Definition and characteristics of climate-adaptive cities: a systematic review

BACKGROUND

Cities, as frontline responders to climate change, necessitate a precise understanding of climate-adaptive features. This systematic review aims to define and outline the characteristics of climate-adaptive cities, contributing vital insights for resilient urban planning.

METHODS

This systematic review, initiated on March 6, 2018, and concluded on August 26, 2021, involved reviewing multiple electronic databases based on the study's objectives. The Critical Appraisal Skills Program (CASP) tool was used for quality assessment and critical evaluation of articles retrieved through a comprehensive and systematic text search. Descriptive and thematic analyses were conducted to extract definitions, features, and characteristics of climate-adaptive cities.

RESULTS

Out of 6104 identified articles, 38 articles met the inclusion criteria. In total, 20 definitions and 55 features for climate-adaptive cities were identified in this review. Codes were categorized into two categories and ten subcategories. The categories included definitions and features or characteristics of climate-adaptive cities.

CONCLUSION

A climate-adaptive city, as derived from the findings of this study, is a city that, through effective resource management, future-oriented planning, education, knowledge utilization, innovation in governance and industry, decentralized management, and low-carbon economy, leads to the adaptability, resilience, sustainability, and flexibility of the capacity of individuals, communities, institutions, businesses, and systems within a city against all climate change impacts and reduces their negative consequences.

The practices of heat adaptation among elderly in Dezful: A qualitative study

BACKGROUND

Useful experiences of the elderly in adapting to the environment may play an important role in formulating future policies. This study was conducted to explain the past experiences of the elderly in Dezful in adapting to heat.

MATERIALS AND METHODS

This study was conducted with a qualitative research approach and a qualitative content analysis method in 2020 and 2021. The experiences of 18 elderly in Dezful were collected through semi-structured interviews via recording, face-to-face interviews, and data observation. Sampling was performed by the purpose-based method, and the data of this stage were analyzed using a content analysis approach using the Zhang and Wildemuth method.

RESULTS

During the data analysis process, three main themes were extracted, including psychophysiological, socioeconomic, and environmental adaptation. Also, twelve subthemes including changes in physiological conditions, urban architecture, house architecture, diet, clothing, business conditions, mindset, life conditions, and the use of factors (spirituality, experience, and natural capacities) were extracted.

CONCLUSION

Explaining the experiences of the elderly in Dezful, who have lived with heat for many years, can provide better identification of solutions and more tangible experiences of adaptation to heat for other communities. These experiences can be used in urban, cultural, and social planning.

Applied distance learning methods in disaster preparedness: A systematic review

Nowadays, accidents and disasters are one of the most important issues facing humans. Training is an important feature in disasters and distance learning is a suitable method for education in every place and at every time. The aim of this study is to determine distance learning methods in disaster preparedness. This study was conducted to this question: what types of distance learning methods can use in disaster preparedness?". In this study, all published English language papers, with no time limit, were extracted by the end of December 2021 through search in PubMed, Scopus, Google scholar, ISI WOS (Web of Science), and Embase. The primary search used "distance learning", "disaster" and their MeSH terms. Quality appraisal carried out with CASP. Information in the articles including study time, study population, e-learning methods, and type of disasters or emergencies were extracted. Based on the search, 46 studies were carried out between 2002 and 2021. The most studied target group in the studies was health professionals and the content of the courses was attributed to disaster preparedness as well as biological disasters. Regarding e-learning methods, the most used method was 'simulation'. At the time of disasters, including pandemics, disruption in education may be long-term and may require overlapping response and recovery periods. And virtual education during a disaster may be rejected or endorsed by individuals or groups based on cultural, ideological, or prejudicial issues. Distance education can be used for effective disaster education in different phases of the disaster cycle, depending on the available facilities and infrastructure.

Heat waves and adaptation: A global systematic review

BACKGROUND

Given the increasing trend of global warming and extreme weather conditions, including heat waves and its effects on health, the present study was done to investigate adaptive behaviors of communities in the world for combating heat waves.

METHOD

ology: In this systematic review, out of 1529 results, 57 relevant and authoritative English papers on adaptation to heat waves hazard were extracted and evaluated using valid keywords from valid databases (PubMed, WOS, EMBASE, and Scopus). In addition, multiple screening steps were done and then, the selected papers were qualitatively assessed. Evaluation results were summarized using an Extraction Table.

RESULTS

In this paper, the adaptive behaviors for combating heat waves hazard were summarized into 11 categories: Education and awareness raising, Adaptation of critical infrastructure, Governments measures, Health-related measures, Application of early warning system, Protective behaviors in workplace, Physical condition, Adaptive individual behaviors, Design and architecture of the building, Green infrastructure (green cover), and Urban design.

CONCLUSION

The findings of this study showed that community actions have significant effects on adaptation to heat wave. Therefore, for reducing heat wave-related negative health effects and vulnerability, more attention should be paid to the above-mentioned actions for mitigation, preparation, and responding regarding heat waves.

PROSPERO REGISTRATION NUMBER

CRD42021257747.

Does Monsoon Itself Cause Health Risks? Lessons From the Flash Flood of Imamzadeh Davood, Iran 2022

During the summer of 2022, several regions worldwide, including Iran, were subjected to intense monsoon rains, resulting in significant adverse impacts on the health, economy, and social well-being of affected populations. However, by focusing on adaptation and resilience measures, not only could the negative consequences of this phenomenon be mitigated, but as evidenced by other countries, the opportunity presented by rainwater could be utilized to promote development, health, and socioeconomic welfare in these areas. This concise report aims to explore the lessons learned from this phenomenon, including its strengths and weaknesses.

Diurnal temperature range and hospital admission due to cardiovascular and respiratory diseases in Dezful, a city with hot climate and high DTR fluctuation in Iran: an ecological time-series study

The results of previous studies have indicated the effects of temperature changes on health status. The present study was conducted to investigate the effects of diurnal temperature range (DTR) and hospital admission on cardiovascular and respiratory diseases in Dezful, in Iran. In this ecological time-series study, data related to hospital admissions based on ICD-10, meteorological, and climatological data were gathered over a period of six years from 2014 to 2019. A distributed lag nonlinear model combined with a quasi-Poisson regression was then used to assess the impact of DTR on cardiovascular and respiratory hospital admissions. Potential confounders, including wind speed, air pollution, seasonality, time trend, weekends and holidays, days of week, and humidity were controlled. In extreme low DTRs, the cumulative effects of cardiovascular admissions significantly increased in total, and in warm and cold seasons (Lag_0-21, P ≤ 0.05). In addition, in extreme high DTRs, the cumulative effects of cardiovascular significantly decreased in total (Lag_0-13 and Lag_0-21, P ≤ 0.05), and in warm (Lag_0-21, P ≤ 0.05) and cold seasons (Lag_0-21, P ≤ 0.05). Moreover, respiratory admissions significantly decreased in total (Lag_0-21, P ≤ 0.05) and in warm season (Lag_0-21, P ≤ 0.05).Our result indicates that extreme low DTRs could increase the risk of daily cardiovascular admissions, and extreme high DTRs may cause a protective effect on daily respiratory and cardiovascular admissions in some regions with high fluctuations in DTR.

Mortality Risk Related to Heatwaves in Dezful City, Southwest of Iran

BACKGROUND

We aimed to evaluate the impact of heatwaves on daily deaths due to non-accidental, cardiovascular and respiratory causes in the city of Dezful in Iran from 2013 to 2019.

METHOD

We collected daily ambient temperature and mortality and defined 2 types of heatwaves by combining daily temperature ⩾90th in each month of the study period or since 30 years with duration ⩾2 and 3 days. We used a distributed lag non-linear model to study the association between each type of heatwave definition, and deaths due to non-accidental, cardiovascular and respiratory causes with lags up to 13 days.

RESULTS

There was no discernible correlation in this area, despite the fact that heatwaves raised the risk of death from cardiovascular causes and lowered the risk from respiratory causes. On the other hand, the risk of total non-accidental mortality on days with the heatwaves is significantly higher than normal days. In main effects, the heatwaves have a significant relationship with the risk of total non-accidental mortality (in the first heatwave definition, Cumulative Excess Risk (CER) in lag_0-2 was 10.4 and in second heatwave definition, CER values in lag_{0, 0-2, and 0-6} were 12.4, 29.2, and 38.8 respectively). Also, in added effects, heatwaves have a significant relationship with the risk of total non-accidental mortality (in the first heatwave definition, CER in lag_{0 and 0-2} were 1.79 and 4.11 and in the second heatwave definition, CER values in lag_{0, 0-2, and 0-6} were 7.76, 18.35 and 24.87 respectively). In addition, heatwaves appeared to contribute to a cumulative excess risk of non-accidental death among the male group as well as the older adults.

CONCLUSION

However, the results showed that heatwaves could have detrimental effects on health, even in populations accustomed to the extreme heat. Therefore, early warning systems which monitor heatwaves should provide the necessary warnings to the population, especially the most vulnerable groups.

Heat wave adaptation paradigm and adaptation strategies of community: A qualitative phenomenological study in Iran

BACKGROUND

Heat wave adaptation is a new concept related to experiencing heat. The present study aims at investigating a conceptual definition, that is, the mental framework of heat wave adaptation and its strategies.

MATERIALS AND METHODS

A phenomenological study was performed to explain the mental concept. At the same time with the data collection process, data analysis was also performed using Colaizzi method. Semi-structured interview method and purposeful sampling with maximum variety were used. Interviews were conducted with 23 different subjects in the community. The accuracy of the data was guaranteed using Lincoln & Guba scientific accuracy criteria.

RESULTS

The two main themes of the adaptation paradigm as well as its strategies were divided into the main categories of theoretical and operational concepts, as well as personal care measures and government measures. Under the category of individual measures, we obtained "clothing, nutrition, building, place of residence and lifestyle," and under the category of governance actions, the "managerial, research, health, organizational" subcategories were obtained.

CONCLUSION

According to the results of the conceptual-operational definition, heat wave adaptation is an active process and an effort to reduce the adverse effects of heat waves on individual and social life, and striking a balance that will not only result in individual awareness and actions that will lead to lifestyle changes, but also mostly requires integrated and comprehensive planning in the community. On the one hand, heat waves could not only be regarded as a threat or danger, but can also become an opportunity for the development of a community through identification and smart measures, and for adaptation, the community must take it as a risk. The community should have a plan in advance, apply the necessary rules and training, and use the new facilities and rules where necessary. This practical concept definition includes the main features of heat wave adaptation.

Effect of Dust Storms on Non-Accidental, Cardiovascular, and Respiratory Mortality: A Case of Dezful City in Iran

BACKGROUND

Despite the fact that Iran has been exposed to severe dust storms during the past 2 decades, few studies have investigated the health effects of these events in Iran. This study was conducted to assess the association between dust storms and daily non-accidental, cardiovascular, and respiratory mortality in Dezful City (Khuzestan Province, Iran) during 2014 to 2019.

METHODS

In this study, mortality, meteorological, and climatological data were obtained from the Dezful University of Medical Sciences, Iranian Meteorological Organization, and Department of Environment in Khuzestan Province, respectively. Days of dust storm were identified based on the daily concentration threshold of particulate matter with an aerodynamic diameter of less than 10 μm (PM10) according to Hoffmanns҆ definition, and then an ecological time-series was used to estimate the short-term effects of dust storms on daily mortality. Statistical analysis was performed using a distributed lag linear model (DLM) and a distributed lag non-linear model (DLNM) packages by R software and the study results were reported as excess mortality.

RESULTS

During the study period, 15 223 deaths were recorded, and 139 dust storms occurred in Dezful city. In addition, there was statistically significant excess risk of mortality due to dust storms in Dezful City (mortality in the group under 15 years of age, lag4: 34.17% and 15-64 years of age groups, lag5: 32.19%, lag6: 3.28%), also dust storms had statistically significant effects on respiratory mortality (lag6: 5.49%).

CONCLUSION

The findings of the current study indicate that dust storms increase the risk of mortality with some lags. An evidence-based early warning system may be able to aware the people of the health effects of dust storms.

Global Health Impacts of Dust Storms: A Systematic Review

BACKGROUND

Dust storms and their impacts on health are becoming a major public health issue. The current study examines the health impacts of dust storms around the world to provide an overview of this issue.

METHOD

In this systematic review, 140 relevant and authoritative English articles on the impacts of dust storms on health (up to September 2019) were identified and extracted from 28 968 articles using valid keywords from various databases (PubMed, WOS, EMBASE, and Scopus) and multiple screening steps. Selected papers were then qualitatively examined and evaluated. Evaluation results were summarized using an Extraction Table.

RESULTS

The results of the study are divided into two parts: short and long-term impacts of dust storms. Short-term impacts include mortality, visitation, emergency medical dispatch, hospitalization, increased symptoms, and decreased pulmonary function. Long-term impacts include pregnancy, cognitive difficulties, and birth problems. Additionally, this study shows that dust storms have devastating impacts on health, affecting cardiovascular and respiratory health in particular.

CONCLUSION

The findings of this study show that dust storms have significant public health impacts. More attention should be paid to these natural hazards to prepare for, respond to, and mitigate these hazardous events to reduce their negative health impacts.Registration: PROSPERO registration number CRD42018093325.

Alcohol intake in an attempt to fight COVID-19: A medical myth in Iran

The coronavirus disease 2019 (COVID-19) spread rapidly worldwide and led to the deaths of thousands of people. To date, there is not any vaccine or specific antiviral medicine that can prevent or treat this virus. This caused panic among people who try their best to prevent being infected. In Iran, methanol poisoning was reported and led to the death of hundreds of people in several provinces. The incident occurred after a rumor circulated in the country that drinking alcohol (ethanol) can cure or prevent being infected by COVID-19.

The Concept of Successful Aging: A Review Article

Background

With the increasing number of elderly people in the world, usage of concepts and terminology related to this phenomenon has substantially increased. One concept in this context is successful aging. The purpose of the present study is to extract and introduce a common concept to be used in studies on measuring successful aging.

Methods

This is a review study. First, by searching the databases of Magiran, Noormags, Medlib, Irandoc, Iranmedex, Barakat Knowledge Network System, Civilica, SID, ISI Web Of Science, PubMed, Scopus, Science Direct and search engines, Google Scholar and Elmnet as well as using standard keywords such as elder, elderly, aging, and successful aging, all related published articles during the period 1995 to 2017 were retrieved. A total of 3417 documents were retrieved. By removing 3390 unrelated, duplicate and unusable documents, 27 articles were included in the study after quality control.

Results

The findings of the study were categorized in three areas: “defining successful aging by focusing on dimensions”, “successful aging principles” and “factors influencing successful aging”. Reviewing various studies, we found that the definition of successful aging deals with cognitive action, perception, control, life satisfaction, and ethics. Successful aging is also defined as having inner feelings of happiness and satisfaction with life for the present and the past. Sometimes successful aging is also considered to be survival with health.

Conclusion

Health care professionals as community health supporters can use the results from the present study for providing the grounds for successful aging. Then, they can use the designed successful aging program for preserving and promoting active and healthy aging for every elderly person in old age.

Cardiovascular and respiratory emergency dispatch due to short-term exposure to ambient PM10 in Dezful, Iran

Introduction: This study was conducted to determine the relation between exposure to particulate matter less than 10 microns (PM₁₀) caused by dust storms and the risk of cardiovascular, respiratory and traffic accident missions carried out by Emergency Medical Services (EMS).

Methods: This was a time-series study conducted in Dezful city, Iran. Daily information on the number of missions by the EMS due to cardiovascular, respiratory and crash problems and data on PM₁₀ were inquired from March 2013 until March 2016. A generalized linear model (GLM) with distributed lag models (DLMs) was used to evaluate the relation between the number of EMS missions and the average daily PM₁₀. The latent effects of PM₁₀ were estimated in single and cumulative lags, up to 14 days.

Results: In the adjusted model, for each IQR increase in the average daily PM₁₀ concentration, the risk of EMS missions in the total population in single lags of 2 to 7 days, and the cumulative lags of 0-7 and 0-14 days after exposure had a 0.8, 0.8, 0.8, 0.8, 0.7, 0.6, 6.7 and 1.4% significant increase. Also, for each IQR increase in the daily mean concentration of PM₁₀ in single 1 to 7, and cumulative lags of 0-2, 0-7, and 0-14 days after exposure, respectively, a 2.4, 2.7, 2.8, 2.9, 2.9, 2.7, 2.5, 7.4, 23.5 and 33. 3 % increase was observed in the risk of EMS cardiovascular missions.

Conclusion: Increase in daily PM₁₀ concentrations in Dezful is associated with an increase in the risk of EMS missions in lags up to two weeks after exposure.

The Methanol Poisoning Outbreaks in Iran 2018

AIMS

To present epidemiological data, probable causes and lessons learned from the outbreak of methanol poisoning in Iran in September 2018, and relate this to the increasing incidence of methanol poisoning worldwide over recent decades.

METHOD

Analysis of all available reliable field information, official news reports and reports from the country's forensic medicine organization and the Ministry of Health.

RESULTS

Overall, 768 people in Iran were documented as poisoned from September 7 to October 7 2018 by consuming an informal alcohol containing methanol, of whom 76 died (10.1% fatality rate); 460 subjects attended state hospitals due to acute methanol poisoning of whom 42 (9.13%) died. Those who were hospitalized comprised 177 subjects (38.4%), with 241 subjects (52.3%) seen and discharged. Males comprised 93% of the deaths. About 41% of those poisoned were aged 25-36. Outbreaks were reported in 21 provinces.

CONCLUSION

These data indicate a high fatality rate of methanol poisoning in Iran, something seen also in some other countries. Considering that such outbreaks take place more in low-income and Islamic countries due to ignorance and legal constraints, it seems necessary to seek an effective educational model for raising public awareness and a fully native and early warning system in this regard to reduce the damage and enhance readiness to deal with the health effects of such outbreaks.

Triage live lecture versus triage video podcast in pre-hospital students' education

Introduction

Triage is the process of determining the priority of patients’ treatments based on the severity of their conditions. The aim of the present study was to survey the effect of triage video podcasting on the knowledge and performance of pre-hospital students.

Methods

Sixty pre-hospital students were randomly divided into two groups of a 30-subject control group and a 30-subject intervention group. A pre-test was administered among all students. Afterwards, for the first group, triage education was offered through lectures using PowerPoint, while for the second group, audio and video podcasts tailored for this training program were employed. Right after the training as well as one month later, post-tests were run for both groups, and the results were analysed using an independent t-test and covariance.

Results

No significant difference was observed between the effects of both types of education on knowledge and performance, either immediately, or one month after training.

Discussion

We suggest that video podcasts are ready to replace traditional teaching methods in triage.

Air pollution and hospital admissions for cardiovascular diseases in Ahvaz, Iran

Cardiovascular disease is one of the main causes of death in Iran. The aim of this study was to determine the relation between air pollution and cardiovascular hospital admissions in Ahwaz, Iran. Daily information about cardiovascular hospital admissions (based on the ICD-10) and data on air pollutants during 2008-2018 were inquired. A quasi-Poisson regression combined with linear distributed lag models; adjusted for trend, seasonality, temperature, relative humidity, weekdays and holidays was used to assess the relation between hospital admission for cardiovascular diseases and the average daily air pollution. The results of this study showed a significant increase in cardiovascular hospital admissions in the total population and women's population in relation to O₃. There was a significant increase in hospital admissions for cardiovascular diseases in the whole population as well as gender and age groups associated with NO₂ and NO. A significant increase was found in hospital admissions for cardiovascular diseases in relation to CO in the 65-74-year-old population. Finally, the results of this study showed that there was a significant increase in hospital admissions for cardiovascular disease associated with SO₂. The main results of the present study confirm the deleterious short term impact of air pollution on cardiovascular morbidity in Ahvaz city. This evidence empasizes the need to implement policies for reducing air pollution.

Earthquake in Western Iran: Renovation Kills

Introduction: Earthquake is the most important cause of death from natural disasters in Iran. This paper brings attention to the main causes of loss of life due to the Kermanshah province earthquake (Nov 12 2017), and provides a wakeup call about the unsafe nature of buildings there. Methods: This study is based on official reports review and a field assessment in the areas affected by the earthquake in western Iran. Results: Although buildings in this area are mainly old structures, strangely, more than 70% of the destroyed buildings in this earthquake were under 5 years of age, newly built or renovated buildings according to mandated building codes. Discussion: Mandated building codes and construction rules and regulations are not respected even for the newly constructed or reconstructed structures buildings. Keywords: Earthquake, Iran, construct, reconstruct, Building codes

Design and implementation of an empowerment model to prevent elder abuse: a randomized controlled trial

Background

Older adults are more vulnerable to health risks than younger people and may get exposed to various dangers, including elder abuse. This study aimed to design and implement an empowerment educational intervention to prevent elder abuse.

Methods

This parallel randomized controlled trial was conducted in 2014–2016 for 18 months on 464 older adults aged above 60 years who visited health houses of 22 municipalities in Tehran. Data were collected using standard questionnaires, including the Elder Abuse-Knowledge Questionnaire, Health-Promoting Behavior Questionnaire, Health-Promoting Lifestyle Profile II, Barriers to Healthy Lifestyle, Perceived Social Support, Perceived Self-Efficacy, Loneliness Scale, Geriatric Depression Scale, Multidimensional Health Locus of Control Scale, and the SCARED (stress, coping, argument, resources, events, and dependence) tool. The intervention was done in twenty 45- to 60-minute training sessions over 6 months. Data analysis were performed using χ² tests, multiple linear and logistic regression, and structural equation modeling (SEM).

Results

The frequency of knowledge of elder abuse, self-efficacy, social support and health promoting lifestyle before the intervention was similar in the two groups. However, the frequency of high knowledge of elder abuse (94.8% in the intervention group and 46.6% in the control group), high self-efficacy (82.8% and 7.8%, respectively), high social support (97.0% and 10.3%, respectively) and high health promoting lifestyle (97.0% and 10.3%, respectively) was significantly higher (P<0.001) and the frequency of elder abuse risk (28.0% and 49.6%, respectively) was significantly less in the intervention group after the intervention. SEM standardized beta (Sβ) showed that the intervention had the highest impact on increase social support (Sβ=0.80, β=48.64, SE=1.70, P<0.05), self-efficacy (Sβ=0.76, β=13.32, SE=0.52, P<0.05) and health promoting behaviors (Sβ=0.48, β=33.08, SE=2.26, P<0.05), respectively. The effect of the intervention on decrease of elder abuse risk was indirect and significant (Sβ=−0.406, β=−0.340, SE=0.03, P<0.05), and through social support, self-efficacy, and health promoting behaviors.

Conclusion

Educational interventions can be effective in preventing elder abuse.

Short-term effects of air pollution on respiratory mortality in Ahvaz, Iran

Background: Urban air pollutants may affect respiratory mortality. This study was conducted to investigate this effect in Ahvaz, one of the most polluted cities in the world. Methods: The impact of 7 major air pollutants including O3, PM10, NO2, CO, and SO2 were evaluated on respiratory mortality in different gender and age groups using a quasi-Poisson, second degree polynomial constrained, distributed lag model, with single and cumulative lag structures adjusted by trend, seasonality, temperature, relative humidity, weekdays, and holiday. Data were analyzed using the dlnm package in R x64 3.2.5 software. Significance level was set at less than 0.05. Results: In adjusted models, for each IQR increase of O3 in the total population, the risk ratio (RR) for respiratory deaths in 0 to 14- day lags was, respectively, 1.009 (95% CI:1.001-1.016) and 1.009 (95% CI:1.002-1.017), and it was 1.021 (95% CI: 1.002-1.040) in cumulative 0 to 14- day lags. For PM10, in the total population and in adjusted models after 0 to 14- day lags and in cumulative lags of 0 to 14 for an IQR increase in the mean concentration of PM10, the RR for respiratory deaths increased significantly and was, respectively, 1.027 (95% CI:1.002-1.051), 1.029 (95% CI:1.006-1.052), and 1.065 (95% CI:1.005-1.128). NO2 showed a significant association with respiratory deaths only in the 18 to 60 year- old age group and in 9- day lags (RR= 1.318, 95% CI:1.002-1.733). Finally, the results showed that for an IQR increase in the mean concentration of CO and SO2, the adjusted RR for respiratory deaths in 9- day lags in the total population was, respectively, RR= 1.058 (95% CI:1.008-1.111) and 1.126 (95% CI:1.034-1.220). Conclusion: Air pollution in Ahvaz is probably causing increased respiratory mortality.

Lag time structure of cardiovascular deaths attributed to ambient air pollutants in Ahvaz, Iran, 2008-2015

OBJECTIVES

There are few studies about the association between breathing polluted air and increased risk of cardiovascular diseases and cardiac death in the Middle East. This study aimed to investigate the relation between air pollutants and cardiovascular mortality (based on ICD-10) in Ahvaz.

MATERIAL AND METHODS

In this ecological study, the data about cardiovascular disease mortality and air pollutants from March 2008 until March 2015 was inquired from the Ahvaz City Authority and the Khuzestan Province Environmental Protection Agency. The quasi-Poisson, second degree polynomial constrained, distributed lag model; using single and cumulative lag structures, adjusted by trend, seasonality, temperature, relative humidity, weekdays and holidays was used for the data analysis purposes.

RESULTS

Findings indicated a direct significant relation between an interquartile range (IQR) increase in ozone and cardiovascular deaths among men after 3 days' lag. There was also a significant relation between an IQR increase in particulate matter below 10 μm and cardiovascular deaths for all people, over 60 years old and under 18 years old after 3 and 13 days' lags. There was a significant relation between an IQR increase in nitrogen dioxide and carbon monoxide, and cardiovascular deaths in the case of under 18-year-olds (in the lag 11) and over 60-year-olds (in the lag 9), respectively. We finally found a significant association between an IQR increase in sulfur dioxide and cardiovascular deaths in the case of men, under 18-year-olds and from 18- to 60-year-olds in the lag 9, 0, and 11, respectively (p-values < 0.05).

CONCLUSIONS

It appears that air pollution is significantly associated with cardiovascular deaths in Ahvaz City. Int J Occup Med Environ Health 2018;31(4):459-473.

Rainfall-Associated Bronchospasm Epidemics: The Epidemiological Effects of Air Pollutants and Weather Variables

BACKGROUND

This study compares different risk factors in patients visiting a hospital during five rainfall-associated bronchospasm epidemics in Ahvaz and those visiting on other occasions.

METHODS

This case-control study was conducted on 5307 patients with bronchospasm admitted to the Emergency Department of Imam Khomeini Hospital in Ahvaz (Iran) from late October to December (as the epidemic) and 916 patients admitted from late January to March (as the nonepidemic) in 2011 to 2015.

RESULTS

A total of the 41.7% of the cases and 48.8% of the controls had episodes of bronchospasm, suggesting a significant difference between the two groups (P < 0.001). The mean concentrations of PM10, NO, NO2, and NO x pollutants (except O3) were significantly higher in the nonepidemic periods (P < 0.05). The adjusted analysis showed a direct significant relationship between emergency respiratory admissions and each unit of increase in NO and SO2 concentration during the epidemic periods and NO2 concentration during the nonepidemic periods. During the epidemic periods, a direct and significant relationship was also observed between respiratory admissions and each unit of increase in relative humidity and evaporation.

CONCLUSION

The results suggest that certain pollutants and weather variables are associated with the risk of emergency respiratory admissions during epidemic periods.