Department of Built Environment and Environmental Health and Disease Laboratory, North Carolina Agricultural and Technical State University, Greensboro, North Carolina, United States of AmericaCorrespondence: [email protected]

Department of Built Environment, North Carolina Agricultural & Technical State University; Greensboro, NC, 27411 USA; [email protected]: This paper explores the mechanisms of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and lead(Pb) exposure and how they interact to promote liver dysfunction. Coronavirus disease 2019 (COVID-19) is caused by SARS-CoV-2. The environment in which one resides may result in acute and chronically Pb-exposed individuals being infected with SARS-CoV-2. The effects of this exposure on liver dysfunction and its mechanisms are not fully understood. This paper seeks to close this gap in the literature by exploring potential ways this interaction may occur. Results indicated that the interaction of Pb and SARS-CoV-2 and its effects on the liver are likely through the promotion of reactive oxygen species (ROS) production, oxidative stress, and inflammation. Specifically, the rise of inflammation and oxidative stress and the promotion of fibrosis and apoptosis via nuclear factor kappa B (NF-κB), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNFα) were all potentially critical pathways identified. The release of liver injury enzymes such as alanine aminotransferase (ALT) and gamma-glutamyl transferase (GGT) and their role in contributing to thrombosis, coagulopathy, and liver injury are also identified. Finally, how combined exposure may lead to endothelial-mediated inflammation and thrombosis, subsequently bringing forth NASH and NAFLD via increased Plasminogen activator inhibitor-1 (PAI-1) is discussed.________________*Address correspondence to Emmanuel Obeng-Gyasi, Department of Built Environment; North Carolina Agricultural & Technical State University; Greensboro, NC, 27411 USA; Phone:1-336-285-3132; Fax:1-336-334-7433 Email: [email protected]: Lead; Exposure; Mixed Exposures; COVID-19; SARS-CoV-2; Metals; Viruses; Exposome; Hepatic; Liver1. Introduction

Department of Built Environment and Environmental Health and Disease Laboratory, North Carolina A&T State University, Greensboro, North Carolina, United States of America Abstract: This paper delves into the emerging role of wearable devices in the realm of environmental justice and public health monitoring, offering a novel perspective on how technology can empower communities, especially those facing disproportionate environmental challenges. It provides an in-depth analysis of various wearable sensor technologies, including air quality monitors, UV exposure sensors, and water quality sensors, highlighting their significance in real-time environmental and health data collection. The research underscores the importance of these devices in enabling marginalized communities to actively participate in monitoring and responding to environmental health hazards. By facilitating access to personalized and location-specific environmental data, wearable technologies not only raise individual awareness but also contribute to community-level advocacy and action. Furthermore, the paper explores the potential advancements in wearable technologies through the integration of AI and machine learning, enhancing their effectiveness in data analysis and interpretation. However, it also critically examines the challenges associated with data privacy, security, and accessibility, emphasizing the need for inclusive and equitable technology deployment. This study is significant for its contribution to understanding the intersection of technology, environmental health, and social justice. It argues that wearable devices can be transformative tools in achieving environmental justice, providing communities with the means to gather evidence, advocate for change, and protect public health. The findings of this paper are pertinent for policymakers, public health officials, and environmental justice advocates seeking to leverage technology for societal benefit. Keywords: Wearable devices, environmental justice, public health, sensor technology, air quality monitoring, environmental health hazards Correspondence: Emmanuel Obeng-Gyasi, PhD, MPH, Department of Built Environment and Environmental Health and Disease Laboratory, North Carolina A&T State University, Greensboro, North C 27411, United States. Email: [email protected];   IntroductionEnvironmental justice (EJ) is defined by the US Environmental Protection Agency (USEPA) as the equitable treatment and meaningful involvement of all individuals, irrespective of “race, color, national origin, or income, in the development, implementation, and enforcement of environmental laws, regulations, and policies” (1).EJ studies scholar Robert Bullard defines environmental justice as a principle of “equal protection and equal enforcement of our environmental, health, housing, land use, transportation, energy, and civil rights laws and regulation” (2).EJ means every individual should be protected, and no group should be disadvantaged or suffer the impact of environmental issues. Individuals, whether majority, minority, rich or poor should have the opportunity to live in a clean and unpolluted environment. EJ is not only about protecting the population from environmental conditions but also about creating a clean and safe environment for individuals to thrive and enjoy a good life.The EJ movement is often recognized as having its roots in the 1982 Warren County protest in North Carolina. This significant event marked a pivotal moment in civil rights and environmental activism, as it brought together a diverse coalition of residents, civil rights activists, and political leaders. They united in response to the proposed construction of a landfill site for the disposal of soil contaminated with polychlorinated biphenyls (PCBs), a group of highly toxic chemicals. This proposal came after the discovery that over 32,000 cubic yards of PCB-contaminated soil had been illegally dumped along roadways in fourteen North Carolina counties in 1978. The protest in Warren County, a community significantly impacted by these actions, stands as a landmark event in the ongoing struggle for environmental justice and equity, highlighting the intersection of racial, social, and environmental issues (3).Even though the protest in Warren County did not ultimately prevent the disposal of PCBs in the area, it nevertheless succeeded in raising the issue of environmental justice to national and international prominence (4). This movement was crucial in spotlighting environmental injustices, particularly how they disproportionately affect marginalized communities in the United States. Following the protest, there was a heightened governmental and scholarly focus on understanding and addressing environmental disparities. This increased attention led to extensive research into the patterns, impacts, and potential solutions for environmental inequities, especially in historically underserved areas.Research findings over the years have consistently highlighted a troubling trend: communities with predominantly African American populations and those of lower socio-economic status were more likely to be selected for the disposal of hazardous waste. This practice not only posed severe environmental risks but also had significant health implications for the residents of these areas. The Warren County protest thus stands as a landmark event in the ongoing efforts to achieve environmental justice and equality, shedding light on the intersection of environmental issues with racial and socio-economic factors (5). This recognition further emphasized the need for comprehensive action to rectify these injustices.Numerous essential research studies have outlined that individuals from marginalized communities, including people of color, those with lower socioeconomic status, indigenous and immigrant populations, are disproportionately impacted by environmentally harmful infrastructures. These infrastructures include landfills, mines, incinerators, polluting factories, and disruptive transportation systems. Additionally, these communities bear a higher burden of negative consequences stemming from ecologically harmful practices, such as climate change/disruption and pesticide exposure (6).Inhabitants of marginalized communities face the dire consequences of environmental injustice, primarily due to their limited access to costly, advanced tools for assessing environmental pollutants. Furthermore, their reliance on governmental authorities to gauge pollution levels often results in agonizingly slow responses (7). State-provided environmental monitoring methods, including air and water quality assessments, soil sampling, and noise pollution evaluations, can be resource-intensive and often inefficient in timely service delivery to impacted communities. It is increasingly critical for residents in marginalized areas to adopt cost-effective, personal monitoring tools to assess environmental pollution levels. This approach not only facilitates a more direct understanding of pollution's impact but also empowers these communities to advocate effectively against detrimental environmental decisions.Wearable environmental monitoring devices can offer a practical solution, particularly for residents in underserved communities. These devices are capable of tracking a range of environmental parameters, such as air quality, temperature, and humidity, directly in the wearer's immediate surroundings. By employing these tools, individuals can obtain real-time data on the extent of environmental pollution, providing a basis for informed community action.This strategy represents a shift from relying solely on traditional, often costly, state-managed monitoring methods. By pooling resources, communities can collectively invest in these wearable devices, thereby enhancing their capacity to independently monitor and respond to environmental challenges, fostering a more sustainable and healthy living environment. Wearable devices: A potential solution for environmental monitoringWearables, defined as compact electronic devices or wireless-enabled computers seamlessly integrated into everyday accessories, clothing, or gadgets, provide a valuable avenue for marginalized communities to manage their environmental health actively. Some iterations of these wearables, like micro-chips or smart tattoos, represent more invasive options. These wearable technologies are primarily designed for collecting, transmitting, and analyzing data typically gathered from human or animal bodies. They can encompass purely mechanical devices or sophisticated mechatronic systems, skillfully constructed using a combination of sensors, actuators, and computational components (8).As per Gao et al (9) wearable electronics refer to devices designed to be worn or attached to human skin for the continuous and close monitoring of an individual's activities, without causing interruption or restriction to the user's movements. Building on this definition, wearables can be succinctly described as electronic devices that are worn as accessories on the human body. They are equipped with integrated sensors to continuously track and display various personal metrics. These metrics often include daily physical activity, heart rate, and sleep patterns, monitored in real time. Common examples of such devices encompass smartwatches, smart glasses, wearable cameras, and virtual reality headsets. Each of these wearables offers unique functionalities and contributes to the growing utility of personal electronic monitoring in everyday life.            Compared to conventional devices, these flexible electronic devices are low in cost and power efficient in their consumption, allowing uninterrupted data acquisition over a long time (10). Wearable devices are on high demand because of its numerous advantages in health care monitoring, environmental and noise pollution, entertainment, communication, and many others. Also, due to their cost-effectiveness, wearable devices can serve as a means for marginalized communities to monitor their environment and assess the impact of pollution on their lives. This approach empowers them to resist decisions that affect their health and environment. By narrowing down the specific details and insights collected through these devices, individuals or communities invested in environmental health are better prepared to address concerns in both practical and political contexts (11). Types of wearable devices The surge in demand for wearable devices can be attributed to their multifaceted functionalities, applicable across various personal and industrial domains. Prominent examples of wearables include smartphones, smartwatches, fitness trackers, and smart glasses, each offering a unique set of features. Smartphones, primarily serving as communication tools through text messages and voice calls, also host a plethora of applications for mapping, weather forecasting, and monitoring daily steps and heart rate.Smartwatches go beyond merely displaying time; they are instrumental in tracking overall wellness by monitoring daily movements, heart rate, blood pressure, and body temperature, among other metrics. Similarly, fitness trackers are not just limited to counting daily steps and distance traveled. They offer a comprehensive view of one's health by tracking sleep patterns, calculating total daily calorie burn, and continuously monitoring heart rate, thus contributing significantly to the personalized health monitoring landscape. Other smart device Smart glasses: Wearable devices equipped with features beyond traditional eyewear. These glasses typically incorporate a small computer or display module, enabling them to provide information directly to the wearer. The recording and shooting functions of smart glasses may violate others' privacy. However, as long as the purpose is clear and the monitor system is perfect, smart glasses will not become a threat to privacy but a practical life assistant and medical tool. Google, for example, already plans to introduce contact lenses with built-in sensors that can detect users' blood sugar levels.Smart clothes and socks smart clothes: They collect body data from users through fabric sensors and collection devices, which can be used to monitor users' exercise data and heat consumption. Also, there are smart baby clothes for infants to monitor their physical condition. Smart shoes: Smart sneakers mainly collect users' sports data to help users improve their sports plans better. In addition, some smart sneakers have new motion detection functions, such as Nike's FuelBand SE, which reminds users to stand up and take a move once in a while. Smart earphones: Smart headphones have new methods of applications, such as intelligent voice analysis and processing, which allow users to operate the equipment more conveniently using voice commands. In the future, it may be possible to integrate sensors directly into in-ear headphones to monitor heart rate, body temperature, and movement (12) Evaluating health risks linked to toxic exposure remains a formidable challenge in the realm of environmental justice. Established connections between specific chemical exposures and certain health conditions are well-documented. However, quantifying exposure levels—including the concentration, duration, and appropriate measurement methods—continues to be a contentious and complex task. This complexity is further amplified by the difficulty of distinguishing these exposures from other concurrent environmental factors (13,14). In the context of environmental justice and the potential role of wearable devices, it's crucial to understand the concept of marginalized communities and the root causes of disparities and inequalities in our society. Marginalization refers to a systematic process in which specific groups are excluded or pushed to the fringe of political and socioeconomic spheres. This relegation is often based on factors such as race, ethnicity, socioeconomic status, geographical location, religion, language, sexual identity, and disability status. Understanding this framework is essential for addressing and mitigating the environmental injustices these communities face (15).  Causes of disparity in marginalized communitiesA striking example of systemic disparity can be seen in a 1984 report by Cerrell Associates, commissioned by the California Waste Management Board. This report candidly advised both industry and state authorities to strategically site waste incinerators in neighborhoods characterized by "lower socioeconomic" status. The rationale behind this recommendation was grounded in the perception that these communities would present a significantly reduced likelihood of political opposition, highlighting a calculated approach to exploiting socioeconomic vulnerabilities (16).In a 1996 paper, Heiman and colleagues (17) discussed a notable example of environmental disparity. Their research revealed the existence of a major commercial hazardous waste management site at a landfill in Adams County, Colorado, and an incinerator in East Liverpool, Ohio. Both of these facilities were located in areas with predominantly Caucasian populations. In a striking contrast, the paper identified that three of the largest hazardous waste landfills, which accounted for over forty percent of the nation's total permitted commercial capacity for hazardous waste, were situated exclusively within two African-American communities (Emelle, Alabama, and Alsen, Louisiana) and one Hispanic community (Kettleman City, California). Remarkably, Kettleman City did not have its own waste management facility. This situation underscored a concerning pattern in environmental justice, highlighting how communities of color were disproportionately impacted by the placement of hazardous waste facilities (17).Communities that have been historically marginalized continue to grapple with the stark realities of environmental injustice. These groups, frequently facing discrimination due to factors like race, economic status, gender, or disabilities, are often deprived of essential societal benefits and opportunities. This disparity is evident in their lack of access to adequate healthcare, education, and sanitation infrastructure, among other basic necessities (6). Significantly, Black communities and those living in lower socioeconomic conditions are the most vulnerable to environmental hazards, including air, water, soil, and noise pollution. The deep-seated causes of these environmental injustices are multifaceted and complex, as discussed in the following sections. Historical inequities Throughout American history, Black communities have faced persistent marginalization, a legacy that originates from the country's foundational years and its intricate history with slavery. The systemic racism, economic inequalities, and societal disparities that continue to impact Black communities today are deeply rooted in this period, where slavery was an entrenched institution in American society (18).The legacy of slavery left an indelible mark on the development of the United States. Black people were subjected to unimaginable discrimination and the denial of fundamental rights. This tragic history laid the groundwork for the systemic racism that persists in various forms. Economic disparities have persisted as a consequence of centuries of unequal treatment, with Black individuals being deprived of opportunities and resources (19).These historic injustices have contributed to a stark contrast in the exposure and health outcomes of Black communities when compared to other racial groups. The consequences of this deep-seated discrimination continue to be felt today, underscoring the need for ongoing efforts to address and rectify these disparities (20). In the history of the United States, minority communities have endured subpar educational systems, with even those fortunate enough to attend schools often facing bullying and discrimination based on their racial background. This unfortunate reality has led to a significant number of students dropping out of school, contributing to increased crime rates within these communities (21). These historical disadvantages have persisted over time, exacerbating the divide between marginalized communities and the rest of society, thus perpetuating social and economic disparities.The roots of this systemic racism trace back to the country's early history. It began when enslaved Black individuals were denied basic human rights and were counted as only three-fifths of a person for the purpose of determining state representation in Congress. Even after the Emancipation Proclamation and the conclusion of the American Civil War, Black Americans still faced harsh restrictions through the imposition of Black Codes, which limited freedoms and compelled many to work for minimal or no wages (22).The Civil Rights Act of 1866 was a landmark piece of legislation in the United States that affirmed the rights of Black people, particularly in matters related to property, labor, and contracts. However, it did not address voting rights or the ability to hold political office, which were issues later tackled by the 15th Amendment in 1870, granting Black men the right to vote. During the subsequent Jim Crow era, a range of segregationist policies were implemented, which had profound and lasting effects on the Black community. These policies entrenched poverty and denied Black Americans numerous economic and educational opportunities. Furthermore, in the 1930s, the discriminatory practice of redlining was instituted. This practice, carried out by federal housing agencies and private lenders, systematically denied financial services such as mortgages and insurance to residents in certain areas, predominantly those with a high concentration of Black residents. The impact of redlining was severe – it led to a decrease in property values in these areas, a deterioration in the quality of local schools and stores, and limited access to equitable healthcare, further exacerbating the socioeconomic challenges faced by the Black community (18).Historically, communities of color in the United States have faced significant challenges in accessing their voting rights. These challenges were often rooted in systemic racism, which played a primary role in creating disparities in voter suppression. Various policies and practices, such as literacy tests, poll taxes, and other discriminatory measures, were explicitly designed to limit the voting rights of these communities. In contemporary times, there are concerns that certain policies and practices may continue to limit ballot access for communities of color. This includes issues like strict voter ID laws, reduction of early voting periods, and the closure of polling places in predominantly minority neighborhoods. Additionally, there is the phenomenon of survey misreporting. This occurs when voter turnout among communities of color is inaccurately reported in surveys, often showing higher rates of participation than actually occur. This misreporting can have significant implications. It may lead to a misunderstanding of the true extent of voter suppression and could potentially influence the development of policies and practices that inadvertently or deliberately continue to suppress the vote among these groups (23).A system of racial segregation and discrimination, known as Jim Crow laws, was prevalent in the United States from the late 1800s to the mid-1960s. These laws, enacted by state and local governments, enforced racial segregation in public places, including schools, housing, and transportation. The Jim Crow era also extended to voting, employment, and other areas of life, systematically marginalizing African Americans. During this period, African Americans were systematically denied the right to vote through various means. These included literacy tests, poll taxes, and violent intimidation, all designed to disenfranchise them. These tactics effectively prevented African Americans from exercising their voting rights, which in turn allowed White politicians to maintain power and control over political and social institutions. The impact of these discriminatory practices contributed to the perpetuation of racial disparities and injustices that echoed into contemporary times, influencing policies and practices related to voting rights (24). Zoning and land use policiesIn their 1993 study, Massey and Denton (25) discussed how historical discrimination, ongoing inequality, and specific policies have contributed to racial segregation in housing in the United States. They highlight practices such as redlining, discriminatory lending, and exclusionary zoning as key factors. Their argument posits that 'systemic racism', rather than just individual preferences or market dynamics, plays a crucial role in creating disparities in housing access and quality for racial minorities. However, it's important to acknowledge that housing challenges are not exclusive to any single racial group. People living in poverty, irrespective of their race, often face significant difficulties related to housing. These include living in inadequate or unsafe conditions, struggling with high housing costs relative to their income, and facing the risk of homelessness. This broader perspective recognizes that while systemic racism significantly affects housing disparities, economic factors also play a critical role in housing challenges experienced by people across different communities (25).Poor communities are often situated in areas that are redlined with less stringent zoning regulation making it easier for industries to locate there.  The areas are marked as high risk, the people in such communities are denied financial services such as mortgages or loans to improve their lives. Also, because of the segregation the land regulations in these communities are not enforced to protect the people and the environment from pollution. Poor communities have become the dumping sites for most industrial toxic waste, landfill sites where garbage with different toxic contaminants are sited, waste incinerators which produce harmful chemicals to the environment are also found in these communities. These pollutants contaminate the air, soil and nearby water bodies.This results in higher exposure to environmental hazards as the communities’ experience air pollution by inhaling harmful gases which can lead to respiratory diseases. Their water is also polluted and by consuming the contaminated water many are at risk of suffering from waterborne diseases. The noise and chemicals from the industrialized factories set up in their locality adversely affect the people and environment.  All this leads to the inhabitants of such communities being at higher risk of being diagnosed with respiratory diseases, lead and other contaminant poisoning, skin cancer, lung cancer, neurological issues, and cardiovascular diseases.  Economic factorsOliver and Shapiro (26) asserted that 'systemic racism' is a primary driver of disparities in the wealth gap. They argue that the wealth gap between Black and White Americans is not simply the result of individual differences in savings or investment behavior but rather is the product of historical discrimination and inequality. They claim past policies such as redlining, discriminatory lending practices, and discriminatory employment practices contributed to the wealth gap (26).Lower-income communities often lack the means to advocate effectively for enhancements in environmental conditions, quality healthcare, access to good education, and the implementation of rigorous land use regulations (27). This disparity is particularly pronounced within minority populations, where higher levels of education are less common, and many individuals find themselves in low-paying, menial jobs, directly impacting their overall quality of life. Regrettably, this reduced standard of living does not promote saving but tends to lead to the accumulation of debt, further diminishing their overall quality of life. These financial constraints frequently hinder their ability to secure mortgages and relocate to areas with superior environmental conditions (25). In addition to these challenges, discriminatory lending policies and high interest rates often contribute to the accumulation of debt, making it even more difficult for these communities to break the cycle of financial hardship.Additionally, limited access to healthcare amplifies their vulnerability to environmental health risks, further compounding challenges (28) comprehensively explored the myriad factors contributing to wealth disparities, shedding light on a multifaceted and intricate challenge. Their research illuminated how income inequality, differences in homeownership rates, educational disparities, and variations in job opportunities all played crucial roles in shaping economic inequalities across various communities. These disparities were not confined to a single racial or ethnic group; they affected individuals from diverse backgrounds who were grappling with economic hardship. The disadvantages identified in their study extended to shared environmental challenges as well. These encompassed living in areas with poor air quality, contaminated water sources, proximity to toxic waste sites, labor market discrimination, and limited access to education and healthcare. Collectively, these adversities had a far-reaching impact, stretching across communities of all racial and ethnic backgrounds experiencing financial difficulties. It's important to underscore that despite the multifaceted nature of this issue, the literature consistently indicates that minority communities often bear a disproportionate burden (29). Their vulnerabilities, rooted in historical and ongoing systemic inequities, compound challenges, making it crucial to address these disparities comprehensively and systematically. Limited political influenceThe issue of underrepresentation of poor communities in mainstream media is a significant factor contributing to environmental justice challenges. Often, these communities are not adequately represented in the media, leading to a generalized lack of awareness and understanding of the specific adversities they face. This situation hampers their ability to effectively voice their concerns and needs, as highlighted in reference (24).Furthermore, these communities typically wield less political clout, posing a substantial obstacle in advocating for and implementing policies that safeguard their interests. A recurring theme in environmental justice discourse is the inadequate representation of minority and impoverished communities in key decision-making forums. Their interests are often sidelined in environmental policy decisions, primarily because these communities seldom have representatives in influential governing bodies. This absence of representation means that decisions affecting their lives and environment are often made without their input or best interests in mind, leading to disproportionate exposure to environmental hazards and pollution. This systemic issue underscores the need for more inclusive representation in decision-making processes to address and rectify environmental injustices. Proximity to industrial zonesBullard (5) argued that communities of color are disproportionately burdened by environmental pollution and other environmental hazards. Policies such as zoning, land use, and environmental regulation have contributed to and perpetuate disparities, asserting that 'systemic racism' is a primary driver in environmental justice (5). Poor communities may be located closer to industrial zones because of lack of employment. The leaders in the local communities encourage industries to be set up in their locality to employ inhabitants of the community. Lack of political power in the poor communities encourages large factories that emit harmful chemical substances to be sited in these communities. They are exposed to these pollutants and their health is impacted negatively. Lack of information and advocacyPeople who have low health literacy may have difficulty understanding health information, navigating the healthcare system, and making informed decisions about their health (24). The majority of the population in marginalized communities are uneducated with little knowledge on environmental pollution and its risk on them. The people in the community are more interested in how to make ends meet instead of what is going on in their environment. These victims do not have any idea of the risk of exposure and its long-term effects on them. Also, they have less advocacy dedicated to their concerns because they lack representation. Their voices are barely heard, and the challenges of these vulnerable people are not considered as important and are totally ignored. Wearable devices for environmental monitoring: Air quality monitoringWith an increase in industrialization in marginalized communities, it is very important to monitor the various air pollutants in the communities both indoors and outdoors. Exposure to air pollutants over a long period of time can have adverse effects of human beings and can cause respiratory diseases such as asthma and lung cancer. Air quality monitoring systems are very useful in effectively monitoring air pollution, allowing for active assessment of air pollutants to identify excess levels early. In the traditional context, air quality monitoring stations are typically characterized by their large size and high installation and maintenance costs. This restricts their potential for widespread deployment in densely populated urban areas (30). It is, therefore, necessary to empower marginalized communities on the importance of wearable devices to monitor the air quality of their surroundings. The wearable devices are less expensive, user-friendly, and do not require technical expertise compared to the traditional ones. Every household in marginalized communities should be encouraged to have a couple to access their environment.  The utilization of affordable sensor technology for air pollution monitoring has advanced significantly over the past decade. These user-friendly devices are portable, low-maintenance, and have the capability to facilitate near real-time, continuous monitoring (31). Wearable devices for environmental monitoringTable 1 below summarizes examples of wearable devices and their uses to monitor air quality in communities (32). Table 1. Wearable devices for air monitoring WEARABLE DEVICE USES PRICE TZOA Measures PM10 and PM2.5, atmospheric pressure, humidity, temperature, ultraviolet exposure, and ambient light. Less than $106 ATMOTUBE PRO Measures PM1, PM2.5, and PM12, volatile organic compounds (VOC) in real-time, humidity, temperature, and atmospheric pressure. Less than $370 ATMOTUBE PLUS Measures pressure, temperature, humidity, and VOC. Less than $53 THE WYND AIR QUALITY TRACKER Senses airborne PM, including dust, allergens, and industrial pollution. Uses iOS and Android application. AIRBEAM Monitors PM1, PM2.5, PM10, temperature, and humidity. Detects outdoor and indoor pollution. Uses iOS and Android application. It also utilizes WiFi and cellular network. HUMA Measures CO2, VOC, PM1, PM2.5, and PM10 in indoor environments. It also measures temperature and humidity.    Monitoring indoor air quality involves assessing the air composition within enclosed spaces like schools, offices, and homes. Several factors, including the concentration of different gaseous and particulate pollutants influence air quality. Insufficient ventilation may elevate indoor pollutant levels, as it fails to introduce adequate outdoor air to dilute emissions from indoor sources. Elevated temperature and humidity levels can also lead to higher concentrations of certain pollutants (33).Monitoring outdoor air involves measuring the concentrations of different pollutants, including Ozone (O3), sulfur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (CO) and particulate matter (PM) at specific locations (34).The concentration of atmospheric pollutants depends on the location, and therefore, also the time and space of the pollutant concentration are important to avoid dangerous exposures of humans (35). Depending on the location, the concentration of air particles may vary between different people in the same community. It is also important to note that paints, chemicals, detergents, behaviors such as smoking, and many others can change air quality, resulting in different homes in the same community.A desirable approach is that air quality sensors are combined or communicated with other everyday portable devices (smartphones, tablets, and laptops) providing instantaneous and easily understandable information readings. An advantage for sensor development would be to contain as many contaminant detectors as possible at the same time, resulting in a challenge for most of the currently developed sensors and integrated platforms, due to the rapidly increasing size and complexity of both hardware and software instruments required to operate the different technologies (36). It is worth noting that accumulating different data from the individuals in the community and trying to draw a conclusion from such data may be inaccurate due to many factors. Measuring atmospheric pollutants is challenging. Some of the difficulties in the analysis of air pollutants are their low concentration, complex chemical composition, and the presence of mixtures of compounds in the air. Standard monitoring devices applied to calculate pollutant exposure use a variety of measurement methods depending on the class of pollutants being measured. For instance, particulate matter concentrations are measured through gravimetric analysis and light-scattering devices. Light-scattering (LS) monitors use a laser beam to shine particles located in a chamber. A light detector then measures the scattered light which depends on the concentration and size of the particles; then, a constant air flow to feed particles into the chamber is required to produce reliable estimates (37).After the protest of the Warren county (3) many marginalized communities have become involved in their communities and try to resist any suspicious illegal dumping of chemicals in the communities. Many individuals have found a need to involve themselves in the various researches in their communities to help them in decision making that will affect them. Throughout the United States and globally, residents are becoming more aware of the impact of pollution sources on their communities, recognizing that exposure to pollutants in their living, working, and recreational areas may pose health risks. Communities are increasingly seeking tools to document these exposures and address environmental health disparities. Currently, regulatory air monitoring systems often fail to assess neighborhood variations in air quality at a sufficiently detailed spatial scale. The proliferation of low-cost air pollution sensors has empowered citizen scientists to collect and utilize air quality data, enhancing their ability to characterize and comprehend the environmental conditions in their localities. Involving communities in science and research is crucial for advancing public health and fostering awareness regarding the sources of air pollution, exposure routes, and the links between contaminants and health outcomes (38). Ultraviolet (UV) exposure sensorsUV is the radiation from the sun that reaches the earth, which helps in the production of vitamin D to strengthen and develop bones. However, excessive UV can negatively affect humans, causing skin cancer, skin aging, and many other harmful conditions.Skin cancer stands out as the most prevalent form of cancer on a global scale. It is estimated that approximately 5 million adults received treatment for skin cancer annually in the United States between 2007 and 2011, incurring average treatment costs of $8.1 billion per year (39). As the incidence of skin cancer is growing rapidly, it has become one of the greatest threats to public health and has created a substantial economic burden for skin cancer treatment, particularly in countries like New Zealand, Australia, United States, United Kingdom and Germany (40). The increase of skin cancer is mainly because of the exposure to the sun. The most proactive and effective method of preventing skin cancer is to increase public education and awareness on this matter, and promote sun protection practices (41).The purpose of wearable UV sensors is to measure personal UV exposure (both UVA and UVB) and provide useful information to users. Because the UVA and UVB intensities are usually not informative to the public, the measured UV is usually converted to UVI or UV dose with reference to the Minimal Erythema Dose (MED). Recent advances in miniaturized electronics and materials have enabled the successful development of wearable UV sensors. Based on photoreaction, they can be classified into photosensitive film-based or electronic integrated sensors. Upon their exposure to UVR, photosensitive film-based sensors undergo photodegradation, while the electronic sensors generate electrical current from incident photon energy. Dosimeter and radiometer are different names for such sensors, based on their measuring capabilities. The radiometer can measure instantaneous Ultraviolet Index (UVI) while the dosimeter can measure the cumulative UV dose. Photosensitive film-based sensors are designed to be dosimeters, whereas electronic sensors are often designed to be radiometers. Since the cumulative UV dose is the integral of the UV intensity with respect to time, time-stamped UV intensity measured by the electronic radiometer can also be processed to determine the cumulative dose. The following text will be divided into two main sections, (i) the photosensitive film-based UV dosimeters, and (ii) electronic integrated UV sensors (42). Portable water quality sensorsAccess to clean water stands as one of the critical resources essential for sustaining life, and the quality of drinking water significantly influences the well-being and health of individuals (43). Water is essential in life and the quality of water needs to be monitored, to ensure individuals are not consuming contaminated water.Traditional ways of monitoring quality water are expensive. However, these methods are time-consuming (leading to delayed detection of and response to contaminants) and not very cost-effective. There is thus a need for more extensive and efficient monitoring methods (44).Various methodologies have been utilized to monitor different contaminant parameters in water, encompassing electrochemical, physical, and optical sensing. Of these, electrochemical sensing is the preferred approach (45).Electrochemical and biosensors provide a cost-effective method for concurrently monitoring water contaminant parameters through a multisensory patch, making them well-suited for online monitoring of extensive water bodies like reservoirs. Traditional glass-based sensors in electrochemical sensing have limitations for online monitoring, as their responses may be affected by varying pressure and temperature conditions. In contrast, electrochemical solid-state sensors utilizing metal–oxides (MOx), polymers, or carbon-based materials (employing thick/thin film technology) prove superior and are suitable for integration into wireless sensor networks (46). Potentiometric and amperometric sensorsAmong various sensor configurations, potentiometric sensors are extensively used to monitor pH and dissolved oxygen (DO). These electrochemical sensors, comprising sensitive and reference electrodes (REs), provide a straightforward and appealing approach, with their sensitivity assessed through the Nernstian equations (47).Some sensors use a reference electrode (RE) made with a thick film of Ag/AgCl/KCl. These sensors show excellent stability over a long time, similar to glass reference electrodes. As a result, they work well for tasks that require collecting data for a long time (48).Because it is really good at sensing things, stays stable, and lasts a long time, RuO2 is often used in pH and dissolved oxygen sensors. With RuO2, a pH sensor that measures from 2 to 13 (with a sensitivity of 58 mV/pH at 23°C) and a dissolved oxygen sensor that measures from 0.6 to 8.0 ppm log [O2] (from -4.71 to -3.59, with a sensitivity of -41 mV/decade at pH 8) have been made. These sensors work really well (49). The responsiveness of these sensors is notably affected by water temperature, displaying slower responses in colder conditions. For instance, at 9°C, the pH sensor exhibits a response time of 8–10 minutes compared to 1–2 seconds at higher temperatures (23°C) (50).Silicon-based thin film sensors have found application in various contexts [52]. Their exceptional response consistency presents a promising Water Quality Monitoring (WQM) opportunity. However, a significant challenge associated with these sensors is the absence of compatible reference electrodes (REs). Numerous thin film-based Ag/AgCl REs studies have reported drift issues (51). To address this concern, a solid-state Ag/AgCl electrode can be situated in a miniature tank containing a KCl solution to enhance ion exchange, as demonstrated in the case of a nitrite monitoring sensor (52).This sensor design holds promise for monitoring various analytes, including phosphates and ammonium. With further modifications to the working electrode (WE), there's potential to adapt this design for monitoring urea and ammonia. An array of RuO2-based sensitive electrodes (SE) has also been implemented to reduce measurement errors in microfabricated sensors developed using Ion-Sensitive Field-Effect Transistor (ISFET) technology (53). These sensors exhibit impressive performance with a sensitivity of 55.64 mV/pH and a low drift rate of 0.38 mV/h at pH. Such sensor arrays could be valuable for monitoring parameters like free chlorine, dissolved oxygen (DO), ions, and heavy metals (46). Fixing problems with the reference electrode (RE) in potentiometric sensors means using the interdigitated electrode (IDE) design. This design is used in different types of sensors, like conductive, capacitive, impedance, and chemiresistive (two electrodes)-based sensors. Different materials, like metal–oxides, polymers, and carbon, work well with the electrodes in IDE-based sensors (54), (55). Among the notable IDE-based sensors documented for Water Quality Monitoring (WQM), hydrogel (polymer) stands out. This hydrogel exhibits both biocompatibility and cost-effectiveness in terms of materials and fabrication. The electrical properties of hydrogels, including conductivity, undergo changes upon interaction with analytes. (56),(57). The downsized pH sensor comprises an active electrode in the form of a hydrogel made from polypyrrole and polyaniline. However, notable limitations of the hydrogel-based sensor include its diminished mechanical strength and relatively short lifespan. Interdigitated and chemiresistive-based sensorsChemiresistive sensing represents another category of sensors that operates without the need for a reference electrode (RE). An example is the paper-based chemisistive sensor designed for the real-time monitoring of free chlorine (58). Utilizing a nanohybrid ink comprised of graphene and PEDOT: PSS, this sensor operates as a chemiresistive pH sensor. In another application, chemiresistive pH sensors, incorporating nanocomposites of single-wall carbon nanotubes (SWCNTs) and Nafion as the sensitive electrode (SE), have been investigated for Water Quality Monitoring (WQM). These sensors are employed in conjunction with drones equipped with wireless communication capabilities (59). The inclusion of a Nafion layer improves the functionality of the flexible sensor by mitigating the deterioration of electrical properties (60). The characteristics are affected by the cracking, and in some cases, breaking, of the sensitive electrode (SE) during bending. Additionally, findings from this sensor type indicate that sensitivity could be heightened by augmenting the number of printed SE layers. This same setup could be applied for real-time monitoring of conductivity, detection of chloride ions, and temperature sensing. Moreover, diverse forms of carbon nanotubes (CNTs) could be employed to enhance sensing performance (61). These electrochemical sensors are important to use in marginalized communities to monitor the water quality used by inhabitants. The sensors detect and measure the chemical components in the water available. The sensors provide real time information such as the pH, and dissolved ions to the user rather than depending on the government to provide findings of research over a period. Users of these electrochemical sensors which can promote water safety and detect contamination of water in marginalized communities. Citizen-led water quality assessmentsCitizen science, a burgeoning trend, has garnered significant popularity, particularly within the realms of ecology, biology, and environmental monitoring. This collaborative approach involves active engagement and contributions from members of the public, who, despite lacking formal scientific training, play pivotal roles in data collection, analysis, and decision-making processes. The inclusive nature of citizen science not only fosters a sense of community involvement but also broadens the scope and scale of scientific inquiry, enabling a diverse range of individuals to actively contribute to our understanding of the natural world (60). This encompasses the monitoring of water quality, including voluntary contributions to watershed health assessments within different programs in the United States, initiated subsequent to the implementation of the Clean Water Act in 1972 (62). Engagement in citizen science has the capacity to markedly extend data collection and analysis, accomplishing this at a fraction of the cost compared to conventional scientific campaigns (63). Education is a fundamental driver for engaging in citizen science, entailing the sharing of knowledge about the frameworks, assumptions, and intricacies that constitute the scientific process (64). Goals of increasing environmental awareness, promoting pro-environmental attitudes (65) and reconnecting people to nature (60) are often inherent within environmental citizen sciences (such as water quality monitoring), which have also been used to include citizens in policy-relevant science (66).Citizen inexperience about how to best collect scientific data can indeed bias or skew data, hindering data quality and reliability (67). Thus, the challenge of understanding how non-professionals operate within scientific programs, including the resultant effect on data quality, has necessitated the development of citizen science frameworks and best practices for practitioners (66). Despite evidence that citizen data can rival professional data, and a growing understanding of what constitutes ‘good’ citizen science, surveys of scientist perceptions show that concerns regarding data quality remain a significant barrier for trusting scientific conclusions derived from citizen science data (68)This mistrust is particularly concerning for policy-relevant science such as environmental research, where apprehension regarding data quality can hamper the use of results derived from citizen data in high-level policy and decision-making (62).Further studies also question whether citizen science effectively engages citizens, such as within environmental policies or management controversies (69). To strengthen citizen led water quality in marginalized communities, the research team should partner with the different community leaders of the community understudy. Relationships can be established through face-to-face meetings, programs such as seminars, fairs and health forums. Through these processes, community leaders volunteer to participate encouraging other inhabitants to also get involved in the study. This encourages continuous support from the community. Promoting access to safe drinking waterInternational human rights law mandates that nations strive for universal access to water and sanitation without discrimination, focusing on those in greatest need. The Committee on Economic, Social, and Cultural Rights, in its General Comment No 15, and the Special Rapporteur on the human right to safe drinking water provide essential guidelines for states in implementing these rights. Key elements include: ·       Availability: Ensuring a sufficient and continuous water supply for personal and domestic uses, encompassing drinking, food preparation, clothes washing and personal and household hygiene. Adequate sanitation facilities must be available within or near each household, as well as in health or educational institutions, workplaces, and other public spaces to meet the needs of every individual. ·       Accessibility: Making water and sanitation facilities physically accessible and within safe reach for all segments of the population, with consideration for specific groups such as persons with disabilities, women, children, and older persons.·       Affordability: Ensuring that water services are affordable for everyone, preventing any denial of access to safe drinking water based on financial constraints.·       Quality and safety: Guaranteeing that water for personal and domestic use is safe and free from micro-organisms, chemical substances, and radiological hazards that pose a threat to health. Sanitation facilities must be hygienically safe, preventing contact with human excreta by humans, animals, or insects.·       Acceptability: Ensuring that all water and sanitation facilities are culturally acceptable and appropriate, taking into account gender, life-cycle, and privacy requirements. Consumption of contaminated water can result in various illnesses, including cholera, hepatitis A, typhoid, and arsenic poisoning (70). Bacterial and viral pathogens, pathogenic protozoa, and other water-borne agents contribute to over five million deaths annually from water-borne diseases, leading to diarrhea and fluid/electrolyte loss (71).VanDesrslice stated (72) that many low income and minority communities did not have access to piped water. It is difficult to determine if a statistically significant relationship exists between income and access to water because many water systems do not collect demographic information from customers. However, this would still not include those relying on private drinking water systems. While a 2007 survey estimated that 0.5–1% of U.S. households lacked access to piped water, in some low income and minority areas, entire communities did not have piped water. In California, counties with a high percentage of minorities had a greater percentage of drinking water violations, 42% compared to 16% (72).Many people in rural communities rely on private wells and/or natural springs for drinking water supply. Periodic testing for contaminants should be standard practice; however, the EPA (Environmental Protection Agency) does not regulate private wells and natural springs. The responsibility for scheduled testing falls to the homeowners, which could be a costly deterrent for low-income residents. Many people in these areas lack the means for regular water testing and may be consuming unsafe water. Boiling does not remove all harmful substances from the water, and contaminants may remain present in wells for years without the owner's knowledge ((73) Noise pollution monitorsNoise mapping serves as a visual depiction of the distribution of sound levels within a specific locale, offering an effective method for assessing noise in urban environments. Additionally, it aids in visually representing noise patterns in regions where land uses are particularly susceptible to noise. This contemporary approach to evaluating noise levels contributes to planning strategies aimed at mitigating the adverse effects of noise pollution (74). The swift advancement of urbanization is resulting in notable levels of air and noise pollution. Consequently, extensive research endeavors are directed towards the development of detailed pollution and noise maps aimed at identifying urban areas causing significant adverse effects on human health. Conventional measurement techniques typically rely on costly and stationary equipment, rendering them unsuitable for the dynamic nature of urban environments due to the low spatio-temporal density of measurements. In contrast, the increasing ubiquity of mobile phones and their technological capabilities present a new avenue for citizen-assisted environmental monitoring.A solution known as mobile crowdsensing (MCS) for monitoring air quality and noise pollution provides a practical illustration of a real-world system deployment, encompassing sensor calibration, data acquisition, and analysis. This approach reveals a correlation between elevated levels of air and noise pollution during peak hours, attributed to increased vehicular activity on the streets (75). Monitoring noise using mobile phones.Smartphones offer a multitude of applications specifically crafted for measuring sound or evaluating noise levels. For instance, a search conducted on June 1, 2013, within the Apple AppStore using the keyword "sound meter" yielded 120 mobile applications compatible with iPhones. Broadening the search with terms like "noise" or "loudness" would extend this selection. Similarly, a comparable exploration in Android Market, Microsoft Mobile Marketplace, or Nokia Ovi might introduce an additional hundred mobile applications to the inventory (76).Nevertheless, it's important to note that smartphones are not effortlessly and immediately deployable as sound meters to generate data for noise management. A significant portion of these mobile applications was primarily created for entertainment purposes, enabling users to gain a general understanding of the noise levels they encounter at specific locations and times, albeit without a high degree of accuracy (76).An examination of scientific literature revealed only three mobile phone applications that were meticulously designed, implemented, and tested for measuring noise through mobile phones within a framework promoting community participation. One notable example is NoiseTube, which was developed in 2009 by a collaborative effort involving European universities from France, Belgium and the Netherlands (77). Another application, known as NoiseSpy, was crafted in 2010 by the University of Cambridge in United Kingdom, as outlined by Kanjo in 2010. Additionally, the Ear-Phone, which emerged in 2010, was spearheaded by the University of New South Wales and CSIRO in Australia, with collaboration from Portland State University in the United States (78,79). These serve as three recent examples that align with the research presented in this context. The NoiseTube project aimed to establish a participatory network for monitoring noise pollution, allowing both citizens and governmental bodies to comprehend the issue of urban noise pollution and its societal repercussions. This initiative was prompted by the European Noise Directive (END), which emphasized creating noise maps to comprehensively depict the population's noise exposure. In a laboratory experiment comparing NoiseTube to a scientific sound meter, the precision achieved was +4 dB within a sound scale ranging from 35 to 100 dB. In 2012, there was a real-world test of NoiseTube within a participatory context, as outlined by D'Hondt, Stevens et al (80) in 2013. The objective was to demonstrate that, if appropriately executed, participatory techniques can attain accuracy levels equivalent to those demanded by conventional noise mapping methods.            Much like the earlier mobile phone application, NoiseSpy functions as a sound sensing system that transforms a mobile phone into an affordable data logger for tracking environmental noise. This enables users to explore urban areas while collectively visualizing noise levels. The primary goal of NoiseSpy was to highlight the mobile phone application's potential for involving people in widespread participation in environmental campaigns, thereby raising awareness of environmental issues and supporting educational initiatives. The utilization of the data for planning and management appears to be of secondary importance, as no assessment of the data's accuracy has been reported (76).The Ear-Phone project aimed to create noise maps, considering the inherent challenges posed by data provision from citizens and mobile phones, such as the fragmented and incomplete nature of data in both space and time. The Ear-Phone project devised a methodology based on compressive sensing to address the issue of reconstructing noise maps from incomplete and random samples gathered through crowd-sourced data collection. In field tests conducted by researchers, Ear-Phone exhibited a precision of +2.7 dB when compared to commercial sound meters.Results from a case study involving six participants indicated that using data from only one person did not reveal distinct patterns in the reconstruction. However, incorporating data from multiple individuals gradually exposed differences between noisy and quiet areas. Moreover, beyond a certain threshold, increasing the number of data contributors did not significantly enhance the accuracy of the reconstruction. This method and experiment underscore the significance of widespread participation in citizen science (76). Health monitoring for environmental justiceA growing body of evidence indicates that low-income groups, a disproportionate percentage of which are people of color, tend to be both more exposed to many environmental pollutants as well as more susceptible to related health effects than the general population. Even though there is not enough statistical evidence to proof, many observational studies conducted found that people of color, people of low income live close to dumping sites, reside in urban areas where ambient levels of many air pollutants tend to be higher, eat significantly greater amounts of contaminated fish, and be employed in potentially dangerous occupations.  It is known that their minority communities are more exposed to environmental hazards and suffer adversely from disabilities, diseases such as skin cancers, kidney problems and more (81).  The role of wearable devices in health trackingDiabetes is a global persistent health condition. Problems associated with diabetes incudes stroke, blindness, heart diseases which can in the long term lead to death. Report provided by the World Health Organization, diabetes is on the rise and diabetic patients has increased from 108 million in 1980 to 422 million in 2014 implying that about 8.5% of adults aged 18 years and older had diabetes, with a potential to surpass 500 million cases in 2030 (82).Type 1 diabetes (T1D) is caused by insufficient insulin secretion by the pancreas, it can be managed by dispensing insulin. Type 2 diabetes (T2D), caused  by bad daily habits, e.g., physical inactivity and unhealthy diet  (83). It is essential to properly manage diabetic patients to reduce the risk of complications. This management can be done by monitoring the glucose levels in a patient’s blood. Diabetic patients also need constant monitoring of their diet, exercise, taking medications and injecting insulin and therefore the need to use the right sensors (84). Lately, BG monitoring has been transformed by the enhancement of Continuous Glucose Monitoring (CGM) sensors, that measure glucose concentration almost without interruption (1–5 min sampling period) for days (85). Low impact needle sensor is used by these equipments fixed in the subcutaneous tissue, in the abdomen or on the arm which measures an electrical current signal generated by the glucose-oxidase reaction.  Air quality and diabetesThe main causes of diabetes are known to be poor lifestyle, unhealthy diet, lack of exercise and genetic background. With the increase in the rise of diabetes among children and adults worldwide, attention has been drawn to the fact that exposure of environmental pollutants contributes to the prevalence of diabetes (86). Various studies confirms that pollutants can disrupt glucose homeostasis and promote metabolic dysfunction (87). Occasional use of pesticides and chemicals found in homes such as flame retardants and bisphenol have been associated with metabolic dysfunction (88).  According to research conducted by Jagai et al (86), it was concluded that air quality in sparsely populated and less urbanized areas has a impact on the prevalence of diabetes. Additionally, environmental pollutants associated with diabetes have been shown to disproportionately affect minority communities (89). Diabetes unevenly impacts African Americans, Latinos, and low-income individuals. In contrast to non-Hispanics, the possibility of developing diabetes is projected to be 66% higher for Hispanics and 77% more for the black race (90). Several studies have indicated elevated exposure to diabetogenic endocrine-disrupting chemicals (EDCs), including polychlorinated biphenyls, organochlorine pesticides, multiple chemical constituents of air pollution, bisphenol A, and phthalates has been a major cause of prevalence of diabetes among the black race and low-income communities (89). EDC is defined as a chemical or mixture of chemicals that disrupts with any aspect of hormone action (91). EDCs can disrupt insulin secretion and function along with affecting other ways that regulate glucose homeostasis (91). PCB is also another substance that can elevate diabetes among the black race. Among female residents of Anniston, serum PCB levels were significantly associated with diabetes (92). Another toxic chemical increasing the rate of diabetes in the minority communities is the organochlorine (OC) pesticide. This particular chemical was banned but however there are still traces found in marginalized communities.We also know for a fact metal such as zinc, iron manganese are needed by humans, metals such as lead and mercury are harmful to humans. Exposure of humans to lead and mercury can be a factor in the prevalence of diabetes amongst humans. Even though lead exposure has reduced in recent years in the developed countries, inhabitants of poor communities are still exposed to lead (93). A typical example is the incident at Flint in Michigan, there was an exposure of lead in the water system of the community which was a water source to the majority of  population (94). It is important to note that exposure to lead only cannot be the cause to diabetes, but other factors including lead exposure makes one at risk of being diabetic. The exposure of metals such as lead to individuals, leads to induce oxidative stress in biological systems. This holds significance since numerous crucial elements of the insulin signaling pathway are known to be constrained by reactive oxygen specific (ROS), fostering the growth of insulin obstruction and diabetes (95). Recent studies have shown a significant relationship between blood lead levels and indicators of oxidative stress in the population. Findings suggest that oxidative stress should be considered in the progression of lead related diseases, even amongst individuals with relatively low exposure to lead (i.e., <10 μg/dL) (96). Most of biological samples ofT2D patients exhibit traces of toxic metals indicating exposure to harmful metals such as lead and nickel. Some of the toxic metals can interfere with the glucose uptake and alter the related molecular mechanism in glucose regulation (97). Cardiovascular health monitoringWearable heart rate monitors are used to monitor the heart rate (HR) of individuals and provide valuable information such as cardiovascular health, duration of exercise, sleep pattern and steps taken (98). Traditional methods of recording HR are more expensive and require software which are used in medical or research laboratories, wearable devices are used to measure HR of individuals because they are less expensive, readily available and have a friendly interface to use (98).Wearable devices used for monitoring heart rates includes the bracelet-sized trackers like the Basis Carbon Steel, the Samsung Gear Fit, Apple watch and the Withings Pulse O2 tout which sometimes runs on  applications such as Androids or IOS. Devices such as the Apple Watch, Samsung Galaxy Gear 2, and Samsung Galaxy S5 mobile phone include embedded heart rate monitors (99), they use photoplethysmogram (PPG) for the measurement of HR of individuals (100). They use light to track your blood and through that the heart rate is measured. These devices illuminate the capillaries with a sensor that gauges rates at which the blood pumps (99). By illuminating your capillaries with a light emitting diode (LED), a sensor adjacent to the light measures the frequency at which your blood pumps your heart rate. These devices are inexpensive and simple to measure the HR of people but its accuracy is questionned. It also vulnerable to motion-induced noise, meaning the optical sensor in these devices expect the user not to move but be still, no talking and even sweating   Also using these bracelet sized trackers is not always accurate and does not always give the true heart rate. This because by the time blood reaches the capillaries in your wrist, it has already reduced to a rate which is not the actual heart rate. Also we have the Garmin Vivofit which is a chest strap heart rate monitor which is more preferred because it functions like the electrocardiogram (EKG) by measuring electrical pulse (beats per minute) reading. The readings on these devices are more accurate because heart rate monitor is used in conjugation with the trackers (99). However it cannot read accelerated heart rates after exercises or workouts but it is accurate for measuring HR both at rest and moderate exercises (101). This device has improved signal-to-noise ratio (SNR) meaning it can tolerate noise and movement better than wrist worn devices. It also has high transmittance in the visible light spectrum, it is waterproof and can withstand sweat, it is of a high quality and therefore can last long (102). Impact of environmental factors on cardiovascular healthCardiovascular disease (CVD) is a leading cause of death worldwide. CVD was a major cause of death for an estimated 13 million people globally in 2010, a quarter of the global totally (increased from just one in five deaths 20 years earlier) (103). Many factors account for the prevalance of CVD, conditions like diabetes, obesity and, behaviors like unhealthy diet, physical inactivity, and too much alcohol can increase a person’s risk of heart disease (105). The major cause of environmental pollution is air pollution, then water and soil pollution with pesticides and other chemicals. Other factors such light exposure, noise from traffic and climate change can negatively impact individual health and can cause CVD (106).Environmental exposure to certain chemicals and metals can increase the risk of one developing CVD. According to World Health Organization (WHO), exposure to metals such as lead, calcium and arsenic can cause people to develop CVD (107). Vehicle emission, burning of trees, tire fragmentation, dust and industrial combustion releases gases such carbon monoxide (CO), oxides of nitrogen, sulfur dioxide (SO2), ozone, lead are released directly into the air.  This causes air pollution leading to the prevalence of CVD globally (108). Long-term exposure to particulate matter is a major cause to CVD leading to death with the largest effects due to ischemic heart disease (108).A good soil is needed for the cultivation of crops for human survival, the soil is needed to absorb carbon which reduces climate change. Soil stores water and protects waterways, thus preventing floods and waterborne diseases. Deposit of toxic waste, pesticides, heavy metals, deforestation on the soil contaminates the soil increase risk of cardiovascular diseases on the population (109). “While these pollutants differ in their chemical composition, they cause disease through shared pathophysiological pathways centred on oxidative stress and inflammation leading to a dysregulation of circadian rhythms. Oxidative stress and inflammation in response to contamination with plastic, heavy metals, overfertilization, pesticides, and toxic agents represent major pathophysiologic mechanisms causing cardiovascular, neurodegenerative, and metabolic diseases” (109).Built environment is the physical changes and construction made by man on the natural environment and surroundings. It includes building or structures as shelter, streets, shaping spaces meeting places, landmarks. Certain elements of structures such as doors, windows, walls, floors, rooms sizes and function make up the built environment (110). Built environments comprises of buildings, spaces around buildings, layout of communities, transportation infrastructure, and parks designed by humans for interaction (111). Built environment in modern cities is a major factor of obesity and hypertension (112). Physical inactivity is a common attribute of the lives of people living in built environment. Labour saving devices are used for household chores, remote jobs causing people to work from home and easy access to individual cars have discouraged people from moving and walking as a means of transportation. Between 1977 and 1995, the number of all walking trips decreased by 32% for adults, with similar reductions for youth (113). People become active with the use of public transportation and they are less likely to be overweight and obese than people who do not use public transportation (114). Because of built of environment there is easy access to groceries and eateries which encourages eating of junk food amongst individual with little or no physical activity. Through these societal changes, chronic diseases and CVD have people become prevalent amongst the working force (115). To minimize cardiovascular disease and death, cities need planning by encouraging the use of more buses than individuals driving, developing greener communities, tree planting to make our environment safe (116). Challenges and considerationsFrom the paper it is important to note that wearable devices are very important in our everyday life and is demand is on the rise because of its various functionalities.  However, it has key challenges such as data privacy and security concerns, technological accessibility, accuracy, and validation especially in environmental monitoring which needs to be addressed.Data privacy and security concernsWearable devices use personal data for its set-up. Users share personal details such as name, date of birth, phone number, address, biometric features and bank account to create profiles. The political preference race, religious denominations and location of individuals are easily captured making it easy to identify individuals (117). Many users of these wearable devices are not aware of the privacy risk associated with the use of these devices. Wearable devices have in built sensors that can give personal information of the user such as location, physiological and emotional behaviors to a third party (118). Wearable devices functions by the use of the internet, this could lead leakage of information based on interaction among devices even though they may not be related (119). Wearable devices are connected to applications using Wifi and Bluetooth which makes the user vulnerable to cyber security threats causing huge lost to individuals and companies (117). Many users have false sense of privacy meaning as they think that wearable devices take right measures to protect user’s sensitive information. They also believe that since they are not using keyboards on the wearables they are not entering or any sensitive information. Users also are not aware of kind of data is taken and stored by these wearable devices (120). Data and activity of users of wearable devices are systematically captured and sold to third party marketing companies. The activities of users can easily be traced and identified through videos, pictures, Global Position System (GPS) without the permission and consent of users. Even though this may not cause any harm to the users it is a breach of privacy (117).  Technological accessibility and the digital divideEven though wearables have become a necessity and are of high demand globally, these wearables still present challenges to users with disabilities. Most of these devices are not easily accessible and user friendly to the disabled (121). Manufacturers of these devices do not consider the requirements of the disabled people when creating applications for these devices.  Because of their special needs, the wearable devices should have easy systems put in place to help the disabled to use the devices without any hindrance (121). Wearable devices are very helpful and can be used by the older generation to monitor their heart rates, track their daily movements, and predict any unusual pattern in the user. However the older population also have difficulty in learning and using these devices. Many of them oppose change and the use of technological devices since they did not grow up with this kind of lifestyle (122). The older population find it difficult to personalize these devices by giving out their personal information (123).Those who are economically stable have the purchasing power to buy these wearable devices than those living in marginalized communities. They can easily purchase the smart watches, heart rate monitors and even different brands of these (124). Those who can even purchase these devices in marginalized communities have limited access to pre-owned devices. Even though the majority of the low-income people use internet, their access is limited and unstable causing connectivity issues (125). High income communities have pay more for internet service and get the best services whiles many of those in the redlined communities have access to internet through their cellular devices and even those who may internet access at home have the poor services (126). It is also easier for the rich to maintain these devices when they get spoilt are simply replace them but the people in the marginalized communities may not even purchase a new one when their devices break down. Environmental data accuracy and validityWearable devices are often created for its technological use without considering the society, culture and environmental policies they function within. The design of these devices should factor the society, culture and environmental policies (127). Wearable devices used for measuring the environment are mostly concerned with the indoor factors than outdoor factors. The use of wearable devices to monitor the outdoor mostly involves a combination of devices to get the accurate measurement of the environmental condition. To get a more accurate result, there needs to be a relationship between monitored data with data obtained through calibrated sensors of a reference instrument. Researchers analyze the data obtained but do not participate in the measuring of the environmental factors. This does not give a reflection of the exact variable being measured (31). To get accurate results using a wearable device, several devices need to be tested to select one that is suitable for the study. Access to data, accuracy and validation of data are some of the factors that will be considered before conducting the study which can be a constraint and cause a delay in the study (128). Many of the wearable devices may need some of technical key or permission before it can be used which can affect the accuracy of results because most of the users of these wearable devices from the marginalized communities have no limited experience on the usage (129). Another challenge is that wearable devices are not sturdy enough as the laboratory-based studies. They are not authenticated enough to be used in different spans of environmental conditions with different ranges in altitude, temperature and humidity levels (130). Ethical considerations in environmental monitoringData obtained from wearable devices improves with data obtained from environmental sensors. The outcome received from wearables can be enhanced using different sensors to ascertain the type and impact of operation of users in a defined environment. To improve the lives of inhabitants in communities, it is better to observe possible causes of environmental conditions from a distance rather than depending on data provided by individual with the use of wearable devices (131).  According to UNICEF, wearables are not designed with the user, that is, it does not generate tailor made solutions based on the needs and preference of the user. Manufacturers of wearables do not ensure solutions are considerate and beneficial especially to the marginalized communities. Wearables also suffer being scalable. They cannot be implemented in the various environments and communities in the ecosystem.  Wearable devices are not designed to be replicable and adaptable across various countries and continents. Wearables for environmental measuring are not user friendly and are also difficult to maintain. UNICEF also stated that these devices are not data driven, they are not developed based on projects to measure milestones and track environment’s progress effectively. Some wearable devices are expensive and cannot be purchased by the ordinary citizen. Wearables run on power, and in communities with power issues, wearable devices are not effective to use.  Future directions and recommendationsWearable sensors provide large magnitude of data which enables detailed analysis, offering valuable insights into different aspects of users’ health, activity, and behavior. Machine learning is an important tool that is needed to identify patterns, examine data for recurring trends and relationships to create meaningful insights. Machine learning will use intuitive steps rather than a systematic approach to determine different trends which are distinct to every user. To use machine learning data obtained from the wearable sensor devices can provide can be stored a cloud computing platform and analyzed using machine learning tools.  Machine learning can be integrated into the application of smartphones. Machine learning provides precise analysis of the data of the user recognizing the diverse movement pattern for more comprehensive and accurate analysis (132).  Building awareness and digital literacyWearable technology is advancing quickly and rapidly, product development cycles can outpace testing, leading to upgraded products even before the product is comprehensively tested (133). The prevalence of wearable devices has necessitated for digital literacy to help effectively communicate with new technologies. In recent years, industries such as Google, Amazon, Facebook have scheduled announcements on the emergence of wearable and immersive technologies in transforming consumer markets and businesses (134). Acknowledging the anticipated outcomes of the new technologies, the 115th United States Congress created the Congressional Caucus on Virtual, Augmented and Mixed Reality Technologies in anticipation of the “tremendous potential for innovation in the fields of entertainment, education and healthcare” (134). Even though teaching digital technologies will become obsolete after some years, it is imperative to use teaching approaches that equips students for 21st century communications and for their future employment (135). Digital literacy can be enhanced through a collaboration with community libraries to provide programs and workshops on technological skills such us using emails, surfing on the internet(136). Libraries can engage people by providing training to new technologies such as artificial intelligence, robotics and 3D modeling (136). Promoting ethical data collection and sharingTo promote ethical data collection and sharing we can promote a logical border which enables anonymous user identification to maintain privacy and security in digital systems. This will use a unique identification that does not expose personal details of the user. This process can be enhanced by setting up default user account which has inbuilt logical borders that restricts engagement to the minimum level (119). To reduce problems with data privacy and security concerns will be to introduce block chain technology. This is a structure that securely records and validates transactions across computer networks. The structure utilizes natural language processing to guarantee adherence with privacy and security policies that are permitted to be stored on the block chain which cannot be interfered with (137). The use of wearables has rapidly increase in society because of its importance in communication, however it still lacks compatibility on rules and regulations for a seamless function (127). The first step is to have it in design elements that is all inclusive of the semblance, individual responses and social influences. (138). The future innovation should include how a user’s personal identification can be altered with the advancement of wearable devices.  Wearables should be designed to support the abilities of individuals especially those with disabilities, helping them to perform activities they find challenging to perform without any difficulty. This will help all individuals to build their identification and change them based on their conditions. Wearables becomes all-inclusive and accessible to everyone in society (127). Stakeholders be it private, public or individuals should intentionally be involved in the designing of these devices and in the governance framework to ensure that the finished product is an innovation of the old product which is functional to a large population. It prevents it from being under-utilized for the population it was manufactured for (138). There should be policy development clearly stating the goals, measurable outcomes and expected outcomes. Users should be educated of the effects of using wearable devices and methods of managing and retaining control of wearable devices to inform the users the kind of data is taken and stored by these wearable devices (138). Strengthening community partnershipsTo strengthen community partnerships, research teams should partner with the different community leaders of the community understudy. Relationships can be established through face-to-face meetings, programs such as seminars, fairs and health forums. Through these processes, community leaders volunteer to participate encouraging other inhabitants to also get involved in the study. This encourages continuous support from the community. ConclusionsIn conclusion, this paper has comprehensively explored the transformative potential of wearable devices in environmental justice and public health monitoring. Through detailed analysis of various sensor technologies, including air quality monitors, UV exposure sensors, and water quality sensors, we've established the critical role these devices play in empowering marginalized communities to actively engage in environmental health monitoring.The paper demonstrates how wearable technology offers a unique opportunity for real-time data collection and personalized health management, particularly in communities disproportionately affected by environmental hazards. These technologies not only enhance individual awareness of environmental risks but also provide valuable data that can inform policy decisions and public health interventions.Looking forward, the integration of advanced technologies such as AI and machine learning will further enhance the capabilities of these wearables, offering even more nuanced and accurate data analysis. However, challenges related to data privacy, security, and technological accessibility must be addressed to ensure these innovations benefit all segments of society equitably.As we continue to grapple with the complex interplay of environmental factors and public health, wearable devices stand out as powerful tools in the pursuit of environmental justice. By bridging the gap between communities and technology, these devices not only empower individuals with crucial health data but also contribute significantly to our collective understanding and management of environmental health risks. Acknowledgement  Conceptualization, E.O.-G.; methodology, A.M. and E.O.-G.; formal analysis, A.M.; investigation, A.M. and E.O.-G.; resources, E.O.-G.; data curation, A.M.; writing—original draft preparation, A.A.; writing—review and editing, A.M. and E.O.-G.; supervision, E.O.-G.; project administration, E.O.-G.; funding acquisition, E.O.-G. Funding Research reported in this publication was supported by the National Institute of General Medical Sciences of the National Institutes of Health under Award Number R16GM149473. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. 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Department of Built Environment, North Carolina A&T State University, Greensboro, North Carolina, United States of AmericaAbstract: Occupational determinants of health encompass a broad spectrum of workplace factors that wield considerable influence over an individual’s holistic well-being, encompassing physical, mental, and social dimensions. This viewpoint aims to provide an expansive and nuanced examination, evaluation, and definition of these determinants, elucidating the intricate interplay between one’s occupation and their health. Extensive research, including a meticulous review of qualitative and quantitative studies conducted between 2000 and 2023, has been undertaken to delineate occupational hazards prevalent across diverse professions. The findings underscore the pivotal roles played by biological and chemical hazards, alongside the intricate web of occupational and socioeconomic factors, in shaping the health landscape of workers. This comprehensive analysis not only highlights the varied dimensions of occupational health but also sheds light on the multifaceted nature of hazards, emphasizing their significant impact on the well-being of individuals within the workforce.Keywords: Occupational, workplace, health, United StatesCorrespondence: Emmanuel Obeng-Gyasi, PhD, MPH, Department of Built Environment, North Carolina A&T State University, Greensboro, NC 27411, United States. Email: [email protected]