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The COVID-19 pandemic was a serious global health emergency in 2020 and 2021. This study analyzed the seasonal association of weekly averages of meteorological parameters, such as wind speed, solar radiation, temperature, relative humidity, and air pollutant PM2.5, with confirmed COVID-19 cases and deaths in Baghdad, Iraq, a major megacity of the Middle East, for the period June 2020 to August 2021. Spearman and Kendall correlation coefficients were used to investigate the association. The results showed that wind speed, air temperature, and solar radiation have positive and strong correlations with the confirmed cases and deaths in the cold season (autumn and winter 2020-2021). The total COVID-19 cases negatively correlated with relative humidity but were not significant in all seasons. Besides, PM2.5 strongly correlated with COVID-19 confirmed cases for the summer of 2020. The death distribution by age group showed the highest deaths for those aged 60-69. The highest number of deaths was 41% in the summer of 2020. The study provided useful information about the COVID-19 health emergency and meteorological parameters, which can be used for future health disaster planning, adopting prevention strategies and providing healthcare procedures to protect against future infraction transmission., Competing Interests: 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., (© 2023 Elsevier Ltd. All rights reserved.)

At the end of 2019, a novel coronavirus COVID-19 emerged in Wuhan, China, and later spread throughout the world, including Iraq. To control the rapid dispersion of the virus, Iraq, like other countries, has imposed national lockdown measures, such as social distancing, restriction of automobile traffic, and industrial enterprises. This has led to reduced human activities and air pollutant emissions, which caused improvement in air quality. This study focused on the analysis of the impact of the six partial, total, and post-lockdown periods (1st partial lockdown from March 1 to16, 2020, 1st total lockdown from March 17 to April 21, 2nd partial lockdown from April 22 to May 23, 2nd total lockdown from May 24 to June 13, 3rd partial lockdown from June 14 to August 19, and end partial lockdown from August 20 to 31) on the average of daily NO 2 , O 3 , PM 2.5 , and PM 10 concentrations, as well as air quality index (AQI) in 18 Iraqi provinces during these periods (from March 1st to August 31st, 2020). The analysis showed a decline in the average of daily PM 2.5 , PM 10 , and NO 2 concentrations by 24%, 15%, and 8%, respectively from March 17 to April 21, 2020 (first phase of total lockdown) in comparison to the 1st phase of partial lockdown (March 1 to March 16, 2020). Furthermore, the O 3 increased by 10% over the same period. The 2nd phase of total lockdown, the 3rd partial lockdown, and the post-lockdown periods witnessed declines in PM 2.5 by 8%, 11%, and 21%, respectively, while the PM 10 increases over the same period. Iraqi also witnessed improvement in the AQI by 8% during the 1st phase of total lockdown compared to the 1st phase of partial lockdown. The level of air pollutants in Iraq declined significantly during the six lockdown periods as a result of reduced human activities. This study gives confidence that when strict measures are implemented, air quality can improve., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Covid-19 was first reported in Iraq on February 24, 2020. Since then, to prevent its propagation, the Iraqi government declared a state of health emergency. A set of rapid and strict countermeasures have taken, including locking down cities and limiting population's mobility. In this study, concentrations of four criteria pollutants, NO 2 , O 3 , PM 2.5 and PM 10 before the lockdown from January 16 to February 29, 2020, and during four periods of partial and total lockdown from March 1 to July 24, 2020, in Baghdad were analysed. Overall, 6, 8 and 15% decreases in NO 2 , PM 2.5 , and PM 10 concentrations, respectively in Baghdad during the 1st partial and total lockdown from March 1 to April 21, compared to the period before the lockdown. While, there were 13% increase in O 3 for same period. During the 2nd partial lockdown from June 14 to July 24, NO 2 and PM 2.5 decreases 20 and 2.5%, respectively. While, there were 525 and 56% increase in O 3 and PM 10 , respectively for same period. The air quality index (AQI) improved by 13% in Baghdad during the 1st partial lockdown from March 1 to April 21, compared to its pre-lockdown. The results of NO 2 tropospheric column extracted from the Sentinel-5P satellite shown the NO 2 emissions reduced up to 35 to 40% across Iraq, due to lockdown measures, between January and July, 2020, especially across the major cities such as Baghdad, Basra and Erbil. The lockdown due to COVID-19 has drastic effects on social and economic aspects. However, the lockdown also has some positive effect on natural environment and air quality improvement., 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 © 2020 Elsevier B.V. All rights reserved.)

Background: Dialysis water quality is one of the most important factors for ensuring the safe and effective delivery of hemodialysis. It has been known for over a decade that there might be hazardous contaminants in the water and concentrates used to prepare dialysis fluid. Rigorous international standards for the purification of dialysis fluids have been established, which were used in the present study to compare the quality of dialysis water as there is no national standard for dialysis water quality in Iraq., Objectives: There are more than 20 dialysis centers in Iraq, most of which contain similar units for the processing of dialysis water. The present study evaluated the quality of water used for dialysis in four dialysis centers located within Baghdad hospitals., Methods: Physical and chemical tests were carried out in the laboratory after sampling water from each dialysis center. Water samples were collected from three locations in each dialysis center. Hospital municipal water samples were collected from the tanks feeding dialysis units; samples of dialysis water were collected from the dialysis water treatment unit outlets; and samples of dialysis water were collected from the distribution network in dialysis rooms., Results: The results showed a fluctuation in the quality of the dialysis water (dialysis water and water from the dialysis distribution network), indicating that it is unacceptable compared to international standards. Chemical analysis showed that 75% of the dialysis water had elevated aluminum concentrations. Chemical analysis also found that dialysis water had elevated concentrations of free residual chlorine at some dialysis centers., Conclusions: All hemodialysis centers need careful monitoring and preventive maintenance to ensure good water quality. In addition, it is important to revise the design of the water treatment units according to water quality., Competing Interests: The authors declare no competing financial interests., (© Pure Earth 2020.)

Monitoring water quality in hemodialysis systems is extremely important to maintain adequate quality services for patients suffering from kidney failure. This work aims to examine and evaluate bacteriological characteristics and endotoxin contamination levels in hemodialysis water produced in dialysis centers. Forty-eight water samples were collected and analyzed from four major hospitals in Baghdad for one year to evaluate seasonal effects. The analysis included the determination of total heterotrophic bacteria using the pour plate method, identification of bacterial isolate using the Vitek2 compact instrument, and the determination of endotoxins levels using Limulus amebocyte lysate (LAL) method. In addition, tap water samples (a source for the hemodialysis water) were also examined bacteriologically. Results showed that 44% of the tested samples for bacterial levels are higher than the maximum value of (100 CFU/ml) set out by the international standards. Endotoxin values for these centers fluctuated during the study period, and 44% of them exceeded the international standards (>0.25 EU/ml). These results call for applying improved technology to modify the existing water treatment units for better control and for national standardization of the microbiological quality of hemodialysis water. PRACTITIONER POINTS: Four hemodialysis centers were assessed by measuring the bacteriological and endotoxins levels of their feed and product water. Product water showed elevated levels of bacteria that exceeded the international guideline value of 100 CFU/ml. Most of the identified bacterial species were Gram-negative that arise the possibility of contributing to endotoxin generation. Product water showed fluctuated values of endotoxins. About 44% of the measured samples were higher than the international guideline values of 0.25 EU/ml., (© 2020 Water Environment Federation.)

Background: The kidney is the first target organ of heavy metal toxicity due to its capacity to reabsorb and accumulate divalent metals. Hemodialysis therapy is used to purify the blood of individuals with impaired kidney function., Objective: The aim of the present study was to evaluate the relationship between dialysis fluid quality and the health of hemodialysis patients., Methods: A field sampling program was conducted to collect blood samples from 320 hemodialysis patients (56% males and 44% females) in order to examine the concentrations of heavy metals that typically occur in municipal water in Baghdad (aluminum (Al), copper (Cu), lead (Pb), and zinc (Zn)), and explore associations with the same metals in dialysis fluid collected from four major dialysis centers in Baghdad hospitals for a period of one year (2018)., Results: The results showed that the dialysis fluid quality was not in compliance with international standards. The dialysis fluid in 63% of the samples contained high Al concentrations, while Cu and Zn concentrations were within international standards. Lead concentrations were elevated in dialysis fluid in some hospitals as well., Discussion: The average blood levels of biologically important heavy elements were significantly varied in hemodialysis patients when compared with local reference values., Conclusions: Since both deficiency and excess elements are potentially harmful, the hypothesis that heavy element status affects the risk of adverse clinical outcomes is a worthy investigation., Participant Consent: Obtained., Ethics Approval: The study was approved by the Baghdad Ethics Committee of the Iraqi Ministry of Health and Environment., Competing Interests: The authors declare no competing financial interests., (© Pure Earth 2020.)

Dialysis water quality is one of the important parameters all over the world because of its direct influence on the health of kidney patients. In Iraq, there are more than 20 dialysis centers; most of them contain identical units for the production of dialysis water. In this work, the quality of water used for dialysis in six dialysis centers located within Baghdad hospitals was evaluated. Samples of product water from each of the six dialysis centers were examined for total heterotrophic bacteria, endotoxin, and chemical contaminants. Endotoxin was measured on-site using a portable instrument. Bacteriological and chemical examinations were done in the laboratory after collecting samples from each dialysis center. The results showed a fluctuation in the produced water quality that makes the produced water unaccepted when compared with international standards. Bacterial counts for 60% of the analyzed samples were above the action level (50 colony-forming units[CFU]/mL), while five out of the six dialysis centers showed values higher than the maximum value (100 CFU/mL). Chemical analysis showed that the dialysis water quality suffers from elevated aluminum concentration for all dialysis centers. All hemodialysis centers need thorough monitoring and preventive maintenance to ensure good water quality. In addition, it is important to revise the design of the water treatment units according to the feed and product water quality., (© 2013 The Authors. Hemodialysis International © 2013 International Society for Hemodialysis.)