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PURPOSE@#Firefighters are exposed to high levels of occupational risk factors, such as safety risks, chemical, ergonomic, and physical hazards that may jeopardize their lives. To overcome these hazards, firefighters must be physically, mentally, and personally fit to work. This study aimed to explore the criteria and factors affecting firefighters' resilience based on stakeholders' experiences.@*METHODS@#This qualitative study was carried out using conventional content analysis. In total, 21 face-to-face interviews were conducted by firefighters who were experienced in the field. The interviews were carried out from July 2019 to January 2020. The data were collected using 3 unstructured interviews and then resumed by 18 semi-structured interviews. Data analysis was done using Graneheim method.@*RESULTS@#The participants had more than 5 years of experience in the field of search and rescue. The extracted codes through data analysis were classified into 3 main categories (individual, organizational, and social factors), 9 sub-categories (mental, physical, occupational, managerial, colleagues-related, equipment-related, environmental, community-related, and family-related factors), as well as 19 sub-sub-categories and 570 codes.@*CONCLUSION@#Firefighters' personality, physical condition, behavior and psychological characteristics can affect their resilience along with organizational and management factors that play significant role in people's safety. Developing a tool for assessing resilience can help decision makers to have a real depict of firefighters' job qualifications.
Subject(s)
Humans , Firefighters/psychology , Qualitative ResearchABSTRACT
Background: Occupational chemical accidents have increased in recent years in the Islamic Republic of Iran. In June and August 2015, three large explosions occurred at chemical warehouses in Rey, Tehran Province, and toxic vapours were released.
Aims: This study reviewed the three chemical accidents and assessed the extent to which the requirements for chemical safety and preparedness for chemical incidents under the International Health Regulations (IHR) are in place, and implemented at local and national levels in the Islamic Republic of Iran.
Methods: Data were obtained from secondary data and field visits to selected chemical plants. The secondary data were used to complete a 33-item checklist based on the IHR and the Ministry of Health and Medical Education checklist. A sample of 15 warehouses in Kahrizak district, Rey County, were visited to assess their capacity in relation to the IHR using a 15-item checklist.
Results: Some weaknesses were seen in the IHR capacity in the study area. The main weaknesses were lack of an effective surveillance system for chemical accidents and low levels of safety in chemical plants and warehouses. Other weaknesses included the lack of awareness of residents about chemical hazards and poorly equipped health centres for the management of victims of chemical accidents. The study area was not prepared for chemical accidents both within industrial plants and residential areas.
Conclusions: Action is needed to improve the areas of weakness so as to achieve the necessary capacities for chemical safety, and preparedness and response to chemical incidents in line with the IHR
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Background: Explosive events refer to events, either natural or man-made, that occur advertently or accidentally. This article aimed to study epidemiology of explosive events and investigate the health consequences of such events. It also aimed to discuss the prevention and management of these events from a healthcare provision viewpoint
Materials and Methods: This descriptive study comprised 2 sections. First, following an extensive review of the literature, a database, containing the related articles was developed. Then, the core research group drafted the first adapted version of the results. Using a Delphi panel methodology, the results were finalized based on the consensus of 11 experts
Results: Terrorist explosion is the most common type and of ever-growing explosions worldwide. It accounts for the largest proportion of casualties caused by man-made events. Health consequences of explosions can be classified into physical, mental, and social ones, which can appear immediately or a long time after the event and affect individuals, families, and societies
Conclusion: Because of the wide range and adverse impacts of explosions, healthcare authorities and staff should have a good grasp of preventive principles, as well as protection and management of explosion sites. Besides they have to be familiar with treating the injured. It is recommended that training courses and simulated explosive events be designed and run by the healthcare sector
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Background: Short golden time is important to save the injured in earthquake and to start search and rescue [SAR] operation as soon as possible in affected regions. This study evaluated application of geographic information system [GIS] for SAR operation in Rigan Town, Kerman Province, which was hit by an earthquake of 6.3 Richter scale on December 12, 2010 at 22:12
Materials and Methods: A GIS-based decision-making system with 99 information layers was used to manage the operations in this earthquake. Decisions were made by using available information layers and a proportional scenario. The scenario was designed based on depth and intensity of the earthquake. All residential areas within the radius of 20 km from the epicenter were defined in emergency operation center [EOC] to be considered by SAR teams. Accordingly, SAR teams were called and dispatched to the affected area quickly. They were guiding using radio navigation
Results: The subsequent assessment on 25, 30, and 40 km buffers showed that there was no need to increase the field of search and rescue. Field managers were supported with provided information about affected people and villages, structural context of buildings, distribution of operational equipments, manpower, resources, and access roads. All of this updated information was provided by designed GIS
Conclusion: Although the earthquake happened at 22:12 in a rural region with scattered population and 250 km far from decision-making center, the search and rescue operation was completed in the shortest possible time at 2:30 morning, next day
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Attention to people with disability is important at all stages of disaster management, besides reducing damage to these groups they cause to prevent the risk of many adverse and irreversible consequences of disasters. According to the previous experiences, not enough attention is being paid to the needs of the disabled people in national disaster management plans. However, this study aimed to collect and review the disability publications and studies conducted by Iranian researchers in order to describe characteristics of the existing evidences and also to explain the position of disabled people in disaster studies and researches in the country. On September 2013, the relevant documents searched by using six databases such as SID, Irandoc, Iran Medex, Magiran, Database of Iranian Rehabilitation and Med Lib. Several keywords such as disability, disabled people, disasters, hazards, events, crisis, and earthquake were applied without any time limit in the publication years. About 13,624 documents were retrieved in initial search; finally, 10 studies including articles and thesis were selected and studied based on the inclusion and exclusion and eligibility criteria. The articles described in three parts: 1] The study of the disability before disasters [2 articles]; 2] The study of the disability after disasters [4 articles]; 3] The disaster management studies related to pre-disaster and post-disaster phases [1 article]. The related thesis were conducted in Kerman University of Medical Sciences and Social Welfare and Rehabilitation Sciences University and just explained in the form of first and second parts. The collected and studied existing scientific and academic documents on people with disability and disasters revealed inadequacy of related scientific resources and documentation. This considerable gap should fill with identifying the challenges and needs of all types of disabilities and reduce the risk of natural and man-made disasters for disabled people as well as improving their preparedness
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Disasters such as earthquake induce large volume of human needs. One of the most important of them is primary health care needs. Following the 5 December 2012 South Khorasan earthquake, the public health system of the province actively involved to provide primary health care for the affected people. This case study investigated the response operations of public health system to earthquake. In this case-descriptive study, data collected by researchers using checklists, interview with healthcare workers in earthquake-affected areas, reviewing documents, and observation of the response operations. An earthquake measuring 5.5 on the Richter scale hit Qaenat and Zirkouh areas caused 6 deaths and 23 injuries. About 2143 people were affected and 38 villages destroyed about 30 to 100%. Responding to the health needs, a rapid health needs assessment was performed immediately. Then, a response plan designed according to "National Public Health Disaster and Emergency Operation Plan". Public health system in collaboration with expert health groups provided the primary health care services for the affected communities. Although the recent earthquake was mild and occurred in the early of night, but it killed some people and destroyed a number of structures. Public health system provided an appropriate response according to EOP. Nevertheless, because Iran is a disaster prone country, the health system should be prepared for different types of hazards
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Humans , Disasters , Delivery of Health Care , Public HealthABSTRACT
The 5[th] Iran National Development Plan, 2011-2015, has emphasized on expansion of rural asphalt roads. This article aims to illustrate the trend of deaths caused by rural road traffic crashes [RTCs] and its association with length of the rural roads in Iran. We carried out a retrospective analysis on secondary data for the period from 2005 to 2010. The Iranian Forensic Medicine Organization, High Commission for Road Safety and Iran's Statistical Center were the sources for the number of RTC death, length of the road and population data, respectively. Number of RTC deaths in rural roads increased from 1,672 in 2005 to 2,206 in 2010. This was associated with expansion of the rural asphalt roads [P = 0.04]. The construction of urban asphalt roads was also on an increasing trend, but the number of traffic deaths in these roads decreased from 26,083 in 2005 to 21,043 in 2010. Adjusted for 100,000 populations, the number of traffic deaths in urban roads showed a decrease from 37.0 to 28.0, while this number increased from 2.4 to 2.9 in rural roads during the study period. Although expansion of rural roads would contribute to economic development in rural areas, it exposes people to risk of severe RTCs if effective preventive actions are not taken. To prevent this threat, the Iranian policy makers need to take the followings into consideration: Public awareness, improving the safety of roads and vehicles, law enforcement, increasing coverage of police and Emergency Medical Services
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The number of disasters is increasing in the world which can lead to death, injury and disability in affected people. Although on-time, rapid and effective recovery and rehabilitation services/measures in post disaster phase prevent more injuries and disabilities. However, providing these services will have some difficulties in the scene of disasters. This study aims to review the potential of advanced technologies in disasters recovery and rehabilitation. Following an expanded English literature review, a database containing the related articles was developed. The core research group classified the appropriate articles and drafted the first version of the results. Using an expert panel methodology, the results were finalized based on the participants view points. Advanced technology can help responders to manage disaster recovery and rehabilitation phase. Using telerehabilitation, telecommunication, Geo Information Technology and mobile technologies are some examples which could reduce post disaster impacts. Despite wide use of advanced technology in pre-disaster phase, this potential has been considered less in disasters recovery and rehabilitation measures. This study suggests more research in disaster rehabilitation engineering
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Technology , Rehabilitation , Telecommunications , Cell PhoneABSTRACT
Iran's health system is expanding the disaster and emergency higher education programs over the country to enhance the capacity of human resources for effective and efficient disaster mitigation, preparedness, response and recovery. In this article we present an overview about the initiatives and progress of disaster and emergency health higher education in Iran. Following the Bam earthquake, in collaboration with the Ministry of Health and Medical Education and National Institute of Health Research, School of Public Health at the Tehran University of Medical Sciences, Iran took the initiative to develop a Master of Public Health [MPH] with disaster concentration in 2006, a PhD in disaster and emergency health in 2011, and a well constructed certificate course in 2008 entitled Disaster Health Management and Risk Reduction [DHMR]. Iran, Kerman and Shahid Beheshti Universities of Medical Sciences and University of Social Welfare and Rehabilitation are other academia that joined this initiative. Regarding the importance of programs evaluation, we have planned for a comprehensive evaluation of MPH and DHMR programs in 2013-4 and the Accreditation and Evaluation Board of Disaster and Emergency Health, based in MOH and ME, is responsible for evaluation of the PhD program in 3-5 years from initiation
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In the past three decades, Tehran, capital of Iran, has experienced warmer summers so we need to determine heat-related mortality to establish appropriate public health activities during hot summers. The aim of this study was to detect heat waves during the last decades and then determine excess mortality in immediate and lagged times. An ecological study based on time-series model was conducted in Tehran for re-cent decade using generalized linear lagged model [GLLM] with Poisson regression in 2001-2011. Maximum daily temperature was heat exposure for death outcome on the same day [lag 0], 3 [lag 01] and also 7 [lag 02] day moving average. Relative risk with 95% confidence was reported to quantify for increasing of daily mortalities for 1[degree sign]C risen exposure. Air pollutants considered as confounders in final model. Total excess mortality during 17 heat waves was 1069 [8.9 deaths/Heat wave days]. All non-external cause of death increased significantly during heat waves [3%-9%] with [RR= 1.03, 95% CI: 1.01, 1.05 and RR=1.09, 95% CI: 1.07, 1.09] and after adjusting for ozone and PM10 raised. Cause-specific deaths [especially circulatory disease] and death among elderly increased during heat waves [especially in the hottest wave]. The largest positive lagged effect of hot temperature although seen during hottest waves for all mortalities. Three waves had the most harvest effect for all categories of mortalities. This study showed excess mortalities resulted from hot temperatures and exacerbated with air pollutants in Tehran in the context of climate change. Forward displacement mortality and lagged mortalities were seen, but our results were not conclusive about the displacement pattern of mortalities
Subject(s)
Humans , Male , Female , Mortality/trends , Air Pollution, Radioactive/adverse effects , Regression Analysis , Environmental Exposure , Climate , WeatherABSTRACT
Vulnerable events could damage structural, non structural and functional components of hospitals that might lead to community crisis, accordingly. Risk assessment is the first step to develop of a hospital disaster plan. In this study, a primary phase of developing a local tool for Iran's hospital disaster risk assessment entitled [Hospital Safety Index [HIS]] was conducted by World Health Organization originally. First, the original index was translated into Farsi in five forms and 145 items. Then a group of four experts from the fields of medicine and engineering assessed the items one-by-one for their relevance and applicability. Revised edition tested three times at Shariati hospital in Tehran. An expert panel also evaluated the feature and content validity of the index. They also weighted the items as well. Test-retest of the index by two independent research groups found 93% of agreement. Furthermore, 244 points were revised or added to the original edition. The most important changes included: Combining instruction parts with related items for increasing educational properties, completing the list of hazards, developing a plan to analysis, and to present a quantitative and graphic of the model and finally to prepare an educational package as well. Persian version of HSI, in response to needs of Iranian's health system, represents a rapid no-expensive tool for screening disaster risks at hospitals; based on an international template that was tested in several countries. Based on this study, the Farsi index would be evaluated in more hospitals around the country. The assessment results will provide Iranian's health system with evidence-based information for more effective allocated resources and interventions evaluating
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Disaster Planning/methods , Residence Characteristics , Pilot ProjectsABSTRACT
First aid education constitutes a major priority area for the Iranian Red Crescent. The present study assesses student volunteers' knowledge of first aid procedures and their attitudes concerning strategies for community education. This survey involved 5287 volunteers selected by simple random sampling in 6 different provinces of Iran. Statistical analysis, based on a complex sampling design, was performed with the Stata 8.0 software package. At the time of the study, 3736 subjects [63.8%] were members of the Red Crescent and the remaining students worked in the Freelance section. A total of 3736 students [70.6%] had attended the Red Crescent's first aid training courses. The mean knowledge score of the sample was estimated at 8.53 out of a maximum of 18 [CI[0.95]=7.36-9.46], with only 773 subjects [14.6%] showing a high level of knowledge. Only previous training showed a statistically significant relationship with the knowledge score [p=0.01]. The mean score in the attitude section was 34.73 out of a maximum of 45 [CI[0.95]=33.57-37.33], and it was found to be related to previous training [p=0.01] and higher economic status [p=0.01]. Our research showed that the Red Crescent must extend the coverage of its first aid training programs targeted at the student volunteers. An effective way to ensure an adequate level of knowledge in volunteers would be to organize regular continuing education programs adapted to the needs of different target groups
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Humans , Health Knowledge, Attitudes, Practice , Health Education , Red Cross , Students , Volunteers , UniversitiesABSTRACT
This article compares the prevalence of primary infertility in Iran estimates provided by different studies. No other study had provided a review about the researches related to epidemiology of infertility in the country. A literature review was undertaken using the scientific resources on the internet and the list of national projects obtained from Deputy of Research and Technology, of Iran Ministry of Health and Medical Education [MOH and ME] and relevant research centers. These resources were attentively reviewed to find about national studies on the epidemiology of primary infertility in Iran during the last decade. Based on their design quality, the National Infertility Study [NIS] [2004-2005], National Health Survey [NHS] [2001] and Tehran Study [1997] were considered for the research. Current primary infertility estimated by National Health Survey [NHS] was 2.8% and by National Infertility Survey [NIS] 3.4%. Tehran study and NIS estimated the prevalence of lifetime primary infertility to be 21.9% and 24.9%, respectively. The minimum prevalence of lifetime primary infertility was found to be 15.8% for the marriage age of 19-27 by Tehran study and 17.2% for the marriage age of 21-26 by NIS. On the average, 21-22% of women experience primary infertility during their marital life. The best age of marriage for women in Iran seems to be 20-27 years. At this age group, the lowest number of women [16-18%] would experience primary infertility
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Epidemiology , Prevalence , Infertility, FemaleABSTRACT
This research looked at the current situation of the early warning system for flash floods in Golestan. Using the questionnaire developed by the Secretariat of the United Nations' International Strategy for Disaster Reduction [ISDR] for assessment of early warning systems, we examined the following components in the province's early warning system: hazard knowledge, monitoring and warning, dissemination/communication and response capacity. The first stage of the study examined current literature on the experience gained so far in Iran and worldwide. Next, we reviewed the existing evidence and documentation from the province's Natural Disaster Center. The third phase of the research began as a qualitative study consisting of in-depth interviews with eight specialists and four people residing in disaster-stricken areas. This was followed by the formation of an 8-member Expert Panel that debated the key issues until agreement was reached by at least four thirds of the members. The study revealed serious flaws in the current warning system, including its inability to make reliable geographical point predictions and possible delays in the transfer of warning from the meteorological services [where most of the predictions are made] to end-users and other organizations. The public receive little warning on rising water levels, and the rare warning messages that do get through are often vague and incomprehensible. There are no clear-cut warning response strategies, including local evacuation programs; hazard maps are non-existent, and response thresholds remain ill-defined. It is clear that many components of the early flash flood warning system in Golestan are in need of functional improvement. A model- to be tested in future studies- is proposed here for the creation of a Village Disaster Taskforce, based on local capabilities and the concept of initiating the warning process at the local level
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Disasters , Surveys and QuestionnairesABSTRACT
Although all newborns in Iran have been vaccinated against hepatitis B since March 1993, routine screening of pregnant women has not been conducted in prenatal care programs, yet transmission of hepatitis B via the maternal-fetal route is still a viable likelihood, which must be entertained. The subjects were divided into 2 groups. The exposed group comprised 97 vaccinated children whose mothers were seropositive for hepatitis B surface antigen [HBsAg] and had not received hepatitis immunoglobulin at birth. The unexposed group consisted of 87 vaccinated children whose mothers were seronegative for hepatitis B surface antigen. We compared these 2 groups to determine the efficacy of vaccine alone in high-risk children. This study was conducted in Tehran, Iran, from June 2002 to December 2002. All children were born after 1993. Chronic infection [HBsAg positivity] was detected in 14.3% of children in the exposed group. There were no instances of chronic infection in the unexposed group [relative risk [RR]=13.48, 95% confidence intervals [CI] 1.8-100.02]. Previous infection of hepatitis B [HBcAb positivity] was found in 29 [29.9%] children in the exposed group, but only one [1.2%] in the unexposed group [RR=26.01, 95% CI: 3.61-186.95]. Immunity [HBsAb positivity] in the exposed group measured 48 [49.5%] and unexposed group measured 56 [64.4%] [R.R=0.76, 95% CI: 0.59-0.99]. Vaccination alone did not induce immunity against hepatitis B in high-risk children; it seems that routine screening of pregnant women is necessary for determining whether neonates need hepatitis B immunoglobulin after birth