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Patwary MM, Sakhvidi MJZ, Ashraf S, Dadvand P, Browning MHEM, Alam MA, Bell ML, James P, Astell-Burt T. Impact of green space and built environment on metabolic syndrome: A systematic review with meta-analysis. Sci Total Environ 2024; 923:170977. [PMID: 38360326 DOI: 10.1016/j.scitotenv.2024.170977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 02/03/2024] [Accepted: 02/12/2024] [Indexed: 02/17/2024]
Abstract
Metabolic Syndrome presents a significant public health challenge associated with an increased risk of noncommunicable diseases such as cardiovascular conditions. Evidence shows that green spaces and the built environment may influence metabolic syndrome. We conducted a systematic review and meta-analysis of observational studies published through August 30, 2023, examining the association of green space and built environment with metabolic syndrome. A quality assessment of the included studies was conducted using the Office of Health Assessment and Translation (OHAT) tool. The Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) assessment was used to evaluate the overall quality of evidence. Our search retrieved 18 studies that met the inclusion criteria and were included in our review. Most were from China (n = 5) and the USA (n = 5), and most used a cross-sectional study design (n = 8). Nine studies (50 %) reported only green space exposures, seven (39 %) reported only built environment exposures, and two (11 %) reported both built environment and green space exposures. Studies reported diverse definitions of green space and the built environment, such as availability, accessibility, and quality, particularly around participants' homes. The outcomes focused on metabolic syndrome; however, studies applied different definitions of metabolic syndrome. Meta-analysis results showed that an increase in normalized difference vegetation index (NDVI) within a 500-m buffer was associated with a lower risk of metabolic syndrome (odds ratio [OR] = 0.90, 95%CI = 0.87-0.93, I2 = 22.3 %, n = 4). A substantial number of studies detected bias for exposure classification and residual confounding. Overall, the extant literature shows a 'limited' strength of evidence for green space protecting against metabolic syndrome and an 'inadequate' strength of evidence for the built environment associated with metabolic syndrome. Studies with more robust study designs, better controlled confounding factors, and stronger exposure measures are needed to understand better what types of green spaces and built environment features influence metabolic syndrome.
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Affiliation(s)
- Muhammad Mainuddin Patwary
- Environment and Sustainability Research Initiative, Khulna, Bangladesh; Environmental Science Discipline, Life Science School, Khulna University, Khulna, Bangladesh.
| | - Mohammad Javad Zare Sakhvidi
- Department of Occupational Health, School of Public Health, Yazd Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Sadia Ashraf
- Environmental Science Discipline, Life Science School, Khulna University, Khulna, Bangladesh
| | - Payam Dadvand
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Matthew H E M Browning
- Department of Parks, Recreation and Tourism Management, Clemson University, Clemson, SC, USA
| | - Md Ashraful Alam
- Department of Computational Diagnostic Radiology and Preventive Medicine, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan
| | - Michelle L Bell
- Yale School of the Environment, Yale University, New Haven, CT, United States
| | - Peter James
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA; Department of Population Medicine, Harvard Medical School, Harvard Pilgrim Health Care Institute, Harvard University, Boston, MA, USA
| | - Thomas Astell-Burt
- School of Architecture, Design, and Planning, University of Sydney, Australia
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Zhu Q, Zhou M, Zare Sakhvidi MJ, Yang S, Chen S, Feng P, Chen Z, Xu Z, Liu Q, Yang J. Projecting heat-related cardiovascular mortality burden attributable to human-induced climate change in China. EBioMedicine 2024; 103:105119. [PMID: 38631093 PMCID: PMC11035030 DOI: 10.1016/j.ebiom.2024.105119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Revised: 03/27/2024] [Accepted: 04/01/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND Cardiovascular disease (CVD) has been found to be particularly vulnerable to climate change and temperature variability. This study aimed to assess the extent to which human-induced climate change contributes to future heat-related CVD burdens. METHODS Daily data on CVD mortality and temperature were collected in 161 Chinese communities from 2007 to 2013. The association between heat and CVD mortality was established using a two-stage time-series design. Under the natural forcing, human-induced, and combined scenarios, we then separately projected excess cause-/age-/region-/education-specific mortality from future high temperature in 2010-2100, assuming no adaptation and population changes. FINDINGS Under shared socioeconomic pathway with natural forcing scenario (SSP2-4.5-nat), heat-related attributable fraction of CVD deaths decreased slightly from 3.3% [95% empirical confidence interval (eCI): 0.3, 5.8] in the 2010s to 2.8% (95% eCI: 0.1, 5.2) in the 2090s, with relative change of -0.4% (95% eCI: -0.8, 0.0). However, for combined natural and human-induced forcings, this estimate would surge to 8.9% (95% eCI: 1.5, 15.7), 14.4% (95% eCI: 1.5, 25.3), 21.3% (95% eCI: -0.6, 39.4), and 28.7% (95% eCI: -3.3, 48.0) in the 2090s under SSP1-2.6, SSP2-4.5, SSP3-7.0, and SSP5-8.5 scenarios, respectively. When excluding the natural forcing, the number of human-induced heat-related CVD deaths would increase from approximately eight thousand (accounting for 31% of total heat-related CVD deaths) in the 2010s to 33,052 (68%), 63,283 (80%), 101,091 (87%), and 141,948 (90%) in the 2090s under SSP1-2.6, SSP2-4.5, SSP3-7.0, and SSP5-8.5 scenarios, respectively. Individuals with stroke, females, the elderly, people living in rural areas, and those with lower education level would exhibit heightened susceptibility to future high temperature. In addition, Southern and Eastern regions of China were expected to experience a faster increase in heat-related attributable fraction of CVD deaths. INTERPRETATION Human activities would significantly amplify the future burden of heat-related CVD. Our study findings suggested that active adaptation and mitigation measures towards future warming could yield substantial health benefits for the patients with CVD. FUNDING National Natural Science Foundation of China.
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Affiliation(s)
- Qiongyu Zhu
- The Key Laboratory of Advanced Interdisciplinary Studies, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China; School of Public Health, Guangzhou Medical University, Guangzhou, 511436, China
| | - Maigeng Zhou
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Beijing, 100050, China
| | - Mohammad Javad Zare Sakhvidi
- Department of Occupational Health, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Siru Yang
- School of Public Health, Guangzhou Medical University, Guangzhou, 511436, China
| | - Sujuan Chen
- School of Public Health, Guangzhou Medical University, Guangzhou, 511436, China
| | - Puyu Feng
- College of Land Science and Technology, China Agricultural University, Beijing, 100193, China
| | | | - Zhiwei Xu
- School of Medicine and Dentistry, Griffith University, Gold Coast, Queensland, Australia
| | - Qiyong Liu
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
| | - Jun Yang
- The Key Laboratory of Advanced Interdisciplinary Studies, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China; School of Public Health, Guangzhou Medical University, Guangzhou, 511436, China.
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Rahmanian M, Zare Sakhvidi MJ, Mehrparvar AH, Zare Sakhvidi F, Dadvand P. Association between occupational noise exposure and diabetes: A systematic review and meta-analysis. Int J Hyg Environ Health 2023; 252:114222. [PMID: 37454581 DOI: 10.1016/j.ijheh.2023.114222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 06/21/2023] [Accepted: 07/04/2023] [Indexed: 07/18/2023]
Abstract
BACKGROUND In addition to the well-known risk factors of diabetes, evidence is accumulating on the negative role of environmental and occupational factors such as noise exposure. We conducted a systematic review and meta-analysis on the association between long-term occupational noise exposure and diabetes. METHODS We systematically searched evidence in PubMed, Scopus, and Web of Science (until August 2022) according to the PRISMA protocol. Risk of bias was assessed using the Newcastle-Ottawa scale. Random-effects meta-analysis was applied separately for risk ratio (odds ratio, relative risk) and hazard ratio. We evaluated the heterogeneity and publication bias. We applied meta-regressions to identify sources of heterogeneity. The overall body of evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) framework. RESULTS Of 533 retrieved articles, twelve studies (11 on non-gestational, and one on gestational diabetes) on total 106,045 population (23,996 diabetic cases) met our inclusion criteria; of which eight studies were cross-sectional, three were cohorts, and one was case-control. Only 40% of papers (five out of 12) had fair, good or very good quality, and most of the papers had poor or very poor quality in terms of risk of bias. We observed a non-significant increased risk of diabetes in association with occupational noise exposure (combined risk estimates: 1.16, 95% confidence interval [CI]: 0.97: 1.34; I2 = 57.7%). Doing separate meta-analyses on cohort and rest of studies, we found similar findings (cohort studies (n = 3): combined risk estimate: 1.17; 95% CI: 0.84: 1.50; I2 = 79%; cross-sectional studies (n = 8): combined risk estimate: 1.26; 95% CI: 0.93: 1.58; I2 = 50.4%). We found no indication of publication bias. CONCLUSIONS The overall evidence on the association between occupational noise exposure and diabetes is heterogeneous, limited, and mostly with low quality. More robust studies in terms of population selection, exposure and outcome assessment, and adjustment for confounders are necessary.
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Affiliation(s)
- Masoud Rahmanian
- Department of Endocrinology, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mohammad Javad Zare Sakhvidi
- Department of Occupational Health, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran; Industrial Diseases Research Center, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
| | - Amir Houshang Mehrparvar
- Industrial Diseases Research Center, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Fariba Zare Sakhvidi
- Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Payam Dadvand
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
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Sabet S, Mirmohammadi SJ, Zare Sakhvidi MJ, Vakili M, Mehrparvar AH, Mirzaei M. Spirometric Parameters in Waterpipe Smokers, Cigarette Smokers, and Non-smokers of Shahedieh Cohort Study. Addict Health 2023; 15:17-22. [PMID: 37560079 PMCID: PMC10408739 DOI: 10.34172/ahj.2023.1350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 05/30/2022] [Indexed: 08/11/2023]
Abstract
BACKGROUND Different kinds of smoking tobacco may affect pulmonary function and reduce some spirometric parameters. This study aimed to assess the relationship between smoking cigarettes and waterpipe and spirometric parameters. METHODS This was a cross-sectional study on 1543 middle-aged individuals, as a sub-study of the Shahedieh cohort study in Yazd. The participants were randomly selected from the Shahedieh cohort population and were divided into 6 groups according to their smoking habits: non-smokers (n=455), cigarette smokers (n=139), waterpipe smokers (n=287), ex-cigarette smokers (n=131), concurrent waterpipe and cigarette smokers (n=121), and cigarette or waterpipe passive smokers (n=410). Spirometry was performed on all participants and spirometric parameters were compared between different groups. The data were analyzed by SPSS (version 20) using Kolmogorov-Smirnov, Kruskal-Wallis, and Mann-Whitney U tests. FINDINGS FEV1 %, FEV1/FVC, and PEF25-75% were significantly lower in cigarette smokers, compared to waterpipe smokers and non-smokers. The measures were not significantly lower in waterpipe smokers in comparison to non-smokers. The frequency of obstructive pattern and small airway diseases was significantly higher in cigarette smokers compared to waterpipe smokers and non-smokers. CONCLUSION The results of this study showed that in the middle-aged population, spirometric parameters related to airway obstruction (FEV1, FEV1/FVC, and FEF25-75%) were significantly lower in cigarette smokers than in non-smokers and waterpipe smokers, but these parameters were not significantly different between waterpipe smokers and non-smokers.
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Affiliation(s)
- Sobhan Sabet
- Occupational Medicine Resident, Industrial Diseases Research Center, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Seyyed Jalil Mirmohammadi
- Department of Occupational Medicine, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mohammad Javad Zare Sakhvidi
- Department of Occupational Health, Faculty of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mahmood Vakili
- Department of Social Medicine, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Amir Houshang Mehrparvar
- Industrial Diseases Research Center, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Masoud Mirzaei
- Yazd Cardiovascular Research Center, Faculty of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Zare Sakhvidi MJ, Lafontaine A, Lequy E, Berr C, de Hoogh K, Vienneau D, Goldberg M, Zins M, Lemogne C, Jacquemin B. Ambient air pollution exposure and depressive symptoms: Findings from the French CONSTANCES cohort. Environ Int 2022; 170:107622. [PMID: 36384066 DOI: 10.1016/j.envint.2022.107622] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 11/06/2022] [Accepted: 11/07/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND AND AIM Few studies have reported the association between air pollution exposure with different dimensions of depression. We aimed to explore this association across different dimensions of depressive symptoms in a large population. METHODS Data from the enrollment phase of the French CONSTANCES cohort (2012-2020) were analyzed cross-sectionally. Annual concentrations of particulate matter with a diameter < 2.5 µm (PM2.5), black carbon (BC), and nitrogen dioxide (NO2) from the land-use regression models were assigned to the residential addresses of participants. Total depressive symptoms and its four dimensions (depressed affect, disturbed interpersonal relations, low positive affect, somatic complaints) were measured using Centre of Epidemiologic Studies Depression questionnaire (CES-D). We reported results of negative binomial regression models (reported as Incidence Rate Ratio (IRR) and 95 % confidence interval (CI) for an interquartile range (IQR) increase in exposure), for each pollutant separately. Stratified analyses were performed by sex, income, family status, education, and neighborhood deprivation. RESULTS The study included 123,754 participants (mean age, 46.50 ± 13.61 years; 52.4 % women). The mean concentration of PM2.5, BC and NO2 were 17.14 µg/m3 (IQR = 4.89), 1.82 10-5/m (IQR = 0.88) and 26.58 µg/m3 (IQR = 17.41) respectively. Exposures to PM2.5, BC and NO2 were significantly associated with a higher CES-D total (IRR = 1.022; 95 % CI = 1.002: 1.042, IRR = 1.027; 95 % CI = 1.013: 1.040, and IRR = 1.029; 95 % CI = 1.015: 1.042 respectively), and with depressed affect, and somatic complaints. For all pollutants, a higher estimate was observed for depressed affect. We found stronger adverse associations for men, lower-income participants, low and middle education groups, those living in highly deprived areas, and single participants. CONCLUSION Our finding could assist the exploration of the etiological pathway of air pollution on depression and also considering primary prevention strategies in the areas with air pollution.
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Affiliation(s)
- Mohammad Javad Zare Sakhvidi
- Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, F-35000 Rennes, France
| | - Antoine Lafontaine
- Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, F-35000 Rennes, France
| | - Emeline Lequy
- Université Paris Cité, Unité "Cohortes en Population" INSERM, Université Paris Saclay, UVSQ, UMS 011 Paris, France
| | - Claudine Berr
- University of Montpellier, INM, Inserm U1198 Neuropeps team, Montpellier, France; Memory Research and Resources Center, Department of Neurology, Montpellier, France
| | - Kees de Hoogh
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland; University of Basel, Basel, Switzerland
| | - Danielle Vienneau
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland; University of Basel, Basel, Switzerland
| | - Marcel Goldberg
- Université Paris Cité, Unité "Cohortes en Population" INSERM, Université Paris Saclay, UVSQ, UMS 011 Paris, France
| | - Marie Zins
- Université Paris Cité, Unité "Cohortes en Population" INSERM, Université Paris Saclay, UVSQ, UMS 011 Paris, France
| | - Cédric Lemogne
- Université Paris Cité, INSERM U1266, Institut de Psychiatrie et Neurosciences de Paris, F-75014 Paris, France; Service de Psychiatrie de l'adulte, AP-HP, Hôpital Hôtel-Dieu, F-75004 Paris, France
| | - Bénédicte Jacquemin
- Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, F-35000 Rennes, France.
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Fallah Madvari R, Zare Sakhvidi MJ, Jafari Nodoushan M, Askari J, Fallahzadeh H, Raiszade Dashtaki M. Effect of sound pressure levels on problem-solving abilities with the mediation of personality traits. Hearing, Balance and Communication 2022. [DOI: 10.1080/21695717.2022.2142371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Rohollah Fallah Madvari
- Occupational Health Research Center, Department of Occupational Health Engineering, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mohammad Javad Zare Sakhvidi
- Occupational Health Research Center, Department of Occupational Health Engineering, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mahdi Jafari Nodoushan
- Occupational Health Research Center, Department of Occupational Health Engineering, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Jafar Askari
- Department of Clinical Psychology, Research Center of Addiction and Behavioral Sciences, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Hossein Fallahzadeh
- Research Center of Prevention and Epidemiology of Non-Communicable Disease, Department of Biostatistics and Epidemiology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Marziye Raiszade Dashtaki
- Occupational Health Research Center, Department of Occupational Health Engineering, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Najafi F, Soltani S, Matin BK, Karyani AK, Rezaei S, Soofi M, Salimi Y, Moradinazar M, Hajizadeh M, Barzegar L, Pasdar Y, Hamzeh B, Haghdoost AA, Malekzadeh R, Poustchi H, Eghtesad S, Nejatizadeh A, Moosazadeh M, Sakhvidi MJZ, Joukar F, Hashemi-Shahri SM, Vakilian A, Niknam R, Faramarzi E, Akbari GA, Ghorat F, Khaledifar A, Vahabzadeh D, Homayounfar R, Safarpour AR, Hosseini SV, Rezvani R, Hosseini SA. Correction: Socioeconomic gradient in physical activity: findings from the PERSIAN cohort study. BMC Public Health 2022; 22:1944. [PMID: 36261809 PMCID: PMC9583554 DOI: 10.1186/s12889-022-14060-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Farid Najafi
- Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.,Social Development and Health Promotion Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Shahin Soltani
- Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran. .,Social Development and Health Promotion Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran.
| | - Behzad Karami Matin
- Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.,Social Development and Health Promotion Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ali Kazemi Karyani
- Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.,Social Development and Health Promotion Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Satar Rezaei
- Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Moslem Soofi
- Social Development and Health Promotion Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Yahya Salimi
- Social Development and Health Promotion Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mehdi Moradinazar
- Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mohammad Hajizadeh
- School of Health Administration, Faculty of Health, Dalhousie University, Halifax, Canada
| | - Loghman Barzegar
- Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Yahya Pasdar
- Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Behrooz Hamzeh
- Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ali Akbar Haghdoost
- Modeling in Health Research Center, Institute for Future Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Reza Malekzadeh
- Liver and pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Poustchi
- Liver and pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Sareh Eghtesad
- Liver and pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Azim Nejatizadeh
- Molecular Medicine Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Mahmood Moosazadeh
- Health Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mohammad Javad Zare Sakhvidi
- Occupational Health Research Centre, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Farahnaz Joukar
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | | | - Alireza Vakilian
- Dept. of Neurology, Medical School, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Ramin Niknam
- Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Elnaz Faramarzi
- Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical sciences, Tabriz, Iran
| | - Ghodrat Akhavan Akbari
- Digestive Disease Research Center, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Fershteh Ghorat
- Traditional and Complementary Medicine Research Center, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Arsalan Khaledifar
- Modeling in Health Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Davoud Vahabzadeh
- Social Determinants of Health Research Center, Urmia University of Medical Sciences, Urmia, Iran
| | - Reza Homayounfar
- Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran
| | - Ali Reza Safarpour
- Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Reza Rezvani
- Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Seyyed Ahmad Hosseini
- Nutrition and Metabolic Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Zare Sakhvidi MJ, Yang J, Mohammadi D, FallahZadeh H, Mehrparvar A, Stevenson M, Basagaña X, Gasparrini A, Dadvand P. Extreme environmental temperatures and motorcycle crashes: a time-series analysis. Environ Sci Pollut Res Int 2022; 29:76251-76262. [PMID: 35668256 PMCID: PMC9553821 DOI: 10.1007/s11356-022-21151-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 05/24/2022] [Indexed: 06/12/2023]
Abstract
Extreme temperature could affect traffic crashes by influencing road safety, vehicle performance, and drivers' behavior and abilities. Studies evaluating the impacts of extreme temperatures on the risk of traffic crashes have mainly overlooked the potential role of vehicle air conditioners. The aim of this study, therefore, was to evaluate the effect of exposure to extreme cold and hot temperatures on seeking medical attention due to motorcycle crashes. The study was conducted in Iran by using medical attendance for motorcycle crashes from March 2011 to June 2017. Data on daily minimum, mean and maximum temperature (°C), relative humidity (%), wind velocity (km/h), and precipitation (mm/day) were collected. We developed semi-parametric generalized additive models following a quasi-Poisson distribution with the distributed nonlinear lag model to estimate the immediate and lagged associations (reported as relative risk [RR], and 95% confidence interval [CI]). Between March 2011 and June 2017, 36,079 medical attendances due to motorcycle road traffic crashes were recorded (15.8 ± 5.92 victims per day). In this time period, the recorded temperature ranged from -11.2 to 45.4 °C (average: 25.5 ± 11.0 °C). We found an increased risk of medical attendance for motorcycle crashes (based on maximum daily temperature) at both extremely cold (1st percentile) and hot (99th percentile) temperatures and also hot (75th percentile) temperatures, mainly during lags 0 to 3 days (e.g., RR: 1.12 [95% CI: 1.05: 1.20]; RR: 1.08 [95% CI: 1.01: 1.16]; RR: 1.20 [95% CI: 1.09: 1.32] at lag0 for extremely cold, hot, and extremely hot conditions, respectively). The risk estimates for extremely hot temperatures were larger than hot and extremely cold temperatures. We estimated that 11.01% (95% CI: 7.77:14.06) of the medical attendance for motorcycle crashes is estimated to be attributable to non-optimal temperature (using mean temperature as exposure variable). Our findings have important public health messaging, given the considerable burden associated with road traffic injury, particularly in low- and middle-income countries.
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Affiliation(s)
- Mohammad Javad Zare Sakhvidi
- Department of Occupational Health, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Jun Yang
- School of Public Health, Guangzhou Medical University, Guangzhou, 511436, China
| | - Danial Mohammadi
- Department of Occupational Health, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Hussein FallahZadeh
- Department of Epidemiology and Biostatistics, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Amirhooshang Mehrparvar
- Department of Occupational Medicine, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mark Stevenson
- Melbourne School of Design/Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Xavier Basagaña
- ISGlobal, Doctor Aiguader 88, 08003, Barcelona, Catalonia, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Melchor Fernández Almagro, 3-5, 28029, Madrid, Spain
| | - Antonio Gasparrini
- Department of Public Health, Environments and Society, London School Hygiene & Tropical Medicine, London, UK
- Centre for Statistical Methodology, London School Hygiene & Tropical Medicine, London, UK
- Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Payam Dadvand
- ISGlobal, Doctor Aiguader 88, 08003, Barcelona, Catalonia, Spain.
- Universitat Pompeu Fabra (UPF), Barcelona, Spain.
- CIBER Epidemiología y Salud Pública (CIBERESP), Melchor Fernández Almagro, 3-5, 28029, Madrid, Spain.
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9
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Zare Sakhvidi MJ, Yang J, Mehrparvar AH, Dzhambov AM, Ebrahimi A, Dadvand P, Jacquemin B. Exposure to greenspace and cancer incidence, prevalence, and mortality: A systematic review and meta-analyses. Sci Total Environ 2022; 838:156180. [PMID: 35618130 DOI: 10.1016/j.scitotenv.2022.156180] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 05/11/2022] [Accepted: 05/19/2022] [Indexed: 06/15/2023]
Abstract
We conducted a systematic review and meta-analysis of the available literature on the association between greenspace exposure and all-sites and site-specific cancer incidence, prevalence, and mortality in adults. We searched PubMed, Scopus, and Web of Science for original articles published, without language restriction until September 2021. We assessed the risk of bias in each study and the overall quality of evidence for exposure-outcome pairs that were reported in two or more studies. Out of the 18 included studies, cross-sectional studies were the most common study design (n = 8), and most of the studies were conducted in Europe (n = 8). In terms of risk of bias, the majority of cohorts (four out of six) and case-control studies (three out of four) were of good or very good quality, and cross-sectional studies were mostly (five out of eight) of poor quality. Outcomes (incidence, prevalence, mortality) on different cancer sites were reported: lung cancer (n = 9), prostate cancer (n = 4), breast cancer (n = 4), skin cancer (n = 3), colorectal cancer (n = 2), all-sites cancer (n = 2), brain cancer (n = 1), mouth and throat cancer (n = 1), and esophageal cancer (n = 1). The meta-analyses for the breast, lung, and prostate cancer incidence did not show statistically significant associations (for example for breast cancer: hazard ratio = 0.83; 95% confidence interval: 0.47-1.48). For skin cancer, the available evidence suggests that greenspace could be a potential risk factor. For the other cancers, the evidence was non-conclusive. The overall quality of evidence of all of the exposure-outcome pairs was very low. Given the wide confidence interval of the pooled estimates and very low quality of evidence, the findings should be interpreted with caution. Future large and longitudinal studies are needed to assess the potential association of greenspace exposure with cancers, considering types and quality of greenspace, evaluation of cancer sub-types, and adjustment for a sufficient set of covariates.
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Affiliation(s)
- Mohammad Javad Zare Sakhvidi
- Occupational Health Department, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran; Univ Rennes, INSERM, EHESP, IRSET (Institut de Recherche en Santé, Environnement et Travail) - UMR_S 1085, F-35000 Rennes, France
| | - Jun Yang
- School of Public Health, Guangzhou Medical University, Guangzhou 511436, China
| | | | - Angel M Dzhambov
- Department of Hygiene, Faculty of Public Health, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - AliAsghar Ebrahimi
- Environmental Health Department, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Payam Dadvand
- ISGlobal, Doctor Aiguader 88, 08003 Barcelona, Spain; Universitat Pompeu Fabra (UPF), Doctor Aiguader 88, 08003 Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Melchor Fernández Almagro, 3-5, 28029 Madrid, Spain
| | - Bénédicte Jacquemin
- Univ Rennes, INSERM, EHESP, IRSET (Institut de Recherche en Santé, Environnement et Travail) - UMR_S 1085, F-35000 Rennes, France.
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10
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Zare Sakhvidi MJ, Zarei A, Hachesu VR, Zolfaghari A. Correction to: Evaluating the relationship between the respiratory exposure to the benzene with the primary damages of deoxyribonucleic acid and total antioxidant capacity in one of the oil companies in Iran. Environ Sci Pollut Res Int 2022; 29:48347. [PMID: 35258741 DOI: 10.1007/s11356-022-19615-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Affiliation(s)
- Mohammad Javad Zare Sakhvidi
- Occupational Health Department, School of Public Health, Yazd Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Abdorreza Zarei
- Occupational Health Department, Health Faculty, Qom University of Medical Sciences, Qom, Iran
| | - Vida Rezaei Hachesu
- Occupational Health Department, School of Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmad Zolfaghari
- Faculty of Environment; University of Tehran; Tehran; Iran, Petroleum Industry Health Organization (PIHO), Isfahan, Iran.
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Sakhvidi MJZ, Zarei A, Hachesu VR, Zolfaghari A. Evaluating the relationship between the respiratory exposure to the benzene with the primary damages of deoxyribonucleic acid and total antioxidant capacity in one of the oil companies in Iran. Environ Sci Pollut Res Int 2022; 29:48340-48346. [PMID: 35187629 DOI: 10.1007/s11356-022-19015-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 01/29/2022] [Indexed: 06/14/2023]
Abstract
Benzene is a carcinogenic chemical substance which causes the injuries and damages through producing the free radicals in DNA (deoxyribonucleic acid) and the antioxidants are the agents which reduce the impacts of DNA damages by inhibiting the free radicals. This study was conducted aiming at determination of primary damages of DNA and level of plasma oxidative stress markers resulting from the respiratory exposure to the benzene found in petroleum compounds among the workers at loading platforms of a petroleum products distribution center. This study was an analytical (case control) research conducted among the workers in a working shift serving at the loading platforms of petroleum products. The exposure group included the workers with a history of contact with benzene and the control group was composed of the persons with no history of exposure to benzene. To investigate the level of the personnel's exposure to benzene, NIOSH-1501 method was utilized; to analyze the samples taken from the air, GC mass (gas chromatography-mass spectrometry) was applied; and to determine the average of DNA primary damages, comet assay was used. Total antioxidant capacity was determined by a photometric method. Results indicated that tail length (TL), tail density (TD), tail momentum (TM), percentage of tail in the DNA (%DNA), and %TAC in control group were 78.59, 8.35, 1.20, 10.05, and 25.58 and in the exposure group were 59.21, 75.74, 57.74, 3.5, and 16.58, respectively. The previously mentioned results showed a decrease in the TL, %DNA, and %TAC values among the workers already exposed to benzene while an increase in the TD and TM values of the same group compared to the control non-exposed group. In comparing the averages between two studied groups, all study variables had statistically meaningful difference (p < 0.05). More studies are recommended to be conducted on using the methods which identify the special places of breakage and damage in DNA chain due to the exposure to benzene and consequently prevent the complications and consequences.
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Affiliation(s)
| | - Abdorreza Zarei
- Occupational Health Department, Health Faculty, Qom University of Medical Sciences, Qom, Iran
| | - Vida Rezaei Hachesu
- Occupational Health Department, School of Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmad Zolfaghari
- University of Tehran, PIHO (Petroleum Industry Health Organization), Isfahan, Iran.
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Sepahi Zoeram F, Ebrahimi AA, Mehrparvar AH, Sarsangi Aliabad A, Fallah Zadeh H, Mehri H, Zare Sakhvidi MJ. Health risk assessment of inhalational exposure to heavy metals in drivers working in an urban desert city in the Middle East. Environ Monit Assess 2022; 194:533. [PMID: 35763174 DOI: 10.1007/s10661-022-10234-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 06/20/2022] [Indexed: 06/15/2023]
Abstract
Heavy metals are threatening the lives of people around the world. This study aims to quantify the adverse health risks of seven heavy metals, including arsenic, cadmium, cobalt, chromium, lead, manganese, and nickel in taxi drivers in an urban desert city, Yazd, Iran. The exposure concentrations were determined through air sampling in the breathing zone of 40 randomly selected intercity taxi drivers, 20 in winter and 20 in summer, in 2019. An ICP-MAS spectrometer was applied to measure the elements. Target hazard quotient (THQ) and excessive cancer risk (ECR) indices were applied to calculate the non-cancer and cancer risks based on the United States Environmental Protection Agency (USEPA) guidelines, respectively. The results showed that arsenic and lead had the highest exposure concentrations among the seven measured heavy metals while cobalt and chromium metals had the lowest concentrations. Arsenic, cadmium, manganese, and nickel would probably cause some adverse non-carcinogenic health problems (THQ > 1) in the drivers over their working life. The percentile 95% ECR of measured heavy metals was 1.3E - 03 in total, which is much higher than the value of 1E - 06. The concentration of arsenic and nickel was higher in winter than in summer. Taxi drivers in Yazd city are at considerable health risk; therefore, swift and serious controlling measures should be taken by responsible authorities. Besides, the taxi drivers should be educated about heavy metals' health effects and their protective behaviors.
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Affiliation(s)
- Faeze Sepahi Zoeram
- Occupational Health Research Center, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Ali Asghar Ebrahimi
- Environmental Science and Technology Research Center, Department of Environmental Health Engineering, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Amir Houshang Mehrparvar
- Industrial Diseases Research Center, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | | | - Hossein Fallah Zadeh
- Research Center of Prevention and Epidemiology of Non Communicable Disease, Department of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Hamidreza Mehri
- Department of Occupational Health, School of Public Health, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Mohammad Javad Zare Sakhvidi
- Occupational Health Research Center and Department of Occupational Health, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
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Zare Sakhvidi MJ, Knobel P, Bauwelinck M, de Keijzer C, Boll LM, Spano G, Ubalde-Lopez M, Sanesi G, Mehrparvar AH, Jacquemin B, Dadvand P. Greenspace exposure and children behavior: A systematic review. Sci Total Environ 2022; 824:153608. [PMID: 35134416 DOI: 10.1016/j.scitotenv.2022.153608] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 01/19/2022] [Accepted: 01/28/2022] [Indexed: 05/27/2023]
Abstract
We systematically reviewed the existing evidence (until end of November 2021) on the association between long-term exposure to greenspace and behavioral problems in children according to the PRISMA 2020. The review finally reached 29 relevant studies of which, 17 were cross-sectional, 11 were cohort, and one was a case-control. Most of the studies were conducted in Europe (n = 14), followed by the USA (n = 8), and mainly (n = 21) from 2015 onwards. The overall quality of the studies in terms of risk of bias was "fair" (mean quality score = 5.4 out of 9) according to the Newcastle-Ottawa Scale. Thirteen studies (45%) had good or very good quality in terms of risk of bias. The strength and difficulty questionnaire was the most common outcome assessment instrument. Exposure to the greenspace in the reviewed studies was characterized based on different indices (availability, accessibility, and quality), mostly at residential address locations. Association of exposure to different types of greenspace were reported for nine different behavioral outcomes including total behavioral difficulties (n = 16), attention deficit hyperactivity disorder (ADHD) symptoms and severity (n = 15), ADHD diagnosis (n = 10), conduct problems (n = 10), prosocial behavior (n = 10), emotional symptoms (n = 8), peer-relationship problems (n = 8), externalizing disorders (n = 6), and internalizing disorders (n = 5). Most of the reported associations (except for conduct problems) were suggestive of beneficial association of greenspace exposure with children's behaviors; however, the studies were heterogeneous in terms of their exposure indicators, study design, and the outcome definition.
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Affiliation(s)
- Mohammad Javad Zare Sakhvidi
- Occupational Health Department, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran; Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, F-35000 Rennes, France
| | - Pablo Knobel
- Environment and Human Health Lab (EH2 Lab), Forest Science and Technology Center of Catalonia, Lleida, Spain
| | - Mariska Bauwelinck
- Interface Demography (ID), Department of Sociology, Vrije Universiteit Brussel, 1050 Brussels, Belgium
| | - Carmen de Keijzer
- ISGlobal, Doctor Aiguader 88, 08003 Barcelona, Spain; Universitat Pompeu Fabra (UPF), Doctor Aiguader 88, 08003 Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Melchor Fernández Almagro, 3-5, 28029 Madrid, Spain
| | - Lilian Marie Boll
- ISGlobal, Doctor Aiguader 88, 08003 Barcelona, Spain; Universitat Pompeu Fabra (UPF), Doctor Aiguader 88, 08003 Barcelona, Spain
| | - Giuseppina Spano
- Department of Agricultural and Environmental Sciences, University of Bari Aldo Moro, Via Amendola 165/A, 70126 Bari, Italy
| | - Monica Ubalde-Lopez
- ISGlobal, Doctor Aiguader 88, 08003 Barcelona, Spain; Universitat Pompeu Fabra (UPF), Doctor Aiguader 88, 08003 Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Melchor Fernández Almagro, 3-5, 28029 Madrid, Spain
| | - Giovanni Sanesi
- Department of Agricultural and Environmental Sciences, University of Bari Aldo Moro, Via Amendola 165/A, 70126 Bari, Italy
| | | | - Bénédicte Jacquemin
- Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, F-35000 Rennes, France
| | - Payam Dadvand
- ISGlobal, Doctor Aiguader 88, 08003 Barcelona, Spain; Universitat Pompeu Fabra (UPF), Doctor Aiguader 88, 08003 Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Melchor Fernández Almagro, 3-5, 28029 Madrid, Spain.
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14
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Lequy E, Zare Sakhvidi MJ, Vienneau D, de Hoogh K, Chen J, Dupuy JF, Garès V, Burte E, Bouaziz O, Le Tertre A, Wagner V, Hertel O, Christensen JH, Zhivin S, Siemiatycki J, Goldberg M, Zins M, Jacquemin B. Influence of exposure assessment methods on associations between long-term exposure to outdoor fine particulate matter and risk of cancer in the French cohort Gazel. Sci Total Environ 2022; 820:153098. [PMID: 35041955 DOI: 10.1016/j.scitotenv.2022.153098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 12/23/2021] [Accepted: 01/09/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Many studies investigated the relationship between outdoor fine particulate matter (PM2.5) and cancer. While they generally indicated positive associations, results have not been fully consistent, possibly because of the diversity of methods used to assess exposure. OBJECTIVES To investigate how using different PM2.5 exposure assessment methods influences risk estimates in the large French general population-based Gazel cohort (20,625 participants at enrollment) with a 26-year follow-up with complete residential histories. METHODS We focused on two cancer incidence outcomes: all-sites combined and lung. We used two distinct exposure assessment methods: a western European land use regression (LUR), and a chemistry-dispersion model (Gazel-Air) for France, each with a time series ≥20-years annual concentrations. Spearman correlation coefficient between the two estimates of PM2.5 was 0.71 across all person-years; the LUR tended to provide higher exposures. We used extended Cox models with attained age as time-scale and time-dependent cumulative exposures, adjusting for a set of confounders including sex and smoking, to derive hazard ratios (HRs) and their 95% confidence interval, implementing a 10-year lag between exposure and incidence/censoring. RESULTS We obtained similar two-piece linear associations for all-sites cancer (3711 cases), with a first slope of HRs of 1.53 (1.24-1.88) and 1.43 (1.19-1.73) for one IQR increase of cumulative PM2.5 exposure for the LUR and the Gazel-Air models respectively, followed by a plateau at around 1.5 for both exposure assessments. For lung cancer (349 cases), the HRs from the two exposure models were less similar, with largely overlapping confidence limits. CONCLUSION Our findings using long-term exposure estimates from two distinct exposure assessment methods corroborate the association between air pollution and cancer risk.
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Affiliation(s)
- Emeline Lequy
- Unité "Cohortes en Population" UMS 011 Inserm/Université de Paris/Université Paris Saclay/UVSQ, Villejuif, France; Centre de recherche du centre hospitalier de l'université de Montréal, Québec, Canada.
| | - Mohammad Javad Zare Sakhvidi
- Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, F-35000 Rennes, France
| | - Danielle Vienneau
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Kees de Hoogh
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Jie Chen
- Utrecht University, Utrecht, the Netherlands
| | | | - Valérie Garès
- Univ Rennes, INSA, CNRS, IRMAR - UMR 6625, F-35000 Rennes, France
| | - Emilie Burte
- Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, F-35000 Rennes, France
| | | | | | | | - Ole Hertel
- Dep. Env. Science, Aarhus University, Frederiksborgvej 399, 4000 Roskilde, Denmark
| | | | - Sergey Zhivin
- Unité "Cohortes en Population" UMS 011 Inserm/Université de Paris/Université Paris Saclay/UVSQ, Villejuif, France
| | - Jack Siemiatycki
- Centre de recherche du centre hospitalier de l'université de Montréal, Québec, Canada
| | - Marcel Goldberg
- Unité "Cohortes en Population" UMS 011 Inserm/Université de Paris/Université Paris Saclay/UVSQ, Villejuif, France
| | - Marie Zins
- Unité "Cohortes en Population" UMS 011 Inserm/Université de Paris/Université Paris Saclay/UVSQ, Villejuif, France
| | - Bénédicte Jacquemin
- Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, F-35000 Rennes, France
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15
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Zare Sakhvidi MJ, Lafontaine A, Yang J, Lequy E, Artaud F, Canonico M, Ozguler A, Vienneau D, Zins M, Jacquemin B. Association between Outdoor Air Pollution Exposure and Handgrip Strength: Findings from the French CONSTANCES Study. Environ Health Perspect 2022; 130:57701. [PMID: 35559615 PMCID: PMC9104871 DOI: 10.1289/ehp10464] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Revised: 04/14/2022] [Accepted: 04/19/2022] [Indexed: 05/30/2023]
Affiliation(s)
- Mohammad Javad Zare Sakhvidi
- Université de Rennes, Institut national de la santé et de la recherche médicale (Inserm, National Institute of Health & Medical Research), Ecole des hautes études en santé publique (EHESP), Irset (Institut de recherche en santé, environnement et travail)—UMR_S 1085, Rennes, France
| | - Antoine Lafontaine
- Université de Rennes, Institut national de la santé et de la recherche médicale (Inserm, National Institute of Health & Medical Research), Ecole des hautes études en santé publique (EHESP), Irset (Institut de recherche en santé, environnement et travail)—UMR_S 1085, Rennes, France
| | - Jun Yang
- Université de Rennes, Institut national de la santé et de la recherche médicale (Inserm, National Institute of Health & Medical Research), Ecole des hautes études en santé publique (EHESP), Irset (Institut de recherche en santé, environnement et travail)—UMR_S 1085, Rennes, France
| | - Emeline Lequy
- Université de Paris, Unité UMS 011 “Cohortes en Population,” Inserm, Université Paris Saclay, Université de Versailles-Saint-Quentin-en-Yvelines (UVSQ), Paris, France
| | - Fanny Artaud
- Paris-Saclay University, UVSQ, Université Paris-Sud, Inserm, Gustave Roussy, “Exposome and Heredity Team,” Centre de recherche en Épidémiologie et Santé des Populations, Villejuif, France
| | - Marianne Canonico
- Paris-Saclay University, UVSQ, Université Paris-Sud, Inserm, Gustave Roussy, “Exposome and Heredity Team,” Centre de recherche en Épidémiologie et Santé des Populations, Villejuif, France
| | - Anna Ozguler
- Université de Paris, Unité UMS 011 “Cohortes en Population,” Inserm, Université Paris Saclay, Université de Versailles-Saint-Quentin-en-Yvelines (UVSQ), Paris, France
| | - Danielle Vienneau
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Marie Zins
- Université de Paris, Unité UMS 011 “Cohortes en Population,” Inserm, Université Paris Saclay, Université de Versailles-Saint-Quentin-en-Yvelines (UVSQ), Paris, France
| | - Bénédicte Jacquemin
- Université de Rennes, Institut national de la santé et de la recherche médicale (Inserm, National Institute of Health & Medical Research), Ecole des hautes études en santé publique (EHESP), Irset (Institut de recherche en santé, environnement et travail)—UMR_S 1085, Rennes, France
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16
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Mehrparvar AH, Ghanbari L, Mirmohammadi SJ, Zare Sakhvidi MJ, Vakili M, Davari MH, Mirzaei M. The Effect of Water-Pipe and Cigarette Smoking on Exhaled Nitric Oxide. Int J Prev Med 2022; 13:79. [PMID: 35706853 PMCID: PMC9188898 DOI: 10.4103/ijpvm.ijpvm_546_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 03/17/2021] [Indexed: 12/02/2022] Open
Abstract
CONTEXT Fractional exhaled nitric oxide can be used as a biomarker of some respiratory diseases. AIMS This study was conducted to compare exhaled nitric oxide in cigarette and water-pipe smokers with nonsmokers. METHODS This cross-sectional study was conducted on 549 adult subjects as a sub-study of Shahedieh cohort in Yazd. Participants were divided into 5 groups according to their smoking habits: non-smokers (n = 202), cigarette smokers (n = 121), water-pipe smokers (n = 129), cigarette ex-smokers (n = 58), water-pipe and cigarette smokers (n = 39). The smokers were also categorized into heavy and light smokers. Fractional exhaled nitric oxide was compared between the groups. STATISTICAL ANALYSIS USED The data were analyzed by SPSS (ver. 20) using Kolmogorov-Smirnov, Kruskal-Wallis, and Mann-Whitney U tests. RESULTS Fractional exhaled NO was lower in all smokers than nonsmokers, but cigarette smokers showed the least level of NO than other groups. Fractional exhaled NO was not significantly lower in water-pipe smokers than nonsmokers. CONCLUSIONS Cigarette smoking significantly affect fractional exhaled NO, but water-pipe smoking did not significantly affect exhaled NO level.
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Affiliation(s)
| | - Laleh Ghanbari
- Department of Occupational Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | | | | | - Mahmood Vakili
- Department of Community Medicine, Monitoring of Health Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mohammad Hossein Davari
- Department of Occupational Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran,Address for correspondence: Dr. Mohammad Hossein Davari, Industrial Diseases Research Center, Shahid Rahnemoun hospital, Farrokhi Ave., Yazd, Iran. E-mail:
| | - Masoud Mirzaei
- Yazd Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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17
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Sepanlou S, Najafi F, Poustchi H, Parsaeian M, Ahmadi A, Somi M, Moradpour F, Alizadeh-Navaei R, Gohari A, Zamani B, Esmaeilinadimi A, Rezaianzadeh A, Mansour-Ghanaei F, Bahramali E, Ansari-Moghaddam A, Hamzeh B, Zanganeh Yousefabadi E, Zare Sakhvidi MJ, Mohebbi I, Fattahi MR, Nejatizadeh A, Marioryad H, Motamed-Gorji N, Roozafzai F, Eghtesad S, Mohammadi Z, Shayanrad A, Sharafkhah M, Etemadi A, Kamangar F, Juraschek SP, Malekzadeh R. Prevalence, awareness, treatment, and control of hypertension based on ACC/AHA versus JNC7 guidelines in the PERSIAN cohort study. Sci Rep 2022; 12:4057. [PMID: 35260709 PMCID: PMC8904851 DOI: 10.1038/s41598-022-07896-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 02/28/2022] [Indexed: 02/08/2023] Open
Abstract
In this cross-sectional population-based study, we used the baseline data of the Prospective Epidemiologic Research Studies in IrAN cohort study collected in Iran from 2014 to 2020. The main outcomes were the prevalence of hypertension and proportion of awareness, treatment, and control based on the 2017 ACC/AHA guideline compared to the seventh report of the Joint National Committee (JNC7). Of the total of 163,770 participants, aged 35-70 years, 55.2% were female. The sex-age standardized prevalence of hypertension was 22.3% (95% CI 20.6, 24.1) based on the JNC7 guideline and 36.5% (31.1, 41.8) based on the ACC/AHA guideline. A total of 24,312 participants [14.1% (10.1, 18.1)] were newly diagnosed based on the ACC/AHA guideline. Compared to adults diagnosed with hypertension based on the JNC7 guideline, the newly diagnosed participants were mainly young literate males who had low levels of risk factors and were free from conventional comorbidities of hypertension. About 30.7% (25.9, 35.4) of them (4.3% of the entire population) were eligible for pharmacologic intervention based on the ACC/AHA guideline. Implementation of the new guideline may impose additional burden on health systems. However, early detection and management of elevated blood pressure may reduce the ultimate burden of hypertension in Iran.
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Affiliation(s)
- Sadaf Sepanlou
- Digestive Disease Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Farid Najafi
- Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Hossein Poustchi
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahboubeh Parsaeian
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Ahmadi
- Department of Epidemiology and Biostatistics, Modeling in Health Research Center, School of Health, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Mohammadhossein Somi
- Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Farhad Moradpour
- Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Reza Alizadeh-Navaei
- Gastrointestinal Cancer Research Center, Non-Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Ali Gohari
- Non-Communicable Diseases Research Center, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Bijan Zamani
- Digestive Disease Research Center, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Ali Esmaeilinadimi
- Non-Communicable Diseases Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Abbas Rezaianzadeh
- Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fariborz Mansour-Ghanaei
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Ehsan Bahramali
- Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran
| | | | - Behrooz Hamzeh
- Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Elham Zanganeh Yousefabadi
- Department of Internal Medicine, Imam Khomeini Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mohammad Javad Zare Sakhvidi
- Occupational Health Research Centre, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Iraj Mohebbi
- Social Determinants of Health Research Center, Clinical Research Institute, Urmia University of Medical Sciences, Urmia, Iran
| | - Mohammad Reza Fattahi
- Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Azim Nejatizadeh
- Molecular Medicine Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | | | - Nazgol Motamed-Gorji
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Farzin Roozafzai
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Sareh Eghtesad
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Mohammadi
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Amaneh Shayanrad
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Sharafkhah
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Arash Etemadi
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Farin Kamangar
- Department of Biology, School of Computer, Mathematical, and Natural Sciences, Morgan State University, Baltimore, MD, USA
| | - Stephen P Juraschek
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Reza Malekzadeh
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, North Kargar Ave., Tehran, 14117-13135, Iran.
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18
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Kheirandish A, Mehrparvar A, Abou-Bakre A, Zare Sakhvidi MJ. Association between long-term occupational noise exposure and obesity. Environ Sci Pollut Res Int 2022; 29:20176-20185. [PMID: 34729714 DOI: 10.1007/s11356-021-17299-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 10/27/2021] [Indexed: 06/13/2023]
Abstract
Noise exposure has been linked to several health outcomes including obesity. This cross-sectional study examined the association between occupational noise exposure and body mass index as a measure of general obesity in 913 textile workers (totally from nine factories) in Yazd city, Iran, from winter to summer of 2018. The sound pressure level (dBA) at each working station was measured by a calibrated sound level meter. The long-term noise exposure score of each worker (as dBA.year) was calculated by multiplying the working history in each unit to its corresponding noise level. Models were adjusted for personal, behavioral, environmental, and family history factors. In total, 81.05% (n = 740) of the participants were exposed to noise levels higher than 85 dBA. The direct association was found for the fully adjusted model (β = 0.002; 95% CI: 0.001: 0.004). For the model with past year noise exposure, a 10.6% increase in odds was observed for each 5 dBA increase in noise exposure (95% CI: 1.005: 1.216). We found a 0.1% increase in the odds of being overweight in mixed-gender analysis (95% CI: 1.001:1.002) for each 5 dBA.year in the fully adjusted model. Occupational noise exposure should be regarded as a risk factor for cardiometabolic outcomes in industrial workers.
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Affiliation(s)
- AhmadAli Kheirandish
- Department of Occupational Health, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Amirhooshang Mehrparvar
- Industrial Diseases Research Center, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Abdellah Abou-Bakre
- Department of Mathematics, Faculty of Sciences and Technics, Sultan Moulay Slimane University, Beni Mellal, Morocco
| | - Mohammad Javad Zare Sakhvidi
- Department of Occupational Health, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
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Zare Sakhvidi MJ, Yang J, Lequy E, Chen J, de Hoogh K, Letellier N, Mortamais M, Ozguler A, Vienneau D, Zins M, Goldberg M, Berr C, Jacquemin B. Outdoor air pollution exposure and cognitive performance: findings from the enrolment phase of the CONSTANCES cohort. Lancet Planet Health 2022; 6:e219-e229. [PMID: 35278388 DOI: 10.1016/s2542-5196(22)00001-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 10/27/2021] [Accepted: 01/04/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Air pollution exposure is one of the modifiable risk factors of cognitive decline. We aimed to test the association between exposure to several outdoor air pollutants and domain-specific cognitive performance. METHODS In this cross-sectional study, we used data from the enrolment phase of the French CONSTANCES cohort. From the 220 000 people (aged 18-69 years) randomly recruited in the French CONSTANCES cohort, participants aged 45 years old or older (104 733 people) underwent a comprehensive cognitive assessment (verbal episodic memory, language skills, and executive functions). After exclusion of those who were not suitable for our analysis, 61 462 participants with available data were included in the analyses. We used annual mean concentrations at residential addresses, derived from land-use regression models, to assign exposure to particulate matter with aerodynamic diameters less than 2·5 μm (PM2·5), nitrogen dioxide (NO2), and black carbon. We used multiple linear regression models with different covariate adjustments to test the associations between each pollutant and cognitive outcomes. We did several sensitivity analyses, including multilevel modelling, meta-analysis by centre of recruitment, and exclusion of specific population groups. FINDINGS We found significantly poorer cognitive function, especially on semantic fluency and domains of executive functions, with an increase in exposure to black carbon and NO2. Exposure to PM2·5 was mainly significant for the semantic fluency test. We found that decrease in cognitive performance with an increase of one interquartile range of exposure ranged from 1% to nearly 5%. The largest effect size (percentage decrease) for both PM2.5 and NO2 was found for the semantic fluency test (PM2.5 4·6%, 95% CI 2·1-6·9 and NO2 3·8%, 1·9-5·7), whereas for black carbon, the largest effect size was found for the digit symbol substitution test of the domains of executive functions (4·5%, 2·7-6·3). Monotonic and linear exposure-response associations were found between air pollution exposure and cognitive performance, starting from a low level of exposures. INTERPRETATION Significantly poorer cognitive performance was associated with exposure to outdoor air pollution even at low levels of exposure. This highlights the importance of further efforts to reduce exposure to air pollution. FUNDING The Caisse Nationale d'Assurance Maladie, and partly funded by Merck Sharp & Dohme and L'Oréal, the French National Research Agency, and Fondation de France. TRANSLATION For the French translation of the abstract see Supplementary Materials section.
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Affiliation(s)
- Mohammad Javad Zare Sakhvidi
- Université de Rennes, Inserm, EHESP, Institut de Recherche en Santé, Environnement, et Travail, UMR_S 1085, Rennes, France
| | - Jun Yang
- Université de Rennes, Inserm, EHESP, Institut de Recherche en Santé, Environnement, et Travail, UMR_S 1085, Rennes, France
| | - Emeline Lequy
- Centre de Recherche du CHUM, Montreal, QC, Canada; Unité Cohortes en Population, Université de Paris, Inserm, Université Paris Saclay, UVSQ, UMS 011, Paris, France
| | - Jie Chen
- Utrecht University, Utrecht, Netherlands
| | - Kees de Hoogh
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Noémie Letellier
- University of Montpellier, Inserm, Institute of Neurosciences of Montpellier, U1298, F34091, Montpellier, France
| | - Marion Mortamais
- University of Montpellier, Inserm, Institute of Neurosciences of Montpellier, U1298, F34091, Montpellier, France
| | - Anna Ozguler
- Unité Cohortes en Population, Université de Paris, Inserm, Université Paris Saclay, UVSQ, UMS 011, Paris, France
| | - Danielle Vienneau
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Marie Zins
- Unité Cohortes en Population, Université de Paris, Inserm, Université Paris Saclay, UVSQ, UMS 011, Paris, France
| | - Marcel Goldberg
- Unité Cohortes en Population, Université de Paris, Inserm, Université Paris Saclay, UVSQ, UMS 011, Paris, France
| | - Claudine Berr
- University of Montpellier, Inserm, Institute of Neurosciences of Montpellier, U1298, F34091, Montpellier, France; Memory Research and Resources Centre, Department of Neurology, Montpellier University Hospital Gui de Chauliac, Montpellier, France
| | - Bénédicte Jacquemin
- Université de Rennes, Inserm, EHESP, Institut de Recherche en Santé, Environnement, et Travail, UMR_S 1085, Rennes, France.
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20
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Yang J, Sakhvidi MJZ, de Hoogh K, Vienneau D, Siemiatyck J, Zins M, Goldberg M, Chen J, Lequy E, Jacquemin B. Long-term exposure to black carbon and mortality: A 28-year follow-up of the GAZEL cohort. Environ Int 2021; 157:106805. [PMID: 34375941 DOI: 10.1016/j.envint.2021.106805] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 06/21/2021] [Accepted: 07/27/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND The current evidence on health effects of long-term exposure to outdoor airborne black carbon (BC) exposure remains scarce. OBJECTIVES To examine the association between long-term exposure to BC and mortality in a large population-based French cohort, with 28 years of follow-up. METHODS Data from the GAZEL cohort were collected between 1989 and 2017. Land use regression model with temporal extrapolation wa used to estimate yearly BC and PM2.5 exposure at the residential addresses from 1989 until censoring for 19,906 participants. Time-varying Cox models with attained age as time-scale was used to estimate the associations between BC and all-cause and cardiovascular mortality, after adjusting for individual and area-level covariates. To handle confounding by PM2.5, we used the residual of BC regressed on PM2.5 as an alternate exposure variable. For all-cause mortality, we also examined effect modification by sex, smoking status, BMI and fruit/vegetable intake. RESULTS The median of 20-year moving average of BC exposure was 2.02 10-5/m in study population. We found significant associations between BC exposure and all-cause mortality (n = 2357) using both 20-year moving average of BC and residual of BC, with corresponding hazard ratios (HR) of 1.14 (95 %CI: 1.07-1.22) and 1.17 (95 %CI: 1.10-1.24) for an inter-quartile range (IQR) increase (0.86 10-5/m for BC and 0.57 10-5/m for residual of BC). We found a similar association between BC and cardiovascular mortality (n = 277) with a HR of 1.15 (95 %CI: 0.95-1.38). The dose-response relationship between BC and all-cause mortality was monotonic but nonlinear with a steeper slope at high BC levels. In addition, the effect of BC was higher among never-smokers and among those having fruit/vegetables less than twice a week. CONCLUSIONS There was a positive association between long-term exposure to BC and increased mortality risk, reinforcing the emerging evidence that BC is a harmful component of PM2.5.
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Affiliation(s)
- Jun Yang
- Univ. Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, F-35000 Rennes, France; Institute for Environmental and Climate Research, Jinan University, Guangzhou 511443, China
| | - Mohammad Javad Zare Sakhvidi
- Univ. Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, F-35000 Rennes, France
| | - Kees de Hoogh
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Danielle Vienneau
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Jack Siemiatyck
- CRCHUM (Centre de recherche du CHUM), Montréal, Québec, Canada
| | - Marie Zins
- Université de Paris, Unité "Cohortes en Population" INSERM, Université Paris Saclay, UVSQ, UMS 011 Paris, France
| | - Marcel Goldberg
- Université de Paris, Unité "Cohortes en Population" INSERM, Université Paris Saclay, UVSQ, UMS 011 Paris, France
| | - Jie Chen
- Institute for Risk Assessment Sciences, Utrecht University, the Netherlands
| | - Emeline Lequy
- CRCHUM (Centre de recherche du CHUM), Montréal, Québec, Canada; Université de Paris, Unité "Cohortes en Population" INSERM, Université Paris Saclay, UVSQ, UMS 011 Paris, France
| | - Bénédicte Jacquemin
- Univ. Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, F-35000 Rennes, France.
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21
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Wu Z, Hullings AG, Ghanbari R, Etemadi A, Wan Y, Zhu B, Poustchi H, Fahraji BB, Sakhvidi MJZ, Shi J, Knight R, Malekzadeh R, Sinha R, Vogtmann E. Comparison of fecal and oral collection methods for studies of the human microbiota in two Iranian cohorts. BMC Microbiol 2021; 21:324. [PMID: 34809575 PMCID: PMC8607576 DOI: 10.1186/s12866-021-02387-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 11/08/2021] [Indexed: 11/13/2022] Open
Abstract
Background To initiate fecal and oral collections in prospective cohort studies for microbial analyses, it is essential to understand how field conditions and geographic differences may impact microbial communities. This study aimed to investigate the impact of fecal and oral sample collection methods and room temperature storage on collection samples for studies of the human microbiota. Results We collected fecal and oral samples from participants in two Iranian cohorts located in rural Yazd (n = 46) and urban Gonbad (n = 38) and investigated room temperature stability over 4 days of fecal (RNAlater and fecal occult blood test [FOBT] cards) and comparability of fecal and oral (OMNIgene ORAL kits and Scope mouthwash) collection methods. We calculated interclass correlation coefficients (ICCs) based on 3 alpha and 4 beta diversity metrics and the relative abundance of 3 phyla. After 4 days at room temperature, fecal stability ICCs and ICCs for Scope mouthwash were generally high for all microbial metrics. Similarly, the fecal comparability ICCs for RNAlater and FOBT cards were high, ranging from 0.63 (95% CI: 0.46, 0.75) for the relative abundance of Firmicutes to 0.93 (95% CI: 0.89, 0.96) for unweighted Unifrac. Comparability ICCs for OMNIgene ORAL and Scope mouthwash were lower than fecal ICCs, ranging from 0.55 (95% CI: 0.36, 0.70) for the Shannon index to 0.79 (95% CI: 0.69, 0.86) for Bray-Curtis. Overall, RNAlater, FOBT cards and Scope mouthwash were stable up to 4 days at room temperature. Samples collected using FOBT cards were generally comparable to RNAlater while the OMNIgene ORAL were less similar to Scope mouthwash. Conclusions As microbiome measures for feces samples collected using RNAlater, FOBT cards and oral samples collected using Scope mouthwash were stable over four days at room temperature, these would be most appropriate for microbial analyses in these populations. However, one collection method should be consistently since each method may induce some differences. Supplementary Information The online version contains supplementary material available at 10.1186/s12866-021-02387-9.
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Affiliation(s)
- Zeni Wu
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology & Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Autumn G Hullings
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology & Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Reza Ghanbari
- Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Science, Tehran, Iran
| | - Arash Etemadi
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology & Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Yunhu Wan
- Frederick National Laboratory for Cancer Research/Leidos Biomedical Research Laboratory, Inc., Frederick, MD, USA.,Cancer Genomics Research Laboratory, Division of Cancer Epidemiology & Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Bin Zhu
- Frederick National Laboratory for Cancer Research/Leidos Biomedical Research Laboratory, Inc., Frederick, MD, USA.,Cancer Genomics Research Laboratory, Division of Cancer Epidemiology & Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Hossein Poustchi
- Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Science, Tehran, Iran
| | - Behnam Bagheri Fahraji
- Department of Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mohammad Javad Zare Sakhvidi
- Department of Occupational Health, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Jianxin Shi
- Biostatistics Branch, Division of Cancer Epidemiology & Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Rob Knight
- Department of Pediatrics, University of California San Diego, La Jolla, CA, USA.,Department of Computer Science & Engineering, University of California San Diego, La Jolla, CA, USA
| | - Reza Malekzadeh
- Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Science, Tehran, Iran.
| | - Rashmi Sinha
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology & Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
| | - Emily Vogtmann
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology & Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
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22
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Zare Sakhvidi MJ, Yang J, Siemiatycki J, Dadvand P, de Hoogh K, Vienneau D, Goldberg M, Zins M, Lequy E, Jacquemin B. Greenspace exposure and cancer incidence: A 27-year follow-up of the French GAZEL cohort. Sci Total Environ 2021; 787:147553. [PMID: 33989869 DOI: 10.1016/j.scitotenv.2021.147553] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 04/22/2021] [Accepted: 04/30/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Greenspace exposure has been suggested to be associated with a range of health outcomes. The available evidence on the association of this exposure with cancer is still very scarce and inconsistent. OBJECTIVES We aimed to study the association between greenspace exposure and all-site and site-specific (prostate, breast, colorectal, bladder, lung, and malignant melanoma of skin) cancer incidence in the GAZEL cohort. METHODS This study was based on over 27 years of follow-up (1989-2016) of 19,408 participants across France. We assessed the residential greenspace exposure within several buffers as well as residential proximity to green spaces (agricultural, urban, and forests) in each follow-up. We used time-dependent Cox models, controlling for time-varying personal and area-level variables, with different lags between exposure and outcome. Additional analysis was conducted according to the urban-rural residence of the participants' over follow-up. RESULTS Over the 294,645 person-years of follow-up, we registered 4075 incident cases of cancer. We found an increase in the risk for all-sites cancer with an inter-quartile range increase of Normalized Difference in Vegetation Index across different buffers (hazard ratio (HR) of 1.08; 95% CI: 1.02, 1.14 for the 100 m buffer). We found a positive association of all-sites cancer with proximity to agricultural lands (HR: 1.03; 95% CI: 1.00, 1.05), and forests (HR:1.04; 95% CI: 1.00, 1.07), but not with urban green spaces. The cancer site-specific analyses suggested a protective role of greenspace for breast, lung, and colorectal cancers (e.g. breast cancer HR at 100 m buffer: 0.82; 95% CI: 0.69, 0.99). Non-significant associations were observed for prostate, bladder, and skin cancer. Stratified analyses based on urban, semi-urban, and rural classification did not suggest any differential pattern. CONCLUSION We identified an increased risk of all-site cancer with increased greenspace and proximity to agricultural lands and forests; whereas potential protective role of greenspace for breast cancer.
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Affiliation(s)
- Mohammad Javad Zare Sakhvidi
- Univ. Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, F-35000 Rennes, France
| | - Jun Yang
- Univ. Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, F-35000 Rennes, France
| | - Jack Siemiatycki
- Centre de recherches du centre hospitalier de l'université de Montréal, Québec, Canada
| | - Payam Dadvand
- ISGlobal, Doctor Aiguader 88, 08003 Barcelona, Spain; Universitat Pompeu Fabra (UPF), Doctor Aiguader 88, 08003 Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Melchor Fernández Almagro, 3-5, 28029 Madrid, Spain
| | - Kees de Hoogh
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Danielle Vienneau
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Marcel Goldberg
- Inserm UMS 11, Villejuif, France; Université de Paris, Paris, France
| | - Marie Zins
- Inserm UMS 11, Villejuif, France; Université de Paris, Paris, France
| | | | - Bénédicte Jacquemin
- Univ. Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, F-35000 Rennes, France.
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23
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Sharafi Z, Ehrampoush MH, Salehi-Abargouei A, Sakhvidi MJZ, Askarishahi M, Mirzaei M, Mehrparvar AH, Fallahzadeh H, Dehghani A, Dalvand A. Investigation of the association between pesticide exposure and the prevalence of type 2 diabetes in Shahedieh population in Yazd. Environ Sci Pollut Res Int 2021; 28:43394-43401. [PMID: 33834337 DOI: 10.1007/s11356-021-13821-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 04/01/2021] [Indexed: 06/12/2023]
Abstract
This study aimed to investigate the effect of exposure to pesticides and the prevalence of type 2 diabetes (T2D). In a cross-sectional study with a population of 9088, the data were collected through Persian Adult Cohort Questionnaire in Shahedieh area of Yazd, Iran. Based on the results, variables such as age, gender, body mass index, physical activity, and education level in the studied population had a significant association with the prevalence of diabetes. Although the obtained data in this study did not show a relationship between exposure to pesticides and the risk of developing T2D, further prospective studies are needed to determine the association between exposure to pesticides and the development of T2D.
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Affiliation(s)
- Zeynab Sharafi
- Environmental Science and Technology Research Center, Department of Environmental Health Engineering, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mohammad Hassan Ehrampoush
- Environmental Science and Technology Research Center, Department of Environmental Health Engineering, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Amin Salehi-Abargouei
- Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mohammad Javad Zare Sakhvidi
- Department of Occupational Health, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mohsen Askarishahi
- Department of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Masoud Mirzaei
- Department of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | | | - Hossein Fallahzadeh
- Department of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Ali Dehghani
- Department of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Arash Dalvand
- Environmental Science and Technology Research Center, Department of Environmental Health Engineering, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
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Shahrokhi S, Zavar Reza J, Andishmand S, Momtaz SM, Zare Sakhvidi MJ. Genotoxic evaluation and plasma oxidative stress markers in copper smelters. TOXIN REV 2021. [DOI: 10.1080/15569543.2019.1570940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Samira Shahrokhi
- Occupational Health Research Center, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Department of Occupational Health, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Javad Zavar Reza
- Department of Biochemistry, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Biotechnology Research Center, International Campus, Shahid Sadoughi University of Medical Science, Yazd, Iran
| | - Sode Andishmand
- Department of Biochemistry, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Seyed Mojtaba Momtaz
- Department of Environmental Health, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mohammad Javad Zare Sakhvidi
- Occupational Health Research Center, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Department of Occupational Health, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Mohammadi D, Zare Zadeh M, Zare Sakhvidi MJ. Short-term exposure to extreme temperature and risk of hospital admission due to cardiovascular diseases. Int J Environ Health Res 2021; 31:344-354. [PMID: 33615930 DOI: 10.1080/09603123.2019.1663496] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2019] [Accepted: 08/26/2019] [Indexed: 06/12/2023]
Abstract
Objective: Numerous epidemiological studies have reported relevance of morbidity and mortality from cardiovascular diseases with short-term exposure to environmental temperature. In this study, we examined the hypothesis between temperature indices and hospital admission because of cardiovascular diseases. Methods: The daily number of CVDs was obtained from all hospitals of the Sabzevar city. A semi-parametric generalized additive model (GAM) following a quasi-Poisson distribution with distributed lag non-linear model (dlnm) was selected as a modeling framework for time-series analysis. Results: The overall CVD risk comparing the 1st percentile and the 99th percentile relative to the mean temperature (at lag 0) was 1.33 (95% CI, 1.11: 1.61), and 1.34 (95% CI, 1.10: 1.64), respectively. For all indicators, the extremely cold effects persisted for the initial 7 days. Conclusions: Our results suggest that extremely cold and extremely hot temperatures increase the relative risk of cardiovascular diseases.
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Affiliation(s)
- Danial Mohammadi
- Occupational Health Research Center, School of Public Health, Shahid Sadoughi University of Medical Sciences , Yazd, Iran
- Department of Occupational Health, School of Public Health, Shahid Sadoughi University of Medical Sciences , Yazd, Iran
| | - Mohammad Zare Zadeh
- Department of Health Care Management, School of Public Health, Shahid Sadoughi University of Medical Sciences , Yazd, Iran
| | - Mohammad Javad Zare Sakhvidi
- Occupational Health Research Center, School of Public Health, Shahid Sadoughi University of Medical Sciences , Yazd, Iran
- Department of Occupational Health, School of Public Health, Shahid Sadoughi University of Medical Sciences , Yazd, Iran
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Kargar-Shouroki F, Miri M, Zare Sakhvidi MJ, Hosseini Sangchi SZ, Madadizadeh F. Genotoxic effect of exposure to polycyclic aromatic hydrocarbons (PAHs) in asphalt workers. EXCLI J 2021; 20:686-697. [PMID: 33883991 PMCID: PMC8056049 DOI: 10.17179/excli2021-3487] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 03/03/2021] [Indexed: 11/10/2022]
Abstract
Asphalt workers are at risk due to exposure to asphalt fumes containing polycyclic aromatic hydrocarbons (PAHs). The main purpose of this study was to measure the urinary metabolite of PAHs and to determine its effect on micronucleus (MN) formation as an indicator of genotoxic damage. In this cross-sectional study, the MN frequency in 48 male asphalt workers exposed to PAHs was measured and compared with 48 male non-exposed employees. PAHs exposure was evaluated by determining urinary 1-Hydroxypyrene (1-OHP). The mean concentrations of 1-OHP in the exposed and non-exposed groups were 0.58 ± 0.41 μmol/mol creatinine and 0.38 ± 0.25 μmol/mol creatinine, respectively. 1-OHP concentration was significantly higher in smokers compared with non-smokers in both exposed and non-exposed groups. Moreover, the mean MN frequency in the exposed group was significantly higher than in the non-exposed group. The MN frequency was significantly higher in asphalt workers with a work history of ≥ 15 years compared to workers with lower work history. In a fully adjusted model, there was a statistically significant association between exposure to PAHs, with MN and 1-OHP concentration, and between smoking status with 1-OHP. The findings of the present study indicated that occupational exposure to PAHs was associated with increased urinary 1-OHP as well as DNA damage in the asphalt workers.
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Affiliation(s)
- Fatemeh Kargar-Shouroki
- Occupational Health Research Center, Department of Occupational Health Engineering, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mohammad Miri
- Non-Communicable Diseases Research Center, Department of Environmental Health, School of Health, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Mohammad Javad Zare Sakhvidi
- Occupational Health Research Center, Department of Occupational Health Engineering, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Seyedeh Zahra Hosseini Sangchi
- Occupational Health Research Center, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Farzan Madadizadeh
- Research Center of Prevention and Epidemiology of Non-Communicable Disease, Department of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Li M, Dong H, Wang B, Zhao W, Zare Sakhvidi MJ, Li L, Lin G, Yang J. Association between ambient ozone pollution and mortality from a spectrum of causes in Guangzhou, China. Sci Total Environ 2021; 754:142110. [PMID: 32920396 DOI: 10.1016/j.scitotenv.2020.142110] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 08/29/2020] [Accepted: 08/29/2020] [Indexed: 05/24/2023]
Abstract
Ambient ozone (O3) has emerged as an important public health issue worldwide. Previous studies found an association between O3 and cardiorespiratory mortality. However, evidence was limited regarding the risk of O3 on mortality from other diseases. In this study, we aimed to estimate the association between O3 and mortality from a broad spectrum of diseases in Guangzhou, China, which has experienced a rapid increase in O3 concentration over the past decades. Daily data were obtained on cause-specific mortality, air pollutant concentrations and weather conditions during 2013-2018. A generalized additive model with quasi-Poisson regression was applied to examine the association between O3 and mortality from 10 broad causes and 26 refined subcategories, with adjustment of long-term and seasonal trends, weather conditions, public holidays and days of the week. We found that the threshold concentrations of O3 were 40 μg/m3 for all-cause, non-accidental, cardiovascular and respiratory mortality. Mortality risk increased monotonically with O3 concentrations above the threshold. Per 10 μg/m3 increase of O3 at lag 0-3 days was associated with 0.54% (95%CI: 0.34-0.74%), 0.56% (95%CI: 0.36-0.76%), 0.59% (95%CI: 0.30-0.88%), 0.78% (95%CI: 0.33-1.24%) and 0.52% (95%CI: 0.21-0.83%) elevated risk of death from all causes, non-accidental causes, cardiovascular diseases, respiratory diseases and neoplasms, respectively. Among the subcategories, the largest effect estimate was observed in people with chronic obstructive pulmonary disease. The elderly suffered from a higher mortality risk from O3. Stringent emission control strategies and multi-sectoral collaborations are needed to reduce the detrimental impact of O3 on vulnerable populations.
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Affiliation(s)
- Mengmeng Li
- Institute for Environmental and Climate Research, Jinan University, Guangzhou 511443, China; State Key Laboratory of Oncology in Southern China, Department of Epidemiology, Cancer Prevention Center, Sun Yat-sen University Cancer Center, Guangzhou 510060, China
| | - Hang Dong
- Guangzhou Center for Disease Control and Prevention, Guangzhou 510440, Guangdong, China
| | - Boguang Wang
- Institute for Environmental and Climate Research, Jinan University, Guangzhou 511443, China; JNU-QUT Joint Laboratory for Air Quality Science and Management, Jinan University, Guangzhou 511443, China; Guangdong-Hongkong-Macau Joint Laboratory of Collaborative Innovation for Environmental Quality, Guangzhou 511443, China
| | - Wenlong Zhao
- Institute for Environmental and Climate Research, Jinan University, Guangzhou 511443, China; JNU-QUT Joint Laboratory for Air Quality Science and Management, Jinan University, Guangzhou 511443, China; Guangdong-Hongkong-Macau Joint Laboratory of Collaborative Innovation for Environmental Quality, Guangzhou 511443, China
| | - Mohammad Javad Zare Sakhvidi
- Department of Occupational Health, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Li Li
- State Key Laboratory of Organ Failure Research, Department of Biostatistics, School of Public Health, Southern Medical University, Guangzhou 510515, China
| | - Guozhen Lin
- Guangzhou Center for Disease Control and Prevention, Guangzhou 510440, Guangdong, China.
| | - Jun Yang
- Institute for Environmental and Climate Research, Jinan University, Guangzhou 511443, China; JNU-QUT Joint Laboratory for Air Quality Science and Management, Jinan University, Guangzhou 511443, China; Guangdong-Hongkong-Macau Joint Laboratory of Collaborative Innovation for Environmental Quality, Guangzhou 511443, China.
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Zare Sakhvidi MJ, Lequy E, Goldberg M, Jacquemin B. Air pollution exposure and bladder, kidney and urinary tract cancer risk: A systematic review. Environ Pollut 2020; 267:115328. [PMID: 32871482 DOI: 10.1016/j.envpol.2020.115328] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 07/07/2020] [Accepted: 07/27/2020] [Indexed: 05/21/2023]
Abstract
BACKGROUND Exposure to outdoor air pollution has been linked to lung cancer, and suspicion arose regarding bladder, kidney, and urinary tract cancer (urological cancers). However, most of evidence comes from occupational studies; therefore, little is known about the effect of exposure to air pollution on the risk of urological cancers in the general population. METHOD We systematically searched Medline, Scopus, and Web of Science for articles investigating the associations between long-term exposure to air pollution and the risk of urological cancer (incidence or mortality). We included articles using a specific air pollutant (PM10, PM2.5, …) or proxies (traffic, proximity index …). We assessed each study's quality with the Newcastle-Ottawa scale and rated the quality of the body of evidence for each pollutant-outcome with the GRADE approach. The different study methodologies regarding exposure or outcome prevented us to perform a meta-analysis. RESULTS twenty articles (four case-control, nine cohort, and seven ecologic) met our inclusion criteria and were included in this review: eighteen reported bladder, six kidney, and two urinary tract. Modeling air pollutants was the most common exposure assessment method. Most of the included studies reported positive associations between air pollution and urological cancer risk. However, only a few reached statistical significance (e.g. for bladder cancer mortality, adjusted odds-ratio of 1.13 (1.03-1.23) for an increase of 4.4 μg.m-3 of PM2.5). Most studies inadequately addressed confounding, and cohort studies had an insufficient follow-up. DISCUSSION Overall, studies suggested positive (even though mostly non-significant) associations between air pollution exposure and bladder cancer mortality and kidney cancer incidence. We need more studies with better confounding control and longer follow-ups.
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Affiliation(s)
- Mohammad Javad Zare Sakhvidi
- University Rennes 1, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail), UMR_S 1085, F-35000, Rennes, France; Occupational Health Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
| | - Emeline Lequy
- INSERM, UMS 011, F-94807, Villejuif, France; Université de Montréal Hospital Research Centre (CRCHUM), Montreal, QC, Canada
| | - Marcel Goldberg
- INSERM, UMS 011, F-94807, Villejuif, France; Université Paris Descartes, 12, Rue de L'école de Médecine, F-75006, Paris, France
| | - Bénédicte Jacquemin
- University Rennes 1, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail), UMR_S 1085, F-35000, Rennes, France.
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Miri M, de Prado-Bert P, Alahabadi A, Najafi ML, Rad A, Moslem A, Aval HE, Ehrampoush MH, Bustamante M, Zare Sakhvidi MJ, Nawrot T, Sunyer J, Dadvand P. Association of greenspace exposure with telomere length in preschool children. Environ Pollut 2020; 266:115228. [PMID: 32763773 DOI: 10.1016/j.envpol.2020.115228] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 06/18/2020] [Accepted: 07/09/2020] [Indexed: 06/11/2023]
Abstract
Exposure to greenspace has been associated with a wide range of health benefits; however, the available evidence on the association of this exposure with telomere length (TL), an early marker of ageing, is still scarce. We investigated the association of greenspace exposure with TL in a sample of 200 preschool children (aged 5-7 years) residing in Sabzevar, Iran (2017). We comprehensively characterized different aspects of greenspace exposure encompassing residential, kindergarten, and total (including both residential and kindergarten) surrounding greenspace (using satellite-derived Normalized Difference Vegetation Index), residential and kindergarten distance to green spaces, time spent in private gardens and public green spaces, and the number of plant pots at home. Relative leukocyte TL (LTL) in blood samples of the study participants was measured using quantitative polymerase chain reaction (qPCR). We applied mixed effects linear regression models with kindergarten and qPCR plate as random effects, to estimate the association of indicators of greenspace exposure (one at a time) with LTL, controlled for relevant covariates. We observed an inverse association between distance from home and kindergarten to green spaces larger than 5000 m2 and LTL. Moreover, higher total surrounding greenspace at 300m and 500m buffers and higher surrounding greenspace at 300m buffer around kindergarten and home were associated with longer LTL. Furthermore, longer time spent (h/week) in the public green spaces was associated with longer LTL. Our findings for residential and kindergarten distance to any green space (regardless of the size), residential surrounding greenspace at 100m and 500m buffers, kindergarten surrounding greenspace at 100m buffer, time spent in private gardens (h/week) and the number of plant pots at home were not conclusive. Our findings were generally suggestive for a positive association between greenspace exposure and LTL in preschool children. More studies are needed to confirm these findings in other settings with different climates and populations.
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Affiliation(s)
- Mohammad Miri
- Non-communicable Diseases Research Center, Department of Environmental Health, School of Public Health, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Paula de Prado-Bert
- ISGlobal, Barcelona, Spain; Pompeu Fabra University, Barcelona, Catalonia, Spain; Ciber on Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Ahmad Alahabadi
- Non-communicable Diseases Research Center, Department of Environmental Health, School of Public Health, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Moslem Lari Najafi
- Pharmaceutical Sciences and Cosmetic Products Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Abolfazl Rad
- Cellular and Molecular Research Center, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Alireza Moslem
- Cellular and Molecular Research Center, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Hamideh Ebrahimi Aval
- Cellular and Molecular Research Center, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Mohammad Hassan Ehrampoush
- Department of Environmental Health, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mariona Bustamante
- ISGlobal, Barcelona, Spain; Pompeu Fabra University, Barcelona, Catalonia, Spain; Ciber on Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Mohammad Javad Zare Sakhvidi
- Occupational Health Research Center, Department of Occupational Health, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran; Univ Rennes 1, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) UMR-S 1085, F-35000, Rennes, France
| | - Tim Nawrot
- Centre for Environmental Sciences, Hasselt University, Hasselt, Belgium; Department of Public Health & Primary Care, Leuven University, Leuven, Belgium
| | - Jordi Sunyer
- ISGlobal, Barcelona, Spain; Pompeu Fabra University, Barcelona, Catalonia, Spain; Ciber on Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Payam Dadvand
- ISGlobal, Barcelona, Spain; Pompeu Fabra University, Barcelona, Catalonia, Spain; Ciber on Epidemiology and Public Health (CIBERESP), Madrid, Spain.
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Najafi F, Soltani S, Karami Matin B, Kazemi Karyani A, Rezaei S, Soofi M, Salimi Y, Moradinazar M, Hajizadeh M, Barzegar L, Pasdar Y, Hamzeh B, Haghdoost AA, Malekzadeh R, Poustchi H, Eghtesad S, Nejatizadeh A, Moosazadeh M, Zare Sakhvidi MJ, Joukar F, Hashemi-Shahri SM, Vakilian A, Niknam R, Faramarzi E, Akhavan Akbari G, Ghorat F, Khaledifar A, Vahabzadeh D, Homayounfar R, Safarpour AR, Hosseini SV, Rezvani R, Hosseini SA. Socioeconomic - related inequalities in overweight and obesity: findings from the PERSIAN cohort study. BMC Public Health 2020; 20:214. [PMID: 32046684 PMCID: PMC7014739 DOI: 10.1186/s12889-020-8322-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 02/05/2020] [Indexed: 12/21/2022] Open
Abstract
Background Overweight and obesity are major health concerns worldwide, with adverse health consequences during the life span. This study measured socioeconomic inequality in overweight and obesity among Iranian adults. Methods Data were extracted from 129,257 Iranian adults (aged 35 years and older) participated in the Prospective Epidemiologic Research Studies in IrAN (PERSIAN) in 14 provinces of Iran in 2014. Socioeconomic-related inequality in overweight and obesity was estimated using the Concentration Index (Cn). The Cn further decomposed to find factors explaining the variability within the Socioeconomic related inequality in overweight and obesity. Results Of the total number of participants, 1.98, 26.82, 40.76 and 30.43% had underweight, normal weight, overweight and obesity respectively. The age-and sex standardized prevalence of obesity was higher in females than males (39.85% vs 18.79%). People with high socioeconomic status (SES) had a 39 and 15% higher chance of being overweight and obese than low SES people, respectively. The positive value of Cn suggested a higher concentration of overweight (0.081, 95% confidence interval [CI]; 0.074–0.087) and obesity (0.027, 95% CI; 0.021–0.034) among groups with high SES. There was a wide variation in socioeconomic-related inequality in overweight and obesity rate across 14 provinces. The decomposition results suggested that SES factor itself explained 66.77 and 89.07% of the observed socioeconomic inequalities in overweight and obesity among Iranian adults respectively. Following SES, province of residence, physical activity, using hookah and smoking were the major contributors to the concentration of overweight and obesity among the rich. Conclusions Overall, we found that overweight and obesity is concentrated among high SES people in the study population. . Accordingly, it seems that intersectional actions should be taken to control and prevent overweight and obesity among higher socioeconomic groups.
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Affiliation(s)
- Farid Najafi
- Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.,Social Development and Health Promotion Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Shahin Soltani
- Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran. .,Social Development and Health Promotion Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran.
| | - Behzad Karami Matin
- Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.,Social Development and Health Promotion Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ali Kazemi Karyani
- Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.,Social Development and Health Promotion Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Satar Rezaei
- Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Moslem Soofi
- Social Development and Health Promotion Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Yahya Salimi
- Social Development and Health Promotion Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mehdi Moradinazar
- Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mohammad Hajizadeh
- School of Health Administration, Faculty of Health, Dalhousie University, Halifax, Canada
| | - Loghman Barzegar
- Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Yahya Pasdar
- Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Behrooz Hamzeh
- Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ali Akbar Haghdoost
- Modeling in Health Research Center, Institute for Future Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Reza Malekzadeh
- Liver and pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Poustchi
- Liver and pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Sareh Eghtesad
- Liver and pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Azim Nejatizadeh
- Molecular Medicine Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Mahmood Moosazadeh
- Health Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mohammad Javad Zare Sakhvidi
- Occupational Health Research Centre, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Farahnaz Joukar
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | | | - Alireza Vakilian
- Dept. of Neurology, Medical School, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Ramin Niknam
- Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Elnaz Faramarzi
- Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical sciences, Tabriz, Iran
| | - Ghodrat Akhavan Akbari
- Digestive Disease Research Center, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Fershteh Ghorat
- Traditional and Complementary Medicine Research Center, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Arsalan Khaledifar
- Modeling in Health Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Davoud Vahabzadeh
- Social Determinants of Health Research Center, Urmia University of Medical Sciences, Urmia, Iran
| | - Reza Homayounfar
- Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran
| | - Ali Reza Safarpour
- Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Reza Rezvani
- Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Seyyed Ahmad Hosseini
- Nutrition and Metabolic Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Abstract
Introduction Exposure to used gasoline engine oils during oil change and other automobile repair services is common for many mechanics, electrical technicians, and other car service workers. We aimed to determine the prevalence of hand dermatitis in car repair workers with different specialty and actual dermal exposure hazards in the workplace. Methods We examined the dermal problems in 153 male car repair workers and compared it to 140 office workers. Exposed and control groups were administered a Nordic Occupational Skin Questionnaire. Dermal exposure score also was calculated. Results The prevalence of hand dermatitis in car repair workers (19.0%) was significantly higher than office worker (7.9%) [OR: 2.74, (95% CI = 1.31, 5.73)] and also higher than general population. Prevalence of atopic dermatitis was significantly higher in exposed group that had hand dermatitis compared with those who had no hand dermatitis (P < 0.001). The highest hand dermatitis as well as actual dermal exposure was observed in the mechanics and transmission technician respectively. Conclusion Car repair workers have an elevated prevalence of hand dermatitis in comparison with office workers. The most important risk factors for hand dermatitis among car repair workers are atopic dermatitis and the next the level of skin exposure to potential skin hazards.
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Affiliation(s)
| | - Ziba Loukzadeh
- Industrial Diseases Research Center, Center of Excellence for Occupational Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Rezaei Hachesu V, Naderyan Fe'li S, Kargar Shouroki F, Mehrparvar AH, Zavar Reza J, Azimi M, Zare Sakhvidi MJ. Carbon load in airway macrophages, DNA damage and lung function in taxi drivers exposed to traffic-related air pollution. Environ Sci Pollut Res Int 2019; 26:6868-6876. [PMID: 30632047 DOI: 10.1007/s11356-019-04179-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Accepted: 01/07/2019] [Indexed: 06/09/2023]
Abstract
To evaluate the potential applicability of carbon load in airway macrophages as a marker of exposure to traffic-related air pollution (TRAP) and its association with parameters of comet assay as a marker of DNA damage, and pulmonary function tests (PFTs) in the group of taxi drivers in Iran. One hundred four male taxi drivers with at least 1-year job history were randomly selected from registered drivers in the taxi union. Airway macrophages were obtained via sputum induction, and then the area of airway macrophages occupied by carbon was measured. DNA damage was determined by comet assay. PFTs were measured by the spirometer. Most of the participants (89.4%) were non-smoker. In this study, 52.7% of non-smoker participants were able to give a sample of sputum with macrophage. Carbon content of airway macrophages was 0.2 μm2. There was no significant difference in pulmonary function and comet assay parameters in terms of smoking status. There was an inverse correlation between carbon load with each of comet assay and PFTs parameters, although not statistically significant. This study identified that long-term exposure to TRAP can be a risk factor for pulmonary disorders.
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Affiliation(s)
- Vida Rezaei Hachesu
- Department of Occupational Health, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
| | - Shadi Naderyan Fe'li
- Department of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Fatemeh Kargar Shouroki
- Occupational Health Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Amir Houshang Mehrparvar
- Department of Occupational Medicine, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Javad Zavar Reza
- Department of Medical Biochemistry, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mohammad Azimi
- Department of Occupational Health, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mohammad Javad Zare Sakhvidi
- Department of Occupational Health, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
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Momtaz SM, Mehdipour P, Dadvand P, Ehrampoush MH, Ghaneian MT, Lotfi MH, Aliabad AS, Molavi F, Zare Sakhvidi MJ. Environmental and behavioral determinants affecting the association of airway macrophages carbon load with distance to major roads and traffic density. Chemosphere 2019; 217:680-685. [PMID: 30447615 DOI: 10.1016/j.chemosphere.2018.11.049] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 10/30/2018] [Accepted: 11/07/2018] [Indexed: 02/08/2023]
Abstract
Biomarkers are promising indicators to evaluate human exposure to air pollutants and to predict the health outcomes. Area of Airway macrophages that is occupied by Black Carbon could be used as a biomarker of personal long term exposure to traffic related air pollution. Association of airway macrophages carbon load with weighted average distance and environmental and subject-specific behavior are considered in this study. Sputum samples were taken from 160 healthy adult women and airway macrophages carbon load (AMCL) were determined in 93 subjects, which represent a success rate of 62% in sputum induction. Nearest distance of the subjects to major roads and average weighted distance were calculated for each subject. A questionnaire was field according to general and behavioral characteristics of the participants. There was not any significant difference (P-value >0.05) between induced and non-induced subjects. Subjects with indoor kitchen without separation wall, passive smokers and those with longer presence time in high traffic streets showed higher carbon area. Weighted average distance had a better association (β = -0.186, 95%CI: -0.139, -0.230, P-value = 0.00) with AMCL than nearest distance to major roads (β = -0.155, 95%CI: -0.109, -0.201, P-value = 0.19). Association of Weighted average distance with AMCL was interrupted in subjects with a garage connected to house environment, those with IK kitchen, those with a hood above the stove and passive smokers. The findings indicated that more generation and distribution of indoor air pollutants can completely enhance the internal exposure and indoor pollution has the same importance as outdoor pollution.
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Affiliation(s)
- Seyed Mojtaba Momtaz
- Environmental Science and Technology Research Center, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Parvin Mehdipour
- Department of Medical Genetics, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Payam Dadvand
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), C/Doctor Aiguader 88, 08003, Barcelona, Spain
| | - Mohammad Hassan Ehrampoush
- Environmental Science and Technology Research Center, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
| | - Mohammad Taghi Ghaneian
- Environmental Science and Technology Research Center, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mohammad Hassan Lotfi
- Department of Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | | | - Fereshte Molavi
- Environmental Science and Technology Research Center, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mohammad Javad Zare Sakhvidi
- Department of Occupational Health, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Mohammadi D, Naghshineh E, Sarsangi A, Zare Sakhvidi MJ. Environmental extreme temperature and daily preterm birth in Sabzevar, Iran: a time-series analysis. Environ Health Prev Med 2019; 24:5. [PMID: 30611198 PMCID: PMC6320631 DOI: 10.1186/s12199-018-0760-x] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Accepted: 12/21/2018] [Indexed: 11/16/2022] Open
Abstract
Objectives Most of the studies on the effect of heat stress on preterm birth (PTB) are conducted in temperate climates. Evidence on this effect in hot and arid countries with low and middle income is limited. This paper describes the short-term effect of exposure to the hot and cold environment on a daily number of PTB in Iran. Methods The daily number of PTB was obtained from all hospitals of the city. Meteorological and air pollution data from 2011 to 2017 were obtained from a metrological station in the city. A semi-parametric generalized additive model following a quasi-Poisson distribution with the distributed lag non-linear model was selected as a modeling framework for time-series analysis to simultaneously model the short-term and lagged effect of heat stress on PTB in the Sabzevar city. Results The minimum and maximum daily temperature were − 11.2 and 45.4 °C respectively. The highest risk estimate at extreme cold temperature was found for apparent temperature (relative risk (RR) 1.83; 95% CI 1.61: 2.09). This pattern was seen for both models. For extreme hot temperatures, the model with mean temperature showed the highest risk increase for both the main model and air pollution adjusted model (RR 1.36; 95% CI 1.25: 1.49). The lowest risk estimate in extremely cold conditions was found in the model with mean temperature. However, for extremely hot temperature conditions, the lowest risk estimate was found for both maximum and apparent temperature. Conclusion Obstetricians working in semi-arid areas should be aware of the influence of environmental extreme temperature on the incidence of PTB. Electronic supplementary material The online version of this article (10.1186/s12199-018-0760-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Danial Mohammadi
- Occupational Health Research Center, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.,Department of Occupational Health, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Elham Naghshineh
- Department of Obstetrics and Gynecology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Alireza Sarsangi
- Department of Remote Sensing and GIS, Faculty of Geography, University of Tehran, Tehran, Iran
| | - Mohammad Javad Zare Sakhvidi
- Occupational Health Research Center, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. .,Department of Occupational Health, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
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Miri M, Nazarzadeh M, Alahabadi A, Ehrampoush MH, Rad A, Lotfi MH, Sheikhha MH, Sakhvidi MJZ, Nawrot TS, Dadvand P. Air pollution and telomere length in adults: A systematic review and meta-analysis of observational studies. Environ Pollut 2019; 244:636-647. [PMID: 30384069 DOI: 10.1016/j.envpol.2018.09.130] [Citation(s) in RCA: 63] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 09/20/2018] [Accepted: 09/26/2018] [Indexed: 05/03/2023]
Abstract
Telomere length (TL) has been suggested to be a surrogate for cellular ageing, and a record of cumulative inflammation and oxidative stress over life. An emerging body of evidence has associated exposure to air pollution to changes in TL. To date there is no available systematic review of literature on this association. We aimed to systematically review and conduct meta-analysis of published studies on the relationship between air pollution and TL in adults. Electronic databases were systematically searched for available English language studies on the association between air pollution and TL published up to 1 July 2018. Meta-analyses were conducted following MOOSE guidelines. The heterogeneity in the reported associations was assessed using Cochran's Q test and quantified as I2 index. Publication bias was assessed using Egger's regression. Our search identified 19 eligible studies including 11 retrospective and eight prospective studies of which, four had excellent quality, ten had good quality and five had fair quality. Meta-analysis result of two studies on long-term exposure to PM2.5 showed an inverse association between these exposures and TL (for 5 μg/m3 PM2.5-0.03 95% CI; -0.05, -0.01). Meta-analysis of short-term exposure to PM2.5 with three studies and Polychlorinated Biphenyls (PCBs) with two studies revealed a direct association between these exposures and TL (0.03 95% CI; 0.02, 0.04 and 0.10 95% CI; 0.06, 0.15 respectively). No statistically significant relationship between exposure to PM10 and polycyclic aromatic hydrocarbons (PAHs) exposure and TL were observed. We observed suggestive evidence for associations between air pollution and TL with potentially different direction of associations for short- and long-term exposures.
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Affiliation(s)
- Mohammad Miri
- Cellular and Molecular Research Center, Department of Environmental Health, School of Public Health, Sabzevar University of Medical Sciences, Sabzevar, Iran.
| | - Milad Nazarzadeh
- The George Institute for Global Health, University of Oxford, Oxford, UK; The Collaboration Center of Meta-analysis Research (ccMETA), Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
| | - Ahmad Alahabadi
- Cellular and Molecular Research Center, Department of Environmental Health, School of Public Health, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Mohammad Hassan Ehrampoush
- Environmental Science and Technology Research Center, Department of Environmental Health, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Abolfazl Rad
- Cellular and Molecular Research Center, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Mohammad Hassan Lotfi
- Department of Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mohammad Hassan Sheikhha
- Research and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mohammad Javad Zare Sakhvidi
- Occupational Health Research Center, Department of Occupational Health, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Tim S Nawrot
- Centre for Environmental Sciences, Hasselt University, Hasselt, Belgium; Department of Public Health & Primary Care, Leuven University, Leuven, Belgium
| | - Payam Dadvand
- ISGlobal, Barcelona, Spain; Pompeu Fabra University, Barcelona, Catalonia, Spain; Ciber on Epidemiology and Public Health (CIBERESP), Madrid, Spain.
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Miri M, Alahabadi A, Ehrampush MH, Rad A, Lotfi MH, Sheikhha MH, Sakhvidi MJZ. Mortality and morbidity due to exposure to ambient particulate matter. Ecotoxicol Environ Saf 2018; 165:307-313. [PMID: 30205333 DOI: 10.1016/j.ecoenv.2018.09.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 07/19/2018] [Accepted: 09/01/2018] [Indexed: 05/21/2023]
Abstract
The aim of this study was to investigate spatial variation and health risk of the exposure to PM2.5 (particulate matter with a diameter of 2.5 µm or less) and PM10 (particulate matter with a diameter of 10 µm or less) in Sabzevar, Iran. PM2.5 and PM10 were measured during three campaigns from April to November 2017, in 26 sampling points. Spatial analysis was performed using kriging and autocorrelations (Moran's index) model in Arc GIS software. Relationship between exposure to the PM2.5 and PM10 and their health impacts were investigated by AirQ 2.2.3 software. The mean concentrations (and standard deviation) of PM 2.5 and PM10 over the entire study period were 32.54 (37.28) and 42.61 (47.76) μg/m3, respectively, which were higher than the guideline of World Health Organization. According to the spatial analysis, the maximum concentrations of PM2.5 and PM10 were around the main highway (beltway) which placed all over the south of Sabzevar. According to the Moran's index, the emission patterns for PM2.5 (Z-score = 2.53; P-value = 0.011) and PM10 (Z-score = 2.82; P-value = 0.004) were clustered. The attributable percentage (AP) of total mortality related to PM2.5 and PM10 were 3.544% (95% confidence interval (CI): 2.623-4.447%) and 2.055% (95% CI: 1.379-2.721%) per increasing each 10 μg/m3 of these pollutants, respectively. According to observed results, it is suggested that the beltway and other pollution sources, such as industries, should be placed at a greater distance from the city, to reduce PM amounts in residential areas.
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Affiliation(s)
- Mohammad Miri
- Environmental Science and Technology Research Center, Department of Environmental Health, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran; Department of Environmental Health, School of Public Health, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Ahmad Alahabadi
- Department of Environmental Health, School of Public Health, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Mohammad Hassan Ehrampush
- Environmental Science and Technology Research Center, Department of Environmental Health, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
| | - Abolfazl Rad
- Cellular and Molecular Research Center, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Mohammad Hassan Lotfi
- Department of Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mohammad Hassan Sheikhha
- Research and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mohammad Javad Zare Sakhvidi
- Occupational Health Research Center, Department of Occupational Health, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Sanei B, Zavar Reza J, Momtaz M, Azimi M, Zare Sakhvidi MJ. Occupational exposure to particulate matters and telomere length. Environ Sci Pollut Res Int 2018; 25:36298-36305. [PMID: 30368702 DOI: 10.1007/s11356-018-3486-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Accepted: 10/16/2018] [Indexed: 06/08/2023]
Abstract
Little is known about the possible association between occupational exposure to mineral particulate matters and change in leukocyte telomere length (LTL) as a hallmark of aging. The present study studied the relationship between occupational exposures to mineral dust and LTL in the exposed group of workers and compared to non-exposed workers. One hundred and ten male workers (80 exposed and 30 non-exposed) from different units of a ceramic factory were recruited in the study. Personal air samples were collected in the breathing zone of the workers for inhalable and respirable fractions. Relative LTL was measured in blood genomic DNA using the quantitative real-time PCR method and expressed as telomere/single copy gene ratio. Exposure to inhalable and respirable dusts in the exposed group was 22.66 ± 52.38 and 2.54 ± 9.34 mg/m3 respectively. Inhalable and respirable exposure values were highly correlated (r2 = 0.43; p < 0.001). Exposure to respirable and inhalable particles in 38.75% and 8.75% of exposed workers was higher than threshold limit value respectively. Mean LTL in the exposed workers (0.64 ± 0.06) was significantly shorter than the non-exposed workers (0.73 ± 0.07) (p < 0.001). Despite the significant difference in exposure intensity according to working units in the exposed group, there was no significant difference in LTL according to the working units (p = 0.60). In the adjusted regression models, but not crude models, marginally significant and positive association was found between both size fractions and LTL. The observed effect size for respirable particles was five times of that found for the inhalable fraction (beta 0.005 and 0.001 respectively). Mineral dust-and not only traffic-related air pollutant exposure-could be regarded as a risk factor in the process of cell aging. Our findings imply that early biological aging, as reflected in telomere shortening, may mediate the effects of occupational air pollution exposure on human health.
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Affiliation(s)
- Behnoush Sanei
- Occupational Health Research Center, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Department of Occupational Health, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Javad Zavar Reza
- Department of Medical Biochemistry, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
| | - Mojtaba Momtaz
- Department of Environmental Health, School of Public Health|, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mohammad Azimi
- Occupational Health Research Center, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mohammad Javad Zare Sakhvidi
- Occupational Health Research Center, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
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Zare Sakhvidi MJ, Zare Sakhvidi F, Mehrparvar AH, Foraster M, Dadvand P. Association between noise exposure and diabetes: A systematic review and meta-analysis. Environ Res 2018; 166:647-657. [PMID: 30006240 DOI: 10.1016/j.envres.2018.05.011] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Revised: 05/08/2018] [Accepted: 05/10/2018] [Indexed: 05/17/2023]
Abstract
BACKGROUND The prevalence of diabetes is on rise worldwide and environmental factors are being increasingly recognized to be involved in this rise. An emerging body of evidence has evaluated the impact of long-term exposure to noise on diabetes mellitus, highlighting the need to synthesize this evidence. OBJECTIVES To systematically review and conduct meta-analysis of the available evidence on the association between long-term exposure to transport and occupational noise exposure and diabetes mellitus. METHODS Selected databases were searched for available evidence published till September 13th, 2017 following MOOSE guidelines. The quality of articles was assessed using the Newcastle-Ottawa Scale. Random effects meta-analysis was applied to abstract combined estimates for diabetes mellitus per 5 dB increase in noise exposure. We evaluated the heterogeneity applying Cochran's Q test and quantified it using I2 statistic. Meta-regressions were conducted to identify sources of heterogeneity. Publication bias was evaluated using funnel plot and Egger's test. RESULTS Fifteen studies met our inclusion criteria of which nine including five prospective cohorts, two cross-sectional and two case-control studies with a total number of 444460 adult participants and 17430 diabetes mellitus cases included in meta-analyses. We observed a 6% (95% confidence interval (CI): 3%, 9%) increase in the risk of diabetes mellitus per 5 dB increase in noise exposure regardless of its source. Source-specific analyses were suggestive for stronger associations for air traffic noise (combined odds ratio: 1.17; 95% CI: 1.06, 1.29 per 5 dB increase in exposure) flowed by road traffic noise (combined odds ratio: 1.07; 95% CI: 1.02, 1.12). We observed some indications of publication bias; however the findings were robust after trim and fill test. Meta-regression analyses showed that the adjustment in general, and not specifically related to air pollution, could predict the between-study heterogeneity in reported associations. CONCLUSIONS The results indicate an increased risk of diabetes mellitus associated with noise exposure, mainly related to air and road traffic.
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Affiliation(s)
- Mohammad Javad Zare Sakhvidi
- Department of Occupational Health, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran; Occupational Health Research Center, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Fariba Zare Sakhvidi
- Department of Biostatistics, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Amir Houshang Mehrparvar
- Industrial Diseases Research Center, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Maria Foraster
- ISGlobal, Barcelona Institute for Global Health, Barcelona, Spain; Pompeu Fabra University, Barcelona, Spain; Ciber on Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Payam Dadvand
- ISGlobal, Barcelona Institute for Global Health, Barcelona, Spain; Pompeu Fabra University, Barcelona, Spain; Ciber on Epidemiology and Public Health (CIBERESP), Madrid, Spain.
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Miri M, Alahabadi A, Ehrampoush MH, Ghaffari HR, Sakhvidi MJZ, Eskandari M, Rad A, Lotfi MH, Sheikhha MH. Environmental determinants of polycyclic aromatic hydrocarbons exposure at home, at kindergartens and during a commute. Environ Int 2018; 118:266-273. [PMID: 29902775 DOI: 10.1016/j.envint.2018.06.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Revised: 06/06/2018] [Accepted: 06/07/2018] [Indexed: 05/12/2023]
Abstract
The aim of this study was to assess the potential health risk of exposure to polycyclic aromatic hydrocarbons (PAHs) at home and kindergarten for pre-school children. The urine samples were taken from 200 pre-school children aged 5-7 years and analyzed for 1-OHP as a biomarker of PAHs. Mixed effect models were applied to investigate the association between effective environmental parameters (mode of transport, distance to major roads, traffic density, greenness, tobacco exposure, home ventilation, and grill foods) and urinary 1-OHP levels. A Monte-Carlo simulation technique was applied to calculate the risk of exposure to PAHs and to check the uncertainty of input variables and the sensitivity of the estimated risk. The median and inter quartile range (IQR) of 1-OHP was 257 (188.5) ng L-1. There was a positive significant association between distance from the kindergartens to the green space with surface area ≥5000 m2 and 1-OHP concentration (β = 0.844, 95% CI: 0.223, 1.46, P-value = 0.009). Also, urinary 1-OHP was found to be inversely associated with the time the window was open at the home (β = -12.56, 95% CI: -23.52, -1.596, P-value = 0.025) and normalized difference vegetation index (NDVI) in a 100 m buffer around the homes. The mean (9.76 E-3) and 95th percentile (3.28 E-2) of the hazard quotient (HQ) indicated that the concentration of urinary 1-OHP is at a safe level for the target population (HQ < 1). According to the sensitivity analysis results, the concentration of 1-OHP is the most influential variable in the estimated risk. Our findings indicated that the proximity of homes and kindergartens to green space areas and their remoteness from the main streets and heavy traffic areas are associated with reduced exposure to PAHs.
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Affiliation(s)
- Mohammad Miri
- Department of Environmental Health, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran; Department of Environmental Health, School of Public Health, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Ahmad Alahabadi
- Department of Environmental Health, School of Public Health, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Mohammad Hassan Ehrampoush
- Department of Environmental Health, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
| | - Hamid Reza Ghaffari
- Department of Environmental Health Engineering, School of Public Health, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Mohammad Javad Zare Sakhvidi
- Department of Occupational Health, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mahboube Eskandari
- Department of Environmental Health, School of Public Health, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Abolfazl Rad
- Cellular and Molecular Research Center, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Mohammad Hassan Lotfi
- Department of Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mohammad Hassan Sheikhha
- Research and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Zare Sakhvidi F, Zare Sakhvidi MJ, Mehrparvar AH, Dzhambov AM. Correction to: Environmental Noise Exposure and Neurodevelopmental and Mental Health Problems in Children: a Systematic Review. Curr Environ Health Rep 2018; 5:396. [PMID: 30054819 DOI: 10.1007/s40572-018-0210-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The first author's name should should be "Fariba Zare Sakhvidi".
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Affiliation(s)
- Fariba Zare Sakhvidi
- Department of Biostatistics, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mohammad Javad Zare Sakhvidi
- Occupational Health Research Center, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Amir Houshang Mehrparvar
- Industrial Diseases Research Center, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Angel M Dzhambov
- Department of Hygiene and Ecomedicine, Faculty of Public Health, Medical University of Plovdiv, 15-A Vassil Aprilov Blvd., 4002, Plovdiv, Bulgaria.
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Zare Sakhvidi F, Zare Sakhvidi MJ, Mehrparvar AH, Dzhambov AM. Environmental Noise Exposure and Neurodevelopmental and Mental Health Problems in Children: a Systematic Review. Curr Environ Health Rep 2018; 5:365-374. [DOI: 10.1007/s40572-018-0208-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Eghtesad S, Mohammadi Z, Shayanrad A, Faramarzi E, Joukar F, Hamzeh B, Farjam M, Zare Sakhvidi MJ, Miri-Monjar M, Moosazadeh M, Hakimi H, Rahimi Kazerooni S, Cheraghian B, Ahmadi A, Nejatizadeh A, Mohebbi I, Pourfarzi F, Roozafzai F, Motamed-Gorji N, Montazeri SA, Masoudi S, Amin-Esmaeili M, Danaie N, Mirhafez SR, Hashemi H, Poustchi H, Malekzadeh R. The PERSIAN Cohort: Providing the Evidence Needed for Healthcare Reform. Arch Iran Med 2017; 20:691-695. [PMID: 29480734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 09/28/2022]
Abstract
In the past, communicable diseases caused the highest mortality in Iran. Improvements in socioeconomic status and living standards including access to safe drinking water, along with the inception of Health Houses in the 1980s, have changed disease patterns, decreasing the spread of and deaths from infectious and communicable diseases. The incidence and prevalence of non-communicable diseases (NCD), however, have now increased in Iran, accounting for nearly 80% of deaths and disabilities. Without interventions, NCD are predicted to impose a substantial human and economic burden in the next 2 decades. However, Iran's health system is not equipped with the necessary policies to combat this growth and must refocus and reform. Therefore, in the year 2013, the Ministry of Health and Medical Education funded a well-designed nationwide cohort study-Prospective Epidemiological Research Studies in IrAN (PERSIAN)-in order to assess the burden of NCD and investigate the risk factors associated with them in the different ethnicities and geographical areas of Iran. The PERSIAN Cohort, which aims to include 200000 participants, has 4 components: Adult (main), Birth, Youth and Elderly, which are being carried out in 22 different regions of Iran. Having an enormous dataset along with a biobank of blood, urine, hair and nail samples, the PERSIAN Cohort will serve as an important infrastructure for future implementation research and will provide the evidence needed for new healthcare policies in order to better control, manage and prevent NCD.
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Affiliation(s)
- Sareh Eghtesad
- Digestive Disease Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.,Liver and Pancreatobiliary Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Mohammadi
- Digestive Disease Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.,Liver and Pancreatobiliary Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Amaneh Shayanrad
- Liver and Pancreatobiliary Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Elnaz Faramarzi
- Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Farahnaz Joukar
- Gastrointestinal and Liver Diseases Research Center, Razi Hospital, Guilan University of Medical Sciences, Rasht, Iran
| | - Behrooz Hamzeh
- Research Center for Environmental Determinants of Health, School of Public Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mojtaba Farjam
- Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran
| | - Mohammad Javad Zare Sakhvidi
- Department of Occupational Health, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | | | - Mahmood Moosazadeh
- Health Sciences Research Center, Addiction Institute, Mazandaran University of Medical Science, Sari, Iran
| | - Hamid Hakimi
- Department of Cardiology, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Salar Rahimi Kazerooni
- Department of Epidemiology, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Bahman Cheraghian
- Research Center for Infectious Diseases of Digestive System, Department of Biostatistics and Epidemiology, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Ali Ahmadi
- Health Research Center, Shahrekord University Medical of Sciences, Shahrekord, Iran
| | - Azim Nejatizadeh
- Molecular Medicine Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Iraj Mohebbi
- Social Determinants of Health Research Center, occupational Medicine Center, Urmia University of Medical Sciences, Urmia, Iran
| | - Farhad Pourfarzi
- Digestive Diseases Research Center, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Farzin Roozafzai
- Liver and Pancreatobiliary Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Nazgol Motamed-Gorji
- Liver and Pancreatobiliary Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Ali Montazeri
- Liver and Pancreatobiliary Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Sahar Masoudi
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Masoumeh Amin-Esmaeili
- Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, Iran
| | - Navid Danaie
- Semnan Birth Cohort, Semnan University of Medical Sciences, Semnan, Iran
| | - Seyed Reza Mirhafez
- Department of Basic Medical Sciences, Neyshabur University of Medical Sciences, Neyshabur, Iran
| | - Hasan Hashemi
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Poustchi
- Liver and Pancreatobiliary Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Malekzadeh
- Digestive Disease Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.,Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
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Norishadkam M, Andishmand S, Zavar Reza J, Zare Sakhvidi MJ, Hachesoo VR. Oxidative stress and DNA damage in the cord blood of preterm infants. Mutat Res Genet Toxicol Environ Mutagen 2017; 824:20-24. [PMID: 29150046 DOI: 10.1016/j.mrgentox.2017.10.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Revised: 10/01/2017] [Accepted: 10/09/2017] [Indexed: 10/18/2022]
Abstract
Preterm birth infants are more susceptible to oxidative stress and aftermaths unwanted outcomes such as DNA damage due to hyperoxic stress. In this study, we compared the DNA strand breaks as one of the results of DNA oxidation in white blood cells, malondialdehyde (oxidative stress marker), catalase and superoxide dismutase activity, and total antioxidant capacity (markers of antioxidant defense) in a cord blood plasma of a group of preterm (n=25) and full term births (n=25). The primary DNA damage and plasma oxidative stress markers were significantly higher in a preterm group (p<0.05). Cord plasma activity of superoxide dismutase was significantly lower in preterm infants (p≤0.001). However, there were no significant differences in the cord blood total antioxidant capacity, catalase activity and malondialdehyde in preterm and term infants. Among the oxidative stress markers, the malondialdehyde concentration showed the strongest effect size (1.54; 95%CI: 0.9-2.17). For comet parameters, the most powerful effect size was observed for tail length (5.24; 95% CI: 4.05-6.42). However, tail DNA percent and tail moment were also significantly higher in cases compared to controls. Significant negative correlation was observed between comet assay parameters and birth weight and gestational age when all cases and controls entered into the analysis. There was no significant association between the levels of oxidative stress markers and early DNA damage in cord blood plasma with future nutritional tolerance in preterm infants. In the present study, the primary DNA damage and plasma oxidative stress markers significantly were increased in a preterm group. Preterm babies are more prone to the outcomes related to the early DNA damage. Tail DNA percent does not depend on experimental conditions as other parameters (tail length and thus also tail moment) and can be used for comparison with other studies.
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Affiliation(s)
- Mahmood Norishadkam
- Mother and Newborn Health Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Soudeh Andishmand
- Department of Biochemistry, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Javad Zavar Reza
- Department of Biochemistry, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
| | - Mohammad Javad Zare Sakhvidi
- Department of Occupational Health, Faculty of Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
| | - Vida Rezae Hachesoo
- Department of Occupational Health, Faculty of Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Azimi M, Bahrami MR, Rezaei Hachesu V, Zavar Reza J, Mihanpour H, Zare Sakhvidi MJ, Mostaghaci M. Primary DNA Damage in Dry Cleaners with Perchlorethylene Exposure. Int J Occup Environ Med 2017; 8:224-231. [PMID: 28970597 PMCID: PMC6679606 DOI: 10.15171/ijoem.2017.1089] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/20/2017] [Accepted: 07/12/2017] [Indexed: 12/22/2022]
Abstract
BACKGROUND Perchloroethylene is a halogenated solvent widely used in dry cleaning. International agency of research on cancer classified this chemical as a probable human carcinogen. OBJECTIVE To evaluate the extent of primary DNA damage in dry cleaner workers who were exposed to perchloroethylene as compared to non-exposed subjects. The effect of exposure modifying factors such as use of personal protective equipment, perceived risk, and reported safe behaviors on observed DNA damage were also studied. METHODS 59 exposed and non-exposed workers were selected from Yazd, Iran. All the 33 exposed workers had work history at least 3 months in the dry cleaning shops. Peripheral blood sampling was performed. Microscope examination was performed under fluorescent microscope (400×). Open comet software was used for image analysis. All biological analysis was performed in one laboratory. RESULTS Primary DNA damage to leukocytes in dry cleaners was relatively high. The median tail length, %DNA in tail, and tail moment in exposed group were significantly higher than those in non-exposed group. There was no significant difference between smokers and nonsmokers in terms of tail length, tail moment, and %DNA in tail. There was no significant correlation between duration of employment in dry cleaning and observed DNA damage in terms of tail length, tail moment and %DNA in tail. Stratified analysis based on exposed and nonexposed category showed no significant relationship between age and observed DNA damage. CONCLUSION Occupationally exposure to perchloroethylene can cause early DNA damage in dry cleaners.
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Affiliation(s)
- Mohammad Azimi
- Department of Occupational Health, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | | | - Vida Rezaei Hachesu
- Department of Occupational Health, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Javad Zavar Reza
- Department of Medical Biochemistry, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Hamideh Mihanpour
- Department of Occupational Health, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mohammad Javad Zare Sakhvidi
- Department of Occupational Health, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
| | - Mehrdad Mostaghaci
- Department of Occupational Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
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Pandeh M, Fathi S, Zare Sakhvidi MJ, Zavar Reza J, Sedghian L. Oxidative stress and early DNA damage in workers exposed to iron-rich metal fumes. Environ Sci Pollut Res Int 2017; 24:9645-9650. [PMID: 28251527 DOI: 10.1007/s11356-017-8657-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Accepted: 02/19/2017] [Indexed: 06/06/2023]
Abstract
Occupational exposure to metal fumes occurs routinely in many occupational settings. The inflammatory response to fumes and metals after exposure could lead to an increase in reactive oxygen species and level of DNA damage. In this study, the level of early DNA damage and oxidative stress was evaluated in a group of steel company (n = 30) and compared to the non-exposed (n = 28) subjects. All DNA damage markers in workers were significantly higher in exposed group in comparison with controls (p < 0.001). Stratified analysis based on smoking showed no significant differences between smoking and comet assay parameters. There was no significant difference between workers and controls in terms of HCT, TIBC, iron, and ferreting. However, HB in controls was significantly lower than exposed group (p < 0.001). A significant increase in catalase activity and MDA serum levels were observed in workers in comparison with controls. These findings suggest for the potential genotoxic effect of iron reach dust. Due to recent findings on the predictive potential of comet assay for cancer development, further, researches should be conducted to investigate the possible biochemical mechanism of such finding.
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Affiliation(s)
- Masoud Pandeh
- Department of Biochemistry, School of Medicine, Shahid Sadoughi University of Medical Sciences, Alem Square, Shohadaye Gomnam Bulverde, Yazd, Iran
| | - Saedeh Fathi
- Department of Biochemistry, School of Medicine, Shahid Sadoughi University of Medical Sciences, Alem Square, Shohadaye Gomnam Bulverde, Yazd, Iran
| | - Mohammad Javad Zare Sakhvidi
- Department of Occupational Health, Faculty of Health, Shahid Sadoughi University of Medical Sciences, Alem Square, Shohadaye Gomnam Bulverde, Yazd, Iran.
| | - Javad Zavar Reza
- Department of Biochemistry, School of Medicine, Shahid Sadoughi University of Medical Sciences, Alem Square, Shohadaye Gomnam Bulverde, Yazd, Iran.
| | - Lyla Sedghian
- School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Zare Sakhvidi MJ, Hajaghazadeh M, Mostaghaci M, Mehrparvar AH, Zare Sakhvidi F, Naghshineh E. Applicability of the comet assay in evaluation of DNA damage in healthcare providers' working with antineoplastic drugs: a systematic review and meta-analysis. Int J Occup Environ Health 2016; 22:52-67. [PMID: 27110842 DOI: 10.1080/10773525.2015.1123380] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Unintended occupational exposure to antineoplastic drugs (ANDs) may occur in medical personnel. Some ANDs are known human carcinogens and exposure can be monitored by genotoxic biomarkers. OBJECTIVE To evaluate the obstacles to obtaining conclusive results from a comet assay test to determine DNA damage among AND exposed healthcare workers. METHODS We systematically reviewed studies that used alkaline comet assay to determine the magnitude and significance of DNA damage among health care workers with potential AND exposure. Fifteen studies were eligible for review and 14 studies were used in the meta-analysis. RESULTS Under random effect assumption, the estimated standardized mean difference (SMD) in the DNA damage of health care workers was 1.93 (95% CI: 1.15-2.71, p < 0.0001). The resulting SMD was reduced to 1.756 (95% CI: 0.992-2.52, p < 0.0001) when the analysis only included nurses. In subgroup analyses based on gender and smoking, heterogeneity was observed. Only for studies reporting comet moment, I2 test results, as a measure of heterogeneity, dropped to zero. Heterogeneity analysis showed that date of study publication was a possible source of heterogeneity (B = -0.14; p < 0.0001). CONCLUSIONS A mixture of personal parameters, comet assay methodological variables, and exposure characteristics may be responsible for heterogenic data from comet assay studies and interfere with obtaining conclusive results. Lack of quantitative environmental exposure measures and variation in comet assay protocols across studies are important obstacles in generalization of results.
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Affiliation(s)
- Mohammad Javad Zare Sakhvidi
- a Faculty of Health, Department of Occupational Health , Shahid Sadoughi University of Medical Sciences , Yazd , Iran
| | - Mohammad Hajaghazadeh
- b Faculty of Health, Department of Occupational Health , Urmia University of Medical Sciences , Urmia , Iran
| | - Mehrdad Mostaghaci
- c Faculty of Medicine, Department of Occupational Medicine , Shahid Sadoughi University of Medical Sciences , Yazd , Iran
| | - Amir Houshang Mehrparvar
- c Faculty of Medicine, Department of Occupational Medicine , Shahid Sadoughi University of Medical Sciences , Yazd , Iran
| | - Fariba Zare Sakhvidi
- d Faculty of Health, Department of Occupational Health , Shahid Sadoughi University of Medical Sciences , Yazd , Iran
| | - Elham Naghshineh
- e Faculty of Medicine, Department of Obstetrics/Gynecology, Isfahan University of Medical Sciences , Isfahan , Iran
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Mehrparvar AH, Mollasadeghi A, Hashemi SH, Sakhvidi MJZ, Mostaghaci M, Davari MH. Simultaneous effects of noise exposure and smoking on OAEs. Noise Health 2015; 17:233-6. [PMID: 26168954 PMCID: PMC4900486 DOI: 10.4103/1463-1741.160716] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Noise is one of the most pervasive hazardous factors in the workplace. Noise-induced hearing loss (NIHL) is the most common disorder related to noise exposure. Smoking is probably associated with hearing loss. The simultaneous effect of noise and smoking on hearing is a recent concern. In this study, we assessed the simultaneous effect of noise and smoking on standard pure tone audiometry (PTA) and distortion product otoacoustic emissions (DP-OAEs). This was an historical cohort study on 224 workers exposed to noise who were divided into two groups: Smokers and nonsmokers. DP-OAE response amplitudes were assessed. Data were analyzed by SPSS software (version 19) using Student's t-test and Mann-Whitney U test. One hundred and five subjects were smokers (case group) and 119 individuals were nonsmokers (control group). All the subjects were exposed to 91.08 + 2.29 dBA [time-weighted average (TWA) for an 8 h work shift]. Mean DP-OAE response amplitude at frequencies higher than 1,000 Hz was significantly higher in the smokers than the nonsmokers. This study showed that smoking can aggravate the effect of noise on hearing in DP-OAEs.
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Affiliation(s)
| | | | | | | | - Mehrdad Mostaghaci
- Department of Occupational Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Sakhvidi MJZ, Ardekani JB, Firoozichahak A, Zavarreza J, Hajaghazade M, Mostaghaci M, Mehrparvar A, Barkhordari A. Archive About the Journal Instructions for Authors Instructions for Reviewers Editorial Office Editorial Board Contact Reviewers 2014 2013 < PREVIOUS NEXT > ORIGINAL PAPER CC BY-NC 3.0 Polska Exhaled breath malondialdehyde, spirometric results and dust exposure assessment in ceramics production workers. Int J Occup Med Environ Health 2015; 28:81-9. [DOI: 10.13075/ijomeh.1896.00262] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Zare Sakhvidi MJ, Mirzaei Aliabadi M, Sakhvidi FZ, Halvani G, Morowatisharifabad MA, Tezerjani HD, Firoozichahak A. Occupational cancer risk perception in Iranian workers. Arch Environ Occup Health 2014; 69:167-171. [PMID: 24325747 DOI: 10.1080/19338244.2013.763759] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
This cross-sectional study examined the occupational cancer risk perception among 269 Iranian industrial workers according to their knowledge, job titles hazard, and demographical properties. The structured questionnaire was used to measure participants' knowledge and perception toward occupational cancers (reliability of the perception questions = .72). There was significant difference in both knowledge and perception about occupational cancers in different age and educational groups. It was significant relation between knowledge and perception (p = .001). True answer to some questions was less than 20%. An optimistic bias was found in participants' perception. These findings prove that cancer risk perception in industrial workforces is affected by several factors. Further efforts should be placed in the training of workers to enhance their knowledge and subsequently their perception toward occupational cancers.
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Affiliation(s)
- Mohammad Javad Zare Sakhvidi
- a Department of Occupational Health , Faculty of Health, Shahid Sadoughi University of Medical Sciences , Yazd , Iran
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Mehrparvar AH, Sakhvidi MJZ, Mostaghaci M, Davari MH, Hashemi SH, Zare Z. Spirometry values for detecting a restrictive pattern in occupational health settings. Tanaffos 2014; 13:27-34. [PMID: 25506373 PMCID: PMC4260070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/11/2014] [Accepted: 05/30/2014] [Indexed: 12/03/2022]
Abstract
BACKGROUND Pulmonary function tests are valuable measures for diagnosis and management of respiratory diseases. In the field of occupational medicine, spirometry is commonly performed, and in a considerable number of spirometries during occupational health evaluations, restrictive pattern is observed without any respiratory symptoms and may necessitate referral of the subject for body plethysmography, which is an expensive test. In this study, we evaluated the diagnostic accuracy of spirometry for detection of restrictive lung pattern in an occupational setting. MATERIALS AND METHODS In a cross-sectional study from 2008 to 2012, 1224 subjects were selected and entered in the study out of 1,486 individuals referred for annual spirometry. Selected subjects underwent spirometry and body plethysmography. Subjects were divided into two groups of restrictive and non-restrictive patterns and then sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of spirometry for detection of restrictive lung pattern were calculated using total lung capacity measured by plethysmography as the gold standard. Receiver operating characteristic (ROC) curves were used as well. RESULTS Spirometry showed sensitivity, specificity, PPV and NPV of 97.75%, 73.04%, 73.72% and 97.67% for FVC< lower limit of normal (LLN) and 98.68%, 78.00%, 77.31% and 98.83% for FVC< LLN along with FEV1/FVC≥ LLN, respectively. According to the ROC curve, the best cut-off point for FVC for detection of restrictive lung pattern was 70%. CONCLUSION This study showed that spirometry is a useful method in occupational health evaluations to rule out restrictive lung patterns with acceptable accuracy; however, it is not an accurate tool for detection of restrictive lung pattern in an occupational setting. Simultaneous use of FVC and FEV1/FVC for detection of restriction increases the predictive value of spirometry.
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Affiliation(s)
- Amir Houshang Mehrparvar
- Occupational Medicine Department, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences
| | | | - Mehrdad Mostaghaci
- Occupational Medicine Department, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences
| | - Mohmmad Hossein Davari
- Occupational Medicine Department, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences
| | - Seyed Hesam Hashemi
- Occupational Medicine Department, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences
| | - Zohreh Zare
- Occupational Medicine Department, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences
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