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This investigation aimed to scrutinize the level of phthalate esters (PEs) in the landfill leachate of a coastal city in the north of the Persian Gulf and the sensitive ecosystem (soil and water) around it. Soil (two depths) and water samples were prepared from 5 stations in wet and dry seasons. The studied landfill leachate contained 114-303 μg/L of phthalates. The highest concentration of phthalates was related to bis (2-ethylhexyl) phthalate (3257 ng/g) in the wet season at surface soil (0-5 cm) in the landfill site, while the lowest one (6 ng/g) belonged to dimethyl phthalate at sub-surface soil at 700 m from the landfill in the dry season. A significant change in the level of Σ6PEs in the dry (303 μg/L) and wet (114 μg/L) seasons (P ≤ 0.05) was observed for water samples. The PE concentrations in wet times were higher in all soil depths than in dry times. With increasing depth, the content of phthalates decreased in all studied environments. A direct relationship was observed between the phthalates concentration and the pH value of leachate/water and soil. The PEs concentration was linked to electrical conductivity (leachate: R 2  = 0.65, P < 0.01 and surface soil: R 2  = 0.77, P < 0.05) and the soil organic content. The ecological risk of di-n-butyl phthalate, benzyl butyl phthalate, bis (2-ethylhexyl) phthalate, and di-n-octyl phthalate in the wet season was greater than one. The results showed that significant levels of phthalate esters are released from landfills to the surrounding environment, which requires adequate measures to maintain the health of the ecosystem and nearby residents., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

The health risk and burden of disease induced by exposure to benzene, toluene, ethylbenzene, and xylene (BTEX) in the outdoor air in Tehran, 2019 were assessed based on the data of five fixed stations with weekly BTEX measurements. The non-carcinogenic risk, carcinogenic risk, and disease burden from exposure to BTEX compounds were determined by hazard index (HI), incremental lifetime cancer risk (ILCR), and disability-adjusted life year (DALY), respectively. The average annual concentrations of benzene, toluene, ethylbenzene, and xylene in the outdoor air in Tehran were 6.59, 21.62, 4.68, and 20.88 μg/m 3 , respectively. The lowest seasonal BTEX concentrations were observed in spring and the highest ones occurred in summer. The HI values of BTEX in the outdoor air in Tehran by district ranged from 0.34 to 0.58 (less than one). The average ILCR values of benzene and ethylbenzene were 5.37 × 10 -5 and 1.23 × 10 -5 , respectively (in the range of probable increased cancer risk). The DALYs, death, DALY rate (per 100,000 people) and death rate (per 100,000 people) induced by BTEX exposure in the outdoor air in Tehran were determined to be 180.21, 3.51, 2.07, and 0.04, respectively. The five highest attributable DALY rates in Tehran by district were observed in the districts 10 (2.60), 11 (2.43), 17 (2.41), 20 (2.32), and 9 (2.32), respectively. The corrective measures such as controlling road traffic and improving the quality of vehicles and gasoline in Tehran could reduce the burden of disease from BTEX along with the health effects of other outdoor air pollutants., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

The health risk and burden of disease induced by exposure to inorganic arsenic (iAs) through drinking water and foodstuffs in Iran were assessed. The iAs levels in drinking water and foodstuffs (15 food groups) in the country were determined through systematic review of three international databases (PubMed, Scopus, and Web of Science) and meta-analysis. Based on the results of the systematic review and meta-analysis, the average iAs levels in drinking water and all the food groups at the national level were lower than the maximum permissible levels. The total average non-carcinogenic risk of dietary exposure to iAs in terms of hazard index (HI) was 3.4. The average incremental lifetime cancer risk (ILCR) values of dietary exposure to iAs were determined to be 1.5 × 10 -3 for skin cancer, 1.0 × 10 -3 for lung cancer, and 4.0 × 10 -4 for bladder cancer. Over two-thirds of the non-carcinogenic and carcinogenic risk of dietary exposure to iAs was attributed to bread and cereals, drinking water, and rice. The total annual cancer incidence, deaths, disability-adjusted life years (DALYs), death rate, and DALY rate (per 100,000 people) were assessed to be 3347 (95 % uncertainty interval: 1791 to 5999), 1302 (697 to 2336), 72,606 (38,833 to 130,228), 1.6 (0.87 to 2.9), and 91 (49 to 160). The contribution of mortality in the attributable burden of disease was 95.1 %. The contributions of the causes in the attributable burden of disease were 72 % for lung cancer, 16 % for bladder cancer, and 12 % for skin cancer. Due to the significant attributable burden of disease, national and subnational action plans consisting of multi-disciplinary approaches for risk management of dietary exposure to iAs, especially for the higher arsenic-affected areas and high-risk population groups in the country are recommended., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier B.V. All rights reserved.)

The aim of this study was to compare maternal and fetal exposure to PCBs in pregnant women from a petrochemical and gas area (PGA) and an urban area (UA), by the analyses of serum samples from mother (MS) and cord (CS). After liquid-liquid extracting, samples were analyzed for 12 PCBs congeners by gas chromatography mass spectrometer. Adjusted multiple linear regression models showed the mean levels (μg/L) of total PCBs in the MS and CS samples from the PGA (1.70 ± 0.81 and 1.19 ± 0.43) were significantly higher than those from UA (1.64 ± 0.75 and 1.07 ± 0.38). PCB 44 was predominant in both MS and CS serum samples, and in both PGA (0.80 ± 0.70 and 0.76 ± 0.67) and UA (0.79 ± 0.39 and 0.67 ± 0.34). A negative correlation was found for PCB 52 as one-unit increase in the cord serum levels was associated with 0.024 g decrease in newborn weight. Similarly, one-unit increase in the maternal serum PCB 18 concentrations were associated with 0.09 and 0.086 cm decrease in newborn height and head circumference. The serum levels of PCB 18 and 52 in the mothers who consumed meat and milk at least 1 meal/week were higher than these who consumed meat and milk never or less than 1 meal/month. The findings in this study indicated that higher maternal exposure to PCBs, as result of living in an industrialized area, leads to higher PCBs accumulation in cord blood, which consequently passes to the developing fetus. These events may cause harmful effects on both them in-utero and afterbirth growth and development., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Plastic wastes are produced in a large amount everywhere, and are commonly disposed in landfills. So landfill leachate seems an obvious source of microplastics (MPs) and phthalate esters (PAEs) due to a huge usage as plastic additives and plasticizers. But this issue still lacks attention and the present study provides the first information on the levels of MPs and PAEs in the fresh landfill leachate of Bushehr port during different seasons. The mean levels of MPs and PAEs in the fresh leachate in all seasons were 79.16 items/L and 3.27 mg/L, respectively. Also, the mean levels of PAEs in MPs were 48.33 μg/g. A statistically significant difference was detected in the levels of MPs and PAEs among different seasons with the highest values in summer and fall. MPs with a size of >1000 μm had the highest abundance in all seasons. The most prominent shape, color, and type of MPs in the leachate were fibers black, and nylon, respectively. Dibutyl phthalate (DBP) and Di(2-ethylhexyl) phthalate (DEHP) were the most dominant PAEs present in the leachate samples. The results of this study revealed high hazard index (HI) and pollution load index (PLI) of MPs in all seasons. Dioctyl phthalate (DOP), DEHP, DBP, diisobutyl phthalate (DiBP), butyl benzyl phthalate (BBP), and diethyl phthalate (DEP) represented a high risk to the sensitive organisms. The results of this study showed that significant levels of MPs and PAEs may release into the surrounding environment from the landfill sites without sufficient protection. This issue is more critical when the landfill sites in particular are located near the marine environments like the Bushehr landfill that is located near the Persian Gulf, which can lead to serious environmental problems. Thus permanent control and monitor of landfills, especially in the coastal areas are highly needed to prevent further pollution., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier B.V. All rights reserved.)

The increase in annual usage of plastics for different purposes has led to an increase in microplastics (MPs) particles in various environments including inside of buildings. In the present study, levels and characteristics of MPs in the indoor dust of buildings with different uses including residential house, mosque, hospital, kindergarten, and university in two cities, Bushehr port and Shiraz in Iran, were determined. Thirty dust samples from various buildings were collected. The average numbers of MPs in the indoor dust of buildings of Shiraz and Bushehr were 90.8 and 80.8 items/mg, respectively. Fiber and polyethylene (PE) were the most common shape and polymer types of identified MPs, respectively. The highest number of MPs was observed in the indoor dust of kindergartens with a mean number of 121 items/mg in Bushehr and 104 items/mg in Shiraz. Except for mosques, a significant difference (p-value <0.05) were not observed between the MPs levels of buildings with similar applications in Bushehr and Shiraz cities. In addition, the high daily intake to MPs via indoor dust ingestion and inhalation were found for infants in kindergartens and mosques. The results of this study showed that MPs are present in high concentrations in indoor environments and may pose a high exposure risk for different age groups., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Overexposure to solar ultraviolet radiation (SUVR) can cause skin and eye adverse effects for outdoor workers. In this study, the burden of disease induced by occupational exposure to SUVR and its spatiotemporal trend at national and sub-national levels in Iran, 2005-2019 were assessed. The attributable burden of disease was assessed using the following five datasets: (1) distribution of occupational exposure to SUVR, (2) total incidences and deaths of health outcomes of SUVR exposure, (3) population attributable fractions of the health outcomes of SUVR exposure, (4) age-gender distribution of outdoor workers, and (5) disability-adjusted life year (DALY) calculation constants. During 2005-2019, the attributable DALYs increased from 2442 to 2907 and the attributable DALY rate (per 100,000 workers) slightly decreased from 11.94 to 11.91. The share of YLL in the attributable burden of disease was in the range of 43%-46%. Out of nine causes, about 90% of the attributable burden of disease in 2019 was related to cataracts (29.9%), malignant skin melanoma (27.4%), squamous-cell carcinoma (18.6%), and sunburn (17.2%). During the study period, the attributable DALY rate in women increased by 60.95% (from 5.04 to 8.11) and in men decreased by 2.06% (from 13.03 to 12.76). The total attributable DALYs and DALY rate rose by age during 2005-2019. The contributions of population growth, risk-deleted DALY rates, exposure risk, and population age structure in temporal changes of the attributable burden of disease were 19.27%, 9.13%, -1.35%, and -14.8%, respectively. The three highest attributable DALY rates in 2019 were observed in South Khorasan (21.28), Chahar Mahal and Bakhtiari (17.42), and Kordestan (17.26), respectively. The preventive interventions against SUVR overexposure, regular screenings, and early treatments with an emphasis on occupations with continuous sun exposure and provinces with increasing attributable DALY rates should be considered in the occupational health action plan in the country., (Copyright © 2021 Elsevier GmbH. All rights reserved.)

Estimating the burden of diseases induced by overexposure to solar ultraviolet radiation (SUVR) can help to prioritize environmental health interventions. The age-sex specific and cause-specific mortality and disability-adjusted life years (DALYs) attributable to overexposure to SUVR at the national and subnational levels in Iran, 2005-2019 were estimated. The burden of disease induced by overexposure to SUVR was quantified in four steps as follows: (1) estimating exposure to SUVR, (2) estimating total incidences and deaths of target causes, (3) assessing population attributable fractions of the target causes for the SUVR, and (4) calculating the attributable burden of disease. The attributable DALYs, deaths, age-standardized DALY rate, and age-standardized death rate at the national level were determined to be respectively 21896, 252, 42.59, and 0.56 in 2005 and were respectively changed to 28665, 377, 38.76, and 0.53 in 2019. The contributions of causes in the attributable DALYs at the national level were different by year and sex and for both sexes in 2019 were as follows: 46.15% for cataract, 20.36% for malignant skin melanoma, 16.07% for sunburn, 12.41% for squamous-cell carcinoma, and 5.01% for the other five causes. The contributions of population growth, population ageing, risk exposure, and risk-deleted DALY rate in the temporal variations of the attributable burden of disease in the country were +20.73%, +20.68%, +2.01%, and -12.51%. The highest and lowest provincial attributable age-standardized DALY rates in 2019 were observed in Fars (46.8) and Ardebil (32.7), respectively. The burden of disease induced by exposure to SUVR caused relatively low geographical inequality in health status in Iran. Due to increasing trends of the SUVR as well as the attributable burden of disease, the preventive interventions against the SUVR overexposure should be considered in the public health action plan all across the country., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

The solar ultraviolet radiation (UVR) at national, provincial and county levels in Iran during 2005-2019 were determined based on Ozone Monitoring Instrument (OMI) dataset. The temporal (annual and monthly) trends and spatial distributions of the UVR in terms of erythemally weighted daily dose (EDD), erythemally weighted irradiance at local solar noon time (EDR), and UV index and the major factors influencing the spatiotemporal trends were analyzed. The population-weighted average values of EDD, EDR, and UV index in Iran were respectively 3631 J/m 2 , 176.3 mW/m 2 , 7.1 in 2005 and rose by 0.22% per year to 3744 J/m 2 , 181.7 mW/m 2 , and 7.3, respectively in 2019, but the annual trend was not statistically significant. The EDD in Iran during the study period exhibited the highest monthly average value in June (6339 J/m 2 ) and the lowest one in December (1263 J/m 2 ). The solar UVA/UVB ratios at the national level during 2005-2019 were considerably lower in summer. The EDD provincial average values in the study period were in the range of 2717 (Gilan) to 4424 J/m 2 (Fars). The spatiotemporal variations of the solar UVR parameters were well described by the linear models as a function of cloud optical thickness (COT), ozone column amount, surface albedo, latitude, and altitude (R 2  > 0.961, p value < 0.001) and the temporal changes of the solar UVR parameters were mainly caused by the COT. The results indicated that non-burning exposure to solar UVR in summer can be more efficient for vitamin D synthesis due to higher contribution of UVB in the solar UVR. The spatial distributions and temporal trends should be considered to determine the optimal duration, time and condition of exposure to the solar UVR for the public and occupational training and public health measures., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

The vulnerability of employees of different occupations from the Coronavirus disease 2019 (COVID-19) pandemic in Iran was assessed using an innovative index. The vulnerability index was developed in five steps as follows: (1) determining the principles and components of employees' susceptibility and resilience, (2) weighting the principles and components, (3) converting the levels of components to the sub-index values, (4) introducing the aggregation functions, and (5) characterizing the vulnerability index values in five categories as very high (80-100), high (65-79), medium (50-64), low (30-49), and very low (0-29). The average values of susceptibility, resilience, and vulnerability index of the employees were determined to be 35.2 ± 15.0, 73.9 ± 17.0, and 32.9 ± 12.7, respectively. The average resilience of the employees was more desirable than their average susceptibility. The distribution of the employees into the vulnerability index categories was 46.3% for very low, 41.9% for low, 3.6% for medium, and 8.2% for high. The worst cases of susceptibility and resilience principles were exposure to contaminated surfaces (59.1 ± 22.8) and top management commitment (66.6 ± 23.1). The elderly staff (especially over 50 years old), employees with low education levels, and employees in private and self-employment sectors were significantly more vulnerable (p value < 0.01) from the COVID-19 pandemic. The principles with significant incremental effects on the vulnerability index (p value < 0.05) were respectively top management commitment (+1.78), exposure to COVID-19 patients at work (+1.36), exposure to contaminated surfaces (+0.82), installing clear shields and wearing PPE (+0.59), observance of social distancing (+0.48), and just culture (+0.22). An especial plan to support the more vulnerable employees with an emphasis on the principles with the most incremental effects on the vulnerability index can efficiently control the inequality between the employees as well as occupational transmission of the COVID-19 in Iran., (Copyright © 2021 Elsevier Inc. All rights reserved.)

The presence of polycyclic aromatic hydrocarbons (PAHs) in the fetal environment is a high-priority concern due to the fetus being more sensitive than adults to these ubiquitous xenobiotics. The aim of the present study was to compare the maternal and fetal serum levels of ΣPAHs and their effects on fetal growth in an industrial and an urban area in Southwest Iran. The industrial area was the petrochemical and gas area (PGA) of the Central District of Asaluyeh County and the urban area (UA) was the Central District of Bushehr County, Ninety-nine maternal serum (MS) and 99 cord serum (CS) samples from the PGA and 100 MS and 100 CS samples from the UA were collected during May 2018 to February 2019. The mean concentrations of ΣPAHs were significantly (p < 0.05) higher in the PGA than the UA in both MS (157.71 vs. 93.56 μg/L) and CS (155.28 vs. 93.19 μg/L) samples. Naphthalene (NAP) was the predominant PAH detected in all the studied samples. Significant negative associations were found between birth weight and anthracene (ANT) level in MS (β = -22.917, p = 0.032; weight decrement = 22.917 g for a 1 μg/L increase in ANT); head circumference and chrysene (CHR) level in MS (β = -0.206, p = 0.023; head circumference decrement = 0.206 cm for a 1 μg/L increase in CHR); and birth height and NAP level in CS (β = -0.20, p = 0.005; height decrement = 0.20 cm for a 1 μg/L increase in NAP). Maternal diet had a significant effect on the serum levels of PAHs. The results of this study showed that transmission of PAHs from mother to fetus through the cord blood is an important issue and mothers who live in industrial areas and consume PAH-containing foodstuffs, and their fetuses, are more at risk than those living in a non-industrial urban area., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Tobacco smoke is known for releasing metals in indoor air of waterpipe/cigarette cafés. However, the worker exposure to metals, and its association with oxidative stress in these cafés are still unclear. To this end, 54 workers and 38 customers from waterpipe/cigarette cafés (the exposed group), 30 workers from non-smoking cafés (the control group 1 (CG&#95;1)) and 32 individuals from the general population (the control group 2 (CG&#95;2)) were selected and toenails samples were then taken from them. Our findings revealed a significant difference in terms of toenail-bounded metal levels between the exposure and control groups (CG&#95;1 and CG&#95;2) (Mann-Whitney U test, P value  < 0.05). This study has also indicated that "type of tobacco" could be considered as a predictor for toenail-bounded heavy metals. Furthermore, our research's results suggest that toenail-bounded heavy metals are positively and significantly correlated with urinary levels of 8- hydroxy-2'-deoxyguanosine (8-OHdG, as a biomarker for the degradation of deoxyribonucleic acid (DNA) oxidative stress). Therefore, it can be concluded that workers of waterpipe/cigarette cafés are at high risks of adverse health of DNA oxidative degradation.

This work aimed to explore the concentration of nickel, manganese, iron, copper, chromium, and lead in the milk of goat herds in the industrial area of Asaluyeh (southern Iran) and the non-industrial area of Kaki. The milk of 16 goat herds (each herd had at least ten goats) was collected in several villages in each area, and at the same time, the drinking water and forage of goats were sampled. The concentration of elements in the samples was determined by ICP-OES. The mean concentrations of chromium, copper, iron, manganese, lead, and nickel in milk samples of the Asaluyeh area were 16.423 ± 0.349, 0.146 ± 0.118, 6.111 ± 0.501, 0.239 ± 0.016, 0.141 ± 0.030, and 1.447 ± 0.101 mg/kg, respectively. Concentrations of heavy metals (except for copper) in the milk of goats in the industrialized area of Asaluyeh were significantly higher than that of Kaki (P < 0.05). Also, the content of heavy metals was significantly correlated with lactose levels (P < 0.05). The hazard index for drinking the goat milk was computed to be 0.444 and 0.386 for the Asaluyeh and Kaki area, respectively, which shows a minimal effect of this exposure pathway.

Health risk and burden of disease induced by exposure to trihalomethanes (THMs, four compounds) and haloacetic acids (HAAs, 5 compounds) from drinking water through ingestion, dermal absorption, and inhalation routes were assessed based on one-year water quality monitoring in four urban communities (Bandar Deylam, Borazjan, Bushehr, and Choghadak) of Bushehr Province, Iran. The total average concentrations of THMs and HAAs at all the communities level were determined to be 92.9 ± 43.7 and 70.6 ± 26.5 μg/L, respectively. The dominant components of the THMs and HAAs were determined to be tribromomethane (TBM, 41.6%) and monobromoacetic acid (MBAA, 60.8%), respectively. The average contributions of ingestion, dermal absorption, and inhalation routes in exposure to the chlorination by-products (CBPs) were respectively 65.0, 15.4, and 19.6%. The total average non-carcinogenic risk as the hazard index (HI) and incremental lifetime cancer risk (ILCR) of the CBPs at all the communities level were found to be 4.03 × 10 -1 and 3.16 × 10 -4 , respectively. The total attributable deaths, death rate (per 100,000 people), age-weighted disability-adjusted life years (DALYs), and age-weighted DALY rate for all ages both sexes combined at all the communities level were estimated to be 1.0 (uncertainty interval: UI 95% 0.3 to 2.8), 0.27 (0.08-0.75), 30.8 (11.3-100.1), and 8.1 (3.0-26.4), respectively. The average contribution of mortality (years of life lost due to premature mortality: YLLs) in the attributable burden of disease was 94.7% (94.4-95.6). Although in most of cases the average levels of the CBPs were in the permissible range of Iranian standards for drinking water quality, the average values of ILCRs as well as attributable burden of disease were not acceptable (the ILCRs were higher than the boundary limit of 10 -5 ); therefore, implementation of interventions for reducing exposure to CBPs through drinking water especially in Kowsar Dam Water Treatment Plant is strictly recommended., (Copyright © 2019 Elsevier Inc. All rights reserved.)

National and subnational burden of disease attributable to elevated fluoride levels in drinking water apportioned by sex, age group, province, and community type in Iran, 2017 were quantified based on disability-adjusted life years (DALYs). The attributable burden of disease was estimated using four input data: (1) effect size of elevated drinking water fluoride levels for dental and skeletal fluorosis, (2) population distribution of drinking water fluoride levels, (3) the threshold levels of fluoride in drinking water for contribution in dental and skeletal fluorosis, and (4) age-sex distribution of population. The attributable burden of disease was only related to dental fluorosis, because the fluoride levels were lower than the threshold value for skeletal fluorosis (4.0 mg/L) in all of the cases. The national attributable prevalence (per 100,000 people), DALYs, and DALY rate in 2017 were calculated to be 60 (95% uncertainty interval 48-69), 3443 (1034-6940), and 4.31 (1.29-8.68), respectively. The national attributable burden of disease was not significantly different by sex, but was affected by age and community type in a manner that the highest DALY rate was related to the age group 10-14 y (6.06 [1.82-12.21]) and over 66% of the national attributable DALYs occurred in rural communities. The attributable burden of disease occurred only in 10 out of 31 provinces and about 94% of the attributable DALYs were concentrated in four provinces Fars (1967 [592-3964]), Bushehr (414 [124-836]), West Azarbaijan (400 [120-808]), and Hormozgan (377 [113-761]). Implementation of fluoride-safe drinking water supply schemes in the four leading provinces can prevent most of the national health losses and partly compensate the increasing trend of disease burden from oral conditions at the national level., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Occurrence of phthalates in water resources, bottled water, and tap water, and health risk of exposure to the phthalates through drinking water in Tehran, Iran, 2018 were studied. The six phthalates with the most health and environmental concerns, including di-(2-ethylhexyl) phthalate (DEHP), butyl benzyl phthalate (BBP), di-n-butyl phthalate (DBP), diethyl phthalate (DEP), dimethyl phthalate (DMP), and di-n-octyl phthalate (DNOP) were monitored in drinking water and water resources. The average levels (±standard deviation: SD) of the total phthalates in drinking water from the water distribution system, bottled water, surface waters, and ground waters were determined to be 0.76 ± 0.19, 0.96 ± 0.10, 1.06 ± 0.23, and 0.77 ± 0.06 μg/L, respectively. The dominant compounds in the phthalates were DMP and DEHP causing a contribution to the total phthalate levels higher than 60% in all the water sources. The phthalate levels of drinking water significantly increased by contact of hot water with disposable plastic and paper cups and by sunlight exposure of bottled water (p value < 0.05). The hazard quotients (HQs) of DEHP, BBP, DBP, and DEP for all ages both sexes combined were determined to be 1.56 × 10 -4 , 1.01 × 10 -5 , 1.80 × 10 -5 , and 1.29 × 10 -6 , respectively that were much lower than the boundary value of 1.0. The disability-adjusted life years (DALYs) and DALY rate (per 100,000 people) attributable to DEHP intake through drinking water for all ages both sexes combined were estimated to be 6.385 (uncertainty interval: UI 95% 1.892 to 22.133), and 0.073 (0.022-0.255), respectively. The proportion of mortality in the attributable DALYs was over 96%. The attributable DALY rate exhibited no significant difference by sex, but was considerably affected by age in a manner that the DALY rates ranged from 0.052 (0.015-0.175) in the age group 65 y plus to 0.099 (0.026-0.304) in the age group 5 to 9 y. Both the carcinogenic and non-carcinogenic health risks of the phthalates in drinking water were considered to be very low. The results can also be of importance in terms of developing frameworks to expand the domain of burden of disease study to the other environmental risks., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Dust storm in Khuzestan region is strongly influenced by transportation and influx of large amount of particulate matter from internal sources (Hawizeh Marshes and East Ahwaz) and external sources (the Arabian Desert in Saudi Arabia, Jordan, Syria and the Sahara Desert). Particulate matter is one of the main components of indoor and outdoor air quality that can be very dangerous for human. The principal objective of this study was the pinpoint of the source of airborne particulate matter by the NOAA HYSPLIT model in Ahvaz City, southwest of Iran. The investigation of dust storm and their origin was performed by the GFSG Meteorological Data (backward trajectories ending analysis of the NOAA HYSPLIT model) and collecting particulate samples with high-volume air samplers during the fall and winter seasons. The results showed the average ambient particulate matter concentration in the cold and warm seasons was 158 and 161 µg/m 3 , respectively. Moreover, the average particulate matter concentration in the cold season was significantly higher than the standard level as presented in the National Ambient Air Quality Standard. Consequently, it seems essential to develop green space, decrease particulate emission from source and make determined efforts to control dust at governmental and international scales.

Phthalate acid esters (PAEs) are widely used as plasticizers in various plastic products and have aroused considerable concern over their ubiquitous presence and potentially hazardous effects on the environment. This research provides the first data on PAEs distribution in the sediments of northern part of the Persian Gulf. To determine the concentration of 16 PAEs, 26 samples of sediments were collected from industrial stations (IS), urban stations (US), agricultural stations (AGS), and natural field stations (NS) from Asalouyeh Harbor coasts from Nov 2016 to Jan 2017. The mean values of Ʃ16PAEs in the samples taken from IS, AGS, US, and NS were 78.08, 11.69, 46.56, and 5.180 µg/g, respectively. The results indicated that the mean concentrations of Ʃ16PAEs in the samples taken from IS and AGS areas were significantly higher (p < 0.05) than the ones taken from US and NS areas. The order of PAEs concentrations in sediment samples were as di(2-ethylhexyl) phthalate (DEHP), di-n-butyl phthalate (DnBP), butylbenzyl phthalate (BBP), and di-n-octyl phthalate (DnOP), respectively. DEHP was detected in all collected samples and the mean ± SD of its concentration in the IS, US, AGS, and NS regions were as 28.15 ± 4.9, 4.040 ± 0.53, 11.58 ± 1.2, and 1.780 ± 0.78 µg/g, respectively. The major sources of PAEs in the sediments collected from the study region were associated with the industrial and agricultural activities. The findings of this study indicated that the sediments of the Asalouyeh coasts are heavily contaminated with PAEs. They have shown potential ecotoxicological effects on the aquatic organisms and benthic. Therefore, more attention should be paid to prediction of the marine ecosystem in this region by the authorities., (Copyright © 2018 Elsevier Inc. All rights reserved.)

We assessed disability-adjusted life years (DALYs) due to dental caries preventable through water fluoridation apportioned by sex, age group, sequela, province, and community type in Iran, 2016. The burden of disease due to dental caries was extracted from the Global Burden of Disease Study 2016 (GBD 2016) and the caries preventive effect of water fluoridation was calculated using a database of fluoride levels in drinking water. All the preventable DALYs were caused by years lived with disability (YLDs) because of the non-fatal character of dental caries. DALYs and DALY rate (per 100,000 people) preventable through water fluoridation at the national level in 2016 were 14,971 (95% uncertainty interval 7348- 24,725) and 18.73 (9.19-30.93), respectively. The national population preventable fraction (PPF) of dental caries by water fluoridation was determined to be as high as 0.176 (0.141-0.189). The share of sequelae in the preventable DALYs at the national level were estimated to be 76.8% for edentulism and severe tooth loss, 21.4% for caries of permanent teeth, and 1.8% for caries of deciduous teeth. The national DALYs and DALY rate preventable through water fluoridation exhibited no difference by sex, but considerably increased by age from 110 (37-223) and 1.5 (0.5-3.1) for the age group 0-4 y to 4331 (2334-6579) and 88.9 (47.9-135.1) for the age group 65 y and older, respectively. Over 80% of the national preventable DALYs occurred in urban areas due to higher population and lower coverage of fluoridated drinking water. The highest provincial DALYs and DALY rate preventable by water fluoridation were observed in Tehran and Gilan to be 3776 (1866-6206) and 37.2 (18.6-60.8), respectively. The results indicated that water fluoridation can play a profound role in the promotion of dental public health and compensate the spatial inequality and increasing temporal trend of health losses from dental caries at the national level., (Copyright © 2018 Elsevier Inc. All rights reserved.)

We estimated age-sex specific and cause-specific mortality, years of life lost due to premature mortality (YLLs), years lived with disability (YLDs) and disability-adjusted life years (DALYs) attributable to 17 individual occupational risks in Iran at the national and subnational levels in 1990-2015 based on the Global Burden of Disease Study 2015 (GBD 2015). The burden of disease attributable to occupational risk factors was calculated using the comparative risk assessment methodology based on 10 outcomes and 21 risk-outcome pairs. The temporal changes in the attributable burden of disease were decomposed into the contribution of population growth, population ageing, risk-deleted DALY rate, and risk exposure. National DALYs attributable to occupational risks at the national level in 1990, 2005, and 2015 were 138,210 (95% uncertainty interval 64,429-223,028), 193,243 (91,645-310,281), and 228,310 (106,782-371,709), respectively indicating a total increase of 65% (65-67) during the study period. Between 1990 and 2015, the share of the attributable DALYs for women rose by 55% (51-58) from 13% (12-14) to 20% (19-21). The proportion of YLLs in national DALYs attributable to occupational risks during the study period slightly decreased from 24% in 1990 to 23% in 2015. The five occupational risks with the highest contributions in the national attributable DALYs in 2015 were ergonomic factors (107,490), noise (52,122), exposure to particulate matter, gases, and fumes (26,847), asthmagens (19,347), and exposure to asbestos (7842). From 1990 to 2015, the increase in total DALYs attributable to occupational carcinogens (112%) was higher than that for other occupational risks. During the study period, changes in risk deleted DALY rate and risk exposure led to decreases in total DALYs attributable to occupational risks by 14% and 30%, respectively. Based on the Gini coefficient, spatial inequality in DALY rate attributable to occupational risks at the provincial level decreased during 1990-2015. A comprehensive plan for management of exposure to occupational risks, especially occupational carcinogens can cause an important effect for control of the increasing trend of occupational health losses., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Purpose: The main objective of the Bushehr Elderly Health Programme, in its first phase, is to investigate the prevalence of cardiovascular risk factors and their association with major adverse cardiovascular events., Participants: Between March 2013 and October 2014, a total of 3000 men and women aged ≥ 60 years, residing in Bushehr, Iran, participated in this prospective cohort study (participation rate=90.2%)., Findings to Date: Baseline data on risk factors, including demographic and socioeconomic status, smoking and medical history, were collected through a modified WHO MONICA questionnaire. Vital signs and anthropometric measures, including systolic and diastolic blood pressure, weight, height, and waist and hip circumference, were also measured. 12-lead electrocardiography and echocardiography were conducted on all participants, and total of 10 cc venous blood was taken, and sera was separated and stored at -80 °C for possible future use. Preliminary data analyses showed a noticeably higher prevalence of risk factors among older women compared to that in men., Future Plans: Risk factor assessments will be repeated every 5 years, and the participants will be followed during the study to measure the occurrence of major adverse cardiac events. Moreover, the second phase, which includes investigation of bone health and cognition in the elderly, was started in September 2015. Data are available at the Persian Gulf Biomedical Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran, for any collaboration., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/)

Serum adiponectin levels have been suggested to be predictors of type 2 diabetes mellitus in diverse populations. However, the relationship between circulating adiponectin levels and the risk of development of type 2 diabetes in postmenopausal women has not been investigated.A total of 382 healthy postmenopausal women who participated in a prospective cohort study were followed for 5.8 years. Type 2 diabetes mellitus was defined according to the criteria set out by the American Diabetes Association. Adiponectin, osteoprotegerin (OPG), and high-sensitivity C-reactive protein (hs-CRP) levels were measured using ELISA.Of 195 women who did not have diabetes at baseline and who were reexamined in the second phase of the study for diabetic status, 35 subjects (17.9%) developed type 2 diabetes mellitus during the 5.8 years follow-up period. The women with type 2 diabetes had lower adiponectin levels than the healthy postmenopausal women. Multiple regression analysis showed that, after adjustments were made for age, cardiovascular risk factors, OPG, and hs-CRP levels, higher baseline adiponectin levels were associated with a lower relative risk (RR) of having type 2 (RR = 0.07, confidence interval [CI]: 0.01-0.66, P = 0.021).Higher baseline adiponectin levels functioned as a predictor of a lower risk of developing type 2 diabetes mellitus among postmenopausal women during a 5.8 years follow-up study. Therefore, it is suggested that elevated adiponectin levels may offer protection against the development of type 2 diabetes mellitus after the menopause.

The impact of the total organic carbon (TOC), chlorine dosage, water temperature, reaction time, pH, and seasonal variation on the formation of haloacetic acids (HAAs) in the Karoon River in Iran was studied. The results showed that dichloroacetic acid and trichloroacetic acid were the most detected HAA5. The HAA5 formation potential (HAA5FP) levels in the Karoon River water in spring time, when the water TOC content exceeded 4 mg/L, were 1.38 times higher than during the winter season, when the water TOC content was below 3.5 mg/L. There was not a strong correlation between the HAA5FP and the residence time for the Karoon River water. For the range of the water temperatures studied, there was little variation in the HAA5FP in cold water, but in warmer water, the values of the HAA5FP varied quickly.

The aim of the study was to determine the effect of a portfolio-based professional development program on nurses' competence in a university hospital in Iran. A pre-test/post-test, controlled, quasi-experimental design was used. From the university hospital's 18 general wards, four wards were randomly selected. Two wards were randomly allocated as the experimental group (35 subjects) and two wards as the control group (38 subjects). Nurses in the experimental group participated in a 12-month portfolio-based professional development program and nurses in the control group participated in the routine professional development programs of their wards. The data were collected by the Nurse Competence Scale and were analyzed using descriptive statistics and independent and paired t-tests. After intervention, the average nurses' competence in the experimental group increased significantly (P < 0.001) but these changes in the control group were not significant (P = 0.08). This study shows that the professional portfolio is an effective tool for improving nurses' competence. The professional portfolios help nurses update their knowledge, skills, and competence towards their full role as nurses., (© 2012 Wiley Publishing Asia Pty Ltd.)

Potential of groundwater contamination by trichloroethylene (TCE) and other volatile organic compounds VOCs near car industry was conducted in this study. TCE, PCE, toluene, xylene, dichloromethane, cyclohexane, n-hexane and n-pentane were detected in all groundwaters. Mean TCE levels in groundwater ranged from 124.37 to 1,035.9 μg L⁻¹ with maximum level of 1,345.7 μg L⁻¹. Due to the data obtained from conventional wastewater treatment in car factory the TCE removal efficiency was only 24 percent which necessitates the TCE removal by advanced treatment processes before the use of well water.