Search Results (348)

The use of seawater in public swimming pools could offer a more sustainable solution given the challenges posed by climate change and the growing scarcity of potable water across Europe. However, the swimming pool sector currently lacks a unified European legislative framework and faces significant fragmentation, particularly regarding the use of seawater. This scoping review applies a methodology to collect and analyze the international and national regulations of 23 coastal European countries relevant to swimming pool water safety. It provides an overview of existing European legislation on the use of seawater in public swimming pools and outlines the permitted disinfection methods. The review also highlights the highly variable and fragmented regulatory frameworks for microbiological and chemical water quality parameters, as well as the limits imposed on disinfection by-products (DBPs). Furthermore, it addresses the potential risks associated with seawater use in pools, with particular attention to the toxicity of DBPs that may form under such conditions. The findings underscore the urgent need for legislative updates in the pool sector and highlight the potential for developing specific European regulations. These would help harmonize practices across the sector and improve the management of both sustainability and public health in recreational aquatic environments. Full article

Substance use during pregnancy is an increasingly important yet under-recognized threat to maternal and child health. This narrative review synthesizes the current evidence available on the epidemiology, pathophysiology, clinical management, and policy landscape of prenatal exposure to alcohol, tobacco, opioids, benzodiazepines, cocaine, cannabis, methamphetamines, and other synthetic drugs. All major psychoactive substances readily cross the placenta and can remain detectable in breast milk, leading to a shared cascade of obstetric complications (hypertensive disorders, placental abruption, pre-term labor), fetal consequences (growth restriction, structural malformations), and neonatal morbidities such as neonatal abstinence syndrome and sudden infant death. Mechanistically, trans-placental diffusion, oxidative stress, inflammatory signaling, and placental vascular dysfunction converge to disrupt critical neuro- and cardiovascular developmental windows. Early identification hinges on the combined use of validated screening questionnaires (4 P’s Plus, CRAFFT, T-ACE, AUDIT-C, TWEAK) and matrix-specific biomarkers (PEth, EtG, FAEE, CDT), while effective treatment requires integrated obstetric, addiction, and mental health services. Medication for opioid use disorders, particularly buprenorphine, alone or with naloxone, confers superior neonatal outcomes compared to methadone and underscores the value of harm-reducing non-punitive care models. Public-health strategies, such as Mexico’s “first 1 000 days” framework, wrap-around clinics, and home-visiting programs, demonstrate the potential of multisectoral interventions, but are hampered by structural inequities and punitive legislation that deter care-seeking. Research gaps persist in polysubstance exposure, culturally tailored therapies, and long-term neurodevelopmental trajectories. Multigenerational, omics-enabled cohorts, and digital longitudinal-care platforms represent promising avenues for closing these gaps and informing truly preventive perinatal health policies. Full article

Objective: To investigate public attitudes in New Zealand towards the euthanasia of dogs and cats and to explore the factors that influence these views. Materials and Methods: Data were collected through a nationwide online survey conducted in 2019 as part of the Furry Whānau Wellbeing research project. The survey included questions about pet euthanasia, and respondents were asked to indicate their level of agreement with various statements. Results: Of 2293 respondents to the 2019 New Zealand Pet Survey, the majority (n = 1756) opposed euthanasia for stray, unwanted, or financially burdensome pets (76.7%; 90.2% and 66.3% of these disagreed or strongly disagreed, respectively). In contrast, a slim majority (n = 1162) supported it for sick animals. Females were less likely to agree with euthanasia in most scenarios compared to males. Māori and New Zealand European respondents (n = 1790) showed higher levels of neutrality than other ethnicities regarding stray animals and lower levels of disagreement regarding financially constrained situations. Older respondents (65+) were more likely to support euthanasia for sick animals, while younger respondents (18–24) were less inclined. Higher education levels are correlated with increased neutrality towards euthanising stray animals and increased support for euthanising feral animals. Respondents with children were more likely to be neutral or to disagree with euthanasia in most scenarios. Those with rural upbringings were more accepting of euthanasia for stray and feral animals. A thematic analysis of 653 respondent comments revealed key themes: euthanasia was seen as complex and context-dependent, a humane last resort for suffering animals, but not for convenience. Respondents emphasised responsible pet ownership and a right to life, even for feral animals, advocating for alternatives such as trap–neuter–release. Conclusion: New Zealanders largely view euthanasia as an ethically acceptable option for terminally ill or suffering animals but reject it when driven by convenience or financial hardship. Attitudes vary across demographic groups, highlighting the need for culturally sensitive education and policy. The findings align with Sustainable Development Goal 3 (Good Health and Well-being) and support broader discussions on responsible pet ownership, ethical decision making, and animal welfare legislation. Full article

In recent years, Italy has experienced a significant increase in violence against healthcare workers, mirroring a global trend. Manifesting as verbal, physical, psychological, and material aggression, this phenomenon endangers both personnel safety and the foundational principles of the National Health Service (SSN) as outlined in Article 32 of the Italian Constitution. The escalation—most acute in emergency departments, psychiatric units, inpatient wards, and community services—affects a broad spectrum of professionals, compromising care quality and institutional integrity. Data from the FNOMCeO-CENSIS Report 2023–2024 reveal over 18,000 reported incidents in 2024, with verbal assaults disproportionately affecting female nursing staff. The COVID-19 pandemic further exacerbated systemic vulnerabilities, heightening user dissatisfaction and psychological strain among healthcare providers. In response, legislative actions—such as Law No. 113/2020 and Decree-Law No. 137/2024—aim to strengthen prevention, monitoring, and penal measures. This article examines legal, institutional, and organizational responses, including on-the-ground and hospital-based strategies to mitigate violence. Adopting a multidisciplinary perspective, it analyzes recent policy developments, regional dynamics, and victim-perpetrator profiles, arguing that safeguarding healthcare environments is both a public security priority and an ethical imperative essential to preserving the dignity of care work and the resilience of the health system. Full article

This study presents the scientific and methodological foundation of Spain’s first national framework for the ethical management of community cat populations: the Action Plan for the Management of Community Cat Colonies (PACF), launched in 2025 under the mandate of Law 7/2023. This pioneering legislation introduces a standardized, nationwide obligation for trap–neuter–return (TNR)-based management of free-roaming cats, defined as animals living freely, territorially attached, and with limited socialization toward humans. The PACF aims to support municipalities in implementing this mandate through evidence-based strategies that integrate animal welfare, biodiversity protection, and public health objectives. Using standardized data submitted by 1128 municipalities (13.9% of Spain’s total), we estimated a baseline population of 1.81 million community cats distributed across 125,000 colonies. These data were stratified by municipal population size and applied to national census figures to generate a model-ready demographic structure. We then implemented a stochastic simulation using Vortex software to project long-term population dynamics over a 25-year horizon. The model integrated eight demographic–environmental scenarios defined by a combination of urban–rural classification and ecological reproductive potential based on photoperiod and winter temperature. Parameters included reproductive output, mortality, sterilization coverage, abandonment and adoption rates, stochastic catastrophic events, and territorial carrying capacity. Under current sterilization rates (~20%), our projections indicate that Spain’s community cat population could surpass 5 million individuals by 2050, saturating ecological and social thresholds within a decade. In contrast, a differentiated sterilization strategy aligned with territorial reproductive intensity (50% in most areas, 60–70% in high-pressure zones) achieves population stabilization by 2030 at approximately 1.5 million cats, followed by a gradual long-term decline. This scenario prioritizes feasibility while substantially reducing reproductive output, particularly in rural and high-intensity contexts. The PACF combines stratified demographic modeling with spatial sensitivity, offering a flexible framework adaptable to local conditions. It incorporates One Health principles and introduces tools for adaptive management, including digital monitoring platforms and standardized welfare protocols. While ecological impacts were not directly assessed, the proposed demographic stabilization is designed to mitigate population-driven risks to biodiversity and public health without relying on lethal control. By integrating legal mandates, stratified modeling, and realistic intervention goals, this study outlines a replicable and scalable framework for coordinated action across administrative levels. It exemplifies how national policy can be operationalized through data-driven, territorially sensitive planning tools. The findings support the strategic deployment of TNR-based programs across diverse municipal contexts, providing a model for other countries seeking to align animal welfare policy with ecological planning under a multi-level governance perspective. Full article

Incineration at sea is a significant source of marine pollution, threatening biodiversity and public health. Although Peru ratified the 1996 London Protocol in 2018, key deficiencies persist in its domestic legal framework, particularly the absence of clear and internationally aligned definitions for “incineration” and “incinerator.” These gaps hinder effective enforcement by the National Maritime Authority (NMA-DICAPI) and limit regulatory compliance with international obligations. This study analyzes Peru’s current legislation in light of the London Protocol and includes a comparative overview of regional regulatory approaches in Latin America. Based on this analysis, the study identifies regulatory inconsistencies that compromise environmental protection and proposes three key legal reforms: (1) refining the definition of “incineration” to reflect international standards; (2) formally incorporating a definition for “incinerator”; and (3) establishing specific administrative and economic sanctions for related infractions. Through comparative analysis with Mexico and Colombia’s approaches, we propose targeted amendments including refined definitions aligned with IMO standards and explicit administrative/economic sanctions. Implementing these recommendations would enhance Peru’s legal clarity, enforcement capacity, and compliance with international maritime law, reinforcing its role as a responsible actor in marine environmental governance. Full article

Background: Pharmacy technicians are increasingly involved in immunization services, enhancing vaccine accessibility and reducing pharmacies’ workload. This scoping review aims to (1) provide a comprehensive overview of pharmacy technicians’ involvement in immunization services across various healthcare settings and countries, and (2) conduct a comparative analysis of training curricula for pharmacy technicians on immunization. Methods: A scoping review was conducted following the Arksey and O’Malley framework. A comprehensive search of the PubMed and Scopus databases was performed using keywords and MeSH terms such as “pharmacy technician(s)”, “immunization”, “vaccination”, “role”, and “involvement”. Studies included assessed pharmacy technicians’ roles in vaccine administration, training, and public health outcomes. Descriptive and thematic analyses were used to synthesize the findings. In addition, a supplementary analysis of immunization training curricula was conducted, reviewing programs from different countries to identify similarities, differences, and gaps in course structure, content, and delivery formats. Lastly, a comprehensive toolkit was developed, offering guidelines intended to facilitate the implementation of immunization training programs. Results: A total of 35 articles met the inclusion criteria, primarily from the United States of America (n = 30), Canada (n = 2), Ethiopia (n = 1), Denmark (n = 1) and United Kingdom (n = 1). The findings indicate that pharmacy technicians contribute significantly to vaccine administration, patient education, and workflow optimization, particularly in community pharmacies. The COVID-19 pandemic accelerated their involvement in immunization programs. Key challenges include regulatory barriers, a lack of standardized training, and resistance from other healthcare professionals. Facilitators include legislative support (e.g., the PREP Act), structured training programs, and collaborative pharmacist–technician models. Conclusions: Pharmacy technicians can play a vital role in expanding immunization services, improving vaccine uptake, and reducing pharmacist workload. Addressing regulatory inconsistencies, enhancing training, and fostering interprofessional collaboration are crucial for their effective integration of immunization programs. Since immunization by pharmacy technicians is not yet allowed in many EU countries, this review will provide a foundational basis to address their potential to support the healthcare workforce and improve access to immunization services. Full article

The continuous variability in the microbiological quality of surface waters presents significant challenges for ensuring the production of safe drinking water in compliance with public health regulations. Inadequate treatment of surface waters can lead to the presence of pathogenic microorganisms in the drinking water supply, posing serious risks to public health. This research presents an in-depth data analysis using machine learning tools for the induction of models to describe and predict microbiological water quality for the sustainable management of the Butoniga drinking water treatment facility in Istria (Croatia). Specifically, descriptive and predictive models for total coliforms and E. coli bacteria (i.e., classes), which are recognized as key sanitary indicators of microbiological contamination under both EU and Croatian water quality legislation, were developed. The descriptive models provided useful information about the main environmental factors that influence the microbiological water quality. The most significant influential factors were found to be pH, water temperature, and water turbidity. On the other hand, the predictive models were developed to estimate the concentrations of total coliforms and E. coli bacteria seven days in advance using several machine learning methods, including model trees, random forests, multi-layer perceptron, bagging, and XGBoost. Among these, model trees were selected for their interpretability and potential integration into decision support systems. The predictive models demonstrated satisfactory performance, with a correlation coefficient of 0.72 for total coliforms, and moderate predictive accuracy for E. coli bacteria, with a correlation coefficient of 0.48. The resulting models offer actionable insights for optimizing operational responses in water treatment processes based on real-time and predicted microbiological conditions in the Butoniga reservoir. Moreover, this research contributes to the development of predictive frameworks for microbiological water quality management and highlights the importance of further research and monitoring of this key aspect of the preservation of the environment and public health. Full article

In 2020, Directive (EU) 2020/2184 was published and subsequently transposed into Italian legislation via Legislative Decree 18/23 (Lgs.D. 18/23). The Directive aims to protect public health through a proactive approach based on a site-specific risk analysis along the entire water supply chain (Water Safety Plan, WSP). Between February and November 2024, a survey was conducted in Italy to assess both hospitals’ knowledge of Lgs.D. 18/23 and the application of the WSP in these facilities. A total of 300 hospitals were asked to complete an anonymous questionnaire containing 60 questions about the characteristics of the facility and the management of the water network, including the chemical–physical and microbiological monitoring of Legionella and other microbiological parameters. A total of 102 questionnaires were sent out (response rate: 34%), but only 72 were properly completed and analyzed. The results of the chemical–physical monitoring are not presented in this manuscript. Overall, 52.8% of the hospitals were built before 2000, and most are aware of Directive (EU) 2020/2184, Lgs.D.18/23 (80.6%), in particular, Article 9 on the risk assessment and management of internal water systems and the guidelines for its implementation (77.8%). All hospitals perform annual microbiological water testing, including Legionella analysis, with a detection rate of <50%. National guidelines for the implementation of WSPs are known in 75% of the hospitals, but only 38.9% have started planning to implement them, and 13.9% organize staff training on the subject. The questionnaire responses highlight the need to train hospital staff in water system risk management and WSP planning, which will be mandatory by 2029. Full article

The 2018 Farm Bill legalized hemp-derived cannabidiol (CBD) products containing less than 0.3% tetrahydrocannabinol (THC) in the United States. This legislative shift catalyzed both public and scientific interest in CBD’s potential health benefits. However, the rapid expansion of the CBD market has considerably outpaced rigorous scientific research, leaving many health claims largely unsubstantiated. While preclinical studies suggest that CBD may exert antitumorigenic effects in colorectal cancer (CRC) by modulating cell proliferation, apoptosis, and inflammation, clinical evidence supporting these effects remains limited. This review critically examines the current evidence on the role of CBD in colorectal tumorigenesis, with particular attention to its molecular mechanisms and interactions with the serotonergic system—a signaling pathway implicated in the development of CRC and possessing potential dual anti- and pro-tumorigenic properties. By influencing the serotonergic system, CBD may confer both protective and potentially deleterious effects during CRC development. This review underscores the need for further research to elucidate the complex mechanisms of CBD in colorectal tumorigenesis and to evaluate its therapeutic potential in clinical settings. Understanding these interactions could pave the way for novel prevention and treatment strategies, optimizing the anticancer efficacy of CBD while mitigating unintended risks. Full article

Air pollution is one of the most serious environmental threats, with particulate matter PM₁₀ and PM_2.5 representing its most harmful components, significantly affecting public health. These particles are primarily generated by transport, industry, residential heating, and agriculture, and are associated with increased incidence of respiratory and cardiovascular diseases, asthma attacks, and heart attacks, as well as chronic illnesses and premature mortality. The most vulnerable groups include children, the elderly, and individuals with pre-existing health conditions. This study focuses on the analysis of health risks associated with PM₁₀ and PM_2.5 air pollution in the city of Zvolen, which serves as a representative case due to its urban structure, traffic load, and industrial activity. The aim is to assess the current state of air quality, identify the main sources of pollution, and evaluate the health impacts of particulate matter on the local population. The results will be compared with selected Slovak cities—Banská Bystrica and Ružomberok—to understand regional differences in exposure and its health consequences. The results revealed consistently elevated concentrations of particulate matter (PM) across all analyzed cities, frequently exceeding the guideline values recommended by the World Health Organization (WHO), although remaining below the thresholds set by current national legislation. The lowest average concentrations were recorded in the city of Zvolen (PM₁₀: 20 μg/m³; PM_2.5: 15 μg/m³). These lower values may be attributed to the location of the reference monitoring station operated by the Slovak Hydrometeorological Institute (SHMÚ), situated on J. Alexy Street in the southern part of the city—south of Zvolen’s primary industrial emitter, Kronospan. Due to predominantly southerly wind patterns, PM particles are transported northward, potentially leading to higher pollution loads in the northern areas of the city, which are currently not being monitored. We analyzed trends in PM₁₀ and PM_2.5 concentrations and their relationship with hospitalization data for respiratory diseases. The results indicate a clear correlation between the concentration of suspended particulate matter and the number of hospital admissions due to respiratory illnesses. Our findings thus confirm the significant adverse effects of particulate air pollution on population health and highlight the urgent need for systematic monitoring and effective measures to reduce emissions, particularly in urban areas. Full article

Ritual slaughter—understood as the killing of animals without prior stunning for religious purposes—constitutes a legally and ethically intricate domain, situated at the intersection of animal welfare, freedom of religion, public health, and consumer protection. This review offers a critical examination of the influence exerted by international and supranational jurisprudence—most notably the case law of the Court of Justice of the European Union—on the regulatory landscape governing ritual slaughter. While the right to religious freedom enjoys robust protection under European constitutional and human rights frameworks, recent judicial decisions have affirmed the legitimacy of national legislative measures mandating pre-slaughter stunning, insofar as such measures pursue objectives of animal welfare and transparency in the public interest. Particular attention is devoted to seminal rulings originating in Belgium and within the broader EU context, with a focus on the application of the principle of proportionality as a legal mechanism for balancing colliding fundamental rights. The analysis further engages with the scientific and ethical discourse surrounding animal suffering and the legal obligations tied to consumer information and labeling. Taken together, these developments reveal an emergent trajectory within EU law toward the progressive tightening of regulatory standards governing ritual slaughter, shaped by an evolving jurisprudential understanding of animal welfare imperatives. Full article

Honey is a sugar-rich product produced by Apis mellifera bees, with significant variability in properties due to the influence of geographic and climatic conditions and the predominant flora in the production region. Economically, beekeeping is an activity that generates profit and fulfills environmental and social functions, reinforcing the pillars of sustainability. This study aimed to characterize samples of honey sold in southern Brazil, including physicochemical analyses, the detection of microbiological contaminants with potential impact on human health, and the detailed identification of bacterial composition through the Next-Generation Sequencing (NGS). The present study was divided into five main stages: (1) sample collection; (2) sample fractionation; (3) physicochemical analysis; (4) microbiological analysis; (5) 16S metataxonomy analysis. The physicochemical analyses agreed with the regulated values, indicating the good quality of the honey and the absence of adulteration. The microbiological analyses indicated the absence of Salmonella spp., in addition to a low count of total coliforms. The limits for molds and yeasts were exceeded in three samples, indicating non-compliance with current MERCOSUR legislation. Metabarcoding analysis identified a total of 15,736 OTUs divided into three different genera: Bacillus (41.54%), Lysinnibacillus, and Rossellomorea, all belonging to the Bacillaceae family. Some pathogenic species were identified, namely the Bacillus cereus group and Bacillus pumilus. Our results point to an increased need for surveillance, as honey contamination can lead to public health problems, requiring improvements in legislation and control parameters. Full article

This review examines how plastics break down into dangerous pollutants like microplastics, nanoplastics, and persistent organic pollutants (POPs) that can contaminate the environment, make their way into the human food chain, and provoke toxicological effects in humans. According to the reviewed literature, new biomarkers associated with their exposure should be identified, and new methods for detecting them in the environment and in food should be developed and validated. It would also be interesting to improve research on the interaction between micro- and nanoplastics and human cells, their impact on DNA, and their long-term health effects. Promoting sustainable practices and adherence to the 3R strategies (reduce, reuse, and recycle) to transform hazardous waste into valuable resources is crucial to protecting public health from dangerous contaminants as we wait on the development of new diagnostic methods and more stringent legislation. Full article

Background: While public water supplies are regulated by Directive (EU) 2020/2184, inconsistencies in member state legislation for individual wells pose health risks. The study investigates the management of Slovak wells, providing insights to inform and potentially strengthen national water policies. Methods: The survey-based study collected data via online and in-person questionnaires during March 2024. It collected retrospective information on well characteristics, usage, stewardship practices, and water quality concerns. Results: We received 251 responses from 52 Slovak districts. The well water for drinking was used by 122 (48.6%) households, with notable regional variations. Only 41.0% of the respondents conducted a proper technical inspection of their wells within the past year. There has been an increase in the use of wells since the millennium. Individuals who drank well water were significantly more likely to conduct water quality tests (p < 0.05). The recommended frequency of technical inspections and annual testing was not reached in either well owners who drink well water or those with wells who drink water from other sources. Conclusions: The amendment of legislation specifically targeting individual wells, along with educational campaigns, appears crucial for well stewardship in Slovakia. The study provides data for further research and public health interventions. Full article