 µg/m³, respectively. Continuous monitoring revealed that daily mean PM2.5 concentrations were above the WHO 24-h guideline value of 15 µg/m³ on 3 days. The maximum daily mean PM2.5 concentration was 43.7 µg/m³, while the median daily mean was 22.5 µg/m³. For PM10, the maximum daily mean reached 70.9 µg/m³ and the median daily mean was 35.6 µg/m³, with exceedance of the WHO 24-hour guideline of 45 µg/m³ observed on one day. Distance from the woodchip pile also had a significant effect on PM concentrations (<em>p</em> &lt; 0.001), with short-term mean levels at 50 m exceeding the WHO 24-h guideline value by 2.9 times for PM2.5 and 1.6 times for PM10. These guideline values are provided for context only, as they represent 24-hour mean concentrations and not instantaneous limits. Beyond 100 m, no further significant reduction in PM levels was observed. Biomass storage operations can cause temporary PM exceedances, particularly during handling and near storage areas. These findings underscore the importance of implementing mitigation strategies to reduce airborne particulate emissions.</div></div>","PeriodicalId":73269,"journal":{"name":"Hygiene and environmental health advances","volume":"16 ","pages":"Article 100154"},"PeriodicalIF":2.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145268131","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":"Unravelling the crucial aging signatures linking cadmium exposure with the risk of frailty and mortality: DNA methylation aging clocks, biological aging indicators, or telomere length?","authors":"Yayuan Mei ,&nbsp;Weitao Su ,&nbsp;Jiaxin Zhao ,&nbsp;Quan Zhou ,&nbsp;Xiuzhi Li ,&nbsp;Yanbing Li ,&nbsp;Ming Yang ,&nbsp;Jingtao Wu ,&nbsp;Yaoyu Hu ,&nbsp;Ang Li","doi":"10.1016/j.heha.2025.100149","DOIUrl":"10.1016/j.heha.2025.100149","url":null,"abstract":"<div><div>We aimed to investigate whether heavy metal exposure is associated with aging acceleration and aging-related outcomes, and whether aging mediates such associations. 6583 participants from a 20-year nationally representative cohort study were included. Blood levels of two typical heavy metals, cadmium (Cd) and lead (Pb), were measured. Eleven aging signatures were assessed, including DNA methylation aging clocks, biological aging indicators, and telomere length. Survey-weighted Cox proportional hazard models, generalized linear models, and logistic regression models were used to evaluate the effects of metals on aging and related outcomes. An unsupervised machine learning algorithm was applied to identify aging-featured clusters. The role of aging acceleration in metal-associated frailty and mortality was tested using average causal mediation effect analysis. We found that Cd was associated with both frailty and mortality risk, and Pb was associated with mortality risk. Significant associations with multiple aging signatures were mainly observed for Cd exposure. Participants were categorized into four clusters. Finally, aging signatures mediated Cd-associated frailty and mortality with mediation proportions ranging from 4.37% to 43.61%. Our findings reveal that Cd exposure is associated with aging acceleration, frailty, and mortality risk. Aging mediated the Cd-associated frailty and mortality, which highlights the potential mechanisms and prevention avenues.</div></div>","PeriodicalId":73269,"journal":{"name":"Hygiene and environmental health advances","volume":"16 ","pages":"Article 100149"},"PeriodicalIF":2.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145221337","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":"What drives toilet cleanliness in urban schools? Roles of infrastructure, resources, and hygiene promotion in Kampala","authors":"Jude Zziwa Byansi ,&nbsp;Swaib Semiyaga ,&nbsp;Alex Yasoni Katukiza ,&nbsp;Najib Lukooya Bateganya ,&nbsp;Frank Kansiime ,&nbsp;Robinah Nakawunde Kulabako","doi":"10.1016/j.heha.2025.100158","DOIUrl":"10.1016/j.heha.2025.100158","url":null,"abstract":"<div><div>Access to clean toilets in schools is essential for a conducive learning environment and safeguarding pupils' health. Urban schools often face sanitation challenges stemming from overcrowding, inadequate facilities, and differences in management practices across school categories such as public or private, primary or secondary, day or boarding, and service level classifications. Identifying key factors influencing toilet cleanliness is vital for improving urban school sanitation. This study investigated the drivers of toilet cleanliness through a cross-sectional study conducted in Kampala City, in Uganda. Kampala City has 852 schools of which 274 were selected for this study. Data collection comprised 274 structured observations guided by a checklist, 548 questionnaires administered to Head Teachers and Sanitation Teachers, and 40 key informant interviews. Logistic regression and decision tree modeling were used for data analysis. Across all school types, significant associations were observed between toilet cleanliness and facility privacy, sex segregation, presence of health clubs, handwashing facilities with soap and water, rainwater harvesting systems, sanitation budget, and toilet paper availability. The decision tree model identified rainwater harvesting, handwashing facilities, and health clubs as the strongest predictors of toilet cleanliness, in that order. Findings indicate that policymakers and school administrators should prioritize investment in water access, hygiene infrastructure, and health clubs to improve and sustain toilet cleanliness in urban schools.</div></div>","PeriodicalId":73269,"journal":{"name":"Hygiene and environmental health advances","volume":"16 ","pages":"Article 100158"},"PeriodicalIF":2.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145528406","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":"Unveiling the mediating role of oxidative stress in the association between endocrine-disrupting chemicals and phenotypic age acceleration: a cross-sectional study","authors":"Ziang Guo ,&nbsp;Yuxuan Tan ,&nbsp;Feng Huang ,&nbsp;Jiyu Nie ,&nbsp;Xiaoxiao Lin ,&nbsp;Yingyin Fu ,&nbsp;Huojie Yao ,&nbsp;Xiaomei Wu ,&nbsp;Guang Yang ,&nbsp;Qinli Wan ,&nbsp;Chunxia Jing","doi":"10.1016/j.heha.2025.100152","DOIUrl":"10.1016/j.heha.2025.100152","url":null,"abstract":"<div><div>Aging presents a significant global public health challenge, raising concerns about environmental factors. However, evidence linking multiple endocrine-disrupting chemicals (EDCs) to aging and their mechanisms is limited. This study explored the link between ten phthalates, four phenols, and two pesticides and biological senescence, along with oxidative stress's regulatory role. This cross-sectional study analyzed data from the National Health and Nutrition Examination Surveys (2005-2016) with 2668 participants and sixteen chemicals. It used multiple linear regression, Bayesian kernel machine regression (BKMR), and quantile g-computation (QGC) to explore the relationships between EDCs and phenotypic aging, as well as the mediating effects of oxidative stress. Multiple linear regression indicated that MCNP, MECPP, MEHHP, and MEOHP were linked to decreased phenotypic age acceleration (PAA). BKMR analysis showed that phthalates significantly impacted both the total population and men, with group PIP values of 0.6335 and 0.8546, respectively. QGC results confirmed negative confounding effects (Estimation [95 % CI]: -0.79 [-1.31, -0.27] for the total population; -0.89 [-1.65, -0.13] for men). Both models identified MECCP and BP3 as key contributors. Mediation analyses revealed that bilirubin and iron mediated the relationship between the chemical mixture and PAA, with proportions of -24.86 % and -21.06 %, respectively.Our findings suggest that exposure to EDCs, both individually and in combination, is linked to slowed aging, particularly with MECCP and BP3. Additional laboratory and multicenter studies are needed to validate these results.</div></div>","PeriodicalId":73269,"journal":{"name":"Hygiene and environmental health advances","volume":"16 ","pages":"Article 100152"},"PeriodicalIF":2.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145221313","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":"Plant-driven strategies for mitigating microplastic pollution in agricultural ecosystems","authors":"Anindita Banerjee ,&nbsp;Pranav Kumar ,&nbsp;Arkaprobha Ghosh ,&nbsp;Soumita Reja ,&nbsp;Surjit Singh","doi":"10.1016/j.heha.2025.100160","DOIUrl":"10.1016/j.heha.2025.100160","url":null,"abstract":"<div><div>Microplastics (MPs) have become a widespread and novel threat to agriculture by degrading soils, damaging plant productivity and ultimately threatening food security. Research on MP contamination paths through plastic mulching, biosolids, compost, and wastewater irrigation has led to a greater understanding the problem, but the physiological and ecological impacts on plants have not been quantified and explained. MPs affect the biophysical properties of the soils, including the water and nutrients, which impacts their flow to the MP-affected plants. Biophysical changes caused by the MPs to the soils include changes to bulk density, porosity, and hydraulic conductivity. In the rhizosphere, they cause disruption to the microbial networks, suppression of enzymes, and the destabilization of symbiotic relationships, which impacts the plants’ ability to biogoechemically cycle and mitigate stress. MP-affected plants result in reduced germination, depressed photosynthetic productivity, oxidative stress leading to altered carbon distribution, secondary metabolites, and loss of other metabolites.</div><div>While there are many studies on the microbial and physicochemical approaches to remediation, the plant pathway and approaches to remediation are still largely unexplored and present a novel opportunity to address the problem. Symbiotic microbial consortia associated with root systems will help with enzymatic transformation of aggregating, immobilizing, and in some cases, biochemically transforming MPs. The detoxification capacity of PGPR and rhizosphere biochar are often situational and short-lived. Most importantly, the short-term laboratory studies using pristine MPs and over concentrated MPs will not accurately influence or predict the ecological impact and applicability to the field.</div><div>This review underscores the need for an integrated, nature-based strategies to combat MP pollution and protect agroecosystem integrity by bridging microbiology, soil science, and sustainable agriculture. Furthermore, a comprehensive understanding of the root system physiology, chemical exudation patterns, and microbial associations has been explored to determine the fate of the MP in deriving implementable plant-driven approaches. Such a framework is necessary to develop resilient self-remediating agroecosystems that can degrade plastic waste while maintaining productive agriculture.</div></div>","PeriodicalId":73269,"journal":{"name":"Hygiene and environmental health advances","volume":"16 ","pages":"Article 100160"},"PeriodicalIF":2.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145623809","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":"Climate changes and cancer risk: Key factors and emerging health threats","authors":"Marina Rayciki Sotomayor ,&nbsp;Aline Graciele Henriques Campos ,&nbsp;Altair Rodrigues Pires de Paula Filho ,&nbsp;Ana Carolina Aredes Goulart ,&nbsp;Beatriz Geovana Leite Vacario ,&nbsp;Julia Fernandes Gois Orrutéa ,&nbsp;Juliana Maria Bitencourt de Morais Valentim ,&nbsp;Tatiane Renata Fagundes ,&nbsp;Shaiane Carla Gaboardi ,&nbsp;Carolina Panis","doi":"10.1016/j.heha.2025.100145","DOIUrl":"10.1016/j.heha.2025.100145","url":null,"abstract":"<div><div>Climate change, driven by global warming and environmental degradation, has far-reaching implications for human health, including its potential role in cancer incidence. Rising temperatures, increased ultraviolet (UV) radiation, and changes in air quality are linked to various cancer risks. disruptions in agricultural practices and food security can influence cancer risk through changes in diet and exposure to carcinogenic compounds such as pesticides. Water contamination due to flooding and chemical runoffs may also increase exposure to carcinogens. Vulnerable populations, particularly those in lower-income regions, are at heightened risk, as they often lack access to healthcare and preventive measures. In this context, this review addresses the relationship between climate changes impact and cancer risk, discussing how these events can increase cancer development.</div></div>","PeriodicalId":73269,"journal":{"name":"Hygiene and environmental health advances","volume":"16 ","pages":"Article 100145"},"PeriodicalIF":2.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145011260","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":"Reflecting mixed method research on drinking water, sanitation and hygiene among unhoused people. Insights into a case study from Germany","authors":"C. Anthonj ,&nbsp;S.N. Stanglow ,&nbsp;J. Flacke ,&nbsp;A. Leinen ,&nbsp;C. Butsch ,&nbsp;F. Meissner ,&nbsp;S. Jendrek ,&nbsp;J. Martinez","doi":"10.1016/j.heha.2025.100139","DOIUrl":"10.1016/j.heha.2025.100139","url":null,"abstract":"<div><h3>Introduction</h3><div>People experiencing homelessness and the drinking water, sanitation and hygiene (WASH) challenges that they are facing are neither well-represented in academic literature, nor in national and international statistics. This dynamic and often invisible vulnerable group is commonly undercounted in national surveys and official statistics are often based on household units, thus, not accounting for unsheltered individuals. Living at the margins, they are often out of reach to be involved in outreach efforts and interventions, and these systemic inequities increase their exposure to risks, while decreasing access to assistance to mitigate and reduce them.</div></div><div><h3>Methods</h3><div>Using a mixed method case study carried out in Germany in 2023, we involved 45 persons experiencing homelessness. We first provide an overview of our study design capturing spatial and non-spatial, individual and collective information through research methods such as in-depth interviews, walking interviews, focus group discussions, collaborative mapping (digital versus on paper), arts-based research, mental mapping, photovoice and shadowing. We then reflect on their feasibility and usefulness.</div></div><div><h3>Results</h3><div>In-depth interviews were most feasible to implement, captured individual, cross-sectional, information and lead to the best results. Participatory methods, collaborative mapping and group discussions were more difficult to implement, yet lead to highly relevant findings. Longitudinal approaches and mental mapping methods were most difficult to realize. Photovoice could not be implemented at all. Shadowing resulted in findings that were only of medium relevance, yet, were very helpful in establishing an improved relationship with the target population, and building trust.</div></div><div><h3>Conclusions and recommendations</h3><div>The multifaceted challenges of unhoused individuals require awareness of their lived realities, great flexibility, time, trust, relationships, openness and adaptations, and research designs tailored to their life realities. Our insights can enable decision-makers to design targeted interventions and have broader applicability among other populations and contexts.</div></div>","PeriodicalId":73269,"journal":{"name":"Hygiene and environmental health advances","volume":"15 ","pages":"Article 100139"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144656622","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}