The destruction of the Roman cities of Pompeii and Herculaneum during the eruption of Mount Vesuvius in 79 AD serves as a well-documented example of the first humanitarian disaster linked to an environmental event. Most of the buildings of the two cities and many of its inhabitants were buried under the volcanic ashes within 48 hours and the rest by further eruptions. Both cities remained hidden until their accidental rediscovery in the 18th century. While dramatic and devastating, events like volcanic eruptions, earthquakes, and tsunamis are naturally occurring and there is no evidence that during the last two millennium even the largest volcanic eruptions affected global climate.¹ In contrast, the Anthropocene era describes the period when human activities have been the dominant influence on global climate and ecosystems (www.nationalgeographic.org). Climate change sceptics point to the fact that urbanisation, industrialisation and associated environmental destruction are not new: for example, the construction of Ancient Rome caused widespread deforestation and soil erosion around the Mediterranean which may have contributed to the fall of the Roman Empire (www.smithsonianmag.com). However, like volcanic eruptions or other natural disasters, these events tended to be local and temporary.

By stark contrast, global industrialisation over the last century and in particular deforestation for agriculture and the burning of fossil fuels for energy, have led to a rapid increase in carbon dioxide (CO₂) in the atmosphere and a rise in world temperatures.² In 2022, UN data showed that 40% of all land is now classified as degraded by deforestation and intense farming³ limiting not only the ability to feed the world's population, but also the recycling of CO₂. The burning of fossils fuel is accompanied by emissions of air pollutants such as nitrogen oxides (NO_x), sulphur dioxide (SO₂), ozone (O₃) and particulate matter (PM). Over the last three decades, mounting epidemiologic evidence have linked outdoor air pollution to increases in respiratory diseases including lung cancer, cardiovascular disease, cognitive decline and dementia (www.gov.uk/government/publications/air-pollution).⁴ Long-term exposure to ambient air pollutants may be associated with lower cancer survival⁴ and has led to worse Covid-19 outcomes during the pandemic.⁵ A recent study has also indicated that air pollution is associated with rising antibiotic resistance across every country and continent.⁶ Overall, human mortality attributable to ambient PM increased from 3.5 million in 1990 to 4.2 million in 2015 and ambient PM was the fifth-ranking mortality risk factor in the world.⁷ In 2020, in the European Union (EU), 96% of the urban population was exposed to levels of PM above the health-based guideline level set by the World Health Organization (WHO) resulting in 238 000 premature deaths (www.eea.europa.eu/publications/air-quality-in-europe-2020-report).

Modern industrialisation has also given rise to the chemical industry. Globally there are currently over 350 000 chemicals and mixtures of chemicals registered for production and use in manufacturing, agriculture, food packaging, cosmetic and pharmaceutical processes, amongst others.⁸ While some of these products have contributed these to human development, many by-products of these chemicals have had a negative impact. Pollutants that do not break down in the environment (“forever chemicals”), along with heavy metal contaminants from mining (such as lead and arsenic), can infiltrate the soil, aquifers, and rivers. These ultimately reach the sea with devastating effects on an ecosystem covering 70% of our planet (www.oceanprotect.org/resources). Of particular concern are those chemicals which are used worldwide such as inorganic fertilizer, pesticides, insecticides, herbicides, hormones, painkillers, antibiotics, disinfectants and nano- and micro-plastic that contaminate drinking water (taps and wells) and food products. The latest quarterly report (23 March 2023) of the Department for Environment, Food & Rural Affairs and Health and Safety Executive has found that half of all bread sold in the UK contains at least two different pesticides (www.gov.uk/government/collections/pesticide-residues-in-food-results-of-monitoring-programme). In 2021, the Pesticide Action Network UK (PAN) found that 30% of vegetables and 69% of fruit contain residues of more than one pesticide (www.pan-uk.org). Unlike ambient air pollution, where a relatively small number of pollutants need tracking, the large range of water pollutants complicates epidemiological studies making it difficult to establish clear associations. Drinking water contaminants like nitrates (NO₃) and nitrites (NO₂), which are by-products of inorganic fertilizer and preservatives used in processed food, have been associated with thyroid disease and an increased risk of gastric, colorectal, breast and bladder cancer.^{9, 10} There is also mounting evidence that transgenerational inheritance - through epigenetic mechanisms – link prenatal environmental exposures to later life risks, including chronic diseases, cancer and infertility.

In the present theme issue, we have gathered the expertise of researchers on the negative impact of the Anthropocene era on women's health. The profound effects associated with climate change and pollution threaten all ecosystems and thus human health and survival (Figure 1). Of course, this works both ways: energy use, waste generation, and CO2 production of modern health care have effects on the environment, too. These insights highlight the urgency of developing comprehensive national and international research programs focused on women's and reproductive health and the environment, and the difference we could make ourselves.

公元 79 年维苏威火山爆发期间，罗马城市庞贝和赫库兰尼姆被毁，这是第一次与环境事件相关的人道主义灾难的有据可查的例子。48小时内，两座城市的大部分建筑和许多居民都被火山灰掩埋，其余的则因进一步喷发而被掩埋。这两座城市一直处于隐秘状态，直到 18 世纪才被意外重新发现。虽然火山喷发、地震和海啸等事件具有戏剧性和破坏性，但它们都是自然发生的，没有证据表明在过去两千年中，即使是最大规模的火山喷发也影响了全球气候。¹相比之下，人类世描述的是人类活动对全球气候和生态系统产生主要影响的时期 (www.nationalgeographic.org)。气候变化怀疑论者指出，城市化、工业化和相关的环境破坏并不新鲜：例如，古罗马的建设造成了地中海周围大范围的森林砍伐和水土流失，这可能导致了罗马帝国的衰落（www. smithsonianmag.com）。然而，与火山爆发或其他自然灾害一样，这些事件往往是局部的、暂时的。

与此形成鲜明对比的是，上个世纪的全球工业化，特别是农业砍伐森林和燃烧化石燃料获取能源，导致大气中二氧化碳（CO _{2 ）的迅速增加和世界气温的上升。}²联合国数据显示，2022 年，40% 的土地因森林砍伐和集约化农耕而被列为退化土地³不仅限制了养活世界人口的能力，而且限制了 CO ₂的循环利用。化石燃料的燃烧伴随着氮氧化物(NO _x )、二氧化硫(SO ₂ )、臭氧(O ₃ )和颗粒物(PM)等空气污染物的排放。在过去的三十年中，越来越多的流行病学证据表明室外空气污染与呼吸道疾病的增加有关，包括肺癌、心血管疾病、认知能力下降和痴呆（www.gov.uk/government/publications/air-pollution）。⁴长期接触环境空气污染物可能会降低癌症存活率⁴并导致 Covid-19 大流行期间的结果更差。⁵最近的一项研究还表明，空气污染与每个国家和大陆的抗生素耐药性上升有关。⁶总体而言，环境 PM 导致的人类死亡人数从 1990 年的 350 万人增加到 2015 年的 420 万人，环境 PM 是世界第五大死亡风险因素。⁷ 2020 年，在欧盟 (EU)，96% 的城市人口接触的 PM 水平高于世界卫生组织 (WHO) 设定的健康准则水平，导致 238 000 人过早死亡 (www.eea .europa.eu/publications/air-quality-in-europe-2020-report）。

现代工业化也催生了化学工业。目前，全球有超过 350 000 种化学品和化学品混合物注册用于制造、农业、食品包装、化妆品和制药工艺等领域的生产和使用。⁸虽然其中一些产品为人类发展做出了贡献，但这些化学品的许多副产品却产生了负面影响。不会在环境中分解的污染物（“永远的化学物质”）以及采矿产生的重金属污染物（例如铅和砷）可能会渗入土壤、含水层和河流。这些物质最终流入海洋，对覆盖地球 70% 面积的生态系统造成毁灭性影响 (www.oceanprotect.org/resources)。特别值得关注的是全世界使用的化学品，如无机肥料、杀虫剂、杀虫剂、除草剂、激素、止痛药、抗生素、消毒剂以及污染饮用水（水龙头和水井）和食品的纳米和微塑料。英国环境、食品和农村事务部以及健康与安全执行部的最新季度报告（2023 年 3 月 23 日）发现，英国销售的所有面包中有一半至少含有两种不同的农药（www.gov.uk/government/收集/食品中农药残留监测计划结果）。2021 年，英国农药行动网络 (PAN) 发现 30% 的蔬菜和 69% 的水果含有一种以上农药残留 (www.pan-uk.org)。与需要跟踪的环境空气污染相对较少的污染物不同，大量的水污染物使流行病学研究变得复杂，很难建立明确的关联。_{硝酸盐 (NO 3} ) 和亚硝酸盐 (NO ₂ )等饮用水污染物是加工食品中使用的无机肥料和防腐剂的副产品，与甲状腺疾病以及胃癌、结直肠癌、乳腺癌和膀胱癌的风险增加有关。^{9, 10}还有越来越多的证据表明，通过表观遗传机制的跨代遗传将产前环境暴露与以后的生活风险（包括慢性病、癌症和不孕症）联系起来。

在本期主题中，我们聚集了研究人员关于人类世时代对女性健康的负面影响的专业知识。气候变化和污染带来的深远影响威胁着所有生态系统，进而威胁到人类的健康和生存（图 1）。当然，这是双向的：现代医疗保健的能源使用、废物产生和二氧化碳产生也会对环境产生影响。这些见解凸显了制定全面的国家和国际研究计划的紧迫性，重点关注妇女和生殖健康以及环境，以及我们自己可以做出的改变。