Burden of cardiovascular disease attributed to air pollution: a systematic review.

BACKGROUND: Cardiovascular diseases (CVDs) are estimated to be the leading cause of global death. Air pollution is the biggest environmental threat to public health worldwide. It is considered a potentially modifiable environmental risk factor for CVDs because it can be prevented by adopting the right national and international policies. The present study was conducted to synthesize the results of existing studies on the burden of CVDs attributed to air pollution, namely prevalence, hospitalization, disability, mortality, and cost characteristics. METHODS: A systematic search was performed in the Scopus, PubMed, and Web of Science databases to identify studies, without time limitations, up to June 13, 2023. Exclusion criteria included prenatal exposure, exposure to indoor air pollution, review studies, conferences, books, letters to editors, and animal and laboratory studies. The quality of the articles was evaluated based on the Agency for Healthcare Research and Quality Assessment Form, the Newcastle-Ottawa Scale, and Drummond Criteria using a self-established scale. The articles that achieved categories A and B were included in the study. RESULTS: Of the 566 studies obtained, based on the inclusion/exclusion criteria, 92 studies were defined as eligible in the present systematic review. The results of these investigations supported that chronic exposure to various concentrations of air pollutants, increased the prevalence, hospitalization, disability, mortality, and costs of CVDs attributed to air pollution, even at relatively low levels. According to the results, the main pollutant investigated closely associated with hypertension was PM2.5. Furthermore, the global DALY related to stroke during 2016-2019 has increased by 1.8 times and hospitalization related to CVDs in 2023 has increased by 8.5 times compared to 2014. CONCLUSION: Ambient air pollution is an underestimated but significant and modifiable contributor to CVDs burden and public health costs. This should not only be considered an environmental problem but also as an important risk factor for a significant increase in CVD cases and mortality. The findings of the systematic review highlighted the opportunity to apply more preventive measures in the public health sector to reduce the footprint of CVDs in human society.

Health risk assessment from inhalation exposure to indoor formaldehyde: A systematic review and meta-analysis.

This systematic review and meta-analysis investigated studies on formaldehyde (FA) inhalation exposure in indoor environments and related carcinogenic (CR) and non-carcinogenic (HQ) risk. Studies were obtained from Scopus, PubMed, Web of Science, Medline, and Embase databases without time limitation until November 21, 2023. Studies not meeting the criteria of Population, Exposure, Comparator, and Outcomes (PECO) were excluded. The 45 articles included belonged to the 5 types of sites: dwelling environments, educational centers, kindergartens, vehicle cabins, and other indoor environments. A meta-analysis determined the average effect size (ES) between indoor FA concentrations, CR, and HQ values in each type of indoor environment. FA concentrations ranged from 0.01 to 1620 µg/m3. The highest FA concentrations were stated in water pipe cafés and the lowest in residential environments. In more than 90% of the studies uncertain (1.00 ×10-6 1.00 ×10-4) due to FA inhalation exposure was reported and non-carcinogenic risk was stated acceptable. The meta-analysis revealed the highest CR values due to inhalation of indoor FA in high-income countries. As 90% of the time is spent indoors, it is crucial to adopt effective strategies to reduce FA concentrations, especially in kindergartens and schools, with regular monitoring of indoor air quality.

To breathe or not to breathe: Inhalational exposure to heavy metals and related health risk.

This study reviewed scientific literature on inhalation exposure to heavy metals (HMs) in various indoor and outdoor environments and related carcinogenic and non-carcinogenic risk. A systematic search in Web of Science, Scopus, PubMed, Embase, and Medline databases yielded 712 results and 43 articles met the requirements of the Population, Exposure, Comparator, and Outcomes (PECO) criteria. Results revealed that HM concentrations in most households exceeded the World Health Organization (WHO) guideline values, indicating moderate pollution and dominant anthropogenic emission sources of HMs. In the analyzed schools, universities, and offices low to moderate levels of air pollution with HMs were revealed, while in commercial environments high levels of air pollution were stated. The non-carcinogenic risk due to inhalation HM exposure exceeded the acceptable level of 1 in households, cafes, hospitals, restaurants, and metros. The carcinogenic risk for As and Cr in households, for Cd, Cr, Ni, As, and Co in educational environments, for Pb, Cd, Cr, and Co in offices and commercial environments, and for Ni in metros exceeded the acceptable level of 1 × 10-4. Carcinogenic risk was revealed to be higher indoors than outdoors. This review advocates for fast and effective actions to reduce HM exposure for safer breathing.

Health risk assessment of heavy metals in exposed workers of municipal waste recycling facility in Iran.

Exposure to heavy metals (HMs) present in the particulate matter from municipal solid waste during pretreatment and recycling processes may pose a serious health risk to workers. This was the first study on the exposure of municipal solid waste (MSW) recycling workers to toxic metals. The concentrations of HMs (Cd, Pb, As, Co, Cr, Ni, Cu, Fe, Mn, and Zn) during personal exposure to PM2.5 among municipal waste recycling facility workers in Kashan City, Iran, were investigated from January 15 to March 15, 2023. The research was performed in the three main stages of the waste recycling process: dismantling, sorting, and collecting. PM2.5 samples were collected using a personal environmental monitor (PEM) attached to a sampling pump. The non-carcinogenic and carcinogenic health risk values and related uncertainty for waste recyclers from HMs inhalational exposure were calculated using USEPA methodology and Monte Carlo simulations. The results showed that the dismantlers exhibited the highest exposure concentrations of PM2.5 (mean 2148 ± 1257 µg m-3), followed by sorters (mean 1864 ± 965 µg m-3), and collectors (mean 1782 ± 876 µg m-3). Health risk assessment indicated that 95th percentile contents of Ni, As, Co, and Zn were responsible for the non-carcinogenic risk (HQ) values exceeding the acceptable level of 1. The contents of As, Ni, and Cr in PM2.5 caused a non-acceptable carcinogenic risk for waste recyclers due to inhalational exposure, as the carcinogenic risk (CR) values exceeded the acceptable threshold of 1 × 10-6. Monte Carlo simulation results revealed that the mean and median CR values from inhalational exposure to carcinogenic HMs exceeded the acceptable level of 1 × 10-6 for municipal waste recyclers. As results of this study indicated the high-risk to hazardous metals for waste recyclers due to occupational exposure in the MSW recycling sites, it is suggested to consider workers' exposure as the public health concern.

Human exposure to heavy metals and related cancer development: a bibliometric analysis.

As notifications on carcinogenicity of heavy metals increase, more and more attention is paid recently to heavy metals exposure. In our study, the human exposure to heavy metals and cancer knowledge epistemology was investigated using bibliometric analysis. The bibliometric data of the research articles were retrieved using following keywords: "heavy metal," "trace element", "cancer", "carcinogen", and "tumor" in the Scopus database. Specifically, 2118 articles published between 1972 and 2023 were found, covering a total of 1473 authors, 252 sources, and 2797 keywords. Retrospective data obtained from 251 documents and 145 journals were further analyzed by performance analysis and techniques of science mapping. The number of studies conducted in this field increased from one article published in 1972 to 18 articles published in 2022 in the study of Michael P Waalkes. The most impactful author regarding the number of published papers was Masoudreza Sohrabi with 7 publications. In the majority of the published papers, the most popular keywords were "cadmium" and "carcinogenicity". However, in recent 4 years, the emphasis has been placed more on epidemiology studies. Our study provides general knowledge about the trend of publication on the role of heavy metals in causing cancer. The leading researchers in the field of the effects of heavy metals on the development of cancer were identified in our studies. Our results might also create a better understanding of new and emerging issues and can be used as a comprehensive road map for future researchers.

Blood-lead level in humans and drug addiction: a comprehensive study in Iran.

Drug abuse has a high prevalence worldwide and causes many health-related disorders. There are limited human exposure studies on establishing lead exposure levels and their propensity for drug addiction. In the present study, blood samples were tested for lead (Pb) concentrations in illicit drug users together with the related symptoms in comparison with control group of non-drug users. The study was performed on 250 volunteers divided equally in four drug groups, namely, opioids, hashish, methadone, and methamphetamine, and one control group of non-drug users. Participants were recruited from drug addiction clinics and camps in Kashan city, Iran, who were using drugs continuously for more than 1 year. Control group was recruited from companions of the patients with no drug use history. In the investigated groups of drug users, the highest blood-lead level (BLL) concentrations were observed in the opioid group (mean 37.57 µg/dL) with almost 3.7 times higher than in the control group (mean 3.39 µg/dL). In the methamphetamine group, type of occupation had the significant association with BLL concentrations. The positive correlation was revealed in the opioid and methadone groups for BLL concentrations and the duration of drug usage. In the opioid group, the highest BLL concentrations were observed among users who used both methods of drug use: smoking and eating. Also, several behavioral and life-style factors were identified which influence the blood-lead concentration in the drug users. The results of our study revealed that the BLL concentrations in investigated drug users' groups were significantly higher than in the control group (P < 0.001). That can be related with the Pb contents in illicitly used drugs. Apart other adverse health effects, long-term illicit drug use might cause to lead poisoning.

Summer and winter variations of BTEX concentrations in an oil refinery complex and health risk assessment based on Monte-Carlo simulations.

The summer and winter concentrations of BTEX pollutants were investigated in various workplaces of an oil Refinery, Iran. In total 252 air samples from the breathing zones of the following employees were collected: supervisors, safetymen, repairmen, site men, and all workers. Carcinogenic and non-carcinogenic risk values were calculated based on the USEPA methodology using Monte Carlo simulations. BTEX concentrations were higher in the summer than in the winter season for all workstations, especially for toluene and ethylbenzene. The mean values of exposure to benzene for repairmen and site men were higher than threshold limit value of 1.60 mg/m3 for both seasons. Non-carcinogenic risk (HQ) values calculated for summer season for benzene, ethylbenzene, and xylene in all workstations, as well as for toluene for repairmen and site men exceeded acceptable level of 1. In winter season the mean HQ values for benzene and xylene in all workstations, for toluene for repairmen and site men, and for ethylbenzene for supervisors, repairmen, and site men were also > 1. For all workstations definite carcinogenic risk was indicated as calculated LCR values for benzene and ethylbenzene exposure were higher than 1 × 10-4 in both summer and winter seasons.

Critical air pollutant assessments and health effects attributed to PM2.5 during and after COVID-19 lockdowns in Iran: application of AirQ+ models.

Objectives: The aim of this study was to evaluate changes in air quality index (AQI) values before, during, and after lockdown, as well as to evaluate the number of hospitalizations due to respiratory and cardiovascular diseases attributed to atmospheric PM2.5 pollution in Semnan, Iran in the period from 2019 to 2021 during the COVID-19 pandemic. Methods: Daily air quality records were obtained from the global air quality index project and the US Environmental Protection Administration (EPA). In this research, the AirQ+ model was used to quantify health consequences attributed to particulate matter with an aerodynamic diameter of <2.5 µm (PM2.5). Results: The results of this study showed positive correlations between air pollution levels and reductions in pollutant levels during and after the lockdown. PM2.5 was the critical pollutant for most days of the year, as its AQI was the highest among the four investigated pollutants on most days. Mortality rates from chronic obstructive pulmonary disease (COPD) attributed to PM2.5 in 2019-2021 were 25.18% in 2019, 22.55% in 2020, and 22.12% in 2021. Mortality rates and hospital admissions due to cardiovascular and respiratory diseases decreased during the lockdown. The results showed a significant decrease in the percentage of days with unhealthy air quality in short-term lockdowns in Semnan, Iran with moderate air pollution. Natural mortality (due to all-natural causes) and other mortalities related to COPD, ischemic heart disease (IHD), lung cancer (LC), and stroke attributed to PM2.5 in 2019-2021 decreased. Conclusion: Our results support the general finding that anthropogenic activities cause significant health threats, which were paradoxically revealed during a global health crisis/challenge.

Inhalational exposure to formaldehyde, carcinogenic, and non-carcinogenic risk assessment: A systematic review.

Formaldehyde is one of the most widely used substances in a variety of industries, although it was classified as a human carcinogen by the International Agency for Research on Cancer (IARC). The present systematic review was conducted to retrieve studies related to occupational exposure to formaldehyde until November 2, 2022. Aims of the study were to identify workplaces exposed to formaldehyde, to investigate the formaldehyde concentrations in various occupations and to evaluate carcinogenic and non-carcinogenic risks caused by respiratory exposure to this chemical among workers. A systematic search was done in Scopus, PubMed and Web of Science databases to find the studies done in this field. In this review, studies that did not meet the criteria specified by Population, Exposure, Comparator, and Outcomes (PECO) approach were excluded. In addition, the inclusion of studies dealing with the biological monitoring of FA in the body and review studies, conference articles, books, and letters to the editors were avoided. The quality of the selected studies was also evaluated using the Joanna Briggs Institute (JBI) checklist for analytic-cross-sectional studies. Finally, 828 studies were found, and after the investigations, 35 articles were included in this study. The results revealed that the highest formaldehyde concentrations were observed in waterpipe cafes (1,620,000 µg/m3) and anatomy and pathology laboratories (4237.5 µg/m3). Carcinogenic and non-carcinogenic risk indicated the potential health effects for employees due to respiratory exposure as acceptable levels of CR = 1.00 × 10-4 and HQ = 1, respectively were reported to be exceeded in more than 71% and 28.57% of the investigated studies. Therefore, according to the confirmation of formaldehyde's adverse health effects, it is necessary to adopt targeted strategies to reduce or eliminate exposure to this compound from the occupational usage.

Dietary exposure to potentially harmful elements in edible plants in Poland and the health risk dynamics related to their geochemical differentiation.

Differences in the health risk values calculated for consumers of potentially harmful elements (PHEs) present in edible plants were investigated. Based on a comprehensive literature search, the highest PHE contents in plants were identified in the southern and western regions of Poland, that also revealed the highest geochemical enrichment with Zn, Pb, Cu, As, Cd, and Tl. The highest unacceptable non-carcinogenic risk (HQ) values for mean PHE contents in Poland were found for Pb: toddlers (2.80), pre-schoolers (1.80), and school-aged children (1.45) and for Cd for toddlers (1.42). The highest unacceptable carcinogenic risk (CR) values for mean As content was observed for adults (5.9 × 10-5). The highest non-carcinogenic risk values for consumers were reported in Silesia, Lower Silesia, Lublin, Lesser Poland, and Opole Provinces, indicating the impact of geochemical variability on risk values.

Respiratory functions and health risk assessment in inhalational exposure to vinyl acetate in the process of carpet manufacturing using Monte Carlo simulations.

Vinyl acetate (VA) is a volatile compound and the main compound of the carpenter's glue. VA causes upper respiratory tract irritation, cough, and hoarseness in occupational exposure. As Iran is one of the biggest carpet producers in the world, this study was carried out to determine the inhalational health risk for employees exposed to VA. To the best of our knowledge, this was the first health risk assessment and the first evaluation of the lung functions and respiratory symptoms in employees exposed to VA. In the six finishing shops of carpet manufacturing industry in Kashan city, Iran the cross-sectional studies were conducted in 2022. The subjects comprised of forty male employees exposed to VA and of forty non-exposed employees in the reference group. VA analyses in the workers' breathing zones were performed based on the National Institute for Occupational Safety and Health (NIOSH) 1453 Method. VA concentrations were measured using Gas Chromatography-Mass Spectrometry (GC-MS). Inhalational risk assessment to VA was performed using the United States Environmental Protection Agency method and the Monte Carlo simulations. Respiratory functions were determined using the spirometry indices. In the exposed employees, considerably higher prevalence rates of pulmonary symptoms were observed in comparison with the control group. Statistical analysis showed a remarkable difference between lung function parameters measured in the case and the control groups. The VA Hazard Quotient (HQ) values for all working posts, except the quality control unit, were > 1 indicating the substantial inhalational non-cancerogenic risk. The sensitivity analysis revealed that the VA concentrations and exposure time had the most significant contribution in the uncertainty assessment. Therefore, it is recommended to decrease exposure to VA concentrations and to reduce the working time of exposed employees.

Microbiota analysis for risk assessment of xenobiotics: toxicomicrobiomics, incorporating the gut microbiome in the risk assessment of xenobiotics and identifying beneficial components for One Health.

This work explores three areas of relevance to the gut microbiome in the context of One Health; the incorporation of the microbiome in food safety risk assessment of xenobiotics; the identification and application of beneficial microbial components to various areas under One Health, and specifically, in the context of antimicrobial resistance. We conclude that, although challenging, focusing on the microbiota resilience, function and active components, are critical for advancing the incorporation of the gut microbiome in the risk assessment of xenobiotics. Moreover, research technologies, such as toxicomicrobiomics, culturomics and genomics, especially in combination, have revealed that the human microbiota may be a promising source of beneficial taxa or other components, with the potential to metabolise and biodegrade xenobiotics. These may have possible applications in several health areas, including in animals or plants for detoxification or in the environment for bioremediation. This approach would be of particular interest for antimicrobials, with the potential to ameliorate antimicrobial resistance development. Finally, we propose that the concept of resistance to xenobiotics in the context of the gut microbiome may deserve further investigation in the pursuit of holistically elucidating their involvement in the balance between health and disease.

Microbiota analysis for risk assessment of xenobiotics: cumulative xenobiotic exposure and impact on human gut microbiota under One Health approach.

Human gut microbiota is the microbial community that, through the constant bidirectional communication with its host, plays the critical role of maintaining the state of eubiosis and health balance, contributing to food digestion, detoxification, and proper endocrine, neurological, immunological and potentially reproductive health. To this extent, gut microbiota is called the 'second brain' as well as the 'second liver'. Xenobiotics, including environmental pollutants, are widely spread in the environment and easily accessible in food, cosmetics, personal care products, drugs and medicinal products. Thus, the gut microbiota can be exposed to these xenobiotics, which in turn might alter its composition and metabolism that can trigger dysbiosis, and they seem associated with disorders and diseases in the host. A specific group of xenobiotics, called endocrine-disrupting chemicals, is particularly important due to relevant adverse health effects. A considerable challenge in risk assessment is the combined exposure to xenobiotics, for which the integrated approaches, including the One Health concept, are still under development. Nevertheless, recent research advancements focus on molecular data in the search for elucidating crucial microbiome biomarkers, associated with physiopathology and specific dysfunctions triggered by xenobiotic exposure. In this context, the application of meta-omics and integration of genomics, metagenomics, metabolomics, metatranscriptomics, proteomics and multidisciplinary approaches are particularly important.

Probabilistic human health risk assessment of 1,3-butadiene and styrene exposure using Monte Carlo simulation technique in the carpet production industry.

Chemicals containing Volatile Organic Compounds (VOCs) are commonly used in the machine carpet production. 1,3-butadiene and styrene are main components of the carpenter's glue used in carpet factories. Exposition to these chemicals can lead to a number of adverse health effects. This is the first study of the human health risk assessment due to inhalational exposure to 1,3-butadiene (BD) and styrene (ST) performed among workers in the carpet factories in Kashan city, Iran. The importance of the study was related with the fact of high popularity of carpet production in the South Asia countries. Inhalation exposure to BD and ST were measured based on the National Institute for Occupational Safety and Health (NIOSH) 1024 and 1501 methods, respectively. The cancerogenic risk (CR) and non-cancerogenic risk described as Hazard Quotient (HQ) values were calculated based on the United States Environmental Protection Agency (USEPA) method. The sensitivity and uncertainty analysis were performed by the Monte Carlo simulation (MCS) technique. The average concentration measured of BD and ST during work shifts of employees were 0.039 mg m-3 (0.017 ppm) and 12.108 mg m-3 (2.84 ppm), respectively. The mean ± SD value of estimated cancerogenic risk in inhalation exposure to BD and ST were equal to 5.13 × 10-3 ± 3.85 × 10-4 and 1.44 × 10-3 ± 2.36 × 10-4, respectively exceeding the acceptable risk level of 10-6 defined by USEPA. The average non-carcinogenic risk (HQ) values of BD and ST were equal to 8.50 × 100 and 5.13 × 100, respectively exceeding the acceptable risk level of 1. As the results of our studies exceeded both cancerogenic and non-carcinogenic risk values it indicates that adverse health effects due to inhalational exposure to BD and ST for workers in the machine carpet industry are very likely. To avoid negative health effects protective measures for employees in the factories should be introduced immediately and furher detailed research are recommended.

Exploring Next Generation Probiotics for Metabolic and Microbiota Dysbiosis Linked to Xenobiotic Exposure: Holistic Approach.

Variation of gut microbiota in metabolic diseases seems to be related to dysbiosis induced by exposure to multiple substances called Microbiota Disrupting Chemicals (MDCs), which are present as environmental and dietary contaminants. Some recent studies have focused on elucidating the alterations of gut microbiota taxa and their metabolites as a consequence of xenobiotic exposures to find possible key targets involved in the severity of the host disease triggered. Compilation of data supporting the triad of xenobiotic-microbiota-metabolic diseases would subsequently allow such health misbalances to be prevented or treated by identifying beneficial microbe taxa that could be Next Generation Probiotics (NGPs) with metabolic enzymes for MDC neutralisation and mitigation strategies. In this review, we aim to compile the available information and reports focused on variations of the main gut microbiota taxa in metabolic diseases associated with xenobiotic exposure and related microbial metabolite profiles impacting the host health status. We performed an extensive literature search using SCOPUS, Web of Science, and PubMed databases. The data retrieval and thorough analyses highlight the need for more combined metagenomic and metabolomic studies revealing signatures for xenobiotics and triggered metabolic diseases. Moreover, metabolome and microbiome compositional taxa analyses allow further exploration of how to target beneficial NGP candidates according to their alleged variability abundance and potential therapeutic significance. Furthermore, this holistic approach has identified limitations and the need of future directions to expand and integrate key knowledge to design appropriate clinical and interventional studies with NGPs. Apart from human health, the beneficial microbes and metabolites identified could also be proposed for various applications under One Health, such as probiotics for animals, plants and environmental bioremediation.

Sustainable or Not? Insights on the Consumption of Animal Products in Poland.

Animal products are one of the main constituents of the human diet. They are the main source of energy, proteins, microelements, and bioactive substances. The most popular negative health impacts linked with the consumption of animal products are obesity, atherosclerosis, heart attacks, and cancer. Apart from human health, consuming animal products is also controversial lately, due to farm animals' well-being and environmental protection issues. Thus, within the context of sustainability, the consumption trends of animal products were investigated through our on-line questionnaire surveys. The following animal products were involved in the survey: unprocessed meat (pork, beef, lamb, veal, mutton, chicken, duck, goose, turkey), processed meat (cold-cuts, sausages, pates), fish products, and eggs. Our research concluded that consumption among respondents with higher education was unsustainable for both unprocessed and processed meat, as eating habits in terms of type and quantity of consumed meat indicated respondents' unawareness. The consumption of fish products was also revealed as unsustainable regarding the quantity of fish consumed in terms of its beneficial nutritional values. Egg consumption was revealed as the most sustainable among the investigated animal products. However, insignificant egg consumption among the respondents showed the actual need of social education in terms of the current knowledge regarding the beneficial aspects of eggs.

Integration of Omics Approaches Enhances the Impact of Scientific Research in Environmental Applications.

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Incorporating the Gut Microbiome in the Risk Assessment of Xenobiotics and Identifying Beneficial Components for One Health.

Three areas of relevance to the gut microbiome in the context of One Health were explored; the incorporation of the microbiome in food safety risk assessment of xenobiotics; the identification and application of beneficial microbial components to various areas under One Health, and; specifically, in the context of antimicrobial resistance. Although challenging, focusing on the microbiota resilience, function and active components is critical for advancing the incorporation of microbiome data in the risk assessment of xenobiotics. Moreover, the human microbiota may be a promising source of beneficial components, with the potential to metabolize xenobiotics. These may have possible applications in several areas, e.g., in animals or plants for detoxification or in the environment for biodegradation. This approach would be of particular interest for antimicrobials, with the potential to ameliorate antimicrobial resistance development. Finally, the concept of resistance to xenobiotics in the context of the gut microbiome may deserve further investigation.

Conventional or Organic? Motives and Trends in Polish Vegetable Consumption.

Vegetables constitute a major component of human food security. They are the main sources of essential nutrients including antioxidants, natural dyes, minerals, and vitamins. Eating habit issues related to the consumption of vegetables are gaining importance within the context of a healthy lifestyle, longevity, and physical fitness. Additionally, food quality is of primary importance, and so-called eco-food (defined as food as natural as possible, without fertilizers, pesticides, or preservatives) seems to be the most popular world-trend in healthy nutrition. Keeping these ideas in focus, research on vegetable consumption in Poland in the context of conventional or organic production was performed using online questionnaire surveys. The results revealed that the rate of vegetable consumption depended primarily on economic status, except for the potato, which was a staple cutting across all economic strata. Among the 108 analyzed respondents, 74% bought vegetables from certified organic farms. However, 59% bought organic vegetables "rarely" or "sometimes", and only 15% "often". Next, respondents chose to buy vegetables from fresh food markets (45%) and in local shops (41%). About 20% of the respondents acquired vegetables from their own farms. Among the reasons for choosing vegetables from certified organic farms, respondents mentioned in decreasing order: "desire for proper nutrition" (30%), "thinking that organic vegetables are healthier" (28%), and "organic vegetables are generally better" (7%).

Impact of Cumulative Environmental and Dietary Xenobiotics on Human Microbiota: Risk Assessment for One Health.

Chemical risk assessment in the context of the risk analysis framework was initially designed to evaluate the impact of hazardous substances or xenobiotics on human health. As the need of multiple stressors assessment was revealed to be more reliable regarding the occurrence and severity of the adverse effects in the exposed organisms, the cumulative risk assessment started to be the recommended approach. As toxicant mixtures and their "cocktail effects" are considered to be main hazards, the most important exposure for these xenobiotics would be of dietary and environmental origin. In fact, even a more holistic prism should currently be considered. In this sense, the definition of One Health refers to simultaneous actions for improving human, animal, and environmental health through transdisciplinary cooperation. Global policies necessitate going beyond the classical risk assessment for guaranteeing human health through actions and implementation of the One Health approach. In this context, a new perspective is proposed for the integration of microbiome biomarkers and next generation probiotics potentially impacting and modulating not only human health, but plant, animal health, and the environment.