Search

Climate change may be associated with human morbidity and mortality through direct and indirect effects. Ahvaz is one of the hottest cities in the world. The aim of this study was to investigate the relation between physiological Equivalent Temperature (PET) and non-accidental, cardiovascular and respiratory disease mortality in Ahvaz, Iran. Distributed Lag Non-linear Models (DLNM) combined with quasi-Poisson regression were used to investigate the effect of PET on death. The effect of time trend, air pollutants (NO2, SO2 and PM10), and weekdays were adjusted.The results showed that in cold stress [1st percentile of PET (2.7 °C) relative to 25th percentile (11.9 °C)] the risk of total respiratory mortality, respiratory mortality in men, and mortality in people under 65 year olds, significantly decreased in the cumulative lags of 0–2, 0–6 and 0–13; but the risk of respiratory mortality increased in the elderly and in the final lags. In contrast, heat stress [99th percentile of PET (44.9 °C) relative to 75th percentile (43.4 °C)] significantly increased the risk of total cardiovascular mortality (CVD), cardiovascular mortality in men, ischemic heart disease and cerebrovascular disease mortality in lags 0 and 0–2. It seems that high PET values increase the risk of cardiovascular mortality, while low PET values increase respiratory mortality only among the elderly in Ahvaz.

BACKGROUND: Occupational exposure to extremely low frequency electromagnetic fields (ELF-EMFs) may have harmful effects on biologic systems and has raised many concerns in the last decades. OBJECTIVE: The aim of this study was to determine the effects of exposure to extremely low frequency electric and magnetic fields on lipid peroxidation and antioxidant enzyme activities. METHODS: This study was conducted on 115 power plant workers as the exposed group and 145 office workers as the non-exposed group. The levels of Malondialdehyde (MDA), superoxide dismutase (SOD), Catalase (Cat), and total antioxidant capacity (TAC) were measured in the serum of all subjects. Exposure to ELF-EMFs was measured based on spot measurements and the IEEE Std C95.3.1 standard. RESULTS: The levels of MDA, SOD, and Cat in the exposed group were significantly higher than in the non-exposed group. However, the level of TAC was not significantly different between the exposed (2.45±1.02) and non-exposed (2.21±1.07) groups. The levels of MDA and SOD were higher among workers with higher exposure to electric fields than workers with low exposure. All oxidative stress indicators increased with increased exposure to magnetic fields, except TAC. CONCLUSIONS: The antioxidant system imbalance among power plant workers may be related to long term occupational exposure to electromagnetic fields.

Background There are few epidemiological studies on the relation between temperature changes and adverse pregnancy outcomes. The purpose of this study was to determine the relation between Physiological Equivalent Temperature (PET) with adverse pregnancy outcomes including stillbirth, low birth weight (LBW), preterm labor (PTL), spontaneous abortion (SA), preeclampsia and hypertension in Ahvaz, Iran. Methods Distributed Lag Non-linear Models (DLNM) combined with quasi-Poisson regression were used to investigate the effect of PET on adverse pregnancy outcomes. In this study the effect of time trend, air pollutants (NO2, SO2 and PM10), and weekdays were adjusted. Results High PET (45.4 C°, lag = 0) caused a significant increase in risk of stillbirth. Also, high levels of PET (45.4, 43.6, 42.5 C°, lag = 0–6) and low levels of PET (9.9, 16.9 C°, lags = 0, 0–13, 0–21) significantly increased the risk of LBW. But, low levels of PET (6.4, 9.9, 16.9 C°, lags = 0–6, 0–13) reduced the risk of gestational hypertension. Conclusion The results of this study showed that hot and cold thermal stress may be associated with increased risk of stillbirth, and LBW in Ahvaz.

Objectives Liveability is a multi-dimensional and hierarchical concept which consists of various criteria and sub-criteria and may be evaluated in different ways. The aim of this study was to systematically review indicators and methods used for the evaluation of urban liveability in literature. Content The five-stage methodological framework of Arksey and O’Malley was used to conduct this scoping review. A systematic search of electronic databases, including Scopus, Medline (via PubMed), Embase, Web of Science and EBSCO was done until May 29, 2019. Web searching, searching reference lists and hand searching was also conducted to retrieve more relevant articles. Two reviewers screened the papers for eligibility based on the inclusion criteria and extracted their key data and reported them descriptively. Summary Sixty seven (67) out of 3,599 papers met the selection criteria. This review showed five distinct domains considered to be important components of liveability. These were Economical, Environmental, Institutional, Social, and Governance (Political) domains. The most important subdomains (indices) which were frequently applied in various studies were Environmental friendliness and Sustainability, Socio-Cultural Conditions and Economic Vibrancy and Competitiveness. We also identified seven different methodologies and six ranking tools used for assessing urban liveability. Among the quantitative methods, three methods accounted for 89.6% of the articles. These methods were the Analytical hierarchy process and entropy (AHP; n=24; 50%), Factor analysis & Principle Component Analysis (FA & PCA; n=12; 25%) and Spatial Multi-criteria Decision-making Method (Spatial; n=7; 14.6%). Among the ranking tools used, three ranking tools accounted for 65.4% of the articles. These tools were the Livable City Scientific Evaluation Standards (LCSES; n=9; 34.6%), The Global Liveable Cities Index (GLCI; n=4; 15.4%) and the Economist Intelligence Unit (EIU; n=4; 15.4%). Outlook This paper discusses and summarizes the latest indicators and methods used for determining urban liveability. The information offered in the review can help future investigators to decide which method suits their purpose and situation better and measure urban liveability more systematically than before.

BackgroundIn recent years, lung cancer (LC) incidence has increased in Iran. The use of opium and its derivatives (O&D) has increased as well. This study aimed to investigate the association between the use of O&D and LC incidence.MethodsIn this case-control study conducted in Kerman, Iran; 140 patients with lung cancer and 280 healthy controls matched by age, sex, and place of residence were included. Data, including O&D use, cigarette smoking, alcohol use, and diet, were collected using a structured questionnaire. The relation between the use of O&D and LC was evaluated using conditional logistic regression adjusted for tobacco smoking, education, daily intake of fruit, vegetables, red meat, and hydrogenated fats.ResultsOpium ever-use was associated with an increased risk of LC (Adjusted Odds Ratio (AOR) =5.95, 95% CI: 1.87–18.92). Participants were divided into low and high use groups based on the median of opium use in the control group. A significant dose-response relation was observed between the amount of daily O&D use and LC; and the relation was stronger in high users (AORlow users = 3.81% CI: 1.13–12.77 and ORhigh users = 9.36, 95% CI: 2.05–42.72). Also, LC was higher among participants starting the use of O&D at younger ages (≤ 41 years old vs never users AOR = 8.64, 95% CI: 1.90–39.18) compared to those who started at an older age (> 41 years old vs never users, AOR = 4.71, 95% CI: 1.38–16.08). The association between opium, and lung cancer among non-smokers was OR: 6.50 (95% CI: 2.89 to 14.64).ConclusionThe results of this study show that opium use is probably a dose related risk factor for lung cancer.

BACKGROUND Mercury is one of the most well-known toxic metals for humans. Chloralkali workers are exposed to mercury vapours extensively, which may be associated with neurotoxicity. OBJECTIVE The aim of this study was to determine the associations between mercury concentration in blood and air samples, and mercury's neuropsychological effects among chloralkali workers. METHODS This study was conducted on 50 chloralkali workers as the exposed group and 50 non-industrial office workers as the unexposed group. All subjects were assessed using the Hamilton Depression Rating Scale, Piper Chronic Fatigue Scale and Essential Tremor Rating Scale. Mercury concentration was measured in blood and air samples using cold vapour atomic absorption spectrometry. RESULTS There was significantly more severe fatigue, depression and tremor in the exposed group compared with the unexposed group. The mean concentration of blood mercury in the exposed group was 22.59±12.5μgL-1 which was significantly higher than the unexposed group (1.28±1.05μg L-1). Based on multiple linear regression, shift work, smoking, fatigue, depression and tremor were predictor variables for blood mercury concentration. CONCLUSIONS This study indicated that this sample of chloralkali workers suffered from neuropsychological problems such as fatigue, depression and tremor, which is probably related to mercury exposure.

Objectives This study was designed to investigate the possible effect of exposure to extremely low frequency electromagnetic fields (ELF‐EMFs) on occupational burnout syndrome and the severity of depression experienced among thermal power plant workers and the role of oxidative stress. Methods In this cross‐sectional study, 115 power plant workers and 124 administrative personnel of a hospital were enrolled as exposed and unexposed groups, respectively, based on inclusion and exclusion criteria. Levels of oxidative stress biomarkers, including malondialdehyde (MDA), superoxide dismutase (SOD), catalase (Cat), and total antioxidant capacity were measured in serum samples. Exposure to electric and magnetic fields was measured using the IEEE Std C95.3.1 standard at each workstation. The burnout syndrome and the severity of depression were assessed using the Maslach Burnout and Beck Depression Inventory. Results The levels of MDA and SOD were significantly lower in the exposed group than the unexposed group. The exposed group reported a higher prevalence of burnout syndrome and higher depression severity. Multiple linear regression showed that work experience, MDA level, and levels of exposure to magnetic fields are the most important predictor variables for burnout syndrome and severity of depression. In addition, a decrease in the level of Cat was significantly associated with increased burnout syndrome. Conclusion The thermal power plant workers exposed to ELF‐EMFs are at risk of burnout syndrome and depression. These effects may be caused directly by exposure to magnetic fields or indirectly due to increased oxidative stress indices.

Background The Crimean-Congo Hemorrhagic fever (CCHF) is endemic in Iran and has a high fatality rate. The aim of this study was to investigate the association between CCHF incidence and meteorological variables in Zahedan district, which has a high incidence of this disease. Methods Data about meteorological variables and CCHF incidence was inquired from 2010 to 2017 for Zahedan district. The analysis was performed using univariate and multivariate Seasonal Autoregressive Integrated Moving Average (SARIMA) models and Generalized Additive Models (GAM) using R software. AIC, BIC and residual tests were used to test the goodness of fit of SARIMA models, and R2 was used to select the best model in GAM/GAMM. Results During the years under study, 190 confirmed cases of CCHF were identified in Zahedan district. The fatality rate of the disease was 8.42%. The disease trend followed a seasonal pattern. The results of multivariate SARIMA showed the (0,1,1) (0,1,1)12 model with maximum monthly temperature lagged 5 months, forecasted the disease better than other models. In the GAM, monthly average temperature lagged 5 months, and the monthly minimum of relative humidity and total monthly rainfall without lag, had a nonlinear relation with the incidence of CCHF. Conclusions Meteorological variables can affect CCHF occurrence.

Background: Researchers should seek applicable solutions and appropriate opportunities to solve or ravage barriers and limitations that worsen diabetes self-management and outcomes. Objectives: The aim of this critical review and research synthesis was to explore whether the enhancement of nutritional literacy can optimize diabetes self-management and to identify barriers and limitations that obstacle diabetes self-management and to suggest the best available solutions and opportunities that were tailored to eliminate these barriers. Methods: Data sources were PubMed and Medline databases. Studies were authorized if they were in English, used an observational or interventional design and were tailored based on the individual's nutritional knowledge or literacy in diabetes management among patients with diabetes. Databases were searched from February 1988 to December 2018. In order to evaluate the studies' quality, the abstracts that met PICO criteria for qualitative studies underwent dual review for data extraction. A qualitative synthesis was also conducted and the GRADE criteria were used to evaluate the quality of studies. Results: A structured inventory consisted of six constructs (socioeconomic determinants, cultural determinants, education, access to health care services, family structure, and thoughts and personal practices) was designed based on the barriers and limitations. As a result, 151 solutions and opportunities were proposed. Most repeated solutions that were frequently suggested to eliminate the existing barriers, were: “The access to optimal nutrition and health literacy”, “Improved health care services”, “Health policies of governments”, “Sustainable lifestyle-based healthcare system”, “Proper implementation of nutritional intervention programs”, and “Comprehensive culturally sensitive diabetes education, and care programs”. Conclusion: Identification and classification barriers and limitations to obstacle diabetes self-management are critical advances in accomplishing the interventions that can improve optimal diabetes outcomes, for different diabetic societies. Well-designed nutrition literacy intervention programs and preventive procedures may ameliorate the health status in diabetic population.

Extremely low-frequency magnetic fields (ELF-MFs) have raised some concerns due to their possible effects on workers’ health. In this study ELF-MFs were measured in different units of the thermal power plant based on gridding the indoor space. The exposure level was measured by spot measurement based on the IEEE Std C95.3.1 and then simulated in units with the highest magnetic field intensity by using ArcGIS software. The operators and balance of plant (BOP) technicians (12.64 ± 9.74 μT) and office workers (2.41 ± 1.22 μT) had the highest and lowest levels of both measured and estimated ELF-MFs exposure. The highest measured ELF-MFs were in the vicinity of the power transmission lines in the transformers’ building (48.2 μT). Our simulation showed the high and low exposure areas and ranked exposure well; but, the actual measurements of ELF-MFs exposure were in all cases higher than the estimated values, which means we still need to improve our estimations.

The health of workers in the concrete and cement industries can be at risk due to occupational exposure to silica dust. The purpose of this study was to evaluate the changes of pulmonary parameters and risk of mortality from lung cancer in concrete workers exposed to crystalline silica. This cross-sectional study was performed on 72 male workers exposed to silica at a concrete manufacturing plant in Neyshabur, Iran. Respiratory zone air sampling was performed using the standard NIOSH7602 method using individual sampling pumps and membrane filters. Then, the amount of silica in the samples was determined using the Fourier Transform Infrared technique. The risk of death from lung cancer was determined using Rice et al.’s model. Respiratory indices were measured using a spirometer. Data were analyzed by the SPSS 20 software. Occupational exposure to silica was 0.025 mg/m3 and mortality was estimated to be 7-94 per thousand. All spirometry indices significantly decreased during these 4 years of exposure to silica dust. The respiratory pattern of 22% of the exposed workers was obstructive and this prevalence was significantly higher than the control group. The results showed that although the average occupational exposure to silica in these concrete workers was below the recommended threshold of national and international organizations, their risk of death was significantly higher; and workers’ lung indices had significantly decreased over four years. Therefore, appropriate measures should be taken to reduce silica exposure among these workers.

Few studies have investigated the different extreme temperature effects (heat-cold) of one geographical location at the same time in Iran. This study was conducted to assess the impact of heat and cold waves on mortality in Urmia city, which has a cold and mountainous climate. Distributed Lag Non-linear Models combined with a quasi-Poisson regression were used to assess the impact of heat (HW) and cold waves (CW) on mortality in subgroups, controlled for potential confounders such as long-term trend of daily mortality, day of week effect, holidays, mean temperature, humidity, wind speed and air pollutants. The heat/cold effect was divided into two general categories A-main effect (the effect caused by temperature), B-added effect (the effect caused by persistence of extreme temperature). Results show that there was no relation between HW and respiratory and cardiovascular death, but in main effects, HW(H1) significantly increased, the risk of Non-Accidental Death (NAD) in lag 0 (Cumulative Excess Risk (CER) NAD = 31(CI; 4–65)). Also in added effects, HW had a significant effect on NAD (CER H1; NAD; lag;0-2 = 31(CI; 5, 51), CER H2; NAD; lag;0-2 = 26(CI; 6, 48)). There was no relation between CW and respiratory death and cardiovascular death, but in added effects, CW(C1) significantly decreased, the risk of non-accidental death in initial lags (CER C1; NAD; lag;0-2 = −19 (CI; −35, −2)). It seems that high temperatures and heat waves increase the risk of non-accidental mortality in northwest of Iran.

Aims and objectives To determine the prevalence and type of occupational injuries in nurses and their associations with workload, working shift, and nurses' individual and organisational factors. Background Nurses are vulnerable to occupational injuries due to the nature of their job. Design A cross-sectional correlational design (based on STROBE Statement) was conducted. Methods This study was conducted among 616 nurses of four public hospitals located in four different provinces in Iran. Data were collected using three questionnaires including an organisational and demographic questionnaire, an occupational injuries checklist and the NASA-TLX questionnaire (about mental workload). Chi-square test, one-way ANOVA and multivariate logistic regression were used in SPSS version 23.0 for statistical analysis. Results Blood and body fluid exposures had the highest prevalence (47.4%) among all injuries. Needlestick injuries showed a significant relation with gender, age, number of shifts in a month and work experience. With increase in mental workload, needlestick injuries increase by 35%. Also, injuries reported by nurses working in rotating shifts were 15%-53% more than nurses working in fixed shifts. Conclusion Working in rotating shifts and work overload was significantly related to all injuries. Decreasing nurses' mental workload, introducing guidelines and efficient training in shift work schedules can help decrease occupational injuries among nurses. Relevance to clinical practice In order to reduce occupational injuries among nurses, in addition to incorporating advanced management and technology, it is necessary to pay attention to psychosocial, individual and organisational risk factors related to occupational injuries and their frequency in nurses. Also, reducing personnel's mental and occupational pressure should be considered.

Background Heavy metals may be carcinogenic and have serious health effects in humans. In this study, levels of lead (Pb) and cadmium (Cd) in human milk samples from Kerman, Iran were evaluated. Methods One-hundred breast milk samples were collected from mothers visiting 20 maternal and child care centers. Demographic, diet and smoking data was collected for each mother. Samples were analyzed by Graphite Furnace Atomic Absorption Spectrometry. Statistical analysis was done in Minitab15, through non-parametric methods, Spearman’s correlation and chi-square. Results The mean ± sd of Pb and Cd was 53.6 ± 64.9 and 8.01 ± 15.5 μg/L respectively. The median (25–75 percentiles) of Pb and Cd was 34.00 (4.00–81.75) and 5.00 (4.00–7.00) μg/L; 6 and 17% of infants were receiving higher than recommended levels of lead and cadmium respectively. Mothers who took fat off their meat before eating and mothers who had a vaginal delivery had higher levels of Cd than others (p value = 0.04, 0.002). Non-primiparous mothers and those who consumed more yogurt had higher levels of Pb (p value = 0.011, 0.025). Conclusion Lead and cadmium contamination was considerable among mothers’ in Kerman, Iran. There is a need for decreasing the current levels in food, air, water and other consumer products such as cosmetics.

Background: Considering the importance of preventing smoking hookah in adolescents and the lack of a standard questionnaire in this field, this study aimed to develop and validate a Persian Preventing Hookah Smoking (PHS) Questionnaire in adolescents based on the Protection Motivation Theory. Materials and Methods: After conducting focus groups discussion, reviewing the literature and scientific resources, an initial self-administered questionnaire including 68 questions was designed and then validated. For face validity, the questionnaires were evaluated by 10 experts considering difficulty, inappropriateness, and ambiguity of the phrases. Both quality and quantity methods were used to evaluate the content validity. The content validity ratio (CVR) and the content validity index (CVI) were determined by a group of experts (10 people). Its internal consistency was estimated and its reliability was determined by the test-retest method. Confirmatory Factor Analysis (CFA) was done using Amos 21.0. Results: From 68 questions in the initial questionnaire, eventually 64 questions remained in the final questionnaire. The CVR value for most questions, except for 3 questions, was above 0.79 and the CVI value of all questions was above 0.79. The Cronbach’s alpha coefficient was 0.79-0.91 and the test-retest coefficient was 0.81-0.91. The results of CFA showed the following values, Chi-square (x2): 1254.712, degree of freedom (df): 3.456, adjusted goodness of fit index (AGFI): 0.964, the root mean square error of approximation (RMSEA): 0.072 which indicates the appropriateness of the tool among Iranian adolescents. Conclusion: The results of this study showed that this Persian questionnaire about preventing hookah smoking in adolescents based on the Protection Motivation Theory has a good validity and reliability and can be used in investigating about prevention of hookah smoking in adolescents.

Introduction In the process of treatment and prevention of relapsing to drug use, it is important to pay attention to mental health and supportive training interventions based on empowerment models. The present study was conducted to investigate the impact of training intervention based on the family - centered empowerment model upon the severity of damages caused by addiction among methamphetamine (MA) users. Material and methods This study was a randomized trial. Subjects were divided into the intervention (95 individuals) and control (95 individuals) groups, randomly. The data collection tools included a demographics checklist and the Addiction Severity Index (ASI) standard questionnaire which were completed before, and three and six months after the educational intervention. The educational intervention was conducted in nine 90-minute sessions using the 5As method, group discussion and distribution of educational pamphlets. Statistical tests like the independent and paired t-test were used to analyze data. Results The research findings indicated that the average scores of ASI subscales including family status, mental status and use of drugs were significantly different between before and three months after the training intervention in the intervention group (P Conclusions It was feasible to implement the family-centered empowerment model among MA users and it improved the severity of damages caused by drug abuse.

Aims: Osteoporosis is a major public health problem in the world, which can be prevented or its onset can be delayed through some lifestyle changes. The aim of this study was to assess the application of the precede-proceed model in promoting physical activity for prevention of osteoporosis among women. Materials and Methods: The present quasi-experimental study examined the application of precede-proceed model on the physical activity of 120 women with the age range of 15 to 49 years old, who were selected by multistage random sampling in Kerman in 2014. The participants were divided to the control (n=60) and intervention (n=60) groups. Among the preventive behaviors of osteoporosis, physical activity was selected for the educational intervention. The educational intervention lasted for 2 months. An international standard questionnaire was used to measure physical activity, and a researcher-made questionnaire, according to the constructs of precede model was used to collect data before and after the intervention. The data were analyzed by SPSS 20, using Mann-Whitney, Wilcoxon, and Chi-square tests as well as descriptive statistics. Findings: After educational interventions, the mean scores of predisposing, reinforcing and empowering factors, as well as osteoporosis preventive behaviors (physical activity) significantly increased only in the intervention group (p

Background & Aims of the Study: Noise is one of the most important environmental pollutants. It is a global health problem, especially among industrial workers. Since there was little information about noise levels in small workshops in Qom city, this study aimed to evaluate noise in small workshops and compare it with national standards. Materials and Methods: This was a cross-sectional study. Initially jobs and workshops that were causing noise pollution were identified. Then, noise was measured with a calibrated sound dosimeter, model CASELLA CEL-320, in A-network, in 108 working places. The results were compared with national noise standards. Results: The total number of workers in the workshops were 317 people, and inside the workshops 76.3% of the workers and 66.7% of the workshops were exposed to noise over the standard threshold. Outside the workshops, in 89% noise pollution was higher than the standard city values. Only 11% of noise pollution in the city workshops, had a 1 or less than 1 dB difference with the standard noise threshold. Conclusion: Small workshops cause a significant amount of noise pollution in Qom city. This can affect the workers’ and the public’s health. Noise control procedures such as controlling the source, and direction of noise distribution, as well as setting up workshops in the right location, and far from residential areas is necessary.

Background Metabolic syndrome (MetS) is a group of risk factors that are associated with increased risk for atherosclerotic cardiovascular disease. Objective The objective of this study was to determine the prevalence of metabolic syndrome and its individual components among Iranian bakery workers. Methods A cross-sectional study enrolling 163 randomly selected bakery workers from Semnan province (Northeast Iran), was conducted in 2017. A standard questionnaire was used for data collection. Analyses were performed using t-test, one-way ANOVA and Latent Class Analysis (LCA) in R software. Results The prevalence of MetS was 19.8% among bakery workers. More bakery workers with MetS had no regular exercise (p = 0.001) and worked more than eight hours a day (p = 0.001). In this study, the International Diabetes Federation (IDF) diagnostic criteria had more agreement with the American Heart Association (AHA) (49.1%) than the World Health Organization (WHO) and Adult Treatment Panel (ATP) criteria. Also, the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATPIII) had the highest sensitivity for diagnosing MetS. The sensitivity of the four diagnostic methods, WHO, IDF, ATP and AHA, were 45.2%, 61.7%, 67.9% and 64.8%; and their specificity were 98.2%, 100%, 100% and 100%, respectively. Conclusion The prevalence of MetS is high among bakery workers in Iran. Increased physical activity and intake of fruit and vegetables are recommended for the prevention of MetS.

Background: The present study aimed to investigate breast cancer trend, incidence, and mortality among Iranian women and was one of the first provincial and population-based studies to investigate breast cancer changes during 14 years in the largest province of Iran, Kerman. Methods: This was a population-based longitudinal study. Information about women diagnosed with breast cancer from 2001 to 2014 was obtained from the Cancer Registry of Kerman University of Medical Sciences. Independent-samples t test, one-way analysis of variance, linear regression, time series graphs, and fitted line plots were performed using SPSS 22 and Minitab 17.Results: A total of 2771 women were diagnosed with breast cancer in Kerman province from 2001 to 2014. The mean age of female patients was 49.52±12.88 years. The total incidence rate was 13.5 per 100,000 women and there was an increasing trend for incidence and age at diagnosis. Also, 254 women died from breast cancer during these 14 years and the mean mortality age was 54.16±14.33 years. There was also an increasing trend for mortality and age of death.Conclusion: There is an increasing trend for incidence and mortality from breast cancer in Kerman province and this requires interventions such as appropriate screening programs. Also, enabling physicians and increasing patient awareness to identify breast cancer symptoms is necessary.

Providing health care services has always been considered as a hazardous job due to a number of reasons. The risk of blood-borne viruses and the importance of their prevention has led to the formulation of principles called standard precautions (SPs). The goal of this study was to investigate the impact of an educational intervention based on the Health Belief Model constructs on the behavior of nurses in emergency centers regarding observing SPs in Sirjan, Iran. This was a quasi-experimental study. The study population included 100 emergency personnel working in health centers in Sirjan city (of Iran), who were randomly divided into two intervention (n = 50) and control (n = 50) groups. The educational intervention was conducted over two sessions each lasting for 60 min. Information was collected by a questionnaire (with 64 questions), completed in an interview conducted directly before the intervention and 3 months later. Data were analyzed using the χ2 test, t-test and paired t-test.The results showed nurses did not have enough information about SPs, but after the intervention, knowledge scores increased in both groups. In the Health Belief Model (HBM) constructs, significant differences were observed in perceived susceptibility, perceived severity, perceived benefits and barriers, cues to action and self-efficacy, after the intervention, in the intervention group (P0.001), but not in the control group (P0.05). HBM was effective in educating SPs among emergency personnel.

Background: Working at height has always been considered as one of the most dangerous industrial activities. Workers' fitness including their physical and psychological ability plays a key role in prevention of occupational accidents. This research was conducted to investigate the physical and mental fitness of telecommunication tower climbers as well as their job stress. Methods: This cross-sectional study was conducted among employees of a contracting company which worked in the field of telecommunication tower installation in Iran during 2016. Sixty out of 93 workers voluntarily participated in this study. Data collection tools were the Persian version of the Work Ability Index (WAI), the Persian version of the Health and Safety Executive (HSE) Stress Indicator Tool and an author-developed measure to assess socio-demographic characteristics. Data was analyzed through statistical tests such as independent t-test, univariate analyses of variance (ANOVAs), Pearson’s correlation coefficient, and multivariate linear regression; using SPSS 19 software. Results: Workers' mean ± SD WAI score was 29.17± 10.33 and for work-related stress was 3.08 ± 1.80. There was a significant relation between WAI and educational level, job tenure, hours of sleep per day, regular exercise, and second job. The repression modeling explained 67.4% of the total variance (adjusted R2) 0f the WAI score. Among the dimensions of work related stress, control (β = 0.21) and changes (β = -0. 40) were significant predictors of the WAI score. Conclusions: To improve the worker’s work ability, intervention programs should focus on promoting level of job control, sleep quality and exercise. Additionally, implementing a comprehensive macroergonomics and participatory program for increase involvement the workers in organization changes should be considered.

The present study was carried out with the aim of determining the effect of spiritual self-care training on the quality of life of mothers of preterm infants. This trial was carried out on 60 mothers with premature infants. Mothers were randomly divided into two intervention and control groups. Training for increasing awareness about the condition of the infants was carried out in both groups. In the intervention group, spiritual self-care training was also done. Data were completed in both groups before, immediately after, and two weeks after the intervention by using the standard WHO quality of life questionnaire. Data were analysed using statistical tests, including ANOVA and Repeated Measures. The results showed that the average quality of life of mothers under study was significantly different at different points of measurement in the intervention group (first, second, and third time-points) (P = 0.016). An increase was observed in the intervention group at the second time-point compared to the first time-point (84.2–88.4, P

There are few epidemiological studies about climate change and the effect of temperature variation on health using human thermal indices such as the Physiological Equivalent Temperature (PET) Index in Iran. This study was conducted in Tabriz, the northwest of Iran and Distributed Lag Non-linear Models (DLNM) combined with quasi-Poisson regression models were used to assess the impacts of PET on mortality by using the DLNM Package in R Software. The effect of air pollutants, time trend, day of the week and holidays were controlled as confounders. There was a significant relation between high (30°C, 27°C) and low (-0.8°C, -9.2°C and -14.2°C) PET and total (non-accidental) mortality; and a significant increase in respiratory and cardiovascular deaths in high PET values. Heat stress increased Cumulative Relative Risk (CRR) for total (non-accidental), respiratory and cardiovascular mortality significantly (CRR Non Accidental Death, PET=30°C, lag 0-30=1.67, 95%CI: 1.31-2.13; CRR Respiratory Death, PET=30°C, lag 0-13=1.88, 95%CI: 1.30-2.72; CRR Cardiovascular Death, PET=30°C, lag0-30=1.67 95%CI: 1.16-2.40). Heat stress increases the risk of total (non-accidental), respiratory mortality, but cold stress decreases the risk of total (non-accidental) mortality in Tabriz which is one of the cold cities of Iran.

Background: Noise pollution is the third most dangerous risk factor for human health after air and water pollution. The aim of this study was to evaluate the effect of noise pollution on sleep disturbance among Neyshabur governmental teaching hospital staff, Iran, in 2015. Materials and Methods: This cross-sectional study was conducted in winter 2015. The sample size was 261 people from 2 hospitals in Neyshabur. The instruments for data collection were a CELL440 sound meter and the Pittsburgh Sleep Quality Index (PSQI) questionnaire. Data were analyzed using SPSS software. Results: The mean sound level in the 22-Bahman and Hakim hospitals was 35.10 ± 8.79 dB and 44.60 ± 10.02 dB, respectively. 87 of the participants had poor sleep quality and 30 had to use sleeping pills to get to sleep. In 94.6, poor nocturnal sleep caused poor performance during the day. 69.3 of participants reported that it took more than 30 minutes for them to get to sleep. Work history and exposure to noise had an inverse association with sleep quality. For each unit increase in noise, the score of sleep quality decreased significantly by 0.6. Conclusions: Sleep quality can affect the performance of hospital personnel and can cause human errors in prescribing and injecting medications and other therapeutic interventions. It consequently has adverse effects on the patients. Therefore, necessary measures should be taken for reducing and controlling the noise, informing the personnel, changing shiftwork patterns, and allowing people to choose shift work voluntarily.

Background: External causes include accidents, injuries or health problems that arise immediately after accidents or other external factors. The purpose of this review was to collect information about the relation between temperature and mortality due to external causes. Methods: A systematic search of articles was conducted in PubMed, Scopus, Science Direct, Embase, and Web of Science until January 2017, with no restriction. Broad searches were conducted in all fields, using key words related to ambient temperature exposure and deaths due to external causes. Results: Nine articles were included in the study. Except two articles, one of which had been designed in a cross-sectional way and the other that was retrospective, the rest of the articles were ecological. The outcomes reported were heterogeneous and different metrics had been used in the results; therefore conducting of meta-analysis was not possible. Five articles had found direct and significant relations between high temperature and deaths due to external causes. Only one study found no relation. In the case of cold, one study showed that the proportion of death due to external causes was low during cold waves. Another study showed that there was no relation between cold waves and mortality due to external causes. But one article showed that death due to external causes increased on cold days, significantly. Conclusion: The results of this systematic review showed that high temperatures (heat) were more likely to cause mortality due to external causes than low temperatures (cold). Due to the small number of studies in this field, especially in the context of cold and death due to external causes, it is difficult to make robust conclusions.

Dendrimers are symmetric, round and ramose macromolecules made up of monomers which have a certain structural order. The aim of this study was to evaluate the antibacterial effects of different concentrations of G3-poly-amidoamine dendrimer (G3-PAD) on 7 species of gram-negative and gram-positive bacteria in aqueous solutions. Different concentrations of G3-PAD were prepared and from each bacterial species, a suspension with a different pH was prepared according to the McFarland 0.5 standard. Bacteria were left in a 37 degrees C incubator and shaker from 0 to 60 min, and were cultivated on a Mueller-Hinton Agar plate. The bacteria that grew on each plate were counted and analyzed. The results showed that the antibacterial effect of G3-PAD in aqueous solutions was directly related to dendrimer concentration, contact time and pH. The strongest effect on Salmonella and Bacillus Subtilis was at pH = 6.5 and 7.5 and contact time 45 min, and in pH = 9, contact time 30 min; for Enterococcus faecalis in all three pH, it was 60 min; for Staphylococcus Aureus in pH = 6.5 and 7.5, 60 min and in pH = 9, 30 min; for E. coli in pH = 6.5 and 7.5, 60 min and in pH = 9, 45 min. G3-PAD showed its strongest effect on Shigella bacteria in pH = 6.5, contact time 60 min. In pH = 7.5 there was no optimum condition and in pH = 9, the optimum contact time was 60 min. The strongest effect of G3-PAD on all species was seen in 2000 ppm concentration. These results show a new strategy to improve bacteria elimination from aqueous solutions. However, safely using dendrimers for disinfecting drinking water still needs more research.

Living in areas with high air pollution may have adverse effects on human health. There are few studies about the association between breathing polluted air and adverse pregnancy outcomes in the Middle East. The aim of this study was to determine the relationship between air pollution and spontaneous abortion, premature birth, and stillbirth in Ahvaz. A time-series study was conducted. Data about spontaneous abortion, premature deliveries, and stillbirth was collected from Ahvaz Imam Khomeini Hospital. Air pollution data including NO, CO, NO2, PM10, SO2, O3, and climate data were, respectively, collected from the Environmental Protection Agency and the Khuzestan Province Meteorology Office from March 2008 until March 2015. The relationship between air pollutants with the number of abortions, premature births, and stillbirths was found using a quasi-Poisson distributed lag model, adjusted by trend, seasonality, temperature, relative humidity, weekdays, and holidays. The average daily dust in Ahvaz on 7.2% days of the year was higher than 500 μg/m3 (very dangerous). Findings from this study indicate a significant association between each 10-unit increase in SO2 and spontaneous abortion in lag 0 and 9 days. There was a significant relation between each 10-unit increase in NO2 and CO, and premature birth in lag 0. Also, we found a significant association between each 10-unit increase in CO and premature delivery in lag 1; PM10 and premature delivery in lags 10, 11, and 12; and NO and premature delivery in lags 3, 4, 10, 11, 12, and 13 (p value

Background and aim: Work-related injuries are among the most important health problems in developing countries, such as Iran. The purpose of this study was to determine the epidemiology of work-related injuries among construction workers who had been insured by the Iranian Social Security Organization (ISSO). Methods: This is a cross-sectional study. The population included all construction workers who had a work- related accident during 2012 in Iran, which were recorded in the ISSO database after inspection. The effects of independent variables on injuries were estimated by logistic regression. SPSS software version 18 was used for analyzing the data. Results: Overall, 5352 work-related injuries were investigated. The incidence rate of fatal and nonfatal injuries was 0.07 in 1000 and 11.18 in 1000 workers, respectively. More than half of these accidents were due to careless activities. A younger age at the time of the accident (OR=0.98, CI: 0.97-0.99, p=0.001), being married (OR=1.37, CI: 1.04-1.79, p=0.02), place of accident (OR=1.86, CI: 1.18-2.92, p=0.007), lack of information (OR=5.28, CI: 1.57-17.75, p=0.007), disrespect of safety regulations (OR=3.11, CI: 1.87-5.17, p=0.001), non-use of protective equipment (OR=2.98, CI: 1.62-5.50, p=0.001), and defective equipment (OR=2.22, CI: 1.18-4.20, p=0.01) had a significant effect on the incidence of work-related injury. Conclusions: The pattern of work-related injury in Iran was almost similar in regard to age, gender, cause and type of the accident, with other parts of the world.

Diurnal Temperature Range (DTR) is a meteorological index which represents temperature variation within a day. This study assesses the impact of high and low values of DTR on mortality. Distributed Lag Non-linear Models combined with a quasi-Poisson regression model was used to assess the impact of DTR on cause, age and gender specific mortality, controlled for potential confounders such as long-term trend of daily mortality, day of week effect, holidays, mean temperature, humidity, wind speed and air pollutants. As the effect of DTR may vary between the hot season (from May to October) and cold season (from November to April of the next year), we conducted analyses separately for these two seasons. In high DTR values (all percentiles), the Cumulative Relative Risk (CRR) of Non-Accidental Death, Respiratory Death and Cardiovascular Death increased in the full year and hot season, and especially in lag (0−6) of the hot season. In the cold season and high DTR values (all percentiles), the CRR of Non-Accidental Death and Cardiovascular Death decreased, but the CRR of Respiratory Death increased. Although there was no clear significant effect in low DTR values. High values of DTR increase the risk of mortality, especially in the heat season, in Urmia, Iran.

Background & Aims of the Study: The Horizontal roughing filters (HRF) are generally formed with three layers. The size of the course at the beginning of the flow path is large and at the end is small. This kind of layering increases absorption capacity while the solids entering the bed–depth gradually separate because of the decline in the holes’ diameters. This study aimed to examine the efficiency of HRFs in removing total suspended solids (TSS) from effluent of a waste stabilization pond. Materials & Methods: This experimental study was conducted in 2013. The pilot project was transferred to the Karaj wastewater treatment plant (waste stabilization pond), Alborz province of Iran. Then, the installation, equipping and start-up of the system began, using an effluent treatment plant. Sampling was done from March to August in 3 rates of 0.5, 1 and 1.5 m/h, which was included simultaneous sampling from inlet and outlet HRF to determine the concentrations of TSS. Results: The results showed that at filtration rates of 0.5, 1, and 1.5 m/h, the average of TSS removal was equaled to 42.46, 56.65 and 33.22%, respectively. The removal efficiency of TSS at the rate of 1m/h was more than 0.5 and 1.5 m/h rate (p

Objectives: Type A influenza is an upper respiratory tract disease. This study evaluated the efficiency of education based on the Health Belief Model (HBM) in promoting the knowledge, attitude and practice (KAP) of pregnant women about preventing influenza type A in Sirjan, Kerman. Materials and Methods: This was a quasi-experimental study. The population under study were 200 pregnant women who visited the health centers of Sirjan. These people were randomly divided into intervention (n = 100) and control (n = 100) groups. The educational intervention was conducted over two 60-minute sessions. Information was collected through a questionnaire (71 questions) before the intervention and three months after it. Chi-square test, Fisher exact test, independent t test, paired t test and Pearson correlation coefficient were calculated. Results: After the intervention, the knowledge score increased in both groups; this was probably due to the routine training programs at those centers, but significant increases in attitude and practice were only observed in the intervention group (P < 0.05). Furthermore, perceived susceptibility, perceived severity, perceived benefits, cues to action and efficacy increased significantly and perceived barriers decreased significantly in the intervention group. Conclusions: HBM was effective in promoting the KAP of pregnant women in Sirjan for preventing type A influenza. Therefore, HBM can be used to help prevent influenza A in the pregnant women.

Background: The reuse of treated municipal wastewater is an important source of water for different purposes. This study evaluated the efficiency of the electrocoagulation process in removing turbidity, total suspended solids (TSS), chemical oxygen demand (COD), nitrate, and phosphate from wastewater at the treatment facility in Karaj, Iran. Methods: This experimental study was performed at a pilot scale and in a batch system. A 4-liter tank made from safety glass with 4 plate electrodes made from aluminum was unipolarly connected to a direct current power supply with a parallel arrangement. Wastewater samples were taken from the influent at the Karaj wastewater treatment facility. Rates of turbidity, TSS, COD, nitrate, and phosphate removal under different conditions were determined. Results: The highest efficiency of COD, TSS, nitrate, turbidity, and phosphate elimination was achieved at a voltage of 30 volts and a reaction time of 30 minutes. The rates were 88.43%, 87.39%, 100%, 80.52%, and 82.69%, respectively. Conclusion: Based on the results of this study, electrocoagulation is an appropriate method for use in removing nitrate, phosphate, COD, turbidity, and TSS from wastewater.

God Locus of Health Control (GHLC) scale is an instrument for assessing to what extent one believes that God controls his/her health or disease. The aim of this study was to describe the cultural adaptation of this scale and to investigate the psychometric properties of Persian version. At first, the scale was forward-translated to Persian, and then, backward-translation was conducted. Finally, the synthesized back-translated version was prepared and compared to the draft Persian-language version of the GLHC. In the next step, in order to test cognitive debriefing, the Persian-language version of the questionnaire was completed by 20 pilgrims. Final version of Persian GHLC scale was answered by 600 pilgrims attending religious holy places. Mean age of respondents was 33.15 (±11.04) years. There was a positive correlation between six items of GLHC scale and inter-item correlation coefficients. The Cronbach's alpha coefficient was 0.84. Exploratory factor analysis showed that the G LHC scale had a one-factor structure. The factor loadings for all items ranged from 0.57 to 0.77. Residual correlations of all items were between -0.2 and +0.2. The people with lower income had significantly higher score of GLHC scale. GLHC scale score had a significant positive correlation with DUREL subscale and MHLC Chance Externality subscale score. There was no a significant correlation between GLHC scale score and Multidimensional Health Locus of Control (MHLC) Internality and Powerful subscales scores. The results of the present study showed that the Persian version of GHLC scale has acceptable factorial validity and internal consistency reliability.

Background: Congenital hypothyroidism (CH) is a common endocrine disease and an important cause of mental retardation. The purpose of this study was to investigate the probable role of season and climatic factors in the incidence of CH in Kerman province, Iran. Methods: Incidence data were collected from the CH screening program files from 2005 to 2011 in Kerman province, a number of 288,437 infants were included in the study. Climate data were collected from the Meteorological Office. The relations were tested by χ2-test, Pearson correlation, and negative binomial regression. Results: The overall incidence of CH in Kerman province was 2.68 per 1000 births. There was a significant difference in both the monthly and seasonal incidence of CH (p Conclusions: It seems like there is no clear relation between CH incidence and climate factors, in Kerman Province. However, CH incidence was highest in October (Autumn) and lowest in June (Summer).

Introduction: Tuberculosis (TB) treatment failure is one of the major problems of the health sector in developing countries. Poor treatment of patients leads to drug resistance, relapse, death, and ultimately prevents TB control programs. This study was conducted to determine the factors affecting tuberculosis treatment failure in Khorasan and Sistan- Balochistan regions which have a high prevalence of TB. Methods: In this case - control study 270 patients with tuberculosis (90 cases, 180 controls) were analyzed. New TB patients registered with failure to treatment according to the national protocol between March 2008 - March 2012 were chosen as cases and new TB patients with negative sputum smear in the same time frame were enrolled as control group. Demographic data and clinical treatment outcomes were collected through interviews and file records. Multivariate logistic regression analysis was used to determine the predictors of treatment failure in SPSS 19. Results: Independent factors and predictors of failure treatment included illiteracy, a three plus positive sputum smear, positive sputum smear at end of the second month, non-implementation of the Directly Observed Treatment Short strategy by healthcare staff, history of addiction and history of diabetes. Conclusion: Intervention programs for early detection and control of diabetes, drug control programs, giving priority to providing DOTS by health care workers, more individual care and attention to patients with initial smear p + 3 or those that remain sputum positive at the end of the second month or those who are less educated is necessary. J Microbiol Infect Dis 2016;6(4): 172-178

Copper contamination is increasing and can be a threat to human health. This review tries to summarize copper levels measured in humans in Iran. Persian databases such as SID, Magiran, and IranMedex and English databases such as Scopus, Pubmed, Science Direct, and the Google Scholar were searched using both English and Persian keywords. Twenty-six articles that measured the concentration of copper in human samples in Iran were included. According to the results of the reviewed studies, copper levels in some Iranian populations were higher than normal levels. These populations included pregnant women with preeclampsia, patients with oral cancer, patients with Giardiasis infection, patients with Parkinson's, children under the age of 12 years with β-thalassemia major, pregnant women in the third trimester, and type 2 diabetic patients. Copper levels were less than normal, in patients with tuberculosis after treatment and post-menopausal women with osteopenia and osteoporosis. Also, copper concentrations in patients with tuberculosis, cutaneous leishmaniasis, brucellosis, and molybdenum unit workers were higher, and copper concentrations in patients with Pemphigus vulgaris and coronary artery disease were less than those of their controls, but all were in the normal range (70-140 μg/dL). The amount of copper adsorption in various teeth was different. High levels of copper have been reported in some Iranian populations and this can be a threat to human health. Monitoring copper levels in some Iranian populations is necessary.

Malaria is a major health problem in many tropical and subtropical countries and in the south of Iran. In this study, due to the importance of the disease in Sistan and Baluchestan province, the influence of temperature, humidity, and rainfall on malaria has been evaluated in areas with a high incidence of malaria. Malaria incidence data were inquired from the Province Health Authority, and climatic variables were inquired from the Bureau of Meteorology from 2000 to 2012 and were analyzed on a monthly basis. Changes in incidence of malaria with climatic factors were analyzed by negative binomial regression by Stata 11, and the correlations were calculated with Minitab15 for determining the potential impact of meteorological variables with and without lags on malaria transmission. The incidence of malaria had a significant positive correlation with the average, minimum, and maximum monthly temperatures and a negative correlation with rainfall and low humidity (60% had a positive impact on incidence; as in the town of Chabahar after adjusting variables such as rainfall and temperature; every one percent increase in humidity caused a 4% increase in malaria incidence in the same month and a significant 6% increase in the next month. Temperature and humidity over 60% are effective climate parameters in the incidence of malaria. These factors should be considered in planning for controlling and preventing malaria.

Background: We sought to evaluate the effect of educational intervention based on the theory of planned behavior (TPB) on nutritional behaviors in relation to the cardiovascular disease (CVD) among health volunteers. Methods: In this quasi-experimental study, the participants included 128 active health volunteers. To conduct the study, 65 and 63 participants were randomly assigned into the intervention and control groups, respectively. Data were collected before and six weeks after the intervention using a validated researcher-made questionnaire. The questionnaire consisted of demographic variables, knowledge questions, and TPB constructs. Data were analyzed by Chi-square, t-test, Mann-Whitney U, and Wilcoxon test. Results: No significant difference was observed between the intervention and control groups with regard to the demographic characteristics, knowledge mean scores, and TPB constructs at the beginning of the study. However, the mean scores of knowledge, attitude, subjective norms, perceived behavioral control (PBC), and nutritional behavior increased significantly (P < 0.001, P < 0.001, P = 0.018, P = 0.007, and P < 0.001, respectively) in the intervention group six weeks after the beginning of study. Significant differences were observed in nutritional performance of the intervention group, in other words the nutritional behavior of the intervention group members changed during the intervention. Conclusion: The PBC was the strongest construct in attitude. To optimize nutritional interventions in preventing the CVD, TPB should be implemented in educational interventions.

In recent years, the geographic information system (GIS) application has used the latest spatial data to help researchers make the right decisions in the shortest time. This study was conducted with the aim of using geographic information systems (ArcGIS) for selecting the best location for installing banners and billboards in a health campaign. This research was an analytical and applied research conducted in Sirjan city, Iran in 2018. In this research, GIS and fuzzy logic methods were used. In order to implement the fuzzy operator in the GIS environment, initially, the main influencing criteria in location selection were determined. Then the weighted layers were put on top of each other and, by considering the sub criteria, the most suitable places to install banners and billboards were identified in the final map. The final map showed the best places to install billboards and educational banners for the ‘hookah is the enemy of health’ campaign. The final number of these places was 30 according to the main criteria, and the number was reduced to 25 places, after considering the sub criteria. ArcGIS can be used in selecting the best locations for installing banners and billboards in a health campaign.

Background: Educational material is frequently used by health providers to inform adolescences about the health hazards of hookah. However, little attention has been paid to the readability and suitability of these adolescent educational materials. Objectives: The aim of this study was to determine the readability and suitability of adolescent educational material in preventing hookah smoking. Patients and Methods: Multiple authoritative resources were chosen for the design and preparation of educational material and were then tailored to the target group. Readability was measured by using the readability assessment of materials (RAM); and suitability was determined by the suitability assessment of materials (SAM) that considers characteristics such as content, graphics, layout/topography, and cultural appropriateness. Fifteen reviewers, including 10 adolescents and 5 health experts scored the educational material. Results: The mean readability score ± standard deviation (SD) of the educational media was 9 ± 1.9, 10 ± 1.1, and 9 ± 1.7, for the pamphlet, brochure, and poster, respectively, which were increased to 15 ± 1.3, 17 ± 0.7, and 16 ± 1.5 after tailoring the content. The average SAM scores before and after tailoring the content were 79% for the pamphlet, which was increased to 90%; 81% for the brochure, which was increased to 93%; and 79% for the poster, which was increased to 93%. The increase in all scores was significant (P < 0.05). The final tailored educational material was rated “superior media” on the SAM ratings. Conclusions: The findings indicated that the readability and suitability of the educational material were increased. Compliance with these recommendations may increase the likelihood of consumer perception and recall.

Iran has variations in the incidence of cancer in its different provinces. Moreover, it is one of the countries with a high incidence of gastrointestinal cancers in the world. The aim of this study was to investigate the relation between the incidence of esophageal, stomach, and colon cancers with ultraviolet radiation. This is an ecological study. The age-standardized incidence of cancer from 2004 to 2008 was obtained from the National Cancer Registry of Iran for all provinces. UV index data was taken from the world weather site. The altitude and latitude of cities were obtained from the National Topography Organization. Demographic variables were taken from the STEPS report of the Ministry of Health. In this study, lung cancer were used as the index of the effects of smoking. Data were analyzed using the SPSS22 software and through linear regression. UV emission levels showed a strong negative correlation with the incidence of esophageal and gastric cancers, in both genders, in all years. However, this correlation was stronger in men. UV radiation showed a significant correlation with colon cancer among both genders as well. There was no relation between altitude and incidence of cancer. Linear regression results showed that with a unit increase in UV, the incidence of gastric and esophagus cancers in males decreases by β = -4.99 and β = - 3.16 significant coefficients, respectively. Cities with higher levels of UV index have a relatively lower incidence of gastrointestinal cancers. Ultraviolet radiation may act as a protective factor against these cancers.

Occupational exposure to lead compounds can cause headache, nausea, encephalopathy, anemia, chronic muscle pain, and saturnism. Exposure to lead in women can affect fertility, and cause abortion or low IQ in the offspring. The aim of this study was to investigate occupational exposure to lead and its relation with blood lead levels in female electrical parts solderers. This cross-sectional (descriptive and analytical) study was carried out on 40 female solderers, working in two electrical parts manufacturing factories in Neyshabur city in 2017–2018. Occupational exposure to lead was determined by the OSHA 121 method, and the NIOSH 8003 method was used to determine the concentration of lead in blood. Lead in blood and air samples were determined by using a flame atomic absorption analyzer. Blood was measured using a Cell Dyn Hematology device. Data were analyzed using STATA 15. The mean age of the solderers was 35.42 ± 6.80 years, and their average work experience was 7.85 ± 5.60 years. Mean occupational exposure to lead was 0.09 ± 0.01 mg/m3, and the mean levels of lead in the blood of solderers were 10.59 ± 3.25 μg/dL. The mean of red blood cells (RBC) was 4.88 mil/uL, white blood cells (WBC) = 8.53 Tho/uL, hemoglobin = 14.02 g/dL, and hematocrit = 42.38%. There was a significant correlation between the concentrations of lead in air and the level of lead in workers’ blood (p = 0.012, r = 0.31). The level of lead in the workers’ respiratory region (β = 0.36, p = 0.033), body mass index (β = 0.25, p = 0.028), and the season of the year (β = 0.21, p = 0.019) were the strongest factors affecting blood lead levels. There was a significant relation between lead in workers’ air and their blood, although all blood indices were in normal range. Using lead-free alloys and local ventilation systems, and reducing exposure times are recommended to decrease exposure to lead among solderers.

Lead is one of the most widely used elements in the world. Lead can cause acute and chronic complications such as abnormal hemoglobin synthesis, kidney damage, abortion, nervous system disorders, male infertility, loss of learning ability, behavioral disorders, and even death. The aim of this study was to carry out quantitative and semi-quantitative risk assessments of exposure to lead among the solderers of the Neyshabur electronics industry. This cross-sectional, descriptive, and analytical study was conducted in 2017 and 2018 on 40 female soldering workers exposed to lead. Semi-quantitative risk assessment was carried out according to the Singapore Health Department and quantitative risk assessment according to the Office of Environmental Health Hazard Assessment (OEHHA) method. The average occupational exposure to lead in the electronics manufacturing industry was 93.89 ± 33.40 μg m-3 with a range from 9 to 150 μg m-3. Occupational exposure to lead in the industrial groups of initial soldering with an average of 130.37 ± 40.23 μg m-3 and cutting wires, electroplating, and coating bare parts with an average of 110.24 ± 30.11 μg m-3 was higher than the secondary soldering groups with an average of 90.78 ± 20.22 and shift supervisors with an average of 43.86 ± 10.97 μg m-3. The mean excess lifetime cancer risk (ELCR) was 0.11 per 1000 people and the mean non-carcinogenic risk (HQ) was 7.20. The results of this study indicate that there is a risk of non-carcinogenic complications among electronic solderers. Therefore, managers and employers should reduce lead exposure through engineering controls (substituting lead-free alloys, efficient ventilation) and management strategies such as reducing exposure hours.

BACKGROUND Several studies have suggested that temperature may have an effect on the number of cardiovascular deaths in societies. Global warming is a concern, and cardiovascular diseases are the top cause of death worldwide. This study investigated the relation between temperature and cardiovascular mortality in Shiraz City, Iran. METHODS In this ecological study, data about temperature and cardiovascular deaths (in age and gender groups) in Shiraz City were inquired from 2006 to 2012. The simultaneous and delayed relation between monthly temperature and cardiovascular deaths was examined using Spearman and Pearson correlation tests, and crude and adjusted negative binomial regression analysis with adjustment for confounding factors such as humidity, rainfall, wind direction, wind speed, and air pollutants. Analysis was done using MINITAB and STATA software. RESULTS During this period 17,167 deaths were reported in Shiraz. The lowest number of cardiovascular deaths was reported in 20 °C. No significant relation was observed between mean monthly temperature and cardiovascular deaths in the same month after adjusting for confounding factors. Although, cardiovascular death in 18- to 60-year-old people showed an inverse significant relation with minimum [Incidence rate ratio (IRR) = 0.98989, P = 0.020], maximum (IRR = 0.99046, P = 0.011), and mean temperature (IRR = 0.98913, P = 0.006) of the same month in the crude model, it was not significant in the adjusted model (IRR = 0.99848, P = 0.848, IRR = 0.99587, P = 0.584, and IRR = 0.99512, P = 0.506, respectively). CONCLUSION It seems that there is no significant relation between temperature and cardiovascular deaths in Shiraz, which is probably due to its moderate climate, and the fact that no major heat or cold wave occurred during this time.

Plastic injection industry workers are exposed to toxic gases and vapors, including styrene. This study aimed to measure exposure to styrene and its relation with urine mandelic acid among plastics injection workers of the electrical parts industry. This descriptive and analytical cross-sectional study was carried out in the plastic injection halls of the electronics industry, in winter 2017 and spring 2018. Styrene gas in the workers’ respiratory region was sampled by the NIOSH 1501 method and was analyzed by gas chromatography–mass spectrometry (GC/MAS). Mandelic acid concentration was determined by high-performance liquid chromatography (HPLC). Statistical data analysis was performed with STATA11. The mean of age and working experience in the population under study were 32.4 ± 8.1 and 6.4 ± 5 years, respectively. The average exposure to styrene was 83.2 ± 32.4 mg·m−3 and the mean of urine mandelic acid was 1570.1 ± 720.6 mg·g ceratinine−1. There were 24 workers (45.3%) exposed to levels above permissible limits recommended by national and international organizations. There was a positive and significant correlation between exposure to styrene and urine mandelic acid (P = 0.006, r = 0.4). In multivariate regression, occupational exposure to styrene (P = 0.002, β = 0.5) was the strongest variable, predicting the amount of urine mandelic acid. Increased occupational exposure to styrene increases mandelic acid in the urine, and applying control measures to reduce exposure to styrene vapor is recommended in high exposure situations.

Extremely low frequency electromagnetic fields (ELF-EMFs) are not known as definite occupational carcinogens, but some studies have reported the genotoxic effects of these fields on cell lines. The present study aimed to evaluate the effects of long-term occupational exposure to these fields on DNA damage. In this cross-sectional study, blood samples were taken from 102 thermal power plant workers as the exposure group and 136 subjects as the unexposed group. DNA damage was evaluated using alkaline comet assay and flow cytometry. Exposure to ELF-EMFs was measured based on spot measurements and the IEEE Std C95.3.1 standard. The indices of comet assay, tail DNA percent, tail factor (%), and damage index were significantly higher in the exposed group compared to the unexposed group. Increased exposure to magnetic fields enhanced comet assay indices, except tail length; while exposure to electric fields had no significant effect on such indices. The percentage of cells at early apoptosis and late apoptosis phases caused by exposure to magnetic fields, respectively, decreased and increased significantly. Long-term occupational exposure to ELF-EMFs can probably cause genotoxic effects.

Background: Traffic accidents is one of the main causes of mortality, and has a high impact on overall health and development. Iran is a country with a high prevalence of traffic accidents, and this has been a big concern. In this study, we aimed to study the past decade’s trend in mortality due to traffic accident in Kerman, Iran, and its relation with ambient temperature by using Generalized Additive Mixed Models. Methods: Meteorological data, such as temperature, humidity, and wind speed were obtained from the Meteorological Organization of Kerman and traffic mortality data were obtained from the Health Deputy of Kerman University of Medical Sciences. In order to explore the relations, Generalized Additive Mixed Models (GAMMs) were used. Additive models are nonparametric forms of regression models in which the summation of regression coefficients × explanatory variables of a linear regression is replaced by a summation of arbitrary smooth functions of the explanatory variables. Results: About 2900 deaths due to traffic accident occurred from March 2005 until May 2017 in Kerman. The monthly average deaths were 20.01(±14.43) that was more for men than women (15.42 vs 4.58), and was highest in the age 31-60 group. Non-linear effect of time on mortality was significant. There was a negative effect of time on mortality until 2009, while all other confounders were adjusted. After a short-term increasing trend till early 2011, and then a decreasing trend until 2013, an increasing trend was observed again. Holding pollutants, temperature and year (trend effect) stable, mortality tended to be higher for the first half of year, with an increasing slope in the first 3 months of the year. Monthly average temperatures below 13°C was related with increased mortality, but average temperatures around 20°C had no effect on mortality. High temperatures (>23°C) were associated with less mortality. Conclusions: Most traffic accident related deaths occurred in first half of year (spring and summer), and it is probably because of increased inter-city traveling during the summer break. Our results showed that high extreme temperatures have less contribution on the mortality. Keywords: Accident, Mortality, Trend, Ambient Temperature