Improving and Expanding Estimates of the Global Burden of Disease Due to Environmental Health Risk Factors

Avoidable mortality, risk factors and policies for tackling noncommunicable diseases – leveraging data for impact: monitoring commitments in the WHO European Region ahead of the Fourth United Nations High-Level Meeting

The report notes that, in order to tackle NCDs and address the commercial, social, environmental and digital determinants of health, there is a need for accelerated multisectoral whole-of-government and whole-of-society action, integrated policies, enhanced preventive measures and strengthened health systems.

Human Health and Ocean Pollution

Background: Pollution – unwanted waste released to air, water, and land by human activity – is the largest environmental cause of disease in the world today. It is responsible for an estimated nine million premature deaths per year, enormous economic losses, erosion of human capital, and degradation of ecosystems. Ocean pollution is an important, but insufficiently recognized and inadequately controlled component of global pollution. It poses serious threats to human health and well-being. The nature and magnitude of these impacts are only beginning to be understood.Goals: (1) Broadly examine the known and potential impacts of ocean pollution on human health. (2) Inform policy makers, government leaders, international organizations, civil society, and the global public of these threats. (3) Propose priorities for interventions to control and prevent pollution of the seas and safeguard human health.Methods: Topic-focused reviews that examine the effects of ocean pollution on human health, identify gaps in knowledge, project future trends, and offer evidence-based guidance for effective intervention.Environmental Findings: Pollution of the oceans is widespread, worsening, and in most countries poorly controlled. It is a complex mixture of toxic metals, plastics, manufactured chemicals, petroleum, urban and industrial wastes, pesticides, fertilizers, pharmaceutical chemicals, agricultural runoff, and sewage. More than 80% arises from land-based sources. It reaches the oceans through rivers, runoff, atmospheric deposition and direct discharges. It is often heaviest near the coasts and most highly concentrated along the coasts of low- and middle-income countries. Plastic is a rapidly increasing and highly visible component of ocean pollution, and an estimated 10 million metric tons of plastic waste enter the seas each year. Mercury is the metal pollutant of greatest concern in the oceans; it is released from two main sources – coal combustion and small-scale gold mining. Global spread of industrialized agriculture with increasing use of chemical fertilizer leads to extension of Harmful Algal Blooms (HABs) to previously unaffected regions. Chemical pollutants are ubiquitous and contaminate seas and marine organisms from the high Arctic to the abyssal depths.Ecosystem Findings: Ocean pollution has multiple negative impacts on marine ecosystems, and these impacts are exacerbated by global climate change. Petroleum-based pollutants reduce photosynthesis in marine microorganisms that generate oxygen. Increasing absorption of carbon dioxide into the seas causes ocean acidification, which destroys coral reefs, impairs shellfish development, dissolves calcium-containing microorganisms at the base of the marine food web, and increases the toxicity of some pollutants. Plastic pollution threatens marine mammals, fish, and seabirds and accumulates in large mid-ocean gyres. It breaks down into microplastic and nanoplastic particles containing multiple manufactured chemicals that can enter the tissues of marine organisms, including species consumed by humans. Industrial releases, runoff, and sewage increase frequency and severity of HABs, bacterial pollution, and anti-microbial resistance. Pollution and sea surface warming are triggering poleward migration of dangerous pathogens such as the Vibrio species. Industrial discharges, pharmaceutical wastes, pesticides, and sewage contribute to global declines in fish stocks.Human Health Findings: Methylmercury and PCBs are the ocean pollutants whose human health effects are best understood. Exposures of infants in utero to these pollutants through maternal consumption of contaminated seafood can damage developing brains, reduce IQ and increase children’s risks for autism, ADHD and learning disorders. Adult exposures to methylmercury increase risks for cardiovascular disease and dementia. Manufactured chemicals – phthalates, bisphenol A, flame retardants, and perfluorinated chemicals, many of them released into the seas from plastic waste – can disrupt endocrine signaling, reduce male fertility, damage the nervous system, and increase risk of cancer. HABs produce potent toxins that accumulate in fish and shellfish. When ingested, these toxins can cause severe neurological impairment and rapid death. HAB toxins can also become airborne and cause respiratory disease. Pathogenic marine bacteria cause gastrointestinal diseases and deep wound infections. With climate change and increasing pollution, risk is high that Vibrio infections, including cholera, will increase in frequency and extend to new areas. All of the health impacts of ocean pollution fall disproportionately on vulnerable populations in the Global South – environmental injustice on a planetary scale.Conclusions: Ocean pollution is a global problem. It arises from multiple sources and crosses national boundaries. It is the consequence of reckless, shortsighted, and unsustainable exploitation of the earth’s resources. It endangers marine ecosystems. It impedes the production of atmospheric oxygen. Its threats to human health are great and growing, but still incompletely understood. Its economic costs are only beginning to be counted.Ocean pollution can be prevented. Like all forms of pollution, ocean pollution can be controlled by deploying data-driven strategies based on law, policy, technology, and enforcement that target priority pollution sources. Many countries have used these tools to control air and water pollution and are now applying them to ocean pollution. Successes achieved to date demonstrate that broader control is feasible. Heavily polluted harbors have been cleaned, estuaries rejuvenated, and coral reefs restored.Prevention of ocean pollution creates many benefits. It boosts economies, increases tourism, helps restore fisheries, and improves human health and well-being. It advances the Sustainable Development Goals (SDG). These benefits will last for centuries.Recommendations: World leaders who recognize the gravity of ocean pollution, acknowledge its growing dangers, engage civil society and the global public, and take bold, evidence-based action to stop pollution at source will be critical to preventing ocean pollution and safeguarding human health.Prevention of pollution from land-based sources is key. Eliminating coal combustion and banning all uses of mercury will reduce mercury pollution. Bans on single-use plastic and better management of plastic waste reduce plastic pollution. Bans on persistent organic pollutants (POPs) have reduced pollution by PCBs and DDT. Control of industrial discharges, treatment of sewage, and reduced applications of fertilizers have mitigated coastal pollution and are reducing frequency of HABs. National, regional and international marine pollution control programs that are adequately funded and backed by strong enforcement have been shown to be effective. Robust monitoring is essential to track progress.Further interventions that hold great promise include wide-scale transition to renewable fuels; transition to a circular economy that creates little waste and focuses on equity rather than on endless growth; embracing the principles of green chemistry; and building scientific capacity in all countries.Designation of Marine Protected Areas (MPAs) will safeguard critical ecosystems, protect vulnerable fish stocks, and enhance human health and well-being. Creation of MPAs is an important manifestation of national and international commitment to protecting the health of the seas.

Emerging contaminants: A One Health perspective

Environmental pollution is escalating due to rapid global development that often prioritizes human needs over planetary health. Despite global efforts to mitigate legacy pollutants, the continuous introduction of new substances remains a major threat to both people and the planet. In response, global initiatives are focusing on risk assessment and regulation of emerging contaminants, as demonstrated by the ongoing efforts to establish the UN’s Intergovernmental Science-Policy Panel on Chemicals, Waste, and Pollution Prevention.

Environmental epidemiology in a crossfire

Two tendencies have emerged in environmental epidemiology that hamper the translation of research findings into prevention of environmental hazards. One is the increased focus on highlighting weaknesses of epidemiology research that is clearly meant to explain away the research conclusions and weaken their possible implications for interventions to control environmental hazards. Another is the voluminous amount of information sharing that involves a substantial amount of misinformation, as part of the ongoing infodemic. In this light, the appearance of the catalogue of doubt-raising strategies, indeed the worst practices of scientific inference, is good news. Collected under the auspices of the International Network for Epidemiology in Policy, it serves to illustrate the range of possible (and impossible) forms of critique that may be raised on behalf of vested interests or other groups who for some reason disagree with the epidemiological conclusions. We believe that this systematic list will be useful in our field and help to identify critiques of policy options that are hidden and sometimes suppressed in weighing the epidemiological evidence.

Sustainable Development Goals

The 2030 Agenda for Sustainable Development was adopted by all United Nations Member States in 2015. It is built around 17 Sustainable Development Goals (SDGs) and 169 targets that represent an ambitious plan for achieving sustainable development and serves as the basis for countries to shape their national policies and priorities. At the heart of the agenda is the recognition that truely sustainable development must combine economic growth and poverty alleviation with strategies that improve health and education, reduce inequality, while addressing climate change and protecting nature. Thus, the interlinked nature of the SDGs calls for an integrated approach to policy decisions. As the international statistical standard for measuring the environment and its relationship with the economy, the SEEA is well positioned to support integrated policies based on a better understanding of the interactions and trade-offs between the environment and economy. Progress toward the 17 goals and 169 targets of the 2030 Agenda are monitored through 244 indicators, entailing the collection of substantial amounts of data. The UN Statistical Commission (UNSC) has encouraged the Inter-Agency and Expert Group on SDG Indicators (IAEG-SDGs), the body tasked with developing and implementing the global indicator framework for the 2030 Agenda, to consider existing standards and frameworks that can improve SDG monitoring, including the System of Environmental-Economic Accounting (SEEA). System of Environmental-Economic Accounting (SEEA). Recently, the Secretariat of the Convention on Biological Diversity (CBD), UN Environment and the UN Statistics Division brought a proposal on upgrading the status of Indicator 15.9.1 to the tenth meeting of the IAEG-SDGs, where the group agreed to the proposal and reclassified the indicator from Tier III to Tier II. The United Nations Committee of Experts on Environmental-Economic Accounting (UNCEEA), an intergovernmental body established by the UNSC to provide overall vision, coordination, prioritization and direction in the field of environmental economic accounting and supporting statistics, has assessed that currently 40 indicators for nine Sustainable Development Goals can be informed by the SEEA. The SEEA is particularly well-suited for deriving ratio indicators that compare environmental and economic information.

Health-Informed Computing: Estimating and Addressing the Public Health Impact of Data Centers

The surging demand for artificial intelligence (AI) has led to a rapid expansion of energy-intensive data centers, contributing to criteria air pollutant emissions and raising public health concerns that have received comparatively limited attention in sustainability assessments. This paper introduces a principled methodology to model air pollutant emissions for data centers and estimate the public health impacts. Our findings reveal that the growing demand for AI and computing technologies is projected to push the total annual public health burden of U.S. data centers up to more than $20 billion in 2028. Although national-level impacts remain modest, data center health costs are unevenly distributed: in the most affected counties, the estimated per-household health burden can reach about seven times the national average. Next, we propose a health-informed computing framework that explicitly incorporates public health impacts into data center resource management across space and time, mitigating public health costs while supporting environmental sustainability. More broadly, we recommend extended energy reporting to include public health impact of data centers and paying attention to all impacted communities.

Health-Informed Computing: Estimating and Addressing the Public Health Impact of Data Centers

The surging demand for artificial intelligence (AI) has led to a rapid expansion of energy-intensive data centers, contributing to criteria air pollutant emissions and raising public health concerns that have received comparatively limited attention in sustainability assessments. This paper introduces a principled methodology to model air pollutant emissions for data centers and estimate the public health impacts. Our findings reveal that the growing demand for AI and computing technologies is projected to push the total annual public health burden of U.S. data centers up to more than $20 billion in 2028. Although national-level impacts remain modest, data center health costs are unevenly distributed: in the most affected counties, the estimated per-household health burden can reach about seven times the national average. Next, we propose a health-informed computing framework that explicitly incorporates public health impacts into data center resource management across space and time, mitigating public health costs while supporting environmental sustainability. More broadly, we recommend extended energy reporting to include public health impact of data centers and paying attention to all impacted communities.

Metrics for biodiversity and health policy integration

Despite over a decade of progressive commitments from parties to the Convention on Biological Diversity (CBD), integrated biodiversity and health indicators and monitoring mechanisms remain limited, hampering achievement of the sustainable development goals and improvements in health and well-being. Adoption of the Kunming-Montreal Global Biodiversity Framework (2022) and the Global Action Plan on Biodiversity and Health (2024) provide a renewed entry point to shape the way governments approach health and wellbeing and address the environmental burden of disease. This is a critical opportunity that scholars at the health-environment nexus should not miss. This Perspective outlines building blocks to mobilize the field, starting with essential terminology and a scope of metrics needed by governments. We then evaluate elements to be considered in the construction of integrated metrics, including concepts, overarching challenges, a review of scientific hypotheses from an ecological perspective, as well as a set of principles and characteristics for indicators. To raise awareness across parallel communities of practice working at the health-environment nexus, we then briefly examine four approaches to integrated metrics developed by: conservationists, Indigenous scholars, One Health experts, and planetary health experts. We conclude with actionable steps to enhance governance, mobilize funding, and apply integrated indicators in national and global strategies. A broad science community is needed to support national governments to meet global commitments to address biodiversity loss and the environmental burden of disease concurrently. The overall aim of this paper is to contribute to addressing biodiversity loss by effectively linking policy and transdisciplinary practice at the health-environment nexus.

STAT

Reporting from the frontiers of health and medicine

Timescales of developmental toxicity impacting on research and needs for intervention

Abstract Much progress has happened in understanding developmental vulnerability to preventable environmental hazards. Along with the improved insight, the perspective has widened, and developmental toxicity now involves latent effects that can result in delayed adverse effects in adults or at old age and additional effects that can be transgenerationally transferred to future generations. Although epidemiology and toxicology to an increasing degree are exploring the adverse effects from developmental exposures in human beings, the improved documentation has resulted in little progress in protection, and few environmental chemicals are currently regulated to protect against developmental toxicity, whether it be neurotoxicity, endocrine disruption or other adverse outcome. The desire to obtain a high degree of certainty and verification of the evidence used for decision‐making must be weighed against the costs and necessary duration of research, as well as the long‐term costs to human health because of delayed protection of vulnerable early‐life stages of human development and, possibly, future generations. Although two‐generation toxicology tests may be useful for initial test purposes, other rapidly emerging tools need to be seriously considered from computational chemistry and metabolomics to CLARITY ‐ BPA ‐type designs, big data and population record linkage approaches that will allow efficient generation of new insight; epigenetic mechanisms may necessitate a set of additional regulatory tests to reveal such effects. As reflected by the Prenatal Programming and Toxicity ( PPTOX ) VI conference, the current scientific understanding and the timescales involved require an intensified approach to protect against preventable adverse health effects that can harm the next generation and generations to come. While further research is needed, the main emphasis should be on research translation and timely public health intervention to avoid serious, irreversible and perhaps transgenerational harm.

Global aid cuts could lead to 23 million deaths by 2030, study estimates

Lab tests are negative for more than 200 pathogens, but testing continues.

Effect of the Tokyo 2020 Summer Olympic Games on COVID-19 incidence in Japan: a synthetic control approach

Background The Tokyo 2020 Summer Olympic Games (23 July–8 August 2021) were held in the middle of Japan’s fifth wave of COVID-19, when the number of cases was on the rise, and coincided with the fourth state of emergency implemented by the host city, Tokyo. Aim This study aimed to assess whether the hosting of the Games was associated with a change in the number of COVID-19 cases in Japan using a synthetic control method. Methods A weighted average of control countries with a variety of predictors was used to estimate the counterfactual trajectory of daily COVID-19 cases per 1 000 000 population in the absence of the Games in Japan. Outcome and predictor data were extracted using official and open sources spanning several countries. The predictors comprise the most recent country-level annual or daily data accessible during the Games, including the stringency of the government’s COVID-19 response, testing capacity and vaccination capacity; human mobility index; electoral democracy index and demographic, socioeconomic, health and weather information. After excluding countries with missing data, 42 countries were ultimately used as control countries. Results The number of observed cases per 1 000 000 population on the last day of the Games was 109.2 (7-day average), which was 115.7% higher than the counterfactual trajectory comprising 51.0 confirmed cases per 1 000 000 population. During the Olympic period (since 23 July), the observed cumulative number of cases was 61.0% higher than the counterfactual trajectory, comprising 143 072 and 89 210 confirmed cases (p=0.023), respectively. The counterfactual trajectory lagged 10 days behind the observed trends. Conclusions Given the increasing likelihood that new emerging infectious diseases will be reported in the future, we believe that the results of this study should serve as a sentinel warning for upcoming mega-events during COVID-19 and future pandemics.

Effect of the Tokyo 2020 Summer Olympic Games on COVID-19 incidence in Japan: a synthetic control approach

Background The Tokyo 2020 Summer Olympic Games (23 July–8 August 2021) were held in the middle of Japan’s fifth wave of COVID-19, when the number of cases was on the rise, and coincided with the fourth state of emergency implemented by the host city, Tokyo. Aim This study aimed to assess whether the hosting of the Games was associated with a change in the number of COVID-19 cases in Japan using a synthetic control method. Methods A weighted average of control countries with a variety of predictors was used to estimate the counterfactual trajectory of daily COVID-19 cases per 1 000 000 population in the absence of the Games in Japan. Outcome and predictor data were extracted using official and open sources spanning several countries. The predictors comprise the most recent country-level annual or daily data accessible during the Games, including the stringency of the government’s COVID-19 response, testing capacity and vaccination capacity; human mobility index; electoral democracy index and demographic, socioeconomic, health and weather information. After excluding countries with missing data, 42 countries were ultimately used as control countries. Results The number of observed cases per 1 000 000 population on the last day of the Games was 109.2 (7-day average), which was 115.7% higher than the counterfactual trajectory comprising 51.0 confirmed cases per 1 000 000 population. During the Olympic period (since 23 July), the observed cumulative number of cases was 61.0% higher than the counterfactual trajectory, comprising 143 072 and 89 210 confirmed cases (p=0.023), respectively. The counterfactual trajectory lagged 10 days behind the observed trends. Conclusions Given the increasing likelihood that new emerging infectious diseases will be reported in the future, we believe that the results of this study should serve as a sentinel warning for upcoming mega-events during COVID-19 and future pandemics.

Safeguarding human health in the Anthropocene epoch: report of The Rockefeller Foundation–Lancet Commission on planetary health

Far-reaching changes to the structure and function of the Earth's natural systems represent a growing threat to human health. And yet, global health has mainly improved as these changes have gathered pace. What is the explanation? As a Commission, we are deeply concerned that the explanation is straightforward and sobering: we have been mortgaging the health of future generations to realise economic and development gains in the present. By unsustainably exploiting nature's resources, human civilisation has flourished but now risks substantial health effects from the degradation of nature's life support systems in the future.

Key Principles for the Intergovernmental Science–Policy Panel on Chemicals and Waste

In 2021, the United Nations Environment Programme (UNEP) recognized chemical pollution as a planetary crisis tantamount to climate change and biodiversity