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Introduction: Increased greenhouse gas emissions since the industrial age have led to higher global temperatures and frequency and severity of climate events, such as heat waves, wildfires, floods, and storms. These changes are adversely affecting human health and increasing disease risk, including risk of allergic diseases. Further understanding of the environmental factors and the cellular and molecular mechanisms mediating these increases can assist in developing strategies to adapt to and mitigate climate change. Materials and Methods: We conducted a scoping review of the literature from 2010 through 2024 using PubMed and Scopus. Results: Thunderstorms, dust storms, wildfires, and other climate change factors increase allergies both directly and indirectly through increases in particulate matter, pollen, migration of disease vectors and decreases in biodiversity. The epithelial barrier, hygiene, “old friends,” and biodiversity hypotheses have been put forward to explain the underlying mechanism mediating these increases. Conclusion: There is an urgent need to reduce the use of fossil fuels to mitigate climate change and protect planetary and human health. While international accords such as the 2015 Paris Agreement have been signed with the aim of lowering greenhouse gases and limiting future global temperature increases, it is clear that increased efforts are needed to meet these goals. Evidence-based solutions for adapting to the increased prevalence of allergic diseases and cost-benefit analysis of current mitigation strategies for lowering allergic diseases are also needed.

Background: Climate change poses significant threats to the health and safety of communities worldwide. Extreme weather events can disrupt critical infrastructure and overwhelm emergency medical services (EMS) systems. As the frequency and intensity of these climate-related disasters continue to increase, it is essential that EMS organizations develop robust strategies to enhance their resilience. One important step in building climate-resilient EMS systems is the development of comprehensive assessment tools. Developing a comprehensive tool for assessing the resilience of EMS in the face of climate change. Methods: This research employs an applied, mixed-methods approach to investigate the development and validation of the Emergency Medical Services Resilience Assessment (EMSRA) tool. The study will be executed across four key phases: (a) A scoping review will be conducted to identify the global dimensions and components of EMS systems that demonstrate resilience to the impacts of climate change. (b) A qualitative study, involving semistructured interviews, will be undertaken to explore the specific dimensions and components of EMS resilience within the Iranian context. (c) Based on the findings from the scoping review and qualitative inquiry, assessment items related to EMS resilience in climate change will be extracted and synthesized to develop a pilot version of the EMSRA tool. (d) The pilot EMSRA tool will undergo a rigorous process of quantitative and qualitative validation, including an evaluation of its psychometric properties, to assess the resilience of EMS systems in the face of climate-related challenges. Conclusions: The development of EMSRA tool will enable the assessment and enhancement of climate change resilience within the national and provincial EMS systems, providing critical data to inform evidence-based strategies and plans for strengthening EMS against the impacts of severe climate changes.

Global warming and climate change have increased the pollen burden and the frequency and intensity of wildfires, sand and dust storms, thunderstorms, and heatwaves—with concomitant increases in air pollution, heat stress, and flooding. These environmental stressors alter the human exposome and trigger complex immune responses. In parallel, pollutants, allergens, and other environmental factors increase the risks of skin and mucosal barrier disruption and microbial dysbiosis, while a loss of biodiversity and reduced exposure to microbial diversity impairs tolerogenic immune development. The resulting immune dysregulation is contributing to an increase in immune-mediated diseases such as asthma and other allergic diseases, autoimmune diseases, and cancer. It is now abundantly clear that multisectoral, multidisciplinary, and transborder efforts based on Planetary Health and One Health approaches (which consider the dependence of human health on the environment and natural ecosystems) are urgently needed to adapt to and mitigate the effects of climate change. Key actions include reducing emissions and improving air quality (through reduced fossil fuel use), providing safe housing (e.g., improving weatherization), improving diets (i.e., quality and diversity) and agricultural practices, and increasing environmental biodiversity and green spaces. There is also a pressing need for collaborative, multidisciplinary research to better understand the pathophysiology of immune diseases in the context of climate change. New data science techniques, biomarkers, and economic models should be used to measure the impact of climate change on immune health and disease, to inform mitigation and adaptation efforts, and to evaluate their effectiveness. Justice, equity, diversity, and inclusion (JEDI) considerations should be integral to these efforts to address disparities in the impact of climate change.

BACKGROUND: The Resilience Evaluation Scale (RES) is a new, free and short self-report questionnaire for measuring psychological resilience. This study aims to translate and assess the psychometric properties of the RES. MATERIALS AND METHOD: In the present methodological study, after the translation process, face and content validity were conducted through qualitative and quantitative methods. To determine the construct validity, exploratory and confirmatory factor analysis (CFA) was used, and for the reliability, Cronbach’s α test and inter-counter coefficient test were calculated. Persian version of the Connor-Davidson Resilience Scale was used to determine the convergent validity of the questionnaire. RESULTS: Results show that the face and content validity of 9 items of RES were acceptable and they were all approved [Impact scores (IS) >1.5, S-CVI/Ave = 0.97, I-CVI = 0.93]; the Internal consistency of the scale was confirmed by the Cronbach’s α coefficient (0.82) and McDonald’s omega (0.83). The reliability of the scale also was confirmed by the Spearman’s correlation coefficient and intra-group correlation coefficient (ICC), with results obtained above 0.8 for all items. The factor analysis identified two factors that accounted for about 56% of the variance. Also, the CFA model fitted well according to the results of the fitting indices (RMSEA = 0.084, CFI = 0.98, SRMR = 0.064, and TLI = 0.97). In addition, the convergent validity of the scale was equal to 0.65 (P < 0.001). CONCLUSION: Development of a valid and reliable psychological resilience scale may bring great benefits to the Persian society. Our findings suggest that the Persian RES has good psychometric properties, and it may serve as a valuable instrument in research and clinical practice.

Abstract Background One of the most important consequences of man-made disasters in the world is the loss of homes and, ultimately, forced population displacement. The sheltering of forcibly refugees to safe areas requires the study of scientific criteria. Methods This qualitative content analysis study was conducted in Iran to identify the criteria for the sheltering of refugees due to conflict. Participants in the study comprised experts and managers who had expertise, experience, or knowledge in the shelter for refugees. Data was collected in semi-structured interviews with 20 individuals and analyzed by qualitative content analysis to extract and categorize the factors affecting sheltering for refugees. Results The results of this study showed that a wide range of factors should be considered in the sheltering of refugees due to conflict, including land type, access to facilities, access to infrastructures, homogeneity, and similarities, security, distance from danger, environmental factors, economic issues, and political and legal issues. These nine categories covered 53 subcategories and 188 factors. Conclusions The comprehensiveness of the factors mentioned in this study showed that the sheltering of refugees due to conflict requires planning, training, culture building, promoting readiness, and inter-organizational coordination. Moreover, managers, policymakers, decision-makers in relief agencies, humanitarian organizations, and organizations involved in sheltering of refugees due to conflict should attend to these factors to improve the process and prevent problems.

BACKGROUND: Useful experiences of the elderly in adapting to the environment may play an important role in formulating future policies. This study was conducted to explain the past experiences of the elderly in Dezful in adapting to heat. MATERIALS AND METHODS: This study was conducted with a qualitative research approach and a qualitative content analysis method in 2020 and 2021. The experiences of 18 elderly in Dezful were collected through semi-structured interviews via recording, face-to-face interviews, and data observation. Sampling was performed by the purpose-based method, and the data of this stage were analyzed using a content analysis approach using the Zhang and Wildemuth method. RESULTS: During the data analysis process, three main themes were extracted, including psychophysiological, socioeconomic, and environmental adaptation. Also, twelve subthemes including changes in physiological conditions, urban architecture, house architecture, diet, clothing, business conditions, mindset, life conditions, and the use of factors (spirituality, experience, and natural capacities) were extracted. CONCLUSION: Explaining the experiences of the elderly in Dezful, who have lived with heat for many years, can provide better identification of solutions and more tangible experiences of adaptation to heat for other communities. These experiences can be used in urban, cultural, and social planning.

Background & Aim: Volunteers’ perceptions may affect their future decisions to participate in crisis intervention. Few studies in Iran have been conducted to examine the experiences of medical personnel who volunteered during the COVID-19 pandemic. This qualitative study describes the experiences of medical volunteers during COVID-19 in Iran. Methods & Materials: A total of 17 healthcare volunteers who worked in COVID-19 hospital wards were recruited using purposive sampling. All participants were recruited in the current study from the hospitals affiliated with the Tehran University of Medical Sciences if they expressed their willingness to participate and had at least two months experience of working as healthcare volunteers in COVID-19 wads. In-depth video-call semi-structured interviews were conducted from August to November 2020. The data were analyzed using the qualitative thematic analysis method. Results: One main theme “from nuisance to helpful assistants” and four sub-themes including the “feeling of inefficiency”, “negligent managing”, “situation orientation”, and “transformation for integrity” emerged from the data. Conclusion: Despite experiencing challenges, the volunteers and hospital staff tried to change their approaches to joint collaboration by improving their capabilities for situation awareness and creating integrity. These findings provide policymakers with a better understanding of health volunteers' challenges in hospitals during crises.

Background: We aimed to evaluate the impact of heatwaves on daily deaths due to non-accidental, cardiovascular and respiratory causes in the city of Dezful in Iran from 2013 to 2019. Method: We collected daily ambient temperature and mortality and defined 2 types of heatwaves by combining daily temperature ⩾90th in each month of the study period or since 30 years with duration ⩾2 and 3 days. We used a distributed lag non-linear model to study the association between each type of heatwave definition, and deaths due to non-accidental, cardiovascular and respiratory causes with lags up to 13 days. Results: There was no discernible correlation in this area, despite the fact that heatwaves raised the risk of death from cardiovascular causes and lowered the risk from respiratory causes. On the other hand, the risk of total non-accidental mortality on days with the heatwaves is significantly higher than normal days. In main effects, the heatwaves have a significant relationship with the risk of total non-accidental mortality (in the first heatwave definition, Cumulative Excess Risk (CER) in lag 0-2 was 10.4 and in second heatwave definition, CER values in lag 0, 0-2, and 0-6 were 12.4, 29.2, and 38.8 respectively). Also, in added effects, heatwaves have a significant relationship with the risk of total non-accidental mortality (in the first heatwave definition, CER in lag 0 and 0-2 were 1.79 and 4.11 and in the second heatwave definition, CER values in lag 0, 0-2, and 0-6 were 7.76, 18.35 and 24.87 respectively). In addition, heatwaves appeared to contribute to a cumulative excess risk of non-accidental death among the male group as well as the older adults. Conclusion: However, the results showed that heatwaves could have detrimental effects on health, even in populations accustomed to the extreme heat. Therefore, early warning systems which monitor heatwaves should provide the necessary warnings to the population, especially the most vulnerable groups.

Introduction: Concerns about nutrition and foods are amongst those problems that the affected communities always were encountered with, because of the natural disasters. This study purpose was to investigate the nutritional problems and sequences after the East Azerbaijan earthquake. Methods: This systematic study searched for the relevant surveys using the main databases including PubMed, Scopus, Google scholar, Cochrane Library, Science Direct, the web of knowledge (for English studies), Google, Yahoo, and also other Persian information and library resources (for Persian studies) with some associated keywords. The collected data were analyzed, summarized, and reported manually by the use of content analysis method. Results: Amongst 975 studies found in the scientific databases, 21 studies were reviewed in order to find some answers for these research complications, and the earthquake problems were categorized into three contexts including food safety, food security, and nutritional consequences. Conclusion: Despite of the fulfilled efforts after the East Azerbaijan earthquake in 2012, diverse nutritional problems and consequences had been formed in the community, especially amongst children and women.

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Background: We aimed to identify indicators affecting firefighters’ resilience through a systematic review. Methods: International electronic databases, including Web of Science, Medline through PubMed, Scopus, Cochrane Library, and Google Scholar, were searched on Dec 23, 2018. The search strategy was developed using main words, including firefighter, resilience, and indicators. Then, the indicators related to firefighters’ resilience were extracted and analyzed using a qualitative synthesis method. Results: Overall, 7178 unique documents were identified by searching different databases. Then, by screening the title and abstract, 7104 articles were excluded, and only 74 full text papers were critically studied. Finally, 31 full text articles were selected for the analysis. Quality appraisal of included studies done by modified STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) tool. Moreover, 186 indicators and criteria were extracted from the included studies and classified into 6 domains and 15 categories. Conclusion: This study suggests six main domains, including physical health, physical fitness, mental health, life style, job-related competencies, and demographic status, to categorize different indicators of firefighters’ resilience. Building resilience in firefighters requires all these domains to be considered in the assessment, planning, and evaluation processes.

Abstract Background Ensuring public health is crucial in any policy debate on climate change. Paris Agreement on climate change is a global contract, through which countries have committed themselves to a public health treaty. The agreement has laid the foundation for mitigation and adaptation. This study was conducted to provide an evidence-based framework for policy-making in the health system of Iran in order to reduce the adverse effects of climate change on public health and to increase the adaptation of the health system as a result. Methods This is a qualitative study. We first used Delphi method to extract the components of Paris Agreement on climate change that were related to the functions and policymaking of health system in Iran. Twenty-three experts in health and climate change were identified purposefully and through snowball sampling as participants in Delphi. Data collection instrument was a structured questionnaire. We used SPSS software version 25 for data analysis based on the descriptive indices including the mean, the percentage of consensus above 75%, and the Kendall coordination coefficient. Results Seventy-nine components classified within nine categories were extracted. The most important examples of the implementation of Paris Agreement on climate change in the health system of Iran were: participation in the formulation of strategies for mitigation and adaptation, identifying vulnerable groups, assessing vulnerability, increasing the capacity of health services delivery during extreme events, using early warning systems, using new technologies to increase the adaptation, evaluation of interventions, financial support, increasing the number of researches, increasing the knowledge and skills of staff, and finally public awareness. Conclusions Evidence-based policy-making is pivotal to develop effective programs to control the health effects of climate change. This research provided policy translation and customization of micro and macro provisions of Paris Agreement on climate change, in line with the political context of health system in Iran. Our finding will pave the ground, we envisage, for further steps towards capacity building and enhancement of resiliency of the health system, adaptation interventions, and evaluation, identification of barriers and facilitators for adaptation and decreasing the adverse health effects caused by the climate change, in Iran and perhaps beyond.

District 20 (Shahr-e-Ray), as the southernmost urban area among the municipal districts of Tehran, has a population of 4553740 individuals and an area of 22km2 within the urban zone and 178km2 outside this zone. The earthquake risk is estimated to be very high in this region due to the tectonic and geographical position, presence of numerous faults around the region, the occurrence of several historical destructive earthquakes within this area, as well as other tectonic and geological evidence. In the present study, by investigating the current status, analyzing and classifying the vulnerability of the habitats in this region, and using the MLP model, a new strategy is presented. The results of the model based on the input models indicated the higher accuracy and efficiency of the standard classification method compared to the standard max/min method. By taking a look at the map of the standard classification method in the applied model, it can be found that the orange and nearly blue spots, which are mostly scattered in the central part of the region, have the highest correlation with the worn texture and the highest vulnerability. According to the results of the model in terms of vulnerability expansion and zone, out of the total area of the region, 21% has the high and very high vulnerability, 61% medium vulnerability, and 18% low vulnerability. Also, the results of the population layers indicated high, medium, and low vulnerability intensities for 56.8%, 27.9%, and 14.1% of the total population, representing the population density in worn-out buildings with narrow pathways. Moreover, the results concerning the layers of material type and important places showed that the material types including metals, bricks, semi-metallic, …, respectively, and the important places such as educational centers, clinics, and medical centers have the highest vulnerability intensities

Objective: To examine all aspects affecting the functioning of the system and the most important factors in its assessment through a systematic review during 1990 to 2017. Methods: This systematic review of the current literature study was conducted during July 2017, and all articles, books, guidelines, manuals and dissertations pertaining to the Incident Command System were analyzed. A total of articles and relevant documents were identified and finally these articles, which we found, were analyzed based on the specified indicators. Results: In this research 992 articles and relevant documents were identified and eventually, 48 articles were included and analyzed. The results were categorized into 6 main groups including 65 subgroups and 221 variables: features of hospital incident command system (14 subgroups and 53 variables), strengths of the system (15 subgroups and 70 variables), weaknesses of the system (10 subgroups and 15 variables), factors influencing the system's performance improvement (12 subgroups and 42 variables), factors that reduce the effectiveness of system include 11 subgroups (10 internal factors and 1 external factor) and 22 variables and important factors in assessing system performance (2 sub-groups and 19 variables). Conclusion: According to the results, Evaluating the effectiveness of a hospital accident command system (HICS) in a valid method can improve the efficiency of this system. In this appraisal, hospital managers and health decision-makers should consider principles, characteristics, strengths and weakness of it.

Background: We aimed to identify the indicators and criteria to locate temporary shelters for conflict refugees. Methods: This systematic review evaluated the full-text of the related articles in international electronic databases, such as Web of Science, Scopus, PubMed, Cochran, and Google Scholar from the beginning and without time limit to 1 June 2019. In addition, this search was based on a strategy developed by the researchers. The studies were selected regardless of their methods and two data extraction forms were used to extract the most relevant and important information. Results: Among 10124 cases of primary documents, 38 articles were selected, and 25 articles were analyzed in full-text. Totally, 45 indicators were identified and classified into two main categories of physical and non-physical indicators with six subcategories of land ownership, host government, access to infrastructures, site safety, land characteristics, and economic, social, and cultural considerations. Conclusion: The selection of temporary shelters for the conflict refugees requires the identification of all the specific influential factors not properly addressed. The final indicators obtained in our review could be incorporated into the development of the models required in this regard.

Objective: Pre-hospital personnels (PHPs) who work in disasters under extreme pressure, uncertainty, and complex situations are victims of disasters themselves, and there is a link between experiencing such incidents and mental health problems. Because most studies focus on the injured and less on the psychological issues of PHPs, the present study aimed to develop a model to provide relief for PHPs in disasters from a psychological perspective.Methods: A grounded theory methodology recommended by Corbin and Strauss (2015) was employed. PHPs (n = 24) participated in a semi-structured interview between July 2018 to May 2020.Results: In the analysis of the pre-hospital staff interviews, three main themes were extracted, namely, providing relief with struggle (complexity of incident scenes, command-organizational and occupational challenges), psychological distress (psychological regression and psychological empowerment), and consequences (resilience and job burnout). Seven categories and 22 subcategories were explored from our data via the grounded theory approachConclusions: The PHPs managed psychological distress with two approaches: psychological self-empowerment and regression, which resulted in resilience and burnout, respectively. Due to the lack of enough support, the resilience of the PHPs was short-term, turned into burnout over time, and affected the structural factors again as a cycle.

Background: Despite the fact that Iran has been exposed to severe dust storms during the past 2 decades, few studies have investigated the health effects of these events in Iran. This study was conducted to assess the association between dust storms and daily non-accidental, cardiovascular, and respiratory mortality in Dezful City (Khuzestan Province, Iran) during 2014 to 2019. Methods: In this study, mortality, meteorological, and climatological data were obtained from the Dezful University of Medical Sciences, Iranian Meteorological Organization, and Department of Environment in Khuzestan Province, respectively. Days of dust storm were identified based on the daily concentration threshold of particulate matter with an aerodynamic diameter of less than 10 μm (PM 10 ) according to Hoffmanns҆ definition, and then an ecological time-series was used to estimate the short-term effects of dust storms on daily mortality. Statistical analysis was performed using a distributed lag linear model (DLM) and a distributed lag non-linear model (DLNM) packages by R software and the study results were reported as excess mortality. Results: During the study period, 15 223 deaths were recorded, and 139 dust storms occurred in Dezful city. In addition, there was statistically significant excess risk of mortality due to dust storms in Dezful City (mortality in the group under 15 years of age, lag 4 : 34.17% and 15-64 years of age groups, lag 5 : 32.19%, lag 6 : 3.28%), also dust storms had statistically significant effects on respiratory mortality (lag 6 : 5.49%). Conclusion: The findings of the current study indicate that dust storms increase the risk of mortality with some lags. An evidence-based early warning system may be able to aware the people of the health effects of dust storms.

Abstract Background Hospitals play a vital role in disaster stricken regions. The resilient hospitals will be able to provide essential services to affected people and it can mitigate the risk of injuries during and after disasters. This study aimed to obtain the indicators required for the evaluation of hospital resilience. Methods This systematic review was conducted in 2018. Through this systematic review, international electronic databases were investigated for the research studies published in English. The exclusion and inclusion criteria were determined to extract the hospital resilience indicators. These indicators will be used in order to develop a model to keep the system performance at an acceptable level during disasters. Results Out of 1794 research studies published until September 2018, 89 articles and guidelines with full text were surveyed. Thirty-two articles and guidelines were then selected and analyzed to collect the indicators related to hospital disaster resilience (HDR). The domains and the indicators were extracted from these selected research studies. The authors collected and categorized them into three domains and twenty seven subdomains. The three domains included constructive, infrastructural, and administrative resilience. The relevant indicators were designed for each subdomain to assess HDR. Conclusion Since diverse indicators affect hospital resilience, other studies should be conducted to propose some models or tools to quantify the hospital resilience in different countries and scopes with an all hazards approach.

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Background: Dust storms and their impacts on health are becoming a major public health issue. The current study examines the health impacts of dust storms around the world to provide an overview of this issue. Method: In this systematic review, 140 relevant and authoritative English articles on the impacts of dust storms on health (up to September 2019) were identified and extracted from 28 968 articles using valid keywords from various databases (PubMed, WOS, EMBASE, and Scopus) and multiple screening steps. Selected papers were then qualitatively examined and evaluated. Evaluation results were summarized using an Extraction Table. Results: The results of the study are divided into two parts: short and long-term impacts of dust storms. Short-term impacts include mortality, visitation, emergency medical dispatch, hospitalization, increased symptoms, and decreased pulmonary function. Long-term impacts include pregnancy, cognitive difficulties, and birth problems. Additionally, this study shows that dust storms have devastating impacts on health, affecting cardiovascular and respiratory health in particular. Conclusion: The findings of this study show that dust storms have significant public health impacts. More attention should be paid to these natural hazards to prepare for, respond to, and mitigate these hazardous events to reduce their negative health impacts. Registration: PROSPERO registration number CRD42018093325

During the first half of 2019, many provinces of Iran were affected by floods, which claimed the lives of 82 people. The present study aimed to investigate the behavioral, health related and demographic risk factors associated with deaths due to floods. We measured the odds ratio and investigated the contribution and significance of the factors in relation to mortality. This case-control study was conducted in the cities affected by flood in Iran. Data were collected on the flood victims using a questionnaire. Survivors, a member of the flood victim's family, were interviewed. In total, 77 subjects completed the survey in the case group, and 310 subjects completed the survey in the control group. The findings indicated that factors such as the age of less than 18 years, low literacy, being trapped in buildings/cars, and risky behaviors increased the risk of flood deaths. Regarding the behavioral factors, perceived/real swimming skills increased the risk of flood deaths although it may seem paradoxical. This increment is due to increased self confidence in time of flood. On the other hand, skills and abilities such as evacuation, requesting help, and escape decreased the risk of flood deaths. According to the results, the adoption of support strategies, protecting vulnerable groups, and improving the socioeconomic status of flood-prone areas could prevent and reduce the risk of flood deaths.

Background: Physical rehabilitation, as one of the rehabilitation disciplines, can play a great role in humanitarian reliefs. The effectiveness of physical rehabilitation services is completely dependent on time of intervention, the importance of good timing in providing services during disasters is not well understood. The objective of this study was to systematically review the physical rehabilitation services provided in disasters and emergencies. Methods: An electronic search of PubMed, Scopus, Cochrane, and PEDro (Physiotherapy Evidence Database) was undertaken from Jan 2000 to Sep 2017. All English studies reporting physical rehabilitation services in natural and man-made disasters were selected regardless of study design. The included studies were analyzed by descriptive and analytical method. Results: Thirteen studies were included after reviewing by title, abstract and full text in this study. Most of the physical rehabilitation studies come back to recent years. Most of the disaster physical rehabilitation services were physiotherapy and occupational therapy. The physical rehabilitation experts have been attended in the affected area from the few first hours until several months after disasters in order to provide the required services to the affected population. Conclusion: There are few studies about physical rehabilitation services provided in the disaster-affected areas and this study showed that the services were limited and at different times. Physical rehabilitation services post disasters should have a comprehensive service model, like other health services. Therefore, it is necessary to conduct further studies to achieve this aim.

INTRODUCTION: Emergency prehospital providers (EPHP) who are constantly providing medical care in threatening conditions are more at risk of displaying psychological distress presentations in disaster situations. Problem-solving strategies are essential for effective and efficient management of event position. Therefore, the present study aimed to explore psychological distress promotion in Iranian EPHP. MATERIALS AND METHODS: A qualitative content analysis study was conducted based on 24 semi-structured interviews. A purposeful sampling method was applied until reaching data saturation. Interviews were transcribed verbatim, and then, data condensing, labeling, coding, and defining categories were performed by the qualitative content analysis recommended by the Landman and Graneheim approach. RESULTS: Based on the experience of study participants, two main themes with six categories developed. The main themes included emotion-based management and problem-based management when confronting with incidence scene. CONCLUSION: The main problems of EPHP in confronting with incidence and disasters scenes are psychological distress which some rescuers have emotional reactions while some others who are more resilience and experience manage this problem in the form of problem-based approach. It is recommended these practical strategies to be taught to less experienced rescuers for avoiding emotional-based reactions and better management of disaster scene.

Background: Explosive events refer to events, either natural or man-made, that occur advertently or accidentally. This article aimed to study epidemiology of explosive events and investigate the health consequences of such events. It also aimed to discuss the prevention and management of these events from a healthcare provision viewpoint. Materials and Methods: This descriptive study comprised 2 sections. First, following an extensive review of the literature, a database, containing the related articles was developed. Then, the core research group drafted the first adapted version of the results. Using a Delphi panel methodology, the results were finalized based on the consensus of 11 experts. Results: Terrorist explosion is the most common type and of ever-growing explosions worldwide. It accounts for the largest proportion of casualties caused by man-made events. Health consequences of explosions can be classified into physical, mental, and social ones, which can appear immediately or a long time after the event and affect individuals, families, and societies. Conclusion: Because of the wide range and adverse impacts of explosions, healthcare authorities and staff should have a good grasp of preventive principles, as well as protection and management of explosion sites. Besides they have to be familiar with treating the injured. It is recommended that training courses and simulated explosive events be designed and run by the healthcare sector.