Human biomonitoring (HBM) is an essential approach for assessing exposure to environmental toxicants and for informing risk assessment frameworks. However, the global expansion of HBM has (1) outpaced efforts to harmonize methodologies, (2) addressed contextual inequalities, and (3) translated findings into public health interventions. This review examined literature regarding HBM across different contaminant categories including atmospheric pollutants, heavy metals, mycotoxins, persistent organic pollutants (POPs) and per- and polyfluoroalkyl substances (PFAS). Drawing on recent studies, key trends, methodological inconsistencies, and systemic biases in research design and population coverage were identified. This review noted an overrepresentation of studies in high-income countries, limited data from vulnerable populations, and a persistent reliance on cross-sectional designs. There is significant heterogeneity in biomarker selection, analytical protocols, and interpretation of exposure-health relationships. Further, many investigations failed to control for confounding variables or explore toxicokinetic and toxicodynamic mechanisms, limiting causal inference. Further, exposure to complex chemical mixtures was routinely underexplored, despite evidence of potential interactive effects. The review presents critical gaps in current knowledge, particularly regarding long-term health effects and translation of biomonitoring data into risk management policies. This review emphasizes the need for standardized methodologies, expanded research in low- and middle-income settings, and integration of biomonitoring with community-based surveillance and environmental justice frameworks. Future research needs to prioritize longitudinal designs, interdisciplinary approaches, and greater inclusion of socially and geographically marginalized groups. By reconceptualizing HBM as both a scientific and socio-political endeavor, the field might more effectively contribute to global environmental health protection.
The microbiome-gut-brain axis is altered by environmental stressors such as heat, diet, and pollutants as well as microbes in the air, water, and soil. These stressors might alter the host's microbiome and symbiotic relationship by modifying the microbial composition or location. Compartmentalized mutualistic microbes promote the beneficial interactions in the host leading to circulating metabolites and hormones such as insulin and leptin that affect inter-organ functions. Inflammation and oxidative stress induced by environmental stressors may alter the composition, distribution, and activities of the microbes in the microbiomes such that the resultant metabolite and hormone changes are no longer beneficial. The microbiome-gut-brain axis and immune adverse changes that may accompany environmental stressors are reviewed for effects on innate and adaptive immune cells, which may make host immunity less responsive to pathogens and more reactive to self-antigens. Cardiovascular and fluid exchanges to organs might adversely alter organ functionality. Organs, especially the brain, need a consistent supply of nutrients and clearance of debris; disruption of these exchanges by stressors, and involvement of gut microbiome are discussed regarding neural dysfunctions with Alzheimer's disease, autistic spectrum disorders, viral infections, and autoimmune diseases. The focus of this review includes the manner in which environmental stressors may disrupt gut microbiota leading to adverse immune and hormonal influences on development of neuropathology related to hyperhomocysteinemia, inflammation, and oxidative stress, and how certain therapeutics may be beneficial. Strategies are explored to lessen detrimental effects of environmental stressors on central and peripheral health navigated toward (1) understanding neurological disorders and (2) promoting environmental and public health and well-being.
Most ecological and human environmental health researchers are motivated both by curiosity and a desire to do work that will be useful sooner rather than later. However, the academic research process does not always produce and present results that meet the needs of those we imagine using it beyond other researchers. The aim of this review was to discuss needs and opportunities associated with research question development, experimental design, data sharing, science communication, and community engagement, with the goal of supporting regulators, policymakers, environmental nonprofits, and pollution-impacted communities. For example, each regulatory agency has unique policies regarding study characteristics required before the agency includes the study results in its policy-making. To illustrate the extent of this problem: systematic reviews used by policymakers often keep only approximately 5% of papers originally found, because others fail to meet inclusion criteria of which academics are often unaware. The review also details the importance of data sharing via databases and science communication and opportunities for engagement with policy-makers, nonprofits, and communities, and obstacles that researchers face in conducting research that generates data useful to such groups. Our findings demonstrate that while not all academic research can or needs to be designed to be quickly applicable, opportunities exist where this is possible with relatively minor changes to typical academic practices. It is hoped that this review will help identify ways that academic researchers might both address fundamental, basic research knowledge gaps and contribute more directly and rapidly to policy making and community needs.
Methicillin-resistant Staphylococcus aureus (MRSA) is among the most prevalent nosocomial pathogens. However, in recent decades, infections were reported in communities, infecting individuals without previous hospitalization, and in livestock. Given this public health concern, this systematic review aimed to analyze studies that isolated MRSA from environmental and animal matrices, with an emphasis on the implications of this pathogen's presence from a One Health perspective. A total of 183 articles were selected between 2005 and 2025. These investigations were conducted in 43 countries, with 44% in Europe and 5% in North America. In South America, only studies from Brazil were identified, indicating a lack of data from other countries in the region. The animal matrix was the most extensively investigated source of MRSA, comprising 153 studies (85%) across a range of wild, domestic, and farm species. In the environmental context, MRSA was primarily identified in water (65.8%), followed by soil (21%), and air (13.2%). The predominance of MRSA isolation in the aquatic environment indicates that water is a critical reservoir for the spread of antimicrobial resistance (AMR). The MRSA isolates exhibited a multidrug resistance profile. Resistance was most frequent to tetracycline (11.51%) and erythromycin (11.51%), followed by clindamycin (9.04%) and penicillin (7.67%). Further, some studies have identified MRSA in foods of animal origin, representing a potential route of transmission to humans. Finally, this study indicates that the MRSA contamination cycle, which involves hospitals, the community, environment, and animals, is a growing One Health problem that necessitates a global multisectoral approach. MRSA has been isolated from environmental and animal matrices.The studies were conducted in 43 countries, with 44% in Europe and 5% in North America.The presence of MRSA in aquatic environments, soil, air, animals, and products suggests a dynamic and interconnected transmission cycle.The presence of MRSA in wild, domestic, and farm animals suggests multiple transmission routes.Excessive use and improper disposal of antimicrobials promote the selection of multidrug-resistant strains.
Sulfoxaflor (SFX, CAS# 946578-00-3) is marketed by Corteva Agrisciences Inc. as Isoclast®. SFX is a Group 4C, nicotinic acetylcholine receptor agonist and is a systemic insecticide that is most active against sucking insects. This paper critically reviews and characterizes the physical and chemical properties of SFX to facilitate development of conceptual models that identify environmental compartments with the greatest potential concentrations and organisms most likely to be exposed. These conceptual models were assessed in a Weight of Evidence (WoE) framework to identify scenarios and organisms at greatest risk. The solubility of SFX in water is approximately 550 mg L-1 and the POW of 0.8, so it will not bioconcentrate or undergo trophic transfer. It has the potential to move in soils, but this is unlikely because of the short half-life (hours to 2-5 days) in agricultural soils where bacteria mediate dissipation. Some of the transformation products of SFX have longer half-lives (months) in soil and are more mobile but are less toxic and not a concern for adverse effects. SFX does not undergo significant photolysis or hydrolysis in water, but this does not lead to a risk in aquatic systems because it is not approved for over-water use and the label recommends buffer zones to protect sensitive aquatic areas. Overall, use of SFX under good agricultural practices is unlikely to result in biologically relevant exposures in non-target species or areas in the environment.
Approximately 75% of the ovarian cancer (OC) patients are diagnosed in advanced stages and platinum-based chemotherapy presents severe side effects and high recurrence rates. This narrative review consolidates current knowledge and describes the pathophysiological characteristics of OC and how molecular aspects influence clinical outcomes of traditional and antibody-drug chemotherapies. Subsequently, a comprehensive picture regarding the current benefits identifies gaps and potential adverse risks of ADCs to treat OC. High-grade serous carcinomas, the most frequently diagnosed OCs, present TP53 and BRCA1/2 mutations, hypermethylation, and deregulation of retinoblastoma 1 and phosphatidylinositol 3-kinase (PI3K)/Akt/Ras pathways. After conventional treatment (surgery with or without systemic chemotherapy) and follow-up by CA125 levels, poly(ADP-ribose) polymerase inhibitors and hormone therapies were included. Unfortunately, approximately half of advanced patients who achieved a complete response following chemotherapy exhibit residual tumor(s). In this context, ADCs displayed marked cytotoxicity and incorporated a hypothesis-driven target identification strategy to recognize specific/tumor overexpressing-proteins. Independent clinical studies bibliographic searches in the PubMed database conducted between January 2020 and May 2025 revealed some ADCs have expanded progression-free survival and displayed partial/complete remission in OC patients at small doses if compared to traditional chemotherapies, suggesting acceptable safety profiles and potential synergism among cisplatin/carboplatin/paclitaxel/doxorubicin and ADC-based immunotherapies. A total of 18 clinical trials selected indicate (i) mild-to-moderate severity of side/adverse effects up to grade 2, (ii) low intervention or drug discontinuation, (iii) few drug-related deaths, and/or (iv) reversible toxicity. Thus, therapeutic performance of ADCs demonstrated that personalized treatment maximizes clinical benefits and improves efficacy for heterogeneous populations and polyclonal tumors.
To support regulatory risk assessment, standardized laboratory tests of toxicity to representative species including honeybees (Apis mellifera L.), orchard bees (Osmia spp.), and bumblebees (Bombus spp.) provide the benchmark toxicity values for use in preliminary Tier 1 assessments and more detailed and realistic higher-tier assessments. In this analysis, we summarize the results of studies of toxicity of SFX to pollinators conducted by the registrant as well as results published in the literature. The geometric mean of 48-hr adult acute oral LD50 values for SFX for honeybees was 0.0740 μg SFX bee-1 (n = 5). Toxicity values for technical grade SFX (SFX-T) and formulated products were not significantly different. The geometric mean 48 hr adult acute contact LD50 values for SFX-T and several formulated products were 0.432 (n = 2) and 0.202 (n = 3) μg SFX bee-1, respectively. Exposures sprayed foliage was not significant after the spray had dried did not cause significant toxicity. Transformation products were not significantly toxic to adult or larval honeybees or other representative bee species. Results showed that, to complete the risk assessment, higher-tier studies were required. Differences in results between standard test methods and the nonstandard methods used in published work affect the outcome of the risk assessment. An understanding of these differences reconciled the differences in the reported findings.
The global spread of Aedes aegypti poses increasing challenges for vector control programs, especially in the context of insecticide resistance and growing environmental concerns. Innovative control strategies include integrated vector management and use of biopesticides as sustainable alternatives to conventional insecticides. However, despite recent advances, critical knowledge gaps remain regarding the efficacy, safety, and sustainability of integrated biopesticide-based strategies for environmentally friendly Aedes aegypti management. The aim of this review was to critically examine the ecotoxicological risks associated with isolated use of conventional pesticides and highlight the benefits and limitations of integrated vector management approaches. Publications from the last 10 years were searched in PubMed, Scopus, Web of Science, and Google Scholar, with inclusion criteria focusing on studies addressing ecotoxicological effects and sustainability of integrated biopesticide-based strategies. Recent evidence demonstrated that integrated strategies provide enhanced efficacy and reduced environmental impact compared to chemical-only interventions. However, knowledge gaps remain regarding long-term ecological safety, operational feasibility, and resistance development. Comprehensive toxicological assessments and further studies are crucial to ensure the safe, effective, and sustainable use of integrated vector control approaches, with a focus on minimizing adverse environmental impacts and delaying insecticidal resistance development.
Per- and polyfluoroalkyl substances (PFAS) comprise a large class of human-made chemicals that are in widespread use and present concerns for persistence, bioaccumulation and toxicity. Whilst a handful of PFAS have been characterized for their hazard profiles, the vast majority of PFAS have not been extensively studied. A comprehensive evaluation to characterize the hazard profiles of the thousands of available PFAS would require extensive resources in terms of cost, number of animals and time. An alternative and more efficient approach is to develop a structural chemical categorization approach to prioritize which PFAS or categories of PFAS should be subject to additional study. To that end, the U.S. Environmental Protection Agency (EPA), in collaboration with the National Institute of Environmental Health Sciences (NIEHS) Division of Translational Toxicology (DTT), initiated a research project in 2018 to screen approximately 150 PFAS through a battery of alternative model organisms, in vitro cell and biochemical assays, and in vitro toxico kinetic (TK) assays in order to inform chemical category and read-across approaches. The aim of this review summarizes the experimental testing undertaken, how data were processed, what insights were derived from a category perspective and how these might potentially inform subsequent tiered testing.
Microplastic particles (MPs) have been detected in a variety of environmental samples, including soil, water, food, and air. Cellular studies and animal exposures reported that exposure to MPs composed of different polymers might result in adverse effects at the portal of entry (local) or throughout the body (systemic). The most relevant routes of particle uptake into the body are oral and respiratory exposure. This review describes the various processes that may contribute to the adverse effects of MPs. Only MPs up to 5 µm were found to cross epithelial barriers to a significant extent. However, MPs may also exert a detrimental impact on human health by acting at the epithelial barrier and within the lumen of the orogastrointestinal and respiratory tract. The potential for adverse effects on human health resulting from the leaching, sorption, and desorption of chemicals, as well as the impact of MPs on nutritional status and dysbiosis, are reviewed. In vitro models are suggested as a means of (1) assessing permeation, (2) determining adverse effects on cells of the epithelial barrier, (3) examining influence of digestive fluids on leaching, desorption, and particle properties, and (4) role of microbiota-epithelial cell interactions. The contribution of these mechanisms to human health depends upon exposure levels, which unfortunately have been estimated very differently.
The widespread production and use of plastics have resulted in accumulation of plastic debris in the environment, gradually breaking down into smaller particles over time. Nano-plastics (NPs) and microplastics (MPs), defined as particles smaller than 100 nanometers and 5 millimeters, respectively, raise concerns due to their ability to enter the human body through various pathways including ingestion, inhalation, and skin contact. Various investigators demonstrated that these particles may produce physical and chemical damage to human cells, tissues, and organs, disrupting cellular processes, triggering inflammation and oxidative stress, and impacting hormone and neurotransmitter balance. In addition, micro- and nano-plastics (MNPLs) may carry toxic chemicals and pathogens, exacerbating adverse effects on human health. The magnitude and nature of these effects are not yet fully understood, requiring further research for a comprehensive risk assessment. Nevertheless, evidence available suggests that accumulation of these particles in the environment and potential human uptake are causes for concern. Urgent measures to reduce plastic pollution and limit human exposure to MNPLs are necessary to safeguard human health and the environment. In this review, current knowledge regarding the influence of MNPLs on human health is summarized, including toxicity mechanisms, exposure pathways, and health outcomes across multiple organs. The critical need for additional research is also emphasized to comprehensively assess potential risks posed by degradation of MNPLs on human health and inform strategies for addressing this emerging environmental health challenge. Finally, new research directions are proposed including evaluation of gene regulation associated with MNPLs exposure.
Globally, national regulatory authorities are both responsible and accountable for health and environmental decisions related to diverse products and risk decision contexts. These authorities provided regulatory oversight and expedited market authorizations of vaccines and other therapeutic products during the COVID-19 pandemic. Regulatory decisions regarding such products and situations depend upon well-established risk assessment and management steps. The underlying processes supporting such decisions were outlined in frameworks describing the complex interactions between factors including risk assessment and management steps as well as principles which help guide risk decision-making. In 2022, experts in risk science proposed a set of 10 guiding principles, further examining the intersection and utility of these principles using 10 diverse risk contexts, and inviting a broader discourse on the application of these principles in risk decision-making. To add to this information, Canadian regulatory practitioners responsible for evaluating health and environmental risks and establishing policies convened at a Health Canada workshop on Principles for Risk Decision-Making. This review reports the results derived from this interactive engagement and provides a first pragmatic analysis of the relevance, importance, and feasibility of such principles for health and environmental risk decision-making within the Canadian regulatory context.
Mosquito-borne diseases remain a major public health challenge, intensified by growing resistance to conventional insecticides. In this context, the green synthesis of silver nanoparticles (AgNPs), especially using plant extracts from the Annonaceae family, has emerged as an effective and environmentally sustainable alternative. This systematic review aimed to examine the use of aqueous extracts of Annonaceae plants in the synthesis of AgNPs, compiling data on synthesis methods, nanoparticle (NP) characteristics, and biological activity. The review followed PRISMA guidelines and included studies identified in 11 databases and gray literature, selected according to the PEO strategy. Five studies met the inclusion criteria and were independently assessed by three reviewers. Methodological quality, evaluated using ARRIVE 2.0, ranged from 79 to 94%, with limitations mainly related to ethical reporting, blinding, and inclusion/exclusion criteria. AgNPs were synthesized using leaves or seeds of Annona glabra, Annona squamosa, and Annona muricata, with synthesis conditions influencing particle size (14-500 nm), morphology, dispersion, and stability (4-8 weeks). In bioassays, AgNPs demonstrated potent larvicidal activity against Aedes, Anopheles, and Culex species, particularly in early larval stages and with smaller particles, surpassing effectiveness of crude extracts. Observed mechanisms included cuticle penetration, molting interference, enzyme inhibition, and metabolic disruption. Overall, Annona-mediated green synthesis of AgNPs constitutes a promising, low-cost, and sustainable strategy, although further standardization, toxicity assessment, and field studies are needed.
Terrestrial and aquatic ecosystems face various chemicals that might induce acute and/or long-term harm. To assess these impacts, ecotoxicological bioassays are essential. However, bioassays using animals, particularly mammals, are costly, time-consuming, and raise ethical concerns. In this context, terrestrial plants emerge as a viable alternative to conventional assays. Thus, the aim of this review was to address the history and evolution of plant bioassays, highlighting the main regulations, guidelines, and protocols governing the use of terrestrial plants in ecotoxicological tests. Initially, plant bioassays were employed to assess the cytogenotoxic effects of chemicals, gaining prominence with the GENE-TOX program in the 80s. Subsequently, plants were used in allelopathy bioassays and in studies aimed to examine the ecotoxicity of pesticides in soil. Currently, ecotoxicological bioassays with plants are regulated by specific standards, such as ASTM E1963-22, EPA 600/3-88/029, EPS 1/RM/45, ISO 11269-1, ISO 11269-2, ISO 17126, ISO 18763, ISO 29200, ISO 22030, OECD-208, OECD-227, OCSPP 850.4100, OCSPP 850.4230, OCSPP 850.4800 and OPPTS 850.4200. The existing protocols standardize bioassays in greenhouse and lab environments, and the duration of the tests varies from hours to months. The main ecotoxicological parameters to be analyzed after exposure include germination percentage, survival rate, root length, aerial part length, fresh mass of exposed plants, and phytotoxicity symptoms. In addition, the absorption rate of substances and genotoxic and mutagenic effects might also be assessed. Therefore, data in this review demonstrate that terrestrial plants represent an important tool in the analysis of environmental risks associated with chemicals and might serve as crucial allies in modern ecotoxicology.
Manganese (Mn) is an essential trace element that, in excess, may initiate adverse health effects. Recent evidence suggested that environmental exposure to Mn may produce thyroid hormone imbalances leading to adverse neurodevelopmental outcomes. The aim of this review was to summarize available evidence regarding Mn exposure and consequent adverse thyroid effects, including potential implications for neurodevelopmental impairment in children. Medline, EMBASE, and Scopus were systematically searched using two concepts: Mn exposure and thyroid function. A total of 31 studies (17 human studies, 14 toxicological studies) fulfilled eligibility criteria. Evidence for effects attributed to Mn on the thyroid from human studies is inconclusive. No apparent studies were identified to directly characterize Mn thyroid-mediated effects on neurodevelopmental outcomes. Although limited evidence from animal studies provides some support for the effects of Mn on thyroid-related hormones, it is unclear whether such hormonal imbalance is a result of a direct or indirect biological mechanism of action. Toxicokinetic data demonstrated that Mn accumulates in thyroid tissue and might interfere with thyroid function. Currently, there are limited data on biological mechanisms of action for the effects of Mn on the thyroid. Although evidence to date is suggestive of Mn thyroid-related activity, the lack of adequate studies precludes a causal interpretation.
Environmentally persistent free radicals (EPFRs) are stable free radicals formed on particulate matter (PM) through processes such as combustion and pyrolysis. These free radicals are generated on transition metal oxide surfaces in the presence of aromatic precursors. Exposure to EPFRs occurs primarily via inhalation of PM deriving from combustion, traffic, industrial activities, and both indoor and outdoor burning. Other environmental factors that might generate EPFRs are radon, electronic and tobacco cigarettes. EPFRs exhibit unexpectedly long half-lives, ranging from several weeks to, in some cases, several years. EPFRs may be carbon-centered, oxygen-centered or mixed, identified by g-values exhibited in electron paramagnetic resonance analysis. The radicals undergo redox cycling within aqueous solutions and in biological tissues/fluids triggering production of reactive oxygen species (ROS), comprised primarily of hydroxyl, superoxide, and peroxyl radicals. The stability of EPFRs, their association with PM2.5, and their ability to generate ROS may pose significant concerns for human health. To determine whether there are sufficient data for risk assessment, recent advances were examined in the following important aspects of EPFR research: (1) atmospheric chemistry, (2) human exposures, (3) animal toxicity, and (4) epidemiology. Our review found insufficient epidemiological and exposure studies; however, toxicological data in animals suggested that EPFR inhalation contributes to cardiovascular, respiratory, and metabolic diseases. Although EPFRs are not currently surveyed by a regulatory monitoring system, data indicate their widespread presence in the environment and their potential to initiate/exacerbate diseases.
Effects of sulfoxaflor (SFX) on aquatic invertebrates were assessed by comparing concentrations predicted to occur in or measured in surface waters to thresholds for adverse effects. Due to the specific mode of toxic action, fishes are relatively tolerant of the effects of SFX. Daphnia magna with an LC50 of 378 mg SFX L-1 (SD = 19.13) was similarly tolerant of the effects of SFX, while the LOEC was > 110 mg SFX L-1. A threshold for effects on aquatic insects, based on the chironomid midge, C. tentans, had LOAEL and NOAEL values of 0.0455 and 0.0618 mg L-1, respectively. The acute-to-chronic ratio was 18. Simulation models and parameters selected for a range of applications to crops predicted environmental concentrations (EECs) in surface waters to range from 2.2 to 7.7 µg L-1. Based on these EECs, the maximum hazard quotient (HQ) was 0.11, which is less than the US EPA level of concern (LOC) of 0.5, which would normally be the threshold to trigger regulatory action or higher-tier assessments. The risks posed by SFX to aquatic organisms are predicted to be de minimis. Hazard quotients based on EEC values predicted in the standard, USEPA farm pond estimated by use of the Pesticides in Water Calculator (PWC version 1.52) for scenarios of maximum application rates for cotton and LOAEL and NOAEL values for aquatic insects for SFX were less than or similar to those for other insecticides including neonicotinoids and organophosphorus compounds.
Field studies involve combinations of exposure, natural dynamics, and effects in natural and agricultural environments. To be more realistic, field studies focussed on pollinating insects must consider the details of biology, life history, behavior, and pollination ecology of the test species. While expensive and time-consuming, these tests provide the most realistic information, especially for social insects, but are valuable for solitary bee species as well. They are more realistic than laboratory studies because they determine the combined effects of natural stressors including weather, food availability, parasites, and pathogens with anthropogenic stressors, such as the pesticide treatment itself, within agroecosystem landscapes. Twenty-four field studies conducted with bees to support the registration of sulfoxaflor and published work are included, and a standardized rating system for the quality and relevance of the studies was used. The studies included Apis mellifera L., Bombus terrestris L., and Osmia bicornis L. The results show that, when SFX products are applied at the highest labeled application rate with bees actively foraging or fed in syrup at equivalent rates, the effects are minor and temporary. Sublethal effects included lethargy, disorientation, and reduced body mass at emergence. No new modes of action and no treatment-related effects on brood rearing were found.
The increasing detection of emerging mycotoxins in food and feed emphasizes the need to assess their potential adverse health risks. Unlike regulated compounds, many mycotoxins lack toxicological data, especially regarding genotoxicity or carcinogenic potential. This systematic review aimed to identify and prioritize emerging mycotoxins for future research and risk assessment. From an initial list of 102 compounds, 32 were excluded for having already been assessed by EFSA, with 15 also regulated in Europe. The remaining 70 were classified as "emerging" and examined through a PubMed and a Web of Science search. A total of 63 articles were included, encompassing in vitro, in vivo, or both types of studies, in conjunction with contextual data from reviews and human studies. Data were extracted from validated or widely used assays and clustered following international genotoxicity testing guidelines (OECD, EFSA, ICH). In the few studies available, genotoxicity was observed for kojic acid, apicidin, tryptophol and, to a lesser extent, with equivocal or conflicting results, for 3-nitropropionic acid, aurofusarin, averufin, fusaric acid, secalonic acids D and F, and mycophenolic acid. Butenolide was also positive but was only tested in one experiment. Bikaverin, culmorin, and skyrin showed no marked genotoxic effects but were only tested once or twice or in protocols not following OECD standards, yielding limited or conflicting results. Overall, the limited number of assays, significant data gaps and methodological limitations hinder conclusive human health risk assessment, emphasizing the need for standardized and comprehensive genotoxicological testing of the emerging mycotoxins.
From a biological point of view, Diversity, Equity, and Inclusion (DEI) are important at multiple levels, which include our genetics, microbiomes, diets, and all organ system interactions. Considering only DEI's sociological aspects is equivalent to the error of "throwing out the baby with the bath water." Variances in microbial diversity within our microbiomes might affect our health through systemic interactions affecting metabolites, maintaining immune homeostasis, and wound healing of cellular damage from an infection, physical stress, or psychological trauma. An imbalance of our immune cell subsets, both innate and adaptive, and the microbes in any of our microbiomes might lead to more cellular damage from excessive inflammation and oxidative stress and less immune regulation. The immune dysregulation may occur due to the loss of endometrial barriers enabling the spread of microbes, environmental pollutants, and allergens. Heat waves, sleep deprivation, and increased prevalence of pollutants such as polychlorinated biphenyls, which weaken endothelial barriers, may be responsible for the enhanced prevalence of physical and psychological stresses. Leakage of our useful gut microbiota into the periphery might initiate inflammatory responses, and an altered gut microbiome might affect the gut-brain axis that influences physical and mental health.