ABSTRACT
Air pollution is a hazardous environmental problem with several adverse health effects including its impact on the development of chronic diseases as diabetes mellitus. This study aimed to investigate the association of geographical distribution of air quality index [AQI] and type 2 diabetes mellitus in an air-polluted city by using geographic information system [GIS]. This cross-sectional study was conducted in Isfahan, Iran. The records that have been registered from 2009 to 2012 in major referral public diabetes clinics were gathered; they included data of 1467 diabetic patients. Their living area was represented with spots in the city map. AQI data were also interpolated from monitoring stations spreading around the city. The GIS maps of air pollutants and diabetes were developed and the associations were determined. The density of diabetic population was higher in highly polluted areas compared with areas with the lower levels of air pollution. No significant correlation was documented between the distribution of diabetic patients and air pollution level throughout the city. Although the density of diabetic patients was higher in areas with higher air pollution, but the lack of association between AQI and the prevalence of diabetes might be because the air of different parts of the city was highly polluted, and we could not compare the prevalence of diabetes in areas with clean and polluted air
Subject(s)
Humans , Male , Female , Air Pollution , Geographic Information SystemsABSTRACT
As geographic science discusses the analysis of environment, human beings and their mutual relations, thus the field of medical geography consists of being inspired from the relations between these two factors, analyzing environmental factors, their identification them and the state of their effects on human health, as well as determining the location of these factors. Some hazards that threat human health are the results of environmental factors and the relevant pollutions. Some important categories of diseases including [Shortness of Breath or, Dyspnea] have considerable differences in various places, as observed in their spatial prevalence and distribution maps. The record of patients with Dyspnea diseases were prepared for this descriptive research, for the period of 2009-2011, from the provincial health center, with the questionnaires were excluded patients with a family history of disease and the spatial diagram for disease prevalence was drawn according to the prepared data. The arsenic geographical distribution diagram in Isfahan province was also prepared and then the relation between an element of Arsenic in the province and the Dyspnea diseases were analyzed. The analyses showed that the highest rate of Arsenic is entered the soil via fertilizers to come eventually into the food cycle of humans. By analyzing the amount of used fertilizers in Isfahan province and the dispersion diagram of Arsenic in Isfahan province, it was found that the highest frequency of Arsenic is in places having agricultural base. The spatial dispersion of Dyspnea diseases also showed that the spreading of Dyspnea diseases is greater in places with higher scale of Arsenic. This study is a logical justification between the two diagrams to confirm the hypothesis regarding the effect of arsenic on Dyspnea
ABSTRACT
The aim of this study is to investigate the association of calcium and magnesium concentration of drinking water with cardiovascular disease [CVDs] in urban and rural areas of a city in Iran. This case-control study was conducted in 2012 in Khansar County in Isfahan province, Iran. We used the official data of the Provincial health center regarding the chemical analysis data of urban and rural areas including the hardness, calcisum and magnesium content of drinking water. Data of patients hospitalized for CVD in the only specialty hospital of the city was gatheresd for the years of 2010 and 2011. In 2010, the increase in the calcium hardness above 72 mg/L, the prevalence of CVDs in 1000 population decreased; in 2011 this decrease in CVDs was observed for calcium hardness of more than 75 mg/L. In 2010, the level of Mg hardness in water ranged from 23 to 57 mg/L. By increasing Mg hardness level above 31 mg/L in 2010 and above 26 mg/L in 2011, the number of CVD in 1000 people decrease. Our study suggests favorable protective effects of water hardness, mainly water magnesium content, on CVDs. Water hardness, as well as calcium and magnesium content of drinking water may have a protective role against CVDs. Further experimental studies are necessary to determine the underlying mechanisms and longitudinal studies are required to study the clinical impacts of the current findings
ABSTRACT
To determine inequality in mortality in 1-59 months children across Iranian provinces focusing on referring system and determinants of death. After designing and examining a national questionnaire for mortality data collection of children 1-59 months, 40 medical universities have been asked to fill in the questionnaires and return to the main researcher in the health ministry in 2009. Mortality in 1-59 months children was unequally distributed across provinces [universities]. The recommended refer was 3466 but only 1620 patients were referred. The first five important determinants of death were congenital [671 children or 20.9%], accident [547 children or 17.1%], pulmonary diseases [370 children or 11.5%], cardiovascular [266 children or less than 8.3%], central nervous system [263 children or 8.2%], and infectious and parasitic diseases [245 children or 7.6%], respectively. Our results suggest that inequality in 1-59 months mortality based on the hospital records, and specially referring system, needs more attention in Iran. In addition, it is advisable to conduct provincially representative surveys to provide recent estimates of hospital access inequalities and to allow monitoring over time
ABSTRACT
Regarding the importance of air pollution issue for large cities, as Tehran metropolis, many plans, programs, projects and regulations have been developed to manage urban air pollution. However, most of them failed to decline the pollution. The purpose of this study is to pathologically analyze air-pollution control plans in order to offer effective solutions for Tehran metropolis. A qualitative content analysis and a semi-structured interview with 14 practicing professionals were used to identify key causes and sources of Tehran's air pollution, to recognize challenges and obstacles towards effective performance of air-pollution control plans in this metropolitan area, and to suggest the most effective controlling solutions. Challenges related to air-pollution control plans can be divided into two major categories: Firstly lack of integrated and organized stewardship and secondly those related to political, economical, social and technical environmental abbreviated as PEST, challenges. For effective control of the Tehran air pollution, the following eight controlling alternatives were identified: Systematization of plan preparation process, organizing the stewardship, standardization and utilization of new technologies and professional experts, cultural and infrastructural development, realization of social justice, developing coordination and controlling mechanisms, improving citizen's participatory capacity, and focusing on effective management of fuel and energy. Controlling air pollution in Tehran should be considered as a priority for policymakers to make enforcements through applying a systemic cycle of preparation effective and comprehensive plans. Further, implement the enforcements and evaluate the environmental impact of the plans through involving all stakeholders
ABSTRACT
To determine the distribution of mortality in 1 - 59 month-old children across Iranian provinces in a national mortality surveillance system. This national survey was conducted in 2009. A questionnaire was designed and standardized for collecting mortality data of children aged 1 - 59 months. The project team, consisting of collaborators from the whole 40 medical universities, filled in the questionnaires and returned them to the Ministry of Health and Medical Education [MOHME]. The mortality in 1 - 59 month-old children was unequally distributed across provinces. The mortality was higher among children of less- educated mothers than in children of more- educated mothers. There was a reverse association between 1 - 59 months mortality and socioeconomic status across Iran as a whole and within most provinces. Our results suggest that socioeconomic distribution in mortality of 1 - 59 month-old children favors the better-off in Iran as a whole and in most of its provinces. Investigating why mortality is higher in some provinces deserves special attention. Furthermore, it is advisable to conduct provincially-representative surveys to provide update estimates of different health situations and to allow their monitoring over time
Subject(s)
Humans , Female , Male , Population Surveillance , Data CollectionABSTRACT
To assess the national inequality of school readiness and autism among 6-year-old Iranian children before school entry using a national health assessment survey. In a cross-sectional nationwide survey, all Iranian children entering public and private elementary schools were asked to participate in a mandatory national screening program in Iran in 2009 in two levels of screening and diagnostic levels. The study population consisted of 955388 children [48.5% girls and 76.1% urban residents]. Of the whole children 31% of the 6 year old children had impaired vision In addition, 1.2, 1.8, 1.4, 7.6, 0.08, 10, 10.9, 56.7, 0.7, 0.8 and 0.6 percent had color blindness, hearing impaired, speech disorder, school readiness, autism, height to age retardation, body mass index extremes, decayed teeth, disease with special needs, spinal disorders, and hypertension, respectively. The distribution of these disorders was unequally distributed across provinces. Our results confirmed that there is an inequality in distribution of school readiness and autism in 6-year-old children across Iranian provinces. The observed burden of these distributions among young children needs a comprehensive national policy with evidence-based province programs to identity the reason for different inequality among provinces
Subject(s)
Humans , Male , Female , Child , Socioeconomic Factors , Cross-Sectional StudiesABSTRACT
A school-based surveillance system entitled the childhood and adolescence surveillance and prevention of Adult No communicable disease [CASPIAN] Study is implemented at national level in Iran. This paper presents the methods and primary findings of the third survey of this surveillance system. This national survey was performed in 2009-2010 in 27 provinces of Iran among 5570 students and one of their parents. In addition to physical examination, fasting serum was obtained. Body mass index was categorized based on the World Health Organization growth charts. Data of 5528 students [2726 girls, 69.37% urban, mean age 14.7 +/- 2.4 years] were complete and are reported. Overall, 17.3% [17.3% of girls and 17.5% of boys] were underweight, and 17.7% [15.5% of girls and 19.9% of boys] were overweight or obese. Abdominal obesity was documented in 16.3% of students [17.8% of girls and 15% of boys]. 57.6% of families consumed breads, the staple food for Iranians, prepared with white flour. Most families [43.8% in urban areas and 58.6% in rural areas] used solid hydrogenated fats. 22.7% of students did not add salt to the table food. 14.2% of students reported to have a regular daily physical activity for at least 30 min a day. Overall, 10.4% of students [11.7% in urban areas and 7.3% in rural areas] reported that they used tobacco products, often water pipe. 32.8% of students experienced at least three times of bullying in the previous 3 months. During the year prior to the survey, 14.46% of students had an injury needing the interference by school health providers. This survey is confirmatory evidence on the importance of establishing surveillance systems for risk behaviors to implement action-oriented interventions
ABSTRACT
Little experience exists on valid and reliable tools for assessment of the determinants of underweight and overweight in children and adolescents living in the Middle-East and North Africa [MENA]. This study aimed to develop a valid and wide-ranging questionnaire for assessment of these parameters in a nationwide sample of Iranian children and adolescents. This national study was conducted in 31 provinces in Iran. The first phase consisted of focus group discussion with 275 children and adolescents and their parents. After a qualitative content analysis, the initial items were extracted. In the next step, the face validity was assessed by expert panelists using the quantitative method of the Impact Score. To assess the content validity, the content validity rate [CVR] and the content validity index [CVI] were determined. The internal consistency was examined by Cronbach alpha, and its test-retest reliability was determined. The socio-demographic variables, perinatal factors, lifestyle factors, family history, knowledge and attitude were assessed. Dietary intakes were assessed using a validated 168-item semi-quantitative food frequency questionnaire. A validated questionnaire for quality of life was filled in anonymously. A team of expert researchers conducted the data analysis of 576 interviews by using qualitative content analysis method. The analysis process began by determining the semantic units associated with the understanding of participants about the concepts studied. The initial questionnaire was developed in four domains by including Likert scale questions. In the face validity step, all questions of the primary questionnaire obtained a score of more than 1.5. In the phase of CVR assessment, 6 questions obtained a score of less than 0.62, and were omitted. The rest of questions were assessed for CVI, and got a score of more than 0.75. Cronbach's alpha coefficient of the whole questionnaire was 0.97, and the Pearson correlation coefficient of the test-retest phase was 0.94. The developed questionnaire is a valid and reliable tool for assessment of the determinants of weight disorders in a nationally representative sample of children and adolescents in the MENA
ABSTRACT
This study aimed to develop and test the validity of a risk score to be used as a simple tool to identify those children at high risk of sonographic non-alcoholic fatty liver disease [NAFLD]. This cross-sectional study was conducted among 962 participants aged 6-18 years in Isfahan, Iran. They consisted of three groups of nearly equal number of normal-weight, overweight and obese individuals. Coefficients of the logistic regression models were used to assign a score value for each variable and the composite sonographic NAFLD risk score was calculated as the sum of those scores. Performance of model was assessed by receiver operating characteristic [ROC] curve procedure. Data of 931 participants was included in the analysis. The sonographic findings of 16.8% of participants were compatible with NAFLD. Age, sex, body mass index, waist circumference and serum triglycerides level were diagnosed as factors associated with NAFLD. The risk score was calculated as 50 for sonographic NAFLD. This study, to the best of our knowledge is the first of its kind in the pediatric age group, focuses on predicting sonographic NAFLD from easily-measured factors. It may suggest an association of hypertriglyceridemic-waist phenotype with NAFLD in the pediatric age group
Subject(s)
Humans , Male , Female , Predictive Value of Tests , Child , Adolescent , Cross-Sectional Studies , Logistic Models , Risk FactorsABSTRACT
To determine the association of cell blood count with obesity and cardiometabolic risk factors in children. This cross-sectional study was conducted from 1 st November 2007 to 1 st October 2008 in the Obesity and Metabolic Syndrome Research Clinic of the Preventive Pediatric Cardiology Department, Isfahan Cardiovascular Research Center, Isfahan, Iran. It comprised 326 [172 girls and 154 boys] obese children aged 6-12 years. The mean age of participants was 8.8 +/- 2.7 years. A significant increasing trend in the mean body mass index [BMI], waist circumference [WC], triglycerides [TG], total- and low density lipoprotein [LDL]- cholesterol were documented across the quartiles of the white blood cell [WBC]count, and for waist-to-hip ratio and total cholesterol across platelet quartiles. A similar increasing trend was documented for BMI, waist and hip circumference, diastolic blood pressure, LDL-C, and for TG from the second to the fourth quartile of the red blood cells. By the increase in the number of components of metabolic syndrome, the mean BMI, WBC, and TG increased significantly. The highest correlation was documented between WBC count and TG. The WBC count increased the risk of increased BMI [odds ratio [OR]=1.45, confidence interval [CI] 95%; 1.11-1.65, p=0.001], increased WC [OR; 1.47, CI 95%; 1.15-1.74, p=0.001], and high TG [CI 95%; 1.241.06-1.44,p=0.005]. We found significant associations between CBC components and cardiometabolic risk factors in young obese children. The findings are confirmatory evidence of the pro-inflammatory state of obese individuals, even in young children
Subject(s)
Humans , Male , Female , Child , Obesity/epidemiology , Metabolic Syndrome/epidemiology , Metabolic Syndrome/blood , Triglycerides/blood , Obesity/blood , Cholesterol/blood , Body Mass Index , Cross-Sectional StudiesABSTRACT
To provide a low- cost and simple model of culturally-appropriate and low cost facilities for improvement of physical activity for girls and their mothers through an after-school program and to determine the changes in anthropometric indexes after this trial. This national study was conducted in 2006-2007 in 7 provinces with different socioeconomic situations in Iran. Female students who studied in the 7[th] through 10[th] grade and their mothers were selected by random cluster sampling. In each province, 24 sessions of after-school aerobic physical activity were held for 90 minutes, two days a week, and 3 months long at school sites in the afternoon. The study comprised 410 participants [204 mothers and 206 daughters], with a mean age of 15.86 +/- 1.01 and 40.71 +/- 6.3 years in girls and their mothers, respectively. The results of the focus group discussions showed that in general, both mothers and daughters of generalized and abdominal obesity improved significantly both in girls and in their mothers [P-value <0.0001 for weight, body mass index and waist circumference]. Our findings may provide a low-cost and simple effective model of motivation for physical activity with targeted interventions for girls and their mothers. We suggest that the success of this trial might be a result of bonding and accompaniment of mothers and daughters. Such model can be integrated in the existing health and education systems to increase the physical activity level
Subject(s)
Humans , Female , Adolescent , Mothers , Anthropometry , Obesity, Abdominal , Obesity , Body Mass Index , Waist Circumference , Body WeightABSTRACT
<p><b>OBJECTIVE</b>Lead poisoning is a potentially devastating problem among young children. Chronic low level lead exposure can lead to learning disabilities and behavior changes such as colic, insomnia, hyperactivity, impaired growth, hearing loss and upper extremity weakness. The purpose of this cross sectional study was to determine the blood lead level in children with neurological disorders in comparison with healthy controls.</p><p><b>METHODS</b>Blood lead concentrations were measured by flame atomic absorption spectrometry in 100 children aged 1-10 years and suffering from various neurological disorders. One hundred age and sex-matched healthy children served as controls.</p><p><b>RESULTS</b>The mean blood lead concentration was higher in children with neurological disorders than in controls (113.2 + or - 47.5 microg/L vs 84.7 + or - 38.0 microg/L; p<0.01). Overall, 44% of children with neurological disorders and 19% of controls were found to have increased blood lead levels, i.e.>100 microg/L.</p><p><b>CONCLUSIONS</b>An increase in blood lead level in children might be related to neurological disorders. The measurement of blood lead level might be included in diagnostic eveluation of children with neurological disorders.</p>