COVID-19 control management in central corona hospitals using SWOT and QSPM matrices: A case study in Kashan central hospitals

Background: During the COVID-19 pandemic, hospitals have been the most important centers for the virus spread. Therefore, this study aimed to evaluate the management of infection control in central corona hospitals in Kashan using the quantitative strategic planning matrix (QSPM) matrix. Methods: The existing documents studied the strengths, weaknesses, opportunities, and threats of the organization identified by environmental health experts. The internal and external factors were identified as internal factor evaluation (IFE) and external factor evaluation (EFE) matrices, respectively, then, prioritized and weighted. In the next step, the SWOT matrix was formed and the type of used strategy by the organization was determined, and solutions to improve the current situation were presented by experts. Finally, the attractiveness table was compiled and weighted using the QSPM method to prioritize the proposed strategies. Results: After identifying 25 strengths, 28 weaknesses, 15 opportunities, and 13 threats, weighting was performed, the final score for internal and external factors was 2.6475 and 2.3825, respectively. The final strategy for implementing COVID-19 disease control in the studied hospitals was the Conservative Strategy (WO). Based on this, six control strategies were presented. The priority and attractiveness of each strategy were evaluated using the QSPM matrix. Finally, the strategy of “structuring the system and providing and upgrading the equipment and infrastructure facilities” was implemented as a priority. Conclusion: According to the results, the combination of SWOT (Strengths, Weaknesses, Opportunities, and Threats) and QSPM methods can play an efficient role in identifying and evaluating the factors affecting the management of the COVID-19 pandemic in hospitals and further developing and prioritizing control strategies for this infectious disease. Keywords: COVID-19, Environmental health, Hospitals, Research desig

Health and safety hazards identification and risk assessment in the swimming pools using combined HAZID and ALARP

Background: Swimming pools are recreation and sport sites where the lack of safety and health can have severe adverse effect on public health. This study aimed to identify and assess health and safety risks using HAZID and ALARP techniques in the different parts of the swimming pools. Methods: In this applied study, health risks were identified by field observations and environmental health questionnaire consisting swimming pool environmental health checklist, safety of equipment and so on. Then, the risks were categorized and corrective revisions were proposed. Data were analyzed using SPSS version 19. Results: After data analysis, 41 types of safety hazard and 35 types of health risk (potential and existing) were identified. A total of 7 work units and 6 jobs in swimming pools were classified, and 52 types of health risk and 69 types of safety risk were identified, assessed, and classified. After providing corrective measures, according to the ALARP principle, unacceptable risks were eliminated and 64 risk were classified as acceptable. Conclusion: According to the results, most of the health risks were related to the swimming pools area. So that health training course for swimmers and increasing health culture have an important role in controlling health risks. Changing the attitude of swimming pools managers and personnel towards health, safety and environment (HSE) issues also have an important role in controlling health and safety risks. Keywords: Environmental health, HAZID, Swimming pools, Risk assessment, Equipment safet

Global age-sex-specific mortality, life expectancy, and population estimates in 204 countries and territories and 811 subnational locations, 1950–2021, and the impact of the COVID-19 pandemic: a comprehensive demographic analysis for the Global Burden of Disease Study 2021

Background: Estimates of demographic metrics are crucial to assess levels and trends of population health outcomes. The profound impact of the COVID-19 pandemic on populations worldwide has underscored the need for timely estimates to understand this unprecedented event within the context of long-term population health trends. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 provides new demographic estimates for 204 countries and territories and 811 additional subnational locations from 1950 to 2021, with a particular emphasis on changes in mortality and life expectancy that occurred during the 2020–21 COVID-19 pandemic period. Methods: 22 223 data sources from vital registration, sample registration, surveys, censuses, and other sources were used to estimate mortality, with a subset of these sources used exclusively to estimate excess mortality due to the COVID-19 pandemic. 2026 data sources were used for population estimation. Additional sources were used to estimate migration; the effects of the HIV epidemic; and demographic discontinuities due to conflicts, famines, natural disasters, and pandemics, which are used as inputs for estimating mortality and population. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate under-5 mortality rates, which synthesised 30 763 location-years of vital registration and sample registration data, 1365 surveys and censuses, and 80 other sources. ST-GPR was also used to estimate adult mortality (between ages 15 and 59 years) based on information from 31 642 location-years of vital registration and sample registration data, 355 surveys and censuses, and 24 other sources. Estimates of child and adult mortality rates were then used to generate life tables with a relational model life table system. For countries with large HIV epidemics, life tables were adjusted using independent estimates of HIV-specific mortality generated via an epidemiological analysis of HIV prevalence surveys, antenatal clinic serosurveillance, and other data sources. Excess mortality due to the COVID-19 pandemic in 2020 and 2021 was determined by subtracting observed all-cause mortality (adjusted for late registration and mortality anomalies) from the mortality expected in the absence of the pandemic. Expected mortality was calculated based on historical trends using an ensemble of models. In location-years where all-cause mortality data were unavailable, we estimated excess mortality rates using a regression model with covariates pertaining to the pandemic. Population size was computed using a Bayesian hierarchical cohort component model. Life expectancy was calculated using age-specific mortality rates and standard demographic methods. Uncertainty intervals (UIs) were calculated for every metric using the 25th and 975th ordered values from a 1000-draw posterior distribution. Findings: Global all-cause mortality followed two distinct patterns over the study period: age-standardised mortality rates declined between 1950 and 2019 (a 62·8% [95% UI 60·5–65·1] decline), and increased during the COVID-19 pandemic period (2020–21; 5·1% [0·9–9·6] increase). In contrast with the overall reverse in mortality trends during the pandemic period, child mortality continued to decline, with 4·66 million (3·98–5·50) global deaths in children younger than 5 years in 2021 compared with 5·21 million (4·50–6·01) in 2019. An estimated 131 million (126–137) people died globally from all causes in 2020 and 2021 combined, of which 15·9 million (14·7–17·2) were due to the COVID-19 pandemic (measured by excess mortality, which includes deaths directly due to SARS-CoV-2 infection and those indirectly due to other social, economic, or behavioural changes associated with the pandemic). Excess mortality rates exceeded 150 deaths per 100 000 population during at least one year of the pandemic in 80 countries and territories, whereas 20 nations had a negative excess mortality rate in 2020 or 2021, indicating that all-cause mortality in these countries was lower during the pandemic than expected based on historical trends. Between 1950 and 2021, global life expectancy at birth increased by 22·7 years (20·8–24·8), from 49·0 years (46·7–51·3) to 71·7 years (70·9–72·5). Global life expectancy at birth declined by 1·6 years (1·0–2·2) between 2019 and 2021, reversing historical trends. An increase in life expectancy was only observed in 32 (15·7%) of 204 countries and territories between 2019 and 2021. The global population reached 7·89 billion (7·67–8·13) people in 2021, by which time 56 of 204 countries and territories had peaked and subsequently populations have declined. The largest proportion of population growth between 2020 and 2021 was in sub-Saharan Africa (39·5% [28·4–52·7]) and south Asia (26·3% [9·0–44·7]). From 2000 to 2021, the ratio of the population aged 65 years and older to the population aged younger than 15 years increased in 188 (92·2%) of 204 nations. Interpretation: Global adult mortality rates markedly increased during the COVID-19 pandemic in 2020 and 2021, reversing past decreasing trends, while child mortality rates continued to decline, albeit more slowly than in earlier years. Although COVID-19 had a substantial impact on many demographic indicators during the first 2 years of the pandemic, overall global health progress over the 72 years evaluated has been profound, with considerable improvements in mortality and life expectancy. Additionally, we observed a deceleration of global population growth since 2017, despite steady or increasing growth in lower-income countries, combined with a continued global shift of population age structures towards older ages. These demographic changes will likely present future challenges to health systems, economies, and societies. The comprehensive demographic estimates reported here will enable researchers, policy makers, health practitioners, and other key stakeholders to better understand and address the profound changes that have occurred in the global health landscape following the first 2 years of the COVID-19 pandemic, and longer-term trends beyond the pandemic

Global, regional, and national burden of disorders affecting the nervous system, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BackgroundDisorders affecting the nervous system are diverse and include neurodevelopmental disorders, late-life neurodegeneration, and newly emergent conditions, such as cognitive impairment following COVID-19. Previous publications from the Global Burden of Disease, Injuries, and Risk Factor Study estimated the burden of 15 neurological conditions in 2015 and 2016, but these analyses did not include neurodevelopmental disorders, as defined by the International Classification of Diseases (ICD)-11, or a subset of cases of congenital, neonatal, and infectious conditions that cause neurological damage. Here, we estimate nervous system health loss caused by 37 unique conditions and their associated risk factors globally, regionally, and nationally from 1990 to 2021.MethodsWe estimated mortality, prevalence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs), with corresponding 95% uncertainty intervals (UIs), by age and sex in 204 countries and territories, from 1990 to 2021. We included morbidity and deaths due to neurological conditions, for which health loss is directly due to damage to the CNS or peripheral nervous system. We also isolated neurological health loss from conditions for which nervous system morbidity is a consequence, but not the primary feature, including a subset of congenital conditions (ie, chromosomal anomalies and congenital birth defects), neonatal conditions (ie, jaundice, preterm birth, and sepsis), infectious diseases (ie, COVID-19, cystic echinococcosis, malaria, syphilis, and Zika virus disease), and diabetic neuropathy. By conducting a sequela-level analysis of the health outcomes for these conditions, only cases where nervous system damage occurred were included, and YLDs were recalculated to isolate the non-fatal burden directly attributable to nervous system health loss. A comorbidity correction was used to calculate total prevalence of all conditions that affect the nervous system combined.FindingsGlobally, the 37 conditions affecting the nervous system were collectively ranked as the leading group cause of DALYs in 2021 (443 million, 95% UI 378–521), affecting 3·40 billion (3·20–3·62) individuals (43·1%, 40·5–45·9 of the global population); global DALY counts attributed to these conditions increased by 18·2% (8·7–26·7) between 1990 and 2021. Age-standardised rates of deaths per 100 000 people attributed to these conditions decreased from 1990 to 2021 by 33·6% (27·6–38·8), and age-standardised rates of DALYs attributed to these conditions decreased by 27·0% (21·5–32·4). Age-standardised prevalence was almost stable, with a change of 1·5% (0·7–2·4). The ten conditions with the highest age-standardised DALYs in 2021 were stroke, neonatal encephalopathy, migraine, Alzheimer's disease and other dementias, diabetic neuropathy, meningitis, epilepsy, neurological complications due to preterm birth, autism spectrum disorder, and nervous system cancer.InterpretationAs the leading cause of overall disease burden in the world, with increasing global DALY counts, effective prevention, treatment, and rehabilitation strategies for disorders affecting the nervous system are needed

The Role of Environmental Education in Increasing the Awareness of Primary School Students and Reducing Environmental Risks

Introduction: Primary schools are children's first social environments. Other people's attitudes towards environmental hazards play a key role in developing children's personality. This study aimed to identify and assess the environmental risks (such as emission of pollutants into the air, discharge of pollutants into water and soil, energy consumption, etc.) in Shohadaye Kork female primary school in Kashan, Iran, and also to investigate the role of environmental education in the promotion of students' environmental knowledge. Materials and Methods: In this quasi-experimental study, at first, environmental hazards were identified by a checklist through field visits and observing students' activities, and then they were assessed through Preliminary Hazard Analysis (PHA) method. After that, the Risk Assessment Code 1 (RAC1) was calculated. By Considering the involved hazards, environmental education was presented and then RAC2 was calculated. Environmental awareness of 172 students was investigated by a questionnaire. SPSS V 19 was used for statistical analysis. Results: 26 environmental hazards were identified, including 22 acceptable and 4 unacceptable (critical) hazards; 21 of them could be directly resolved by proper education. The mean scores of students' environmental tests were 5 and 18.21, respectively before and after the education. After taking control of measures all hazards were placed within the acceptable range. Conclusion: Schools environmental management plays an important role in preparing students for environmental education that the results of this study showed a significant relationship between education and promotion of students' environmental awareness

Pesticides residues determination and probabilistic health risk assessment in the soil and cantaloupe by Monte Carlo simulation: A case study in Kashan and Aran-Bidgol, Iran

Cantaloupe is a popular agricultural product in the hot season of Iran. On the other hand, the frequent use of pesticides in cantaloupe fields is the most important threat to the health of farmers and consumers. Therefore, the present study aims to measure the concentration of diazinon (DZN), chlorpyrifos (CPF), and malathion (MLT) in cantaloupe cultivated in Kashan and Aran-Bidgol (Iran) and to estimate the possible oral and dermal risk of these pesticides by Monte Carlo simulation (MCS). 36 cantaloupe samples, 18 samples before, and 18 samples after the latent period were collected from different places of cantaloupe cultivation from April to May 2021. After measuring the pesticides using the QuEChERS approach, oral and dermal risk assessments were calculated.The mean and standard deviation of the concentrations of chlorpyrifos, malathion, and diazinon in 18 cantaloupe samples, after the latent period, were (30.39 ± 13.85), (18.361 ± 1.8), and (21.97 ± 0.86) μg kg-1, respectively. Concentration of Malathion, diazinon, and Chlorpyrifos in the soil were 0.22, 0.25, and 0.3 mg kg-1, respectively, and pesticide cumulative risk assessment in soil was obtained 0.011 for Malathion, 0.05 for diazinon and 0.03 for Chlorpyrifos. Target Hazard Quotient (THQ) according to the cantaloupe consumption and dermal exposure in children and adults, was safe range. Although non-cancerous dermal and oral risk of cantaloupe is low, constant exposure can be harmful. Therefore, the findings of this study play an important role in increasing the understanding of the negative health consequences of pesticide contamination in cantaloupe for consumers, especially local residents, and can help by adopting remedial strategies to reduce environmental concerns

Applying Job Hazard Analysis and William Fine Methods on risks Identification and assessment of Jobs in Hot Rolling Steel, Iran

Background and purpose: Comprehensive evaluation of jobs in industries is a practical and effective method that could identify the jobs and industries with negative effects on the environment. This study identified environmental hazards of hot rolling process and assessing their risks. Materials and methods: An observational study was carried out in which identification of human activity and job´s risks in production hall of Kavir Steel Complex was done according to ISO 14001 approaches (pollutant emissions to air, discharges to water, energy consumption, energy released as heat, wastes, side products, etc) by Job Hazard Analysis method (JHA). Then the risks identified were prioritized and assessed using William Fine method. Results: We identified 205 environmental hazards (in 9 groups) associated with production personnel (n= 81), mechanics and maintenance personnel (n= 44), bed personnel (n= 9), personnel of cleaning services (n= 33), and water plant personnel (n= 38). The highest and lowest rate of risks were due to creation and distribution of wastes (n= 73) and corrosion and depreciation of equipment, (n= 1), respectively. Conclusion: The production personnel were mainly responsible for environmental emissions. The leading causes were stress and anxiety about stoppage of production, payment reduction, and lack of awareness and workers and supervisors on environmental issues

Helping HSE Team in Learning from Accident by Using the Management Oversight and Risk Tree Analysis Method

Introduction: The effects of accidents vary from minor injuries to fatalities and from insignificant damage to severe damage to the environment and property. In order to prevent accidents in the work place, the root causes of and events should be identified using a systematic method and the results should be published. The current study aims to investigate the given causes of an accident in order to implement preventive actions in accidents and similar organizations. Materials and Methods: In this case study, after choosing the main event; to analyze the accidents, at first a set of questions in Management Oversight and Risk Tree (MORT) were answered. By answering the questions, the final events, and the inappropriate management risks (color-coded red) followed by the leading causes of the accident were identified. Results: After analyzing the given accident, 22 inappropriate final events (color-coded red) and 4 assumed risks were identified. Of the total 12 identified basic causes, about 75 % were classified as the management policies and decision makings group, 17 % as the individual factors, and 18 % as the environmental factors group. Conclusion: The analysis using MORT method helped the organization with learning lessons from the accident especially at the management level. In order to prevent the similar and dissimilar accidents, the inappropriate informational network within the organization, inappropriate operational readiness, lack of proper implementation of work permit, the inappropriate and lack of updated technical information systems regarding equipments and working process, and the inappropriate barriers should be considered in a special way

Identification, classification and management of industrial waste in Kavir steel complex according to the Bazel convention and RCRA

Introduction: Requiring industries for implementing industrial waste management programs and planning for proper waste disposal is essential in order to achieve sustainable development. Therefore, industrial waste management program was done in Kavir Steel Complex, in Aran va Bidgol region to identify and classify industrial waste and also to present solutions for improving waste management. In this complex, production process is hot rolling steel and the product is rebar. Material and Method: The preset study was conducted in Kavir Steel Complex. Following survey of production process and sources of waste, the type and volume of produced waste were identified and measured during 3 months. Then, the classification of wastes was done according to the Bazel Convention and Resource Conservation and Recovery Act (RCRA), and finally new industrial & health solid waste management program was presented. Result: Considering the volume, industrial waste of production process in Kavir Steel Complex was between 130 to 180 grams per each ton of rebar. Main industrial waste included oxide of steel billet, industrial sludge, used oil and lubricant which were classified according to the RCRA: 8 materials with T code, 1 with C code, 5 with I code and 3 materials with C code. Conclusion: The results revealed that the most amount of industrial waste in Kavir Steel Complex is the waste of steel billet and industrial sludge, and more than 90% of Kavir steel industrial waste were reused and recycled inside or outside of this complex. It is recommended that used oil to be transport and maintain in the safe containers

Study of the Reasons for Tendency to Use Desalination Systems in the Households of Bandar Lengeh, Hormozgan, Iran

Introduction and purpose: The need to access and produce clean water is currently felt more than ever by the communities due to the pollution of drinking water sources and the consumers’ growing concern and awareness about the absence of healthy drinking water. As a result, in the recent years, the use of water purification systems has been widely increased in the urban and rural regions of Iran. Regarding this, the aim of the present study was to investigate the causes of the tendency to use home desalination systems in the households of Bandar Lengeh, Hormozgan, Iran. Methods: This descriptive, cross-sectional study was conducted on 140 households in the fall of 2014. The study population was selected through simple random sampling technique. The data were collected using a questionnaire enquiring the cause of using home desalination systems among the people living in Bandar Lengeh. Data analysis was performed in SPSS, version 24 using Chi-square test. Results: According to the results of the present study, none of the investigated households directly used the water distributed in the city for drinking. Only 12.9% of the households used this water for cooking. Therefore, the water distributed in the urban network was mostly used for irrigation as well as washing dishes and clothes. Furthermore, the most frequently reported reasons for the non-use of the water were discoloration of tea and slowing down the cooking of food. Conclusion: As the findings of the present study indicated, it is not essential to use the domestic purification systems. Accordingly, the tendency to use these systems are mainly raised by incorrect beliefs about this issue. This highlights the necessity of implementing educational programs targeting toward the improvement of the households’ awareness regarding the health issues