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Additional file 2. Characteristics of the articles and other sources included in a systematic review of the literature.

Additional file 1: Supplementary file. Questionnaire. Researcher-made questionnaire: First round of Delphi. As a part of research at Tehran University of Medical Sciences, we conducting a survey that extracts the components of functions and policymaking to provide an evidence-based framework for health policy-making towards reducing greenhouse gases emissions and adapting to the health effects of climate change in Iran.

PURPOSE: The number of flood disaster deaths has been on the rise in recent years. The current review investigated and categorized the risk factors of deaths from floods in parallel with preventive and control measures designed to minimize deaths from floods. METHODS: In a systematic review, International electronic databases including PubMed, Scopus, Web of Science, and Google Scholar were investigated for articles published in English language. In addition, Iranian databases including IranMedex, Irandoc, Magiran, and Scientific Information Database (SID) were investigated for studies published in Persian. ProQuest database was also searched for related theses. The studies were selected regardless their methods but based on the inclusion and exclusion criteria. The data were extracted, coded and prepared for further analysis. Finally, descriptive and thematic analyses were conducted. RESULTS: A total of 114 factors were identified and categorized into the following five category that can influence on flood death.: hazard related factors, and individual, environmental, socio-economic, and managerial categories. CONCLUSIONS: The study identified many factors that affect flood deaths. The variety and the diverse nature of the factors necessitate appropriate interventions for removing or reducing the effects of the identified factors. More quantitative analytical studies are needed to confirm causal relationship between extracted factors and floods death. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s40201-020-00511-x) contains supplementary material, which is available to authorized users.

Background: Over recent years, the exposure of people and assets to disasters has been faster than reducing vulnerability in all countries. As a result, new risks have been formed and losses due to disaster are progressively increasing. Suffering from significant losses in the aftermath of disasters every year, Iran is no exception. Governmental and non-governmental stakeholders are jointly responsible for managing the risks of disasters. Hence, appropriate, collaborative and timely interactions of involved organizations will play an important role in their operation, especially during disasters. Methods: In this study, we used the Social Network Analysis (SNA) to analyze the network of stakeholders in disaster risk management in Iran. Our review of literature, laws, and regulations of disaster risk management plus brainstorming identified a list of 85 stakeholders. We used the Delphi method among purposefully selected experts to score the relationship between the stakeholders. We then used the modularity optimization method to identify groups with greater interaction. Organizations with key-roles in the network and the ones in need of stronger relationships were identified through centrality measurements. Results: The density of this network was 0.75, which represented that not all the stakeholders were connected. Among all organizations identified, the National Disaster Management Organization and Civil Defense Organization showed higher influences considering their responsibilities. Conclusion: To provide a visual and tangible picture of the status and interrelationships among the stakeholders, this method identified groups with better interaction using community/cluster detection and modularity optimization methods. Understanding the current structure of the network and strengths and weaknesses of the interactions among stakeholders may help improve disaster risk management in Iran. Results of this research determine the role and importance of different organizations, their weakness, and strong points. Also, results help them to plan to strengthen their roles and solve their problems.

Background: In Spring 2018, due to intense rainfalls in Iran, plenty of mushrooms had grown, some of which were poisonous and their consumption had induced poisoning in people of different provinces; 1151 mushroom poisoning cases were reported within 25 days from 12 May to 9 July 2018. Objectives: This study aimed to address this issue from the public health perspective. The study further aimed at reporting the mortality and morbidity associated with mushroom poisoning and ascertaining the reasons behind the increase in the numbers of the affected persons. Methods: This report was based on the review of official reports and a field assessment in the areas affected by mushroom poisoning in the western part of Iran. Results: There were 1151 mushroom poisoning cases, out of which 1133 (98.4%) were hospitalized, and unfortunately, 18 (1.56%) died. Kermanshah province had the highest rate of mushroom poisoning casualties, out which seven people died. A total of 12 provinces were affected. Conclusions: Lack of knowledge of local people about the types of mushroom and their inability to differentiate between the toxic and non-toxic mushrooms, as well as lack of a swift and convenient immediate warning system has caused this incident of massive mushroom poisoning. However, planning and proper management can help to resolve these problems.

Climate Change Adaptation (CCA) is a complex, multi-disciplinary, and culture-dependent concept. This study aims to explore a conceptual definition, the subjective framework of CCA including its domains, attributes, and consequences. The approach of qualitative conventional content analysis was considered for the explanation of the subjective concept, and at the same time as the collection process, data analysis was performed using Zhang and Wildemuth's method. The interview method was semi-structured and sampling was targeted and with maximum diversity. The interview was conducted with 22 qualified experts. The accuracy and validity of the data were ensured using Guba and Lincoln scientific accuracy criteria. Six main categories including "sustainability, productivity, stability, empowerment, transformation, and flexibility" were conceptualized in the theme of adaptation characteristics. "Sustainable development, life improvement, response coordination and integration, creativity and innovation, resilience promotion, vulnerability reduction, effective management, and independence" were the main categories in the theme of the adaptation consequences. According to the results, the following conceptual-functional definition can be presented for adaptation to climate change: "CCA refers to the ability of system instability, sustainability, empowerment, productivity, flexibility, and transformation to climate change through the optimal use of resources, resistance, and coping, capacity building and opportunity creation". This definition is conceptual, it means that includes the main features of climate-adaptation and is also functional that is, includes adaptation strategies for climate change.

Background Drought is a serious issue which might be caused by climate change that could create famine and health problems. Drought reduces air quality, increases fungal infestation, reduces people hand washing, affects mental health, leads to malnutrition by decreasing agricultural production, and increases diseases transmitted by insects. This study aimed to determine and describe community health status through building drought resilience in Ethiopia. Methods This review was conducted based on the available peer-reviewed articles that were published from January 2004 to December 2018 Online databases from PubMed, MEDLINE, Scopus, EMBASE and Google Scholar were searched for studies related to the building drought and community health resilience at different regions of Ethiopia that were published in English language. The search was made by using "Emergency disaster", "prevention", "preparedness", "response", "recovery", "drought", "food insecurity", "coping strategies" and "drought health policy" as keywords. Results Most of the reviewed articles deal with the impact of climate change on the human health in relation to food security. The associated factors of the impact of drought on food security is basically due to lack of irrigation and farmland, the scarcity of water due to the direct effect of drought, flood, severe soil erosion, livestock dispossession, family size of the household and literacy of the households. Various coping strategies were employed by the households to alleviate the high and continued food insecurity problem such as reducing the number and amount of meal, scrounging cash and grain, searching for off-farm and non-farm jobs, getting food aid, vending of livestock, and partake in food for work programs. Conclusion The findings explored components of the coping strategies to the building resilience create fruitful health conditions for the food insecure household. The effect of agricultural support services as reliance's on drought and community health situation was regarded as a positive outcome. Moreover, the means to get adequate food security strategies in all regions of Ethiopia should be designed. Furthermore, future researches are recommended for finding the best building strategies for each region of Ethiopia.

Aims To present epidemiological data, probable causes and lessons learned from the outbreak of methanol poisoning in Iran in September 2018, and relate this to the increasing incidence of methanol poisoning worldwide over recent decades. Method Analysis of all available reliable field information, official news reports and reports from the country's forensic medicine organization and the Ministry of Health. Results Overall, 768 people in Iran were documented as poisoned from September 7 to October 7 2018 by consuming an informal alcohol containing methanol, of whom 76 died (10.1% fatality rate); 460 subjects attended state hospitals due to acute methanol poisoning of whom 42 (9.13%) died. Those who were hospitalized comprised 177 subjects (38.4%), with 241 subjects (52.3%) seen and discharged. Males comprised 93% of the deaths. About 41% of those poisoned were aged 25-36. Outbreaks were reported in 21 provinces. Conclusion These data indicate a high fatality rate of methanol poisoning in Iran, something seen also in some other countries. Considering that such outbreaks take place more in low-income and Islamic countries due to ignorance and legal constraints, it seems necessary to seek an effective educational model for raising public awareness and a fully native and early warning system in this regard to reduce the damage and enhance readiness to deal with the health effects of such outbreaks.

Background: In 2015, it was estimated that the burden of disease in Iran comprised of 19 million disability-adjusted life years (DALYs), 74% of which were due to non-communicable diseases (NCDs). The observed leading causes of death were cardiovascular diseases (41.9%), neoplasms (14.9%), and road traffic injuries (7.4%). Even so, the health research investment in Iran continues to remain limited. This study aims to identify national health research priorities in Iran for the next five years to assist the efficient use of resources towards achieving the long-term health targets.Methods: Adapting the Child Health and Nutrition Research Initiative (CHNRI) method, this study engaged 48 prominent Iranian academic leaders in the areas related to Iran's long-term health targets, a group of research funders and policy makers, and 68 stakeholders from the wider society. 128 proposed research questions were scored independently using a set of five criteria: feasibility, impact on health, impact on economy, capacity building, and equity.Findings: The top-10 priorities were focused on the research questions relating to: health insurance system reforms to improve equity; integration of NCDs prevention strategy into primary health care; cost-effective population-level interventions for NCDs and road traffic injury prevention; tailoring medical qualifications; epidemiological assessment of NCDs by geographic areas; equality in the distribution of health resources and services; current and future common health problems in Iran's elderly and strategies to reduce their economic burden; the status of antibiotic resistance in Iran and strategies to promote rational use of antibiotics; the health impacts of water crisis; and research to replace the physician-centered health system with a team-based one.Conclusions: These findings highlight consensus amongst various prominent Iranian researchers and stakeholders over the research priorities that require investment to generate information and knowledge relevant to the national health targets and policies. The exercise should assist in addressing the knowledge gaps to support both the National General Health Policies by 2025 and the health targets of the United Nations' Sustainable Development Goals by 2030.

Introduction: Earthquake is the most important cause of death from natural disasters in Iran. This paper brings attention to the main causes of loss of life due to the Kermanshah province earthquake (Nov 12 2017), and provides a wakeup call about the unsafe nature of buildings there. Methods: This study is based on official reports review and a field assessment in the areas affected by the earthquake in western Iran. Results: Although buildings in this area are mainly old structures, strangely, more than 70% of the destroyed buildings in this earthquake were under 5 years of age, newly built or renovated buildings according to mandated building codes. Discussion: Mandated building codes and construction rules and regulations are not respected even for the newly constructed or reconstructed structures buildings. Keywords: Earthquake, Iran, construct, reconstruct, Building codes

INTRODUCTION: Recent years have witnessed community disaster resilience becoming one of the most heavily supported and advocated approach to disaster risk management. However, its application has been influenced by the lack of assessment tools. This study reviews studies conducted using the resilience concept and examines the tools, models, and methods adopted. It examines the domains, indicators, and indices have been considered in the tools. It provides a critical analysis of the assessment tools available for evaluating community disaster resilience (CDR). METHODS: We investigated international electronic databases including Scopus, MEDLINE through PubMed, ISI Web of Science, Cochrane Library, Cumulative Index to Nursing and Allied Health (CINAHL), and Google Scholar with no limitation on date, and type of articles. The search terms and strategy were as follow: (Disaster* OR Emergenc*) AND (Resilience OR Resilient OR Resiliency) that were applied for titles, abstracts and keywords. Extracted data were analyzed in terms of studied hazards, types of methodology, domains, and indicators of CDR assessment. RESULTS: Of 675 publications initially identified, the final analysis was conducted on 17 full text articles. These studies presented ten models, tools, or indices for CDR assessment. These evinced a diverse set of models with regard to the domains, indicators and the kind of hazard described. Considerable inter dependency between and among domains and indicators also emerged from this analysis. CONCLUSION: The disparity between the articles using the resilience concept and those that offer some approach to measurement (675 vs. 17) indicates the conceptual and measurement complexity in CDR and the fact that the concept may be being used without regard to how CDR should be operationalized and assessed. Of those that have attempted to assess CDR, the level of conceptual diversity indicates limited agreement about how to operationalize the concept. As a way forward we summarize the models identified in the literature and suggest that, as a starting point for the systematic operationalization of CDR, that existing indicators of community disaster resilience be classified in five domains. These are social, economic, institutional, physical and natural domains. A need to use appropriate and effective methods to quantify and weigh them with regard to their relative contributions to resilience is identified, as is a need to consider how these levels interrelate to influence resilience. Although assessment of disaster resilience especially at the community level will inform disaster risk reduction strategies, attempts to systematically do so are in preliminary phases. Further empirical investigation is needed to develop a operational and measurable CDR model. Language: en

On June 2, 2014, a local thunderstorm winds of speed as high as 118 km/h hit Tehran, capital of Iran. This thunderstorm plugged the city into darkness for hours, emotionally affected the citizens, and damaged properties. Based on Tehran Disaster Mitigation and Management Organization meteorological station, the temperatures suddenly dropped from 33.83 to 18.46 centigrade within 2 h and the air humidity elevated from 14.2% to 68.4%. This thunderstorm resulted in eight deaths, 81 injuries (63 male and 18 female and an estimated property damage of about $40 million at the official exchange rate.). More than half (58.5%) of the injuries were caused by multiple trauma. Shortly after thunderstorm stop, Tehran emergency operation and command center was mobilized for rapid assessment and emergency response to the event. One hundred electricity response teams, 15 search and rescue teams, and emergency medical and municipal teams were involved in response phase. After 6 h, about 24 response phases were accomplished and the city entered to recovery phase. This storm highlighted the challenges of need for harmonized individual and organized organizational participation, necessity for education of people through mass media and training all construction workers, and vulnerable parts of Tehran megacity during a disaster period.