Healthy, uncontaminated soils and clean water support all life on Earth and are essential for human health. Chemical pollution of soil, water, air and food is a major environmental threat, leading to an estimated 9 million premature deaths worldwide. The Global Burden of Disease study estimated that pollution was responsible for 5.5 million deaths related to cardiovascular disease (CVD) in 2019. Robust evidence has linked multiple pollutants, including heavy metals, pesticides, dioxins and toxic synthetic chemicals, with increased risk of CVD, and some reports suggest an association between microplastic and nanoplastic particles and CVD. Pollutants in soil diminish its capacity to produce food, leading to crop impurities, malnutrition and disease, and they can seep into rivers, worsening water pollution. Deforestation, wildfires and climate change exacerbate pollution by triggering soil erosion and releasing sequestered pollutants into the air and water. Despite their varied chemical makeup, pollutants induce CVD through common pathophysiological mechanisms involving oxidative stress and inflammation. In this Review, we provide an overview of the relationship between soil and water pollution and human health and pathology, and discuss the prevalence of soil and water pollutants and how they contribute to adverse health effects, focusing on CVD.

健康、未受污染的土壤和清洁的水支撑着地球上的所有生命，对人类健康至关重要。土壤、水、空气和食品的化学污染是主要的环境威胁，估计导致全球 900 万人过早死亡。全球疾病负担研究估计，2019 年，污染导致 550 万人因心血管疾病 (CVD) 死亡。强有力的证据表明，重金属、农药、二恶英和有毒合成化学品等多种污染物与心血管疾病风险增加有关。一些报告表明微塑料和纳米塑料颗粒与 CVD 之间存在关联。土壤中的污染物会降低其生产粮食的能力，导致农作物出现杂质、营养不良和疾病，并且它们会渗入河流，加剧水污染。森林砍伐、野火和气候变化引发水土流失并将隔离的污染物释放到空气和水中，从而加剧污染。尽管污染物的化学组成各不相同，但污染物通过涉及氧化应激和炎症的常见病理生理机制诱发CVD。在这篇综述中，我们概述了土壤和水污染与人类健康和病理学之间的关系，并讨论了土壤和水污染物的流行情况以及它们如何对健康产生不利影响，重点关注心血管疾病。