Evaluating the efficiency of lettuce disinfection according to the official protocol in Iran

The objective of this study was to evaluate the efficacy of Sanitization of Lettuce according to the protocols set forth by Iranian Ministry of Health and Medical Education for reducing populations of total coliform, fecal coliform, and helminth eggs present on lettuce. In the present study, we determined the load of total coliform, fecal coliform, and parasites of lettuce. The lettuce was sanitized by protocol of Iranian Ministry of Health and Medical Education. The protocol consists of 3 levels to disinfect the fruits and vegetables. The procedure was as follows: first washing stage. The leaves of leafy vegetables washed with tap water, second stage, separation of helminth eggs by 3 to 5 droplets of detergent per liter for 5 min; third stage, disinfection of vegetables by calcium hypochlorite solution [with 200 mg/1 free chlorine] for 5 min; and finally the disinfected vegetables were washed with tap water. The average initial levels of total coliform and fecal coliform in the samples were 3.36 Iog[10]cfu/g and 2.31 log[10]cfu/g, respectively. Helminth eggs were not detected in any of the samples tested. The efficiency of total coliform and fecal coliform removal were 78.1% [0.75 Iog[10]cfu/g] and 79.6% [0.67 Iog[10]cfu/g], respectively, after washing. This increased up to 94.8[1.44 Iog[10]cfu/g] and 98.5% [1.90 log[10]cfu/g] after the use of detergent. Chlorine disinfection rose these amounts up to 98.3% [2.18 Iog[10]cfu/g] and 100% [2.31 Iog[10]cfu/g], respectively. By applying the protocol large parts of microorganisms existing on lettuce have indeed been removed

Population attributable fraction of bronchial anthracosis due to smoke exposure while baking home-made bread in ground oven

Some case-report studies in Iran showed probable association between anthracosis and smoke exposure due to baking homemade bread, population. Therefore we estimated the population attributable fraction [PAF] for this probable association in Iranian population. A hospital-based case-control study, including 83 anthracotic subjects [cases] with 72 controls from surgical ward which were matched by age, conducted in Imam Khomeini hospital in Tehran [From September 2009 to December 2010]. Patients in both case and control groups were interviewed according to [American Thoracic Society] guideline. Exposure to smoke was considered both as a binary and continuous variable [number of years being exposed to smoke] and the population attributable fraction [PAF] were estimated due to smoke exposure. Univariate analysis showed that exposure to smoke as binary variables, age and occupation exposure to dust and education were associated with anthracosis. After Adjusting, only smoke exposure [OR: 3.35, 95% Cl: 1.49-7.55] remain significant. Univariate logistic regression model showed exposure to smoke as continuous variable has significant association with anthracosis. In multiple logistic model only duration [years] of smoke exposure remained significant [OR: 1.05, 95%CI: 1.01-1.09]. PAF due to smoke exposure estimated approximately 48% in our population. Based on the findings of this study, it could be concluded that approximately half of the anthracotic cases are attributed to smoke exposure

Effect of air pollution on onset of acute coronary syndrome in susceptible subgroups

While long-term exposure to air pollutants is associated with an increase in heart diseases and mortality, little information is available about the short-term effects of air pollution. This case-crossover study assessed the relationship of particulate matter [PM[10]] and carbon monoxide [CO] levels with hospital admission for acute coronary syndrome in Tehran, Islamic Republic of Iran. We interviewed 250 patients with a first episode of acute coronary syndrome and obtained data from hospital records and Tehran Air Quality Control Company. The risk of acute coronary syndrome was significantly associated with elevated concentrations of CO the day before the event [OR 1.18; 95% CI: 1.03-1.34] but not significantly with PM[10] [OR 1.00; 95% CI: 0.99-1.02]. Stratification by age, sex, diabetes, hypertension and smoking status did not affect the results, but women were more susceptible than men to CO levels [OR for women/men 1.68; 95% CI: 1.25-2.26]

Noise pollution evaluation in residential and residential-commercial areas in Tabriz-Iran

Over the last three decades environmental pollutions became a more noticeable problem in all around of the world. In many countries, noise pollution as a basic problem has a great importance.Development of the city, increasing of industrial centers, increasing vehicles, other annoying noise resources and also little information about the noise pollution of Tabriz city, has led to the doing of this research. Sampling and measuring of noise pressure levels was done 180 times According to the EPA standards, measuring was done simultaneously in two stations [commercial-residential areas], three times a day [morning 7:30 -9:30 am, midday 12:30-14:30 pm and night 19:00-21:00 pm] and 30 days in month. Sound pressure level in both stations was higher than the standards and the highest average level with 71.4 db was recorded in Raste-koche station at midday. Also lowest calculated average value with 68.5 db was measured in Golbad station at the morning time that is 8.5 db higher than the standards. Average measured sound pressure level in two stations was higher than the standards. The results show that Tabriz has a noise pollution in commercial and residential - commercial areas. It is suggested that other noise pollution resources identified and the proper management actions for its reduction be done

Investigation of indirect contact freezing process in desalination of boshehr beach's saline water

Nowadays, most countries of the world have shortage of water due to many reasons such as population growth, rising of living standards, indiscriminate water use, and so on. Besides, in absence of adequate water resources, desalination of brackish and saline waters have been used to supply potable water. Freezing process is one of the methods which can be used to desalinate saline waters.The aim of this study was to survey freezing process to produce potable water from saline water of Persian Gulf shores. This study was conducted in lab-scale by using indirect contact freezing. Three samples of 50 liter were provided from Bushehr shores. The implemented process steps were freezing [crystallization], separation of crystals, surface washing, and thawing. Freezing of the samples [each in 0.5 liter containers] were performed by a refrigerator at -20°C and 0.1KW/h energy consumption. The removal efficiencies of TDS in the first, second, and third samples by first freezing process were 56, 56, and 51 percent, respectively. Moreover, the removal efficiencies by EC were 42, 44, and 40 percent, respectively. Meanwhile, the removal efficiencies of TDS in first, second, and third samples by second freezing process observed 69, 69, and 68 percent, respectively. Moreover, the removal efficiencies by EC were 61, 60. and 63 percent, respectively. Also, the removal efficiencies of TDS in first, second, and third samples by third freezing process were 72, 73, and 72 percent, respectively. Moreover, the removal efficiencies by EC were 77, 78, and 77 percent, respectively. The production of the potable water by this method was 15-20 percent of the entry water. According to the obtained results, potable water was obtained after third freezing of the saline water. Meanwhile, TDS of the produced water was less than maximum allowed concentration of Iranian standards

Levels of bisphenol A and bisphenol F in canned foods in Iranian markets

Bisphenol A and bisphenol F are chemical substances widely used in industry as monomers in the production of epoxy resins and polycarbonates, and as antioxidants in PVC. Epoxy resins are used as inner surface coating of food and beverage cans. The contamination of cans' content by bisphenol A and bisphenol F may pose a serious threat to human because of their estrogenic activity. In this study, the concentration of bisphenol A and bisphenol F in 48 cans of different kinds of foods [corn, tomato paste, stew and tuna fish] were determined by gas chromatography-mass spectrometry after solvent extraction with acetonitrile and preconcentration by headspace-solid-phase microextraction [HS-SPME]. Quantitative analysis was carried out based on spiked calibration samples and analyses were performed for each sample in triplicate. Bisphenol F was not detected in any of the canned foods with detection limits of 0.10 micro g/kg. There were significant differences among the mean concentrations of bisphenol A in all kinds of canned foods. The mean concentrations of bisphenol A increased significantly all samples after heating in [ANOVA p<0.05 and Kruskal-Wallis test p<0.05]; also tuna fish samples were found to be probably the most polluted groups in this study

Investigation of indoor and outdoor air bacterial density in Tehran subway system

The wide use of subway system by citizens underlines the importance of hygienic issues including indoor air pollution in these public places especially in metro stations. The aim of this study was to investigate the bacterial contamination in indoor and outdoor air of two metro stations [Imam Khomeini and Sadeghiyeh stations] in Tehran subway system. In this cross sectional study, three sampling locations were selected in each station. Also, sampling was conducted in indoor air of two types [old and new] of trains. The range of bacterial colony count was 35-1501 CFU/m[3]. Maximum and minimum bacterial contamination levels in Imam Khomeini and Sadeghiyeh platform stations were averagely 1073 CFU/m[3] and 242 CFU/m[3], respectively. 14 bacterial species and genera were isolated; among them the dominant species were Staphylococcus epidermidis, Micrococcus luteus and Bacillus spp. Results showed that bacterial concentrations in indoor air were higher than the outdoor air; also the bacterial counts correlated significantly with number of the passengers [p<0.001] and air temperature [p<0.001]

Extremely low frequency magnetic flux densities measured near hospital in Tehran

The ever increasing rate of power consumption has led to an increase in public exposure to extremely low frequency magnetic fields [ELF-MFs] and brought severe concerns about their health effects. Considering previous studies and the facts about potential health effects of these fields, the present study aimed to evaluate the ELF-MF flux densities from power distribution lines near hospitals in Tehran. ELF-MF measurements were performed according to IEEE standard procedures-Std 644-1994 near the hospitals entrances using HI-3604 Power Frequency Field Strength Measurement System during three different time periods [i.e. 12-3 AM, 9-12 AM, 6-9 PM]. The results were analyzed using One-Way ANOVA Test. Mean, minimum, and maximum values of ELF-MF flux densities were 0.165 +/- 0.08 microT, 0.018 microT, 0.52 microT, respectively. There were no statistically significant differences in ELF-MF flux densities neither among different hospital groups nor among different time periods. The ELF-MF flux densities from power distribution lines around Tehran hospitals were much less than the standards values, implying that it can be considered only in epidemiological studies. In fact, in the case of powerful sources, magnetic field intensity is declined rapidly by distance and is limited to a few meters around the sources. This subject is considered as one of the main reasons for contradictory results in previous studies. Results of the present study can be used as a part of hospital patients' exposure to quantify the total exposure levels of patients as a critical and sensitive group in Tehran hospitals

Psychosocial care for breast cancer: physicians' perspective

Many literatures have documented that psychosocial care can improve health outcomes and reduce morbidity in women with breast cancer. The aim of this study was to evaluate the opinion of the breast cancer professional team members on integration of psychosocial care in regular management of breast cancer. A cross sectional sample of 313 physicians involving in diagnosis, treatment and supportive care for breast cancer patients were interviewed using a questionnaire. The majority of participants [52.7%] declared that psychosocial care is necessary for all patients with breast complaints. All except one of the respondents irrespective to their age and job believed that providing the patients with psychosocial supportive care definitively have some positive points for the patients with breast cancer. Of all respondents, 29.6% thought it should be offered as soon as suspicion is raised toward breast cancer, 54.7% preferred to provide such care after the diagnosis of malignancy is confirmed, 11.3% thought it should be prescribed before surgery and 4.4% believed that care should be provided before adjuvant therapy. The necessity of providing psychosocial care for breast cancer patients was mentioned by the majority of respondents; however there are some major differences among the team members of breast cancer care in regard to psychosocial supportive care. The results of this study highlight the insufficient collaboration among medical team members and the necessity of multidisciplinary approach to all aspects of the important disease through programmed sessions and provide the patients with an integrated comprehensive care

Optimization of reactive blue 19 decolorization by ganoderma SP. using response surface methodology

Synthetic dyes are extensively used in different industries. Dyes have adverse impacts such as visual effects, chemical oxygen demand, toxicity, mutagenicity and carcinogenicity characteristics. White rot fungi, due to extracellular enzyme system, are capable to degrade dyes and various xenobiotics. The aim of this study was to optimize decolorization of reactive blue 19 [RB19] dye using Ganoderma sp. fungus. Response Surface Methodology [RSM] was used to study the effect of independent variables, namely glycerol concentration [15, 20 and 25 g/L], temperature [27, 30 and 33 °C] and pH [5.5, 6.0 and 6.5] on color removal efficiency in aqueous solution. From RSM-generated model, the optimum conditions for RB19 decolorization were identified to be at temperature of 27°C, glycerol concentration of 19.14 mg/L and pH=6.3. At the optimum conditions, predicted decolorization was 95.3 percent. The confirmatory experiments were conducted and confirmed the results by 94.89% color removal. Thus, this statistical approach enabled to improve reactive blue 19 decolorization process by Ganoderma sp. up to 1.27 times higher than non-optimized conditions

Determination of urinary concentrations of organic oxygenates in urban workers

Methyl tert-butyl ether, ethyl tert-butyl ether and tert-amyl methyl ether are oxygenated compounds added to gasoline to enhance octane rating in replacement of alkyl-lead compounds. In the present study the excretion of urinary methyl tert-butyl ether, ethyl tert-butyl ether and tert-amyl methyl ether were evaluated as biomarkers of exposure to gasoline. With this aim, 10 policemen engaged in traffic control, 10 gas station workers and ten occupationally non-exposed persons were investigated. Spot urine samples were obtained prior to and at the end of the work shift from each subject. The urinary levels of oxygenated ethers were determined by using head-space gas chromatography and mass spectrometry detection. There were significant differences among the mean urinary concentrations of methyl tert-butyl ether in pre-shift samples of gas station workers [1193 ng/L], policemen [734 ng/L] and occupationally non-exposed persons [49 ng/L]. The mean urinary concentrations of methyl tert-butyl ether and tert-amyl methyl ether differed significantly among post-shift samples of gas station workers [16636 and 8655 ng/L], policemen [14458 and 1472 ng/L] and occupationally non-exposed persons [324 and 59 ng/L] [ANOVA: p<0.05 and Kruskal-Wallis test: p<0.05]. There was a significant difference in methyl tert-butyl ether concentrations between job categories [p<0.05 by ANOVA and Kruskal-Wallis test], and gas station workers and policemen were found to be probably the most exposed groups in this study

Survey on degradation rates of trichloroethylene in aqueous solutions by ultrasound

Sonochemical degradation of different compounds such as chlorinated aliphatic hydrocarbons is one of the recent advanced oxidation processes and it may be effective for removing low concentration organic pollutants from aqueous streams. Trichloroethylene [TCE] is one of these compounds that is mainly used as a degreaser. Important studies about TCE sonolysis have been focused at millimolar levels and natural pH, but in this study the ultrasonic degradation of TCE at different micromolar initial concentrations [30, 300 and 3000 micro g/L] and 4 different initial pH with a 35 kHz frequency was investigated. Furthermore, the degradation of TCE by ultrasound with different concentrations of hydrogen peroxide at pH= 7 was also performed. Gas chromatography with FID detector was used for analyses of TCE. Results showed that the degradation of TCE increased with decrease in the initial concentration of TCE from 3000 to 30 micro g/L at all initial pH. Initial pH of solution and different concentrations of H[2]O[2] did not affect significantly the TCE destruction

Neonatal mortality risk factors in a rural part of Iran: a nested case-control study

Due to complex causal framework of neonatal mortality, improvement of this health indicator is quite gradual and it's decreasing trend is not as great as other health indicators such as infant and under 5 mortality rates.This study was conducted to evaluate neonatal mortality risk factors based on nested case-control design. The study population was 6900 neonates who were born in rural areas of Kohgiluyeh and Boyerahmad province [South of Iran]. They were under follow up till the end of neonatal period and the outcome of interest was neonatal death. By using risk set sampling method, 97 cases and 97 controls were selected in study cohort. Prematurity [OR = 5.57], LBW [OR= 7.68], C-section [OR = 7.27], birth rank more than 3 [OR = 6.95] and birth spacing less than 24 months [OR = 4.65] showed significant statistical association [P < 0.05] with neonatal mortality. The Population Attributable Fraction [PAF] was 0.45 for LBW, 0.40 for prematurity, 0.28 for C-section, 0.30 for birth rank more than 3, and 0.16 for birth spacing less than 24 months. Prematurity, low birth weight, C-section, birth spacing less than 24 months and birth rank more than 3 are important risk factors for neonatal mortality

[Methodological assessment of case-crossover studies]

The case-crossover design was developed in the early 1990s to study the effects of transient, short-term exposures on the risk of acute events such as myocardial infarction. To estimate relative risk, the exposure frequency during a period just before outcome onset [hazard period] is compared with exposure frequency during control time[s] in that person rather than in a control. One or more "control times" are supplied by each of the cases themselves to control for confounding by constant characteristics and self-confounding between the trigger's acute and chronic effects. In the analysis of case-crossover studies, exposure frequency in the hazard period is compared with the control period or the individual's usual frequency of exposure. The design has been used frequently for heart diseases, injuries and air pollution epidemiology. This review article looks at published case-crossover studies and is intended to help the reader gain a better understanding of the strengths and limitations of the case-crossover design in studying the epidemiology of injuries and air pollution

[Qualitative assessment of dimensions and degree of autonomy granting to university hospitals]

The aim of this study was to determine the key organizational dimensions that influence the autonomy of university hospitals and the level of granted autonomy in each dimension. Six hospitals were randomly selected from those affiliated with three medical universities of Tehran, Iran and Shahid Beheshti. In this qualitative study, we interviewed 27 hospital managers [response rate of 82%]. The semi-structured interview guide was developed based on the results of four initial in-depth interviews and the organizational reform model of the World Bank. We used the framework method for the analysis of qualitative data. Nine themes were identified as the key factors influencing hospital autonomy: decision right in strategic management, decision right in human resources management, decision right in financial management, decision right in physical resources management, product market exposure, procurement market exposure, financial residual claim, governance arrangements and accountability mechanisms, and social functions of the hospitals. Limited decision rights in strategic, human resources, and physical resources management were granted to hospitals. Hospitals were not the financial residual claimant, but were exposed to competitive product market. Autonomy was limited regarding the procurement market. Governance systems were hierarchical and accountability mechanisms were supervisor-supervisee oriented. Some of the social functions of the hospitals were defined, but the expenses of these functions were not totally reimbursed by the government and the insurance industry. The autonomy granted to the hospitals is unbalanced and paradoxical. More decision rights should be granted for management of strategic, human resources and physical resources as well as hospitals entry to the procurement market. Hospitals need to be the financial residual claimant. The hierarchical administrative systems should be transformed to cooperative ones. Instead of supervisor-supervisee oriented control measures, Ministry of Health and Medical Education needs more regulatory mechanisms for controlling hospitals' performance and social functions

[HIV positive patients and utilization of dental health services]

To determine the level of dental health services utilization by HIV-positive patients. In this study we used a proportional random sampling method to select 230 HIV-positive patients from three HIV counseling centers. An anonymous questionnaire was completed for each patient. The total demand for dental services was 165. The rate of demand was 47.9% and the rate of utilization was estimated 75.9%. Most patients [56%] did not have insurance. Only 60% of these individuals notified the health workers of their HIV status. The most common reason for not demanding services was high cost, and the most common reason of non-utilization was the refusal by health workers to provide services. The main reason for not reporting the HIV-positive status was fear of rejection by the dentist. Inadequate insurance coverage and poverty might result in decreased access to dental health in HIV-positive individuals. In addition there is need to improve knowledge of HIV in dentists and change their attitudes and practices in order to increase utilization of dental services by HIV-positive patients

[Qom wastewater disinfection with hydrogen peroxide-silver ion complex]

Hydrogen peroxide solution with stabilized formulation with oligodynamic amounts of silver ion [trade mark: Nanosil] recently became a popular disinfectant for fruits, vegetables, surfaces, medical instruments and so on. This study was based on determining efficiency of hydrogen peroxide-silver ion complex in six different concentrations measured through removal of total coli forms from samples taken from Qom wastewater. All six different concentrations of disinfectant were incubated separately with wastewater for one hour. Sample size was 12 and sampling was done weekly. In the concentration of 80 and 480 mg/1, logarithmic removal value of total coli forms was 1.9 and 4.5 respectively. In CT value 8600 [mg/l].min and more, the total coli forms effluent standard for surface water discharge and agriculture irrigation was achieved [Iranian environmental protection agency act]. Use of hydrogen peroxide-silver ion complex as a water and wastewater disinfectant, has some benefits such as elimination of hazardous by products, measurable residual amount and so on. However its application in wastewater effluent is more costly than other usual disinfectants so it is not economically advisable

[Noise pollution in Zanjan city in 2007]

Noise pollution is an important environmental problem that may cause hazardous effects, such as hearng loss, sleep disorders, hypertension and digestive problems in communities. To prevent these effects, achieving recommended standards of noise pollution measuring in cities is mandatory. This study was aimed to evaluate noise pollution in zanjan city in 2007. For measuring environmental noise levels, 64 samples were selected in 2 weeks. They were selected from 16 residential and commercial areas, 4 times daily [morning, noon, evening and night]. Noise indices were measured in A weight channel. Measurements at considered stations were gathered using a sound meter apparatus model cel-268. The maximum equivalent sound level, in A weight channel was detected at night from Sadre Jahan crossroad and at day from Sadi crossroad, being 72db and 77.7db respectively. Significant difference was seen between equivalent sound levels of night and noon [P=0.048] and night and evening [P=0.03]. It was concluded that Zanjan city noise pollution at both residential and commercial areas is higher than that of international standards in most instances. The results were also similar to the findings of other studies in Iran

Economic valuation of premature mortality and morbidity

The air in Tehran is one of the most polluted airs in the entire world. Because of the air pollution in the Great Tehran area, morbidity, mortality and symptoms emerge. This study has been conducted for the first time in Iran. According to this study the total annual direct medical costs of morbidity estimated at US$ 3258255.48.Our work also led to the estimation of an income elasticity of WTP for reduction in the probability of premature mortality,that is, an income elasticity of the value of a statistical life. The total annual mortality damage cost estimated at US Dollar 232538684.38. Contingent valuation [CV] was utilized in order to place monetary values on symptoms. By using CV, the economic value of each symptoms was estimated per person per day. The use of CV in this study required that a questionnaire be prepared and the Willingness to Pay of Tehran citizens be estimated by a random sampling. Finally the total health damage costs of air pollution in Tehran or benefits of reducing air pollution estimated at US Dollar 663776276 annually

[Evaluation of the effects of high-risk pregnancy on neonatal mortality in a rural area of Iran: a nested case-control study]

A pregnancy can be considered high-risk if there are conditions that put the mother or the baby at higher-than-average risk of morbidity or mortality. Neonatal mortality rate is one of the most important indices of children's health status. The present study was conducted to evaluate the effects of high-risk states on neonatal mortality. We performed a nested identified case-control study in the rural areas of Kohgiluyeh and Boyerahmad province. Within the study cohort, 97 cases and 97 controls were selected by a risk-set sampling method. Data were analyzed with univariate and multivariate conditional logistic regression models. Neonatal mortality was shown to increase significantly in high-risk pregnancies. There were no substantial differences between crude odds ratios and those adjusted for the presence of other risk factors [crude odds ratio decreased from 5.5 to an adjusted figure of 3.25 for pregnancies with one risk factor and from 5.21 to adjusted level of 4.80 for pregnancies with more than one risk factor]. High-risk pregnancies need great attention in family health and prenatal care programs, especially in remote rural areas. Within our rural health network there are potential cohorts for use in nested case-control studies, especially in the evaluation of neonatal mortality risk factors