Background: Fertilizers are widely used to supply nutrients to crops, thereby increasing yields and soil fertility. However, the effects of their production and application on human health through occupational, residential, and environmental exposure remain unclear. Objective: To conduct a systematic review of epidemiological studies on the association between exposure to fertilizers and health-related outcomes. Methods: We searched in PubMed, Scopus, and Web of Science for cohort, case-control, cross-sectional, and ecological studies (up to May 2024) related to exposure to fertilizers and any reported human health endpoints across all age groups, without language or geographical limitations. Data were extracted for population and study characteristics, type of fertilizer used, exposure assessment, sample size, outcome and its definition, effect estimate, and quality characteristics from the eligible studies, and they were descriptively synthesized. Results: We found 65 eligible publications, with 407 postulated associations. Forty-six publications (321 associations) assessed exposure to inorganic fertilizers, and nineteen studies (93 associations) assessed organic fertilizers. Exposure assessed was related to occupation, residence, and/or proximity. The assessed outcomes were diverse, with considerable harmonization challenges. Inorganic fertilizers have been associated with an increased risk of cancerous outcomes in a small number of studies with methodological limitations and low replication validity, while organic fertilizers have been associated with infections and diarrhea. Conclusions: The epidemiological evidence suggests possible associations between inorganic fertilizers with solid organ tumors and hematological malignancies and organic fertilizers with infections and diarrhea. However, the available evidence is limited, and heterogeneity prevails. Further research is needed to enlarge the evidence base and increase the replication validity and robustness of the results.

To systematically address all the relevant evidence of the association between high-density lipoprotein cholesterol (HDL-C) and COVID-19 infection. We searched PubMed, PubMed Central and medRxiv databases (up to May 2021) for studies related to HDL-C and COVID-19 infection. A qualitative synthesis of published prospective and retrospective studies for the role of low HDL-C levels on COVID-19 infection severity was performed. Thirty-three studies (6 prospective, 27 retrospective) including 11,918 COVID-19 patients were eligible for the systematic review. Twelve studies compared HDL-C levels on admission in COVID-19 patients with healthy controls. In these 12 studies, COVID-19 patients had significantly lower HDL-C levels on admission compared with that of healthy controls. Twenty-eight studies observed the HDL-C levels among COVID-19 diagnosed patients, to establish the role of low HDL-C values in the prognosis of the infection. Twenty-four studies showed a correlation between low HDL-C levels with disease severity, while only 4 studies showed no association. Low HDL-C levels should be added in the list of the others well-known risk factors for COVID-19 severity.

We describe the profile of dietary supplement use and its correlates in the Epirus Health Study cohort, which consists of 1237 adults (60.5% women) residing in urban north-west Greece. The association between dietary supplement use and demographic characteristics, lifestyle behaviors, personal medical history and clinical measurements was assessed using logistic regression models, separately for women and men. The overall prevalence of dietary supplement use was 31.4%, and it was higher in women (37.3%) compared to men (22.4%; p-value = 4.2⁻⁰⁸). Based on multivariable logistic regression models, dietary supplement use in women was associated with age (positively until middle-age and slightly negatively afterwards), the presence of a chronic health condition (OR = 1.71; 95% CI, 1.18–2.46), lost/removed teeth (OR = 0.52; 95% CI, 0.35–0.78) and diastolic blood pressure (OR per 5 mmHg increase =0.84; 95% CI, 0.73–0.96); body mass index and worse general health status were borderline inversely associated. In men, dietary supplement use was positively associated with being employed (OR = 2.53; 95% CI, 1.21–5.29). A considerable proportion of our sample used dietary supplements, and the associated factors differed between women and men.