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Objectives: This study aimed to assess the impact of wearing N95 and surgical masks on carbon dioxide (CO2) concentrations during various activity levels, to understand the implications for mask use in different settings, especially in light of the COVID-19 pandemic. Study design: Systematic Review and Meta-Analysis. Methods: A systematic review was conducted, retrieving 6798 articles from PubMed, Web of Science, and Scopus databases. Twenty-nine articles met the inclusion criteria. Mask types were categorized into N95 and surgical masks, while activities were classified as low, medium, and high. Results: The meta-analysis revealed CO2 concentrations (mmHg) for different scenarios: No mask (37.91, 95 % CI: 36.46, 39.35), N95-low (36.83, 95 % CI: 33.57, 40.10), N95-moderate (37.85, 95 % CI: 36.51, 39.20), N95-high (39.51, 95 % CI: 38.00, 41.02), N95 with exhalation valve (35.82, 95 % CI: 32.89, 38.75), N95 without exhalation valve (38.45, 95 % CI: 37.10, 39.81), surgical mask-low (38.31, 95 % CI: 34.48, 42.14), surgical mask-moderate (35.05, 95 % CI: 31.12, 38.97), surgical mask-high (36.07, 95 % CI: 34.18, 37.96). Conclusions: Our findings indicate that N95 masks lead to higher CO2 accumulation during various activities compared to surgical masks. Moreover, surgical masks exhibit higher CO2 concentrations during low activity compared to moderate and high activities. Notably, CO2 concentrations are higher in N95 masks without an exhalation valve compared to those with a valve. No significant difference was observed between not wearing a mask and wearing either N95 or surgical masks in terms of CO2 accumulation. These results provide important insights for mask selection and usage recommendations in different scenarios.

Background Coronary heart disease (CHD) is the most prevalent type of cardiovascular disease in Iran. This study aims to investigate the estimation and determinants of direct hospitalisation cost for patients with CHD in Iranian hospitals.Methods We identified patients with CHD in Iran in 2019–2020. Data were gathered from the Iran Health Insurance Organisation information systems and the Ministry of Health and Medical Education. This was a cross-sectional prevalence-based study. Generalised linear models were used to find the determinants of hospitalisation cost for patients with CHD. A total of 86 834 patients suffering from CHD were studied.Results Mean hospitalisation cost per CHD patient was US$382.90±US$500.72 while the mean daily hospitalisation cost per CHD patient was US$89.71±US$89.99. In-hospital mortality of CHD was 2.52%. Hospitalisation accommodation and medications had the highest share of hospitalisation costs (25.59% and 22.63%, respectively). Men spent 1.12 (95% CI 1.11 to 1.13) times more on hospitalisation costs compared with women, and individuals aged 60 to 69 had hospitalisation costs 1.04 (95% CI 1.02 to 1.06) times higher than those in the 0–49 age range. Patients insured by the Iranian Fund have significantly higher costs 1.17 (95% CI 1.14 to 1.19) than the Rural fund. Hospitalisation costs for patients with CHD who received surgery and angiography were significantly 2.36 (95% CI 2.30 to 2.43) times higher than for patients who did not undergo surgery and angiography.Conclusion Applying CHD prevention strategies for men and the middle-aged population (50–70 years) is strongly recommended. Prudent use and prescribing of medications will be helpful to reduce hospitalisation cost.

Air contamination is one of the serious problems for the environment and the health of society. Air contamination risk assessment, health effects assessment tools are used to identify the place and time of public health effects and risk prevention strategies to reduce negative health effects. Considering that there may be a relationship between factors affecting risk, in this study, interactions between them are investigated using Fuzzy Decision Test and Experimental Evaluation Method (fuzzy DEMATEL). The cause of the health air contamination risk in an industrial area are the activity of industrial complexes and port (D+R=45.98, D-R=2.09) and the presence of hydrogen sulfide (46.82, 2.61), benzene (50.87, 2.87), sulfur dioxide (43.87, 4.32) and PM10 (53.51, 5.63) and the effects of these factors will affect the amount of carbon monoxide (39.56, -4.47), ozone (38.80, -4.20), nitrogen dioxide (50.33, -1.62) and PM2.5 (44.18, -1.26). Hospitals and nursing homes (49.01, -2.58), schools (50.99, -0.59), storage and industrial facilities, roads (45.72, -0.59), urban core (51.38, -0.55) and Natural zones, agriculture and waterways (48.86, -0.17) are affected by other factors. Population density is also affected by cause factors. Population density has a two-way relationship with PM2.5. The main human and social factors include GDP per capita and urbanization rate. Hydrogen sulfide has a one-way relationship with population density. People who work in certain industries may be exposed to higher amounts of hydrogen sulfide than the general population. These industries include the production of rayon textiles, pulp and paper factories, oil and natural gas drilling operations, and wastewater treatment plants. Therefore, by controlling the activity of industrial complexes, port and the amounts of hydrogen sulfide, benzene, sulfur dioxide and PM10 in the ambient air can be prevented from the effects after that.

ObjectivesWe evaluated studies that used the World Health Organization’s (WHO) AirQ and AirQ+ tools for air pollution (AP) health risk assessment (HRA) and provided best practice suggestions for future assessments.MethodsWe performed a comprehensive review of studies using WHO’s AirQ and AirQ+ tools, searching several databases for relevant articles, reports, and theses from inception to Dec 31, 2022.ResultsWe identified 286 studies that met our criteria. The studies were conducted in 69 countries, with most (57%) in Iran, followed by Italy and India (∼8% each). We found that many studies inadequately report air pollution exposure data, its quality, and validity. The decisions concerning the analysed population size, health outcomes of interest, baseline incidence, concentration-response functions, relative risk values, and counterfactual values are often not justified, sufficiently. Many studies lack an uncertainty assessment.ConclusionOur review found a number of common shortcomings in the published assessments. We suggest better practices and urge future studies to focus on the quality of input data, its reporting, and associated uncertainties.

Background: In recent years, new findings on the relationship between human health and air pollutants have emerged, underscoring the necessity for appropriate site selection of air monitoring stations. Methods: This analytical-cross-sectional study aimed to compare the concentration levels of PM10 and PM2.5, as measured by weight method, with data collected from an air quality monitoring station (AQMS) in Tehran. Initially, data were collected from the Tarbiat Modares AQMS. The accuracy of this data was then evaluated using a high-volume sampler and Grimm dust monitor situated approximately 200 meters away from the Tarbiat Modares station. The study period was between June 2017 and October 2017, and the frequency of sampling was every six days according to the instructions. Results: The results revealed that the average concentration levels of PM10, as measured during the sampling period by the high-volume sampler, the Grimm device, and the air quality measurement station, were 143.54 ± 33.84, 70.95 ± 7.06, and 110.06 ± 27.08 μg.m-3, respectively. The highest daily concentration of PM10 was recorded by the high-volume sampler device at 197.12 μg.m-3. Conclusion: This study found a weak correlation between the aerosol concentration data obtained from the monitoring station and those obtained from the Grimm device and the high-volume sampler. Therefore, it is crucial to ensure the quality control and assurance of data collected from monitoring stations for accurate decision-making and planning.

Fine particulate matter (PM2.5) air pollution is a leading contributor to the global burden of cardiovascular disease (CVD). One important underlying mechanism is an increase in blood pressure (BP). A growing number of studies have reported a beneficial effect of portable air cleaners (PACs) on systolic and diastolic BP; SBP and DBP. We conducted an updated systematic review and meta-analysis of studies using true versus sham mode filtration reporting the effects on BP. Of 214 articles identified up to February 5, 2023, seventeen (from China, USA, Canada, South Korea and Denmark) enrolling approximately 880 participants (484 female) met the inclusion criteria for meta-analyses. Aside from studies conducted in China, research on PACs and BP has been conducted in relatively low pollution settings. Mean indoor PM2.5 concentrations during the active and sham mode purification were 15.9 and 41.2 µg/m3, respectively. The mean efficiency of PACs against indoor PM2.5 was 59.8 % (ranging from 23 % to 82 %). True mode filtration was associated with a pooled mean difference of − 2.35 mmHg (95 % confidence interval [CI]: − 4.5, − 0.2) and − 0.81 mmHg (95 % CI: − 1.86, 0.24) in SBP and DBP, respectively. After removing the studies with high risk of bias, the magnitude of the pooled benefits on SBP and DBP increased to − 3.62 mmHg (95 % CI: − 6.69, − 0.56) and − 1.35 mmHg (95 % CI: − 2.29, − 0.41), respectively. However, there are several barriers to the use of PACs, specifically in low- and middle-income countries (LMICs), such as the initial purchase cost and filter replacements. There may be several avenues to help overcome these economic burdens and improve cost effectiveness, such as implementing government or other subsidized programs to distribute PACs targeting vulnerable and higher-risk individuals. We propose that environmental health researchers and healthcare providers should be better trained to educate the public regarding the use of PACs to reduce the impacts of PM2.5 on cardiometabolic diseases globally.

Abstract We estimated mortality and economic loss attributable to PM2·5 air pollution exposure in 429 counties of Iran in 2018. Ambient PM2.5-related deaths were estimated using the Global Exposure Mortality Model (GEMM). According to the ground-monitored and satellite-based PM2.5 data, the annual mean population-weighted PM2·5 concentrations for Iran were 30.1 and 38.6 μg m−3, respectively. We estimated that long-term exposure to ambient PM2.5 contributed to 49,303 (95% confidence interval (CI) 40,914–57,379) deaths in adults ≥ 25 yr. from all-natural causes based on ground monitored data and 58,873 (95% CI 49,024–68,287) deaths using satellite-based models for PM2.5. The crude death rate and the age-standardized death rate per 100,000 population for age group ≥ 25 year due to ground-monitored PM2.5 data versus satellite-based exposure estimates was 97 (95% CI 81–113) versus 116 (95% CI 97–135) and 125 (95% CI 104–145) versus 149 (95% CI 124–173), respectively. For ground-monitored and satellite-based PM2.5 data, the economic loss attributable to ambient PM2.5-total mortality was approximately 10,713 (95% CI 8890–12,467) and 12,792.1 (95% CI 10,652.0–14,837.6) million USD, equivalent to nearly 3.7% (95% CI 3.06–4.29) and 4.3% (95% CI 3.6–4.5.0) of the total gross domestic product in Iran in 2018.

Objectives: National ambient air quality standards (NAAQS) are critical tools for controlling air pollution and protecting public health. We designed this study to 1) gather the NAAQS for six classical air pollutants: PM2.5, PM10, O3, NO2, SO2, and CO in the Eastern Mediterranean Region (EMR) countries, 2) compare those with the updated World Health Organizations Air Quality Guidelines (WHO AQGs 2021), 3) estimate the potential health benefits of achieving annual PM2.5 NAAQS and WHO AQGs per country, and 4) gather the information on air quality policies and action plans in the EMR countries.Methods: To gather information on the NAAQS, we searched several bibliographic databases, hand-searched the relevant papers and reports, and analysed unpublished data on NAAQS in the EMR countries reported from these countries to the WHO/Regional office of the Eastern Mediterranean/Climate Change, Health and Environment Unit (WHO/EMR/CHE). To estimate the potential health benefits of reaching the NAAQS and AQG levels for PM2.5, we used the average of ambient PM2.5 exposures in the 22 EMR countries in 2019 from the Global Burden of Disease (GBD) dataset and AirQ+ software.Results: Almost all of the EMR countries have national ambient air quality standards for the critical air pollutants except Djibouti, Somalia, and Yemen. However, the current standards for PM2.5 are up to 10 times higher than the current health-based WHO AQGs. The standards for other considered pollutants exceed AQGs as well. We estimated that the reduction of annual mean PM2.5 exposure level to the AQG level (5 μg m−3) would be associated with a decrease of all natural-cause mortality in adults (age 30+) by 16.9%–42.1% in various EMR countries. All countries would even benefit from the achievement of the Interim Target-2 (25 μg m−3) for annual mean PM2.5: it would reduce all-cause mortality by 3%–37.5%. Less than half of the countries in the Region reported having policies relevant to air quality management, in particular addressing pollution related to sand and desert storms (SDS) such as enhancing the implementation of sustainable land management practices, taking measures to prevent and control the main factors of SDS, and developing early warning systems as tools to combat SDS. Few countries conduct studies on the health effects of air pollution or on a contribution of SDS to pollution levels. Information from air quality monitoring is available for 13 out of the 22 EMR countries.Conclusion: Improvement of air quality management, including international collaboration and prioritization of SDS, supported by an update (or establishment) of NAAQSs and enhanced air quality monitoring are essential elements for reduction of air pollution and its health effects in the EMR.

Introduction: Air pollution is one of the most important environmental risks to human health. The particulate matter tend to be carcinogenic for humans and can pose a greater hazard to children due to their immaturity and lack of development of the immune system. The current study is aimed to investigate the difference in the concentration of Particulate Matter (PM2.5 and PM10) in the ambient air in the breathing height of children and adults. Materials and methods: Particulate matter were measured cross-sectionally in sidewalks, streets, alleys, squares, and parks of Tehran simultaneously at two heights of 160 cm and 70 cm from the ground. As well as, other variables such as vegetation, buildings and meteorological data were also measured in each location. Results: There was a difference between the concentration of PM2.5 at the breathing height of children, with the average concentration of 52.0 μg/m3, and the concentration of PM2.5 at the breathing height of adults with the average concentration of 51.6 μg/m3, with p-value of 0.013. Even though the difference is significant, it does not seem to have a significant impact on health. No significant difference was observed between the PM10 concentration at the breathing height of children and adults; however, there was significant difference between the concentrations of PM2.5 with the clean air standard of Iran and data from monitoring stations. Conclusion: The amount of PM2.5 and PM10 is almost the same in children and adults based on the difference in breathing height.

Objective Stroke is the second most prevalent cardiovascular disease in Iran. This study investigates the estimation and predictors of hospitalisation expenses and in-hospital mortality for patients who had a stroke in Iranian hospitals.Setting Patients who had a stroke in Iran between 2019 and 2020 were identified through the data collected from the Iran Health Insurance Organization and the Ministry of Health and Medical Education. This study is the first to conduct a pervasive, nationwide investigation.Design This is a cross-sectional, prevalence-based study. Generalised linear models and a multiple logistic regression model were used to determine the predictors of hospitalisation expenses and in-hospital mortality for patients who had a stroke.Participants A total of 19 150 patients suffering from stroke were studied.Results Mean hospitalisation expenses per patient who had a stroke in Iran amounted to US$590.91±974.44 (mean±SD). Mean daily hospitalisation expenses per patient who had a stroke were US$55.18±37.89. The in-hospital mortality for patients who had a stroke was 18.80%. Younger people (aged ≤49 years) had significantly higher expenses than older patients. The OR of in-hospital mortality in haemorrhagic stroke was significantly higher by 1.539 times (95% CI, 1.401 to 1.691) compared with ischaemic and unspecified strokes. Compared with patients covered by the rural fund, patients covered by Iranian health insurance had significantly higher costs by 1.14 times (95% CI, 1.186 to 1.097) and 1.319 times (95% CI, 1.099 to 1.582) higher mortality. There were also significant geographical variations in patients who had a stroke’s expenses and mortality rates.Conclusion Applying cost-effective stroke prevention strategies among the younger population (≤49 years old) is strongly recommended. Migration to universal health insurance can effectively reduce the inequality gap among all insured patients.

Background and Objective: This study was conducted to investigate the long-term temporal trends and spatial variations of ambient PM10, PM2.5, O3, concentrations in Tabriz city during the years 2006-2017. Materials and Methods: Real-time hourly concentrations of PM10, PM2.5, O3 measured at nine air quality monitoring stations (AQMSs) were obtained from the Tabriz Department of Environment (TDoE) during 2006-2017 and analyzed. Spatial and temporal variations of pollutants using the Mann-Kendall's test and Moran’s I index were analyzed. Results: The results of this study showed that the annual trend of PM10, PM2.5 was decreasing but remained almost constant for O3 during the study period. During some of the studied days, PM10, PM2.5 levels were exceeded greater than the WHO AQG and National standard levels. Moreover, the highest monthly mean concentrations of PM10 in October (80.3 µg/m³), PM2.5 in January (42.9 µg/m³) and O3 in June (77.8 µg/m³) were observed. Comparison between the stations indicated that the Raste Kuche station was more polluted than other stations. Conclusion: Effective control planning and implementation policies are essential to improve the air quality of the Tabriz environment. Hence, information provided in this research can be used as a key step for city managers, policymakers, and health officials to reduce the health impacts of air pollution.

Introduction: Air pollution is the leading environmental risk factor for health. This study aimed to assess heavy metals in Particulate Matter (PM10, PM2.5) and their health impact assessment for a desert city in Iran, Birjand. Materials and methods: In this study, the concentrations of PM10 and PM2.5 were measured from September 2019 to March 2020. Measurements were performed once every six days for 24 h using high-volume samplers. Moreover, health-related effects attributed to the suspended particles were estimated using the AirQ2.2.3. Results: Mean and standard deviation of PM10 and PM2.5 concentrations were 97.5±38.7 μg/m3 and 36.3±19.1 μg/m3, respectively. The mean metal concentrations in PM2.5 were in the Co> Cd> Ce> V order, while the metal concentrations in PM10 were in the Cd> As> Ce>V order. The lowest and highest number of deaths attributed to PM2.5 per 100,000 persons were related to ischemic heart disease (1.73) and chronic respiratory disease (18.35). The highest number of deaths attributed to PM10 per 100,000 persons was related to chronic bronchitis in adults (35.74). Conclusion: This study revealed that particle-based air pollution negatively affects health as caused by heavy metals, whereas further research is required to determine the effects of bacterial and fungal bioaerosols on human health. Monitoring the elemental composition of atmospheric particles can contribute to better air quality management.

Objective Malaria remains endemic in most of sub-Saharan Africa and has a negative impact among pregnant women, resulting in morbidity and poor birth outcomes. The purpose of this study was to assess the relationship between malaria and adverse birth outcomes among prenatal women in the Northern Region of Ghana.Design This is a prospective cohort study of singleton pregnancies at 28 weeks of gestational age and above recruited between July 2018 and May 2019 from four public hospitals in the Northern Region of Ghana.Outcome measures Low birth weight (LBW), preterm birth and perinatal death.Results A total of 1323 pregnant women completed the study out of the 1626 recruited, with an average age of 27.3±5.2 years. The incidence of malaria in this population was 9.5% (95% CI 7.9 to 11.1). After adjusting for newborn admissions to the neonatal intensive care unit, parity, maternal age and glucose-6-phosphate dehydrogenase, women who were exposed to malaria during the third trimester of pregnancy had 2.02 times (95% CI 1.36 to 2.99) higher odds of premature delivery. Furthermore, they had 2.06 times (95% CI 1.09 to 3.93) higher chance of giving birth to babies with LBW, irrespective of their socioeconomic status. With an OR of 1.02 (95% CI 0.26 to 4.01), there was no difference in perinatal mortality between pregnant women with malaria and those without malaria after adjusting for caesarean section.Conclusion This study confirms that prenatal malaria increases the odds of both preterm and LBW deliveries. A decisive policy to eradicate or minimise perinatal malaria is needed to contribute to the prevention of LBW and adverse pregnancy outcomes.

Satisfying indoor air quality in public environments has become essential in cities. In the present study, indoor PM2.5, CO2, NO2, SO2, nicotine, and BTEX have been assessed in 12 categories of public places. The highest average concentrations of PM2.5, NO2, and SO2 were observed in waterpipe cafés (233, 29.6, and 5.1 µg/m3), whereas the lowest concentrations were found in health clubs and hospitals, respectively. Moreover, indoor BTEX concentration varied from 69.5 µg/m3 (passenger terminals) to 1739.2 µg/m3 (elderly care centers). Given nicotine, the highest concentrations were found in waterpipe cafés, ranging from approximately 11.0 to 50 µg/m3. The mean hazard quotient (HQ) and Hazard Index (HI) for benzene, toluene, ethylbenzene, and xylene were calculated in all types of public environments, and results showed that the amount of HQ and HI in none of the places was more than 1. Furthermore, the lifetime cancer risk (LTCR) exceeded the guideline threshold in hospitals, restaurants, elderly care centers, passenger terminals, movie theaters, and beauty salons. The findings of our study indicate that the indoor air quality in most public settings within Tehran city is not acceptable and necessitates appropriate management. These findings underscore the importance of monitoring indoor air quality and implementing effective strategies to mitigate exposure to air pollutants.

Abstract Inflammatory biomarkers in exhaled breath condensate (EBC) are measured to estimate the effects of air pollution on humans. The present study was conducted to investigate the relationship between particulate matter and inflammatory biomarkers in blood plasma and exhaled air in young adults. The obtained results were compared in two periods; i.e., winter and summer. GRIMM Dust Monitors were used to measure PM10, PM2.5, and PM1 in indoor and outdoor air. A total of 40 healthy young adults exhaling air condensate were collected. Then, biomarkers of interleukin-6 (IL-6), Nitrosothiols (RS-NOs), and Tumor necrosis factor-soluble receptor-II (sTNFRII) were measured by 96 wells method ELISA and commercial kits (HS600B R&D Kit and ALX-850–037-KI01) in EBC while interleukin-6 (IL-6), sTNFRII and White Blood Cell (WBC) were measured in blood plasma in two periods of February 2013 (winter) and May 2013 (summer). Significant association was found between particulate matter and the white blood cell count (p

Background and Objective: Air pollution is one of the most important environmental risk factors that exposure to it can cause many acute and chronic effects on human health. Some regions of Iran, especially the western, southern and southeastern provinces of the country, have been affected with dust storm for years. Studies on the frequencies of dusty days in the country show that central pits of Iran and the cities of Zabol and Zahedan have the highest incidence of dusty days. The purpose of this study was to determine the concentration of suspended particles with aerodynamic diameter of 2.5 μm or less (PM2.5) in various seasons and months during 2019 in Zahedan. Materials and Methods: In this descriptive-analytical and cross-sectional study samples were typically collected once every 6 days during a 24-hour period as well as on dusty days using an air sampler (PQ200 / BGI) from July 2018 to July 2019. Results: The results show that the mean concentration of PM2.5 in Zahedan during this study was 36.86 µg/m3. The maximum and minimum PM2.5 daily concentrations in the sampling days were also measured as 130.8 and 4.75 µg/m3, respectively. Conclusion: In conclusion, 88% of samples contained PM2.5 concentration above the WHO 24-hr air quality guideline level (25 µg/m3), which could be due to the high incidence of summer dust storms. This indicates that particulate matters are a serious health threat to people living in those areas and calls for the implementing measures to tackle the problem.

Background and Objective: In this study, we aimed to assess Iran’s position and trends for environmental health status among the countries of “Iran’s perspective document in 1404” according to the indicators used in Environmental Performance Index (EPI) report in 2018. Materials and Methods: The score of indicators in environmental health area; air quality (including household solid fuels, exposure to PM2.5, and PM2.5 exceedance), water and sanitation (including drinking water and sanitation) and heavy metals (including lead) were extracted for all studied countries as well as for the last and baseline (generally ten years prior to last report) years from EPI 2018 database. According to EPI scores, the performance of the studied countries in each indicator was ranked. The percent change in the score of each indicator from baseline to current year was calculated and compared with the mean percent change for all studied countries. Results: Iran ranked 7th regarding air quality in 2016. Also, it ranked 6th, 8th, and 9th in terms of household solid fuels, exposure to PM2.5, and PM2.5 exceedance, respectively. The EPI score for Iran regarding water and sanitation was 54.4 in 2005 and 58.74 in 2016 (percent change=7.98%). Iran ranked 21st in 2005 regarding lead exposure index. Although this index showed a growth of 100% in 2016, which is very desirable compared to the average growth of all countries (34.47%), but only leads to one step up in the ranking of Iran and was ranked 20th in comparison with other countries. Conclusion: Totally, according to EPI 2018, Iran ranked 6th in the field of environmental health issues among 23 countries of “Iran’s perspective document in 1404”. However, there is uncertainty in the accuracy of the EPI raw data used for calculating index scores. Hence, caution should be exercised in their interpretation.

Background: Airborne fungi play an important role the quality of indoor and outdoor air. The aim of this study was to investigate the concentration of airborne fungi around different parts of the wastewater treatment plant (WWTP) in the west of Ahvaz and its relationship with some important meteorological parameters. Methods: This study was conducted on a WWTP in the west of Ahvaz during 4 months in both cold and warm seasons. Samples were collected from 2- and 10-m intervals of the grit chamber (GCh), primary sludge dewatering basin (PSDB), and aeration tank (AT), as well as 60 m upstream (US), downstream (DS), and administrative building (AB) of the WWTP. Bioaerosols were collected using passive sampling method. Temperature, humidity, wind speed, wind direction, and ultraviolet index (UV) were also measured at the time of sampling. Results: The total concentration of fungi was 46.1 ± 43 CFU/plate/h. The highest concentration of fungi (92.2 ± 28.12 CFU/plate/h) was found 2 m away from the GCh in the cold season and the lowest one (24.6 ± 6.67 CFU/plate/h) was found at the 10-m distance of the AT in the warm season. The dominant fungal genus included Cladosporium, Alternaria, Yeast, and Aspergillus, respectively. Also, there was a significant relationship between the degree of fungal contamination in different units, the US and DS of the WWTP, and there was a negative relationship between the release of fungi and UV. Conclusion: According to the results, grit chamber plays an important role in releasing airborne fungi. Also, airborne fungi were reduced with an increase in distance and UV.

Background: Air pollution is one of the major public health challenges in many parts of the world possibly has an association with breast cancer. However, the mechanism is still unclear. This study aimed to find an association between exposure to six criteria ambient air pollutants (PM2.5, PM10, SO2, NO2, O3, and CO) and mammographic breast density (MBD), as one of the strongest predictors for developing breast cancer, in women living in Tehran, Iran. Methods: Participants were selected from women attending two university hospitals for screening mammography from 2019 to 2021. Breast density was rated by two expert radiologists. Individual exposures to 3-year ambient air pollution levels at the residence were estimated. Results: The final analysis in 791 eligible women showed that low and high breast density was detected in 34.8 and 62.2 of participants, respectively. Logistic regression analysis after considering all possible confounding factors represented that an increase in each unit of NO2 (ppb) exposure was associated with an increased risk of breast density with an OR equal to 1.04 (95CI: 1.01 to 1.07). Furthermore, CO level was associated with a decreasing breast density (OR = 0.40, 95CI = 0.19 to 0.86). None of the other pollutants were associated with breast density. Conclusion: Higher MBD was associated with an increased level of NO2, as a marker of traffic-related air pollution. Furthermore, CO concentration was associated with a lower MBD, while other criteria air pollutants were not related to MBD. Further studies are needed to evaluate the association between ambient air pollutants with MBD.

Background: We aimed to assess prevalence and predictors of pre-existing hypertension in pregnant women in three districts of Northern region, Ghana. Methods: This cross-sectional study was conducted among 1626 women in the third trimester of pregnancy across four antenatal centers in 2018. A questionnaire was used to collect medical information including weight and height. We used descriptive statistics to characterize all qualitative variables and performed logistic regression analyses to estimate association of hypertension and other risk factors. Results: We included 1626 women; mean age standard deviation (SD) of pregnant women was 27.4 (5.1) years. About 4.5% (95% confidence interval [CI]: 3.6-5.7) of pregnant women reported they had earlier been diagnosed of having hypertension by a doctor or midwife, before pregnancy. Obese pregnant women had 2.9 times increased adjusted odds of having hypertension relative to non-obese pregnant women (Odds Ratio (OR))=2.9, 95% [CI]: 1.39-5.85, P=0.004). Further, gestational diabetes was a predictor of pre-existing hypertension at an increased odds of 4.9 times relative to those without gestational diabetes (OR= 4.9, CI: 0.92-26.75, P=0.061). Women with two or more children had 3.2 times the adjusted odds of having hypertension (OR=3.2 CI: 1.59-6.69, P=0.001). Conclusion: Although the prevalence pre-existing hypertension was not too high, obesity, gestational diabetes and number of children were independent predictors of pre-existing hypertension in pregnant women.

The presence of bio-aerosols is one of the main causes of hospital infections that can be dangerous especially for immunocompromised patients. This research aimed to determine the relationship between hospital infections and surgical incision size in addition to determining the concentration and bacterial and fungal bioaerosols found in the operating rooms. This cross-sectional descriptive-analytic study was carried out in the operating rooms of Shariati Hospital in Karaj, Iran during the years 2016 and 2017. A total of 198 bacterial samples and 198 fungal samples were collected and analyzed using a passive sampling standard method (1/1/1) for 180 days. Tryptic Soy Agar (TSA) and Sabouraud Dextrose Agar (SDA) medium were used for bacterial and fungal samples, respectively. Relevant differential tests were used to determine the genus and species of bacteria and fungi such as DNase test, Bile-esculin, motility test urease test. In general, this work presents: • The present evaluated the relationship between bioaerosols concentration and surgical incision size. • The intraoperative concentration of bacterial and fungal bioaerosols in indoor air of the orthopedic, internal and cesarean operating rooms was significantly higher than their preoperative concentration (p-value

Introduction: The occurrence of dust storms in recent years, has led to the use of data recorded in ground measurements stations to determine the sources and investigate the occurrence of these storms in the past; however, it is associated with the possibility of measurement errors or failures in some cases. Materials and methods: In this study, using the data records by synoptically stations, dust storms that occurred in Tehran during March 21, 2014 to March 20, 2015 were determined. To verify the detected cases of dust storms through the index, satellite imagery was collected and analyzed on the days. For remote sensing, Modis Level 1 images were processed using the ENVI 5.3. In order to show dust, NDDI, BTD (32-31), and BTD (20-31) indices were used. Finally, the sensitivity and specificity of all two items were compared with the weather data announced on these days; using R software. Results: Results indicate, compared to actual observations, that the sensitivity of this method was 100% and its specificity was 98%. Conclusion: Because the index used in this study consisted of three parameters of wind speed, PM10 concentration, and horizontal visibility, it minimized the possibility of mistakes due to the simultaneous use of all three parameters to show dust storms.

Introduction: Airborne Cladosporium spores in different regions of the world are known as the main cause of allergic diseases. This study aimed to identify the Cladosporium species airborne fungi in Ahvaz wastewater treatment plant area and its adjacent places and check the effect of some meteorological parameters on their emissions. Materials and methods: Cladosporium spores were cultured on Sabouraud`s dextrose agar (SDA) medium in both cold and warm seasons. The passive sampling method was performed and after incubation, colonies were counted as CFU/Plate/h. Then, according to the macroscopic and microscopic characteristics of the genus, the fungal was studied. The meteorological parameters including temperature, humidity, air pressure, dew point, wind speed, and ultraviolet index were measured. Results: At least, 3358 colonies were counted. 1433 colonies were related to the Cladosporium species. The amount of Cladosporium in indoor air was 46% of the total Cladosporium. The average of meteorological parameters includes temperature, humidity, air pressure, dew point, wind speed and UV index during the study were 27.8 °C, 32.9%, 548.7 °Kpa, 3.6°, 9.1 km / h and 3.9 respectively. 42.6% of the total number of colonies was related to the Cladosporium species. Cladospiromes had a direct correlation with the dew point, temperature, humidity, air pressure, wind speed, and ultraviolet index (Pvalue

Introduction: Exposure to benzene has been associated with a range of acute and long-term adverse health effects. We aimed to estimate national and provincial level of benzene emissions from 1990 to 2013 in Iran. Materials and methods: Benzene emission was estimated through two main sources: unburned benzene content of fuel and evaporated benzene. Unburned benzene content of fuel estimated by gasoline consumption rate, kilometers traveled by non-diesel-based cars, and benzene emission factor. Evaporated benzene estimated by evaporated gasoline and volumetric percentile of benzene. Results: The estimated provincial annual mean benzene estimation range was between 5.9 (ton) and 1590 (ton) from 1990 to 2013. Our results showed that maximum benzene emission over the past 24 years occurred in Tehran, Mean (SD) ((1147.23(308.57) (ton)), Isfahan ((423.45(132) (ton)), Khorasan Razavi) (410.48(122.23) (ton)) provinces, respectively. There was an upward trend in the benzene emission into atmosphere at national and subnational level from 1990 to 2007. Also a significant decrease trend is observed from 2008 to 2013. Conclusion: The findings of this study will provide an insight into the extent of emitted benzene in the atmosphere at different regions of Iran for policy makers and scientists and may be a groundwork for field studies on benzene concentration estimation.

This study was aimed to investigate the types and number of bacterial and fungal bioaerosols in indoor air of hospitals according to the type of wards and operating theaters. Bacterial and fungal samples were collected using the passive sampling method of 1/1/1 scheme during a six months' period in the Khatam-Al-Anbia hospital, Tehran, Iran. A simple linear regression was used to determine the relationship between bioaerosol concentrations and the number of active beds. Bacterial bioaerosol concentrations were mainly higher than fungi in all sampling sites. A significant association was found between airborne fungal concentrations and the numbers of beds (R2 = 0.76, p

Introduction: Exposure to indoor radon increases the risk of lung cancer. This study examined the level of indoor radon in dwellings of Khorramabad city, by using passive alpha-track detector (CR-39) during winter of 2016. Materials and Methods: In the present study, we detected the concentration of indoor radon in 56 dwellings. A passive sampling instrument (alpha-track detector with CR-39 polycarbonate films) was utilized to measure indoor radon gas concentration. The distribution map of indoor radon concentration was prepared using Arc GIS software. Results: Radon concentration in the dwellings varied from 1.08 to 196.78 Bq/m3, with a mean value of 43.43±40.37 Bq/m3. The average annual effective dose received by the residents of the studied area was estimated to be 1.09 mSv. Our results showed a significant difference between the average radon concentrations in houses and apartments, with a higher level in houses. Conclusion: Indoor radon concentration in 10.1% of the dwellings was determined to be higher than the limit (100 Bq/m3) recommended by the World Health Organization.

Introduction: The importance of air quality and paying attention to what we breathe have been valuable always. So that air pollution is one of the key environmental issues in urban communities. Several studies show that the potential effects of air pollution on human health include increased mortality and changes in cardiovascular and respiratory functions. Materials and methods: The population of this study was people in 22 districts of Tehran megacity. The questionnaires were placed at the municipality centers of 22 districts and randomly completed by people who came to the center. Questions included the importance of air pollution, the comparison of air quality with last year, the main sources of air pollution, the problems created by air pollution, the quality of informing system, as well as questions about their satisfaction about government’s actions on air pollution control plans. Data analysis was performed using SPSS 24. Results: 84.14 % of the participants stated that air pollution is important to them and has a negative influence on their lives. Also, most of them were not satisfied with the measures taken and expected that actions would be better to reduce air pollution. 91.10 % of the participants considered cars as the main causes of air pollution. Also, 68.22 % of people believed that air pollution had a significant negative impact on their quality of life. Conclusion: Most people are willing to live at a higher cost but a less polluted environment, while more of them are not well aware of their role in reducing air pollution. Moreover further education should be provided on the role of people in reducing air pollution. Additionally, the government must deal with air pollutants and take serious measures.

Introduction: Most vehicles with over 20 years of age have low combustion efficiency by no catalytic converters. One of the most important ways to control and reduce emissions from vehicles is to conduct periodic technical inspection (PTI). According to the regulations of each country, the frequency of periodic technical inspection is different and is determined by the quality of air. Materials and methods: Data of light vehicles, which had been tested in 2010, was collected from Tehran vehicle technical inspection bureau. Collected information of data on vehicles manufactured from 2004 to 2008 including Pride, Peugeot 206, Peugeot 405, Peugeot Pars, Samand and Roa. About 248865 and 236084 vehicles were studied for HC and CO emissions, respectively. Results: According to results one vehicle among every 6 Roa, every 14 Pride, every 22 Peugeot 405, every 40 Peugeot 206, every 125 Samand and every 111 Peugeot Pars, which were referred to technical inspection centers for first time, two years after manufacture, had higher pollutants emission compared to the permitted standards. Conclusion: The results showed that if the periodic technical inspection intervals of vehicles increase from two years to more than two years, for example to five years, about 17.5 % of Peugeot 405 and 10.8 % of pride will be recorded for CO emissions higher than standard rate. Also, about 62 % of new vehicles will have higher levels of HC emissions, which can cause air pollution and an increase in the concentration of pollutants and eventually cause serious harm to public health.

Introduction: Predicting the concentration and emission rates of air pollutants before constructing industrial towns via modeling can be an appropriate method for determining the industrial towns’ construction sites. For this purpose, it is necessary to compile proper information about fuel consumption rate by industrial units in various groups. Materials and methods: In order to obtain the average fuel consumption in different groups, some questionnaires were prepared, then, filled in 5 industrial towns. Subsequently, using the AP - 42 emission factors, the production rate of various pollutants produced by these industrial groups was estimated. Later, the collected data were used to investigate the effect of constructing phase-II of Baharan Industrial Town, Hamadan, on the area’s weather in an area of 15*15 km2 using AERMOD. Results: Based on the results derived from the questionnaires, the highest natural gas consumption rate was related to the food and textile zones with the estimated average consumption rates of 0.023532 (m3 / ha.s) and 0.021785 (m3 / ha.s), respectively. However, the lowest rate was related to the non - metallic minerals zone with the estimated average consumption rate of 0.00097 (m3/ ha.s). Conclusions: Zoning the modeling results indicated that constructing phase-II of Baharan Industrial Town, Hamadan, would not increase the average concentration of air pollutants in the area to above the standard level.

Introduction: Air pollution is a serious health concern worldwide, accounting for high premature morbidity and mortality annually. In this article, we explain the framework of a series of interrelated researches for studying particulate matter (PM10, PM

Air pollution is a major environmental issue in all regions of the world. We aimed to assess the health impacts of particulate matter with an aerodynamic diameter 10 µm (PM10) in Sanandaj, Kurdistan, Iran. The air pollution data were obtained from Sanandaj Department of Environment Protection. The annual mortality and morbidity, including cardiovascular and respiratory diseases attributable to PM10 exposure were estimated using AirQ model, which is the proposed method for health impact assessment of air pollution by World Health Organization. The annual, winter, and summer averages of PM10 in 2013 were 81.5, 64.7, and 98.3 μg/m3, respectively. The total mortality, cardiovascular mortality, respiratory mortality, hospital admissions due to cardiovascular diseases, and hospital admissions due to respiratory diseases, respectively, were estimated 228, 120, 23, 118, and 305 cases. Approximately 11.7% of total mortality was associated with concentrations more than 20 μg/m3. This study was the first attempt to assess the health impacts of air pollution in Sanandaj, Kurdistan, Iran. In summary, we found increased mortality and morbidity attributable to PM10 exposure.

Background: The eastern Mediterranean region is comprised of 22 countries: Afghanistan, Bahrain, Djibouti, Egypt, Iran, Iraq, Jordan, Kuwait, Lebanon, Libya, Morocco, Oman, Pakistan, Palestine, Qatar, Saudi Arabia, Somalia, Sudan, Syria, Tunisia, the United Arab Emirates, and Yemen. Since our Global Burden of Disease Study 2010 (GBD 2010), the region has faced unrest as a result of revolutions, wars, and the so-called Arab uprisings. The objective of this study was to present the burden of diseases, injuries, and risk factors in the eastern Mediterranean region as of 2013. Methods: GBD 2013 includes an annual assessment covering 188 countries from 1990 to 2013. The study covers 306 diseases and injuries, 1233 sequelae, and 79 risk factors. Our GBD 2013 analyses included the addition of new data through updated systematic reviews and through the contribution of unpublished data sources from collaborators, an updated version of modelling software, and several improvements in our methods. In this systematic analysis, we use data from GBD 2013 to analyse the burden of disease and injuries in the eastern Mediterranean region specifically. Findings: The leading cause of death in the region in 2013 was ischaemic heart disease (90·3 deaths per 100 000 people), which increased by 17·2% since 1990. However, diarrhoeal diseases were the leading cause of death in Somalia (186·7 deaths per 100 000 people) in 2013, which decreased by 26·9% since 1990. The leading cause of disability-adjusted life-years (DALYs) was ischaemic heart disease for males and lower respiratory infection for females. High blood pressure was the leading risk factor for DALYs in 2013, with an increase of 83·3% since 1990. Risk factors for DALYs varied by country. In low-income countries, childhood wasting was the leading cause of DALYs in Afghanistan, Somalia, and Yemen, whereas unsafe sex was the leading cause in Djibouti. Non-communicable risk factors were the leading cause of DALYs in high-income and middle-income countries in the region. DALY risk factors varied by age, with child and maternal malnutrition affecting the younger age groups (aged 28 days to 4 years), whereas high bodyweight and systolic blood pressure affected older people (aged 60–80 years). The proportion of DALYs attributed to high body-mass index increased from 3·7% to 7·5% between 1990 and 2013. Burden of mental health problems and drug use increased. Most increases in DALYs, especially from non-communicable diseases, were due to population growth. The crises in Egypt, Yemen, Libya, and Syria have resulted in a reduction in life expectancy; life expectancy in Syria would have been 5 years higher than that recorded for females and 6 years higher for males had the crisis not occurred. Interpretation: Our study shows that the eastern Mediterranean region is going through a crucial health phase. The Arab uprisings and the wars that followed, coupled with ageing and population growth, will have a major impact on the region's health and resources. The region has historically seen improvements in life expectancy and other health indicators, even under stress. However, the current situation will cause deteriorating health conditions for many countries and for many years and will have an impact on the region and the rest of the world. Based on our findings, we call for increased investment in health in the region in addition to reducing the conflicts. Funding: Bill & Melinda Gates Foundation.

In this study, we used the positive matrix factorization (PMF) model to evaluate the sources of ambient coarse particulate matter (PM) and their temporal variations in two sampling sites, i.e., a school dormitory and a retirement home, located in central Tehran. 24-h ambient PM samples were collected using low-volume air samplers from May 2012 to June 2013. The collected filters were analyzed for their chemical components, including water-soluble ions, metals, and trace elements, which were used as the input to the PMF model. Our results indicated annual averages of 45.7 ± 3.8 µg/m3 and 36.2. ± 4.0 µg/m3 for coarse PM at the School dormitory and Tohid retirement home, respectively. Moreover, higher ambient coarse PM mass concentrations were observed in the warm season (53.3 ± 5.8 µg/m3 for school dormitory and 43.1 ± 6.1 µg/m3 for Tohid retirement home) as opposed to the cold season (41.4 ± 4.7 µg/m3 for school dormitory and 28.7 ± 4.6 µg/m3 for Tohid retirement home). Our PMF analysis also identified road dust, soil, and industry, and atmospherically processed coarse PM as the three sources of ambient coarse PM in central Tehran. Road dust, soil, and industry were the major sources of ambient coarse PM, contributing respectively to 74 ± 9% and 19 ± 2% of the total coarse PM mass concentration, while atmospherically aged aerosols had a rather minimal contribution of 7 ± 1% to total coarse PM mass concentration. The temporal trends of the resolved factors also revealed higher contributions of road dust to total ambient coarse PM during warm season as opposed to cold season, due to the increased resuspension rate from road surfaces as a result of higher wind speeds, and temperatures, combined with lower relative humidity. Similarly, higher resuspension rate of mechanically originated particulates resulted in higher warm-season time contributions of the soil factor. Results of this study clearly revealed the key role of road dust and non-tail pipe emissions on ambient coarse PM mass concentrations in crowded areas of central Tehran, and have important implications on the potential health impacts that can be caused by these difficult to mitigate sources of coarse PM.

Background and Objectives: Wind-induced particulate air pollution from iron ore piles can causes environmental and economic problems for steel industries. In this experimental study, the effectiveness of various additives in reducing particulate air pollution from iron ore piles was investigated in a laboratory wind tunnel.Materials and Methods: The experimental set up consisted of a prismatic pile and a wind tunnel. Four different wind speeds of 4.3, 5, 7 and 11 m/s was used in the study Municipal water, quick lime (2%), seawater, treated industrial wastewater and Polylatice (0.25%) were used as additives to stabilize the upper layer of the pile. Results: Emission factors for non-stabilized (without additive) piles at 4.3, 5, 7 and 11 m /s wind speeds were 46.7, 73.2, 1025.4 and 13768.7 g/m2, respectively. Stabilized piles with 2.6, 2.7, 2.8, 2.7 and 2.8 percent additive (moisture content of the upper layer of the pile) for municipal water, Polylattice (0.25%), treated industrial wastewater, seawater and quick lime (2%) indicated a decrease of 99.4%, 100%, 99.3%, 99.5% and 99.5% particulate emission reduction, respectively. Conclusions: Proper selection and use of additives on iron piles has the potential for decreasing more than 99% of the wind-induced particulate emissions. Operational factors such as covered area, spray frequency, pile geometry, seasonal adjustments related to ambient temperature and humidity, wind speed and operator training need to be an integral part of the pollutant reduction program.

Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background and Objective: Dioxins and Furans are dangerous and highly toxic compounds entering to the environment from natural and manmade sources. Having high stability and half-life, these compounds remain for a long period in the medium and bring about severe effects on human beings and the environment. The aim of this study was to identify dioxins and furans emission sources in Iran and to estimate their contribution in emission rate. ‌Materials and Methods: First, we identified the emission sources of dioxins and furans and then necessary data was gathered by referring to the authorized organizations and filling the prepared UNEP questionnaires. We used Excel software to analyze the data collected.Results: According to the results obtained, total dioxins and furan emission in Iran in 2010, was 1957 g TEQ/yr; out of this amount, 705.8 g TEQ is emitted to the atmosphere and 643.2 g TEQ is residual ash. Therefore, dioxins and furans emission rate was 26.4 µg TEQ/capita in Iran. The most rates of emissions were associated with uncontrolled open burning (732.8 g TEQ/yr) and ferrous and nonferrous metal production (635.7 g TEQ/yr) such as cupper, iron, and steel.‌Conclusion: Our findings showed that the emission rate of Dioxins and Furans is much higher in Iran compared with other countries and appropriate management strategies are required to control these dangerous pollutants. st1":*{behavior:url(#ieooui) } /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;}

Introduction: Polycyclic aromatic hydrocarbons are among the main pollutants in the urban and industrial atmosphere. An investigation on variation of PAHs in the urban and suburban atmosphere of Tabriz, Iran was conducted in this study. Materials and methods: TSP and PM10 (particulate matter with aerodynamic diameter

Introduction: Multiple sclerosis (MS) is an inflammatory autoimmune disease of the central nervous system that affects women more than men. Environmental factors such as sunlight, through Ultraviolet (UV) radiation can have a pivotal role in MS prevalence. MS is more common in mid latitude temperate climatic areas, such as the northern United States, southern Canada and northern Europe. It has been shown that there is a low risk of MS in the hot, moist and extremely dry equatorial zone, and vice versa. Materials and methods: In this study, UV radiation data as UV index were collected from a geographic database provided by The Environmental Health Information System of Islamic Republic of Iran. The monthly average UV index during pregnancy leading to 15th of each month has been used to create GIS maps by using ArcGIS 9.3. Results: In this paper, It was focused on the potential effect of UV radiation on MS prevalence. It was found that there is a low maternal exposure to UV radiation in people born in April and May in all provinces of Iran and they can be more susceptible to MS. Conclusions: This study shows that Iranian high exposure to UV radiation can reduce the risk of MS. It was indicated that Iran is a low risk area for MS and people born in April and May are more susceptible to MS due to low exposure to UV radiation. Thus, birth months could be considered as an important factor in MS prevalence.