Health Scope
Year:2018 | Volume:7 | Issue:4|Papers Count:25

Dear Editor, In the recent years, methadone/buprenorphine maintenance treatment (MMT/BMT) centers have been able to be effective in controlling drug abuse and related high-risk behaviors in Iran (1). The treatment protocol of these centers is multi-component. In addition to drug therapies, this protocol includes psychotherapy and social work services (2, 3). According to the protocol defined by the Iran Health Ministry for MMT/BMT centers, each patient during the first six months of the treatment is obliged to refer to the center every day (3). This instruction is actually facing serious challenges, as recent studies indicate the highest rate of dropout occurs in the first six months of treatment (3, 4)...

Background: How tight fitting respirators fit on the users face is an important factor in their effectiveness. Objectives: The aim of this study was to investigate the qualitative fitting of N95/FFP2 respirators among Health Care Workers (HCWs) in six educational hospitals affiliated to Shiraz University of Medical Sciences, Shiraz, Iran. Methods: This cross-sectional study was carried out on 284 HCWs. They were using medium size respirators of flat-fold FFP2 (3M-model; 8222 and SPC-model; 8226) and cup-shaped N95 respirators (3M-model; 8210). At first, a medical evaluation questionnaire was completed by all employees. Qualitative fit testing was performed by JSP kit (Oxford, England). Critical face anthropometric dimensions in fitting of respirators were measured using sliding caliper. All data analysis was performed with SPSS version 21 and STATA 13. Results: In this study, only 10. 6% of the participants passed the qualitative fit test. Cup-shaped respirators had better fitting compared to flat-fold respirators. A total of 10. 2% of the individuals who were using N95 respirators were not medically competent to wear a respirator. Most individuals who passed the fit test were placed in the medium cell (10%) of fit testing NIOSH Bivariate panel. Conclusions: Studied medium size of N95/FFP2 respirators could not provide proper fitting on the face of Iranian HCWs. More studies with different sizesandmodelsof available respirators in the Iranmarketis required tofindthemostappropriate respirators to provide proper fit on Iranian HCWs.

Refugee’ s health has become an increasingly important policy concern in Turkey. The aim of this record-based study was to present the size and economic dimension of services provided to refugees in public hospitals throughout the country and explain the legal status related to health insurance. The legal regulations and data on utilization of hospitals were obtained from the Ministry of Health. The results showed that all refugees used preventive and emergency services free of charge and also registered refugees had the right to use public primary and secondary health services for free. According to utilization data, number of births was 103347, deaths 3460, operations 260212, emergency and outpatients 8. 849518, and inpatients 252470 in 2014 to 2015. Total health spending for the public hospitalswasapproximately $ 338392896 in thesameyears. It can be suggested that the roleandcapacity of preventive health services and primary health services provided by family physicians should be increased in order to reduce the work load in public hospitals caused by the Syrian patients.

Dear Editor, Emerging infections are a big global public health concern. There are many new emerging diseases that require serious attention. Currently, Zika virus infection is a major global problem, which has not been successfully controlled so far (1, 2). Zika virus infection is a mosquito borne infectious disease transmitted by Aedes species mosquito. There are also many new reports on atypical modes of disease transmission (such as sexual contact) (2). The emergence of Zika virus infection in anewsetting due to disease importation by international travelers is also an important public health concern. From the first outbreak in South America in 2017, Zika virus has already been imported to several countries in America, Europe, Asia, and Oceania...

Background: Heat is one of the harmful physical factors in the workplace. Occupational heat stress refers to the net load that the workers should put up with as a result of the combined impact of metabolic heat, environmental factors, and clothing causing heat storage in the body. Objectives: This study aimed to compare the correlation between environmental stress index (ESI) and other thermal indices including wet-bulb globe temperature (WBGT), wet-bulb dry temperature (WBDT), thermal work limit (TWL), heat index (HI), standard effective temperature (SET), and physiological equivalent temperature (PET). Methods: Data were collected from 30 workers in one pelletizing factory located in southeastern Iran. The measurement of environmental variables and workers’ physiological responses at the workplace was implemented in 10 conditions. Pearson productmoment correlation coefficient and linear regression were utilized to determine the relationship between ESI and environmental/ physiological variables. Results: The results showed that the strongest correlation was recorded between ESI and dry temperature (r = 0. 96), natural wet temperature (r = 0. 96), and heart rate in the working condition (r = 0. 94). ESI was strongly correlated withWBDT(r = 0. 99) andWBGT (r = 0. 98). Conclusions: It is concluded that ESI is strongly related to heat indices(WBGT, WBDT, TWL, HI, SET, PET, PSI, andPSIHR)andheat stress was higher than the legitimate range in some of the working stations. The highest coefficient was recorded for the relationship between ESI and WBDT.

Background: Proper designing of chairs based on ergonomics increases efficiency, promotes quality of education, leads to correct posture in students, and reduces risk of musculoskeletal disorders. Objectives: The aim of this study was to design and develop an ergonomic chair, based on anthropometric data of students in educational settings. Methods: Anthropometric parameters were obtained from a stratified-random sample of 207 students. The data were analyzed using the SPSS 20 software, and the results were extracted as mean, standard deviation, and percentiles. The chair was planned in the CATIA software and developed by a three-dimensional print. Results: In this study, an ergonomic chair was designed based on anthropometric data from students. The seat height, depth, and width of the chair were determined as 44 cm, 42 cm, and 42. 15 cm, respectively. The height of the desk was adjustable in 19 to 29 cm, and the depth and length of the desk were considered as 51 cm and 65 cm. The width and height of the backrest were also 54 cm and 44 cm, and the backrest angle was adjustable in 95° to 105° . Conclusions: An ergonomic chair with adjustable parts was designed to achieve a well-match between anthropometric characteristics of students and the furniture. Such chair can reduce musculoskeletal disorders in students. Some ergonomic characteristics of this chair include adjustability of footrest, backrest, armrests, and desk. A chair with such characteristic can be used by many students with different body sizes.

Background: Due to high risks for occupational accidents, process industries are one of the most dangerous industries around the world. Accidents’ size in these industries are influenced by combination of different factors. Objectives: The present study aimed at analyzing and modeling occupational accidents’ size and investigating the role of different risk management factors on accidents’ size in process industries. Methods: This analytical study was carried out on accidents in ten process industries, including petrochemicals, refineries, and chemical industries during eight years (2008 to 2015). Studied data were included variables and factors of risk management systems and information about human injuring accidents. Data analysis and modeling were done based on feature selection by Pearson  2 coefficient and structural equation modeling (SEM) approach using statistical software of IBM SPSS AMOS v22. 0. Results: Lost working days (LWD) as index of accident size was estimated 197. 42 111. 06 days. Results of feature selection and SEM approach showed that LWDwas affected by different factors such as safety and health (S and H) training, risk management, and risk control, and its indicator variables (P < 0. 05). Conclusions: The findings implied that structural equation modeling is a reliable and applicable accidents analysis method. Furthermore, the results should be considered to prevent and reduce occupational accidents’ size in process industries.

Background: Polymer composites with interpenetrated polymer network (IPN) structure are widely used as sound and vibration damping materials due to their high viscoelastic properties within the glass transition temperature range. In this study, polyurethane (PU)/poly (methyl methacrylate) (PMMA)-based interpenetrating polymer network with different ratios of PU to PMMA (i. e. 85: 15, 75: 25, and 65: 35) were prepared by in situ polymerization. Methods: The properties of as-prepared IPN and its components were evaluated by different scanning calorimetry (DSC), dynamic mechanical analysis (DMA), and sound absorption. Tensile properties were also determined. As indicators of effective damping capability, viscoelastic parameters including loss factor (tan  ), glass transition temperature (Tg), and effective damping interval (tan  > 0. 3) were also determined. In order to determine the sound absorption coefficient in the prepared IPNs, a two-microphone impedance tube at the frequency of one octave was used. Results: The comparison of pure polymers (i. e. polyurethane and polymethyl methacrylate) and prepared IPNs indicated that the semi interpenetrated polymer network morphology was created through a broader range of tan  in different IPNs. Incorporation of PMMA into polyurethane in the form of interpenetrating polymer networks enhanced the damping acoustic properties of the semi-IPNs due to the permeability of the two polymers. In the temperature range of-50 to 11 ° C, both IPNs components showed high damping characteristics (tan   0. 3). Conclusions: Evaluation of the results indicated that the blends are capable of exerting viscoelastic effects for damping and sound attenuation.

Objective: In this systematic review, we aimed at estimating the pooled prevalence of catastrophic health expenditures (CHE) in Iran and identifying and summarizing the determinants of CHE among Iranian households. Methods: We comprehensively searched the literature on November 2016 in PubMed, Scopus, Web of Science, the Cochrane Library, and 3 Persian databases. We also obtained the literature through colleague communications. Two review authors independently selected studies, extracted data, and evaluated them. We performed meta-analysis of prevalence of CHEand subgroup meta-analyses to assess the influence of data source and scope of research. Moreover, we categorized the determinants of CHE in Ian. Results: In this review, 16 studies met the inclusion criteria, and of them, 2 presented the results of multiple surveys. Results of 27 cross-sectional studies were used to estimate the pooled prevalence of CHE in Iran during 1995 and 2015, which was found to be 3. 91% (95% confidence interval, CI:-3. 26-11. 07). Subgroup meta-analyses based on data source revealed that the highest prevalence estimate of facing CHE was associated with author-made questionnaires, and the lowest to the statistical Centre of Iran (SCI) questionnaire. Also, meta-regression showed that the difference in sample size and year of study did not have any significant effect on the prevalence of CHE. Some of the variables such as use of inpatient, outpatient, and dentistry services, education, place of residence, and household income, which were considered as determinants of CHE in Iran, increased the possibility of facing CHE. Conclusions: Decrease in CHEto less than 1%, which was the objective of the 2 of Iran’ s five-year development plans in 2007 and 2015, was not met. This percentage may need to be reconsidered according to the pooled estimate of CHE. Also, the factors revealed to be the determinants of an increase in the probability of facing CHE could indicate the need for health care services and socioeconomic variables that lower one’ s capacity to pay for health services.

Background: Recently, increasing exposure to radiations such as ultraviolet (UV) and gamma has led to growing incidence of different types of cancer and damage to aquatic and terrestrial ecosystems. Studies have shown that natural features such as latitude, elevation, weathering, local pollution, cloudy cover and earth surface play a remarkable role in distribution of UV and gamma radiations. In this regard, modeling and predicting UV and gamma rays distribution in each region is necessary. Objectives: The purpose of this study was modeling environmental UV and gamma radiations in Gonabad city, Iran. Methods: In this cross-sectional study, for modeling environmentalUVandgammaradiations, several stations inGonabadcity were selected. Distance between two stations was 5 km, and a total of 1800 samples were collected from the considered region. UV and gamma radiations were detected by radiometer and survey-meter, respectively. In the end, data were modeled by Kriging model in GIS 10. 3 and MATLAB software programs and their relationships were analyzed by performing t-test and ANOVA in SPSS version 16. Results: The predicted values for UV andgammaranged from 0. 03 to 1. 829Wm-2 and from 0. 08 to 0. 42 mSv, respectively. The highest UV and gamma doses were observed in the southwest region of Gonabad city. Minimum mean square error (MMSE) in GIS model related to UV and gamma were 0. 24 and 0. 02, respectively. Based on MATLAB, distribution of UV and gamma radiations showed high and low scattering, respectively, versus elevation and latitude. The most permanent weather condition for the measured UV and gamma radiations was sunny condition. Weather conditions had a significant (P < 0. 001) and insignificant relationship (P > 0. 001) with UV and gamma radiations, respectively. Conclusions: Integration of Kriging and MATLAB models led to obtaining more valuable estimates and maps about distribution of UV and gamma radiations from solar and terrestrial resources and weather conditions in a large region. These models showed that the population residing in mountainous areas received higher doses of UV and gamma radiations.

Background: Human factors play an important role in process safety and can have dramatic effects on the safety performance of organizations. In addition, human factors are very important elements in safety management system and management of major accident hazards in process industries. Many variables of human factors may affect the safety in process industries, which need to be addressed in a more holistic approach. Objectives: This study was designed to determine the most important variables of human factors in the management of major accident hazards in process industries through the fuzzy analytic hierarchy process (fuzzy AHP) approach in 2017. Methods: After specifying human factors variables including the job, the individual (personal), and the organization factors and related sub-factors, fuzzy AHP approach was proposed to determine the weights and the degree of importance of factors and related sub-factors. Factors and related sub-factors were weighted using triangular fuzzy numbers in pairwise comparisons and fuzzy linguistic variables. Results: Organization factors got the highest relative weights (0. 381) in comparison with other studied factors. Amongorganization sub-factors, safety culture had the highest importance (0. 33). Among individual sub-factors, competence of personnel is recognized as the most important sub-factor (0. 37). The highest relative weights for job sub-factors were obtained for ergonomic design and environmental factors (0. 17). Conclusions: Determining and identifying the most important variables of human factors in process safety are very important for organizations. The present study demonstrates that organization factors are the most important variables in the management of major accident hazards in process industries with the application of fuzzy AHP. Safety culture, staff competence, ergonomic design, and environmental factors are the most important sub-factors.

Background: Exposure to the evaporated gases during the welding process has short-or long-term effects on welders’ health. Assessment of the risk by identifying and determining the chemical risk rating might be a useful tool for the experts in industrial hygiene. Objectives: The present study aimed at evaluating the exposure of welders to welding gases in seven welding types in the Steel Industry. Methods: The present study was conducted in one of the factories of the steel industry in 2017. Seven types of welding were studied includingSMAW-E7018, SMAW-E730, MIG, MAG, PAW, SAW, and GTAW. Sampling from theNO, NO2, CO, CO2, andO3 was done via directreading instruments. To assess the health risk of exposure, the used approach was the one proposed by the division of occupational safety and health of the labor department of Singapore. Results: Findings of the present study revealed that the average range of welders’ exposure to NO, NO2, CO, CO2, and O3 gases in various welding processes was 30-50, 2456-5000, 2-12, 3. 5-6, and 0. 16-0. 5 parts per million (ppm). Maximum and minimum concentrations of exposure to each of the gases were observed in MIG and PAWwelding processes, respectively. The results of risk assessment showed that ozone and nitrogen dioxide had a very high-risk rating and nitrogen monoxide had a rank of “ negligible” in all types of welding. Among the different types of welding, the most and the least risks of welding types were in MIG and PAW welding, respectively. Conclusions: MIG welders have a high occupational exposure to various types of welding gases. Use of control measures such as installing a local ventilation system, workplace air monitoring, implementing appropriate respiratory protection, and training the workers are recommended for safety of the welders.

Objectives: Breakfast is the most important meal of the day and plays an important role in the physical and mental health of students. Young people, especially girls, frequently skip breakfast. One of the best theories that have been used successfully in various nutritional behaviors, such as breakfast consumption, is the social cognitive theory (SCT). The purpose of this study was to investigate the effectiveness of training intervention based on (SCT) increase breakfast consumption among female students of Hamadan University of Medical Sciences. Methods: In this quasi-experimental study, 100 female students living in two dormitories of Hamadan University of Medical Sciences allocated into two groups by using cluster sampling (control = 50 / intervention = 50) in 2014. The intervention group received 3 sessions, booklet, poster, and 3 cell phone SMS reminders. Measures included the constructs of SCT and consumption of breakfast during the past week. All participants completed questionnaires before, 10 days, and 4 months after the last session. Data was analyzed using the 16 SPSS software and based on independent t-test, paired t-test, Chi-square test, and repeated measures analysis. The significance level was considered (0. 05). Results: At first, there were no significant differences between groups for demographic data and outcome variables (i. e.; constructs of SCT and behavior). The results showed that interventions led to increase breakfast consumption and improve scores of social cognitive theory structures in the intervention group. Also, in both follow up assessments, the level of knowledge, outcome expectancies, social support, self-efficacy, and frequency of breakfast consumption in the intervention group significantly increased (P < 0. 001) compared with the control group. However, there were no differences between the two groups in terms of outcome expectations (P = 0. 750) and observational learning (P = 0. 427). Conclusions: This study supports the assumption that SCT-based interventions create a significant increase in breakfast consumption. Due to the effectiveness and low cost of this intervention, it seems that the extension of this program can lead to the increase in the frequency of breakfast consumption among students.

Background: Patients’ fall is considered as a challenge to patient safety, which entails not only prolonged hospital stays and higher costs, however, it may also result in injuries and even death. Objectives: This study aimed to identify attributed root causes and to develop preventive strategies. Methods: The present study is a multiphase qualitative study in which all fall incidents were studied deploying a root cause analysis process in accordance with the modified NPSA protocol in an educational hospital within a 9-month period. The contribution and association of risk factors attributed to each fall incident were analyzed using descriptive and analytical statistics. Finally, a nominal group technique was used, with specialist and holding three separate rounds, for determining preventive strategies of falling in health care facilities. Results: Out of a total of 110 fall incidents, 657 root causes were identified. Three groups of attributed causes, including patient, task, and education factors were found to have a greater share in the patient falling. Based on the identified root causes, fall prevention interventions were selected by members as specialized panels, who rated the solutions in several sessions. Ultimately, interventions agreed less than 70% were removed, and other potential preventive interventions were implemented in the form of a hospital-based trial. Conclusions: We found that a fall is the result of intrinsic and extrinsic risk factors. The first step in preventing falls is proper assessment of the patient in terms of clinical condition. Evaluation of the environment of the hospital is also essential to identify problems as well as developing amendment programs. Due to missing data on falls reported by nurses, it seems unwise to solely rely on the submitted reports.

Background: Situational temptations are important key points for smoking cessation. However, temptation to engage in smoking across different situations is yet challenging. In Iran, there is no measurement to assess situational temptations among workers. Objectives: The current study aimed at psychometrically evaluating the short form of situational temptations scale for smoking cessation based on transtheoretical model. Methods: By stratifiedrandomsampling method, 218 male current smoking automobile factory workers were selected and assessed through the short form of situational temptation scale. Exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and Cronbach’ s alpha were applied. Results: The mean age of the workers was 30. 52  6. 66 years. CVI and CVR of each question were > 0. 71. The result of EFA with principal component approach showed 1 factor with 45% cumulative variance and KMO was 91%, which were the good fit index in CFA. In the area of CFA, the result showed REMSEA = 0. 006, GFI = 0. 973, AGFI = 0. 955; P value = 0. 452, which were the good fit index in CFA. The reliability was also confirmed with Cronbach’ s alpha ( = 80. 1%). Conclusions: The current study approved the short form of situational temptation scale for smoke cessation. However, to ensure a reliable/valid instrument to realize smoking behaviors, doing more researches are recommended.

Background: Thalassemia is acommongenetic disease in Iran and is most prevalent in northern and southern parts of the country. Methods: Dueto vulnerable metabolic organs of thalassemia patients, the present studywasconducted to examine the relationship between Bone Mineral Density (BMD) and thyroid hormones along with some other variables. Results: A total of 5491 (2647 males and 2634 females) cases were studied in Tehran (the capital of Iran), Sari (in northern Iran), Bandar Abbas, Iranshahr, and Zahedan (in southern Iran). The mean age standard deviation of the patients was 24. 22 12. 7 years (24. 4 0. 23 in both male and female patients). Conclusions: Based on the results, 30. 6% of the patients had lumbar osteoporosis, 39. 0% had lumbar osteopenia, 8. 6% had femoral neck osteoporosis, and40. 4% hadfemoral neck osteopenia. Although thyroidhormonesdid not correlate withosteoporosis, greater changes were observed in these hormones in patients with thalassemia major than in other patients.

Background: Noise-induced hearing loss (NIHL) is one of the most important public health problems. There is scant information about NIHL, the prevalence and using patterns of headphones and music player devices in Iran. Objectives: This study aimed to assess the prevalence and using patterns of earphones and investigate the relationship between earphone use and hearing loss in a sample of students from Qazvin University of Medical Sciences (QUMS). Methods: In this cross-sectional study, 890 students were randomly selected using a proportional cluster sampling method in April and May 2015. The students completed a self-administered questionnaire assessing the pattern of their earphone use and hearing loss. Receiver operating characteristic (ROC) curve analysis was used to determine the cut-off point for the questionnaire. Results: The results suggested that 60. 2% (95% confidence interval (CI): 56. 9-66. 4) of the students reported a history of hearing loss and hearing impairment and 86. 4% (95% CI: 84. 0-88. 5) of the participants reported using an earphone in the past. Most of the participants listened to music on their cell phones (81. 7%) and 89. 6% of them used headphones for listening to music. The results indicated that 51. 3% of those who used earphones used earbud-style earphones, 42. 2% used supra-aural earphones, and 6. 5% used headphones. Students who used earphones, those who used earphones more frequently during the week, and those who used earphones for more years had higher hearing loss scores compared to other students. Conclusions: Students have a risky pattern of using personal listening devices. The higher hearing loss score among headphone users requires further attention in order to implement interventions to increase students’ awareness and attitude towards the use of headphones.

Background: Oily acidic sludge (OAS) from re-refineries has a high concentration of total petroleum hydrocarbons (TPH), elements, and heavy metals. Objectives: This research investigated the monitoring of elements during in-vessel composting of OAS with urban immature compost. Methods: This experimental study was conducted as a batch mode in a plastic container (500 mL). The ratios of OAS to compost were 1: 0 (as control), 1: 5 to 100 (as dry basis) at a C: N: P ratio of 100: 5: 1, and with 45%-65% moisture content for 70 days. The elements Zn, Cu, Fe, Mo, B, Mn, Al, Pb, Cr, Sn, Ni, Li, V, As, Cd, Co, and Hg were monitored every week. Results: The highest and lowest total petroleum hydrocarbons (TPH) removals were observed in mixing ratios of 1: 5 (71. 6%) and 1: 100 (48. 6%), respectively. The amount of Zn, Cu, Fe, Al, and B in OAS was very high. Element analyses after mixing OAS with immature compost showed that the initial concentrations of the elements had decreased. ANOVA test results showed that the changes in time were not effective on the average concentrations of elements (P = 0. 99). Conclusions: According to the obtained results, the mixing ratio of 10: 1 can be selected as the preferred choice for removing TPH and reduce elements’ concentrations.

Background: People might simultaneously be exposed to noise and carbon monoxide in occupational settings. The previous studies revealed that the inhalation of molecular hydrogen (H2) exerts some healing effects on multiple diseases including hearing loss. Objectives: The levels of free radicals have been shown to increase due to the exposure to noise plus carbon monoxide. This study examined the possible protective effects of hydrogen inhalation following simultaneous exposure to noise and carbon monoxide in Guinea pigs. Methods: Twelve Guinea pigs were randomly divided into two different groups: (1) Exposed to noise plus carbon monoxide and (2) exposed to noise plus carbon monoxide along with the inhalation of hydrogen. Auditory brainstem responses (ABRs) at different frequencies of 2, 4, 8, and 16 kHz were measured before and immediately after the exposure. Results: The ABR thresholds measured immediately after the simultaneous exposure to noise and carbon monoxide significantly increased at all frequencies in group 1 while in group 2, the ABR thresholds measured immediately after the inhalation of hydrogen significantly reduced at 4, 8, and 16 kHz (P values < 0. 05). Conclusions: This finding indicates that there is a protective effect associated with the inhalation of 2% hydrogen on the development of hearing loss after the simultaneous exposure to noise and carbon monoxide and this effect was fairly significant at higher frequencies.

Background: Formaldehyde (FA) is a reactive carcinogenic compound and is used routinely in anatomy theatres. Recently, biological monitoring is introduced as a method of choice for monitoring of exposed workers to hazardous chemicals with systemic absorption. Objectives: Considering the toxicity of formaldehyde and lack of a comprehensive method for its biological monitoring, the aim of this study was to explore a new and non-invasive method for biological monitoring of formaldehyde exposure in the staffs of anatomy theatre. Methods: This study was a cross-sectional investigation and the population of this study was comprised of 20 exposed staffs in an anatomy theatre in Tehran, Iran. The personal monitoring of 20 staff was carried out during the early winter, according to a method from the National Institute of Occupational Safety and Health No. 2016. Biological monitoring was conducted by measuring FA in staff’ s exhaled breath after termination of the work shift. The data obtained were statistically analyzed using correlation analysis. Results: The mean FA personal exposure and its concentration in the exhaled breath of anatomy’ s staffs were 698  34 and 195  17 as ppb, respectively. Correlation of staff’ s personal exposures to formaldehyde with the excreted formaldehyde in their exhaled breath was statistically significant (P < 0. 001). Conclusions: The present study showed that the personal exposure of staffs to the FA was higher than the permissible exposure limit. Statistically significant positive correlation of staff exposure with the content of FA in their exhaled breath indicated the potential of biological monitoring of exposed group to FA through exhaled breath.

Background and Objectives: Beyond being very valuable assets, hospitals are symbols of health and societal well-being. Destruction of a hospital or damage due to fire may result in a loss of trust by local authorities as well as injuries for patients and staff and will not allow provision of health care services. This study aimed at assessing fire quantify risk assessment and the effect of crisis management team on fire risk. Methods: This study was a descriptive analytically study. At first, according to fire risk assessment method for engineering (FRAME), fire risk was calculated for 15 hospital wards and then, the crisis management team was formed and trained, and the effects of fire risk were calculated. Data were analyzed by SPSS 20 software at a significant level of P < 0. 05 with the Wilcoxon test. Results: Overall, 13. 33% of the risk was for buildings (mean = 0. 57 and SD = 0. 51), 100% of the risk was for individuals (mean = 4. 60 and SD = 2. 37), and 53. 33% of the risk was for activities (mean = 1. 81 and SD = 1. 56), which were greater than one (unfavorable). An effective crisis management team reduces fire risk by an average of 31. 4%. Conclusions: Due to the poor state of fire safety in all hospitals studied in the research, organizing a crisis management team in each hospital can reduce fire risk by a relatively large amount.

Objective: Height is a multifactorial characteristic affected by genetics, hormonal and environmental factors. The aim of this study was to systematically review the effects of environmental pollutants, chemical factors, and climate changes on children and adolescents’ height. Methods: This study searched scientific databases including PubMed, ISIWeb of Science, and Scopus using key words such as “ Environmental Pollution” , “ Climate Change” , “ Growth” , “ Body Height” , “ Child and adolescent development” , and their combination. By removing duplicates, relevant papers were selected in three phases. This review included studies that were conducted among children and adolescents up to the age of 18. After the quality assessment, data was extracted by a reviewer and rechecked by another one. The authors summarized information of 52 articles about the possible effects of environmental factors and climate change on height. Articles were divided to four categories, including air, soil, water pollutants, and climate changes. Results: The evidence indicates that exposure to environmental pollutants have different effects on height growth; some of them, such as air pollution with lead, arsenic, fossil fuels and smoking, as well as exposure to nuclear radiation among children is associated with shorter stature, while exposure to some soil pollutants and airport noise did not have any effect on children’ s height growth. Conclusions: The current study proposes that exposure to some environmental pollutants and chemicals during childhood and puberty might have negative effects on height growth. Therefore, various interventions are necessary for reducing the production of these pollutants and the exposure of growing children to these environmental factors.

Background: Use of air purifier masks is one of the ways to reduce exposure to harmful respiratory pollutants in the workplace. The present research was conducted to evaluate the efficiency of respiratory masks used by refractory workers in controlling refractory ceramic fibers (RCF) and particles in a steel industry. Methods: In this study, three types of masks, namely FFP3 (APOLO), FFP2 (3MAX), and 3M elastomeric half-face mask with P100 filter against particle pollutants and FFP3 (APOLO) masks against fibrous contaminants were evaluated. To investigate penetration percentage and efficiency of the mask, the concentrations of particles were measured outside (Cout) and inside (Cin) the masks. The number of samples for each mask was 20. Results: The result showed that mean penetration of total particles in FFP3, FFP2, and 3M elastomeric half-face mask with P100 filter is 10. 92, 9. 4, and 4. 37%, respectively. Onthe other hand, themeanpenetration of respirable particles in FFP3, FFP2, and3Melastomeric half-face mask with P100 filter was 40. 76, 14. 26, and 2. 07%, respectively. The evaluation of the FFP3 (APOLO) mask against fibrous contaminants showed that this mask does not have a good efficiency against fibrous contaminants and provides a penetration of 15. 1%. Conclusions: The faceseal leakage due to inappropriate fitting of the mask on the face and the high surface resistance the mask against airflow can be a major cause for poor efficiency of the masks.

Background: Fungi are ubiquitous in indoor environments and are responsible for a wide range of infections in immunocompromised patients. Objectives: This study aimed to determine the type and amount of fungal contamination in an organ transplantation hospital in Mashhad. Methods: In this cross-sectional study, 96 samples were taken from three operating theatres, hemodialysis wards for women and men, kidney and liver transplant wards, and intensive care unit (ICU) of an organ transplant hospital of Mashhad University of Medical Sciences. Air samples were taken according to the NIOSH standard instructions and Anderson procedure with a flow rate of 28. 3 L per two minutes on sabarose dextrose agar media. Results: Among the five wards, liver transplantation was the least contaminated of fungal concentration in indoor air (5. 53 4. 08 CFU/m3). Indoor fungal were observed, women’ s hemodialysis (9. 01  5. 57 CFU/m3), kidney transplantation (9. 70  5. 99 CFU/m3), ICU (11. 09 4. 12 CFU/m3), and men’ s hemodialysis (11. 78 8. 31 CFU/m3), respectively. The most important fungal contaminations in operating theatres respectively was related to Aspergillus and Penicillium. Conclusions: The mean of fungal contamination in operating theatres and wards was compared with the European union good manufacturing practices guideline (EU GMP). Concentration of fungal in the hospital was in class B (clean state). However, due to the high sensitivity of transplantation recipients and immunocompromised patients to nosocomial fungal infections, the periodic surveys of the hospitals, environmental controls, and using an efficient ventilation system are necessary.

Background: Physical and chemical processes involved in wastewater treatment cause heavy metals that are present in rawsewage to accumulate in sludge, which limits utilization of sludge as a fertilizer. Large quantities of these metals negatively affect ecosystems and human health. Objectives: The present study aimed to investigate the possibility of leaching heavy metals from wastewater sludge by bioleaching (Acidithiobacillus ferrooxidans), Fenton/bioleaching, and bioleaching/Fenton-like processes. Methods: Bioleaching tests with iron concentrations of 1-4 g/L were carried out for 9 days. Combined Fenton/bioleaching and Bio-acidification/Fenton-like methods were also conducted with Fe2+ concentrations of 0. 5-2 g/L and H2O2 concentrations of 0. 25-1 g/L. Results: The results showed that the bioleaching method with Fe2+ concentration of 2 g/L led to removal of 87. 1% of zinc, 9% of cadmium, 69. 9% of lead, and 69. 9% of copper from sludge in 5 days. In the combined methods, the highest amount of removal was related to Fe2+ 2 g/L and H2O2 1 g/L in 2 days. Under these circumstances, 93% of Zn, 97. 06% of Cd, 87% of Pb, and 94. 5% of Cu in the bio-acidification/Fenton-like were removed. Conclusions: The results suggested that in comparison to single Fenton and bioleaching methods, the combined methods consumedless hydrogen peroxideanddid not requirepHadjustment, thus, resulting in higher efficiency in the removal of heavy metals from sludge.