Publications by authors named "Mahmood Yousefi"

64 Publications

Mapping QLQ-C30 Onto EQ-5D-5L and SF-6D-V2 in Patients With Colorectal and Breast Cancer From a Developing Country.

Value Health Reg Issues 2021 Jan 25;24:57-66. Epub 2021 Jan 25.

Health Policy and Management Research Center, Department of Health Services Management, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Electronic address:

Objectives: Many studies have mapped the QLQ-C30 onto the EQ-5D or the SF-6D utilities; however, these studies were limited to developed countries. So this study aimed to map QLQ-C30 onto the SF-6D version 2 (SF-6D-v2) and EQ-5D-5L using the data collected from colorectal and breast cancer patients in a developing country.

Methods: A cross-sectional data set of 668 inpatient and outpatient cancer patients was gathered from 4 teaching hospitals of cancer treatment in Tehran and Yazd from May 2017 to November 2018. The ordinary least squares (OLS) and censored least absolute deviations (CLAD) models were applied to estimate the utility values of both EQ-5D-5L and SF-6D-V2 using the QLQ-C30. Predicted R and adjusted R were used to evaluate the goodness of fit of the models. Moreover, the predictive performance of 2 models was assessed through estimating the mean absolute error (MAE), root mean square error (RMSE), intraclass correlation coefficients (ICC), and Spearman's rho. The 10-fold cross-validation method was also applied for validation of models.

Results: The OLS Model E4 was the best-performing model for EQ-5D-5L (Adj R = 71.7%, Pred R = 71.15%, MAE = 0.0770, RMSE = 0.1026), and the OLS Model S4 performed best for SF-6D-V2 (Adj R = 74.64%, Pred R = 73.86%, MAE = 0.0465, RMSE = 0.0621).

Conclusion: The OLS Model E4 for EQ-5D-5L and the OLS Model S4 for SF-6D-V2 were the best models for policy makers to have more accurate evaluation of the healthcare interventions when the data are gathered through non-preference-based instruments.
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http://dx.doi.org/10.1016/j.vhri.2020.06.006DOI Listing
January 2021

Interim value set for the EQ-5D-5L in Iran using the Crosswalk method.

Med J Islam Repub Iran 2020 15;34:121. Epub 2020 Sep 15.

Social Development and Health Promotion Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.

The EuroQol five-dimensional 5 level (EQ-5D-5L) value set is not currently available for the Iranian general public, while the value set for EuroQol five-dimensional 3 level (EQ-5D-3L) is available. The present study aimed to generate an interim EQ-5D-5L value set for the context of Iran. The Iranian interim EQ-5D-5L value set was generated using the crosswalk method, which maps EQ-5D-3L and EQ-5D-5L responses. The EQ-5D-3L value set has previously been estimated by Time Trade-Off (TTO) method. The interim value set obtained for EQ-5D-5L was compared with the value set of EQ-5D-3L by using measures of mean, median, and skewness.The analysis was done using STATA version 15. The mean and median scores of the Iranian interim value set were 0.499 and 0.451 for EQ-5D-5L and 0.455 and 0.459 for Iranian EQ-5D-3L, respectively. The range of value for both EQ-5D-3L and interim EQ-5D-5L was -0.113 to 0.919. Data skewness of EQ-5D-3L and interim EQ-5D-5L was-0.099 and -0.114, respectively. In addition, the figure of distribution of value sets for both data sets had a tail extended towards the left. The states of "good health"(i.e., states with value>0.8) for the EQ-5D-3L value set were proportionally more than the Iranian interim EQ-5D-5Lcrosswalk value set (2.47% vs. 0.448%). An EQ-5D-5L value set was generated using the crosswalk method for the Iranian general public, and now researchers and policy-makers can apply it to their economic and clinical analyses.
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http://dx.doi.org/10.34171/mjiri.34.121DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7787042PMC
September 2020

Spatio-seasonal variation, distribution, levels, and risk assessment of airborne asbestos concentration in the most industrial city of Iran: effect of meteorological factors.

Environ Sci Pollut Res Int 2021 Jan 2. Epub 2021 Jan 2.

Department of Environmental Health Engineering, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.

Like other dangerous pollutants in the air, asbestos has negative and adverse effects on human and animal health. The present study is designed to determine the concentration of asbestos in the air of the most industrial city of Iran (Karaj) in 2018-2019. For this purpose, 4 samples were taken from different areas of the air of Karaj during a year with an SKC pump and flow of 6 L/min for 8 h and in 45 days, and a total of 68 samples of asbestos fibers were collected. Then, the samples were analyzed by phase-contrast microscope (PCM) and scanning electron microscopy (SEM). Eventually, the health effects of asbestos fibers were evaluated by the IRIS EPA method. The average concentration of asbestos fibers was 1.84 f/L PCM and 18.16 f/L SEM. Also, the results of statistical correlation analysis indicated that asbestos fibers are positively correlated with wind speed but negatively correlated with the other three parameters (temperature, relative humidity, and pressure). On the other hand, the average annual risk of asbestos fiber in the ambient air of Karaj for all samples was in the range of 4.32 × 10 to 1.81 × 10 which in some places had more danger than the recommended risk range. According to the EPA guidelines, carcinogenicity acceptable levels are in the range of 10 and 10. Values higher than 10 have more carcinogenic risk and values lower than 10 have a lower carcinogenic risk.
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http://dx.doi.org/10.1007/s11356-020-11941-3DOI Listing
January 2021

Correction to: Assessment of groundwater quality around municipal solid waste landfill by using Water Quality Index for groundwater resources and multivariate statistical technique: a case study of the landfill site, Qaem Shahr City, Iran.

Environ Geochem Health 2020 Nov 9. Epub 2020 Nov 9.

Department of Food Science, Faculty of Food Engineering, University of Campinas (UNICAMP), Rua Monteiro Lobato, 80, Caixa Postal: 6121, Campinas, São Paulo, CEP: 13083-862, Brazil.

In the original publication of the article, the name of the seventh author is incorrectly published as "Fazzel Amiri".
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http://dx.doi.org/10.1007/s10653-020-00765-2DOI Listing
November 2020

Health-Related Quality of Life and its Associated Factors in COVID-19 Patients.

Osong Public Health Res Perspect 2020 Oct;11(5):296-302

Health Policy and Management Research Center, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.

Objectives: Health-related quality of life (HRQoL) is one of the most important outcome measures for patients. The purpose of this study was to evaluate HRQoL and related factors in Coronavirus disease 2019 (COVID-19) patients.

Methods: A total of 420 COVID-19 patients who had been discharged from hospital were selected using a systematic sampling. The EuroQol 5-dimensional-5 levels (EQ-5D-5L) questionnaire along with medical records of the patients were used to gather the data. The test and analysis of variance were employed to test the difference between mean EQ-5D-5L scores, and the BetaMix model was used to investigate factors associated with EQ-5D-5L scores.

Results: The mean score for the patients who completed the EQ-5D-5L questionnaire ( = 409) was 0.6125. The EQ-5D-5L scores were significantly higher in males, patients with younger age, those with a low level of education, the employed, patients who worked in uncrowded workplaces, patients without diabetes, and those who were not admitted to intensive care unit. The BetaMix model showed that gender, age, education, employment status, having diabetes, heart failure, and admission to the intensive care unit were significant independent predictors of the EQ-5D-5L index values.

Conclusion: The mean score for EQ-5D-5L in COVID-19 patients was low in this study. Some of the factors, especially aging and having diabetes, should be considered in the aftercare of patients to improve their HRQoL.
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http://dx.doi.org/10.24171/j.phrp.2020.11.5.05DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7577388PMC
October 2020

Cost-Effectiveness Analysis of Colorectal Cancer Screening: A Systematic Review.

Risk Manag Healthc Policy 2020 10;13:1499-1512. Epub 2020 Sep 10.

National Cancer Control Secretariat, Ministry of Health and Medical Education, Tehran, Iran.

Introduction: Colorectal cancer (CRC) is a significant health problem with an increasing incidence worldwide. Screening is one of the ways, in which cases and deaths of CRC can be prevented. The objective of this systematic review was to evaluate the cost-effectiveness of the different CRC screening techniques and to specify the efficient technique from a cost-effectiveness perspective.

Methods: The economic studies of CRC screening in general populations (average risk), aged 50 years and above were reviewed. Two reviewers independently reviewed the titles, abstracts, and full-texts of the studies in five databases: Cochrane, Embase, Scopus, Web of Science and PubMed. The disagreements between reviewers were resolved through the authors' consensus. The main outcome measures in this systematic review were the incremental cost-effectiveness ratio (ICER) of screening versus no-screening and then in comparison with other screening techniques. The ICER is defined by the difference in cost between two possible interventions, divided by the difference in their effect.

Results: Eight studies were identified and retained for the final analysis. In this study, when screening techniques were compared to no-screening, all CRC screening techniques showed to be cost-effective. The lowest ICER calculated was $PPP -16265/quality-adjusted life-year (QALY) (the negative ICERs were between purchasing power parity in US dollar ($PPP) -16265/QALY to $PPP -1988/QALY, whereas the positive ICERs were between $PPP 1257/QALY to $PPP 55987/QALY). For studies comparing various screening techniques, there was great heterogeneity in terms of the structures of the analyses, leading to diverse conclusions about their incremental cost-effectiveness.

Conclusion: All CRC screening techniques were cost-effective, compared with the no-screening methods. The cost-effectiveness of the various screening techniques mainly was dependent on the context-specific parameters and highly affected by the framework of the cost-effectiveness analysis. In order to make the studies comparable, it is important to adopt a reference-based methodology for economic evaluation studies.
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http://dx.doi.org/10.2147/RMHP.S262171DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7490076PMC
September 2020

Direct and Indirect Costs Associated with Coronary Artery (Heart) Disease in Tabriz, Iran.

Risk Manag Healthc Policy 2020 31;13:969-978. Epub 2020 Jul 31.

Department of Health Economics, Iranian Center of Excellence in Health Services Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran.

Purpose: Cardiovascular diseases (CVDs) are the major causes of mortalities worldwide. This study was conducted to evaluate the direct and indirect costs of coronary artery disease (CAD) in Iran.

Patients And Methods: This is a prevalence-based cost-of-illness (COI) study that estimates the direct and indirect costs of CAD. The study conducted over a six-month period from April to September in 2017. Patients were recruited from Madani hospital in Tabriz, Iran. A total of 379 patients were investigated from societal perspective. Direct costs were estimated using the bottom-up costing approach and indirect costs were estimated using the Human Capital (HC) approach. A generalized linear model of regression was used to explore the relation between total cost and socio-demographic variables. The total annual mean cost was compared to Gross Domestic Product (GDP) per capita which was reported in the form of Purchasing Power Parity (PPP) index. To deal with uncertainty, one-way sensitivity analysis was performed.

Results: Total costs per patient in one year were estimated to be IRR 63452290.17 ($PPP 7736.19) at a 95% confidence interval (58191511.73-68713068.60), the biggest part of which is related to direct medical costs with IRR 33884019.53 per year ($PPP 4131.18) (54%). Direct non-medical costs were estimated IRR 1655936.68 ($PPP 201.89) per patient (2%) and indirect costs were estimated IRR 27912333.97 per patient ($PPP 3403.11) (44%), which 62% of indirect costs is related to patients' work absenteeism.

Conclusion: This study estimates the direct (56%) and indirect (44%) costs associated with CAD. The study explores the essential drivers of the costs and provides the magnitude of the burden in terms of the share of GDP. The outcomes can be used in priority setting, in particular for cost benefit analysis, and adopting new policies regarding insurance coverage and equity issues.
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http://dx.doi.org/10.2147/RMHP.S261612DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7406327PMC
July 2020

Mapping the cancer-specific FACT-B onto the generic SF-6Dv2.

Breast Cancer 2021 Jan 25;28(1):130-136. Epub 2020 Jul 25.

Health Policy and Management Research Center, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.

Introduction: The health-related quality of life (HRQoL) data extracted from cancer-specific questionnaires are often non-preference based, while patient preference-based utility data are required for health economic evaluation. This study aimed to map Functional Assessment of Cancer Therapy-Breast (FACT-B) subscales onto the Short Form six Dimension as an independent instrument (SF-6Dv2) using the data gathered from patients with breast cancer.

Methods: Data for 420 inpatient and outpatient patients with breast cancer were gathered from the largest academic center for cancer patients in Iran. The OLS and Tobit models were used to predict the values of the SF-6Dv2 with regard to the FACT-B subscales. Prediction accuracy of the models was determined by calculating the root mean square error (RMSE) and mean absolute error (MAE). The relationship between the fitted and observed SF-6Dv2 values was examined using the Intraclass Correlation Coefficients (ICC). Goodness of fit of models was assessed using the predicted R (Pred R) and adjusted R (Adj R). A tenfold cross-validation method was used for validation of models.

Results: Data of 416 patients with breast cancer were entered into final analysis. The model included main effects of FACT-B subscales, and statistically significant clinical and demographic variables were the best predictor for SF-6Dv2 (Model S3 of OLS with Adj R = 61.02%, Pred R = 59.25%, MAE = 0.0465, RMSE = 0.0621, ICC = 0.678, AIC = -831.324, BIC = -815.871).

Conclusion: The best algorithm developed for SF-6Dv2 enables researchers to convert cancer-specific instruments scores into preference-based scores when the data are gathered using cancer-specific instruments.
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http://dx.doi.org/10.1007/s12282-020-01141-9DOI Listing
January 2021

Comparative efficacy of hospital disinfectants against nosocomial infection pathogens.

Antimicrob Resist Infect Control 2020 07 22;9(1):115. Epub 2020 Jul 22.

Clinical Research Development Unit of Emam Khomeini Hospital, Urima University of Medical Sciences, Urmia, Iran.

Background: Due to the increasing rate of hospital-acquired infections, it is essential to select appropriate disinfectant agents. In this study, the efficacy of hospital disinfectants against nosocomial infection pathogens was compared.

Methods: High level disinfectants (Steranios 2%, Deconex HLDPA, and Microzed Quatenol) were tested for their antibacterial effects by determining their minimum inhibitory (MIC) and minimum bactericidal concentrations (MBC) against Enterococcus faecalis ATCC 29212 and Burkholderia cepacia ATCC 10673.

Results: E. faecalis, as gram-positive bacterium, was more susceptible to high level disinfectants compared to gram-negative B.cepacia. The MIC = MBC values of 2% Steranios, Deconex HLDPA and Microzed Quatenol against E. faecalis and B.cepacia were 0.31, 9.77, 2.2 mg/L and 9.8, 78.13, 70.31 mg/L, respectively.

Conclusions: According to the findings of this study, the most effective disinfectants against both E. faecalis and B.cepacia were Steranios 2%, Microzed Quatenol, and Deconex HLDPA in order. Considering the importance of these bacterial strains in healthcare-associated infections, the use of these effective disinfectants is recommended in the hospitals.
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http://dx.doi.org/10.1186/s13756-020-00781-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7374963PMC
July 2020

Determinants of catastrophic health expenditures in Iran: a systematic review and meta-analysis.

Cost Eff Resour Alloc 2020 15;18:17. Epub 2020 May 15.

6Institute for Global Health, University College London, London, UK.

Background: Catastrophic health expenditures (CHE) are of concern to policy makers and can prevent individuals accessing effective health care services. The exposure of households to CHE is one of the indices used to evaluate and address the level of financial risk protection in health systems, which is a key priority in the global health policy agenda and an indicator of progress toward the UN Sustainable Development Goal for Universal Health Coverage. This study aims to assess the CHE at population and disease levels and its influencing factors in Iran.

Methods: This study is a systematic review and meta-analysis. The following keywords and their Persian equivalents were used for the review: Catastrophic Health Expenditures; Health Equity; Health System Equity; Financial Contribution; Health Expenditures; Financial Protection; Financial Catastrophe; and Health Financing Equity. These keywords were searched with no time limit until October 2019 in PubMed, Web of Science, Scopus, ProQuest, ScienceDirect, Embase, and the national databases of Iran. Studies that met a set of inclusion criteria formed part of the meta-analysis and results were analyzed using a random-effects model.

Results: The review identified 53 relevant studies, of which 40 are conducted at the population level and 13 are disease specific. At the population level, the rate of CHE is 4.7% (95% CI 4.1% to 5.3%, n = 52). Across diseases, the percentage of CHE is 25.3% (95% CI 11.7% to 46.5%, n = 13), among cancer patients, while people undergoing dialysis face the highest percentage of CHE (54.5%). The most important factors influencing the rate of CHE in these studies are health insurance status, having a household member aged 60-65 years or older, gender of the head of household, and the use of inpatient and outpatient services.

Conclusion: The results suggest that catastrophic health spending in Iran has increased from 2001 to 2015 and has reached its highest levels in the last 5 years. It is therefore imperative to review and develop fair health financing policies to protect people against financial hardship. This review and meta-analysis provides evidence to help inform effective health financing strategies and policies to prioritise high-burden disease groups and address the determinants of CHE.
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http://dx.doi.org/10.1186/s12962-020-00212-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7229629PMC
May 2020

Assess the annual effective dose and contribute to risk of lung cancer caused by internal radon 222 in 22 regions of Tehran, Iran using geographic information system.

J Environ Health Sci Eng 2020 Jun 24;18(1):211-220. Epub 2020 Feb 24.

4Department of Environmental Health Engineering, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.

Radon gas is one of the most influential sources of indoor exposure. All its physical properties together make it a significant risk factor for lung cancer in the population. The research aims are outlined as (1) to measure the radon concentration in Tehran city and compare results with the international standards (2) to determine spatial distribution of radon gas concentration using Geographical Information System (GIS) software and (3) to estimate the annual effective dose and potential risk of lung cancer by radon-222 in Tehran city. In this study, 800 Alpha Track detectors were installed in houses in 22 regions of Tehran city and retrieved after 3 months. The measurements were repeated for spring and summer and autumn seasons. The annual effective dose and risk of lung cancer were assessed using standard equations. Data were analyzed using SPSS 20. Result showed the minimum and maximum radon concentration were observed in and Ghalee-kobra (0.13 Bq.m) and Charbagh-ponak district (661.11 Bq.m) respectively. There was no observed relationship between radon concentration and houses' model, cracking condition and constructionn materials. Expectedly, the storehouses and basements had significantly higher ( = 0.016) radon concentration than occupied rooms. The min and max of the estimated annual effective dose were 0.65 and 2.03 mSv, respectively. Result showed that around 5% of the sampling sites had higher level of radon than the maximum allowed by EPA. A rough estimation of the expected radon-attributed lung cancer incidences yielded approximately 5958 cases in the total population of Tehran every year. In view of the growing trend in cancer incidences, appropriate measures addressing radon should be undertaken in areas of increased exposure to this noble gas.
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http://dx.doi.org/10.1007/s40201-020-00454-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7203366PMC
June 2020

Modeling and optimizing parameters affecting hexavalent chromium adsorption from aqueous solutions using Ti-XAD7 nanocomposite: RSM-CCD approach, kinetic, and isotherm studies.

J Environ Health Sci Eng 2019 Dec 11;17(2):873-888. Epub 2019 Dec 11.

7Department of Environmental Health Engineering, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.

Background: Due to the high toxicity of chromium, particularly as Hexavalent chromium Cr (VI), it is removed from industrial effluents before their discharge into the environment by a variety of methods, including loading catalysts onto the polymeric supports. This study focused on the removal of Cr(VI) from aqueous solutions using Amberlite XAD7 resin loaded titanium dioxide (Ti-XAD7).

Methods: Ti-XAD7 was synthesized using Amberlite XAD-7 impregnated with titanium tetraethoxide. The prepared Ti-XAD7 was characterized by using Fourier transform infrared spectroscopy (FTIR), scanning electron microscopy (SEM) and X-ray diffraction (XRD). Isotherms and kinetic studies were carried out to describe the adsorption behavior of adsorbent for the removal of Cr(VI) ions. Quadratic models considering independent variables, i.e. the initial Cr(VI) concentration, adsorbent dosage, time, and pH, were evaluated and optimized to describe the behavior of Cr(VI) adsorption onto the Ti-XAD7 using RSM based on a Five-level-four-factor CCD approach.

Results: The accuracy and the fitting of the model were evaluated by ANOVA with R > 0.725 and value = 5.221 × 10. The optimum conditions for the adsorption process were an initial Cr(VI) concentration 2750 ppb, contact time of 51.53 min, pH of 8.7, and Ti-XAD7 dosage of 5.05 g/L. The results revealed that the Langmuir and Sips isotherm models with R = 0.998 and 0.999 were the The adsorption capacity of Ti-XAD7 and R constant were 2.73 mg/g and 0.063-0.076 based on the Langmuir isotherm, respectively. Kinetic studies also indicated that the adsorption behavior of Cr(VI) was acceptably explained by the Elovich kinetic model with a good fitting (R = 0.97).

Conclusions: Comparison of the Ti-XAD7 and XAD7 yield in chromium adsorption showed that modified XAD7 had higher removal efficiency (about 98%) compared to XAD7 alone.
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http://dx.doi.org/10.1007/s40201-019-00405-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6985374PMC
December 2019

Health risk assessment of heavy metals in cosmetic products sold in Iran: the Monte Carlo simulation.

Environ Sci Pollut Res Int 2020 Mar 29;27(7):7588-7595. Epub 2019 Dec 29.

Department of Medical Sciences, Surgical and Advanced Technologies "G.F. Ingrassia"-Hygiene and Public Health, Laboratory of Environmental and Food Hygiene (LIAA), University of Catania, 95131, Catania, Italy.

Cosmetics can contain harmful compounds such as heavy metals. Several metals have a cumulative effect on the body, especially fatty tissues, and may have different health effects on the human body over the long term. Therefore, the main objective of this study was to assess the health risks of heavy metals in cosmetics in Iran. Also, in this study, Monte Carlo simulation was used to investigate uncertainties. In this study, heavy metals data of cosmetics were extracted from studies carried out at intervals 2010-2018. International and Iranian databases such as Google Scholar, Web of Science, Springer, Science Direct, PubMed, Scopus, Irandoc, Magiran, Scientific Information Database (SID), and Information Institute for Scientific (ISC) were searched for this purpose. In this study, the index of the Margin of Safety was calculated to determine the risk of human contact with metallic impurities in cosmetic products used by humans. In the selected period, 11 studies were conducted on the measurement of heavy metals in cosmetics in Iran. In these studies, cosmetics such as eye shadow, eye pencil, powder, cream, and lipstick were studied. The Margin of Safety (MoS) values calculated for different metals were higher than the established safe standard by WHO. The highest and lowest amount of systemic exposure dosage in all types of cosmetic investigated (lipstick, cream, eye pencil, face powder, and eye shadow) was related to Fe and Hg. The mean hazardous quotient (HQ) for Cd, Cr, Ni, Cu, Mn, Zn, Pb, and Hg was 1.05E-03, 1.03E-01, 7.95E-03, 2.59E-03, 1.05E-03, 4.98E-03, 7.22E-04, 1.85E-01, and 1.35E-05, respectively. The highest HQ (6.10E-01) was found for Pb, which was observed in the cream.
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http://dx.doi.org/10.1007/s11356-019-07423-wDOI Listing
March 2020

Non-Carcinogenic Health Risk Assessment due to Fluoride Exposure from Tea Consumption in Iran Using Monte Carlo Simulation.

Int J Environ Res Public Health 2019 11 2;16(21). Epub 2019 Nov 2.

Health Education and Promotion, Department of Public Health, Maragheh University of Medical Sciences, Maragheh, Iran.

Excessive intake of fluoride can cause adverse health effects. Consumption of tea as a popular drink could be a potential source of fluoride exposure to humans. This research aimed to evaluate the fluoride concentration in tea among the Iranian people using the available data in the literature and to assess the health risk related to the consumption of tea in men, women, and children. The health risk assessment was conducted using the chronic daily intake and hazard quotient according to the approach suggested by the Environmental Protection Agency. The fluoride content in published studies varied noticeably, ranging from 0.13 to 3.27 mg/L. The results revealed that the hazard quotient (HQ) in age groups of women (21-72 years) and children (0-11 years) was within the safe zone (HQ < 1) which showed that there was no potential of non-carcinogenic risk associated with drinking tea in these groups. However, in one case of the men (21-72 years), the HQ > 1 which shows a probable risk of fluorosis. The order of non-carcinogenic health risks in the studied groups was in the order of men > women > children. The results of this can be useful for organizations with the responsibility of human health promotion.
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http://dx.doi.org/10.3390/ijerph16214261DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6862652PMC
November 2019

Enhanced Kinetic Removal of Ciprofloxacin onto Metal-Organic Frameworks by Sonication, Process Optimization and Metal Leaching Study.

Nanomaterials (Basel) 2019 Oct 8;9(10). Epub 2019 Oct 8.

Department of Environment & Energy, Sejong University, Seoul 05006, Korea.

Metal-organic frameworks (MOFs) are currently recognized as unique platforms for environmental studies. This study evaluated the potential of nine MOFs from ZIF-8, ZIF-67, and UIO-66 families for the removal of ciprofloxacin (CIP), a toxic, bio-accumulative, and persistent fluoroquinolone antibiotic. ZIF-67-SO, with a rhombic crystalline morphology and 1375 m/g BET surface area, has the highest CIP adsorption efficiency among the studied MOFs. The mathematical sorption model predicted that the highest CIP removal (99.2%) occurs when adsorbent dose, pH, and agitation time are adjusted to 6.82, 832.4 mg/L, and 39.95 min, respectively. Further studies revealed that the CIP adsorbed onto ZIF-67-SO in monolayer (q: 2537.5 mg/g) and chemisorption controlled the rate of the process. Mass transfer kinetic coefficients improved significantly by sonication at 35 KHz in comparison with mechanical agitation. Thermodynamic parameters (minus signs of ∆G° [7.8 to 14.2], positive signs of ∆H° (58.9 KJ/mol), and ∆S° (0.23 KJ/mol·K)) demonstrated the spontaneous, endothermic, and chemical sorption of CIP. The level of cobalt leached from ZIF-67-SO structure varied 1.2-4.5 mg/L, depending on pH, mixing time, and agitation type. In conclusion, the excellent adsorption properties of ZIF-67-SO for CIP, made it an outstanding candidate for environmental protection purposes.
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http://dx.doi.org/10.3390/nano9101422DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6835299PMC
October 2019

Assessment of groundwater quality around municipal solid waste landfill by using Water Quality Index for groundwater resources and multivariate statistical technique: a case study of the landfill site, Qaem Shahr City, Iran.

Environ Geochem Health 2020 May 28;42(5):1305-1319. Epub 2019 Sep 28.

Department of Food Science, Faculty of Food Engineering, University of Campinas (UNICAMP), Rua Monteiro Lobato, 80, Caixa Postal: 6121, Campinas, São Paulo, CEP: 13083-862, Brazil.

Groundwater is a precious natural water resource which can be considered as an available and safe source of water for domestic uses. In some cities in northern Iran, groundwater is being polluted due to various human activities. In this regard, the located municipal solid waste landfills close to these areas without the requested controls regarding the landfill leachate and gas emission are among the major sources of environmental pollution, which are deteriorating groundwater quality around landfill sites. In this context, the current study was aimed to assess the quality of collected groundwater samples around a landfill site using the modified Water Quality Index for groundwater resources (WQIG). Also, the water quality map has been prepared by using WQIG in GIS environment. Therefore, thirty-three groundwater samples were collected and analyzed around 11 water wells close to the landfill site. Variety of physicochemical parameters including nitrate (NO), fecal coliform, sodium absorption ratio (SAR), electrical conductivity, biological oxygen demand (BOD), phosphate (PO), total dissolved solids, dissolved oxygen, pH were assessed in groundwater samples based on recommended standard methods by American Public Health Association (APHA). Geostatistics analysis including Kriging, semi-variogram, and variogram methods also was used to evaluate the spatial variations in the variables and to provide the necessary data for further interpolation. According to the results of WQIG, most of the groundwater wells (98.85%) are polluted due to the existing of the landfill site in the investigated area. Generally speaking, based on the WQIG the water samples were defined as not suitable for drinking applications. Also, the high concentrations of nitrate and hardness in the downstream wells (W-W) of the landfill were demonstrated by the results of Kriging assay which can be correlated with the penetration of leachate into these wells. Considering the SAR results, all wells in the studied area are classified as (CS) that means the groundwater of this area is suitable for agricultural approaches. Moreover, the reduction in the water quality from the south to the north and northeast was demonstrated by the results of spatial dispersion. Evaluation of the changes in water quality near landfill sites showed that 2149.56 m of total area had a relatively poor potential for the region's groundwater recharge.
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http://dx.doi.org/10.1007/s10653-019-00417-0DOI Listing
May 2020

Telepsychiatry- Based Care for the Treatment Follow-Up of Iranian War Veterans with Post-Traumatic Stress Disorder: A Randomized Controlled Trial.

Iran J Med Sci 2019 Jul;44(4):291-298

Health Information Technology, School of Management and Medical Informatics, Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.

Background: Physical limitations, distance, and time are major obstacles to access to mental health services for veterans and soldiers. This study was aimed at comparing the efficacy of telepsychiatry and face-to-face consultation as methods of treating post-traumatic stress disorder (PTSD). The comparison was based on treatment costs, access to health services, completion of therapy sessions, and patient satisfaction as variables.

Methods: This research was a double blinded clinical trial supported by Tabriz University of Medical Sciences and conducted in 2015 to 2016 in Tabriz, Iran. Totally, 60 patients were included in the study. Through simple randomization, the patients were divided into experimental and control groups, both of whom were treated through face-to-face consultations for the first 3 sessions. Six follow-up sessions were then held remotely with the experimental group and face to face with the control group. Data were collected using a self-designed and reliable questionnaire and entered in SPSS, version 16. Intergroup comparisons were performed using descriptive statistical measures. Finally, the results were tested using the test method.

Results: A significant relationship was found between the use of information technology and increased patient satisfaction, completion of therapy sessions, and reduction in treatment costs; however, no significant difference was found between the groups in terms of reduction in waiting time and access to a psychiatrist.

Conclusion: Telepsychiatry is an effective means of delivering mental health services to psychiatric outpatients living in remote areas with limited resources. The results provide preliminary support for the use of telepsychiatry in treating PTSD and improving access to care. IRCT2016020826449N1.
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http://dx.doi.org/10.30476/IJMS.2019.44944DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6661519PMC
July 2019

Carcinogenic and non-carcinogenic health risk assessment of heavy metals in drinking water of Khorramabad, Iran.

MethodsX 2019 19;6:1642-1651. Epub 2019 Jul 19.

Department of Environmental Health Engineering, School of Health and Nutrition, Lorestan University of Medical Sciences, Khorramabad, Iran.

The continuous urbanization and industrialization in many parts of the world and Iran has led to high levels of heavy metal contamination in the soil and then on the surface and groundwater. In this study, the concentrations of 8 heavy metals were determined in forty water samples along distribution drinking water of Khorramabad, Iran. The ranges of heavy metals in this study were lower than EPA and WHO drinking water recommendations and guidelines and so were acceptable. The mean values of CDI of heavy metals concentrations in adults were found in the order of Zn > Ba > Pb > Ni > Cr > Cu > Cd > Mo. The health-risk estimation indicated that total hazard quotient (HQ + HQ) and hazard index values were below the acceptable limit, representing no non-carcinogenic risk to the residents via oral intake and dermal adsorption of water. Moreover, the results of total risk via ingestion and dermal contact showed that the ingestion was the predominant pathway. This study also presents that the carcinogenic risk for Pb, Cr, Cd and Ni were observed higher than the acceptable limit (1 × 10). The present study will be quite helpful for both inhabitants in taking protective measures and government officials in reducing heavy metals contamination of urban drinking water. •The data analyzed in this study show a clear situation regarding the quality of drinking water in Khorramabad.•The results of this study can be used to improve and develop the quality of drinking water that directly affects the health of consumers.•The present study will be quite helpful for both inhabitants in taking protective measures and government officials in reducing heavy metals contamination of urban drinking water.
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http://dx.doi.org/10.1016/j.mex.2019.07.017DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6660555PMC
July 2019

Influence of postharvest application of chitosan combined with ethanolic extract of liquorice on shelflife of apple fruit.

J Environ Health Sci Eng 2019 Jun 14;17(1):331-336. Epub 2019 Feb 14.

1Department of Environment Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.

Background: Edible coatings are useful method that applied to preserve postharvest quality of production. The coatings can extend the shelf life of products and inhibit microbial growth. Chitosan based coatings are one of the best methods to prolong fruit and vegetable shelf life. The antimicrobial and other properties of chitosan are developed when it is combined with other functional ingredients.

Methods: The effectiveness of chitosan, ethanolic extract of liquorice (LE) and complex of chitosan-liquorice extract (CHLE) was evaluated for controlling blue mold and extending shelf life in apples. The fruits were coated with chitosan(1.0%), LE (62.5 mg/ml) and CHLE coating, and stored at 25 °C. Quality properties of fruit (such as weight loss, firmness, total soluble solid content(TSS), titrable acidity and pH) and decay incidence were assessed on 0,1,4,7 and 14 days of incubation, respectively.

Results: The results of experiments indicated that minimum of water loss(3.8%), TSS(14.53) and firmness(5.6 kg/cm ) were in CHLE coated apples. In addition, this coating significantly inhibited during the storage and the lowest decay incidence was for apples coated with CHLE(29 mm). Chitosan and LE coating retarded undesirable changes during postharvest storage and inhibited decay incidence compared with uncoated samples. There was no significant difference ( ≤ 0/05) between treatments and control overtime in terms of titrable acidity and pH levels.

Conclusions: The results reported here indicate importance and efficacy of CHLE coating in extending shelflife and reduction of postharvest losses of apple in storage time.
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http://dx.doi.org/10.1007/s40201-019-00351-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6582078PMC
June 2019

Assessment of Heavy Metal Pollution and Human Health Risks Assessment in Soils Around an Industrial Zone in Neyshabur, Iran.

Biol Trace Elem Res 2020 May 18;195(1):343-352. Epub 2019 Jul 18.

Department of Environmental Health Engineering, Neyshabur University of Medical Sciences, Neyshabur, Iran.

Heavy metal pollution of soils in industrial zones continues to attract attention because of its potential human health risks. The present research is an attempt to assess the pollution status of heavy metals including As, Cd, Cr, Ni, and Pb using various indices like contamination factor (CF), pollution index (I), and geo-accumulation index (I). In total, 60 surface soil samples were collected from four area (north, south, east, and west) in Khayyam industrial zone from depths of 10-20 cm. The results indicated that average metal concentration ranges (in mg/kg) observed in study soils were 8.84, 1.9, 37.66, 15.77, and 57.33 for As, Cd, Cr, Ni, and Pb, respectively. The concentrations of heavy metals As, Cr, Ni, and Pb with the exception of Cd in soils of southern areas of the industrial zone were higher. Cd concentration vary negligibly in sampling sites of north, south, east, and west. Based on the CF, I, and I indices, the pollution of soil in regard to concentration of heavy metals was in the following order: Cd > As > Pb > Ni > Zn. Industrial activities have therefore resulted in elevated concentrations of so in the soil environments in the Khayyam industrial zone. Based on the results of human health risk assessments, the soil metals pose negligible carcinogenic and non-carcinogenic risks to the adults and children living in this area. The need for the monitoring of the soil around the industrial zone, especially for Cd and As, is needed to reduce potential environmental issues.
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http://dx.doi.org/10.1007/s12011-019-01816-1DOI Listing
May 2020

Evaluation of phosphate removal from aqueous solution using metal organic framework; isotherm, kinetic and thermodynamic study.

J Environ Health Sci Eng 2019 Jun 28;17(1):209-218. Epub 2019 Jan 28.

4Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Khorasan Razavi Province, Iran, P.O. Box: 91735-951, Mashhad, IR Iran.

Background: Phosphate (PO) is the main etiological factor of eutrophication in surface waters. Metal organic frameworks (MOFs) are novel hybrid materials with amazing structural properties that make them a prominent material for adsorption.

Methods: Zeolitic imidazolate framework 67 (ZIF-67), a water stable member of MOFs, with a truncated rhombic dodecahedron crystalline structure was synthesized in aqueous environment at room temperature and then characterized using XRD and SEM. PO adsorption from synthetic solutions using ZIF-67 in batch mode were evaluated and a polynomial model (R: 0.99, R: 0.98, LOF: 0.1433) developed using response surface methodology (RSM).

Results: The highest PO removal (99.2%) after model optimization obtained when ZIF-67 dose, pH and mixing time adjusted to 6.82, 832.4 mg/L and 39.95 min, respectively. The optimum PO concentration in which highest PO removal and lowest adsorbent utilization occurs, observed at 30 mg/L. PO removal eclipsed significantly in the presence of carbonate. The equilibrium and kinetic models showed that PO adsorbed in monolayer (q: 92.43 mg/g) and the sorption process controlled in the sorption stage. Adsorption was also more favorable at higher PO concentration, according to the separation factor (K) graph. Thermodynamic parameters (minus signs of ∆G°, ∆H° of 0.179 KJ/mol and ∆S° of 44.91 KJ/mol.K) demonstrate the spontaneous, endothermic and physisorption nature of the process.

Conclusion: High adsorption capacity and adsorption rates, make ZIF-67 a promising adsorbent for PO removal from aqueous environment.
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http://dx.doi.org/10.1007/s40201-019-00341-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6582016PMC
June 2019

Distribution of fluoride contamination in drinking water resources and health risk assessment using geographic information system, northwest Iran.

Regul Toxicol Pharmacol 2019 Oct 18;107:104408. Epub 2019 Jun 18.

Department of Environmental Health Engineering, Neyshabur University of Medical Sciences, Neyshabur, Iran. Electronic address:

This paper considers exposure to the concentration of fluoride in drinking water resources of Showt city in West Azerbaijan Province in, Iran, and its related potential health risk assessment issues to the resident populations. For this purpose, 88 drinking water samples were analyzed in 2016 by using the spectrophotometric method. Non-carcinogenic health risks due to F exposure through consumption of drinking water were assessed using the US EPA method. In addition, the associated zoning maps of the obtained results were presented using a geographic information system (GIS). The results indicated that fluoride concentration in drinking water ranged from 0.0 to 5.5 mg L of the study area. Based on this research, 36.36% of the samples had a fluoride level higher than the permissible level, 13.63% had less than the permissible limit, and 50% of the samples had a level within the optimum limit of 0.5-1.5 mg L. The Hazard Quotient index (HQ) for children, teenager and adults had health hazards (HQ > 1) in 54.55%, 31.82%, and 22.73% of samples, respectively. Groundwater resources having a risk of more than one were located in the villages of Khilajajam, Kolos, and Shorboulagh. So, in these study areas, there are potential risks of dental and skeletal fluorosis.
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http://dx.doi.org/10.1016/j.yrtph.2019.104408DOI Listing
October 2019

An innovative swimming pool water quality index (SPWQI) to monitor and evaluate the pools: design and compilation of computational model.

Environ Monit Assess 2019 Jun 19;191(7):448. Epub 2019 Jun 19.

Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.

This research aimed to develop an index known as swimming pool water quality index (SPWQI) for quantifying the water pollution potential. The index is a quantitative tool to show the data on the water quality of swimming pools consistently. It makes summarizing the complex data on water quality possible and paves the way for its communication to the general public and decision makers. In this study, the SPWQI has been formulated according to the literature review and Delphi method. According to literature review and the total judgment of the panelist (23 experts specialized in environmental health engineering), 13 physicochemical and biological parameters along with their weights were selected for inclusion in the SPWQI. The results indicated the possibility of calculating a single numerical value (i.e., SPWQI), which indicates the combined effect of significant selected parameters on water quality. In addition, biological composition (47%) had a strong preference weighting than physical and chemical parameters in evaluating the index. Next, it was attempted to implement a novel and user-friendly mathematical model for evaluating the SPWQI. Then, the model accuracy and performance was confirmed by a case study. Overall, it could be said that the assessment of SPWQI sheds light on the concurrent power of several pollutants and can help the authorities to decide upon water quality management and treatment approaches.
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http://dx.doi.org/10.1007/s10661-019-7577-yDOI Listing
June 2019

Efficiency of ultrasound for degradation of an anionic surfactant from water: Surfactant determination using methylene blue active substances method.

MethodsX 2019 17;6:805-814. Epub 2019 Apr 17.

Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.

The removal of a surfactant from wastewater is usually difficult due to its toxicity and low biodegradability. The aim of this study was to apply sonoreactor for degradation of an anionic surfactant from aqueous solution. An ultrasonic bath with frequency of 130 kHz was used to investigate the effects of different operational parameters such as sonication time, initial concentration and power. In this study, experiments of linear alkylbenzene sulfonates solution were performed using methylene blue active substances method. Experiments were performed at initial concentrations of 0.2 , 0.5 , 0.8  and 1 mg/L, frequency of 130 kHz, acoustic powers value of 400 and 500 W, temperature of 18-20 °C and pH value of 6.8-7. This study showed that linear alkylbenzene sulfonates degradation rate was found to increase with increasing sonication time and power. In addition, as the concentration increased, the linear alkylbenzene sulfonates degradation rate decreased in the ultrasonic reactor. •Surfactants are one of the largest groups of pollutants which exist in almost all urban and many industrial wastewaters.•Ultrasonic reactors alone may not be useful for reducing completely complex wastewaters of high surfactant load.•Application of ultrasonic reactors in combination with other treatment processes including Ozone, UV irradiation, chlorination, Fenton, nanoparticles and HO could be used as a pre-treatment unit in a sequential chemical and biological treatment process.
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http://dx.doi.org/10.1016/j.mex.2019.03.028DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6487303PMC
April 2019

Mapping EORTC-QLQ-C30 and QLQ-CR29 onto EQ-5D-5L in Colorectal Cancer Patients.

J Gastrointest Cancer 2020 Mar;51(1):196-203

Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.

Purpose: Patient-level utility data are needed for cost-utility analysis; in oncology, however, the data are commonly gathered using disease-specific questionnaires that are often not appropriate. Present study aimed to derive an algorithm which can map the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30 (EORTC QLQ-C30) scales and the Colorectal Cancer-Specific Quality Of Life Questionnaire (QLQ-CR29) scales onto the EuroQoL 5-Dimension 5-Level (EQ-5D-5L) values in patients with colorectal cancer (CRC).

Methods: Using the Ordinary Least Square (OLS) model, a cross-sectional dataset of 252 patients with CRC were gathered from three academic centers of cancer treatment in Tehran in 2017. The predicted R (Pred R) and adjusted R (Adj R) are used to evaluate model goodness of fit. Additionally, mean absolute error (MAE), root mean square error (RMSE), Spearman's correlation coefficients (ρ), and intraclass correlation (ICC) are applied to assess predictive ability of models. The tenfold cross-validation procedure was applied for validation models.

Results: According to the results of our study, the model C4 from EORTC QLQ-C30 was the best predictive model (Pred R = 66.57%, Adj R = 67.67%, RMSE = 0.10173, MAE = 0.07840). Also, the model R4 from QLQ-CR29 performed the best for EQ-5D-5L (Adj R2 = 48.42%, Pred R = 45.54%, MAE = 0.10051, RMSE = 0.12997).

Conclusions: The mapping algorithm successfully mapped the EORTC QLQ-C30 and QLQ-CR29 scales onto the EQ-5D-5L values; therefore, it enables policymakers to convert cancer-specific questionnaires scores to the preference-based scores.
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http://dx.doi.org/10.1007/s12029-019-00229-6DOI Listing
March 2020

Spatial Distribution Variation and Probabilistic Risk Assessment of Exposure to Fluoride in Ground Water Supplies: A Case Study in an Endemic Fluorosis Region of Northwest Iran.

Int J Environ Res Public Health 2019 02 15;16(4). Epub 2019 Feb 15.

Department of Medical Sciences, Surgical and Advanced Technologies "G.F. Ingrassia"⁻Hygiene and Public Health, Laboratory of Environmental and Food Hygiene (LIAA), University of Catania, 95123 Catania, Italy.

Prevalence of fluorosis is a worldwide public health issue, especially in the West Azerbaijan province of Iran. The aim of this study was to investigate fluoride concentration in drinking water resources within Maku city, in both the warm and cold seasons, to perform a health risk assessment. Fluoride were measured using UV-visible spectrophotometry. The spatial distribution was calculated by the software ArcGIS and Hazard Quotients (HQs) were calculated according to the US EPA method. The fluoride concentrations ranged between 0.29 to 6.68 and 0.1 to 11.4 mg/L in the cold and warm seasons, respectively. Based on this report, 30.64 and 48.15% of the samples revealed a fluoride level higher than the permissible level in the cold and warm seasons, respectively. Moreover, results showed that the HQ value in the warm season for different age groups was higher than the HQ value in the cold season. In both seasons, the non-carcinogenic risks of fluoride for the four exposed populations varied according to the order: children > teenagers > adults > infants. The HQ values for three age groups (children, teenager and adults) for both seasons were higher than 1 with a high risk of fluorosis. The results of this study, support the requests that government authorities better manage water supplies to improve health quality.
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http://dx.doi.org/10.3390/ijerph16040564DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6406884PMC
February 2019

Cadmium in Groundwater Consumed in the Rural Areas of Gonabad and Bajestan, Iran: Occurrence and Health Risk Assessment.

Biol Trace Elem Res 2019 Dec 8;192(2):106-115. Epub 2019 Feb 8.

Department of Environmental Health Engineering, Faculty of Health, Social Development and Health Promotion Research Center, Gonabad University of Medical Sciences, Gonabad, Iran.

Evidences show that high levels of cadmium intake may be contributing to a wide range of deleterious health effects. This study was performed to estimate the concentration of cadmium and the health risk to human by cadmium through the ingestion of groundwater in 39 rural areas of Gonabad and Bajestan, eastern Iran. The mean cadmium concentrations in groundwater in the studied rural areas of Gonabad and Bajestan ranged from 0.087 to 14.32 μg/L and from 0.417 to 18.36 μg/L, respectively. Health risk quotient for cadmium contamination for 16 and 38% of children and infants in rural areas of Gonabad and Bajestan, respectively, was more than 1 which causes non-carcinogenic risk to the local population. The carcinogenic risk of cadmium in drinking water for adults, children, and infants in 16, 33, and 33% of studied rural areas of Gonabad and Bajestan, respectively, was higher than the safe limit of 1.0 × 10. For rural areas of Bajestan, the cancer risk in 42, 52, and 52% of adults, children, and infants was above the safe limit. It was strongly suggested that the accessible procedures of treatment should be taken for a portion of contaminated rural areas before the distribution of the groundwater for the local population.
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http://dx.doi.org/10.1007/s12011-019-1660-7DOI Listing
December 2019

Monitoring of salt iodisation programme in Iran; Health outcomes, shortages and perspective.

J Trace Elem Med Biol 2019 Mar 10;52:6-11. Epub 2018 Nov 10.

Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran; Center for Air Pollution Research (CAPR), Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran; Centre for Water Quality Research (CWQI), Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran. Electronic address:

Iodine deficiency disorders include a wide range of metabolic and nonmetabolic disorders including goiter. To control IDDs, the World Health Organization and responsible agencies in countries established daily iodine uptake. Almost all the countries in the world provide the required iodine through salt iodisation. IDDs are not completely eradicable, so monitoring the salt iodisation programme is necessary for control of IDDs. In Iran, a salt iodisation programme was started in 1996. In this study, we took salt samples from all legally produced salt brands in Iran in 30 provinces and measured iodine concentration. The results of the monitoring programme for iodine concentration in schoolchildren's urine was used to compare accessibility to iodized salts and health outcomes. The results show that more than 80% of available salts have a suitable or acceptable concentration of iodine. Despite large variance in iodine concentration in available salt in some provinces, the median of iodine concentration in salts is within an acceptable range. Also, the urinary concentration of iodine (national median = 161) confirms that shortage of iodine intake is very low in Iran. The high rate of salt consumption of the Iranian people also has a significant effect on iodine uptake, but can lead to hyperthyroidism and hypertension that must be controlled.
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http://dx.doi.org/10.1016/j.jtemb.2018.11.004DOI Listing
March 2019

Performance of granular ferric hydroxide process for removal of humic acid substances from aqueous solution based on experimental design and response surface methodology.

MethodsX 2019 18;6:35-42. Epub 2018 Dec 18.

Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.

Response surface methodology has been used to design experiments and to optimize the effect of independent variables responsible for higher adsorption of humic acid (HA) by granular ferric hydroxide (GFH) from aqueous solutions. The variables of pH (3-11), contact time (15-120 min), adsorbent dose (1-5 g/L) and initial concentration of humic acid (5-20 mg/L) were examined. The adsorption isotherms and kinetics of humic acid substances on granular ferric hydroxide (GFH) were studied. Also the design of the experiments was performed using R software by the CCD (central composite design) method. Variance analysis (ANOVA) was used as the statistical response analysis method. Result of this study proved the optimal values of the independent variables of the adsorbent dose, contact time, initial concentration of humic acid and pH were 4 g/L, 93.75 min, 16.25 mg/L, and 5, respectively. The experimental data followed the Langmuir isotherm and pseudo-second kinetic model. Based on the response surface methodology, higher HA removal efficiencies were obtained with acidic condition, longer reaction time, and appropriated loading amount of GFH.
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http://dx.doi.org/10.1016/j.mex.2018.12.010DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6308244PMC
December 2018

Study of particle number size distributions at Azadi terminal in Tehran, comparing high-traffic and no traffic area.

MethodsX 2018 27;5:1549-1555. Epub 2018 Nov 27.

Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.

Vehicle traffic is known as the anthropogenic aerosol source in megacities. Exposure to ambient air pollution, especially particulate matter has become the most environmental risk factor. The main aim of this study is to determine the particle number and their size distribution in Tehran at Azadi terminal (located in the West of Tehran), crossing of Nawab and Azadi streets the area with high traffic, and campus of Tehran University as an area without traffic. Particle size distribution (0.3-1 μm) was measured using a Grimm Environmental Dust Monitor and was conducted in two seasons, hot and cold (summer 2016 and winter 2016). The measurement was performed twice per month. Although the average number of particles at Azadi Terminal was more than the other two locations in both seasons but it was not significant) p > 0.05). The average number of particles larger than 0.3 μm was 286.72 ± 129.55 and 183.61 ± 86.79 cm in winter and summer respectively. In relation to particles size distribution, the average number of particles larger than 0.4, 0.5, 0.65, 0.8 and 1 μm in winter and summer were 111.5 ± 120, 29.3 ± 23.7, 8.2 ± 5.8, 4 ± 3, 2 ± 1.5 and 52.5 ± 37, 14.4 ± 10.8, 6.1 ± 5, 3.8 ± 3.5, 2.3 ± 2 cm respectively. In the current study the highest number of particles significantly observed in winter time in comparison to summer. In addition, had no significant difference between the number of particles at three sampling locations.
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http://dx.doi.org/10.1016/j.mex.2018.11.013DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6282095PMC
November 2018