Journal of Health Research in Community

1-11

Authors: Mohammad Reza Nezhadhossein , Leila Sadat Barati , Shokat Faraj , Sadegh Lolo , Somayeh Parvin , Mohammad Ali Nejad Rasouli

Introduction and purpose: Health literacy refers to the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions. This concept is an important element of a person’s ability to engage in health promotion activities. Regarding this, the present study was conducted to evaluate health literacy among the urban and rural communities of Behbahan County in Iran. Methods: This study descriptive analytical study was performed on 794 literate individuals aged 17 years or higher. The study population was selected using cluster sampling method. The data were collected using the Iranian Health Literacy Questionnaire. Results: The mean age of the subjects was 40.2±14.21% years. About 53% of the subjects were male. In terms of education level, 32.5% and 18.6% of the participants had diploma and bachelor’s degrees, respectively. Furthermore, the mean health literacy of urban and rural communities was obtained as 70.22%. The results revealed no significant differences between the urban and rural communities in terms of health literacy (P>0.05). Conclusion: The findings indicated that overall health literacy was at a desirable level in Behbahan County. However, given a lower health literacy in women, village residents, and elderly and middle-aged groups, health providers should adopt more effective methods for the transmission of information to these people.

20-33

Authors: Kamyar Yaghmaeian , Safiyeh Ghobakhloo , Sajad Mazloomi

Introduction and purpose: Urban outdoor air is contaminated with a variety of harmful agents that can lead to an increase in mortality and morbidity rate through short-term exposure. In recent studies conducted in Iran, the health effects of suspended particles with a diameter of less than 2.5 micrometers (PM2.5) have been investigated and the results of many studies have proven the adverse effects of air pollutants on human health. The present study investigated the air quality and evaluated the health effects of PM2.5 on the residents of Semnan in 2017. Methods: The air quality index (AQI) introduced by the Environmental Protection Agency was used in order to evaluate the air quality. In addition, for the purpose of health effects evaluation AirQ software was utilized, which is proposed by the World Health Organization. It is worth mentioning that AQI was calculated by the interpolation between the concentration of the pollutants for PM2.5 and classified based on standard charts and tables. In AirQ software, the concentration of PM2.5 was utilized to assess human exposure and health effects in terms of the ratio attributable to the health implications, annual number of deaths for all causes, as well as cardiovascular and respiratory diseases. Results: According to the obtained results of this qualitative study, it was revealed that air quality has exceeded the standard level almost 18% (AQI>100); it was reported as unhealthy and dangerous in 6% and 2% of the days of the year, respectively. Based on the findings, the annual average of concentration was estimated as 18 μg/m3. Moreover, the maximum number of exposure days to PM 2.5 was related to the concentration of 13-25 μg/m3. Furthermore, more than 80% of the cardiovascular and respiratory mortalities, as well as the referrals of outpatients with respiratory and heart diseases, belonged to the same concentration class. Conclusion: Despite the limitations of using AirQ software (version 2.2.3) this method is an effective, easy, and helpful tool for decision-making.

42-55

Authors: Zahra Asadi-Saatlou , Navid Dinparast Djadid , Saber Raeghi , Naseh Maleki-Ravasan , Saber Gholizadeh

Introduction and purpose: Human malaria is one of the widespread vector-borne diseases worldwide. Lots of efforts have been made to control and eliminate the vectors of the disease. Anopheles gambiae and Anopheles stephensi (A. stephensi) are the main vectors of malaria in Africa and Asia. The members of Anopheles gambiae complex contain the vector and non-vector species. A. stephensi has three biological forms with different vector capacities. The phenotypic and genotypic diversity has made it more difficult to identify vector populations and consequently the surveillance and control of malaria. The present study aimed to compare the morphological and molecular diagnostic characteristics of the two important malaria vectors in the two world continents. Methods: After searching, studying, and organizing published papers related to the subject, Anopheles gambiae and A. stephensi species were compared based on the morphological and molecular characteristics. Different morphological keys for the two species, the specimens from the insectarium of Urmia University of Medical Sciences, as well as the present species of national insectarium in Pasteur Institute of Iran, were used for morphological comparison. In addition, all the present sequences of five molecular markers, including COI, COII, D3, ITS2, and OBP1, were extracted from GenBank and analyzed using bioinformatics software. Results: Based on the obtained results of the present study, the number of ridges on Anopheles gambiae eggs was more than that on A. stephensi eggs. However, unlike A. stephensi in Anopheles gambiae, the number of ridges was not a diagnostic characteristic for the identification of Anopheles gambiae complex. There were four diagnostic characteristics in the larvae comparison of the two species and there were three different characteristics in adults. All the molecular markers were capable of separating the two species; however, ITS2 and D3, as well as COI, COII, and OBP1 markers were preferred for inter-species and intra-species comparisons, respectively. Conclusion: The combination of traditional diagnostic and new molecular methods can be simultaneously used in inter-species separation. As a result, in order to eliminate malaria in Iran and the countries covered by The World Health Organization Regional Office for the Eastern Mediterranean, it is recommended that the combination of morphological, molecular, and field epidemiological data can provide practical solutions for vector control programs. Obviously, none of these data exclusively respond to the needs of the mentioned programs. Furthermore, the coordination, design, implementation, and evaluation of applied projects, as well as executive actions, are necessary for the success of these programs regarding the elimination and eradication of malaria and other vector-borne diseases.

68-78

Authors: Mostafa Mohammadnejad Araei , Hamidreza Nassehinia , Yousef Dadban Shahamat , Mohammad Ali Zazouli

Introduction and purpose: One of the important problems in the management of waste is the health and environmental hazards of the leachate leakage of urban waste landfills to groundwater. This research aimed to investigate the improvement of the landfill properties using recycled polymer. Methods: In this study, PET: Polyethylene Terephthalate and clay were mixed with the ratio of 0, 0.1, 0.2, 0.3, 0.4, 0.5, 0.6, 0.7, 0.8, 0.9 and 1 wt%. Moreover, Moreover, its effect on the quality parameters of clay, including consolidation, settlement, shear stress, adhesion, and infiltration were determined in soil mechanics laboratory located in the city of Gorgan. All experiments were conducted based on American Society for Testing and Materials. Results: Results showed that the internal friction angle in clay and clay composed with polymer were 20.93 wt% and 30.3 wt%, respectively. Moreover, the compaction of clay decreased from 0.163 g/cm2 to 0.110 g/cm2. Permeability results showed that the use of PET decreased the permeability of soil from 1.82 E-3cm/min to 1.57 E-3cm/min. Conclusion: The use of recycled polymer can improve the soil conditions of landfills in terms of permeability and resistance to leaching, which could reduce the volume and the recycling process of waste. Moreover, this issue contribute to the quality and strength of the substrate to prevent environmental contamination as well as groundwater polution.

1-13

Authors: Majid Kermani , Ali Esrafili , Roghaye Piri , Nastaran Asadzadeh Seyedeh

Introduction and purpose: Chlorophenol is known as one of the toxic and dangerous pollutants in industrial wastewaters that’s a essential to it’s removal from industrial wastewaters and ground waters. The aim of this study was to investigate the efficiency of 4-Chlorophenol (4-CP) degradation using Ultraviolet/Hydrogen Peroxide process (UV/H2O2). Methods: The variables of the present study included initial concentration of pollutant, contact time, pH, and H2O2 concentration on 4-Chlorophenol removal on a laboratory scale. The concentration of residual 4-Chlorophenol was determined using UV/Visible at a wavelength of 280nm. In addition, the amount of mineralization in optimal conditions was evaluated using the measurement of total organic carbon (TOC) removal range according to the standard method 5310- B. Synthetic models of the process were also investigated. Results: The optimum removal efficiency of 4-CP by UV/H2O2 process regarding the concentration of hydrogen peroxide was 580 mg/L. pH of 3 and initial 4-CP concentration was obtained as 380 mg/L, and the presence of UV rays with a wavelength of 254 nm during 30m contact was 84.92% . In addition, 84.69% of the TOC was removed under the optimal condition. Moreover ,it was found that the data followed the first-order synthetic models. Conclusion: Considering the growing use of UV radiation in water treatment processes and the considerable efficiency of UV/ H2O2 process in removing 4-CP, this method can be proposed for the elimination of 4-CP after performing cost-benefit analyses. It can be concluded that with regard to purification goals and standards for wastewater treatment, UV/ H2O2 process can be used as a pre or final treatment.

23-32

Authors: Somayeh Samani , Maryam Ghaljahi

Introduction and purpose: Musculoskeletal disorders (MSDs) are among the most important causes of disinclination to work and reduced work incentives and can lead to occupational stress over time. The purpose of this study was to investigate the relationship between the prevalence of MSDs and occupational stress among rural carpet weavers in Sistan and Baluchestan, Iran. Methods: This descriptive analytical study was conducted on 100 female carpet weavers living in four villages of Sistan province. The study population was selected through convenience sampling technique. The estimation of the prevalence of MSDs and job stress was accomplished using the Nodric questionnaire for Psychological and Social Factors at Work. Data analysis was performed in SPSS software (version 16) using t-test and Pearson correlation coefficient.Results: According to the results, the female carpet weavers had a high level of occupational stress. The most frequent MSD was observed in the upper back (98%), while the least frequent one was related to the knee disorders (45%). Occupational stress showed a positive relationship with MSDs and their components (except for the three components of the hip, knee, and leg) (P=0.001).Conclusion: Based on the findings of the research, it is essential to take effective measures to reduce occupational stress among rural female carpet weavers. Furthermore, considering the effect of six out of nine components of MSDs on occupational stress, the consideration of the improvement and proper design of the workplace, mental and emotional needs of carpet weavers, proper way of siting and mobility, and exercise at certain times can effectively reduce occupational stress and skeletal disorders.

39-46

Authors: Marzieh Kolahkaj , Sedigheh Battalebloie

Introduction and purpose: High accumulation of heavy metals in food chain at critical doze has detrimental effects on the living organisms. Regarding the fact that rice is highly consumed as a main dish in Iran, this study aimed to investigate the level of cadmium and lead in Meydavood rice, as well as their effects on the inhabitants of this region. Methods: This study was conducted on 10 rice samples from Meydavood farmlands, located in Khoozestan Province, Iran. After preparation, samples were analyzed for lead and cadmium using inductively coupled plasma mass spectrometry. The levels of lead and cadmium doses in daily rice consumption for each person (110 grams for 70 kg body weight) were calculated using SPSS statistical software. Results: The mean concentrations of cadmium and lead in rice samples were 0.02 and 1.07 mg/kg, respectively. Based on the obtained results, the level of cadmium was lower and the level of lead was higher than the standard level proposed by the World Health Organization (WHO). The total weekly intake of cadmium and lead through rice consumption was evaluated based on provisional tolerable daily intake determined by WHO/Food and Agriculture Organization (FAO). Conclusion: According to provisional tolerable daily intake, it can be concluded that the daily intake of cadmium and lead through rice was in the standard range recommended by WHO and FAO. In addition, it is important to have a healthy diet to protect the health of the inhabitants due to the high levels of cadmium and lead in rice samples, and other agricultural products.

57-67

Authors: Ramazan ali Dianati tilaki , Mohammad Mahmoudi

Introduction and purpose: Groundwaters provide the main source of drinking water in Mazandaran province; however, the high concentration of soluble salts and hardness in these waters result in probable sedimentation and corrosion in water distribution systems of these areas. Therefore, the aim of this study was to determine the sedimentation and corrosion potential in the drinking water resources in Amol, Babol, Ghaemshahr, Sari, and Neka in the second and first halves of 2015 and 2016, respectively. Methods: A total of 192 water samples from selected cities of Mazandaran province were tested using determining parameters of sedimentation and corrosion indices by a standard method. The indices, such as Langelier saturation, Ryznar stability, Puckorius scaling, Aggressive, and Larson-Skold were determined using relevant data. Results: The results of the study showed that out of 192 analyzed samples in the surveyed cities, 76 and 81.3 % of them had the sedimentation propertiesand potentials considering Ryznar stability and Langelier saturation indices, respectively. With regard to Puckorius scaling index, sedimentation potential was observed in 68.8 % of water samples. Aggressive and Larson-Skold indices have also showed sedimentation properties of water. Conclusion: It can be concluded that the drinking water in the water distribution systems of these cities has relatively sedimentation properties

1-11

Authors: Farin Fatemi , Mahdi Mohammadiyan

Introduction and purpose: Surgeons are exposed to different risk factors for musculoskeletal disorders (MSDs) due to their occupational nature. The aim of the current research was to investigate the ergonomics of surgeons during laparoscopic and open surgeries and present applicable ergonomic strategies for the reduction of MSDs risk factors among this population.Methods: This cross-sectional study was conducted on 85 surgeons, performing laparoscopic and open surgeries, in one of the general hospitals of Tehran, Iran, in 2016. The participants were assessed by means of two ergonomic assessment methods, namely Rapid Upper Limb Assessment (RULA) and Strain Index (SI). Additionally, they filled out the Nordic body map questionnaire. Finally, the equipment and environmental conditions of the operation rooms were also evaluated. The data were analyzed using Excel and SPSS software.Results: The highest MSD prevalence rate was related to the lumber (76.4%) and neck (64.7%). Furthermore, laparoscopic surgery had the upper risk level of MSDs; in this regard, this risk was obtained as 72% and 86% by RULA and SI methods, respectively. Furthermore, among the laparoscopic surgeries, neck posture risk level was significantly different from that of the open surgeries in the RULA approach (P<0.05). Likewise, in the SI method, the risk level of the wrist in laparoscopic surgeries was significantly different from that of the open surgeries (P<0.05).Conclusion: As the findings of the present study indicated, the risk level of laparoscopic operation was higher than that of the open surgeries. However, much non-compliance in terms of the surgeons and non-ergonomic equipment was observed with ergonomic instructions in both of the mentioned operations. Therefore, it is suggested to adopt ergonomic corrective measures with the priority of laparoscopic surgeries in order to prevent MSDs among surgeons.

27-34

Authors: Rajabali Hokmabadi , Hamid Tavakoli , Morteza Morteza esmailzade , Hossien Ebrahimyan

Introduction and purpose: Today, occupational stress is an outcome of occupational processes, factors, and conditions. The bus driver job is one of the most stressful occupations. The main objective of this study was the assessment of occupational stress level in Bojnurd city-bus drivers. Methods: This cross-sectional, descriptive-analytical study was performed on 61 bus drivers in the city of Bojnurd, Iran, who were chosen using the simple random sampling method in 2016. The data were gathered using Philip el Rice standard job stress questionnaire. Data analysis was performed in SPSS version 18. Results: The results showed that all the drivers were male and married. The mean age of the subjects was 41±5 years, and the average working experience was 12±5 years. The average occupational stress score in drivers was 147.5±24.8. The results indicated that 97% of the drivers were under high stress. In addition, the results showed a significant relationship between job stress and work shift. However, there was not any significant association between job stress and other variables such as age, work experience, educational level, and employment type. Conclusion: High stress level in the studied drivers indicated that the implementation of a comprehensive stress management program is required.

49-64

Authors: Atena Ramezani - , Atefeh Ramezani -

Introduction and purpose: There are several important factors for prevention of cardiovascular diseases (CVD). Out of all, diet modification has a great amount of efficacy. However, the genetic differences in individuals make diet effects dissimilar in various people. In fact, the difference in metabolic responses of individuals to foods due to different genotypes is known as noregenetics. Nutrigenomics represents a suitable approach to CVD prevention and treatment through optimization of individuals’ dietary intakes based on genotype.Methods: This review study was conducted to investigate the most important polymorphisms associated with CVD risk factors. To this end, the English articles related to polymorphism and expression of the genes involved in CVDs and inflammation having been published since 2000 were searched in Pubmed, Science direct, Google scholar.The search process was accomplished using the following keywords: “Nutrigenetics”, “Gene”, “Polymorphism”, “Diet therapy”, and “Cardiovascular disease”.Results: Understanding the interaction of genes and nutrients requires tools for the study of Nitrigenomics, Noregenetics, and phenotypic characteristics. The human genome project revealed small changes in single polymorphism Nucleotide is called Single-nucleotide Polymorphism (SNPS) and it's happening in the genes. These changes in the genotype cause a change in function due to the activation of the gene.In a review of studies, it was found that SNPS not only clearly affects the level of cytokine production in humans; But also plays a very close role in mortality in a wide range of diseases. In the present study, the most important polymorphisms associated with risk factors for cardiovascular disease are discussed.Conclusion: Therefore, from the perspective of health, knowledge in the field of prevention and treatment of diseases, heart arteries, and general dietary recommendations can be applied to each particular genotype group.

79-88

Authors: Seyed Aboalhassan Naghibi , Mahbubeh Ahmadi , Farzaneh Afkhaminia

Introduction and purpose: Anemia is one of the most common nutritional disorders in the world and is often associated with iron deficiency. Iron deficiency anemia causes waste of educational resources and health care, reduction of productivity through increased mortality, and finally the reduction of physical and psychological capacity in a large part of society. Regarding this, the present study was conducted to determine the knowledge, attitude, and practice of female junior high school students in Neka city, Iran, about iron deficiency in 2016. Methods: This cross-sectional study was conducted on 480 junior high school students in Neka, who were educating during 2016. The study population was selected through multi-stage sampling technique. The data collection tools included a questionnaire covering demographic data and assessing the knowledge (18 items), attitude (14 items), and performance (9 items) about iron deficiency. The collected data were analyzed using descriptive and inferential statistics, including independent t-test and one-way ANOVA, in SPSS software (version 20). Results: According to the results, the mean age of the students was 12.91±0.79. In this study, 17.1%, 38.3%, and 1.9% of the students had good level of knowledge, attitude, performance regarding iron deficiency, respectively. The results also revealed a significant relationship between paternal education level and knowledge score (P=0.001). Furthermore, maternal education showed a significant relationship with knowledge (P=0.001) and performance (P=0.019). There was also a significant difference between the different levels of paternal occupation in terms of the mean score of knowledge (P=0.001) and performance (P=0.002). However, maternal occupation demonstrated no significant relationship with knowledge, attitude, and performance.Conclusion: As the findings indicated, the knowledge of the majority of students about iron deficiency was at a moderate level; however, most of them had a poor performance in this regard. Therefore, in line with the Health Promoting School programs, the design of family-centered and school-based interventional programs is recommended to empower parents, students, and school about iron deficiency anemia.