Awareness and Performance towards Proper Use of Disinfectants to Prevent COVID-19: The Case of Iran

Validity and reliability of Household Disinfectants-Cleaners Questionnaire (HDCQ) to investigate public awareness and performance in the Emirate of Abu Dhabi

BACKGROUND

Although household disinfectant cleaners are used at home frequently, less research has focused on standardized assessment tools to measure public awareness and precautions in practice, especially during health crises. The COVID-19 pandemic highlighted the important role of household disinfectants-cleaners in preventing infections. However, poor public awareness and unsafe practices can undermine their effectiveness. This study indirectly addresses this lack by developing and validating the Household Disinfectants-Cleaners Questionnaire (HDCQ), to make available an evidence-based comprehensive tool to support future assessments, public health research, and policy development.

OBJECTIVE

To assess the validity and reliability of a questionnaire designed to measure public awareness and performance regarding the safe use of household disinfectants-cleaners in Abu Dhabi.

METHODS

A cross-sectional Google survey, involving a sample of 750 Abu Dhabi residents, was analyzed using IBM-SPSS (Version 27.0) and RStudio (Version 1.1.456, Inc., 2009-2018). Validity tests included face, content, and construct evaluations by nine academic experts based on seven parameters. Reliability was assessed through Cronbach's alpha and inter-item correlation. Principal Factor Analysis (PFA), including the Kaiser-Meyer-Olkin (KMO) measure and Bartlett's test, was conducted for each section in SPSS. Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA) in RStudio identified the underlying factors explaining item covariation.

RESULTS

Cronbach's alpha values for the awareness and performance domains were 0.854 and 0.883, indicating high internal consistency. Expert ratings indicated high face validity, with importance levels ranging from 0.89 to 1.00. The average Content Validity Ratio (CVR) for the questionnaire was 0.95, indicating strong content relevance. The PFA results demonstrated adequate sampling adequacy, with a KMO measure values of 0.879 and 0.891 and Bartlett's test was statistically significant (χ2 = 2,368, P < 0.001) and (χ2 = 3,274, P < 0.001) for each section respectively, confirming factorability and suitability for factor analysis. Both EFA and CFA indicated a good model fit with RMSEA of 0.077 for Sect. 1 and 0.090 for Sect. 2, CFI of 0.990 for Sect. 1 and 0.975 for Sect. 2, and TLI of 0.986 for Sect. 1 and 0.967 for Sect. 2, confirming the robustness of the factor structure and the questionnaire's validity.

CONCLUSIONS

The findings demonstrate that this questionnaire is a valid and reliable tool for assessing public awareness and performance regarding the safe use of household disinfectants-cleaners for future pandemics. Recognizing inherent limitations, detailed in the conclusion section, is essential for effective application in public health contexts.

Validity and reliability of chemical-based disinfectant use questionnaire in a sample of the Lebanese public community

INTRODUCTION

Worldwide, people heavily use chemical-based disinfectants to prevent the spread of COVID-19 with limited or no safety instructions. Awareness about the safe use of chemical-based disinfectants is highly recommended to limit the spread of COVID-19 and to avoid any health risks when misused, especially in developing countries where a poor healthcare system is prominent. Awareness in this context refers to the understanding and knowledge of proper usage, safety protocols and potential health risks associated with chemical disinfectants. Practices refer to the actual behaviours and actions taken when using disinfectants, including frequency of use, methods of application and adherence to safety guidelines.

OBJECTIVE

The purpose of this paper is to develop a valid and reliable questionnaire to assess the community level of awareness and practice concerning chemical-based disinfectant use during COVID-19 in Lebanon.

DESIGN

The questionnaire was adapted and modified from a previous study held in Iran, in which the questions were generated and developed with content validity ratio and index (CVR and CVI). The study design was divided into the qualitative phase/development of the Disinfectants Use Questionnaire (DUQ) and the quantitative phase/psychometric properties of the DUQ. The questionnaire was subjected to face and content validity tests through expert reviews. Data validation, for 130 participants (80.8% females, 85.5% bachelor's degree and above, 80.8% students and 70.8% aged within 30 years), was examined through psychometric properties at the final stage of the validation. CVI for items (I-CVI), scale-level CVI (S-CVI), universal agreement calculation (S-CVI/UA), S-CVI and the average calculation method (S-CVI/Ave), based on I-CVI and based on proportion relevance, were calculated to determine the content validity.

RESULTS

23 items of the 28-item scale had an I-CVI of 1, and the I-CVI of the remaining five ranged between 0.75 and 0.88. The S-CVI/UA was 0.82 and the S-CVI/Ave was 0.96, which meant that the items were good for the underlying construct. For the psychometric measures, principal axis factoring was performed and the Kaiser-Meyer-Olkin (KMO) measure of sampling adequacy, Bartlett's test, eigenvalues and total variances were quite accepted and satisfactory.

CONCLUSION

This study showed that DUQ is a valid and reliable tool for evaluating the community level of awareness and practice concerning chemical-based disinfectant use during COVID-19.

Learning from an experience, challenges and approaches in the workplace during COVID-19 pandemic: a content analysis of international documents

BACKGROUND

This study aims to investigate international measures for pandemic control in the workplace based on guidelines from international organizations to learn from their experiences.

METHODS

We conducted a qualitative study using content analysis. The search method involved reviewing published guidelines on preventing and responding to the COVID-19 pandemic in workplaces. After the screening process, ten guidelines were included in the content analysis. During the analysis, 200 meaning codes, 49 subcategories, and eleven categories were identified. Trustworthiness criteria were utilized to ensure the accuracy and strength of the findings.

RESULTS

Eleven categories of international content during the COVID-19 pandemic were legal requirements and duties of employees and employers, structural and program changes, risk assessment, risk communication, information and training, internal and external consultation and cooperation, provision of facilities and tools for workplace hygiene, special conditions, special groups, closing and reopening workplaces, reducing contact and exposure and mental health.

CONCLUSIONS

Protecting employees during a pandemic requires a multifaceted approach and strong advocacy. The operational plan for pandemic control should be developed based on the level of risk, with support tailored to employees' conditions and needs. Cooperation among international organizations is essential to develop a standardized plan and issue comprehensive guidelines in response to health emergencies with a global perspective and local implementation, drawing from the lessons learned during the COVID-19 pandemic.

Evaluation of awareness and performance towards COVID-related disinfectant use: a comparative study between Jordan and United Arab Emirates

BACKGROUND

The World Health Organization recommended the use of chemical-based disinfectants as an effective prevention of the COVID-19 pandemic. However, calls for poisoning were reported in several medical centers. The widespread use of chemical-based disinfectants as a preventive measure during the COVID-19 pandemic has underscored potential gaps in community awareness and performance, posing health risks. This study evaluates and compares levels of awareness and performance regarding the safe use of disinfectants in Jordan and UAE.

METHODS

The study was conducted between October 2022 and June 2023 via an online questionnaire. Data of respondents from Jordan (n = 828) and UAE (n = 619) were analyzed using SPSS. ANOVA, Mann-Whitney, and Kruskal-Wallis tests evaluated significant differences in awareness and performance levels across different demographic groups in Jordan/UAE and between them. Spearman's correlation test examined the correlation between awareness and performance among respondents. Multinomial logistic regression analysis explored associations between various variables and awareness/performance levels within each population.

RESULTS

Findings reveal weak awareness (72.4% and 9.03% in UAE and Jordan, respectively) and moderate performance level (98.8% in UAE and Jordan), with a weak correlation (UAE, rho = 0.093; Jordan, rho = 0.164) observed between the two countries (P < 0.05). Multinomial logistic regression analysis indicates gender-related associations with awareness levels and education-related associations with performance levels.

CONCLUSIONS

The study emphasizes the urgent need for awareness campaigns and workshops to promote safer disinfectant practices to develop effective interventions aligning with sustainable development goals.

Analyzing heavy metal contamination for one of the high-rate consumption fruits in Iran: A probabilistic health risk assessment

Good health and well-being is one of the sustainable development goals (SDGs) that can be achieved through fruit consumption. This study measured cucumber (Cucumis sativus L.) heavy metal concentrations. Inductively coupled plasma-mass spectrometry (ICP-OES) was used to analyze the samples for heavy metal content. The uncertainty and sensitivity analyses of carcinogenic and non-carcinogenic heavy metal intake via cucumber (Cucumis sativus L.) consumption were assessed by Monte Carlo simulation. The mean ± SD levels of Cu, Pb, Zn, Cd, and As were determined to be 157.87 ± 128.54, 33.81 ± 6.27, 288.46 ± 114.59, 35.22 ± 18.67, and 33.6 ± 18.1 μg/kg, respectively. The 95th percentile of HI related to heavy metal intake via cucumber (Cucumis sativus L.) among children and adults were 2.64 and 1.75, respectively. Also, the 95th percentile of ELCR related to heavy metal were 8.26E-4 and 4.14E-3 among children and adults, respectively. The 95th percentile of LTCR of As among adults and As, Cd, and Pb among children were in the WHO target range (1E-04 to 1E-06) so reducing the concentration of them can help to reduce overall LTCR. When HQ and LTCR are below the cut limits, reducing heavy metals in high-consumption meals is a good way to lower them. In general, due to the wide consumption of various fruits, such as cucumber (Cucumis sativus L.), the concentration of environmental pollutants in their edible tissues should be monitored regularly, and the concentration of pollutants in these tissues should be minimized by proper planning.

Hand hygiene during the spread of COVID-19: a cross-sectional study of awareness and practices among academic institutions in Lebanon

Introduction

During the pandemic, the World Health Organization has recommended hand hygiene as one of the effective preventive measures to limit the global spread of COVID-19. However, the awareness gap of hand hygiene protocols could increase the spread of COVID-19 and consequently increase the absenteeism rate among academic institutions. This study aims to assess hand hygiene awareness and practices levels among various university communities in Lebanon.

Methods

A cross-sectional study was conducted between December 2021 and June 2022 among 1,291 participants from academic settings in Lebanese universities. An online survey (score-based questionnaire) of hand hygiene was conducted to evaluate the awareness and practices among university communities (faculty, staff, and students). Mann-Whitney and Kruskal-Wallis tests were used to determine whether significant differences exist in the levels of awareness with regard to gender, age, provinces, educational level, and university status. Pearson's chi-squared test was applied to assess differences among the sample characteristics and participants' practice of hand hygiene.

Results

It was found that most of the participants showed a moderate level of awareness (76.4%) with a mean score of 7.59 out of 12 (SD = 1.68). The Mann-Whitney test indicated that females recorded higher levels of awareness than males with a significant difference of 102, 104: p < 0.05. Another notable variable was the educational level of the participants with university degrees holders recording higher scores of awareness than the ones with high school degrees as per the Kruskal-Wallis test (p < 0.05). Significant differences were also shown in awareness scores among the age groups and the university status (p < 0.05). The Pearson's chi-squared test results showed that females used alcohol-based hand rubs or soap and water more frequently than males (p < 0.05). However, males significantly preferred the frequent use of water alone compared to females (p < 0.05).

Conclusion

The study findings highlighted the necessity of awareness campaigns and health educational programs addressing the technical skills of hand hygiene among both genders (especially males) of the academic communities in Lebanon.

Evaluation of awareness and performance towards COVID-related disinfectant use among the university communities in Lebanon

BACKGROUND

The fast spread of COVID-19 reinforced the daily use of disinfectants around the world. However, the awareness gap of disinfectant use could lead to health risks during the prevention of the pandemic. This study aims to assess the level of awareness and performance towards COVID-related disinfectant use among various university communities (student, staff, and faculty) in Lebanon.

METHODS

A cross-sectional study was conducted between December 2021 and June 2022 among 925 participants (males and females aged between 18 and 64 years old) from academic settings in Lebanese universities using convenience sampling. An online validated survey (score-based questionnaire) of personal disinfectants' utilization was conducted to evaluate the awareness and performance levels using SPSS (version 21). Mann-Whitney and Kruskal-Wallis tests were used to check significant differences in awareness and performance levels among gender, age, provinces, educational level, university status, and field of study. Friedman test was used to test for significant differences in performance level questions pre-and post-COVID-19. The Spearman correlation test was used to determine the correlation between the awareness and performance of the respondents regarding the use of disinfectants.

RESULTS

It was found that the majority of the respondents showed a weak level of awareness (70.8%) while their performance (61.9%) was moderate. Spearman's correlation analysis concluded a weak correlation between the awareness and performance levels (p < 0.01). The Mann-Whitney test indicated that there was a significant difference (p < 0.05) in awareness and performance levels between males and females. Another notable variable was the educational level of the respondents (p < 0.05) with postgraduate degrees holders recording higher mean scores of awareness than the ones with undergraduate and high school degrees as per Kruskal-Wallis test. Significant differences were shown in awareness scores among the age groups and in performance scores among the field of study (p < 0.05).

CONCLUSIONS

The study findings highlighted the necessity of awareness campaigns and training programs addressing the technical handling of disinfectants among the communities in Lebanon. Lebanese governmental authorities (Ministry of Public Health, MoPH, and Ministry of Education and Higher Education, MEHE), and the healthcare professionals and public health researchers in Lebanon may utilize this new evidence to initiate public health interventions as a part of the United Nations (UN) sustainability goal of wellbeing (Sustainable Development Goal 3, SDG 3).

Evaluation of public awareness and performance toward the safe use of household disinfectants-cleaners to prevent COVID-19 in the Emirate of Abu Dhabi

Introduction

Disinfection is one of the most effective hygienic practices that would limit the spread of the Coronavirus Disease (COVID-19) through deactivating the coronavirus on contaminated skin, supplies, and surfaces. However, the type and concentration of disinfectants should be carefully selected to avoid damaging surfaces and to limit the side effects of these chemicals on household members and users. The aim of this study is to assess the public levels of awareness and performance concerning the safe use of household cleaning products and disinfectants during the spread of COVID-19 in the Emirate of Abu Dhabi.

Methods

The cross-sectional study was conducted between October and December 2021 among 750 residents of Abu Dhabi, Al Dhafrah, and Al-Ain regions. A google survey was distributed electronically for the online recruitment of the general population. Mann-Whitney and Kruskal-Wallis tests were used to determine whether significant differences exist in the levels of awareness and performance with regard to gender, region, education level, and diagnosis with COVID-19. Spearman correlation was used to test if any correlation existed between levels of awareness and performance. Kruskal-Wallis test was also used to check if significant differences exist in the mean score of performance with respect to irritation-to-poisoning symptoms.

Results

The study population recorded a lower mean score of awareness (5.37 out of 12) than performance (11.75 out of 16). The majority of the study population claimed a minimum of one irritation-to-poisoning symptom during the handling of household cleaners and disinfectants. Significant differences exist in the awareness and performance mean scores among various educational levels (P < 0.001). The level of awareness was statistically significant with regard to infection with SARS-CoV-2 (P < 0.05). Also, the level of performance was significantly different between males and females (P < 0.001). Kruskal-Wallis test showed that the mean score of performance is statistically significant with all the studied irritation-to poisoning symptoms (P < 0.05).

Conclusions

Awareness campaigns and training programs are recommended to address the safe use of household cleaning products and disinfectants in the United Arab Emirates (UAE).

Health impact assessment and evaluation of economic costs attributed to PM2.5 air pollution using BenMAP-CE

Air pollution is considered the most prominent public health. Economically, air pollution imposes additional costs on governments. This study aimed to quantify health effects and associated economic values of reducing PM_2.5 air pollution using BenMAP-CE in Qom in 2019. The air quality data were acquired from Qom Province Environmental Protection Agency, and the population data were collected from Qom Province Management and Planning Organization website. The number of deaths due to Stroke, Chronic Obstructive Pulmonary Disease, Lung Cancer, and Ischemic Heart Disease attributable to PM_2.5 were estimated using BenMAP-CE based on two control scenarios, 2.4 and 10 μg/m³, known as scenarios I and II, respectively. The associated economic effect of premature deaths was assessed by value of a statistical life (VSL) approach. The annual average of PM_2.5 concentration was found to be 16.32 μg/m³ (SD: 9.93). A total of 4694.5 and 2475.94 premature deaths in scenarios I and II were found to be attributable to PM_2.5 in overall, respectively. The total associated cost was calculated to be 855.91 and 451.40 million USD in scenarios I and II, respectively. The total years of life lost due to PM_2.5 exposure in 2019 was 158,657.06 and 78,351.51 in scenarios I and II, respectively. The results of both health and economic assessment indicate the importance of solving the air pollution problem in Qom, as well as other big cities in Iran. The elimination of limitations, such as insufficient local data, should be regarded in future studies.

Potential Mucosal Irritation Discrimination of Surface Disinfectants Employed against SARS-CoV-2 by Limacus flavus Slug Mucosal Irritation Assay

Preventive measures have proven to be the most effective strategy to counteract the spread of the SARS-CoV-2 virus. Among these, disinfection is strongly suggested by international health organizations' official guidelines. As a consequence, the increase of disinfectants handling is going to expose people to the risk of eyes, mouth, nose, and mucous membranes accidental irritation. To assess mucosal irritation, previous studies employed the snail Arion lusitanicus as the mucosal model in Slug Mucosal Irritation (SMI) assay. The obtained results confirmed snails as a suitable experimental model for their anatomical characteristics superimposable to the human mucosae and the different easily observed readouts. Another terrestrial gastropod, Limacus flavus, also known as " Yellow slug ", due to its larger size and greater longevity, has already been proposed as an SMI assay alternative model. In this study, for the first time, in addition to the standard parameters recorded in the SMI test, the production of yellow pigment in response to irritants, unique to the snail L. flavus, was evaluated. Our results showed that this species would be a promising model for mucosal irritation studies. The study conducted testing among all those chemical solutions most commonly recommended against the SARS-CoV-2 virus.