Hematological impacts of environmental toxicants and sustainable strategies for prevention

Environmental toxicants represent a growing global health challenge due to their ubiquity, environmental persistence, and the complexity of human exposures. A wide spectrum of contaminants, including heavy metals, benzene and related organic solvents, pesticides, dioxins, particulate matter, and emerging pollutants such as PFAS, engineered nanomaterials, and microplastics, contaminate air, water, soil, and food chains. These exposures occur at chronic low doses and disproportionately affect vulnerable populations. The hematopoietic system is particularly susceptible because hematopoietic stem and progenitor cells continuously proliferate and directly interact with circulating toxicants and their metabolites. This narrative review synthesizes literature from 2000 to 2025 to examine how major environmental toxicants disrupt hematopoiesis, immunity, and leukemogenic pathways through oxidative stress, enzymatic inhibition, genotoxicity, immune dysregulation, epigenetic alterations, and microenvironmental injury. In parallel, it evaluates sustainable prevention strategies, including advanced water and soil remediation technologies, air pollution control, regulatory frameworks, occupational protections, biomonitoring systems, circular-economy models, and green-chemistry innovations. Future priorities include developing predictive multi-omics biomarkers, strengthening global biomonitoring, advancing safe-by-design chemical innovation, and enhancing regulatory enforcement within sustainability and planetary-health frameworks. Addressing these gaps is essential for mitigating hematotoxic risks and safeguarding population health.