Environmental exposures and health outcomes in Augsburg, Germany: a systematic review

Abstract Background Environmental exposures such as air pollution and extreme temperatures are major public health concerns. This systematic review synthesized epidemiological evidence from Augsburg, Germany, to assess local health impacts and contextualize them within global findings. Methods A comprehensive literature search was conducted across PubMed and Web of Science for studies published from 2000 to 2025. Thirty eligible studies were identified, focusing on environmental exposures and health outcomes, including cardiovascular, respiratory, metabolic, and subclinical endpoints. Results Air pollutants such as PM 2.5 , NO 2 , and ultrafine particles were consistently associated with cardiovascular events, inflammation, and metabolic disturbances. Notable findings include elevated myocardial infarction (MI) risks and cancer-related mortality linked to pollution. Temperature extremes were associated with increased cardiovascular mortality and MI, with stronger effects observed in Augsburg than global averages. Vulnerable populations—particularly older adults, people with diabetes, and those with low BMI—were consistently more affected. Few studies addressed children or long-term impacts. Conclusion Augsburg-specific evidence supports global findings on the adverse health effects of environmental stressors but suggests locally heightened sensitivity. Findings reinforce the need for regional health preparedness, targeted interventions, and future research addressing long-term and vulnerable populations.