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In this study, oxidative stress was investigated as the possible mechanism of action of organochlorine pesticides (OCPs) and organophosphorus pesticides (OPPs) in primary brain tumors (PBT). The levels of seven OCP residues and enzymatic antioxidant biomarkers including erythrocyte acetylcholinesterase (AChE), superoxide dismutase (SOD), glutathione peroxidase (GPx), catalase (CAT), and paraoxonase-1 (PON-1) along with non-enzymatic oxidative biomarkers including malondialdehyde (MDA), protein carbonyl (PC), total antioxidant capacity (TAC), and nitric oxide (NO) were measured in blood samples of 73 patients with PBT and 104 healthy controls. A significant association was found between farming activities and PBT (55% of patients were engaged in farming activities while 45% had no farming experience). The mean levels of β-HCH, γ-HCH, 2,4 DDE, 4,4 DDE, 4,4 DDT, MDA, PC, NO, SOD, CAT, and GPx were significantly higher in PBT patients, whereas the levels of TAC, PON-1, and AChE were significantly lower in these patients. Regression analysis showed that PBT was correlated with β-HCH, γ-HCH, 2,4 DDE, 4,4 DDE, and 4,4 DDT. Based on these results, it can be concluded that OCPs and OPPs may play a role in PBT development through the formation of reactive oxygen species (ROS) and promoting oxidative stress.

The aim of this study was to investigate exposure to dust, and metal fumes, changes in pulmonary function indices among industrial workers to estimate the carcinogenic and non-carcinogenic risk of exposure to occupational metal fume.br /br /Methods: This cross-sectional study was performed on 98 workers exposed to metal fumes. Air sampling was performed according to the NIOSH 0500 method and was analyzed by gravimetry and metal levels were analyzed by atomic absorption spectrometry. Spirometric results for 2010-2016 were collected. Carcinogenic and non-carcinogenic risk assessments were performed according to the US Environmental Protection Agency guidelines. Data were analyzed by SPSS 20 software.The mean occupational exposure of the subjects to workplace dust and iron fumes was 15.95 ± 6.65 mg/m3 and 13.18 ± 3.06 mg/m3 respectively. During these 6 years, the FVC (P=0.04), PEFR (P=0.04), and FEV1 (P=0.03) indices decreased significantly among welders, but there was no significant difference between FEV1/ FVC indexes. Also, the mean of FEV1 and PEFR decreased significantly amongst casting workers, but FVC and FEV1/ FVC had no significant difference. Multivariate regression showed that in both jobs, BMI and work history were related to pulmonary function indices. The mean total excess ifetime carcinogenic risk (ELCR) of hexavalent chromium in the study population was 0.708 per 1000 people and the mean non-carcinogenic risk of hexavalent chromium was HQ = 19.62.The results showed that exposure to metal fumes in casting and welding jobs reduces pulmonary function indices. Although the average occupational exposure to hexavalent chromium is lower than the recommended limit and the risk of carcinogenesis is within an acceptable range, the risk of non-carcinogenic effects among workers is significant Therefore, it is important to prevent this problem, by adequate ventilation and using respiratory masks.

Exposure to air pollutants may lead to various health effects and is a major public health issue. Concerns about these effects exist in both developed and developing countries. The Air Q software was developed to estimate the health impacts of air pollution based on reported levels of air pollutants in real world studies. In Iran several studies have been conducted to estimate human morbidity and mortality based on this software. We conducted this review to summarize articles which have predicted the effects of air pollution on human health in Iran using Air Q. We conducted a systematic search for relevant studies published until 24 April 2021 in Web of Science, PubMed, Scopus, and SID (Scientific Information Database which includes articles in Farsi language). We applied no time or language restrictions.A total of 44 studies out of 525 identified articles met our inclusion criteria. The main air pollutants under investigation were particulate matter (PM), NO

Malaria is a vector-borne disease, likely to be affected by climate change. In this study, general circulation model (GCM)-based scenarios were used for projecting future climate patterns and malaria incidence by artificial neural networks (ANN) in Zahedan district, Iran. Daily malaria incidence data of Zahedan district from 2000 to 2019 were inquired. The gamma test was used to select the appropriate combination of parameters for nonlinear modeling. The future climate pattern projections were obtained from HadGEM2-ES. The output was downscaled using LARS-WG stochastic weather generator under two Representative Concentration Pathway (RCP2.6 and RCP8.5) scenarios. The effect of climate change on malaria transmission for 2021-2060 was simulated by ANN. The designed model indicated that the future climate in Zahedan district will be warmer, more humid, and with more precipitation. Assessment of the potential impact of climate change on the incidence of malaria by ANN showed the number of malaria cases in Zahedan under both scenarios (RCP2.6 and RCP 8.5). It should be noted that due to the lack of daily malaria data before 2013, monthly data from 2000 were used only for initial analysis; and in preprocessing and simulation analyses, the daily malaria data from 2013 to 2019 were used. Therefore, if proper interventions are not implemented, malaria will continue to be a health issue in this region.

Organophosphate (OPPs) and organochlorine pesticides (OCPs) are the two predominant forms of pesticides extensively used all around the world and are being reconsidered as environmental pollutants. The current study sought to assess the role of socioeconomic factors on the level of pesticides residues and the oxidative effects of exposure to OPPs and OCPs among the farmworkers of southeast Iran. In this cross-sectional study, 192 farmworkers and 74 non-farmworkers (controls) were involved. Gas chromatography (GC) was performed to measure the serum levels of organochlorine chemicals (2,4-DDT, 4,4-DDT, 2,4-DDE, 4,4-DDE, α-HCH, β-HCH, and γ-HCH). Furthermore, acetylcholinesterase (AChE) activity, arylesterase activity of paraoxonase-1 (PON-1), and several oxidative stress (OS) markers were assessed. In addition, the impact of several parameters such as home to farm distance, education level, ventilation status, and personal protective equipment (PPE) on pesticide levels was analyzed. The levels of OCPs in the farmworkers were significantly higher than the control subjects. In addition, AChE activity, arylesterase activity of PON-1, and total antioxidant capacity in farmworkers were significantly less, and MDA levels were higher than the controls. Education level was associated with farmworkers’ protective behavior. The current findings suggested that some phased out OCPs can still be measured in human samples in the southeast of Iran. Furthermore, the current study demonstrated that exposure to OCPs and OPPs was accompanied by adverse consequences regarding OS parameters and subsequent health problems. In addition, the findings of the present study suggest that improving farmworkers’ education might be associated with reduced exposure to pesticides and less adverse health effects.

Background and aims: The novel coronavirus (COVID-19) epidemic has far been the biggest global health threat of the 21st century. Protective measures are still one of the most effective methods for controlling COVID-19. Practicing hygiene and control measures are largely influenced by knowledge and attitude towards COVID-19. This study aimed to investigate the knowledge, attitude, and practice of Iranians towards COVID-19 as well as the demographic factors related to it in April and May, 2020. Methods: The study population in this cross-sectional, descriptive-analytical, and web-based study included 3736 Iranian individuals who were collected via convenience sampling method. A validated Iranian knowledge, attitude, and practices (KAP) Questionnaire about COVID-19 was used for collecting the required data. Ordinal multivariate generalized estimating equations (GEEs) were applied to analyze data. Results: The majority of participants (88.1%) had considerable knowledge, the right attitude (91%), and good practices (90.3%). In the multivariate models, factors related to greater knowledge were age>20 years (P20 years (P

Objective Sunlight and vitamin D intake are considered as essential elements for human health. Insufficient intake of this vitamin is one of the causes of various cancers and some other diseases. The aim of this study was to investigate the relation between bladder, prostate, cervical and ovarian cancers with solar ultraviolet exposure in Iran. In this ecological study, data from 30 provinces were studied and analyzed by correlation and linear regression tests in SPSS software version 22. Physical activity, gender, human development index, lung cancer and altitude were adjusted at population level. Results The incidence of bladder cancer in both sexes was inversely related to ultraviolet radiation, but it was significant only in men. Unlike bladder cancer, the incidence of cervical cancer showed a positive relation with ultraviolet radiation. No relation was found between the incidence of prostate and ovarian cancers with ultraviolet radiation. Among the adjusting variables, the incidence of lung cancer (surrogate for smoking) in women had the highest coefficient in the linear regression model.

Background and aims: Knowledge, attitude, and practice (KAP) toward coronavirus disease 2019 (COVID-19) are important factors for adherence to protection strategies. The aim of this study was to construct and validate a questionnaire about the KAP of Iranians regarding COVID-19. Methods: Initially, a questionnaire about the KAP with regard to COVID-19 was constructed in this cross-sectional study. The initial questionnaire was prepared based on a review of the extensive research literature and global and national guidelines. This researcher-made questionnaire was developed using the COVID-19-KAP questionnaire, which was originally used in China in 2020, and the influenza epidemic KAP Questionnaire (2015), the MERS KAP Questionnaire (2015), the H1N1 flu KAP questionnaire (2017), and the WHO KAP questionnaire about COVID-19. The applied questionnaire consists of three parts including knowledge- (n=26), attitude- (n=8), and practice-related (n=11) questions, respectively. Then, the face, content, and construct validity and the reliability of the questionnaire was determined, and analyzes were performed using SPSS v. 26 and AMOS v. 24 software. Results: In the face validity stage, 2 questions with an impact score of less than 1.5 were excluded from the questionnaire. In the content validity check, all questions had a content validity index (I-CVI) of more than 0.7. However, the content validity ratio (CVR) for 6 questions was less than 0.51, and these questions were removed accordingly. The compliance of the CVI with the chance agreement was close to one for all questions, indicating the lack of a chance agreement. In the exploratory factor analysis stage, the Kaiser-Meyer-Olkin (KMO) value of 0.90 was obtained, implying the adequacy of the sample size for factor analysis. The significance of the Bartlett test (chi-square: 5820.06, df: 630, P

Background Climate change may jeopardize the health of mothers and their offspring. There are few studies on the association between increasing temperature and pregnancy outcomes. The aim of this study was to investigate the relation between Universal Thermal Climate Index (UTCI) and 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 research the effect of UTCI on adverse pregnancy outcomes. The effect of time trend, air pollutants (NO2, SO2 and PM10), and weekdays were adjusted. Results The results showed that the low values of UTCI index (11.6 °C, in lags 0–6, 0–13) caused significant increase in the risk of preterm labor. However, hot thermal stress (high UTCI) significantly increased the risk of stillbirth in lag 0–13. We did not observe any significant relation between UTCI and other pregnancy outcomes in this study. Conclusions It seems like both hot and cold weathers can be associated with adverse pregnancy outcomes., Plain Language Summary Scientists have found that climate change has adverse effects on human health. Because pregnant women are one of the most vulnerable groups, these negative impacts may affect their fetuses, which make up the next generation. In this study, we examined the effect of temperature on some pregnancy outcomes, including low birth weight, preterm labor, spontaneous abortion, preeclampsia and gestational hypertension in Ahvaz city, which is one of the hottest cities in the world. One way to assess temperature impact on humans is by using temperature indicators. In this study we used the Universal Thermal Climate Index (UTCI) for this purpose. The data at different time intervals were collected and evaluated with specific models. Our results showed that low values of UTCI, which is equivalent to cold weather, significantly increase the risk of preterm labor. But, high levels of UTCI, which means hot weather, significantly increase the risk of stillbirth. In conclusion; both hot and cold weather can be associated with adverse pregnancy outcomes in Ahvaz city. Therefore, pregnant women should protect themselves from exposure to hot and cold weather.

BackgroundEarthquakes cause many casualties worldwide. Taking preventive measures and improving community preparedness is critical to reducing earthquake damage. The social cognitive theory explains how individual and environmental factors cause behavior. This review was conducted to identify the social cognitive theory structures, in research on the preparedness of households against earthquakes.Materials and methodsThis systematic review was performed based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A search was conducted from January 1, 2000, to October 30, 2021 in Web of Science, Scopus, PubMed, and Google Scholar. Studies were selected based on inclusion and exclusion criteria. The initial search yielded 9,225 articles, and finally, 18 articles were selected. Articles were assessed using the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist.ResultsEighteen articles about disaster preparedness behaviors based on the socio-cognitive constructs were identified and reviewed. The essential constructs used in the reviewed studies included self-efficacy, collective efficacy, knowledge, outcome expectations, social support, and normative beliefs.ConclusionBy identifying the dominant structures that have been used in studies related to the preparedness of households against earthquakes, researchers can implement appropriate and more cost-effective interventions by focusing on improving suitable structures.

Evidence shows that climate change may have adverse effects on human health. The purpose of this study was to investigate the relation between Physiologically Equivalent Temperature (PET) and cardiovascular hospital admissions in Ahvaz. Distributed Lag Non-linear Models (DLNM) combined with quasi-Poisson regression models were used to investigate the effect of PET on hospital admissions. Low PET values (6.4 °C, 9.9 °C and 16.9 °C) in all lags, except lag 0-30, significantly decreased the risk of hospital admissions for total cardiovascular diseases, hypertension, ischemic heart diseases, and cardiovascular admissions in men, women and ≤65 years. But, low PET (6.4 °C) in lags 0 and 0-2 significantly increased the risk of hospital admissions for cerebrovascular diseases; and high PET values increased the risk of ischemic heart diseases and in men. Both cold and hot stress are involved in cardiovascular hospital admissions.

IntroductionEarthquakes cause a lot of damage and casualties. For various reasons, most households are not prepared for earthquakes. This study aims to identify the challenges and barriers to households' preparedness against earthquakes from the viewpoint of Kerman residents.MethodsThis qualitative-directed content analysis study was conducted from December 2021 to May 2022 in the city of Kerman in southeast Iran. Data was collected by purposive sampling through in-depth and semi-structured individual face-to-face interviews with 48 households.ResultsAfter multiple rounds of analyzing and summarizing the data based on the social-cognitive theory and taking into consideration similarities and differences, five main categories and 19 subcategories created based on the results of data analysis and including (1) Challenges related to cognitive factors (2) Challenges related to behavioral factors (3) Challenges related to the physical environment (4) Challenges related to the social environment and (5) Challenges related to financial factors.ConclusionAlthough the participants listed many challenges and barriers in different fields, in order to overcome the barriers and challenges of preparing households for an earthquake, the support of the authorities and the cooperation of the residents are necessary.

Urinary incontinence is a silent epidemic that has a serious impact on a person's quality of life (QOL). This study aimed to evaluate the efficacy of frankincense-based herbal product (FHP) in urinary incontinence compared with placebo and solifenacin. In this randomized, double-blind clinical trial, 120 postmenopausal women with mixed urinary incontinence were randomized to one of the three groups of FHP, placebo, and standard treatment (solifenacin). Frequency, amount of leakage, and score of urinary incontinence as well as the QOL were measured at the end of the second and fourth weeks and 2 weeks after the interruption of the treatment. The ICIQ-UI SF and I-QOL questionnaires were used for the measurements. Mean frequency of urinary incontinence and amount of leakage significantly decreased in the FHP and solifenacin groups in the fourth week compared to the placebo group. In addition, 2 weeks after treatment completion, the effects of the FHP were significant compared to the solifenacin group. Due to the effect of FHP on improving the QOL and also the prolonged effect of this drug, the use of FHP in urinary incontinence, as a complementary treatment could be suggested.

Thalassemia is one of the most prevalent genetic disorders in Iran. The birth of a child with thalassemia major is associated with many problems for the family, and society. In the present study, the reasons for marriage among people with thalassemia minor in Iran, in spite of receiving medical advice against it, have been investigated. The present study was a qualitative content analysis conducted in 2019 with the participation of 12 couples (24 participants) with thalassemia minor living in Rafsanjan, Iran; and 2 counselors working with thalassemia patients. Data collection was conducted through in-depth interviews. All interviews were recorded and transcribed. The text was read several times, categorized and main themes were extracted according to content analysis methods. The present study shows that giving inadequate or inaccurate information to people, strong emotional attachment between couples, taking the test at the wrong time, family interference and family insistence on marriage, having seen cases with no problems, and specific thoughts and beliefs are the most important reasons for marriage among couples with thalassemia minor in Iran. According to the results of the present study, the importance of providing thorough and accurate information to the public, setting an appropriate time for counseling and screening which is not immediately before the marriage ceremony, and briefing more efficiently at the time of counseling can help prevent marriage among couples with thalassemia minor in Iran.

Background: There is little information about air pollution and epilepsy attacks. The aim of this study was to investigate the relation between air pollution and epilepsy admission in Kerman, Iran.Methods: This was an ecological study, in which the concentrations of ambient air pollutants and meteorological data were inquired from the Kerman Environmental Protection Agency and the Kerman Meteorology Organization respectively, and epilepsy admission data were obtained from Kerman’s Shafa hospital Epilepsy Registry. Generalized Additive Models (GAM) with lags up to 7 days were used for estimating the Relative Risks (RR).Results: During 2008 until 2020, 894 epilepsy admission occurred in Kerman which 498 (55.7%) were male. The strongest relation between epilepsy admission was seen in the over 59 years group for CO in lag 0 (RR = 2.1455, 95% CI: 1.5823–2.9091), for NO2 in lag 0 (RR =1.0409, 95% CI: 1.0282–1.0537), and for PM2.5 in lag 5 (RR =1.0157, 95% CI: 1.0062–1.0252). Also for PM10 in the under 18 year's group in lag 2 (RR =1.0064, 95% CI: 1.0029–1.0098), for O3 in lag 0 (RR =0.9671, 95% CI: 0.9581–0.9761) and for SO2 in lag 5 (RR = 0.9937, 95% CI: 0.9891–0.9983).Conclusion: The findings of this study showed that CO, NO2, PM2.5, and PM10 air pollutants might be risk factors for epilepsy admission in Kerman.

PURPOSE: Salmonella is one of the main causes of gastroenteritis, and its incidence may be affected by meteorological variables. This is the first study about the effect of climatic factors on salmonella incidence in Kermanshah, Iran. METHODS: Data about salmonellosis cases in Kermanshah were inquired from Center for Communicable Disease Control, at the Ministry of Health and Medical Education of Iran, for the 2008 to 2018 time-frame. Meteorological variables including maximum, minimum and mean of temperature and humidity, sunshine hours and rainfall were inquired for the same time frame. Negative binomial generalized linear models (GLM) were used to assess the effect of meteorological variables on the weekly incidence of salmonellosis. RESULTS: During the years under study, 569 confirmed cases were registered in Kermanshah province. Study results showed a 3 % increase in salmonellosis incidence, after 1 % increase in minimum humidity in the week before (incidence rate ratio (IRR): 1.03; 95 % confidence interval (CI):1.02–1.05) and also a 4 % increase in incidence for 1 °C increase in mean temperature in the same week (IRR: 1.04; 95 % CI:1.02–1.06). CONCLUSIONS: Increase in minimum humidity and mean temperature may have a role in increasing the incidence of salmonellosis in Iran.

Although Ahvaz is considered as one of the warmest cities around the world, few epidemiological studies have been conducted on the adverse effects of temperature on human health using thermal indices in this city. This study investigates the relation between physiologically equivalent temperature (PET) and respiratory hospital admissions in Ahvaz. Distributed lag non-linear models (DLNMs) combined with quasi-Poisson regression models were used to investigate the relation between PET and respiratory disease hospital admissions, adjusted for the effect of time trend, air pollutants (NO2, SO2, and PM10), and weekdays. The analysis was performed by utilizing R software. Low PET values significantly decreased the risk of hospital admissions for total respiratory diseases, respiratory diseases in men and women, chronic obstructive pulmonary diseases (COPD), and bronchiectasis. However, low PET (16.9°C) in all lags except lag 0-30 significantly increased the risk of hospital admissions for asthma. The results indicate that in Ahvaz, which has a warm climate, cold weather decreased overall respiratory hospital admissions, except for asthma.

Background: Hookah is addictive and hazardous for health, but it has become popular particularly among adolescence.Purpose: The aim of this study was to determine the effectiveness of Health Commun...

Cadmium (Cd) is a widespread environmental pollutant. A number of observational studies have reported that Cd might be a cause of nasopharyngeal (NPC), pharyngeal (PC), or laryngeal cancers (LC). In this study evidence about the relation of Cd and NPC, PC, and LC has been summarized. A literature review was conducted until 20 June 2020 in PubMed, Ovid, Scopus, Web of Science and Google scholar databases to investigate the epidemiologic evidence for the relation between cadmium exposure and cancers of the nasopharynx, pharynx, and larynx. Ten articles were selected after careful screening of retrieved studies. All of these studies obtained a Newcastle-Ottawa Scale (NOS) quality score from 6 to 8. Due to high heterogeneity, in all analyses, random effect was used. The pooled results showed that cadmium levels in NPC (standard mean difference (SMD=0.55; 95% CI=0.20, 0.89; p=0.002) and PC (SMD=9.79; 95% CI=0.62, 18.96; p=0.036) patients/tissues were significantly higher than their controls. But cadmium levels were not significantly different between LC cases/tissues and their controls. (SMD=−0.05; 95% CI=−0.99, 0.89; p=0.921). Exposure to cadmium is likely to cause nasopharyngeal and pharyngeal cancer.

This study examines the relation between fear of victimization, types of victimization, and advocacy, adjusted for grade and gender on 834 students from 16 Iranian public middle schools. Multilevel linear modeling was used to explore relations between types of victimization and fear of victimization. The results showed that higher fear of victimization was associated with higher verbal, social, and cyber victimization, and higher peer advocacy. The cyber victimization experience had the most impact on fear of bullying victimization (β = 0.15, P

Diurnal temperature range (DTR) is one of the climate indicators likely to be related to human health. The purpose of this study was to investigate the relation between mortality and DTR in Kerman, Iran. The DLNM (Distributed Lag Non-linear Model)with a quas/i-Poisson regression model was used to evaluate the effect of DTR on mortality in age and sex groups by controlling the confounding variables (long-term trend of daily mortality, effect of day of the week, holidays, mean temperature, humidity, and air pollution). Since DTR effects on mortality may vary in cold and warm seasons, separate analyses were conducted for cold and warm seasons. DTR showed a non-linear relation with mortality. Mortality increased at the 90th percentile of DTR (CRR = 1.16, 95% CI 1.00–1.34), in lag 0–21 and at the 10th percentile of DTR in lag 0–13 (1.27, 95% CI 1.06–1.52), and lag 0–21 1.35 (95% CI 1.06–1.71). Increased mortality was more observed in the > 60 age group and in men. High levels of DTR after long lags (13 days) in the cold season were associated with increasing mortality. High and low diurnal temperature range may be a risk factor for mortality, especially in the men and elderly.

Objectives Some studies have shown that environmental risk factors, including air pollution, might be related to the incidence or recurrence of multiple sclerosis (MS). This systematic review was conducted to investigate the relation between air pollution and MS. Methods A systematic search was conducted in PubMed, Scopus, Science Direct, Embase, and Web of Science; until January 2020 with no restrictions. The search strategy was conducted with air pollution key words such as CO, PM2.5, PM10, SO2, and NO2, for exposure and the key word “Multiple sclerosis” as the outcome. Results Eventually, after applying the inclusion and exclusion criteria, 17 articles were included. The methodologies and outcomes reported were heterogeneous and different metrics had been used in the results; therefore conducting a meta-analysis was not possible. Eight studies had analyzed the relation between particulate matter (PM) and the prevalence or relapse of MS and had observed a significant relation. NO2 and NOx were associated with recurrence or prevalence of MS in three studies. But, in three cohort studies, no association was observed between air pollution and recurrence or occurrence of MS. Conclusions The results of this systematic review show that outdoor air pollution, especially PM and nitrogen oxides might be related to the prevalence or relapse of MS.

Introduction: This study was conducted aimed to determine the relationship between a healthy lifestyle, self-esteem and subjective vitality of the elderly in Sirjan in 2020.Method: In this descriptive-analytical study, 200 elderly people aged 60 years and older were selected from comprehensive health centers in Sirjan by two-stage random sampling method. The data were collected using validated Healthy Lifestyle Questionnaire among Iranian Elderly, Rosenberg Self-Esteem Scale and validated Subjective Vitality Scale.Results: The mean and standard deviation of healthy lifestyle score was 134.42±13.78, 36.34±4.62 for self-esteem and 21.80±2.85 for subjective vitality. A direct and significant relationship was between healthy lifestyle and self-esteem (p Conclusion: A direct and significant relationship was between healthy lifestyle, self-esteem and subjective vitality of the elderly. Therefore, the elderly should take care of their health and benefit from self-esteem and vitality by selecting a healthy lifestyle.

Background: Manganese (Mn) is an essential element for the human body, but it can cause adverse effects on the Central Nervous System at high doses. Exposure to manganese fumes during welding can harm welders' health. Objectives: The current study aimed to measure manganese produced by shielded metal arc welding (SMAW) in the breathing zone air and blood of welders and investigate the relationship between manganese concentrations in air and blood. Methods: In this descriptive-analytical cross-sectional study, 35 welders were enrolled as the exposed group and 40 office workers as the control group. Manganese concentration in air was measured according to NIOSH method 7301. Air and blood sample analyses were carried out by ICP-OES. Statistical analysis was performed with MINITAB 17. Data were analyzed using Pearson correlation coefficient, one-sample t-test, paired t-test, and logistic regression. The significance level was set at P < 0.05. Result: The mean concentration of welding respirable particles and manganese fumes were 9.56 ± 1.67 and 0.45 ± 0.08 mg/m3, three and 22 times the exposure limit recommended by ACGIH, respectively. Average manganese was significantly higher in the welders’ blood (0.16 ± 0.02 µg/mL) than in the controls’ blood (0.04 ± 0.002 µg/mL). There were strong and significant correlations between the welding respirable particles and manganese concentration in welders’ breathing zone and blood manganese levels. Also, with each year of work experience, the manganese concentration in the welders’ blood increased by 1.5%. Conclusions: Welders are at risk of contamination with manganese. Manganese exposure reduction through more efficient ventilation systems, reducing welder’s exposure time, staff training, and appropriate respiratory protection equipment should be applied to reduce manganese exposure among welders and prevent health complications.

Background: Unhealthy eating habits are an important cause of Non-communicable Diseases (NCDs). One of the most effective methods to prevent these diseases is the use of health education interventions. The aim of this study was to evaluate the effect of educational intervention performed by Women Health Volunteers (WHV) on knowledge, attitude, and modification of dietary habits among women in Kerman. Methods: This research was a quasi-experimental study performed on 400 women in Kerman. Participants were selected using multistage cluster sampling. Data were collected immediately before and 6 weeks after the intervention by a questionnaire, including demographic information and questions related to knowledge, attitude, and dietary habits. Data were analyzed using Pearson and Spearman correlation, paired t-test, and Wilcoxon-test in SPSS 24. Results: The average age of women was 41.91±12.87 years. Before the intervention, a positive and significant correlation was observed between knowledge and dietary habit (r=0.249) (p Conclusion: Education provided by WHV was effective in promoting knowledge, and attitude, and in modifying the dietary habits of women. Therefore, the use of local human resources can help improve public health.

Background and aims: COVID-19 is one of the most dangerous pandemics of the 21st century, which has caused disease in humans and has had various consequences for humans. One of the most at-risk groups are bank employees. Therefore, this study was conducted to investigate the predictors of protective behaviors against COVID-19 in bank employees of Sirjan. Methods: This descriptive-analytical cross-sectional study was conducted in 2020 in Sirjan. The participants in this study were 280 bank employees who were selected randomly. The data collection tool was a questionnaire in three sections, including demographic information, knowledge, and questions related to the Protection Motivation Theory, which was self administered. After collecting the data, descriptive tests (frequency and percentage), Pearson correlation and linear regression were used to analyze the data in SPSS 23. Results: The mean age of participants was 41.6±2.16 years. The results of correlation coefficients showed that there was a significant correlation between perceived susceptibilityand perceived severity. However, it should be noted that there were positive correlations between protection motivation with perceived susceptibility (r = .414, P

Introduction: Simultaneous exposure to noise and dust may have detrimental health effects. This study was conducted to determine the effect of exposure to noise and dust on oxidative stress. Methods: In this cross-sectional study, 82 employees of two livestock and poultry feed factories in Golestan Province, Iran, were selected as the exposed group and 82 office workers were selected as the control group. Occupational noise and dust exposure were measured using a dosimeter, sampling pump, and vinyl chloride filter. Oxidative stress was determined by measuring the levels of malondialdehyde (MDA) and superoxide dismutase (SOD) in blood samples. T-tests, one-way analysis of variance, and multivariate linear regression were used to analyze the data. Results: The levels of MDA and SOD in the exposed group were significantly higher and lower than the control group ( p < 0.001), respectively. The results showed the subgroup with both over the threshold dust and noise exposure had the highest MDA levels. The SOD level among those exposed to noise more than the recommended level, in the subgroup with more dust exposure, was significantly less than the subgroup with low noise exposure ( p = 0.017). Conclusion: Noise and dust exposure probably increase the level of oxidative stress by increasing the level of lipid peroxidation (MDA) and reducing the level of antioxidant enzymes (SOD).

Background & Aims of the Study: Since beta-thalassemia is the most commonly inherited disease in Iran, its preventive and controlling programs are considered vitally important in the healthcare system. This study was conducted to investigate the incidence rate and epidemiology of major beta-thalassemia (MBT) over the last twenty years in Kerman, Iran. Materials and Methods: This cross-sectional study, as a kind of health system research, carried was out on all patients with beta-thalassemia (born from March 1998 to March 2018) registered in Kerman Health Center. The data, extracted from the national records of genetic diseases, were analyzed in SPSS software (version 16) using Fisherchr('39')s exact test. Results: Based on the results of the present study, the incidence rate of MBT was calculated at 0.99 cases per 10,000 live births. According to this result, 29 subjects with MBT were born from 1998 to 2018. The most important cause of thalassemia was determined as non-identification of thalassemia minor in carrier couples and their lack of awareness about their complication (62%). The other cause was the non-cooperation of screened carrier couples in attending prenatal diagnosis (20.7%). It was revealed that in 23 MBT cases, the parents were relatives (79.3%). The diagnosis of 62% of patients had been made before they turned one year. Conclusion: It is recommended that the following measures been adopted to avoid MBT incidence: strengthening the care team, cooperating with gynecologists in identifying pregnant women suspected of having thalassemia minor in the first weeks of pregnancy and referring them to genetic counseling centers for condition determination, educating families and changing carrier couples attitudes toward abortion, monitoring and improving screening laboratories, and implementing public education programs for specific groups.

There is some evidence about the short-term effects of air pollutants on adverse pregnancy outcomes. The aim of this study was to determine the association between air pollutants and spontaneous abortion, stillbirth, gestational hypertension, preeclampsia, gestational diabetes and macrosomia in Ahvaz, which is one of the most polluted cities in the Middle East. Data on adverse pregnancy outcomes and air pollutants including ozone (O3), nitric oxide (NO), nitrogen dioxide (NO2), sulfur dioxide (SO2), carbon monoxide (CO), particles with a diameter of less than 10 µm (PM10) and particles with a diameter less than 2.5 µm (PM2.5) were inquired from the Health Department of Ahvaz Jundishapur University of Medical Sciences and the Environmental Protection Agency of Khuzestan Province for the years 2008–2018. A time series analysis using the generalized additive model (GAM) with up to 6-day lags was used. The results showed that the SO2 pollutant on 0, 1, 3, 4, and 6-day lags and PM10 on lag 0 had direct and significant associations with spontaneous abortion. NO, NO2 and CO on 0–6-day lags, and O3 on 6-day lags showed direct and significant associations with preeclampsia. NO and NO2 pollutants showed significant and direct associations with gestational diabetes, during 0- and 6-day lags. NO on 0-, 3- and 4-day lags, CO in all 0–6-day lags and PM2.5 on 1-, 3-, 5-, and 6-day lags showed direct and significant associations with macrosomia. None of the pollutants showed significant associations with stillbirth or gestational hypertension. The results of this study suggest that some air pollutants are associated with spontaneous abortion, preeclampsia, gestational diabetes and macrosomia. This study further emphasizes the need to control ambient air pollution.

Some epidemiological studies have suggested that exposure to extremely low-frequency magnetic fields (ELF-MFs) can affect the immune system. This study aimed to investigate the effects of antioxidant vitamin consumption on proinflammatory cytokines and biochemical parameters changes. In this randomized, controlled double-blinded trial study, power plant workers exposed to ELF-MFs were enrolled based on inclusion criteria. Ninety-one eligible subjects were randomly divided into four groups: the first group (400 units of vitamin E/day), second group (1,000 mg of vitamin C/day), third group (400 units of vitamin E and 1,000 mg of vitamin C/day), and control group. The intervention was conducted for 3 months. Proinflammatory cytokines interleukin-1β (IL-1β), IL-6, and tumor necrosis factor-α (TNF-α), and biochemical parameters (fasting blood sugar, total cholesterol, triglyceride, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol [HDL-c], total protein, and albumin) were measured among the participants' serums, before and after the intervention. The mean level of IL-6 in all vitamin-receiving groups, the mean level of IL-1β in vitamin C and EC groups, and the mean level of TNF-α in the vitamin C group, decreased significantly after intervention. The arithmetic means of the effect sizes for IL-1β, IL-6, and TNF-α were 0.71, 0.57, and 0.2, respectively. The level of HDL-c in the vitamin E and vitamin EC groups and the level of triglyceride in the vitamin C group significantly increased after the intervention. Taking antioxidant vitamins can prevent an increase of proinflammatory cytokines induced by prolonged exposure to ELF-MFs. Bioelectromagnetics. 2021;42:18-26. © 2020 Bioelectromagnetics Society.

Computational fluid dynamics (CFD) is a powerful method for predicting the release of pollutants in the workplace and has recently been used as a valuable tool by health authorities. The purpose of this study was to predict the distribution of lead fume in the workplace using computational fluid dynamics in the electronics manufacturing industry. A cross-sectional descriptive and analytical study was conducted in the Neyshabur electronics industry (2019). Individual exposure to lead fume was measured by the OSHA121 method. Simulation and prediction of lead fume emission in the workplace were done using computational fluid dynamics and by the ANSYS16 software. The mean of personal exposure to lead fumes was 0.04 ± 0.01 mg/m3. The software predicted the distribution of lead fumes in the respiratory zone of the worker to be in the range of 0.04 to 0.07 mg/m3, which is very close to the real values. By doubling the suction power of the topical ventilation used, workers' exposure to lead fumes was nearly halved and reached well below the recommended limit. The results showed that CFD is a useful tool for simulating individual contact with pollutants in a geometry. Also, given that the CFD shows the diffusion and distribution of pollutants in all points of a geometry, it is useful to indicate critical locations and conditions.

Background: The lack of a comprehensive instrument to measure school climate with good psychometric properties in Iran is strongly felt. This study aimed to examine the construct validity of the multidimensional structure of the Maryland Safe and Supportive Schools Climate Survey (MDS3) among Iranian pupils. Methods: This validation study was peformed on a sample of 1540 pupils from 42 schools in Mazandran province in 2017. Confirmatory factor analyses (CFA) and exploratory structural equation modeling (ESEM) were employed to evaluate the construct validity of each of the three scales of the questionnaire (Safety, Engagement, and Environment). The current study tested measurement invariance across gender, school type, and grade levels. Results: Our findings confirmed the factor structures and measurement invariance across gender, school types, and grade levels regarding Safety, Engagement, and Environment scales of the Persian version of the MDS3 Climate Survey. This study revealed a conceptual overlap between the dimensions of school climate which can be well shown by ESEM (CFI=0.975, TLI=0.945, RMSEA=0.053, SRMR=0.029 for Safety scale; CFI=0.987, TLI=0.961, RMSEA=0.027, SRMR=0.018 regarding Engagement scale; CFI=0.960, TLI=0.926, RMSEA=0.036, SRMR=0.025 concerning Environment scale). Furthermore, the Pearson correlations of all school climate sub-scales were significant (P Conclusion: The Persian version of MDS3 Climate Survey can be used to measure the three key domains of school climate (Safety, Engagement, and Environment) in Iranian context and the epidemiological studies associated with student health and behaviors.

Background: Diabetes is one of the most common metabolic diseases in the world and a serious health problem, that requires comprehensive interventions. This systematic review was conducted to summarize educational interventions based on the Health Belief Model aimed to prevent and control diabetes. Methods: Searches were done on May 30, 2019 in PubMed, Web of Science, Google Scholar, Embase, Scopus, SID, Magiran, and IranMedex databases in English and Persian. The inclusion criteria included quantitative original interventional studies that aimed to control type 2 diabetes, and the intervention was based on the Health Belief Model. Studies done outside of Iran, interventions on other types of diabetes, non-interventional studies, and reviews were excluded. Results: Eventually, 13 studies (6 English and 7 Persian articles) entered this systematic review. The intervention durations were from 2 to 3 months. These studies fell into three broad categories: 1- Prevention of the disease 2- Improving Nutrition behaviors in patients 3-Prevention of disease complications or its progress. All of the educational interventions showed a positive effect for education on the prevention and control of diabetes. Conclusions: Interventions based on the HBM have shown an effective role in controlling and preventing diabetes.

Background and aim Although air pollution is a serious problem in Ahvaz, the association between air pollution and respiratory diseases has not been studied enough in this area. The aim of this study was to determine the relation between short-term exposure to air pollutants and the risk of hospital admissions due to asthma, COPD, and bronchiectasis in Ahvaz. Methods Hospital admissions data and air pollutants including O3, NO, NO2, SO2, CO, PM10, and PM2.5 were obtained from 2008 to 2018. Adjusted Quasi-Poisson regression with a distributed lag model, controlled for trend, seasonality, weather, weekdays, and holidays was used for data analysis. Results The results showed a significant increase in hospital admissions for asthma (RR=1.004, 95% CI: 1.002-1.007) and COPD (RR=1.003, 95% CI: 1.001-1.005) associated with PM2.5. PM10 was associated with increased hospital admissions due to bronchiectasis in both genders (Men: RR=1.003, 95% CI: 1.001-1.006) (Female: RR=1.003, 95% CI: 1.000-1.006). NO2 was also associated with an increased risk of hospital admissions for asthma (RR=1.040, 95% CI: 1.008-1.074) and COPD (RR=1.049, 95% CI: 1.010-1.090). SO2 was associated with the risk of hospital admissions of asthma (RR=1.069, 95% CI: 1.017-1.124) and bronchiectasis (RR=1.030, 95% CI: 1.005-1.056). Finally, CO was associated with COPD (RR=1.643, 95% CI: 1.233-2.191) and bronchiectasis (RR=1.542, 95% CI: 1.035-2.298) hospital admissions. Conclusion Short-term exposure to air pollutants significantly increases the risk of hospital admissions for asthma, COPD, and bronchiectasis in the adult and elderly population.

Background: Head and Neck (H and N) cancers include malignant tumors of the nasal cavity, pharynx, paranasal sinuses, oral cavity, larynx and salivary glands. Opium use might be related to these cancers. The aim of this study was to investigate the relation between Opium and its Derivatives (O and D) use and the incidence of H and N cancers. Methods: In this case-control study conducted in Kerman, 140 patients with HandN cancers and 280 healthy controls (matched for age, gender, and place of residence) were included. Information about their use of OandD, cigarette smoking, alcohol and diet were collected using a structured questionnaire. Conditional logistic regression was used to investigate the relation between variables. Results: The use of opioids was associated with an increased risk of HandN cancers (Adjusted OR: 8.13; CI: 4.08-16.2). A significant dose-response relation between OandD use was observed, with high use Adjusted OR=8.91; 95 CI: 4.03-19.65 and low use Adjusted OR=6.52; 95 CI: 3.18-13.36. This dose-response association was stronger in patients with laryngeal cancer and opioids use, with high use Adjusted OR = 11.17; 95 CI=4.48-28.09 and low use Adjusted OR = 9.46; 95 CI= 3.97-22.52. Conclusion: The results show that opium use can be considered as an important risk factor for H and N cancers. Also in Iran, opium seems to play a more important role than cigarette smoking. © 2020, Asian Pacific Organization for Cancer Prevention.

The prevalence of non-communicable diseases is increasing worldwide. Multimorbidity and long-term medical conditions is common among these patients. This study aimed to investigate the patterns of non-communicable disease multimorbidity and their risk factors at the individual and aggregated level. Data was inquired from the nationwide survey performed in 2011, according to the WHO stepwise approach on NCD risk factors. A latent class analysis on multimorbidity components (11 chronic diseases) was performed and the association of some individual and aggregated risk factors (urbanization) with the latent subclasses was accessed using multilevel multinomial logistic regression. Latent class analysis revealed four distinct subclasses of multimorbidity among the Iranian population (10069 participants). Musculoskeletal diseases and asthma classes were seen in both genders. In males, the odds of membership in the diabetes class was 41% less by increasing physical activity; but with increased BMI, the odds of membership in the diabetes class was 1.90 times higher. Tobacco smoking increased the odds of membership in the musculoskeletal diseases class, 1.37 and 2.30 times for males and females, respectively. Increased BMI and low education increased the chances of females’ membership in all subclasses of multimorbidity. At the province level, with increase in urbanization, the odds of membership in the diabetes class was 1.28 times higher among males (P = 0.027). Increased age, higher BMI, tobacco smoking and low education are the most important risk factors associated with NCD multimorbidity among Iranians. Interventions and policies should be implemented to control these risk factors.

The present study aimed to determine the effect of taking antioxidant vitamins including vitamins E and C in reducing oxidative stress levels and improving blood parameters. This double-blind randomized controlled trial study was conducted among the employees working in different parts of a power plant in Semnan, Iran, in 2017. A total of 91 employees were randomly allocated to four groups including vitamin E (400 units per day), vitamin C (1000 mg per day), vitamin E + C for 90 days, and control. The levels of malondialdehyde (MDA), superoxide dismutase (SOD), catalase (Cat), and total antioxidant capacity (TAC) in plasma, and hematological parameters were measured in the participants before and after the intervention. A significant increase was seen in the mean level of SOD, Cat, and TAC in the vitamin-treated groups as well as a significant decrease in mean MOD in vitamin C and vitamin E groups after the intervention. In the intervention groups, the number of red blood cells, hematocrit, and the level of mean corpuscular hemoglobin (MCH) and MCH concentration significantly increased. After the intervention, the mean levels of MDA, SOD, and Cat in vitamin E group were significantly lower than the control group. The mean level of TAC decreased only in the vitamin C group compared to the control group. Taking vitamins E and C as nonenzymatic scavengers of free radicals appears to decrease lipid peroxidation and increase the level of antioxidant enzymes, which can be imbalanced by exposure to extremely low-frequency electromagnetic fields in power plant employees. Furthermore, some hematological parameters can be improved by consuming these vitamins.

Recently the short term effects of air pollutants on cardiovascular and respiratory morbidity and mortality has attracted the attention of many researchers. This study comprehensively examined the ...

Background: There are few studies on the association between bullying types and psychosomatic issues in pupils. The current study aimed to examine the association of verbal, relational, physical, and cyber bullying with psychosomatic problems among students. Methods: This was a cross-sectional study conducted in northern Iran on 834 participants, which were in 8th and 9th grades in 2014. Bullying and psychosomatic problems were measured by the Iranian-version of the Olweus Bullying and the Health and Illness Questionnaires. Descriptive statistics and multilevel logistic regression analysis were used for data analysis. Results: Findings revealed that bad temper was the most prevalent psychosomatic problem and the prevalence of headache (P=0.021), feeling low (P=0.009), bad temperedness (P=0.004), nervousness (P Conclusions: The results showed the different psychological and somatic burdens associated with various types of bullying. Therefore, it is necessary to implement preventive and interventional programs so as to reduce bullying behaviors in Iran. Implications of these findings for health care professionals, educational systems, and parents were further discussed.

Heat stress causes physiological changes, and changes in hematological parameters and hormonal levels in the human body, known as thermal strain. This study was conducted to determine the effect of exposure to heat stress on hematological parameters and oxidative stress in the bakers of Shahroud City, Iran. A total of 163 bakery workers (exposed group) and 135 office workers (unexposed group) with a minimum of 1-year working experience were selected. Exposure to heat stress was measured using ISO-7243 criteria on the hottest days of the year (late July and August). Wet-bulb globe temperature (WBGT) was calculated based on indoor environments. Oxidative stress indices including malondialdehyde (MDA), nitric oxide (NO), total antioxidant capacity (TAC) in the bakers' and office workers’ serum and hematological parameters were measured. Statistical analysis was done through independent t-test, and multivariate linear regression using SPSS v24. Analysis of hematological parameters showed that about 70% and 68% of the bakers had abnormal mean cell volume (MCV) and white blood cell (WBC) count, respectively, while only around 12% of them had abnormal mean cell hemoglobin concentration (MCHC). The counts of red blood cells (RBC), WBC, lymphocytes (LYM), and MCV showed significant differences in different occupational groups ( p < 0.05). The levels of MDA and NO were significantly higher in bakers with WBGT more than the threshold value ( p < 0.05). The WBGT index for assessing heat stress can be used as a predictor variable for MDA and NO levels. In addition, heat stress exposure could be a risk factor for abnormal WBC, RBC, LYM, and MCV.

Introduction: Attention deficit hyperactivity disorder (ADHD) has the highest prevalence among psychiatric disorders in children. The present study investigated the effect of adenotonsillectomy on the symptoms of ADHD in a 6-month follow-up. Materials and Methods: This cross-sectional study was performed on 100 patients referred for respiratory problems during sleep due to adenotonsillar hypertrophy (ATH). The patients’ parents were asked to complete the Diagnostic and Statistical Manual of Mental Disorders Fourth Edition checklist as a standard benchmark for ADHD before, 2 weeks, and 6 months after the surgery. The data were analyzed by SPSS software (version 20) through paired t-tests and McNemar’s test. Results: The age averages of male and female children were 7.15 and 8.4 years, respectively. The frequency of ADHD in the studied population was 30%, which is much higher than the prevalence of this disorder in the normal population. In the second week after the surgery, the mean score of ADHD decreased from 4.97±2.97 (attention deficit [AD]) and 6.77±1.61 (hyperactivity disorder [HD]) before the surgery to 3.86±2.25 (AD) and 4.28±2.02 (HD) 2 weeks after the surgery (P=0.001). After a 6-month follow-up, these figures further decreased (AD=2.34±2.32; HD=1.97±2.44; P

BackgroundThe cement industry is one of the main world industries with exposure to a wide range of hazardous chemical and physical occupational agents that can increase free radicals and cause diseases. The aim of this study was to evaluate oxidative stress, and biochemical markers and psychological parameters among cement plant workers who were exposed to variety of hazardous occupational agents.MethodsIn this cross-sectional study 40 workers exposed to cement and 40 office employees, were selected as the exposed and control group, respectively. Exposure to cement dust, silica and noise were respectively assessed using the NIOSH 0600, NIOSH 7601 and noise dosimetry methods. Oxidative stress biomarkers including malondialdehyde (MDA), superoxide dismutase (SOD), catalase (CAT), total antioxidant capacity (TAC), and biochemical parameters were measured in the serum of all participants. Depression, anxiety and stress were assessed by Depression Anxiety Stress Scales (DASS-21) questioner. Statistical analysis was performed by SPSS22 software. Independent t-test, Mann-Whitney U, Chi-square were used to evaluate the relation between variables. ResultsThe results demonstrated that the level of MDA as a marker of oxidative stress was significantly higher in the exposed group.Antioxidant enzymes including SOD and CAT were significantly higher, and TAC was insignificantly lower in the exposed group. Alkaline phosphatase (ALP), aspartate transaminase (AST), depression and stress were also significantly higher in the exposure group. It seems like working in cement plants, can have hazardous effects on liver function, enzyme activity and mental health.

ObjectiveLeukaemia is one of the most common cancers and may be associated with exposure to environmental carcinogens, especially outdoor air pollutants. The objective of this study was to investigate the association of ambient air pollution and leukaemia in Tehran, Iran.DesignIn this retrospective cohort study, data about the residential district of leukaemia cases diagnosed from 2010 to 2016 were inquired from the Ministry of Health cancer database. Data from a previous study were used to determine long-term average exposure to different air pollutants in 22 districts of Tehran. Latent profile analysis (LPA) was used to classify pollutants in two exposure profiles. The association between air pollutants and leukaemia incidence was analysed by negative binomial regression.SettingTwenty-two districts of Tehran megacity.ParticipantsPatients with leukaemia.Outcome measuresThe outcome variables were incidence rate ratios (IRR) of acute myeloid and lymphoid leukaemia across the districts of Tehran.ResultsThe districts with higher concentrations for all pollutants were near the city centre. The IRR was positive but non-significant for most of the air pollutants. However, annual mean NOx was directly and significantly associated with total leukaemia incidence in the fully adjusted model (IRR (95% CI): 1.03 (1.003 to 1.06) per 10 ppb increase). Based on LPA, districts with a higher multiple air-pollutants profile were also associated with higher leukaemia incidence (IRR (95% CI): 1.003 (0.99 to 1.007) per 1 ppb increase).ConclusionsOur study shows that districts with higher air pollution (nitrogen oxides and multipollutants) have higher incidence rates of leukaemia in Tehran, Iran. This study warrants conducting further research with individual human data and better control of confounding.