Journal of Health Research in Community

1-11

Authors: Majid Kermani, Sevda Fallah Jokandan, Mina Aghaei, Mohsen Dolati

Introduction and Purpose: Nowadays, the air quality in many major cities is one of the most important environmental problems that seriously compromises the health of residents and causes a range of acute and chronic health effects. Therefore, this study was aimed to quantify and estimate the health effects related to the pollutants NO2 and O3 in metropolis of Tehran in 2014 was done by AirQ model. Methods: Data acquired were collected from the environmental organization and the center of air quality control in Tehran. This data were analyzed by Microsoft Excel software, and the processed data was entered AirQ model. The relative risk, baseline incidence and the attributed proportion was estimated and the overall results in case of mortality and morbidity were presented in tables and graphs. Results: The results showed that the average annual concentration of NO2 and O3 in Tehran, was respectively 130 and 64 μg/m3 . According to the results with baseline incidence of 543.5 per 100,000, the total cumulative number of mortalities attributed to nitrogen dioxide and ozone, were estimated respectively to be 1593 and 946, that included about 2.66% and 1.58% of total mortalities except traffic accidents in Tehran. Conclusion: Our results showed that the level of air pollution has increased in Tehran, which requires more attention of authorities and policy makers to control the air pollution.

21-27

Authors: Fatemeh Arab, Mojtaba Rezaei Rad, Kambiz Esmaeil Nia

Introduction and Purpose: Workaholism can be enjoyable, but at the same time, frustrating and problematic with positive and negative repercussions. This study aimed to investigate the relationship of workaholism and organizational silence with burnout in staff of Mazandaran University of Medical Sciences. Methods: This descriptive, correlational study was performed in 302 individuals selected through stratified random sampling. The data collection tools included Workaholism Analysis Questionnaire (Spence and Robbins, 1992), organizational silence questionnaire (Hashushian, 2013), and Maslach Burnout Inventory (Maslash and Jackson, 1981). To analyze the data, descriptive and inferential statistics (Pearson’s correlation coefficient test and regression analysis) were performed, using SPSS version 20. Results: The mean of workaholism, organizational silence, burnout, and organizational commitment were 3.57±0.46, 2.89±0.71, 2.12±0.75, and 4.18±0.73, respectively. There was a significant inverse relationship between workaholism and burnout, while there was a significant direct association between organizational silence and burnout. Conclusion: Considering our results regarding workaholism, organizational silence, burnout, and organizational commitment, designing and implementing training programs for staff to promote their awareness regarding these concepts can be beneficial.

37-44

Authors: Farbod Ebadi Fardazar, Syyedeh Shahrbanou Hashemi, Mahnaz Solhi, Kamyar Mansori

Introduction and Purpose: Accidents are the first cause of death in children under five years, especially in low- and middle-income countries. The aim of this study is to determination the effect of Educational intervention on promotion of prevention behaviors of home accidents in mothers with children less than five year in Joibar city based on protection motivation theory (PMT) in 2015. Methods: In this controlled interventional study 190 mothers with children less than five year were participated (95 in case group and 95 incontrol group).The data collection toolwas researcher made questionnaire based on the structures of protection motivation theory.After done pre-test and the results obtained from it, appropriate educational intervention designed and was conducted only in case group. Then two months after the educational intervention,evaluation was done and data into SPSS 20 software and by using statistical tests T-test, Paired T test, chi _square, Pearson correlation coefficient and regression analysis was analyzed. Results: Statistically significant difference was found between mean scores of all structures of PMTin the case and control groups after the educational intervention, so that in all cases in the case group was better than control group (P<0.05). There was a significant difference between the mean scores of all structures of PMT in case group in before and after the educational intervention (P<0.05), Whereas no significant difference was seen between mean scores of all structures in control group in before and after the educational intervention (P>0.05). Conclusion: The results of this study showed that PMT can be used as a framework in designing educational programs in order to promotion of prevention behaviors of home accidents in mothers with children less than five year.

53-63

Authors: Shabnam Amanali Khani, Mohamadhossein Salmani Nadooshen, Mohamadhasan Ehrampoosh, Mehdi Mokhtari

Introduction and Purpose: Production of large quantities of sludge is a major problem in wastewater treatment plants, which necessitates adopting proper economical and environmental approaches for its management and treatment. The aim of this study was to investigate the effect of polyacrylamide polymer, modified with aluminum oxide nanoparticles, on dewatering of sludge produced from municipal wastewater treatment. Methods: In-vitro preparation and dewatering of sludge by combination of polyacrylamide activated with aluminum oxide nanoparticles were carried out in two main steps of determination of pH and optimal dose of activated coagulant aid. For measuring sludge dewatering capability, tests of time of filtration (TTF), sludge cake moisture content, turbidity, and total suspended solids of effluent from sludge cake filtration were evaluated. Results: Modified coagulant aid with aluminum oxide nanoparticles in optimum pH and concentrations of 5 and 4 mg/l, respectively, had the best efficiency and was more suitable than a primary coagulant without any modification. The levels of TTF, sludge cake moisture, turbidity, and total suspended solids of effluent reduced 24.4%, 11.2%, 57.2%, and 58%, respectively, in comparison with the control group. Conclusion: The results showed that polyacrylamide coagulant aid modified with aluminum oxide nanoparticles could be appropriate for sludge dewatering. Therefore, it can be employed as an alternative coagulant aid for sludge dewatering.

1-8

Authors: Majid Kermani, Farshad Bahrami Asl, Mahdi Farzadkia, Kazem Nadafi, Dariush Zeinalzadeh, Anahita Dehghani.

Introduction and purpose: In recent years, contact with bioaerosols has appeared as a major health concern. In this study, we aimed to compare fungal aerosols in terms of distribution in the ambient air of Milad Hospital, Blood Transfusion Organization, and Shahrake Ghods Waste Water Treatment Plant in Tehran, Iran. Methods: This cross-sectional study was conducted in Milad Hospital, Blood Transfusion Organization, and Shahrake Ghods Waste Water Treatment Plant within a period of four months. Passive sampling technique was applied every six days for one hour. Sabouraud dextrose agar was used as the culture medium. Results: Based on the comparison of the selected units, the highest level of fungal contamination was reported within a 100 meter distance from the last waste water treatment unit (67 CFU), while the lowest level of contamination was reported in Milad Hospital (30 CFU). Cladosporium was the dominant fungal genus in Shahrake Ghods Waste Water Treatment Plant and Blood Transfusion Organization (49% and 84%, respectively), while Alternaria was the most common fungus in the ambient air of Milad Hospital (47%). Conclusion: According to the results, processing and operating units in waste water treatment plants can affect the concentration and distribution of bioaerosols. Therefore, administrative organizations are required to take effective measures to develop guidelines and standards related to bioaerosols. Also, following environmental health norms in waste water treatment plants can be an important factor in reducing aerosol distribution.

16-24

Authors: Amirhossein Davoudian Talab, Ahmad Badiee Nejad, Mohammad Beit Abdollah, Farshid Mahmoudi, Mansour Barafrashtehpour, Gholamhossein Akbari

Introduction and purpose: Radiation is a constant hazard in modern medicine, and there is no doubt about its harmful effects. We aimed to evaluate the knowledge, practice, and attitudes of radiographers toward radiological protective principles and to provide controlling solutions. Methods: This cross-sectional, descriptive, analytical study was conducted on 185 radiographers in imaging centers of Khuzestan province, Iran, in 2013. The data were collected using three questionnaires (Demographic, Knowledge, performance, and attitudes toward radiation protection, and an open-ended questionnaire). The participants were chosen through cluster–randomized sampling. The obtained data were analyzed performing Pearson correlation and descriptive tests, using SPSS version 16. Results: The mean age of the participants was 33±92 years (age range: 21-55 years). The mean obtained scores for awareness, performance, and attitudes of radiographers were 48.35±14.02, 48.79±18.01, and 76.97±16.01, respectively. No significant relationship was found between age, gender, and experience and knowledge, performance, and attitudes (P>0.05). However, there was a significant positive relationship between participating training courses and knowledge, performance, and attitudes (P<0.05). Conclusion: Knowledge and performance of the samples was in a moderate level, while their attitudes were in a satisfactory level. In addition, the target population was willing to attend training courses, which can raise awareness and improve attitudes and performance of radiologists.

33-40

Authors: Abuzar Sadeghi, Khosro Keshavarz, Mahdieh Sadat Ahmadzadeh, Alireza Yousef

Introduction and purpose: Magnetic resonance imaging (MRI) plays an important role in the treatment process. However, MRI scanners are costly for health centers to purchase and maintain, and for patients to use. This study aimed to determine the appropriateness of MRI services provided in Chamran Hospital of Shiraz and the cost of inappropriate MRI services to reduce unnecessary MRI use. Methods: This cross-sectional study was done in March 2015. The data regarding MRI services were collected from the hospital information system according to region and type of MRI though census sampling. To estimate the cost of unnecessary MRI services the report of Vice Chancellery for Clinical Affairs in 2013 was used. Chi-square test was performed using SPSS version 20. Results: During this period, 2105 cases of MRI use were reported, 24% of which showed normal results. The cost of unnecessary MRI services was estimated at 609180000 rials. Moreover, a significant relationship was observed between type of MRI and normal and abnormal results. Conclusion: Given the high costs of MRI services for both patients and insurance companies, identifying the factors affecting the improper use of these services can prevent the increasing use of this service and might lead to its more efficient application.

53-60

Authors: Aram Tirgar, Zahra Aghalar, Fatemeh Salari

Introduction and purpose: Musculoskeletal disorders (MSDs) and computer work are common in the majority of societies and both of them are on a growing trend. This study was conducted to determine the frequency of somatic complaints, symptoms of MSDs, and awareness of employees regarding ergonomic considerations of computer use. Methods: This cross-sectional study was conducted on 128 administrative staff of medical, dental, and paramedical faculties in 2012. The samples were selected through simple random sampling. The data were obtained using a self-made questionnaire containing five open and 13 closed-ended questions. The data were analyzed using descriptive and analytical tests. Results: The mean age of the participants was 38.16±7.78 years, 55.5% of them were female, and 63.3% had bachelor’s degree. More than 50% of the samples spent two hours or more on their computer every day. Moreover, 72% of the cases reported experiencing one or more symptoms of MSDs and less than 10% of them were aware of ergonomic considerations in this regard. A significant difference was found between MSDs and duration of using computer (P<0.05). Conclusion: Our results indicated that more than 70% of the samples complained about MSDs, most of them were unaware of ergonomic considerations, and many of the employees were eager to learn about this issue. Therefore, workplace modifications and training on ergonomic principles to prevent MSDs are recommended.

1-11

Authors: Zazouli MA, Belarek D , Mahdavi Y ,

Introduction and purpose: One of the problems concerning industrial effluent, particularly those of textile industries, is the existence of dye. Therefore, it is mandatory to treat these effluents before being discharged to the environment. This study aims to evaluate the adsorption rate of acid orange (AO7) from aqueous solution by activated red mud. Methods: In this empirical laboratory study, we used red mud as an absorbent to remove acid orange 7 dye. The effect of various parameters on performance of absorbent was investigated, and the isotherms and kinetics of adsorption were determined. The dye concentration was measured at wavelength of 452 nm by a spectrophotometer. Results: Red mud surface area was 30 mg/g, and dye removal was the highest at a solution pH of 3 and an absorbent powder dose of 12 g/L. The AO7 removal percentage decreased by 43% in a 60-minute contact time, while the dye concentration increased from 10 mg/L to 100 mg/L. The absorption study highly correlated with the Langmuir isotherm and the second order kinetic models. Conclusion: The results of this study showed that red mud has a good ability to absorb dye and can be used as an efficient and cost-effective absorbent for treating textile industry effluent.

22-28

Authors: Asghari M, Naghibi SA, Rostami F,

Introduction and purpose: Diabetes is a very important health problem and is the most common chronic metabolic disease in the world. With regard to this problem, self-care programs are suggested to improve care and life quality of diabetic patients. This study aims to determine the effect of training on self-care promotion of type 2 diabetic patients in rural health centers of Noor, Iran. Methods: This experimental study was conducted on 200 type 2 diabetic patients. The participants were divided into case and control groups. The data were collected using a self-care questionnaire, which included items on physical exercise, foot care, drug consumption and insulin injection. At first, the data were collected in a pre-test and then, an integrated training intervention was performed. The post-test was conducted eight weeks following the intervention. The data were analyzed using SPSS, version 20. Results: The mean score of knowledge was 2.944 in the case group and 2.244 in the control group. In addition, a significant relationship was found between the demographic characteristics (i.e., age, gender and level of education) and self-care promotion in the two groups, and no significant correlation was found between job and self-care promotion. Conclusion: This study indicates the importance of continuous and integrated training on type 2 diabetes self-care. Therefore, it seems necessary for patients to participate in training programs to increase their awareness and to improve their attitude and performance.

38-46

Authors: Ghaeni GH, Nassehinia H, Dadban Shahamat Y

Introduction and Purpose: Population growth and the pollution caused by discharge of sewage, waste leachate and surface runoff has caused water contamination. Zoning river water quality is the first and most important step in managing quality of water resources; because it clarifies the process of change in pollution, according to the time and place. Water health quality evaluation of the Cheshmeh Gerdoo river is of great importance, since it is a drinking-water supply and pollutants have been discharged into this river. Methods: In this study, sampling from six stations was performed, during three months. Then, water-quality parameters, i.e., dissolved oxygen (DO), biological oxygen demand (BOD), fecal coliform, NO3, PO4, TS, turbidity, temperature and pH were examined along the river. The data were analyzed using NSFWQI quality indices. Results: In this study, the lowest DO quantity was equal to 6.4 mg/l at station 6 and the maximum amount was equal to 8.5 mg/l at station 1. Other parameters showed an increasing trend. In accordance with our results, NSFWQI index was calculated at the best and worst cases to be 54.85 and 39.19, respectively. Thus, the water-quality index in the upper part of the river, at station 1, was in the “average” category, and at the stations 4, 5 and 6 it was in the “bad” category. Conclusion: Raise in the levels of fecal coliform and BOD, from the beginning to the end of the river, indicated an increase in pollution. This problem might be caused by discharge of untreated sewage, since the river passes through rural and urban areas. Moreover, the increase in the levels of NO3 and PO4 can be resulted from pollution with agricultural effluents. Also, increase of TS and turbidity can be related to absence of suspended solids deposited along the river.

55-62

Authors: Mohammad Ali Zazouli, Maryam Yousefi, Ramezan Ali Dianati, Mitra Roohafzaee, Ashour Mohammad Marganpour

Introduction and purpose: Chlorine, due to its residual effect, has an important role in water disinfection. However, its by-products, which could be harmful to consumers’ health, has led the researchers to investigate the use of other methods or materials for disinfection. The aim of this study was to evaluate the performance of ozone in disinfection of Escherichia coli (an index of fecal pollution) contaminated water. Methods: E. coli was used for contaminated water preparation. Culture and counting methods were performed based on the book entitled “The Standard Methods of Water and Wastewater” and were recorded with colony forming unit (CFU)/ml. Normality of the data was analyzed using Kolmogorov- smirnov test, and t-test and ANOVA were performed to analyze the data. Results: The results showed that destruction of E. coli increased by increasing ozone concentration and decreasing bacteria’s density. Removal efficiency of the 1 mg/L dose, as compared to the 5 mg/L dose of ozone, in densities of 104 and 105 CFU/ml was significant (P-value<0.05). The statistical results demonstrated that removal efficiency of bacteria with a number of 105 CFU/ml, at the contact time of 1 min versus 5,10 and 20 min was significant (P<0.05). The removal efficiency of E. coli at the contact time of 10 min and above, reached 100%. Conclusion: Ozone, due to its oxidizing effect on microorganisms, has good disinfectant properties. The results of this study suggest that ozone can be significantly effective in disinfecting water contaminated with E. coli.

1-10

Authors: Ashrafian Amiri H, Mikaniki E, Nasrollahpour Shirvani D, Kabir MJ4 Jafari N, Dadashi A, Ovis GH, Naeimi Tabiei M

Introduction & Purpose: Family physicians (FP) are responsible for providing services through the appropriate management of the personnel in the healthcare team. This study evaluated the satisfaction of healthcare personnel from the performance of rural family physicians in the northern provinces of Iran. Methods: This cross-sectional study was carried out in winter 2013 and 25% of centers providing rural insurance and family physician program (139 centers) in three provinces of Golestan, Mazandaran and Guilan were selected by systematic random sampling. All healthcare staffs with at least one-year work experience were enrolled by census method. For data collection a researchermade questionnaire was used that validity and reliability of it was confirmed in advance. Data were analyzed using SPSS 17 at p<0.05 as the significant level. Results: From the 561 subjects, 380 (67.7%) were females. The majority of the participants (48%) had a bachelor’s degree. The average level of satisfaction scores from FPs performance were 3.7±1, 3.5±1, 3.7±1, 3.9±1.1 and 3.5±0.9 in the field of health management (of 5 score), external cooperation, health promotion, prevention and health service provision and health care referral, respectively. There was a significant difference between the level of satisfaction of healthcare staffs among the northern provinces of Iran (P=0.006). Conclusion: The satisfaction of healthcare staffs from FPs performance has been slightly higher than the average level, so appropriate interventional programs should be established and implemented to maintain and improve the functional level of the FPs.

20-27

Authors: Malekzadeh Kebria R, Shabani F, Emadi HR, Vala F, Nasrollahpour Shirvani SD

Introduction and purpose: AIDS is a serious threat to the health of communities. Social awareness plays an important role in the prevention of this condition. The aim of this study was to determine the awareness level of marriage candidates about AIDS in Babol, Iran. Methods: This cross-sectional study was conducted on young couples (n=732), referring to premarital counseling centers; the subjects were selected via census sampling. Data were collected, using a researcher-made questionnaire consisting of six items on demographic characteristics and nine items on AIDS awareness; the validity and reliability of the questionnaire were confirmed. AIDS awareness (rated as good, medium and weak) was analyzed, using SPSS version 18. Results: The mean age of samples was 24.2±5.7 years. Overall, 54% and 46% of subjects were female and male, respectively. The level of awareness about AIDS in 19.4%, 36.5% and 44.1% of volunteers was poor, medium and good, respectively. Television and radio were the main sources of information in 44.1% of subjects. There was a significant relationship between educational level, age and level of awareness (r=-0.337, P=001 and r=-0.143, P=001, respectively). Also, there was a significant relationship between gender, place of residence, occupational status and level of awareness (P=001). Conclusion: This study showed that still more than half of young men and women do not have enough information about AIDS. Therefore, it is necessary to continue educational programs at the community level.

35-41

Authors: Shahryari A, Nikaeen M, Hassanzadeh A

Introduction & Purpose: Fecal coliforms and Escherichia coli have been conventionally used as indicators of microbial pollution of drinking water. The European Directive on drinking water quality has recently included Clostridium perfringens as one of the microbiological organisms suitable for using in control of the quality of water for human consumption. This study endeavored to assess the efficacy of Clostridium perfringens in comparison with fecal coliforms and Escherichia coli in detection of the microbial pollution of water sources. Methods: In this study, 60 raw water samples were collected from drinking water in the Isfahan province, Iran from May to November 2012. Fecal coliforms, Escherichia coli, fecal streptococci and Clostridium perfringens were investigated by multiple-tube fermentation technique (MFT) using double-strength medium in 10 series of tubes according to the standard methods. Statistical analyses were carried out using SPSS version 18 at the 95% confidence level (α = 0.05). Results: The results of this study showed that 46.2 % of water samples were positive with regard to fecal contamination at least for one bacterial indicator. Clostridium perfringens was the most frequently detected indicator (36.5%), followed by fecal streptococci (34.6%), fecal coliforms (28.8%) and Escherichia coli (25%). According to Pearson’s coefficient, the most significant correlation was found between Clostridium perfringens and fecal streptococci (0.88). Conclusion: Clostridium perfringens is an important indicator for waterquality monitoring in communities, where raw water is used directly for human consumption without purification. Evaluation of the spores of this bacterium can provide an added margin of safety for predicting the microbial quality of drinking water

49-55

Authors: Dehghani M, Kamali Y, Ghanbarian M, Shamsedini N

Introduction & Purpose: The quality of Indoor air is important particularly in health care facilities. One of the most important factors affecting the air quality is aerosols transferring microorganisms and deposits to the respiratory tract. The purpose of this study was to measure the concentration of suspended particles in outdoor and indoor of Dena hospital and determine the relationship between these parameters.Methods: A cross-sectional study was done in Dena hospital in Shiraz in 2012 by collecting 315 samples for analysis. Sampling was performed by an Aerosol Mass Monitor sampler, (Model GT-331, Japan) to measure the particle concentration of PM10 and PM2.5. The concentration of indoor suspended particles in air in different wards of the hospital were measured and compared with hospital outdoor particles. The data were analyzed using SPSS version 16. Results: The findings showed that average PM10 in the air in hospital wards as well as all outdoor air samples were significantly lower than the 24-hour WHO and the 24-hour USEPA standards (p<0.001). Significant relationships were observed between the average concentrations of PM2.5 in all the sampling sites and the 24-hour WHO and the USEPA standards (p<0.001). Conclusion: The concentration of suspended particulate in indoor air was lower than outdoor air that represents the appropriate function of the sectors ventilation systems.