Publications by authors named "Masud Yunesian"

156 Publications

Iranian population exposures to heavy metals, PAHs, and pesticides and their intake routes: a study protocol of a national population health survey.

Environ Sci Pollut Res Int 2021 Jan 4. Epub 2021 Jan 4.

Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.

Cancer is the second leading cause of death in the world and the third leading cause of death in Iran. It has been proven that numerous cancer cases are caused by exposure to environmental pollutants. There is a public health concern regarding an increase in exposure to carcinogens across Iran through different sources (air, food, and water) and a lack of research to address this issue. This study aims to gather data on exposure to heavy metals, polycyclic aromatic hydrocarbons (PAHs), and pesticides and their intake routes during the implementation of a national population health survey. This is a cross-sectional study of environmental pollutants in Iran, with a stratified multi-stage random sampling method, which led to 660 nationally representative samples in 132 clusters in three sequential parts. The first will be questionnaires to obtain demographics, assets, food records, air quality, and food frequency. The second will be physical measurements, including anthropometric and body composition. The third will be lab assessments that measure 26 types of environmental pollutants (7 heavy metals, 16 PAHs, and 3 pesticides) in urine, inhaled air, and consumed food and water of the population under study using ICP-MS and GS-MS devices. The results of this study will inform policymakers and the general population regarding the level of threat and will provide evidence for the development of interventional and observatory plans on the reduction of exposures to these pollutants. It could also be used to develop local standards to control contaminants through the three exposure routes. This study protocol will obtain data needed for policymakers to set surveillance systems for these pollutants at the national and provincial level to address the public concerns regarding the contamination of food, air, and water.
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http://dx.doi.org/10.1007/s11356-020-12004-3DOI Listing
January 2021

Associations between short term exposure to ambient particulate matter from dust storm and anthropogenic sources and inflammatory biomarkers in healthy young adults.

Sci Total Environ 2021 Mar 14;761:144503. Epub 2020 Dec 14.

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

This study examined the association between particulate matter from anthropogenic and natural sources and inflammatory biomarkers, including hs-CRP, IL-6, sTNF-RII, and WBCs, in two groups of healthy young subjects. We followed up subjects of two panels (16 to 22 years old), including 22 subjects selected from the urban area (Tehran city) with high-level pollution background and 22 subjects selected from the rural area (Ahmadabad) with low-level pollution background. In each group, we collected 4 times blood samples in various air pollution conditions, In the subjects of the urban group, there was a substantial difference (p < 0.05) between inversion days and cold season control days, and between dust storm days and warm season control days for concentrations of hs-CRP, IL-6, and WBCs biomarkers. In the subjects of the rural group, a significant difference could be detected in the concentration of hs-CRP, IL-6, and WBCs biomarkers (p < 0.05) between inversion days and cold season control days, and between dust storm and warm control days. We found that the difference in concentrations of hs-CRP, IL-6, and WBCs biomarkers between dust storm days and warm control conditions in the rural group were higher than the difference in inversion and cold control conditions, which can be attributed to low background air pollution in the rural area. In the urban area, the health effect of anthropogenic sources of PM is higher than the dust storm condition, which can be attributed to the stronger effect of anthropogenic pollution effect.
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http://dx.doi.org/10.1016/j.scitotenv.2020.144503DOI Listing
March 2021

Tehran environmental and neurodevelopmental disorders (TEND) cohort study: Phase I, feasibility assessment.

J Environ Health Sci Eng 2020 Dec 9;18(2):733-742. Epub 2020 Sep 9.

Department of Research Methodology and Data Analysis, Institute for Environmental Research, Tehran University of Medical Sciences, Tehran, Iran.

Purpose: To advance knowledge about childhood neurodevelopmental disorders and study their environmental determinants, we conducted a study in Tehran, Iran to assess the feasibility of prospective birth cohort study.

Methods: We evaluated participation of pregnant women, feasibility of sampling biological material, and health care services availability in Tehran in four steps: (1) first trimester of pregnancy; (2) third trimester of pregnancy; (3) at delivery; and (4) two to three months after delivery. We collected related data through questionnaires, also various biological samples were obtained from mothers (blood, urine, milk and nails-hands and feet) and newborns (umbilical cord blood, meconium, and urine samples) from February 2016 to October 2017.

Results: overall 838 eligible pregnant women were approached. The participation rate was 206(25%) in our study and about 185(90%) of subjects were recruited in hospitals. Out of 206 participants in the first trimester, blood, urine, hand nail, and foot nail samples were collected from 206(100%),193(93%), 205(99%), and 205(99%), respectively. These values dropped to 65(54%), 83(69%), 84(70%), and 84(70%) for the remaining participants 120(58%) in the third trimester, respectively. Also, we gathered milk samples from 125(60%) of mothers at two to three months after delivery.

Conclusion: Our findings suggest that hospitals were better places for recruitment of subjects in a birth cohort in Tehran. We further concluded that birth cohort study recruitment can be improved by choosing appropriate gestational ages. Obtaining the newborn's urine, meconium, and umbilical cord blood were challenging procedures and require good collaboration between hospital staff and researchers.
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http://dx.doi.org/10.1007/s40201-020-00499-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7721759PMC
December 2020

Human health and ecological risk assessment of heavy metal(loid)s in agricultural soils of rural areas: A case study in Kurdistan Province, Iran.

J Environ Health Sci Eng 2020 Dec 8;18(2):469-481. Epub 2020 May 8.

Epidemiology and Biostatistics Department, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.

Background: Agricultural soils pollution with heavy metal (loid) s (HMs) can create significant ecological and health problems. The aims of present study were to characterize HMs pollution profile of dry farmland soils in rural areas of Kurdistan province in Iran and evaluate potential associated ecological and health risks.

Methods: Different indices of Geo-accumulation index (I), Individual contamination factor (ICF), Nemerow composite pollution index (NCPI) and Potential Ecological Risk Index (PERI) were employed to assess the bio-accumulation of the HMs and evaluate associated ecological risks. Human health risks estimated with total hazard index (THI) and total carcinogenic risk (TCR) indices based on ingestion, inhalation and dermal exposure pathways for children and adults.

Results: As, Cd, Cr, Ni and Pb exceeded the soil standards. The spatial maps of the I showed that As pollution was at severe level in eastern part of the study region. According to the ICF results, the studied soils were extremely contaminated with As, Cd, Cr, Ni and Zn. Furthermore, based on the pollution indices, some of sampling sites were critically polluted by abovementioned HMs. For children and adults groups, the THI values in 13 and 97% of sampling sites were more than 1 and the TCR in 7 and 14% of sampling sites were more than 10, respectively. The farmland soil pollution of the study area by As and Cr were found to be quite serious and dangerous.

Conclusion: The findings of this study suggest that further attention should be paid by decision-makers to control the HMs pollution in the agricultural soils of the study area.
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http://dx.doi.org/10.1007/s40201-020-00475-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7721949PMC
December 2020

Dropout of infertility treatments and related factors among infertile couples.

Reprod Health 2020 Dec 2;17(1):192. Epub 2020 Dec 2.

Reproductive Studies and Women's Health Research Center, Shahroud University of Medical Sciences, Shahroud, Iran.

Background: Dropout of infertility treatments is a global issue and many factors play role in this phenomenon. It is one of the most challenges in life of infertile couples. The purpose of this study was to determine dropout rate and related factors/reasons in the world and in Iran.

Methods: We will conduct a mixed method study with sequential exploratory design (systematic review, qualitative and quantitative phase). In the first stage a systematic review on dropout rate of infertility treatments and related factors will be done. In second stage (quantitative-qualitative study), a retrospective cohort study will be conducted on infertile couples to determine dropout rate of infertility treatments. The follow-up period to assess the discontinuation of treatment in patients, who have discontinued the treatment, will be considered 6 months after the treatment cessation. Data would be analyzed by descriptive statistics. We want to determine proportion and percentage of discontinuation rate among different groups with different causes of infertility. Then, we also will use Chi-square test to compare discontinuation rates among these groups. In qualitative section of second stage, semi-structured interviews would be performed with infertile female who had the history of infertility treatments failure. In this stage, participants will be selected using purposeful sampling method with maximum variation in terms of age, education, occupation, type of infertility, type of treatments, number of unsuccessful treatment and infertility duration. Data would be analyzed using conventional content analysis.

Discussion: Determining dropout rate and its related factors/reasons would be helpful for future studies to plan suitable interventions for supporting infertile couples. It also helps politicians to have a better understanding of infertility and its consequences on infertile couple's life. In today's world, infertility is a common phenomenon due to postponement of childbearing following the older age of marriage, tendency to reach higher educational level, economical problems and etc. Infertility brings many challenges and stresses to the individuals by itself and it is very hard to cope with. The problem gets worse, when it is associated with failure in treatments. Many of infertile couples cannot tolerate this failure and may decide to discontinue treatments before achieving pregnancy for ending many stressors which are associated with treatments. As we know, childbearing and having at least one child has important position in some societies such as Iranian culture; so ending the treatment before achieving optimal result may have some adverse consequences in the families such as divorce, remarriage, family conflicts, et. Absolutely many factors play role in dropout of infertility treatments, and many studies around the world have suggested many factors/reasons in dropout of infertility treatments, but there are still many gaps about this subject, especially among Iranian society. This study would be conducted in three consecutive stages, in the first stage; we will do a complete review of existing studies of the world to find out related factors/reasons of dropout in detail. In second stage, dropout rate of infertile couples (380 couples) after at least one unsuccessful cycle of treatment would be achieved by assessing medical records and telephone interview. Data of the first and second stage will help us to have better vision about the issue of dropout and would be used to construct a semi structured interview for the last stage. And finally in the third stage, reasons of dropout would be asked by an in depth interview from infertile couples. We hope the information from this study will help politicians better understand and plan for dropout of treatment.
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http://dx.doi.org/10.1186/s12978-020-01048-wDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7709385PMC
December 2020

Clinical Characteristics and Outcomes of 905 COVID-19 Patients Admitted to Imam Khomeini Hospital Complex in the Capital City of Tehran, Iran.

Arch Iran Med 2020 11 1;23(11):766-775. Epub 2020 Nov 1.

Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran.

Background: We studied the clinical characteristics and outcomes of 905 hospitalized coronavirus disease 2019 (COVID-19) patients admitted to Imam Khomeini Hospital Complex (IKHC), Tehran, Iran.

Methods: COVID-19 patients were recruited based on clinical symptoms and patterns of computed tomography (CT) imaging between February 20 and March 19. All patients were tested for the presence of COVID-19 RNA. The Poisson regression model estimated the incidence rate ratio (IRR) for different parameters.

Results: The average age (± standard deviation) was 56.9 (±15.7) years and 61.77% were male. The most common symptoms were fever (93.59%), dry cough (79.78%), and dyspnea (75.69%). Only 43.76% of patients were positive for the RT-PCR COVID-19 test. Prevalence of lymphopenia was 42.9% and more than 90% had elevated lactate dehydrogenase (LDH) or C-reactive protein (CRP). About 11% were severe cases, and 13.7% died in the hospital. The median length of stay (LOS) was 3 days. We found higher risks of mortality in patients who were older than 70 years (IRR = 11.77, 95% CI 3.63-38.18), underwent mechanical ventilation (IRR = 7.36, 95% CI 5.06-10.7), were admitted to the intensive care unit (ICU) (IRR = 5.47, 95% CI 4.00-8.38), tested positive on the COVID-19 test (IRR = 2.80, 95% CI 1.64-3.55), and reported a history of comorbidity (IRR = 1.76, 95% CI 1.07-2.89) compared to their corresponding reference groups. Hydroxychloroquine therapy was not associated with mortality in our study.

Conclusion: Older age, experiencing a severe form of the disease, and having a comorbidity were the most important prognostic factors for COVID-19 infection. Larger studies are needed to perform further subgroup analyses and verify high-risk groups.
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http://dx.doi.org/10.34172/aim.2020.102DOI Listing
November 2020

Prospective cohort study on the social determinants of health: Tehran University of Medical Sciences employees` cohort (TEC) study protocol.

BMC Public Health 2020 Nov 13;20(1):1703. Epub 2020 Nov 13.

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

Background: In this study, the association between the social determinants of health (SDH) as well as other health risk factors and outcomes will be evaluated at different socioeconomic layers.

Methods/design: This is a prospective cohort study that was launched in January 2018 on Tehran University of Medical Sciences' employees. The initial enrolment phase will continue up to March 2021, or until a sample size of 5500 is reached. In addition to annual phone-calls, the participants will be followed thrice at 5-year intervals. Data are collected through blood and urine samples, complete physical examination, anthropometric evaluation, and the completion of questionnaires related to SDH, such as socioeconomic status and social capital, history of diseases, lifestyle (including, nutrition, physical activity, cigarette and hookah smoking), occupational exposures (including psychosocial factors at work and work-family conflicts), and different aspects of physical, mental and occupational health as health outcomes. The association between independent variables and health (objective or subjective) are examined using multiple models and by controlling the confounding effects. Moreover, the trend in lifestyle changes and its impact on health are evaluated.

Discussion: Our study will explore the key social determinants as well as other factors including socioeconomic status and social capital, history of diseases, lifestyle and occupational exposures that affect health. This will provide social and occupational health decision-makers and stakeholders with new and valuable evidence in an era in which we are witnessing huge changes in lifestyle.
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http://dx.doi.org/10.1186/s12889-020-09798-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7666496PMC
November 2020

Short-term effects of exposure to air pollution on biophysical parameters of skin in a panel of healthy adults.

Dermatol Ther 2020 11 23;33(6):e14536. Epub 2020 Nov 23.

Center for Research & Training in Skin Diseases & Leprosy, Tehran University of Medical Sciences, Tehran, Iran.

Little research on impact of air pollution on human skin is available. We aimed to clarify the association between acute exposure to criteria air pollutant with biophysical characteristics of the skin. We followed a panel of 20 volunteers free of any skin diseases in skin evaluation study in Tehran, Iran from April 2017 to April 2018. Two distinct body parts including middle forehead and inside the right upper arm were evaluated at six time periods. The associations of the weighted averages of personal exposure to air pollutants at 24 hours up to 6 days, and multiday average before the skin assessment with biophysical characteristics of normal skin including sebum content, hydration, transepidermal water loss (TEWL), erythema index, melanin index, pH, temperature, friction, and elasticity were assessed in a random intercept linear mixed effects modeling approach. We observed significant positive association for the arm sebum content with exposure to PM , and SO ; the arm and forehead TEWL with NO , the arm and forehead friction with O , and forehead hydration with PM and PM in early lags. We found significant negative association for the arm melanin index, elasticity, and erythema index with exposure to O ; and forehead elasticity with PM and PM . Our results provided some evidence that short-term exposure to particulate and gaseous air pollutants have detrimental effects on biophysical and biomechanical properties of skin. The association varied across body area and depended on pollutant type.
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http://dx.doi.org/10.1111/dth.14536DOI Listing
November 2020

Subnational exposure to secondhand smoke in Iran from 1990 to 2013: a systematic review.

Environ Sci Pollut Res Int 2021 Jan 2;28(3):2608-2625. Epub 2020 Nov 2.

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

Every year, almost eight million people die from tobacco-related diseases, among which around 1.2 million die from secondhand smoke (SHS) exposure. Generally, it is estimated that SHS constituents generated in the interval between puffs are approximately 3 times more toxic than those produced at the moment of puffing. There is no risk-free level of SHS exposure, and even brief exposure can be harmful to health. The aim of this study was to assess SHS exposure and its trend in the different provinces of Iran from 1990 to 2013. To collect available data on SHS exposure, a systematic review was performed. We searched international and national databases using a combination of Medical Subject Headings (MeSH) and relevant text words in the titles, abstracts, and/or keywords. Also, the data in national surveys were gathered. The frequency of exposure in different provinces as well as age, sex, and rural/urban areas were extracted. Afterwards, modeling was done to estimate SHS exposure from the smoking data. According to our findings, SHS exposure was more prevalent among young people. Moreover, this exposure was greater in rural areas as compared to urban areas. A national study on 13-15-year-old individuals showed the highest exposure occurred outdoors. In addition, a declining trend was observed on SHS exposure over time. It seems that attention to the importance of SHS exposure in researches in Iran dates back to 2001, and gradually, especially in recent years, further studies have been conducted on SHS exposure.
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http://dx.doi.org/10.1007/s11356-020-11199-9DOI Listing
January 2021

Fuel type use and risk of respiratory symptoms: A cohort study of infants in the Northern region of Ghana.

Sci Total Environ 2021 Feb 25;755(Pt 1):142501. Epub 2020 Sep 25.

Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.

Little evidence exists about the association between fuel type use and risk of respiratory symptoms among infants; we aimed to evaluate this hypothesis through a cohort study in the Northern Region of Ghana. The study was carried out from April 2018 to May 2019. We recruited 28 weeks old pregnant women at selected hospitals and prospectively followed them at birth in the hospital ward to register their newborns and at homes when the baby had attained 3 to 7 months to collect data on respiratory symptoms of infants. A logistic regression model was used to investigate the odds of respiratory symptoms in infants. Exactly 1270 infants completed the study; the average age of women was 27.1 years and standard deviation of 5.1. The study found that infants of mothers who cooked with charcoal and those with firewood had increased odds of having cough with cold 4.10 (95% CI, 2.21-7.61) and 3.95 (95% CI, 2.06-7.58), increased odds of congestion, phlegm with cold by 3.89 (95% CI, 1.73-8.79) and 3.45 (95% CI, 1.44-8.26), increased odds of wheezing 4-14 days or nights by 1.68 (95% CI, 0.72-3.91) and 3.37 (95% CI, 1.41-8.04) and increased odds of seeking medical treatments in a health facility for chest illness by 3.97 (95% CI, 1.31-12.02) and 6.67 (95% CI, 2.14-20.77) in comparison with liquid petroleum gas respectively. Some significant predictors of respiratory infections were maternal malaria, hospitalisations of an infant after birth, residence, cooking location, composite breastfeeding, sharing of a bedroom with infant and air-conditioner or fan in the living room. Our findings indicate increased odds of infant respiratory symptoms in households using solid fuel in Ghana. Although our observational design precludes ascribing any causal relationships, our results are consistent with other studies suggesting clean fuel use during pregnancy and infancy may benefit this vulnerable age group.
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http://dx.doi.org/10.1016/j.scitotenv.2020.142501DOI Listing
February 2021

Validity of a Serological Diagnostic Kit for SARS-CoV-2 Available in Iran.

Arch Iran Med 2020 09 1;23(9):629-632. Epub 2020 Sep 1.

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

Background: The Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) epidemic broke out in December 2019 and is now characterized as a pandemic. Effective control of this infectious disease requires access to diagnostic techniques, for both case finding and epidemic size estimation. The molecular technique is routinely used worldwide. Although it is the "standard" case detection and management method, it has its own shortcomings. Thus, some easy-to-use rapid serological tests have been developed.

Methods: One hundred and fourteen positive RT-PCR-diagnosed patients were tested by VivaDiag Kit, a brand of rapid serological kits available in hospitals affiliated to Tehran University of Medical Sciences (TUMS), Tehran, Iran. Frozen serum specimens taken from healthy people in summer and fall 2019 were also tested as negative controls.

Results: Test sensitivity was 47.9% (95% confidence interval [CI]: 38.8-56.9) for IgM and 47.0% (95% CI: 38.0-56.0) for IgG. There was no difference between IgG and IgM seropositivity except in one case. Specificity was calculated as 99.0% (95% CI: 96.4-99.9) for IgM and of 100.0% (95% CI: 0.98.2-100.0) for IgG. Sensitivity was higher in men and older participants.

Conclusion: This test can be used for epidemiological investigations, especially for the estimation of the level of infection in the community, after it is properly corrected for sensitivity and specificity. The low sensitivity could be attributed to the technical limitations of the kit or low levels of antibodies after infection. The different sensitivity in age and sex groups supports the hypothesis that different people show different immune responses to this virus.
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http://dx.doi.org/10.34172/aim.2020.75DOI Listing
September 2020

COVID-19 and Substance Use Disorder: Study Protocol for the International Society of Addiction Medicine Practice and Policy Interest Group Global Survey.

Basic Clin Neurosci 2020 Mar-Apr;11(2):155-162. Epub 2020 Apr 15.

Department of Psychiatry, Tehran University of Medical Sciences, Tehran, Iran; Substance Abuse and Dependence Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.

Introduction: As one of the major health problems in the present century, the COVID-19 pandemic affected all parts of the global communities and the health of substance users are potentially at a greater risk of harm. This global study has been designed and conducted by the International Society of Addiction Medicine Practice and Policy Interest Group (ISAM-PPIG) to understand better the health related issues of people with Substance Use Disorders (SUD) as well as responses of the relevant health care systems during the pandemic.

Methods: This is a cross-sectional study using convenient sampling. The data gathering was carried out with two follow-up stages each two months apart through an online conducted survey prepared using Google platform. The survey started by emergence of COVID-19 as a pandemic in March 2020 and respondents were followed till September 2020 when most of the initial lockdowns by most countries are supposed to be reopened.

Ethics And Dissemination: The study was approved by the ethics committee of University of Social Welfare and Rehabilitation Sciences, Tehran, Iran. The results will be published in relevant peer reviewing journals and communicated with different international stakeholders.
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http://dx.doi.org/10.32598/bcn.11.covid19.2545.1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7368101PMC
April 2020

The concentration of BTEX compounds and health risk assessment in municipal solid waste facilities and urban areas.

Environ Res 2020 12 23;191:110068. Epub 2020 Aug 23.

Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran; Center for Solid Waste Management (CSWM), Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran. Electronic address:

In this study, human exposure to benzene, toluene, ethylbenzene, xylenes (BTEX), along with their respective risk assessment is studied in four major units (n = 14-point sources) of the largest municipal solid waste management facilities (MSWF) in Iran. The results were compared with four urban sites in Tehran, capital of Iran. Workers at the pre-processing unit are exposed to the highest total BTEX (151 μg m). In specific, they were exposed to benzene concentrations of 11 μg m. Moreover, the total BTEX (t-BTEX) concentrations measured over the conveyor belt was 198 μg m at most, followed by trommel (104), and active landfills (43). The mean concentration of ambient t-BTEX in Tehran is 100 μg m. On average, xylenes and toluene have the highest concentrations in both on-site and urban environments, with mean values of 24 and 21, and 41 and 37 μg m, respectively. Even though the non-carcinogenic risk of occupational exposure is negligible, BTEX is likely to increase the chance of carcinogenic risks (1.7E-05) for workers at the pre-processing unit. A definite carcinogenic risk of 1.3E-04, and non-carcinogenic effect, of HI = 1.6 were observed in one urban site. With the exception of the pre-processing unit, the citizens of Tehran had higher exposure to BTEX. Overall, BTEX concentrations in the largest MSWF of Iran remains an issue of public health concern.
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http://dx.doi.org/10.1016/j.envres.2020.110068DOI Listing
December 2020

Exposure to endotoxins and respiratory health in composting facilities.

Ecotoxicol Environ Saf 2020 Oct 2;202:110907. Epub 2020 Jul 2.

Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran; Department of Research Methodology and Data Analysis, Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran. Electronic address: http://yunesian.tums.ac.ir.

The impact of bioaerosols in municipal solid waste management is nowadays identified as a growing health concern worldwide. In this study, exposure to endotoxin in composting facilities and its association with lung function and clinical symptoms was investigated in Tehran municipal solid waste management complex (Aradkooh) as one of the largest solid waste management facilities in the Middle East. Airborne endotoxins were collected between June and July 2019 and the concentrations were determined by Limulus Amebocyte Lysate (LAL) method. Healthy workers with no history of respiratory disease were recruited and data on clinical symptoms (cough, phlegm, wheezing, dyspnea, fatigue, headache, eye irritation, runny nose, runny eyes, and sore throat) was obtained by the modified American Thoracic Society questionnaire, and spirometric measurement was performed by an expert. The binary logistic regression test was used and adjusted for confounding variables. The results didn't show any difference in lung function parameters (FEV, FVC, FEV/FVC, PEF, FEF), and most of the respiratory symptoms despite a relatively high difference in the concentration of endotoxin observed in air samples of different locations. Only the increased risk of cough (OR 10.5, 95% CI: 2.4 to 44.8 in the moderately exposed group and 7.8, 95% CI: 1.6 to 39.1 in highly exposed ones), fatigue (OR 3.7, 95% CI: 1.2 to 11.7), and headache (OR 6.02, 95% CI: 1.4 to 24.5) were found in the exposed groups compared to controls after adjusting for age, active and passive smoking. However, findings of the study might be underestimated due to some issues including healthy worker effect, intra and intersubject variability, and self-reporting bias, thereby the results should be interpreted with caution. Although we did not find any relationship, due to the high concentrations of endotoxins observed in some sites, it is recommended to consider some possible prevention measures such as using personal protective equipment to reduce the exposure of workers at an acceptable level.
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http://dx.doi.org/10.1016/j.ecoenv.2020.110907DOI Listing
October 2020

Association of systemic inflammation and coagulation biomarkers with source-specific PM mass concentrations among young and elderly subjects in central Tehran.

J Air Waste Manag Assoc 2021 Feb 11;71(2):191-208. Epub 2020 Dec 11.

Department of Civil and Environmental Engineering, University of Southern California , Los Angeles, CA, USA.

In this study, we investigated the association between short-term exposure to different sources of fine particulate matter (PM) and biomarkers of coagulation and inflammation in two different panels of elderly and healthy young individuals in central Tehran. Five biomarkers, including white blood cells (WBC), high sensitive C-reactive protein (hsCRP), tumor necrosis factor-soluble receptor-II (sTNF-RII), interleukin-6 (IL-6), and von Willebrand factor (vWF) were analyzed in the blood samples drawn every 8 weeks from the subjects between May 2012 and May 2013. The studied populations consisted of 44 elderly individuals at a retirement home as well as 40 young adults residing at a school dormitory. Positive Matrix Factorization (PMF)-resolved source-specific PM mass concentrations and biomarker levels were used as the input to the linear mixed-effects regression model to evaluate the impact of exposure to previously identified PM sources at retirement home and school dormitory in two time lag configurations: lag 1-3 (1-3 days before the blood sampling), and lag 4-6 (4-6 days before the blood sampling). Our analysis of the elderly revealed positive associations of all biomarkers (except hsCRP) with particles of secondary origin in both time lags, further corroborating the toxicity of secondary aerosols formed by photochemical processing in central Tehran. Moreover, industrial emissions, and road dust particles were positively associated with WBC, sTNF-RII, and IL-6 among seniors, while vehicular emissions exhibited positive associations with all biomarkers in either first- or second-time lag. In contrast, most of the PM sources showed insignificant associations with biomarkers of inflammation in the panel of healthy young subjects. Therefore, findings from this study indicated that various PM sources increase the levels of inflammation and coagulation biomarkers, although the strength and significance of these associations vary depending on the type of PM sources, demographic characteristics, and differ across the different time lags. : Tehran, the capital of Iran with a population of more than 9 million people, has been facing serious air pollution challenges as a result of extensive vehicular, and industrial activities in the previous years. Among various air pollutants in Tehran, fine particulate matters (PM, particles with aerodynamic diameters < 2.5 µm) are known as one of the most important critical pollutants, causing several adverse health impacts including lung cancer, respiratory, cardiovascular, and cardiopulmonary diseases. Therefore, a number of studies in the area have tried to investigate the adverse health impacts of exposure to PM. However, no studies have ever been conducted in Tehran to examine the association between specific PM sources and biomarkers of coagulation and systemic inflammation as indicators of cardiovascular disorders. Indeed, this is the first study in the area investigating the association of source-specific PM with biomarkers of inflammation including white blood cells (WBC), high sensitive C-reactive protein (hsCRP), tumor necrosis factor-soluble receptor-II (sTNF-RII), interleukin-6 (IL-6), and von Willebrand factor (vWF). Our results have important implications for policy makers in identifying the most toxic sources of PM, and in turn designing schemes for mitigating adverse health impacts of air pollution in Tehran.
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http://dx.doi.org/10.1080/10962247.2020.1806140DOI Listing
February 2021

Association of adverse birth outcomes with exposure to fuel type use: A prospective cohort study in the northern region of Ghana.

Heliyon 2020 Jun 8;6(6):e04169. Epub 2020 Jun 8.

Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.

We aimed to investigate the potential associations between exposure to fuel types for cooking and birth outcomes in Northern Region of Ghana. Third trimester pregnant women were recruited during antenatal visit to the hospital and followed-up till delivery. Three questionnaires were administered covering baseline information, exposure to fuel types, and birth outcomes. Adjusting for potential confounding factors, log binomial regression model was applied to investigate the association between low birth weights (LBW), preterm birth and perinatal deaths in mothers and fuel types. Of the 1626 participants recruited at baseline, about 1323 women in the delivery period completed the study. At delivery period, maternal mean (SD) age was 27.3 (5.2) years. Mothers who used charcoal and firewood for cooking had 1.47 times (95% CI 1.04-2.05) and 1.18 times (95% CI 0.83-1.69) increased in risk of preterm birth respectively after controlling for potential confounding variables. Although, non-significant, mothers who used charcoal had 1.34 times (95% CI 0.45-3.97) increased risk in LBW, while those who used firewood had 1.23 times (95% CI 0.41-3.71) risk in LBW. Similarly, babies of mothers who used charcoal and those who used firewood respectively had 1.72 times (95% CI 0.52-5.65) and 1.70 times (95% CI 0.49-5.92) risk in small for gestational age after controlling for maternal BMI at first visit and anemia. Lastly, mothers who used charcoal and those who used firewood respectively had 1.87 times (95% CI 0.29-11.64) and 2.02 times (95% CI 0.31-13.04) increased risk in perinatal mortality after controlling for potential confounding variables. We observed a significant association between charcoal and preterm birth. Also, we observed a non-significant association between charcoal and firewood users and LBW, SGA and perinatal mortality respectively, compared to those using gas or electricity. This suggests cooking with charcoal and firewood could have health consequences on the outcome of pregnancy.
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http://dx.doi.org/10.1016/j.heliyon.2020.e04169DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7287244PMC
June 2020

The acute effects of short term exposure to particulate matter from natural and anthropogenic sources on inflammation and coagulation markers in healthy young adults.

Sci Total Environ 2020 Sep 15;735:139417. Epub 2020 May 15.

Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran; Center for Solid Waste Research, Institute for Environmental Research, Tehran University of Medical Sciences, Tehran, Iran. Electronic address:

Airborne particulate matter is associated with increasing the risk of cardiovascular diseases. The purpose of this study was to investigate the association between air pollution conditions and MDA, vWF, and fibrinogen markers in the blood of two panels of healthy young individuals in an urban area in Tehran city with a high air pollution background and another group was living in a rural area (Ahmad Abad Mostofi), with a low air pollution background. In each group, 4 blood samples were taken as follows: one in inversion days, the second in winter, but during the existence of normal condition in terms of air pollution, the third sample in the spring during the normal condition in terms of air pollution and the fourth sample during the dust storm conditions. In the urban and rural groups, there was a significant difference between the concentration of MDA, vWF, fibrinogen between inversion and cold season control conditions, and between dust storm conditions and warm season control conditions (p < 0.05). The results showed that the association of dust storm condition on the measured biomarkers was stronger than the inversion condition, which health consideration in the dust conditions be taken into account similar to the inversion conditions.
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http://dx.doi.org/10.1016/j.scitotenv.2020.139417DOI Listing
September 2020

Assessment of hydrogeochemical characteristics and quality of groundwater resources in relation to risk of gastric cancer: comparative analysis of high- and low-risk areas in Iran.

Environ Geochem Health 2021 Jan 26;43(1):1-21. Epub 2020 May 26.

Avicenna Center for Medicine and Organ Transplant, Avicenna Hospital, Shiraz, Iran.

The chemical quality of groundwater supplies in two high-risk area (HRA) and low-risk area (LRA) for gastric cancer in Iran was assessed through hydrogeochemical analysis and water quality indices. For this aim, Piper and Schoeller diagrams and water quality index (WQI) were applied. In addition, exposure to nitrate via drinking water and its corresponding risk were also assessed using Monte Carlo simulation technique. Data on physicochemical properties of groundwater resources were obtained from Iran Water Resources Management Company. Sampling and analysis of tap water for nitrate concentration were conducted in two cities of Shiraz (as a representative of LRA) and Ardabil (as a representative of HRA). According to Piper diagrams, the dominant hydrogeochemical facies of groundwater supplies in HRA and LRA were Na-HCO (43.75%) and Ca-HCO (41.77%), respectively. The predominant cations in groundwater resources of HRA were found to be Na (68.06%) and Ca (31.94%). For LRA, the typical cations were in decreasing trend: Ca (39.64%) > Mg (18.35%) > Na (17.26%). For two areas, HCO, SO and Cl were, respectively, the most frequent anions. Two-sample Wilcoxon test showed that there were statistically significant difference between two areas in terms of anions and cations concentrations (p value < 0.05). The mean of total hardness (Ca + Mg) concentration of water supplies in LRA (528.1 mg/L) was higher than HRA (263.1 mg/L), whereas the mean of Na concentration was found to be lower in LRA (90.6 mg/L) compared with HRA (108.1 mg/L). The sum of nitrate intake and its risk in LRA was higher than HRA. WQI results showed that drinking water quality in HRA and LRA ranged from excellent to poor and most water resources were of a good quality class. Further studies are suggested to investigate the role of drinking water in the etiology of gastric cancer in Iran.
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http://dx.doi.org/10.1007/s10653-020-00562-xDOI Listing
January 2021

Comprehensive Risk Assessment of Health-Related Hazardous Events in the Drinking Water Supply System from Source to Tap in Gaza Strip, Palestine.

J Environ Public Health 2020 29;2020:7194780. Epub 2020 Jan 29.

Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.

Background: The traditional approach in the management of the quality drinking water, and relying on end-product testing, has proven ineffective in protecting public health. Therefore, the transition to a systematic approach in drinking water supply systems management from the source to the consumer tap was taken as a water safety plan (WSP).

Objective: The study aims to investigate the health-related hazardous events in order to decide on the best risk-reduction strategies in the supply of drinking water in the Gaza strip.

Methods: A semiquantitative matrix method for risk assessment was applied. Also, chlorine residual, electrical conductivity, and nitrate concentration further tested in 109 water wells, 109 small-scale water desalination plants, 197 tanker trucks, and 384 households distributed over five governorates of the Gaza strip.

Results: The mean of the measured chlorine residual values was less than the recommended national and international limits (0.2-1 mg/liter). The mean of electrical conductivity at catchment points and household municipal water taps was 2165.1 S·cm and 2000 S·cm, respectively. Furthermore, zero percent of water samples met the recommended criteria, indicating that the groundwater in the Gaza strip is nonpotable. Only 12.8% and 8.8% of water samples met the permissible levels at catchment areas and municipal water at household, respectively, indicating sever health impacts on the public. Moreover, the most hazardous events were related to high levels of groundwater salinity, the low level of disinfection, the effect of electricity outages on the efficiency of the desalination process, and leakage of water from the tanker truck tank reservoirs. Therefore, urgent interventions are required to improve the quality of water and to mitigate the possible health effects.

Conclusion: The prioritization of hazardous events that are proportional to the degree of their attributed risk could help guide in making the right risk-reduction decisions. Urgent interventions are required to improve the quality of water and to mitigate the possible health effects.
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http://dx.doi.org/10.1155/2020/7194780DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7204139PMC
September 2020

The burden of cardiovascular and respiratory diseases attributed to ambient sulfur dioxide over 26 years.

J Environ Health Sci Eng 2020 Jun 21;18(1):267-278. Epub 2020 Apr 21.

2Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.

Introduction: Developing countries, particularly those with a rapid development, are experiencing increasing pollution by sulfur dioxide (SO). Despite the considerable SO exposure effect on health, there is little evidence regarding this fact in Iran, as one of the largest oil and gas producing countries in the world. The present study, therefore, was designed to investigate the burden of cardiovascular and respiratory diseases attributed to the SO exposure in Iran, over a 26-year period.

Materials And Methods: All measured SO levels were collected from 92 air quality monitoring stations (AQMSs) in 29 cities, during 1996-2013. Since the study years were from 1990 to 2015, and also due to missing data at existing stations, the spatiotemporal model was used to estimate the exposure to this gas during this period. To calculate the burden of cardiovascular and respiratory diseases, the population attributable fraction (PAF) value was calculated, and the SO-attributed mortality and years of life lost (YLL) were determined per province, and in the whole country.

Results: The results of this study showed that the SO concentration was increased from 22.00 ppb (7.69-67.28) in 1990 to 27.81 ppb (9.88-82.27), in 2015. The lowest annual value of 11.53 ppb (4.68-32.06) and the highest value of 45.11 ppb (16.58-1226) were estimated at 2004 and 1997, respectively. There was a sinusoidal trend in the gas concentration changes. The highest occurrence of SO-attributed deaths due to cardiovascular and respiratory diseases were 0.080 (0.024-0.168) and 0.076 (0.026-0.165), and the lowest levels were 0.017 (0.004-0.044) and 0.047 (0.017-0.124), respectively.

Conclusions: According to the results in our country, the SO trend was sinusoidal during 26 years, with a recurrent rise occurring after each declining period. It is recommended to design the sustainable national method policies and programs with the continuous evaluation and modification for the reduction of fossil fuel consumption and further implementation in the use of clean energy.
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http://dx.doi.org/10.1007/s40201-020-00464-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7203314PMC
June 2020

Association between exposure to ambient fine particulate matter and prevalence of type 2 diabetes in Iran: an ecological study.

Environ Sci Pollut Res Int 2020 Jul 2;27(21):26182-26190. Epub 2020 May 2.

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

Epidemiological evidence for the link between long-term exposure to air particulate matter (PM) and occurrence of type 2 diabetes (T2D) is limited such that little is known about the effect of PM exposure and adult T2D prevalence. Thus, the aim of this ecological study is to evaluate the contribution of ambient PM exposure to the adult T2D prevalence in the large population of Iran. The study was conducted based on Iran's large-scale cross-sectional surveilling non-communicable diseases (NCDs) risk factors (Timpka et al. 2015b). A total of 31,050 participants were enrolled in three sequential processes of study using cluster random sampling. PM data in the urban area of 31 provinces of Iran were acquired from Tehran Air Quality Control Company (AQCC) and the Department of Environment (DoE) of Iran during 2012-2016. Moreover, major and minor diabetes risk factors were considered; the Pearson correlation and a stepwise regression model were performed to estimate associations between risk factors and diabetes and prediabetes prevalence. The results showed T2D prevalence was more frequent among women (10.61%) than men (9.35%). A weak positive correlation was observed between PM level and diabetes prevalence with a correlation coefficient of 0.275, although there was no significant association between PM value and prediabetes prevalence. Moreover, none of the variables included in the regression model could predict the prevalence of diabetes and prediabetes. According to our study results, it can be suggested that investigating the association between PM exposure and T2D prevalence at individual level may provide a better understanding of PM exposure and the risk of T2D prevalence.
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http://dx.doi.org/10.1007/s11356-020-08659-7DOI Listing
July 2020

Can respirator face masks in a developing country reduce exposure to ambient particulate matter?

J Expo Sci Environ Epidemiol 2020 07 21;30(4):606-617. Epub 2020 Apr 21.

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

Respirator face masks (RFMs) as a personal-level intervention is increasingly being utilized to reduce ambient particulate matter (PM) exposure, globally. We tested the effectiveness of 50 commercially available ones in reducing the exposure of ambient particle number concentrations (PNC), PM, PM, and PM (PM ≤ 10, 2.5, and 1 μm in diameter, respectively) in a traffic-affected urban site in Tehran. To examine the efficiency of RFMs, we applied a specific experimental setup including vacuum pumps, dummy heads, connecting tubes, glass chambers, and GRIMM Aerosol Spectrometer to measure all metrics after dummy heads. The average effectiveness of RFMs was in the range of 0.7-83.5%, 3.5-68.1%, 0.8-46.1%, and 0.4-32.2% in reducing ambient PNC, PM, PM, and PM, respectively. Considering all metrics, the highest effectiveness was observed always for Biomask, followed by 3 M 9332, due to their well-designed physical characteristics (e.g., adjustable nose clip for any face/nose shape, and size, soft inner material in the nose panel to provide a secure seal against leakage, adjustable or elasticated straps/ear loops to better adjust on any face). Biomask reduced ambient PM with a mean value of 94.6 μg m (minimum-maximum: 51.7-100.3 μg m), whereas it filtered on average just 29.0 μg m (25.7-43.5 μg m) of ambient PM and 18.2 μg m (14.7-21.8 μg m) of PM. A fuzzy analytical hierarchy process to find the most important design-related factors of RFMs affecting their effectiveness, which showed the exhalation valve and its diaphragm (20.4%), nose clip (19.7%), and cheek flaps (18.6%) are ranked as the main design-related variables. The fuzzy technique for order preference by similarity to ideal solution indicated that Biomask and 3M 9332 had scores of 1 and 0.97, the highest scores compared with other RFMs. This study provides crucial evidence-based results to elucidate the effectiveness and design-related factors of RFMs in real-environmental circumstances.
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http://dx.doi.org/10.1038/s41370-020-0222-6DOI Listing
July 2020

Association Between Leukocyte Telomere Length and Serum Concentrations of PCBs and Organochlorine Pesticides.

Arch Environ Contam Toxicol 2020 Jul 16;79(1):122-130. Epub 2020 Apr 16.

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

Exposure to polychlorinated biphenyls (PCBs) and organochlorine pesticides (OCPs) through food, water, and air occurred during the life, which may change telomere length (TL) in peripheral blood leukocytes. The present study was designed to investigate the association between TL and serum levels of PCBs and OCPs in Tehran male's population. Whole blood samples were randomly taken from 300 adult males, aged between 25 and 40 years. TL was determined by real-time PCR to measure the number of the telomere (T) repeats to the number of a single-copy gene (S). We applied the multivariate linear regression model to compare the effect of each lipid adjusted serum levels of PCBs and OCPs congener on the TL, with adjustment for age, body mass index, education, smoking, and food patterns. Each doubling of the nondioxin-like PCBs, dioxin-like PCBs, and OCPs levels were associated with 1.9% [95% confidence interval (CI) - 0.70 to 5.40%], 2.5% (95% CI 0.30-8.3%), and - 2.4% (95% CI - 0.70 to - 6.2%) variation in the TL, respectively. The percent difference in the TL with exposure to nondioxin-like PCBs, dioxin-like PCBs, and OCPs for participants with older than age 37 years were 6.45% (95% CI  2.81-16.50%), 4.52% (95% CI  1.60-10.54%), and - 7.44% (95% CI - 1.55 to - 15.51%), respectively. Exposures to nondioxin-like PCBs (except for PCB 28 and 52) with high chlorine in structure and dioxin-like PCBs were related to longer TLs. Conversely, serum levels of OCPs can be associated with oxidative stress and systemic inflammation that lead to telomere shortening.
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http://dx.doi.org/10.1007/s00244-020-00732-zDOI Listing
July 2020

A field indoor air measurement of SARS-CoV-2 in the patient rooms of the largest hospital in Iran.

Sci Total Environ 2020 Jul 6;725:138401. Epub 2020 Apr 6.

Department of Virology, School of Public Health, Tehran University of Medical Sciences. Electronic address:

The coronavirus disease 2019 (COVID-19) emerged in Wuhan city, China, in late 2019 and has rapidly spread throughout the world. The major route of transmission of SARS-CoV-2 is in contention, with the airborne route a likely transmission pathway for carrying the virus within indoor environments. Until now, there has been no evidence for detection of airborne severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and this may have implication for the potential spread of the COVID-19. We investigated the air of patient rooms with confirmed COVID-19 in the largest hospital in Iran, on March 17, 2020. To collect the SARS-CoV-2 particles, ten air samples were collected into the sterile standard midget impingers containing 20 mL DMEM with 100 μg/mL streptomycin, 100 U/mL penicillin and 1% antifoam reagent for 1 h. Besides, indoor particle number concentrations, CO, relative humidity and temperature were recorded throughout the sampling duration. Viral RNA was extracted from samples taken from the impingers and Reverse-Transcription PCR (RT-PCR) was applied to confirm the positivity of collected samples based on the virus genome sequence. Fortunately, in this study all air samples which were collected 2 to 5 m from the patients' beds with confirmed COVID-19 were negative. Despite we indicated that all air samples were negative, however, we suggest further in vivo experiments should be conducted using actual patient cough, sneeze and breath aerosols in order to show the possibility of generation of the airborne size carrier aerosols and the viability fraction of the embedded virus in those carrier aerosols.
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http://dx.doi.org/10.1016/j.scitotenv.2020.138401DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7194859PMC
July 2020

Prenatal urinary concentrations of environmental phenols and birth outcomes in the mother-infant pairs of Tehran Environment and Neurodevelopmental Disorders (TEND) cohort study.

Environ Res 2020 05 2;184:109331. Epub 2020 Mar 2.

Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran; Department of Research Methodology and Data Analysis, Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran. Electronic address:

Daily exposure to environmental phenols can lead to potential undesirable effects on the health of pregnant women and fetuses. The present study is aimed to evaluate the relationship between maternal urinary concentrations of phenols in pregnancy and anthropometric birth outcomes. The studied population comprised of 189 pregnant women participating in the Tehran Environment and Neurodevelopmental Disorders (TEND) prospective cohort study, which had been ongoing since March 2016 in some hospitals and health care delivery centers in Tehran, Iran. Concentrations of bisphenol-A, triclosan, 4-nonylphenol, and parabens were determined in spot urine samples of pregnant mothers in the first trimester. Weight, length, and head circumference at birth were also extracted from the mothers' delivery files. Multivariable linear regression was used to examine the relationship between log-concentrations of phenols and birth outcomes. When we analyzed all samples regardless of neonates' gender, none of the urinary concentrations of phenols were associated with weight and length at birth. Indeed, in sex-stratified adjusted models, one log-unit increase of butylparaben was related to a 283.6 g (95% CI: 23, 544) increase in boys' birth weight. Prenatal urinary concentration of triclosan and propylparaben was respectively related to a decrease of 4.8 cm (95% C: -8.5, -1.1) in boys' length and 0.9 cm (95%CI: -1.8, -0.04) in girls' length. In the adjusted models for estimating the changes in head circumference, one log-unit increase of triclosan, methylparaben, and butylparaben led to a reduction of 1.6 cm (95% CI: -3.17, 0.03), increase of 0.8 cm (95% CI: -0.01, 1.6) and 0.7 cm (95% CI: 0.08, 1.4) in head circumference at birth respectively. Our results suggested that prenatal triclosan and parabens exposure might be associated with head circumference at birth. Furthermore, we observed a sexually dimorphic pattern between maternal triclosan and parabens exposure during pregnancy and fetal growth. However, these findings must be interpreted while taking into account the limitations of this study.
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http://dx.doi.org/10.1016/j.envres.2020.109331DOI Listing
May 2020

Serum level of PCBs and OCPs and leukocyte telomere length among adults in Tehran, Iran.

Chemosphere 2020 Jun 1;248:126092. Epub 2020 Feb 1.

Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Enghelab St., Tehran, Iran; Department of Research Methodology and Data Analysis, Institute for Environmental Research (IER), Tehran University of Medical Sciences, Kargar St., Enghelab Sq., Tehran, Iran.

Exposure to polychlorinated biphenyls (PCBs) and organochlorine pesticides (OCPs) may change leukocyte telomere length (TL) at the end of the DNA sequence. The purpose of this study was to investigate the association between PCBs and OCPs exposure with TL in Tehran adult males. Whole-blood samples were randomly taken from three hundred adult males in population-based cross-section study from October 2016 to November 2017. We studied the serum levels of PCBs, OCPs as well as socio-demographic characteristics of individuals. The quantitative PCR was used to investigate the number of the telomere (T) repeats to the number of a single copy gene. We measured the effect of each PCBs and OCPs congeners on TL using linear regressions adjusted for age, BMI, smoking, and dietary patterns. The median level of the six non-dioxin-likes, five dioxin-likes PCBs three OCPs and TL in the study population were 344.5, 306.0, 45.0 ng/g lipid and 5377.7 ± 573.4 base pairs, respectively. In the adjusted model, the percent difference in the TLs with exposure to Σnon-dioxin-like PCBs, Σdioxin-like PCBs, and OCPs were 1.93 (-0.70 to 5.4), 3.4 (1.8-8.3) and -2.4 (-0.80 to -6.2), respectively. In the fourth quartile compared to the first quartile, the percent difference in the TLs due to Σnon-dioxin-like PCBs, Σdioxin-like PCBs, and OCP exposure were 0.01 (-0.01 to 0.05), 10.3 (2.9-18.1) and -0.20 (-0.10 to -4.5), respectively. Exposures to ndl-PCBs and dl-PCBs (except for PCB28) were related to longer TLs, but OCPs exposure can be related to telomere shortening.
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http://dx.doi.org/10.1016/j.chemosphere.2020.126092DOI Listing
June 2020

Evaluation of chlorpyrifos residue in breast milk and its metabolite in urine of mothers and their infants feeding exclusively by breast milk in north of Iran.

J Environ Health Sci Eng 2019 Dec 3;17(2):817-825. Epub 2019 Sep 3.

4Center for Air Pollution Research (CAPR), Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, 1417993359 Iran.

Background: The most common method of combating insects in low-income communities and developing countries, is the use of insecticides. The use of organophosphate insecticides is increasing due to their low prices and availability on the market. Chlorpyrifos is a medium-risk insecticide for human. The widespread use of organophosphorus insecticides, especially chlorpyrifos, in residential homes has undoubtedly created many health concerns. Babies have a high sensitivity to pesticides and environmental contaminants because of their evolutionary status. On the other hand, the main source of infants' exposure who are breast-fed exclusively to environmental pollutants is through breast milk and oral contact with objects that are covered with dust and particles.

Methods: In this cross-sectional study, the concentration of chlorpyrifos in breast milk and its metabolite in urine samples of mothers and their under six months infants, feeding exclusively by breast milk in north of Iran have been investigated. The demographic data was collected through interviewing with selected mothers and completion of prepared data collecting forms. The data were statistically analyzed to investigate the relationships between exposure of mothers and their infants to chlorpyrifos.

Results: The mean concentration of chlorpyrifos and its metabolite in mothers' urine and milk samples and infant's urines were 1.3 ± 0.6, 2.1 ± 1.4 and 1.4 ± 0.7 μg/L, respectively. Also, the mean concentration of chlorpyrifos in the dust on the house floors was73.4 ± 49 ng/g. There are good correlations between the mean values of chlorpyrifos concentrations and its metabolite in mother's milk and urine (r = 0.872,  = 0.001), and the mother's milk and infant's urine (r = 0.722, p = 0.001). Also, there was a significant correlation between the concentration of chlorpyrifos in floor dust and its metabolites in the infant's urine (r = 0.554,  = 0.001).

Conclusion: Our study suggests that the infants are the recipient of concentrated forms of chlorpyrifos residues through breast milk and house dust and it is quite well known that OP pesticides are toxic and have different kinds of adverse health effects. However, further research needs to be done to determine what these chemicals are doing to our children.
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http://dx.doi.org/10.1007/s40201-019-00398-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6985376PMC
December 2019

Air pollution and exacerbation of skin itching and sleep disturbance in Iranian atopic dermatitis patients.

J Environ Health Sci Eng 2019 Dec 23;17(2):811-816. Epub 2019 Aug 23.

1Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Poursina Street, Keshavarz Boulevard, Tehran, 1417613151 Iran.

Background: For about three decades now, the number of people suffering from atopy including atopic dermatitis (AD) has been increasing in developed countries. Genetic background and environmental factors including air pollution play an effective role in its incidence. This study examined the association between air pollutants and exacerbation of AD symptoms including sleep disturbance and itching in AD patients of Tehran.

Methods: In this panel study, 31 patients with AD who admitted to Razi Hospital, dermatology hospital in Tehran, entered the research. Daily information including questions on disease symptoms (sleep disturbance, itching) and duration of outdoor stay (in hours) were collected using a questionnaire. The mean 24-h concentrations of PM and PM pollutants were obtained from the Air Quality Control Company. The relationship between the concentrations of the pollutants and exacerbation of the disease symptoms was investigated using the GEE (Generalized Estimating Equations) model.

Results: There was a significant relationship between the concentrations of air pollutants and exacerbation of sleep disturbance and itching on the same day, before, and after adjusting the effects of the confounding variables, so that the estimated odds ratios (95% confidence interval) between PM and PM and exacerbation of itching were 1.06 (1.02-1.10) and 1.17 (1.07-1.28), respectively.

Conclusions: There was a significant statistical relationship between the concentration of particulate matter (PM and PM) and exacerbation of sleep disturbance and itching. PM showed a stronger relationship with the exacerbation of symptoms compared to PM.
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http://dx.doi.org/10.1007/s40201-019-00397-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6985420PMC
December 2019

Endotoxin and Der p1 allergen levels in indoor air and settled dust in day-care centers in Tehran, Iran.

J Environ Health Sci Eng 2019 Dec 11;17(2):789-795. Epub 2019 Aug 11.

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

Background: Allergens like endotoxin and mite allergen Der p 1 are associated with early wheezing and asthma morbidity. Day-care centers can be an important source of exposure to allergens. The aim of this study was to evaluate children's exposure to endotoxin and mite allergen (Der p 1) associated with total suspended particulate matter (TSP) and settled dust in day-care centers in two phases in years of 2015 and 2016 in Tehran city, Iran.

Methods: Endotoxin and mite allergen Der p 1 in TSP and settled dust were measured in 23 day-care centers in Tehran. After collecting dust samples and weighting them, and then their extraction, Endotoxin and Der p 1 allergen were determined using QCL-1000 Endpoint chromogenic LAL Assay and ELISA, respectively.

Results: The mean concentrations of endotoxin and mite allergen Der p 1 in settled dust were 0.3 EU/mg and 0.2 ng/mg, respectively. The mean concentration of endotoxin and mite allergen Der p 1 in indoor air TSP were 0.8 EU/m and 0.4 ng/m, respectively. A significant negative correlation was found between endotoxin both in settled dust and in TSP with measured relative humidity in winter. Also, moderate correlation was observed between Der p 1 in settled dust and relative humidity in winter; however, the correlation between allergen in TSP and relative humidity was not significant.

Conclusion: Day-care centers can be an important source of endotoxin and Der p 1 allergen, so, implementation of proper interventions in these places can reduce exposure to them.
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http://dx.doi.org/10.1007/s40201-019-00395-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6985405PMC
December 2019

Maternal exposure to air pollutants and birth weight in Tehran, Iran.

J Environ Health Sci Eng 2019 Dec 22;17(2):711-717. Epub 2019 Jun 22.

1Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Poursina Street, Keshavarz Boulevard, Tehran, 1417613151 Iran.

Background: Air pollution can cause various health outcomes, especially in susceptible groups including pregnant women. Low birth weight (LBW) is among the adverse birth outcomes and is one of the main causes of infant mortality. The aim of this study was to assess the association between air pollutants and LBW in Tehran, Iran.

Methods: In this case-control study, 2144 babies born in three hospitals of Tehran (Iran) during 2011 to 2012 whose mothers were the residents of this city in last 5 years were considered. Of these, 468 infants with birth weight < 2500 g and 1676 with birth weight ≥ 2500 g were regarded as case and control groups, respectively. Gestational age was also considered for definition of cases (small for gestational age (SGA)) and controls (appropriate for gestational age). Land use regression models were used to assess exposure to particulate matter ≤10 μm in aerodynamic diameter (PM), sulfur dioxide (SO), nitrogen dioxide (NO) and volatile organic compounds (benzene, toluene, ethylbenzene, o-xylene, m-xylene, p-xylene (BTEX), and total BTEX) during pregnancy. Logistic regression model was applied to assess the association between air pollutants and LBW.

Results: The concentrations of air pollutants were very high but similar in cases and controls. After adjustment for potential confounding variables, no statistically significant association was observed between air pollutants and LBW. The adjusted odds ratios (95% confidence interval) for PM, SO, and benzene were 0.999 (0.994-1.005), 0.998 (0.993-1.003), and 0.980 (0.901-1.067), respectively.

Conclusions: No association was found between LBW and air pollutants. Further studies with more rigorous designs and access to more comprehensive information are suggested to assess the effect of other air pollutants, such as CO, O, PM, ultrafine particles, and oxidative potential of particles on birth outcomes.
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http://dx.doi.org/10.1007/s40201-019-00386-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6985325PMC
December 2019