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The Intergovernmental Panel on Climate Change (IPCC) released its latest report on March 31, 2014. This report was the second instalment of the Fifth Assessment Report, prepared by Working Group 2, on impacts, vulnerability, and adaptation to climate change. In this Comment, we, as contributors to the chapter on human health, explain how the IPCC report was prepared and highlight important findings.

[...]consideration of the value-laden nature of policy interventions and the creation of forums to debate the moral and ethical dimensions of different approaches to urban health and city environments are essential. [...]attention to health inequalities within urban areas should be a key focus of planning the urban environment.

Human activity is rapidly transforming most of Earth’s natural systems. How this transformation is impacting human health, whose health is at greatest risk, and the magnitude of the associated disease burden are relatively new subjects within the field of environmental health. We discuss what is known about the human health implications of changes in the structure and function of natural systems and propose that these changes are affecting human health in a variety of important ways. We identify several gaps and limitations in the research that has been done to date and propose a more systematic and comprehensive approach to applied research in this field. Such efforts could lead to a more robust understanding of the human health impacts of accelerating environmental change and inform decision making in the land-use planning, environmental conservation, and public health policy realms.

Traditional Ecological Knowledge (TEK) is a term, relatively new to Western science, that encompasses a subset of traditional knowledge maintained by Indigenous nations about the relationships between people and the natural environment. The term was first shared by tribal elders in the 1980s to help raise awareness of the importance of TEK. TEK has become a construct that Western scientists have increasingly considered for conducting culturally relevant research with Tribal nations. The authors aim to position TEK in relation to other emerging schools of thought, that is, concepts such as the exposome, social determinants of health (SDoH), and citizen science, and to explore TEK's relevance to environmental health research. This article provides examples of successful application of TEK principles in federally funded research when implemented with respect for the underlying cultural context and in partnership with Indigenous communities. Rather than treating TEK as an adjunct or element to be quantified or incorporated into Western scientific studies, TEK can instead ground our understanding of the environmental, social, and biomedical determinants of health and improve our understanding of health and disease. This article provides historical and recent examples of how TEK has informed Western scientific research. This article provides recommendations for researchers and federal funders to ensure respect for the contributions of TEK to research and to ensure equity and self-determination for Tribal nations who participate in research. https://doi.org/10.1289/EHP858.

The latest generation of virtual and mixed reality hardware has rekindled interest in virtual reality GIS (VRGIS) and augmented reality GIS (ARGIS) applications in health, and opened up new and exciting opportunities and possibilities for using these technologies in the personal and public health arenas. From smart urban planning and emergency training to Pokémon Go, this article offers a snapshot of some of the most remarkable VRGIS and ARGIS solutions for tackling public and environmental health problems, and bringing about safer and healthier living options to individuals and communities. The article also covers the main technical foundations and issues underpinning these solutions.

This article gives a brief overview of the Internet of Things (IoT) for cities, offering examples of IoT-powered 21st century smart cities, including the experience of the Spanish city of Barcelona in implementing its own IoT-driven services to improve the quality of life of its people through measures that promote an eco-friendly, sustainable environment. The potential benefits as well as the challenges associated with IoT for cities are discussed. Much of the 'big data' that are continuously generated by IoT sensors, devices, systems and services are geo-tagged or geo-located. The importance of having robust, intelligent geospatial analytics systems in place to process and make sense of such data in real time cannot therefore be overestimated. The authors argue that IoT-powered smart cities stand better chances of becoming healthier cities. The World Health Organization (WHO) Healthy Cities Network and associated national networks have hundreds of member cities around the world that could benefit from, and harness the power of, IoT to improve the health and well-being of their local populations.

Winter air pollution in Ulaanbaatar, Mongolia is among the worst in the world. The health impacts of policy decisions affecting air pollution exposures in Ulaanbaatar were modeled and evaluated under business as usual and two more-strict alternative emissions pathways through 2024. Previous studies have relied on either outdoor or indoor concentrations to assesses the health risks of air pollution, but the burden is really a function of total exposure. This study combined projections of indoor and outdoor concentrations of PM2.5 with population time-activity estimates to develop trajectories of total age-specific PM2.5 exposure for the Ulaanbaatar population. Indoor PM2.5 contributions from secondhand tobacco smoke (SHS) were estimated in order to fill out total exposures, and changes in population and background disease were modeled. The health impacts were derived using integrated exposure-response curves from the Global Burden of Disease Study. Annual average population-weighted PM2.5 exposures at baseline (2014) were estimated at 59 μg/m3. These were dominated by exposures occurring indoors, influenced considerably by infiltrated outdoor pollution. Under current control policies, exposures increased slightly to 60 μg/m3 by 2024; under moderate emissions reductions and under a switch to clean technologies, exposures were reduced from baseline levels by 45% and 80%, respectively. The moderate improvement pathway decreased per capita annual disability-adjusted life year (DALY) and death burdens by approximately 40%. A switch to clean fuels decreased per capita annual DALY and death burdens by about 85% by 2024 with the relative SHS contribution increasing substantially. This study demonstrates a way to combine estimated changes in total exposure, background disease and population levels, and exposure-response functions to project the health impacts of alternative policy pathways. The resulting burden analysis highlights the need for aggressive action, including the elimination of residential coal burning and the reduction of current smoking rates.

In the paper, the pollution of playgrounds in Lublin with heavy metals was assessed. Since playgrounds are a place of activity of children—the most vulnerable group of city residents, identifying the degree of pollution and the related health hazards is particularly important. 50 playgrounds were investigated, and samples were collected from three types of places: soil in the playgrounds, soil beneath the swings and soil in the sandpits (a total of 91 samples); heavy metal levels were determined in the < 0.05-mm fraction. The mean heavy metal levels were Cd—4.7 mg kg −1 , Cr—192.4 mg kg −1 , Cu—16.3 mg kg −1 , Hg—0.027 mg kg −1 , Ni—12.7 mg kg −1 , Pb—41 mg kg −1 , and Zn—79.8 mg kg −1 , and they were in the following order when normalised to the geochemical background: Cd > Cr > Zn > Pb > Hg > Ni > Cu. The highest mean levels occurred in the case of soil collected from beneath the swings (Cd, Cr, Ni and Zn) or soil in the playgrounds (Cu, Hg and Pb). Geochemical indices such as I geo and EF indicate the lack of pollution or low level of pollution with Cu, Cr, Ni, Zn and Pb. Moderate or considerable pollution with Cd and, sporadically, with Hg occurred in some playgrounds. A significant ecological risk was found for all samples due to the presence of Cd and, for about 20% of the samples, the concentration of Hg. In all the cases analysed, the values of health hazard indices ( HI , CR ) for children are very low and well below the hazard threshold for each element.

Although defined more broadly, exposure science has mainly focused on exposures to environmental chemicals and related stressors, such as airborne particulate matter. There is an opportunity for exposure science to contribute more substantially to improving public health by devoting more attention to microorganisms as key stressors and agents in exposure. The discovery that pathogenic microbes cause disease in humans precipitated a revolution in public health science and disease prevention. With a continued global urgency to address spread of pathogenic microbes, contributions of microorganisms to both infectious and noninfectious processes merit more attention from the exposure science community. Today, discoveries of the importance of the human microbiome as a determinant of health and disease are precipitating a second revolution. Emerging knowledge creates a major opportunity to expand the scope of exposure science to incorporate the human microbiome as a target and modulator of exposure. A study committee of the National Academies of Sciences, Engineering, and Medicine has defined a research strategy to address health risks that pertain to the interaction of environmental chemicals with the human microbiome. Some aspects of this strategy pose important challenges and opportunities for the exposure science community.

This opinion piece postulates that quantitative environmental research and public health spatial analysts unknowingly tolerate certain spatial statistical model specification errors, whose remedies constitute some of the urgent emerging trends and issues in this subfield (e.g., forecasting disease spreading). Within this context, this paper addresses misspecifications affiliated with omitted variable bias complications arising from ignoring, and hence abandoning, negative spatial autocorrelation latent in georeferenced disease data, and/or being ill-informed about reigning teledependencies (i.e., long-distance spatial correlations). As imperative academic challenges, it advances elegant and convincing arguments to do otherwise. Its two particular themes are positive–negative spatial autocorrelation mixtures, and hierarchical autocorrelation generated by hegemonic urban systems. Comprehensive interpretations and implementations of these two conjectures constitute future research directions. Important conceptualizations for treatments reported in this paper include confounding variables and Moran eigenvector spatial filtering. This paper’s fundamental implication is an advocacy for a prodigious paradigm shift, a marked change in the collective mindsets and applications of spatial epidemiologists when specifying spatial regression equations to describe either environmental health data, or a publicly transparent geographic diffusion of diseases.