Background and Objective: According to the International Labor Organization (ILO), occupational accidents cause the greatest human hardship and economic compensation. The economic costs of accidents are not only borne by the victims but also by the relevant companies and the government. This study aimed to estimate the burden of occupational accidents in Kashan, Iran. Materials and Methods: This cross-sectional study was conducted on the working population of Kashan, Iran. In order to collect data, all information related to occupational accidents registered in the Department of Labor, Cooperation, and Social Affairs of Kashan was used. The burden of occupational accidents was assessed using the method by the World Health Organization. Moreover, Excel software was utilized to estimate the number of years lost due to early death and disability, and the overall years of life lost regarding social values. Results: The results showed that 407 accidents occurred during the study period. Furthermore, the total number of DALY (Disability Adjusted Life Years) cases in the present study was 523. 138 years, out of which 308 (58%) years are related to YLL (Years of Life Lost) and the remaining 138/218 years are related to YLD (Years Lived with Disability). Conclusion: Given the high number of years of life lost due to disability caused by occupational accidents, this study highlights the importance of providing occupational health services in industries to protect human resources against occupational accidents.

Background: The measurement of health benefits is a key issue in health economic evaluations. There is very scarce empirical literature exploring the differences of using quality-adjusted life years (QALYs) or disability-adjusted life years (DALYs) as benefit metrics and their potential impact in decision-making.Methods: Two previously published models delivering outputs in QALYs, were adapted to estimate DALYs: a Markov model for human papilloma virus (HPV) vaccination, and a pneumococcal vaccination deterministic model (PNEUMO). Argentina, Chile, and the United Kingdom studies were used, where local EQ-5D social value weights were available to provide local QALY weights. A primary study with descriptive vignettes was done (n=73) to obtain EQ-5D data for all health states included in both models. Several scenario analyses were carried-out to evaluate the relative importance of using different metrics (DALYS or QALYs) to estimate health benefits on these economic evaluations.Results: QALY gains were larger than DALYs avoided in all countries for HPV, leading to more favorable decisions using the former. With discounting and age-weighting – scenario with greatest differences in all countries – incremental DALYs avoided represented the 75%, 68%, and 43% of the QALYs gained in Argentina, Chile, and United Kingdom respectively. Differences using QALYs or DALYs were less consistent and sometimes in the opposite direction for PNEUMO. These differences, similar to other widely used assumptions, could directly influence decision-making using usual gross domestic products (GDPs) per capita per DALY or QALY thresholds.Conclusion: We did not find evidence that contradicts current practice of many researchers and decision-makers of using QALYs or DALYs interchangeably. Differences attributed to the choice of metric could influence final decisions, but similarly to other frequently used assumptions.

Background: This study uses data of the global burden of diseases (GBD) study 2010 to report death, disability-adjusted life year (DALYs), years of life lived with disability (YLDs) and years of life lost due to premature mortality (YLLs), attributed to suboptimal breastfeeding by age and gender during 1990 to 2010 in Iran. Materials and Methods: The GBD assessments were used, together with estimates of death and DALYs due to specific risk factors to calculate the attributed burden of each risk factor exposure compared with the theoretical-minimum-risk exposure. Uncertainties in the distribution of exposure, relative risks, and relevant outcomes were incorporated into estimates of mortality attributable and burden and were presented as 95 % uncertainty interval (UI). Results: In both genders, the age standardized DALYs rates and the age standardized death rate [(from 5 (95% UI: 2-8) to 1 (95% UI: 0-2) per 100, 000 populations], attributed to breastfeeding, had a decreasing trends. The age standardized YLD rate increased from 7 (95% UI: 2-15) to 10 (95% UI: 3-23) per 100, 000 populations in boys and, from 7(95% UI: 2-16) to 11(95% UI: 3-26) per 100, 000 populations in girls. The YLD changes showed some variation according to age categories. For both genders, the age standardizes YLL rate decreased from 395 (95% UI: 185-681) per 100, 000 populations to 111(95% UI: 42-213) per 100, 000 populations. Conclusion: The burden attributed to suboptimal breastfeeding had a considerable reduction rate from 1990 to 2010. Additional studies on burden of exclusive breastfeeding with more accurate data are recommended for policies make decision.

Dear Editor, In December 2019, pneumonia of unknown origin was reported in Wuhan, China. Scientists later identified it as SARS-CoV-2, and the new name nCoV-2019 provided information about it (1), causing many symptoms in affected people (2). The rapid spread of the virus and the lack of definitive treatment caused countries to face large numbers of infected people and created social, economic, and health challenges (3, 4). The form of the epidemic has not been the same in different countries (5). Quantifying the impact of COVID-19 relative to other causes of disease and injury is essential in every country, and understanding and quantifying the combined impact of mortality and morbidity from a disease is a key step in standardizing comparisons across countries (6). In this regard, disability-adjusted life years (DALY) is the best health measure to determine the effectiveness of social and systematic interventions. It is introduced by the World Bank and theWorld Health Organization to quantify the burden of diseases and injuries in studying the global burden of disease. This index, which is a combination of years of life with disability and years lost due to premature death, shows the severity of the disease on a scale of 0 (complete health) to 1 (death) (7). It is widely used to calculate the economic effects of alternative interventions in the health sector...

Background: Maintenance of health and its fair and just promotion in any society is the responsibility and duty of its respective government. Appropriate financial allocations and prudent decisions in the health sector requires the definition of an index that would reveal the loss resulting from early deaths of any cause and originate from disabilities due to nonfatal outcomes.The disability adjusted life years (DALY) index has such a characteristic. Esophageal cancer is the third prevalent cancer of the gastrointestinal tract. In Golestan Province, among the variety of cancers, it is the third leading cause of death and its incidence rate in the province is the highest in the country. In this study we try to compute the burden of this cancer. In this manner, while estimating the importance of this disease in Golestan Province, we aim to pave the way for scientific and effective assessments of this disease and determine an action plan for its containment.Materials and Methods: In this cross-sectional study, we used Dismod II software that has been designed for cancer modeling in populations. With this software, we computed the burden of cancer for the year 1387 in Golestan Province. The data needed as input for Dismod II included the population of the province, mortality and incidence rates that originated from esophageal cancer, all which were obtained from the 1385 census, Mortality Registry System, Cancer Registry System and expert panel views.Results: Total burden of esophageal cancer according to DALY in Golestan Province during 1387 was 2992.48 years in the total population. Amongst males, it was 1533.65 years and 1408.46 years in females due to years of lost life (YLL). As a result of years lived with disability (YLD), it was 25.54 years in males and 24.84 years in females.The burden of esophageal cancer per 1000 population of Golestan Province equaled 1.76 years for females and 1.88 years for males.The peak age of esophageal cancer burden was in the age groups of 60 to 80 years and above 80 years.Conclusion: The relative high burden of esophageal cancer in Golestan Province compared to other parts of the country is justifiable due to the existence of the highest incidence rate in this province. Therefore, we believe that esophageal cancer should be one of the highest priorities of the health system of the province. However, the final and definitive judgment is contingent upon computations of the burden of other cancers and diseases at the provincial level and its respective rankings.