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 (PM10) 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 PM10 (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)

Content validity of national post marriage educational program using mixed methods

Background: Although the validity of content of program is mostly conducted with qualitative methods, this study used both qualitative and quantitative methods for the validation of content of post marriage training program provid-ed for newly married couples. Content validity is a preliminary step of obtaining authorization required to install the program in country's health care system. Methods: This mixed methodological content validation study carried out in four steps with forming three expert panels. Altogether 24 expert panelists were involved in 3 qualitative and quantitative panels; 6 in the first item devel-opment one; 12 in the reduction kind, 4 of them were common with the first panel, and 10 executive experts in the last one organized to evaluate psychometric properties of CVR and CVI and Face validity of 57 educational objectives. Results: The raw data of post marriage program had been written by professional experts of Ministry of Health, using qualitative expert panel, the content was more developed by generating 3 topics and refining one topic and its respec-tive content. In the second panel, totally six other objectives were deleted, three for being out of agreement cut of point and three on experts' consensus. The validity of all items was above 0.8 and their content validity indices (0.8-1) were completely appropriate in quantitative assessment. Conclusion: This study provided a good evidence for validation and accreditation of national post marriage program planned for newly married couples in health centers of the country in the near future. © 2015, Iranian Journal of Public Health. All right reserved

Composition and production rate of dental solid waste and associated management practices in Hamadan, Iran

The objective of this study was to identify the components, composition and production rate of dental solid waste and associated management practices in dental offices in Hamadan. A total of 28 offices, including ten general dentist offices, eight specialist dentist offices, five practical dentist offices and five denture maker offices were selected in a random way. Three samples from each selected type were taken and the waste was manually separated into 74 sub-fractions and each sub-fraction was weighed. The results showed that the total annual dental waste production in dental offices was 41947.43 kg. Domestic type, potentially infectious, chemical and pharmaceutical and toxic waste constituted 71.15, 21.40, 7.26 and 0.18, respectively of this amount. Only seven fractions including gypsum, latex gloves, nylon, dental impression material, used medicine ampoules, saliva-contaminated paper towels and saliva ejectors constituted about 80 of the waste. It was also indicated that there were no effective activity for waste minimization, separation, reuse and recycling in dental offices and the management of sharps, potentially infectious waste and other hazardous waste was poor. © The Author(s) 2012

The frequency of vaginal intercourse during pregnancy: A systematic and meta-analysis study

Objectives: Sexual life may change during pregnancy. Due to negative attitudes toward having sex, unpleasant feeling, and fear of several issues, women might avoid vaginal intercourse during pregnancy. Therefore, the present systematic review aimed to investigate the frequency of vaginal intercourse in pregnancy.Materials and Methods: Comprehensive literature review was conducted to find the relevant articles published (from December 1990 to April 2018) on the issue including observational studies (e.g., cross-sectional and cohort studies) that certainly determined the mean frequency of vaginal sex throughout pregnancy. In this regard, online international databases such as ISI, PubMed, Scopus, Cochrane, and Google Scholar were independently explored and checked by two authors. Duplicate articles were removed by the EndNote X7 Reference Manager. The results were analyzed using RevMan 5.3 software. The P < 0.05 was considered significant. Results: Totally, after excluding the duplicate and irrelevant articles based on having the mean frequency of vaginal intercourse during pregnancy, 13 articles were obtained. The range of vaginal intercourse frequency varied from 6.01 to 21 times every month pre-pregnancy, 3.67-9.87 times monthly in the first trimester, 2.78-7.21 times monthly in the second trimester, and 1.35-5.9 times monthly in the third trimester. Five out of the 13 selected articles reporting the mean and standard deviation were entered the current meta-analysis. The frequency of vaginal intercourse was obtained 7.75 (7.13-8.38) times monthly prior to pregnancy, 4.16 (3.86-4.46) times in the first trimester, 6.37 (5.60-7.14) times monthly in the second trimester, and 1.81 (1.49-2.13) times monthly in the third trimester. Conclusions: Generally, the frequency of vaginal intercourse decreased in the first trimester while increasing in the second trimester. However, a sharp decline was observed between the second and third trimesters of pregnancy. © 2019 The Author (s)

Air pollution and hospitalization due to angina pectoris in Tehran, Iran: A time-series study

Background: Health effects of air pollution have been studied in many different parts of the world. Although a fairly large number of studies have explored the cardiovascular impacts of air pollution, because of its unique location we studied the association between air pollutants and hospital admissions due to angina pectoris in Tehran for the first time. Methods: This is a retrospective time-series study. The variables of the study include the levels of five air pollutants - nitrogen dioxide (NO2), carbon monoxide (CO), ozone (O3), sulfur dioxide (SO2), and particulate matter &lt;10 μm in aerodynamic diameter (PM10) - as independent variables; daily hospitalizations due to angina pectoris in 25 academic hospitals in Tehran as the dependent variable; and mean daily temperature and humidity, seasonality, time trend, and day of the week as potential confounders. All variables were measured during a 5-year period from 21 March 1996 to 20 March 2001. The data of mean daily levels of NO2, CO, O3, SO2, and PM10 were collected from one of the stations of Tehran's Air Quality Control Corp. Data were analyzed using Poisson regression models. Relative risks of angina pectoris admissions were calculated for an increase in 1 mg/m3 for CO and 10 μg/m 3 for the other pollutants. Results: Daily admissions due to angina pectoris were significantly related to the CO level, after controlling for confounder effects. Each unit increase in the CO level caused a 1.00934 increase in the number of admissions (95 CI, 1.00359-1.01512). This association was verified with a lag of 1 day. There was no significant association between the other air pollutants and the number of daily admission due to angina pectoris. Conclusions: We found that with increasing levels of the pollutant CO, the number of admissions due to cardiac angina rose. Ischemic heart disease is the leading cause of death in Iran. Air pollution control will reduce the number of this preventable disease and resulting deaths. © 2004 Elsevier Inc. All rights reserved

Acute symptoms related to air pollution in urban areas: a study protocol

BACKGROUND: The harmful effects of urban air pollution on general population in terms of annoying symptoms are not adequately evaluated. This is in contrast to the hospital admissions and short term mortality. The present study protocol is designed to assess the association between the level of exposure to certain ambient air pollutants and a wide range of relevant symptoms. Awareness of the impact of pollution on the population at large will make our estimates of the pertinent covert burden imposed on the society more accurate. METHODS/DESIGN: A cross sectional study with spatial analysis for the addresses of the participants was conducted. Data were collected via telephone interviews administered to a representative sample of civilians over age four in the city. Households were selected using random digit dialling procedures and randomization within each household was also performed to select the person to be interviewed. Levels of exposure are quantified by extrapolating the addresses of the study population over the air pollution matrix of the city at the time of the interview and also for different lag times. This information system uses the data from multiple air pollution monitoring stations in conjunction with meteorological data. General linear models are applied for statistical analysis. DISCUSSION: The important limitations of cross-sectional studies on acute effects of air pollution are personal confounders and measurement error for exposure. A wide range of confounders in this study are controlled for in the statistical analysis. Exposure error may be minimised by employing a validated geographical information system that provides accurate estimates and getting detailed information on locations of individual participants during the day. The widespread operation of open air conditioning systems in the target urban area which brings about excellent mixing of the outdoor and indoor air increases the validity of outdoor pollutants levels that are taken as exposure levels

A field indoor air measurement of SARS-CoV-2 in the patient rooms of the largest hospital in Iran

The coronavirus disease 2019 (COVID-19) emerged in Wuhan city, China, in late 2019 and has rapidly spread throughout the world. The major route of transmission of SARS-CoV-2 is in contention, with the airborne route a likely transmission pathway for carrying the virus within indoor environments. Until now, there has been no evidence for detection of airborne severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and this may have implication for the potential spread of the COVID-19. We investigated the air of patient rooms with confirmed COVID-19 in the largest hospital in Iran, on March 17, 2020. To collect the SARS-CoV-2 particles, ten air samples were collected into the sterile standard midget impingers containing 20 mL DMEM with 100 μg/mL streptomycin, 100 U/mL penicillin and 1 antifoam reagent for 1 h. Besides, indoor particle number concentrations, CO2, relative humidity and temperature were recorded throughout the sampling duration. Viral RNA was extracted from samples taken from the impingers and Reverse-Transcription PCR (RT-PCR) was applied to confirm the positivity of collected samples based on the virus genome sequence. Fortunately, in this study all air samples which were collected 2 to 5 m from the patients' beds with confirmed COVID-19 were negative. Despite we indicated that all air samples were negative, however, we suggest further in vivo experiments should be conducted using actual patient cough, sneeze and breath aerosols in order to show the possibility of generation of the airborne size carrier aerosols and the viability fraction of the embedded virus in those carrier aerosols. © 2020 Elsevier B.V

Short-term associations between daily mortality and ambient particulate matter, nitrogen dioxide, and the air quality index in a Middle Eastern megacity.

There is limited evidence for short-term association between mortality and ambient air pollution in the Middle East and no study has evaluated exposure windows of about a month prior to death. We investigated all-cause non-accidental daily mortality and its association with fine particulate matter (PM2.5), nitrogen dioxide (NO2), and the Air Quality Index (AQI) from March 2011 through March 2014 in the megacity of Tehran, Iran. Generalized additive quasi-Poisson models were used within a distributed lag linear modeling framework to estimate the cumulative effects of PM2.5, NO2, and the AQI up to a lag of 45 days. We further conducted multi-pollutant models and also stratified the analyses by sex, age group, and season. The relative risk (95% confidence interval (CI)) for all seasons, both sexes and all ages at lag 0 for PM2.5, NO2, and AQI were 1.004 (1.001, 1.007), 1.003 (0.999, 1.007), and 1.004 (1.001, 1.007), respectively, per inter-quartile range (IQR) increment (18.8??g/m3 for PM2.5, 12.6?ppb for NO2, and 31.5 for AQI). In multi-pollutant models, the PM2.5 associations were almost independent from NO2. However, the RRs for NO2 were slightly attenuated after adjustment for PM2.5 but they were still largely independent from PM2.5. The cumulative relative risks (95% CI) per IQR increment reached maximum during the cooler months, including: 1.13 (1.06, 1.20) for PM2.5 at lag 0-31 (for females, all ages); 1.17 (1.10, 1.25) for NO2 at lag 0-45 (for males, all ages); and 1.13 (1.07, 1.20) for the AQI at lag 0-30 (for females, all ages). Generally, the RRs were slightly larger for NO2 than PM2.5 and AQI. We found somewhat larger RRs in females, age group >65 years of age, and in cooler months. In summary, positive associations were found in most models. This is the first study to report short-term associations between all-cause non-accidental mortality and ambient PM2.5 and NO2 in Iran

Urban air pollution and emergency room admissions for respiratory symptoms: a case-crossover study in Palermo, Italy

<p>Abstract</p> <p>Background</p> <p>Air pollution from vehicular traffic has been associated with respiratory diseases. In Palermo, the largest metropolitan area in Sicily, urban air pollution is mainly addressed to traffic-related pollution because of lack of industrial settlements, and the presence of a temperate climate that contribute to the limited use of domestic heating plants. This study aimed to investigate the association between traffic-related air pollution and emergency room admissions for acute respiratory symptoms.</p> <p>Methods</p> <p>From January 2004 through December 2007, air pollutant concentrations and emergency room visits were collected for a case-crossover study conducted in Palermo, Sicily. Risk estimates of short-term exposures to particulate matter and gaseous ambient pollutants including carbon monoxide, nitrogen dioxide, and sulfur dioxide were calculated by using a conditional logistic regression analysis.</p> <p>Results</p> <p>Emergency departments provided data on 48,519 visits for respiratory symptoms. Adjusted case-crossover analyses revealed stronger effects in the warm season for the most part of the pollutants considered, with a positive association for PM₁₀(odds ratio = 1.039, 95% confidence interval: 1.020 - 1.059), SO₂(OR = 1.068, 95% CI: 1.014 - 1.126), nitrogen dioxide (NO₂: OR = 1.043, 95% CI: 1.021 - 1.065), and CO (OR = 1.128, 95% CI: 1.074 - 1.184), especially among females (according to an increase of 10 μg/m³in PM₁₀, NO₂, SO₂, and 1 mg/m³in CO exposure). A positive association was observed either in warm or in cold season only for PM₁₀.</p> <p>Conclusions</p> <p>Our findings suggest that, in our setting, exposure to ambient levels of air pollution is an important determinant of emergency room (ER) visits for acute respiratory symptoms, particularly during the warm season. ER admittance may be considered a good proxy to evaluate the adverse effects of air pollution on respiratory health.</p