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Household air pollution generated from the use of polluting cooking fuels and technologies is a major source of disease and environmental degradation in low- and middle-income countries. Using a novel modelling approach, we provide detailed global, regional and country estimates of the percentages and populations mainly using 6 fuel categories (electricity, gaseous fuels, kerosene, biomass, charcoal, coal) and overall polluting/clean fuel use – from 1990-2020 and with urban/rural disaggregation. Here we show that 53% of the global population mainly used polluting cooking fuels in 1990, dropping to 36% in 2020. In urban areas, gaseous fuels currently dominate, with a growing reliance on electricity; in rural populations, high levels of biomass use persist alongside increasing use of gaseous fuels. Future projections of observed trends suggest 31% will still mainly use polluting fuels in 2030, including over 1 billion people in Sub-Saharan African by 2025. Household air pollution derived from cooking fuels is a major source of health and environmental problems. Here, the authors provide detailed global, regional and country estimates of cooking fuel usage from 1990 to 2030 and project that 31% of people will still be mainly using polluting fuels in 2030.

Living near, recreating in, and feeling psychologically connected to, the natural world are all associated with better mental health, but many exposure-related questions remain. Using data from an 18-country survey ( n  = 16,307) we explored associations between multiple measures of mental health (positive well-being, mental distress, depression/anxiety medication use) and: (a) exposures (residential/recreational visits) to different natural settings (green/inland-blue/coastal-blue spaces); and (b) nature connectedness, across season and country. People who lived in greener/coastal neighbourhoods reported higher positive well-being, but this association largely disappeared when recreational visits were controlled for. Frequency of recreational visits to green, inland-blue, and coastal-blue spaces in the last 4 weeks were all positively associated with positive well-being and negatively associated with mental distress. Associations with green space visits were relatively consistent across seasons and countries but associations with blue space visits showed greater heterogeneity. Nature connectedness was also positively associated with positive well-being and negatively associated with mental distress and was, along with green space visits, associated with a lower likelihood of using medication for depression. By contrast inland-blue space visits were associated with a greater likelihood of using anxiety medication. Results highlight the benefits of multi-exposure, multi-response, multi-country studies in exploring complexity in nature-health associations.

Wind turbines are a relatively new threat to bats, causing mortalities worldwide. Reducing these fatalities is essential to ensure that the global increase in wind-energy facilities can occur with minimal impact on bat populations. Although individual bats have been observed approaching wind turbines, and fatalities frequently reported, it is unclear whether bats are actively attracted to, indifferent to, or repelled by, the turbines at large wind-energy installations. In this study, we assessed bat activity at paired turbine and control locations at 23 British wind farms. The research focussed on Pipistrellus species, which were by far the most abundant bats recorded at these sites. P. pipistrellus activity was 37% higher at turbines than at control locations, whereas P. pygmaeus activity was consistent with no attraction or repulsion by turbines. Given that more than 50% of bat fatalities in Europe are P. pipistrellus , these findings help explain why Environmental Impact Assessments conducted before the installation of turbines are poor predictors of actual fatality rates. They also suggest that operational mitigation (minimising blade rotation in periods of high collision risk) is likely to be the most effective way to reduce collisions because the presence of turbines alters bat activity.

The near-surface temperature in Mediterranean climate-type regions has increased overall similarly or more rapidly than the global mean rates. Although these regions have comparable climate characteristics and are located at similar latitudes, recent warming acceleration is most pronounced in the Mediterranean Basin. Here, we investigate the contributions of several climate drivers to regional warming anomalies. We consider greenhouse gases, aerosols, solar irradiance, land–atmosphere interactions, and natural climate variability modes. Our results highlight the dominant role of anthropogenic greenhouse gas radiative forcing in all Mediterranean climate-type regions, particularly those in the northern hemisphere. In the Mediterranean Basin, the recent warming acceleration is largely due to the combined effect of declining aerosols and a negative trend in near-surface soil moisture. While land-atmosphere feedbacks are also important in other locations (e.g., California and Southern Africa), this synergy is unique in the Mediterranean Basin. These two regional climate drivers have natural and anthropogenic components of equivalent importance. Such feedbacks are not fully resolved in the current regional climate projections.

The Eastern Mediterranean is a rapidly warming climate change hotspot where heat and air pollution increasingly interact to affect human health. This study quantifies the mortality burden attributed to the synergistic effects of thermal stress and air pollution in Thessaloniki, Greece. Daily mortality data (2001–2019) were analyzed together with pollutant concentrations (PM10, NO2, O3) and the modified Physiologically Equivalent Temperature (mPET) using a hierarchical Generalized Additive Model with Distributed Lag Non-Linear terms to capture combined, lagged, and age-specific responses. A refined, count-independent definition of the Attributable Fraction (AF) was introduced to improve stability in small strata. The results show that heat and pollution act synergistically, explaining on average 20–30% of daily mortality during severe co-occurrence events. Seniors were most affected during hot, polluted summers (AF ≈ 27%), while adults showed higher burdens during cold, polluted winters (AF ≈ 30%). Intra-urban analyses revealed stronger simultaneous effects in the western, more industrial districts, reflecting combined environmental and socioeconomic vulnerability. The findings demonstrate that temperature extremes amplify pollution-related mortality and underline the need to integrate air quality and bioclimatic indicators into early warning and adaptation systems in Eastern Mediterranean cities.

Exposure to natural environments is associated with a lower risk of common mental health disorders (CMDs), such as depression and anxiety, but we know little about nature-related motivations, practices and experiences of those already experiencing CMDs. We used data from an 18-country survey to explore these issues (n = 18,838), taking self-reported doctor-prescribed medication for depression and/or anxiety as an indicator of a CMD ( n  = 2698, 14%). Intrinsic motivation for visiting nature was high for all, though slightly lower for those with CMDs. Most individuals with a CMD reported visiting nature ≥ once a week. Although perceived social pressure to visit nature was associated with higher visit likelihood, it was also associated with lower intrinsic motivation, lower visit happiness and higher visit anxiety. Individuals with CMDs seem to be using nature for self-management, but ‘green prescription’ programmes need to be sensitive, and avoid undermining intrinsic motivation and nature-based experiences.

The effects of ‘nature’ on mental health and subjective well-being have yet to be consistently integrated into ecosystem service models and frameworks. To address this gap, we used data on subjective mental well-being from an 18-country survey to test a conceptual model integrating mental health with ecosystem services, initially proposed by Bratman et al. We analysed a range of individual and contextual factors in the context of 14,998 recreational visits to blue spaces, outdoor environments which prominently feature water. Consistent with the conceptual model, subjective mental well-being outcomes were dependent upon on a complex interplay of environmental type and quality, visit characteristics, and individual factors. These results have implications for public health and environmental management, as they may help identify the bluespace locations, environmental features, and key activities, that are most likely to impact well-being, but also potentially affect recreational demand on fragile aquatic ecosystems.

Background Cholera in Kolkata remains endemic and the Indian city is burdened with a high number of annual cases. Climate change is widely considered to exacerbate cholera, however the precise relationship between climate and cholera is highly heterogeneous in space and considerable variation can be observed even within the Indian subcontinent. To date, relatively few studies have been conducted regarding the influence of climate on cholera in Kolkata. Methods We considered 21 years of confirmed cholera cases from the Infectious Disease Hospital in Kolkata during the period of 1999–2019. We used Generalised Additive Modelling (GAM) to extract the non-linear relationship between cholera and different climatic factors; temperature, rainfall and sea surface temperature (SST). Peak associated lag times were identified using cross-correlation lag analysis. Results Our findings revealed a bi-annual pattern of cholera cases with two peaks coinciding with the increase in temperature in summer and the onset of monsoon rains. Variables selected as explanatory variables in the GAM model were temperature and rainfall. Temperature was the only significant factor associated with summer cholera (mean temperature of 30.3 °C associated with RR of 3.8) while rainfall was found to be the main driver of monsoon cholera (550 mm total monthly rainfall associated with RR of 3.38). Lag time analysis revealed that the association between temperature and cholera cases in the summer had a longer peak lag time compared to that between rainfall and cholera during the monsoon. We propose several mechanisms by which these relationships are mediated. Conclusions Kolkata exhibits a dual-peak phenomenon with independent mediating factors. We suggest that the summer peak is due to increased bacterial concentration in urban water bodies, while the monsoon peak is driven by contaminated flood waters. Our results underscore the potential utility of preventative strategies tailored to these seasonal and climatic patterns, including efforts to reduce direct contact with urban water bodies in summer and to protect residents from flood waters during monsoon.

Meteorological station measurements are an important source of information for understanding the weather and its association with risk, and are vital in quantifying climate change. However, such data tend to lack spatial coverage and are often plagued with flaws such as erroneous outliers and missing values. Alternative meteorological data exist in the form of climate model output that have better spatial coverage, at the expense of bias. We propose a probabilistic framework to integrate temperature measurements with climate model (reanalysis) data, in a way that allows for biases and erroneous outliers, while enabling prediction at any spatial resolution. The approach is Bayesian which facilitates uncertainty quantification and simulation based inference, as illustrated by application to two countries from the Middle East and North Africa region, an important climate change hotspot. We demonstrate the use of the model in: identifying outliers, imputing missing values, non-linear bias correction, downscaling and aggregation to any given spatial configuration.

Amphibian populations are declining globally, however, the contribution of reduced reproduction to declines is unknown. We investigated associations between morphological (weight/snout-vent length, nuptial pad colour/size, forelimb width/size) and physiological (nuptial pad/testis histomorphology, plasma hormones, gene expression) features with reproductive success in males as measured by amplexus success and fertility rate (% eggs fertilised) in laboratory maintained Silurana / Xenopus tropicalis . We explored the robustness of these features to predict amplexus success/fertility rate by investigating these associations within a sub-set of frogs exposed to anti-androgens (flutamide (50 μg/L)/linuron (9 or 45 μg/L)). In unexposed males, nuptial pad features (size/colour/number of hooks/androgen receptor mRNA) were positively associated with amplexus success, but not with fertility rate. In exposed males, many of the associations with amplexus success differed from untreated animals (they were either reversed or absent). In the exposed males forelimb width/nuptial pad morphology were also associated with fertility rate. However, a more darkly coloured nuptial pad was positively associated with amplexus success across all groups and was indicative of androgen status. Our findings demonstrate the central role for nuptial pad morphology in reproductive success in S . tropicalis , however, the lack of concordance between unexposed/exposed frogs complicates understanding of the utility of features of nuptial pad morphology as biomarkers in wild populations. In conclusion, our work has indicated that nuptial pad and forelimb morphology have potential for development as biomarkers of reproductive health in wild anurans, however, further research is needed to establish this.