Leishmaniasis is a complex disease. Any change in weather conditions affects the humans’ social and agricultural expansion and, consequently, the parasite’s life cycle in terms of ecology, biodiversity, social stigma, and exclusion. This population-based prospective longitudinal investigation was conducted between 1991 and 2021 in a well-defined CL (cutaneous leishmaniasis) focus in Bam County, southeastern Iran. A robust health clinic and health surveillance system were responsible for the ongoing systematic documentation, detection, identification, and management of CL cases. The exponential smoothing method via the state space model was used in the univariate time series. The TTR, smooth, and forecast packages were used in R software. Landsat satellite images from 1991, 2001, 2011, and 2021 were employed in the physical development. During this period, the temperature increased while the rainfall and humidity decreased. The findings showed a downward trend in the standardized drought index. Also, the results showed that climate warming and ecological changes profoundly affected the area’s agricultural patterns and topographical features. Furthermore, the last three decades witnessed an elimination trend for zoonotic CL (ZCL) and the predominance of anthroponotic CL (ACL). The present findings showed that the critical factors in the predominance of ACL and elimination of ZCL were rising temperature, drought, migration, unplanned urbanization, earthquake, and agrarian reform. The wall-enclosed palm tree gardens excluded the primary ZCL reservoir host. They controlled the disease while providing suitable conditions for the emergence/re-emergence of ACL in the newly established settlements and the unplanned ecozone. Therefore, robust health infrastructures, sustained financial support, and evidence-based research studies are crucial to facilitating the necessary surveillance, monitoring, and evaluation to control and eliminate the disease.
Temporal change in heat and cold-related burden of mortality needs to be investigated in Iran. In this study, the burden between 2015 and 2022 was compared with 2008-2014 in eight cities of Kurdistan which is located to the west of Iran. The overall dose-response association between temperature and mortality by different years (i.e., interaction effect between year and temperature) was assessed using bivariate response surface model and the framework of generalized additive model (GAM). The cumulative dose-response as well as lag-response associations in the two periods was compared by a time-varying distributed lag non-linear model. The associations were pooled using a two-stage regression model in which average temperature and temperature range were adjusted to control for the heterogenicity between cities. The attributable fraction (AF) and number (AN) were estimated in each city to ease the interpretation. Compared to 2008-2014, heat and extreme heat caused more mortality than cold and extreme cold in 2015-2022; the relative risk (RR) values of heat in second period were significantly higher than first period, and the cumulative RR of the extreme heat was 1.56 (%95 CI: 1.23-1.98) and 0.88 (%95 CI: 0.66-1.18) in second and first periods, respectively. Also, the cumulative RR of extreme cold was 1.01 (0.87, 1.17) and 0.89 (0.76, 1.05) in second and first periods, respectively. In second period, the extreme heat values approximately caused a minimum of 100 deaths in Marivan and a maximum of 400 in Sanandaj. The AF in Baneh, Kamyaran, and Sanandaj was significantly higher than other cities. All subgroups’ people were at risk of heat-related mortality in second period, and the cold had no significant impact in the period. Heat-related mortality was increased in recent years while cold had no significant impact. The results highlight the need for an adaptation or preventive strategy of heat-related mortality in the regions.
Compared to previous decade, impact of heat waves (HWs) on mortality in recent years needs to be discussed in Iran. We investigated temporal change in added impact of summer HWs on mortality in eight cities of Iran. The pooled length of HWs was compared between 2015-2022 and 2008-2014 using random and fixed-effects of meta-analysis regression model. The temporal change in impact of HWs was evaluated through interaction effect between crossbasis function of HW and year in a two-stage time varying model. In order to pool the reduced coefficients of each period, multivariate meta-regression model, including city-specific temperature and temperature range as heterogenicity factors, was used. In addition to relative risk (RR), attributable fraction (AF) of HW in the two periods was also estimated in each city. In the last years, the frequency of all HWs was higher and the weak HWs were significantly longer. The only significant RR was related to the lowest and low severe HWs which was observed in the second period. In terms of AF, compared to the strong HWs, all weak HWs caused a considerable excess mortality in all cities and second period. The subgroup analysis revealed that the significant impact in the second period was mainly related to females and elderlies. The increased risk and AF due to more frequent and longer HWs (weak HWs) in the last years highlights the need for mitigation strategies in the region. Because of uncertainty in the results of severe HWs, further elaborately investigation of the HWs is need.
From March to April 2019, a flood occurred in several regions of Iran. The most affected provinces were Golestan, Lorestan, and Khuzestan. AIMS: The present study aimed to determine the prevalence and determinants of psychological distress and depression among the affected adult population 6 months after the event. METHODS: A cross-sectional household survey with face-to-face interview was carried out on a random sample of 1,671 adults aged above 15 years living in the flood-affected areas from August to September 2019. We applied GHQ-28 and PHQ-9 for the assessment of psychological distress and depression, respectively. RESULTS: The prevalence of psychological distress and depression were 33.6% (95% CI [29.5, 37.7]) and 23.0% (95% CI [19.4, 26.7]), respectively. Determinants of psychological distress were a history of mental disorders (Adjusted odds ratio [AOR] = 4.7), primary (AOR = 2.9) or high school (AOR = 2.4) education (vs. university), no compensation received (AOR = 2.1), high damage to assets (AOR = 1.8), the house flooded more than 1 m (AOR = 1.8), female gender (AOR = 1.8), and limited access to health care services (AOR = 1.8). Determinants of depression were unemployment (AOR = 5.3) or being a housewife (AOR = 2.7), a history of mental disorders (AOR = 4.1), high damage to assets (AOR = 2.5), no compensation received (AOR = 2.0), the house flooded more than 1 m (AOR = 1.8), limited access to health care services (AOR = 1.8), and high wealth index (AOR = 1.7). CONCLUSION: The results of this study revealed a high prevalence of psychological distress and depression in the flood-affected adult population. The high-risk group, particularly flood victims who had a history of mental disorders, and those exposed to severe damages of flood, should be prioritized for screening, and mental health services.
Climate change will affect the distribution of species in the future. To determine the vulnerable areas relating to CL in Iran, we applied two models, MaxEnt and RF, for the projection of the future distribution of the main vectors and reservoirs of CL. The results of the models were compared in terms of performance, species distribution maps, and the gain, loss, and stable areas. The models provided a reasonable estimate of species distribution. The results showed that the Northern and Southern counties of Iran, which currently do not have a high incidence of CL may witness new foci in the future. The Western, and Southwestern regions of the Country, which currently have high habitat suitability for the presence of some vectors and reservoirs, will probably significantly decrease in the future. Furthermore, the most stable areas are for T. indica and M. hurrianae in the future. So that, this species may remain a major reservoir in areas that are present under current conditions. With more local studies in the field of identifying vulnerable areas to CL, it can be suggested that the national CL control guidelines should be revised to include a section as a climate change adaptation plan.
We aimed to evaluate the impact of heatwaves on daily deaths due to non-accidental, cardiovascular and respiratory causes in the city of Dezful in Iran from 2013 to 2019. METHOD: We collected daily ambient temperature and mortality and defined 2 types of heatwaves by combining daily temperature ⩾90th in each month of the study period or since 30 years with duration ⩾2 and 3 days. We used a distributed lag non-linear model to study the association between each type of heatwave definition, and deaths due to non-accidental, cardiovascular and respiratory causes with lags up to 13 days. RESULTS: There was no discernible correlation in this area, despite the fact that heatwaves raised the risk of death from cardiovascular causes and lowered the risk from respiratory causes. On the other hand, the risk of total non-accidental mortality on days with the heatwaves is significantly higher than normal days. In main effects, the heatwaves have a significant relationship with the risk of total non-accidental mortality (in the first heatwave definition, Cumulative Excess Risk (CER) in lag(0-2) was 10.4 and in second heatwave definition, CER values in lag(0, 0-2, and 0-6) were 12.4, 29.2, and 38.8 respectively). Also, in added effects, heatwaves have a significant relationship with the risk of total non-accidental mortality (in the first heatwave definition, CER in lag(0 and 0-2) were 1.79 and 4.11 and in the second heatwave definition, CER values in lag(0, 0-2, and 0-6) were 7.76, 18.35 and 24.87 respectively). In addition, heatwaves appeared to contribute to a cumulative excess risk of non-accidental death among the male group as well as the older adults. CONCLUSION: However, the results showed that heatwaves could have detrimental effects on health, even in populations accustomed to the extreme heat. Therefore, early warning systems which monitor heatwaves should provide the necessary warnings to the population, especially the most vulnerable groups.
The main objective of this study is to know the current state of thermal discomfort and its changes in the coming decades in one of the semi-arid climates of Iran. This study is very important considering the importance and direct impact of climate change and global warming on human health and can help adopt preventive policies to face them properly. Thermal discomfort changes were assessed by the temperature-humid index (THI) and effective temperature (ET) in Arak City as a representative of the semi-arid climate of Iran. The modeling was done using the CanESM2 general circulation model. The statistical downscaling model (SDSM) software was used to downscale the model data in the period of 2011 to 2099 with three different scenarios of optimistic (RCP 2.6), intermediate (RCP 4.5), and pessimistic (RCP 8.5). The results showed that based on all three scenarios, the values of THI in January, February, and May in the coming decades will be higher than the base values (1976-2005), which will indicate an increase in thermal discomfort in these months. The pattern of changes based on the ET index was almost similar to the THI except in the optimistic scenario in all periods. In this scenario, there is a slight downward trend from 8.1% in the base period to 1.9%, 4.3%, and 3.7% in the decades 2011 to 2040, 2041 to 2070, and 2071 to 2099, respectively. In general, the increasing temperature in the study area based on all three scenarios will cause major changes in thermal comfort, so that thermal discomfort increases not only in hot seasons, but also in other seasons.
Vector-borne viral diseases (VBVDs) continue to pose a considerable public health risk to animals and humans globally. Vectors have integral roles in autochthonous circulation and dissemination of VBVDs worldwide. The interplay of agricultural activities, population expansion, urbanization, host/pathogen evolution, and climate change, all contribute to the continual flux in shaping the epidemiology of VBVDs. In recent decades, VBVDs, once endemic to particular countries, have expanded into new regions such as Iran and its neighbors, increasing the risk of outbreaks and other public health concerns. Both Iran and its neighboring countries are known to host a number of VBVDs that are endemic to these countries or newly circulating. The proximity of Iran to countries hosting regional diseases, along with increased global socioeconomic activities, e.g., international trade and travel, potentially increases the risk for introduction of new VBVDs into Iran. In this review, we examined the epidemiology of numerous VBVDs circulating in Iran, such as Chikungunya virus, Dengue virus, Sindbis virus, West Nile virus, Crimean-Congo hemorrhagic fever virus, Sandfly-borne phleboviruses, and Hantavirus, in relation to their vectors, specifically mosquitoes, ticks, sandflies, and rodents. In addition, we discussed the interplay of factors, e.g., urbanization and climate change on VBVD dissemination patterns and the consequent public health risks in Iran, highlighting the importance of a One Health approach to further surveil and to evolve mitigation strategies.
Scorpion stings are one of the most important health challenges and high priority research topic in public health. In this study, we aimed to model habitat suitability of the Mesobuthus phillipsii (Pocock 1889), a species with low medical concern, under current and future climatic conditions in Iran. We also identified vulnerable populations to scorpion stings in the country. Scorpion sting risk modeling was done using an ensemble approach by considering two species distribution modeling methods: MaxEnt and Random Forest methods. Distribution modeling was performed using the sdm R package. The results showed that due to climate change in 2070, the high-risk areas will increase from 20,839 to 79,212 km2. Habitats with a moderate risk of scorpion stings will also increase from 139,347 to 222,833 km2. Consequently, the number of villages in high-risk areas of scorpion stings will increase from 2,870 to 7,017, while this number will increase from 12,759 to 20,104 in the case of medium-risk villages. The results of this study can be used for scorpion stings management in Iran. This study can be used as an example for similar studies on scorpions with high medical emergency.
One of the most essential purposes of the health system is to ensure that people affected by various disastrous events, such as floods, have access timely to basic health services. Therefore, enhancing the preparedness and response plans for such events should be a national priority. Because of the complexity and devastating impacts of floods on public health, it is a crucial to understand the various aspects of flood experience in the country. The experiences of managers and operational staff from various units of the Iranian health system are a valuable source for understanding flood complexities. These experiences were explored using 19 semi-structured interviews with people who had firsthand experience of this phenomenon. Based on the results, in order to provide a flood response plan, it is necessary to adhere to the principles and foundations that can meet the needs arising from the flood. Our study showed that the health system’s response to flooding can be divided into two categories: initial and specific functions. A comprehensive response requires an initial function to prevent flood impacts, and specific functions are needed to prevent and treat flood-related diseases. These results could form the basis for the health system’s response to future floods.
The Jazmurian basin in Iran is an area affected by climate change and desertification where aerosols and dust storms are common. The aim of this work was to determine the human and ecological risks from atmospheric particles during dust storms in different cities in the Jazmurian basin. For this purpose, the dust samples were collected from Jiroft, Roodbar Jonoob, Ghaleh Ganj, Kahnooj and Iranshahr cities, which are located around the Jazmurian playa in southeast of Iran. Satellite-based Moderate Resolution Imaging Spectroradiometer (MODIS) aerosol products and the Aerosol Optical Depth (AOD) were used to detect aerosol loading in the atmosphere. Moreover, the trace element composition of the collected particles was determined and used to evaluate human and ecological impact assessment using US EPA human health risk assessment and ReCiPe 2016 endpoint hierarchist impact assessment method incorporated in the OpenLCA 1.10.3 software. The human health risk assessment of the particles revealed high non-carcinogenic risks for children from exposure to nickel and manganese and carcinogenic risks in both adults and children due to hexavalent chromium, arsenic and cobalt during dust storm events. Terrestrial ecotoxicity was found to have the largest ecological impact on ecosystems with copper, nickel and zinc exhibiting the largest contributions.
Blood pressure (BP) is influenced by both individual and environmental factors such as ambient temperature. However, the gender-stratified and component-specific impact of temperature on BP is not well understood. Herein, we examined the temperature and seasonal effects on four main BP components, namely systolic BP (SBP), diastolic BP (DBP), mean arterial pressure (MAP), and pulse pressure (PP), in both genders. A total of 8990 (3954 men) Tehranian adults during 2015-2018 were included. Linear regression models for analyzing data in three models including unadjusted, age-adjusted, and further adjusted for known sociodemographic and cardiovascular confounders were conducted. Among women, each 10 °C increment was associated with a significant decrease of - 0.48 mmHg (95% confidence interval (CI): - 0.86, - 0.19) and - 0.65 mmHg (- 0.76, - 0.41) in SBP and MAP, respectively. In men, the corresponding value for SBP was - 0.46 (- 0.82, - 0.16) mmHg (P = 0.058). Gender-specific analysis in each season showed that among women, PP increased in autumn and winter with each 10 °C decrease (P < 0.05). The mean increase in SBP (3.4 and 2.06 mmHg in women and men, respectively), DBP (1.66 and 1.19 mmHg), and MAP (2.71 and 1.12 mmHg) was observed during winter compared to summer (all P < 0.05). PP showed seasonality only in women (1.46 mmHg, P-value = 0.003). In both genders, SBP in age > 60 years was more susceptible to variation compared to younger ages. Furthermore, obese women had more SBP changes compared to their non-obese counterparts (all P for interaction < 0.05). In conclusion, there was a sex difference in BP response to the outdoor temperature, with higher vulnerability among women. The reverse relation between temperature and BP occurred particularly among elderly and obese individuals. Careful monitoring of BP in cold seasons, specifically in the mentioned subgroups, could potentially attenuate cardiovascular risks.
Asthma is a chronic respiratory disease resulting from a complex interaction between genetic and environmental factors. Many environmental factors have been associated with incidence or prevalence of asthma although there is still limited knowledge of major environmental causes of asthma in the general population. This study, for the first time, investigated the effects of climatic and geographical variability on asthma hospitalization among an adult population living in Fars province, southwest Iran. During the study period, the home addresses of patients hospitalized with acute asthma from 2016 to 2019 were mapped. The effects of geo-climatic factors including temperature, rainfall, humidity, evaporation, number of rainy and frosty days, slope, and land covers were assessed on adult asthma hospitalization by Geographical Information System (GIS). Data were analyzed using univariate and multivariate binary logistic regression. A total of 349 patients were recruited, including 157 (44.98%) males and 192 (55%) females. The mean age was 57.77 +/- 18.84 years, ranging from 19 to 98 years. Asthmatic patients came from a total of 82 points including villages, towns, and cities. In the univariate analysis, urban setting (OR = 13) and Mean Annual Rainy Days (OR = 1.03) were identified as the factors associated with increased asthma hospitalization, while Mean Annual Temperature (MAT) (OR = 0.927), MinMAT (OR = 0.933), MaxMAT (OR = 0.925), Mean Annual Evaporation (MAE) (OR = 0.999), and slope (OR = 0.925) negatively affected asthma hospitalization. Urban setting was considered the only significant factor in multivariate analysis (OR = 11.026). The major risk zones for adulthood acute asthma in southwest Iran were urban settings and areas with higher numbers of rainy days, lower temperatures, and evaporation at lower slopes.
The results of previous studies have indicated the effects of temperature changes on health status. The present study was conducted to investigate the effects of diurnal temperature range (DTR) and hospital admission on cardiovascular and respiratory diseases in Dezful, in Iran. In this ecological time-series study, data related to hospital admissions based on ICD-10, meteorological, and climatological data were gathered over a period of six years from 2014 to 2019. A distributed lag nonlinear model combined with a quasi-Poisson regression was then used to assess the impact of DTR on cardiovascular and respiratory hospital admissions. Potential confounders, including wind speed, air pollution, seasonality, time trend, weekends and holidays, days of week, and humidity were controlled. In extreme low DTRs, the cumulative effects of cardiovascular admissions significantly increased in total, and in warm and cold seasons (Lag(0-21), P ≤ 0.05). In addition, in extreme high DTRs, the cumulative effects of cardiovascular significantly decreased in total (Lag(0-13) and Lag(0-21), P ≤ 0.05), and in warm (Lag(0-21), P ≤ 0.05) and cold seasons (Lag(0-21), P ≤ 0.05). Moreover, respiratory admissions significantly decreased in total (Lag(0-21), P ≤ 0.05) and in warm season (Lag(0-21), P ≤ 0.05).Our result indicates that extreme low DTRs could increase the risk of daily cardiovascular admissions, and extreme high DTRs may cause a protective effect on daily respiratory and cardiovascular admissions in some regions with high fluctuations in DTR.
During the summer of 2022, several regions worldwide, including Iran, were subjected to intense monsoon rains, resulting in significant adverse impacts on the health, economy, and social well-being of affected populations. However, by focusing on adaptation and resilience measures, not only could the negative consequences of this phenomenon be mitigated, but as evidenced by other countries, the opportunity presented by rainwater could be utilized to promote development, health, and socioeconomic welfare in these areas. This concise report aims to explore the lessons learned from this phenomenon, including its strengths and weaknesses.
In this paper, the outline of national guideline for gender-sensitive post-disaster needs assessment (PDNA) that was developed based on the experiences of 2019 Iran floods is presented. Accordingly, at first, the baseline information on female-headed households, elderly, disabled women and the employment situation of females that should be collected before the disaster is introduced. Then, the mechanism for evaluation the effects and impacts of disasters on women and girls is presented. Finally, considering the recovery strategies, their needs in recovery and reconstruction are addressed. The results can be used in other countries to develop the gender-sensitive PDNA guidelines.
There is a growing concern in countries around the world, including Iran, about the effects of extreme climate change, diversification, and events on food production, food security, and livelihoods. The link between climate change and food security in the Iranian food system is the subject of this article. This review, based on the available literature, used the food system approach to achieve a broader view on issues related to food security in Iran. To this end, this study investigated climatic challenges facing food security in Iran with a focus on two essential products in Iranians’ food basket, namely, wheat and rice: Decreased agricultural productivity, food losses along production and distribution chains, postharvest loss, low resilience of poor people in rural areas, and the prevalence of malnutrition among children. The results showed that in addition to measures, such as making food production systems resistant to climate change and the necessary changes in existing food systems to adapt to the consequences of climate change, achieving food security requires a long-term vision to transform the Iranian food system. Accordingly, it is necessary to develop a climate-smart agriculture system that encompasses all aspects of food system security. Except for investigating the productivity of some essential components of this food basket, the results showed that there are scant studies on the effects of climate change on the food system of Iran.
BACKGROUND: Climate change may jeopardize the health of mothers and their offspring. There are few studies on the association between increasing temperature and pregnancy outcomes. The aim of this study was to investigate the relation between Universal Thermal Climate Index (UTCI) and adverse pregnancy outcomes including stillbirth, low birth weight (LBW), preterm labor (PTL), spontaneous abortion (SA), preeclampsia and hypertension in Ahvaz, Iran. METHODS: Distributed Lag Non-linear Models (DLNM) combined with quasi-Poisson regression were used to research the effect of UTCI on adverse pregnancy outcomes. The effect of time trend, air pollutants (NO(2), SO(2) and PM(10)), and weekdays were adjusted. RESULTS: The results showed that the low values of UTCI index (11.6 °C, in lags 0-6, 0-13) caused significant increase in the risk of preterm labor. However, hot thermal stress (high UTCI) significantly increased the risk of stillbirth in lag 0-13. We did not observe any significant relation between UTCI and other pregnancy outcomes in this study. CONCLUSIONS: It seems like both hot and cold weathers can be associated with adverse pregnancy outcomes.
Heavy rains in March 2019 led to severe floods in large parts of Iran, with severe financial and physical casualties (in the Golestan province, 11 districts were trapped in water). An increase in the EMS missions while serving a big portion of the needed population was a big problem for the health system during the flood; Therefore, a new solution was needed to overcome this problem. Using a farm tractor for transporting the patients and injured people was the first relief experience ever documented in the whole country. In the present report, despite the limitations and challenges, the tractor has been shown to be a proper and effective disaster relief vehicle. This report could help other similar countries face disasters, especially floods.
Atmospheric conditions in any place can affect people’s health. In recent years, researchers have focused on heat stress and its effect on the exacerbation of some diseases. The main objective of this study is to identify the bioclimatic conditions and its relationship with the admission rate of cardiovascular patients in of Tabriz city. In addition to meteorological variables, daily cardiovascular patient admission rates were obtained from Shahid Madani Heart Hospital in Tabriz during the statistical period of March 27th, 2007 to February 17th, 2017. To do so, the bioclimatic conditions of Tabriz were identified on a daily scale based on bioclimatic indices including Perceived Temperature (PT), Physiological Equivalent Temperature (PET) and Predicted Mean Vote (PMV). Then, the relationship between each bioclimatic condition and the number of cardiovascular patients’ referrals in Tabriz was investigated using Kruskal-Wallis test. Findings illustrated that the impact of cold stress in the rate of cardiovascular patients was more than that of the warm stress, which was obtained for all study indicators in a similar way. On the other hand, the results showed that based on PET and PMV indices, there is a significant difference between various bioclimatic classes in the rate of cardiovascular patients’ admission. The results of Kruskal-Wallis test include Sig = 0.040 and Sig = 0.049 for PET and PMV, respectively. However, Sig values for and PT indice showed no significant difference between bioclimatic classes in the rate of admission of cardiovascular patients. Generally, it was found that there is a significant difference (Sig = 0.000) between the three classes of bioclimatic cold, warm and comfort with the number of hospital admissions of cardiovascular patients.
Malaria is a vector-borne disease, likely to be affected by climate change. In this study, general circulation model (GCM)-based scenarios were used for projecting future climate patterns and malaria incidence by artificial neural networks (ANN) in Zahedan district, Iran. Daily malaria incidence data of Zahedan district from 2000 to 2019 were inquired. The gamma test was used to select the appropriate combination of parameters for nonlinear modeling. The future climate pattern projections were obtained from HadGEM2-ES. The output was downscaled using LARS-WG stochastic weather generator under two Representative Concentration Pathway (RCP2.6 and RCP8.5) scenarios. The effect of climate change on malaria transmission for 2021-2060 was simulated by ANN. The designed model indicated that the future climate in Zahedan district will be warmer, more humid, and with more precipitation. Assessment of the potential impact of climate change on the incidence of malaria by ANN showed the number of malaria cases in Zahedan under both scenarios (RCP2.6 and RCP 8.5). It should be noted that due to the lack of daily malaria data before 2013, monthly data from 2000 were used only for initial analysis; and in preprocessing and simulation analyses, the daily malaria data from 2013 to 2019 were used. Therefore, if proper interventions are not implemented, malaria will continue to be a health issue in this region.
Malaria is one of the most widespread communicable diseases in the southeast regions of Iran, particularly the Chabahar County. Although the outbreak of this disease is a climate-related phenomenon, a comprehensive analysis of the malaria-climate relationship has not yet been investigated in Iran. The aims of this study are as follows: a) analyzing the seasonal characteristics of the various species of the infection; b) differentiating between number of patients during El Niño and La Niña and also during the wet and dry years. The monthly malaria statistics collected from twelve health centers were firstly averaged into seasonal scale and then composited with the corresponding data of the ground-based meteorological records, Southern Oscillation Index (SOI), and the satellite-based rainfall data. The proper statistical tests were used to detect differences in the number of patients between El Niño and La Niña and also between the adopted wet and dry episodes. Infection rate from the highest to the lowest was associated with summer, autumn, spring, and winter, respectively. Plasmodium falciparum, P. vivax, and the other species were responsible for 22%, 75%, and 3% of the sickness, respectively. The outbreak of P. falciparum/P. vivax occurs during autumn/summer. Due to the malaria eradication programs in urban areas, infection statistics collected from the rural areas were found to be more climate-related than that of urban regions. For rural/urban areas, the infection statistics exhibited a significant decline/increase during El Niño episodes. In autumn, spring, and winter, the patient number has significantly increased/decreased during the dry/wet years, respectively. These relationships were, however, reversed in summer.
The present study was conducted to assess the short-term effects of the meteorological factors on the COVID-19 mortality in Qom, Iran. The GAM with a quasi-Poisson link function was used to evaluate the impact of temperature, DTR, relative humidity, and absolute humidity on the COVID-19 mortality, controlling potential confounders such as time trend, air pollutants, and day of the week. The results showed that the risk of COVID-19 mortality was reduced, in single-day lag/multiple-day average lag, per one-unit increase in absolute humidity (percentage change in lag 0=-33.64% (95% CI (-42.44, -23.49)), and relative humidity (percentage change in lag 0=-1.87% (95% CI (-2.52, -1.22)). Also, per one-unit increase in DTR value, COVID death risk increased in single-day and multiple-day average lag. This study demonstrated a significant relationship between the four meteorological variables and the COVID-19 mortality.
Working in cold environments can have a variety of negative consequences on health, efficiency, quality, safety, and performance. The present study investigates the risk of cold stress in petroleum transfer centers in Iran’s northwestern cold regions. The proposed method by ISO-15743 (E) was used to assess the risk of cold stress. The activity level (M) was calculated using the ISO 8996:2021 standard. The evaluation of local cooling, contact of cold surfaces, and hand and face temperature was performed using ISO 11079, ISO 13732-3, and ISO 9886, respectively. During their work, 28 outdoor site men and mechanics as a case group and 8 operators as a control group put through subjective analysis. According to the findings, the mean I(cl,r), IREQ(min,) and IREQ(neutral) were 1.59 ± 0.33, 2.1 ± 0.44, and 2.43 ± 0.45, respectively. The mean equivalent chill temperature was -13.83 ± 5.45, and workers were at risk of local cooling stress at levels 1 and 2. The case group showed greater losses in finger skin temperatures after short term exposure to extremely cold environments than the control group (P < 0.001). Based on the questionnaire results a significant percentage of workers performing the activity during the winter have more difficulty. Prolonged general and local cold exposure can cause pain, numbness, and frostbite in site men and mechanics. Careful planning, training, extensive distribution of cold protective clothing, rest periods, a relatively short stay in the cold environment, and proper equipment can greatly reduce these hazards.
BACKGROUND: Cystic echinococcosis (CE) is one of the most important parasitic infections in subgroup seven common neglected diseases of humans and animals. It is in the list of 18 neglected tropical diseases of the WHO. We aimed to analyze the situation of the disease in Iran using Geographical Information System (GIS) and satellite data analysis. METHODS: The data obtained from the Ministry of Health and Medical Education, Tehran, Iran and other related centers from 2009 to 2018 were analyzed using GIS. Then, the spatial distribution maps of the disease were generated, and the hot spots of the disease in Iran were determined using spatial analysis of ArcGIS10.5 software. Geographically weighted regression (GWR) analysis in ArcGIS10.5 was used to correlate the variables affecting the disease including temperature, relative humidity, normalized different vegetation index (NDVI) and incidence of hydatidosis. Data analysis was performed by Linear regression analysis and SPSS 21 software using descriptive statistics and chi-square test. RESULTS: Zanjan, Khorasan Razavi, North Khorasan, Chaharmahal Bakhtiari, Hamedan, Semnan, and Ardabil provinces were the hot spots of CE. The results of geographical weighted regression analysis showed that in Khorasan Razavi, North Khorasan, Chaharmahal Bakhtiari, Hamedan, Semnan, Ardabil, Zanjan, Qazvin, and Ilam provinces, the highest correlation between temperature, humidity, vegetation density and the incidence of hydatidosis was observed (P<0.001). CONCLUSION: The use of maps could provide reliable estimates of at-risk populations. Climatic factors of temperature, humidity, NDVI had a greater impact on the probability of hydatidosis. These factors can be an indicator used to predict the presence of disease. Environmental and climatic factors were associated with echinococcosis.
Dysentery is a water- and food-borne infectious disease and its incidence is sensitive to climate change. Although the impact of climate change on dysentery is being studied in specific areas, a study in Iran is lacking. In this study, RCP 4.5 and RCP 8.5 scenarios were used to predict the prevalence of dysentery in Iran between 2050 and 2070. This study is a secondary analysis using Geographically Weighted Regression, and 273 cities of Iran were analyzed between March 2011 and March 2017. Bioclimate variables were used as independent variables. Ecological data about the prevalence and incidence of dysentery, which were collected between 2011 and 2017, were used as the dependent variables. The result shows the incidence of dysentery is significantly associated with bioclimate change exposure, in 2050 and 2070, based on RCP 4.5 and RCP 8.5. Our findings showed that in the absence of adaptation of the population, an increase in the risk of bioclimate-related diseases is expected by around 95.6% in the mid-century compared with the beginning of the century with regional variations. Based on these findings, the geographical distribution of the disease will also change. In 2050, the pattern of disease distribution would be changed, and the north of Iran will be included in the vulnerable regions. In 2070, the southeastern and northern parts of Iran will have the most vulnerability to climate change. Our study contributes important knowledge to this perspective by providing insightful findings and pieces of evidence for climate change adaptation and mitigation.
This study was aimed to investigate the air pollutants impact on heart patient’s hospital admission rates in Yazd for the first time. Modeling was done by time series, multivariate linear regression, and artificial neural network (ANN). During 5 years, the mean concentrations of PM(10), SO(2), O(3), NO(2), and CO were 98.48 μg m(-3), 8.57 ppm, 19.66 ppm, 18.14 ppm, and 4.07 ppm, respectively. The total number of cardiovascular disease (CD) patients was 12,491, of which 57% and 43% were related to men and women, respectively. The maximum correlation of air pollutants was observed between CO and PM(10) (R = 0.62). The presence of SO(2) and NO(2) can be dependent on meteorological parameters (R = 0.48). Despite there was a positive correlation between age and CD (p = 0.001), the highest correlation was detected between SO(2) and CD (R = 0.4). The annual variation trend of SO(2), NO(2), and CO concentrations was more similar to the variations trend in meteorological parameters. Moreover, the temperature had also been an effective factor in the O(3) variation rate at lag = 0. On the other hand, SO(2) has been the most effective contaminant in CD patient admissions in hospitals (R = 0.45). In the monthly database classification, SO(2) and NO(2) were the most prominent factors in the CD (R = 0.5). The multivariate linear regression model also showed that CO and SO(2) were significant contaminants in the number of hospital admissions (R = 0.46, p = 0.001) that both pollutants were a function of air temperature (p = 0.002). In the ANN nonlinear model, the 14, 12, 10, and 13 neurons in the hidden layer were formed the best structure for PM, NO(2), O(3), and SO(2), respectively. Thus, the R(all) rate for these structures was 0.78-0.83. In these structures, according to the autocorrelation of error in lag = 0, the series are stationary, which makes it possible to predict using this model. According to the results, the artificial neural network had a good ability to predict the relationship between the effect of air pollutants on the CD in a 5 years’ time series.
BACKGROUND: Although scorpionism is recorded worldwide, some regions such as Iran present a higher incidence. Due to the great prevalence of scorpion stings in Khuzestan province, southwestern Iran, the present study examined the relationship between different climate parameters and the scorpion sting rate in this area from April 2010 to March 2015. METHODS: In this cross-sectional descriptive-analytical study, we considered all scorpion sting cases recorded in the Department of Infectious Diseases, Ahvaz Jundishapur University of Medical Sciences. Data were analyzed using statistics, frequency distribution and Pearson’s correlation coefficient. RESULTS: A total of 104,197 cases of scorpion stings was recorded from 2010 to 2015. The cumulative incidence of scorpion sting was 2.23%. The spatial distribution of scorpion stings showed that most cases occurred in the Dehdez district (4,504 scorpion stings/100,000 inhabitants) and the Masjed Soleyman county (4,069 scorpion stings/100,000 inhabitants). A significant association was found between climate factors (temperature, evaporation rate, sunshine duration, humidity, and precipitation) and the scorpion sting rate. An increase in rainfall and humidity coincided with a reduction in scorpion stings whereas an increase in temperature, evaporation, and sunshine duration was accompanied by a growth of scorpion stings. No significant correlation was found between wind velocity/direction and the incidence rate of stings. Moreover, the seasonal peak incidence of scorpion stings was recorded in summer (an average of 8,838 cases) and the lowest incidence was recorded during winter (an average of 1,286 cases). The annual trend of scorpion sting cases decreased during the period from 2010 to 2015. CONCLUSION: Climate variables can be a good index for predicting the incidence of scorpion stings in endemic regions. Since they occur mostly in the hot season, designing preventive measures in the counties and districts with a high incidence of scorpion stings such as Dehdez and Masjed Soleyman can minimize mortality and other burdens.
Cotton is one of the important crops that play an important role in creating a livelihood for rural people in many parts of Iran. Cotton production necessitates a large amount of resources (e.g., fossil energy and agrochemicals, all of which have the potential to damage the environment in various ways). The purpose of the current study was to evaluate the environmental effects of cotton production in the South Khorasan Province of Iran. For this purpose, life cycle assessment (LCA) and data envelopment analysis (DEA) techniques have been applied to investigate the environmental impacts of cotton production. LCA is a practical method to evaluate the environment on the product flow, in which all aspects of the product life cycle are examined by a comprehensive approach. Furthermore, combining the LCA method with other managerial strategies such as DEA could allow researchers to provide decision-makers with more practical and interpretable data. The findings of the efficiency test showed that the average technical efficiency, pure technical efficiency, and scale efficiency were 0.81, 0.92, and 0.87, respectively. Respiratory inorganics (i.e., respiratory effects resulting from winter smog caused by emissions of dust, sulfur, and nitrogen oxides to air) posed the greatest environmental burden in cotton production, followed by non-renewable energy, carcinogens, and global warming. In addition, the highest effects were on human health, and then, on resources and climate change. Energy, on-system pollution, and waste played a crucial role in the environmental impacts of cotton processing. This study suggests improving farmers’ knowledge toward the optimum application of chemical fertilizers, or their substitution with green fertilizers, which reduces the environmental effect of growing cotton in the area.
BACKGROUND: Asthma is a chronic respiratory disease resulting from a complex interaction between genetic and environmental factors. Among environmental factors, climatic and geographical variations have an important role in increasing asthma hospitalization. The current study aimed to investigate the effect of geoclimatic factors on the occurrence of childhood asthma hospitalization in Fars province, southwest Iran. METHOD: We mapped the addresses of 211 hospitalized patients with childhood asthma (2016-2019) and investigated the effects of different temperature models, mean annual rainfall and humidity, number of frosty and rainy days, evaporation, slope, and land covers on the occurrence of childhood asthma hospitalization using a geographical information system. The Kriging and Spline methods have been used for generating interpolated models. Data were analyzed using logistic regression. RESULTS: In the multivariate model, urban setting was recognized as the most important childhood asthma hospitalization predictor (p < 0.001, odds ration [OR] = 35.044, confidence interval [CI] = 9.096-135.018). The slope was considered the determinant of childhood asthma hospitalization when analyzed independently and its increase was associated with decreased childhood asthma hospitalization (p = 0.01, OR = 0.914, CI = 0.849-0.984). CONCLUSION: In the current study, the urban setting was the most important risk factor associated with increased childhood asthma hospitalization.
Climate change has increased the exposure risk of workers to occupational health risk factors and diseases. This study aims to investigate the impacts of climate change on the occupational health indicators at the workplaces in Iran. This study was conducted during 2021 in three climatic regions of Iran. Required data was collected from Health Deputies of Medical Universities and Iran Meteorological Organization. Stepwise linear regression model used for data analysis and predictions were done based on three scenarios of SSP1-2.6, SSP3-7.0, and SSP5-8.5 during the period of 2021-2100. This indicated 2.6 and 2.9 times higher percentage of workers who were exposed to heat stress and Ultra Violet (UV) radiation, respectively, in the provinces understudy. This study suggests a holistic approach to address potential impacts of climate change on workers’ health and safety that would benefit in making decisions on climate-related planning and developing the adaptation strategies at workplaces.
OBJECTIVE: Brucellosis is a zoonosis almost chronic disease. Brucellosis bacteria can remain in the environment for a long time. Thus, climate irregularities could pave the way for the survival of the bacterium brucellosis. Brucellosis is more common in men 25 to 29 years of age, in the western provinces, and in the spring months. The aim of this study is to investigate the effect of climatic factors as well as predicting the incidence of brucellosis in Qazvin province using the Markov switching model (MSM). This study is a secondary study of data collected from 2010 to 2019 in Qazvin province. The data include brucellosis cases and climatic parameters. Two state MSM with time lags of 0, 1 and 2 was fitted to the data. The Bayesian information criterion (BIC) was used to evaluate the models. RESULTS: According to the BIC, the two-state MSM with a 1-month lag is a suitable model. The month, the average-wind-speed, the minimum-temperature have a positive effect on the number of brucellosis, the age and rainfall have a negative effect. The results show that the probability of an outbreak for the third month of 2019 is 0.30%.
This study focused on the measurement of BTEX (benzene, toluene, ethylbenzene and xylene) concentrations in the air of various regions and indoor-outdoor environments in Bandar Abbas, Iran. Air samples were taken actively and analyzed by gas chromatography-mass spectrometry (GC-MS) during two one-month periods i.e., Feb 2020 (period I) and Sep/Oct 2020 (period II). The mean air temperature and the levels of all BTEX compounds were higher in period II. The highest total BTEX (t-BTEX) levels (median [min-max]) were found in the urban region (18.00 [5.21-67.24] μg m(-3)), followed by industrial region (7.00 [2.05-14.76] μg m(-3)) and rural region (2.81 [ND-7.38] μg m(-3)). The significant positive correlations between all BTEX compounds and T/B ratio >1 indicated the vehicular traffic as the main source of emission. At 95th percentile probability, the non-cancer risk of t-BTEX in urban region was only less than one order of magnitude below the threshold level of unity (1.91E-01) and the cancer risk of benzene exceeded the recommended level of 1.0E-06 by U.S. EPA in urban (7.69E-06) and industrial (2.97E-06) regions. It was found that the indoor/outdoor ratio of BTEX concentration in beauty salon and hospital was greater than 1. Overall, the current levels of BTEX in the ambient air of study area, especially near urban roadside and in some indoor environments, should not be overlooked and appropriate mitigation actions should be undertaken.
The generation and emission of volatile organic compounds (VOCs) affects the environment and air quality, playing an important role in global warming, depletion of atmospheric ozone and emission of unpleasant odors, but also directly affect human health. This study investigated the health risks of benzene, toluene, ethylbenzene, xylene (BTEX) compounds and biogas released in and around the municipal landfill. Sampling of the VOCs was carried out by the 1501NIOSH method from 8 points over 5 months. The samples were analyzed for BTEX in the ambient air of the landfill, resulting in 0.03-18.09 ppm concentrations, while for biogases a 0.08-25.2 ppm range was found. Assessment of definite health and potential risks showed that the lifetime cancer risk (LCR) for benzene and hazard quotient (HQ) for the BTEX components in all studied sampling sites are higher than the acceptable standard. The high concentration of benzene measured in ambient air indicated that petroleum compounds containing benzene and its derivatives have the highest value in the category of BTEX compounds among all emissions. Therefore, high concentrations of volatile compounds derived from VOCs, especially benzene, should be reduced at the site with control engineering measures.
Climate change affects human health, and severe acute respiratory syndrome (SARS) incidence is one of the health impacts of climate change. This study is a retrospective cohort study. Data have been collected from the Iranian Ministry of Health and Medical Education between 17 February 2016 and17 February 2018. The Neural Network Model has been used to predict SARS infection. Based on the results of the multivariate Poisson regression and the analysis of the coexistence of the variables, the minimum daily temperature was positively associated with the risk of SARS in men and women. The risk of SARS has increased in women and men with increasing daily rainfall. According to the result, by changes in bioclimatic parameters, the number of SARS patients will be increased in cities of Iran. Our study has shown a significant relationship between SARS and the climatic variables by the type of climate and gender. The estimates suggest that hospital admissions for climate-related respiratory diseases in Iran will increase by 36% from 2020 to 2050. This study demonstrates one of the health impacts of climate change. Policymakers can control the risks of climate change by mitigation and adaptation strategists.
BACKGROUND: Cutaneous leishmaniasis (CL) has been reported in recent years in South Khorasan Province, a desert region of eastern Iran, where the main species is Leishmania tropica. Little is known of the influence of geography and climate on its distribution, and so this study was conducted to determine geo-climatic factors by using geographic information system. METHODS: The home addresses of patients with CL patients who were diagnosed and notified from 2009 to 2017 were retrieved from the provincial health center and registered on the village/town/city point layer. The effects of mean annual rainfall (MAR) and mean annual humidity (MAH), mean annual temperature (MAT), maximum annual temperature (MaxMAT), minimum annual temperature (MinMAT), mean annual number of high-velocity wind days (MAWD), mean annual frosty days (MAFD) and snowy days (MASD), elevation, soil type and land cover on CL distribution were examined. The geographical analysis was done using ArcMap software, and univariate and multivariate binary logistic regression were applied to determine the factors associated with CL. RESULTS: A total of 332 CL patients were identified: 197 (59.3%) male and 135 (40.7%) female. Their mean age was 29.3 ± 2.1 years, with age ranging from 10 months to 98 years. CL patients came from a total of 86 villages/towns/cities. By multivariate analysis, the independent factors associated with increased CL were urban setting (OR = 52.102), agricultural land cover (OR = 3.048), and MAWD (OR = 1.004). Elevation was a protective factor only in the univariate analysis (OR = 0.999). Soil type, MAH, MAT, MinMAT, MaxMAT, and MAFD did not influence CL distribution in eastern Iran. CONCLUSIONS: The major risk zones for CL in eastern Iran were urban and agricultural areas with a higher number of windy days at lower altitudes. Control strategies to reduce human vector contact should be focused in these settings.
BACKGROUND/OBJECTIVE: Natural disasters (NDs) are calamitous phenomena that can increase the risk of infections in disaster-affected regions. This study aimed to evaluate the frequency of malaria and cutaneous leishmaniasis (CL) before and after earthquakes, floods, and droughts during the past four decades in Iran. METHODS: Malaria and CL data were obtained from the reports of the Ministry of Health and Medical Education in Iran for the years 1983 through 2017. The data of NDs were extracted from the Centre for Research on the Epidemiology of Disasters (CRED). Interrupted time series analysis with linear regression modeling was used to estimate time trends of mentioned diseases in pre- and post-disaster conditions. RESULTS: For the periods preceding the disasters drought and flood, a decreasing time trend for malaria and CL was found over time. The time trend of malaria rate preceding the 1990 earthquake was stable, a downward trend was found after 1990 disaster until 1997 (β coefficient: -10.7; P = .001), and this declining trend was continued after 1997 disaster (β coefficient: -2.7; P = .001). The time trend of CL rate preceding the 1990 earthquake had a declining trend, an upward trend was found after 1990 earthquake until 1999 (β coefficient: +8.7; P = .293), and a slight upward trend had also appeared after 1999 earthquake (β coefficient: +0.75; P = .839). CONCLUSION: The results of the current study indicated the occurrence of earthquakes, floods, and droughts has no significant effect on the frequency of malaria and CL in Iran.
Evidence shows that climate change may have adverse effects on human health. The purpose of this study was to investigate the relation between Physiologically Equivalent Temperature (PET) and cardiovascular hospital admissions in Ahvaz. Distributed Lag Non-linear Models (DLNM) combined with quasi-Poisson regression models were used to investigate the effect of PET on hospital admissions. Low PET values (6.4 °C, 9.9 °C and 16.9 °C) in all lags, except lag 0-30, significantly decreased the risk of hospital admissions for total cardiovascular diseases, hypertension, ischemic heart diseases, and cardiovascular admissions in men, women and ≤65 years. But, low PET (6.4 °C) in lags 0 and 0-2 significantly increased the risk of hospital admissions for cerebrovascular diseases; and high PET values increased the risk of ischemic heart diseases and in men. Both cold and hot stress are involved in cardiovascular hospital admissions.
Background: There are few epidemiological studies on the relation between temperature changes and adverse pregnancy outcomes. The purpose of this study was to determine the relation between Physiological Equivalent Temperature (PET) with adverse pregnancy outcomes including stillbirth, low birth weight (LBW), preterm labor (PTL), spontaneous abortion (SA), preeclampsia and hypertension in Ahvaz, Iran. Methods: Distributed Lag Non-linear Models (DLNM) combined with quasi-Poisson regression were used to investigate the effect of PET on adverse pregnancy outcomes. In this study the effect of time trend, air pollutants (NO2, SO2 and PM10), and weekdays were adjusted. Results: High PET (45.4 C°, lag = 0) caused a significant increase in risk of stillbirth. Also, high levels of PET (45.4, 43.6, 42.5 C°, lag = 0–6) and low levels of PET (9.9, 16.9 C°, lags = 0, 0–13, 0–21) significantly increased the risk of LBW. But, low levels of PET (6.4, 9.9, 16.9 C°, lags = 0–6, 0–13) reduced the risk of gestational hypertension. Conclusion: The results of this study showed that hot and cold thermal stress may be associated with increased risk of stillbirth, and LBW in Ahvaz.
Excessive ambient air temperature due to global warming and climate change is capable of imposing heat stress on outdoor workers. This study had a quantitative, secondary, and analytical design. The present study aimed at modelling the trend of climate change by Hadley atmosphere-ocean general circulation model (HadCM) and Long Ashton Climate Generator (LARS) to predict future climate change trends, and determining heat stress in exposed farmworkers with high working energy demand who work full time in the unsheltered farm area. In this study, the data of the three synoptic metrological monitoring stations (located at the cities of Dezful (32.3831 degrees N, 48.4236 degrees E), Ahvaz (31.3183 degrees N, 48.6706 degrees E), and Dehdez (31.7011 degrees N, 50.2946 degrees E)) in a 30 years duration (1986-2016) was used. To predict the future trend of air temperature, HadCM and LARS were applied. Also, the Wet-Bulb Globe Temperature (WBGT) index was used to determine heat stress. The results showed that the temperature will increase throughout the coming years in the 3 cities (Ahvaz, Dezful, and Dehdez). The determination coefficient (R-2) ranges from 0.91 to 0.96 for the results. The rise of temperature rate between the time duration of 2011-2040 and 2041-2070 will be about 5 degrees C, and the WBGT indexes in June, July, and August were obtained as very hot (danger; > 28 degrees C). And the rate of increase in air temperature in the city of Ahvaz will be higher than in the other two cities. According to the results, it was revealed that heat stress coincidence with global warming will increase and exposure to heat for farmworkers will be much more severe.
BACKGROUND: Disaster planning and management pose a serious challenge to most countries. These challenges point to insufficient planning to deal with these events. Therefore, it is necessary to pay attention to the methods and characteristics of the decision-making approaches in these events. In this study, we tried to identify most appropriate approaches for the Iranian health system by studying disaster planning approaches. MATERIALS AND METHODS: This study was conducted using mixed methods in 2020-2021 in two phases: qualitative and quantitative. First, we reviewed at the research literature. Our goal was to identify studies that suggested approaches to disaster planning. The next step in this study was a qualitative study using semi-structured interviews. Participants in qualitative phase included managers and employees from different parts of the Iranian health system from the provinces of Golestan, Fars, Khuzestan, Lorestan, Kerman, Sistan, and Baluchestan. RESULTS: By combining approaches taken from literature reviews and qualitative study, four main approaches were identified. The results of our study have shown that disaster response planning approaches include function, risk assessment, capability, and futuristic base. CONCLUSION: This study provides complete overview of disaster planning approaches that enable health professionals to use them to develop response plans. Our findings indicate that in complex and large-scale events such as floods and pandemics, it is necessary to combine the introduced methods for operational planning.
BACKGROUND: Malaria is the third most important infectious disease in the world. WHO propose programs for controlling and elimination of the disease. Malaria elimination program has begun in first phase in Iran from 2010. Climate factors play an important role in transmission and occurrence of malaria infection. The main goal is to investigate the spatial distribution of incidence of malaria during April 2011 to March 2018 in Hormozgan Province and its association with climate covariates. METHODS: The data included 882 confirmed cases gathered from CDC in Hormozgan University of Medical Sciences. A Poisson-Gamma Random field model with Bayesian approach was used for modeling the data and produces the smoothed standardized incidence rate (SIR). RESULTS: The SIR for malaria ranged from 0 (Abu Musa and Haji Abad districts) to 280.57 (Bandar-e-Jask). Based on model, temperature (RR= 2.29; 95% credible interval: (1.92-2.78)) and humidity (RR= 1.04; 95% credible interval: (1.03-1.06)) had positive effect on malaria incidence, but rainfall (RR= 0.92; 95% credible interval: (0.90-0.95)) had negative impact. Also, smoothed map represent hot spots in the east of the province and in Qeshm Island. CONCLUSION: Based on the analysis of the study results, it was found that the ecological conditions of the region (temperature, humidity and rainfall) and population displacement play an important role in the incidence of malaria. Therefore, the malaria surveillance system should continue to be active in the region, focusing on high-risk areas of malaria.
Flash-flooding affected Iran in March 2019 causing the displacement of thousands of people. Social workers established a Child Friendly Space (CFS) and applied comprehensive case management to provide psychosocial support for people who were affected by flooding (PWAF) (n = 565) in a community in Poldokhtar, covering a period of 3 months. Outreach services, involving community-volunteers, providing counseling, establishing CFS, training PWAF for reducing violence, and preventing child abuse were essential social work post-disaster interventions to support vulnerable populations. The article reflects upon the often-neglected role of social workers in post-disaster settings, and brings new material for discussion from the unexplored field of Iranian social workers.
Flood hazard characteristics play a key role in flood-induced mortality. Therefore, it is crucial to evaluate the associations between these factors and flood fatalities. This case-control study was performed in the flood-prone regions of Iran with recorded flood-induced mortality rates during 2005-2018. In total, 369 subjects completed the survey (123 cases and 246 controls); they were selected from 12 provinces and 30 cities. In this study, descriptive and analytical analyses were carried out to measure flood hazard characteristics. Afterward, the correlation of flood hazard characteristics with flood-induced mortality was measured. According to the descriptive analysis, most deaths occurred in summer, during hours of darkness, in areas with one- and five-year flood return periods, and in floods with short rainfall durations. In addition, the spatial analysis demonstrated that most deaths occurred in flash floods, floods accompanied by bad weather, and floods with floating debris. The results of Chi-square and Fisher’s exact test also indicated significant correlations between darkness, flood return periods, flood behavior, floods with floating debris, bad weather, other hazards, and flood discharge with flood-induced mortality. According to the regression analysis, the variables of flood discharge over 500 m3/s, flash floods, nighttime floods, and floods with floating debris increased the risk of flood-induced mortality 3.64, 1.62, 3.34, and 1.06 times, respectively. Although changing flood hazard characteristics seems to be impossible, damages caused by floods can be decreased and the lives of people can be protected through appropriate preventive and managerial solutions, planning, training, promotion of preparedness, and timely warnings.
BACKGROUND: In recent years, the prevalence of dust events has increased in the region and the world. According to the Meteorological Organization, the most frequent days with dust events are on stations located in Khuzestan province. Objective: Assessment of the effects of dust events and meteorological elements on stroke morbidity in health in Iran: a health promotion approach. MATERIALS AND METHODS: The present study was a retrospective cohort study 2020 and 2013 provided between based on ecological data-based on population. Information about patients with stroke was obtained from the hospital. Information on the dust events and meteorological elements was also from the data center of the Meteorological Organization of Iran. Using STATA the correlation between the diseases and the, 14 statistical software version occurrence of dust events and changes in meteorological elements was obtained and the statistical model (Spearman correlation coefficient) individually estigate the equation was used inv modified by Poisson regression simultaneous effect of variables. RESULTS: the results of adjusted statistical models show that increasing the severity of dust event increases the risk of stroke in males (lag 0-21 confidence interval [CI] 95% = 1.496-1.0067 relative risk [RR] = 1.03 P = 0.01). Increasing the average wind speed also increases the risk of stroke in males (lag 0-3 CI 95% = 1.0491-0.9996 RR = 1.02 P = 0.05). Increased rainfall and average relative humidity increase the risk of stroke in people under 60 years (lag 0-7 CI 95% = 1.0012-0.9058 RR = 1.95 P = 0.05). Increasing the average daily temperature reduces the risk of stroke in males (lag 0-3 CI 95% = 0.9874-0.9254 RR = 0.51 P < 0.001). CONCLUSION: Increasing the intensity of dust storms along with meteorological elements has increased the risk of stroke. However, increasing the average temperature has had a protective effect on the risk of stroke.
Sexual violence is largely absent from studies on violence against women in disasters. The role of men in perpetrating violence against women is overlooked or excused and women are usually blamed in both countries. A review of 2 studies of men’s violence against women after floods and earthquakes in Iran and bushfires in Australia show remarkable similarities. Although cultural contexts and the way gender inequality is established and demonstrated are different, these studies reveal unexpected parallels. The context of disaster lays it bare. Participants of both studies were disaster-affected people in Iran and Australia who revealed the taboos that prevent women speaking of violence that is exacerbated in a disaster context. Men play important roles in preventing and responding to violence against women as the result of their responsibilities and positions at the household and community levels. The objective of this paper was to compare the findings from these studies and consider the difficulties faced in conducting studies related to the roles of men and women roles during and after disaster events.
BACKGROUND: Outbreaks of infectious diseases are the major concern after flooding. Flood makes people displacement which would be more complicated with inadequate sanitation. Settling in crowded shelters in absence of clean water and inaccessibility to health care services makes people more vulnerable to get infection. This review aimed to discuss about potential undesirable outcomes of flooding occurred in 2019 in Iran. METHODS: A comprehensive search was carried out in databases including PubMed, Google scholar, Scopus, Science Direct, Iran medex, Magiran and SID (Scientific information database) from 2000 to 2019. All original descriptive articles on flood were concerned. Related articles on flood disturbance were considered. Also, publication of red cross society was considered as only reliable reference in evaluation of consequences of flood occurred in 2019 in Iran. RESULTS: Flooding in Iran, was started in March 2019 and lasted to April 2019. Flood affected 31 provinces and 140 rivers burst their banks, and southwestern Iran being hit most severely. According the reports of international federation of red cross society, 3800 cities and villages were affected by the floods with 65,000 destroyed houses and 114,000 houses partially damaged. Also 70 hospitals or health care centers with 1200 schools were damaged along with many infrastructures including 159 main roads and 700 bridges. CONCLUSIONS: Considering 365,000 displaced persons and estimation of mentioned damages, it was one of the greatest natural disaster during the last 20 years. Various risk factors in favor of infectious diseases such as overcrowding, disruption of sewage disposal, poor standards of hygiene, poor nutrition, negligible sanitation and human contact among refugees provide suitable conditions for increased incidence of infectious diseases after flooding and also cause epidemics.More attention is needed to provide hygienic situation for people after natural disasters including flood.
PURPOSE: Salmonella is one of the main causes of gastroenteritis, and its incidence may be affected by meteorological variables. This is the first study about the effect of climatic factors on salmonella incidence in Kermanshah, Iran. METHODS: Data about salmonellosis cases in Kermanshah were inquired from Center for Communicable Disease Control, at the Ministry of Health and Medical Education of Iran, for the 2008 to 2018 time-frame. Meteorological variables including maximum, minimum and mean of temperature and humidity, sunshine hours and rainfall were inquired for the same time frame. Negative binomial generalized linear models (GLM) were used to assess the effect of meteorological variables on the weekly incidence of salmonellosis. RESULTS: During the years under study, 569 confirmed cases were registered in Kermanshah province. Study results showed a 3?% increase in salmonellosis incidence, after 1?% increase in minimum humidity in the week before (incidence rate ratio (IRR): 1.03; 95?% confidence interval (CI):1.02-1.05) and also a 4?% increase in incidence for 1 °C increase in mean temperature in the same week (IRR: 1.04; 95?% CI:1.02-1.06). CONCLUSIONS: Increase in minimum humidity and mean temperature may have a role in increasing the incidence of salmonellosis in Iran.
The study was conducted to determine thermal stress and its trend in Iran. The atmospheric variables of 304 synoptic stations, including mean temperature, relative humidity, wind speed and cloudiness, for the period 1961-2010, were used to identify the thermal stress conditions in Iran. These data were prepared on a daily basis from the Iran Meteorological Organization. Physiologically equivalent temperature (PET) and standard effective temperature (SET*) were used to identify thermal stress. Also, thermal stress was studied with a simple linear regression method and at a 95% confidence level. The results of the study revealed that in Iran each location can experience different types of environmental conditions throughout the year. At a specified time, thermal stresses of different intensities can be seen. The other results showed that the mountainous regions, especially the highlands of the northwest, along with the Zagros and Alborz mountains, had the highest co-efficient of variability (> 50%). Also, the southern regions of Iran have both monthly and annual scales with the least co-efficient of variability (< 20%) in bioclimatic conditions. In general, a diversity of bioclimatic conditions is evident in Iran both temporally and spatially. The other part of the study determined that heat and cold stress and heat comfort had a positive trend (fewer than 60 stations) in parts of Iran, a negative trend in some other parts (more than 50 stations), and no specific trend in the remaining parts (more than 250 stations). Most of the northern stations, especially on the Caspian coast, have been shown to have a positive trend in the event of cold stress. Indeed, extreme bioclimatic conditions (very cold and hot conditions) have been rising in both the southern and northern latitudes of the country. Even in southern parts, a positive trend of cold and very cold conditions can be observed at some stations.
Visceral leishmaniasis (VL) as a vector-borne disease, is an endemic in the northwest and south of Iran and sporadic in other areas in the country. This study was performed to investigate the Granger causality analysis of the impacts of climatic factors on VL in northwestern Iran throughout the period from 1995 to 2019. In a longitudinal study, the epidemiological data of patients suffering from VL were collected from the health centers and hospitals in Meshkinshahr County, Ardabil province, between 1995 and 2019. Moreover, the environmental and climatic data of each location, such as temperature, humidity, rainfall, the number of frost and warm days in the year, were obtained from the meteorological center of the county and put into the Excel software. The incidence rate of VL was modeled by time series analysis and to compare its relationship with other time series covariates, the Granger causality analysis was used. The results of Granger causality analysis showed that some climatic variables including daily mean temperature, absolute minimum temperature, maximum and minimum temperature and maximum humidity were the main factors affecting the prevalence of VL in northwestern Iran. The findings greatly demonstrated that the potential of Granger causality in epidemiologic status of VL in northwestern Iran. Moreover, the results suggest that in addition to patient-related and biological factors, environmental and climatic factors such as temperature and humidity also play a major role in completing the transmittance cycle of VL in an endemic focus.
In recent years, there have been considerable changes in the distribution of diseases that are potentially tied to ongoing climate variability. The aim of this study was to investigate the association between the incidence of cutaneous leishmaniasis (CL) and climatic factors in an Iranian city (Isfahan), which had the highest incidence of CL in the country. CL incidence and meteorological data were acquired from April 2010 to March 2017 (108 months) for Isfahan City. Univariate and multivariate seasonal autoregressive integrated moving average (SARIMA), generalized additive models (GAM), and generalized additive mixed models (GAMM) were used to identify the association between CL cases and meteorological variables, and forecast CL incidence. AIC, BIC, and residual tests were used to test the goodness of fit of SARIMA models; and R(2) was used for GAM/GAMM. 6798 CL cases were recorded during this time. The incidence had a seasonal pattern and the highest number of cases was recorded from August to October. In univariate SARIMA, (1,0,1) (0,1,1)(12) was the best fit for predicting CL incidence (AIC=8.09, BIC=8.32). Time series regression (1,0,1) (0,1,1)(12) showed that monthly mean humidity after 4-month lag was inversely related to CL incidence (AIC=8.53, BIC=8.66). GAMM results showed that average temperature with 2-month lag, average relative humidity with 3-month lag, monthly cumulative rainfall with 1-month lag, and monthly sunshine hours with 1-month lag were related to CL incidence (R(2)=0.94). The impact of meteorological variables on the incidence of CL is not linear and GAM models that include non-linear structures are a better fit for prediction. In Isfahan, Iran, meteorological variables can greatly predict the incidence of CL, and these variables can be used for predicting outbreaks.
PURPOSE: The aim of the present study was to investigate the effect of short-term exposure to ambient black carbon (BC) on daily cause-specific mortality, including mortality due to respiratory, cardiovascular, ischemic heart and cerebrovascular diseases in Tehran, Iran. MATERIALS AND METHODS: Daily non-accidental death counts, meteorological data and hourly concentrations of air pollutants from 2014 to 2017 were collected in Tehran. A distributed lag non-linear model was used to assess the association between exposure to BC and daily mortality. RESULTS: The mean daily BC concentration during the study period was 3.96?±?1.19 µg/m(3). The results indicated that BC was significantly associated with cardiovascular, ischemic heart disease, and cerebrovascular mortality, but not with respiratory mortality. In first model, each 10 µg/m(3) increase in at lag 3, lag 4 and lag 5 were associated with cardiovascular mortality in 16-65 year age group with the relative risks (RRs) of 1.17 (95?% CI: 1.02-1.33), 1.17 (95?% CI: 1.04-1.31) and 1.12 (95?% CI: 1.02-1.24), respectively. The highest mortality rate per 10 µg/m(3) increase in exposure was found for ischemic heart diseases with RR of 3.98 (95?% CI: 1.04-1.81, lag 01) for 16-65 age group. Cerebrovascular mortality was associated with 10 µg/m(3) increases in non-cumulative exposure with RR of 1.17 (95?% 1.009-1.35, lag 5) in the age group ? 65 years. In the second model for a 10 µg/m(3) increase in BC, cardiovascular mortality at specific lag days (5 and 6 days) in the age group ? 16 years were associated with RR of 1.34 (95?% CI 1.08-1.66) and 1.35(95?% CI 1.02-1.77), respectively. CONCLUSIONS: This study in Tehran found significant effects of BC exposure on daily mortality for cardiovascular, ischemic heart disease, cerebrovascular disease. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40201-021-00659-0.
Climate change may be associated with human morbidity and mortality through direct and indirect effects. Ahvaz is one of the hottest cities in the world. The aim of this study was to investigate the relation between physiological Equivalent Temperature (PET) and non-accidental, cardiovascular and respiratory disease mortality in Ahvaz, Iran. Distributed Lag Non-linear Models (DLNM) combined with quasi-Poisson regression were used to investigate the effect of PET on death. The effect of time trend, air pollutants (NO(2), SO(2) and PM(10)), and weekdays were adjusted.The results showed that in cold stress [1st percentile of PET (2.7 °C) relative to 25th percentile (11.9 °C)] the risk of total respiratory mortality, respiratory mortality in men, and mortality in people under 65 year olds, significantly decreased in the cumulative lags of 0-2, 0-6 and 0-13; but the risk of respiratory mortality increased in the elderly and in the final lags. In contrast, heat stress [99th percentile of PET (44.9 °C) relative to 75th percentile (43.4 °C)] significantly increased the risk of total cardiovascular mortality (CVD), cardiovascular mortality in men, ischemic heart disease and cerebrovascular disease mortality in lags 0 and 0-2. It seems that high PET values increase the risk of cardiovascular mortality, while low PET values increase respiratory mortality only among the elderly in Ahvaz.
Although Ahvaz is considered as one of the warmest cities around the world, few epidemiological studies have been conducted on the adverse effects of temperature on human health using thermal indices in this city. This study investigates the relation between physiologically equivalent temperature (PET) and respiratory hospital admissions in Ahvaz. Distributed lag non-linear models (DLNMs) combined with quasi-Poisson regression models were used to investigate the relation between PET and respiratory disease hospital admissions, adjusted for the effect of time trend, air pollutants (NO(2), SO(2), and PM(10)), and weekdays. The analysis was performed by utilizing R software. Low PET values significantly decreased the risk of hospital admissions for total respiratory diseases, respiratory diseases in men and women, chronic obstructive pulmonary diseases (COPD), and bronchiectasis. However, low PET (16.9°C) in all lags except lag 0-30 significantly increased the risk of hospital admissions for asthma. The results indicate that in Ahvaz, which has a warm climate, cold weather decreased overall respiratory hospital admissions, except for asthma.
This study aimed to estimate morbidity risk/number attributed to air extreme temperatures using time-stratified case crossover study and distributed lag non-linear model in a region of Iran during 2015-2019. A time-stratified case crossover design based on aggregated exposure data was used in this study. In order to have no overlap bias in the estimations, a fixed and disjointed window by using 1-month strata was used in the design. A conditional Poisson regression model allowing for over dispersion (Quasi-Poisson) was applied into Distributed Lag Non-linear Model (DLNM). Different approaches were applied to estimate Optimum Temperature (OT). In the model, the interaction effect between temperature and humidity was assessed to see if the impact of heat or cold on Hospital Admissions (HAs) are different between different levels of humidity. The cumulative effect of heat during 21 days was not significant and it was the cold that had significant cumulative adverse effect on all groups. While the number of HAs attributed to any ranges of heat, including medium, high, extreme, and even all values were negligible, but a large number was attributable to cold values; about 10000 HAs were attributable to all values of cold temperature, of which about 9000 were attributed to medium range and about 1000 and less than 500 were attributed to high and extreme values of cold, respectively. This study highlights the need for interventions in cold seasons by policymakers. The results inform researchers as well as policy makers to address both men and women and elderly when any plan or preventive program is developed in the area under study.
This study was conducted in order to explore the effect of thermal comfort on all-cause mortality using three indices in different lag times, in a semi-arid to dry region of Iran. Three thermal comfort indices based on the energy balance of the human body including physiologically equivalent temperature (PET), predicted mean vote (PMV), and standard effective temperature (SET) were used to assess the effects of thermal comfort on mortality. Distributed lag non-linear models were used to assess the relation. The natural cubic spline was chosen as the basis function for the space of predictors and lags, with 4 degrees of freedom. All three indices showed the same pattern in general, but the relative risk for PMV values were more than the other indices in different lags. For all three indices, lag 0 had the highest relative risk of mortality in warm and hot indices. The relative risk for warm and hot values was more than cool and cold values in lag 0, and for the PMV index, it was larger than the two other indices. These results were different in lags 5 to 8, and the relative risks for cool and cold values were more than warm and hot values. This study showed that heat stress has a stronger and more immediate adverse effect on mortality than cold stress. Also, the elderly and females are more vulnerable than others. The most apparent effect was seen in lags 0-12.
Arid and semi-arid climates, including that of Iran, are more susceptible to environmental changes due to their special ecological structure than other climates. Therefore, climate change in these areas appears to have significant effects on agricultural and food production systems. The present study explores the effect of climatic changes on total horticultural production and food security in agro-ecological zones of Iran. The study was conducted in two steps. In the first step, the effects of climatic parameters on total horticultural production were investigated using time series data (1985-2017) and a regression model. In the second step, due to the important role of horticultural products in per capita food consumption in Iran, the effect of climate parameters on food security was also examined. Results revealed that total horticultural production was influenced by temperature, evapotranspiration, and wind speed at the 0.05 level. With the increase in temperature (at a rate of one unit), total horticultural production is reduced to 0.01 million tons. Evapotranspiration and wind speed have had a negative effect on total horticultural production, and with increasing evapotranspiration and wind speed, total horticultural production was 0.029 and 0.008 million, respectively, tons decreased. Also, food security was influenced by temperature, precipitation, and wind speed.
Objective: To determine the significance of temperature, rainfall and humidity in the seasonal abundance of Anopheles stephensi in southern Iran. Methods: Data on the monthly abundance of Anopheles stephensi larvae and adults were gathered from earlier studies conducted between 2002 and 2019 in malaria prone areas of southeastern Iran. Climatic data for the studied counties were obtained from climatology stations. Generalized estimating equations method was used for cluster correlation of data for each study site in different years. Results: A significant relationship was found between monthly density of adult and larvae of Anopheles stephensi and precipitation, max temperature and mean temperature, both with simple and multiple generalized estimating equations analysis (P<0.05). But when analysis was done with one month lag, only relationship between monthly density of adults and larvae of Anopheles stephensi and max temperature was significant (P<0.05). Conclusions: This study provides a basis for developing multivariate time series models, which can be used to develop improved appropriate epidemic prediction systems for these areas. Long-term entomological study in the studied sites by expert teams is recommended to compare the abundance of malaria vectors in the different areas and their association with climatic variables.
BACKGROUND: The Crimean-Congo Hemorrhagic fever (CCHF) is endemic in Iran and has a high fatality rate. The aim of this study was to investigate the association between CCHF incidence and meteorological variables in Zahedan district, which has a high incidence of this disease. METHODS: Data about meteorological variables and CCHF incidence was inquired from 2010 to 2017 for Zahedan district. The analysis was performed using univariate and multivariate Seasonal Autoregressive Integrated Moving Average (SARIMA) models and Generalized Additive Models (GAM) using R software. AIC, BIC and residual tests were used to test the goodness of fit of SARIMA models, and R(2) was used to select the best model in GAM/GAMM. RESULTS: During the years under study, 190 confirmed cases of CCHF were identified in Zahedan district. The fatality rate of the disease was 8.42%. The disease trend followed a seasonal pattern. The results of multivariate SARIMA showed the (0,1,1) (0,1,1)(12) model with maximum monthly temperature lagged 5?months, forecasted the disease better than other models. In the GAM, monthly average temperature lagged 5?months, and the monthly minimum of relative humidity and total monthly rainfall without lag, had a nonlinear relation with the incidence of CCHF. CONCLUSIONS: Meteorological variables can affect CCHF occurrence.
OBJECTIVE: By studying the effect of environmental factors on health, it is clear that geographical, climatic and environmental factors have a significant impact on human health. This study, based on the data of the patients with breast cancer in Iran since 2010 to 2014 and using the statistical methods has determined the effect of geographical features of Iran (solar radiation status, radiation angle) on the frequency and distribution of this disease. RESULTS: The maximum amount of total solar radiation occurs in the vicinity (surrounding) of the tropic of cancer, which covers some parts of the south of Iran and in the atmosphere of the northern latitudes of Iran. The amount of humidity and cloudiness is more than the southern latitudes, which causes more reflection of short waves of the sun during the day. Findings showed that the rate of breast cancer in low latitudes is higher than high latitudes. It was also found that with increasing longitude, the rate of cancer increases significantly due to the high thickness of the atmosphere and receiving more sunlight in the electromagnetic spectrum, as well as dry air and low water vapor in low altitude areas of eastern and southeastern Iran.
Few studies have investigated the different extreme temperature effects (heat-cold) of one geographical location at the same time in Iran. This study was conducted to assess the impact of heat and cold waves on mortality in Urmia city, which has a cold and mountainous climate. Distributed Lag Non-linear Models combined with a quasi-Poisson regression were used to assess the impact of heat (HW) and cold waves (CW) on mortality in subgroups, controlled for potential confounders such as long-term trend of daily mortality, day of week effect, holidays, mean temperature, humidity, wind speed and air pollutants. The heat/cold effect was divided into two general categories A-main effect (the effect caused by temperature), B-added effect (the effect caused by persistence of extreme temperature). Results show that there was no relation between HW and respiratory and cardiovascular death, but in main effects, HW(H1) significantly increased, the risk of Non-Accidental Death (NAD) in lag 0 (Cumulative Excess Risk (CER) (NAD) = 31(CI; 4-65)). Also in added effects, HW had a significant effect on NAD (CER (H1; NAD; lag;0-2) = 31(CI; 5, 51), CER (H2; NAD; lag;0-2) = 26(CI; 6, 48)). There was no relation between CW and respiratory death and cardiovascular death, but in added effects, CW((C1)) significantly decreased, the risk of non-accidental death in initial lags (CER (C1; NAD; lag;0-2) = 19 (CI; 35, 2)). It seems that high temperatures and heat waves increase the risk of non-accidental mortality in northwest of Iran.
BACKGROUND: Risk perception is an important predictor to mitigate climate change effects which can produce mental health consequences such as anxiety and depression. For developing policies of climate risk adaptation, awareness of public attitudes, beliefs, and perception is essential. At this study, researchers tried to focus on the often “unseen” psychological aspects of climate change. MATERIALS AND METHODS: A qualitative approach was done with a consistent content analysis method. The study consisted of 33 participants including ordinary people and experts in disasters and climate change. Purposeful sampling was adopted until data saturation. The data collection was performed through in-depth and semi-structured interviews. All interviews were transcribed after listening again and again and reading several times to catch an overall understanding of the interviews. RESULTS: The main theme of the study was “Complexity nature of climate change risk perception” and related categories including “the Mental health dimension,” “the Cognitive dimension” and “Interaction of imposed components.” The structure of the research community strongly reflected effects of cultural and religious factors in all aspects of community life. Participants’ life experiences of extreme events were associated to their perception of climate change. CONCLUSIONS: Risk perception is multifactorial and complicate and should clearly be understood to improve community participation to manage climate change-related risks. We propose that authorities and related managers should pay attention to it as a priority. This may assist in developing research on public mental health practices.
BACKGROUND: The prevalence of Acute Myocardial Infarction (AMI) varies from region to region caused by seasonal climate changes and temperature variation. This study aimed to assess the relationship between changing meteorological conditions and incidence of AMI in Iran. METHODS: This retrospective prevalence study was based on medical records of the heart center of Mazandaran Province on all patients diagnosed with AMI in Mazandaran, northern Iran between 2013 and 2015. Patients’ sex and the day, month, year and time of hospital admission were extracted from patients’ records. Moreover, the meteorological reports were gathered. RESULTS: A statistically significant difference was found between the distributions of AMI cases across 12 months of the year (P < 0.01). Fuzzy clustering analysis using 16 different climatic variables showed that March, April, and May were in the same cluster together. The other 9 months were in different clusters. CONCLUSION: Significant increase in AMI was seen in March, April and May (cold to hot weather).
BACKGROUND: Estimating the effects of climate change on human health can help health policy makers plan for the future. In Iran, there are few studies, about investigating the effects of climate change on mortality. This study aimed to project the effect of low (cold) and high (heat) temperature on mortality in a dry region of Iran, Kerman. METHODS: Mortality attributed to temperature was projected by estimating the temperature-mortality relation for the observed data, projection of future temperatures by the statistical downscaling model (SDSM), and quantifying the attributable fraction by applying the observed temperature-mortality relation on the projected temperature. Climate change projection was done by three climate scenarios base on Representative Concentration Pathways (RCP2.6, RCP4.5 and RCP8.5). Adaptation was considered by using different minimum mortality temperatures (MMT) and risk reduction approaches. The current decade (2010-19) was considered as the reference period. RESULTS: All three climate change scenarios, showed that the mean of temperature will rise about 1 °C, by 2050 in Kerman. The number of deaths attributed to heat were obviously higher than cold in all periods. Assuming no adaptation, over 3700 deaths attributed to temperature will happen in each decade (2020s, 2030s and 2040s) in the future, in which over 3000 deaths will be due to heat and over 450 due to cold. In the predictions, as Minimum Mortality Temperature (MMT) went up, the contribution of heat to mortality slightly decreased, and cold temperature played a more important role. By considering the risk reduction due to adaptation, the contribution of heat in mortality slightly and insignificantly decreased. CONCLUSION: The results showed that although low temperatures will contribute to temperature-related mortality in the future, but heat will be a stronger risk factor for mortality, especially if adaptation is low.
Background: Iran is a disaster-prone country, and many flood events occur in its provinces annually. The unprecedented amount of rainfall in the northern region of Iran (from March 17 to 22, 2019) led to flash flooding of the Golestan Province. Objectives: This study assessed the challenges and strengths of health-related needs in the first 10 days after the great flood in Golestan; via interviews with experts. Methods: This cross-sectional and qualitative study was carried out in Gonbad-e-Kavoos, Anbar Alum, Aq-Qala, Simin Shahr, and Gomishan cities of the flood-hit province of Golestan from March 21, to April 13 in 2019. The data were collected using the researcher’s field observations and interviews with 26 experts and policymakers. Results: The findings were categorized into 10 main groups namely mental health, environmental health, health education, maternal, infant, and child health, nutrition, epidemics, drugs, mobile hospitals, non-communicable diseases, and management. Environmental health issues were faced with a wide range of challenges. Conclusion: Due to the insufficient development of many health infrastructures in underdeveloped and developing countries, health policymakers and disaster management experts should collaborate before and after the disaster to detect and resolve the flaws. This could help reduce health problems and challenges when a natural disaster occurs, particularly by diminishing the number of morbidities and mortalities.
OBJECTIVES: This study investigated the modification of temperature effects on cardiovascular and respiratory mortality by air pollutants (particulate matter less than 2.5 and 10 µm in diameter [respectively], ozone, nitrogen dioxide, carbon monoxide, and sulfur dioxide). METHODS: Poisson additive models with a penalized distributed lag non-linear model were used to assess the association of air temperature with the daily number of deaths from cardiovascular and respiratory diseases in Ahvaz, Iran from March 21, 2014 to March 20, 2018, controlling for day of the week, holidays, relative humidity, wind speed, air pollutants, and seasonal and long-term trends. Subgroup analyses were conducted to evaluate the effect modification for sex and age group. To assess the modification of air pollutants on temperature effects, the level of each pollutant was categorized as either greater than the median value or less than/equal to the median value. RESULTS: We found no significant associations between temperature and cardiovascular and respiratory mortality. In the subgroup analyses, however, high temperatures were significantly associated with an increased risk of cardiovascular mortality among those 75 years old and older, with the strongest effect observed on day 0 relative to exposure. The results revealed a lack of interactive effects between temperature and air pollutants on cardiovascular and respiratory mortality. CONCLUSIONS: A weak but significant association was found between high temperature and cardiovascular mortality, but only in elderly people. Air pollution did not significantly modify the effect of ambient temperature on cardiovascular and respiratory mortality.
Investigation of temperature extremes is very important as one of the most important climate parameters in different parts. If exposed to enough heat, humans will suffer from extreme heat. Maximum temperature and heat can adversely affect many living organisms. The effects of extreme heat on people with chronic lung disease, including asthma and emphysema, are greater; even for people with healthy lungs, outdoor activities are not recommended during high ozone levels. The purpose of this study is to monitor and analyze the effects of atmospheric temperature extreme and extreme heat on human health in Central Iran. Therefore, the minimum and maximum data of 15 synoptic stations in the study area for the period (1988-2018) using hybrid artificial neural network (HANN) and adaptive neuro-fuzzy inference system (ANFIS) models were used. Finally, multi-criteria decision-making (MCDM) models TOSIS and SAW were used to prioritize the areas exposed to rising temperature. The results showed that according to ANFIS modelling for predicting extreme temperatures, the lowest mean training error and the mean error of validation for the minimum temperature were equal to 0.10 for the Yazd Station and 1.66% for the Damghan station. The lowest mean training error and the mean error of validation for the maximum extreme temperature obtained 0.016 for the Garmsar station and 9.39% for the Shahroud station. The maximum extreme temperature of two stations of Garmsar and Bafgh (1 and 0.9689, respectively) was more exposed to extreme temperatures based on the TOPSIS model. Garmsar and Salafchegan Stations (1 and 0.9873, respectively) were more exposed to extreme temperatures based on the SAW model. Climate change is fundamentally changing the Earth’s climate system in a way that directly and indirectly endangers human physical and mental health. Severe increase in temperature is directly associated with death from cardiovascular and respiratory diseases, especially in the elderly. Also in the study area, the house is a place for peace and comfort for every human being. Climatic and weather conditions have a direct impact on creating a sense of comfort in any architectural space. Proper heating and air conditioning in the interior of the building is another case of architecture that will not be easy because this architectural issue is related to the comfort or non-comfort of man, and the concepts of heat or cold are mostly due to the natural feeling of man and his physiological conditions. The rising trend of thermal stresses in the studied stations increases the need to pay attention to the issue of thermal stresses and the spread of diseases (heat attack, syncope, and muscle cramps) in terms of crisis planning and management.
SARS CoV-2 (COVID-19) Coronavirus cases are confirmed throughout the world and millions of people are being put into quarantine. A better understanding of the effective parameters in infection spreading can bring about a logical measurement toward COVID-19. The effect of climatic factors on spreading of COVID-19 can play an important role in the new Coronavirus outbreak. In this study, the main parameters, including the number of infected people with COVID-19, population density, intra-provincial movement, and infection days to end of the study period, average temperature, average precipitation, humidity, wind speed, and average solar radiation investigated to understand how can these parameters effects on COVID-19 spreading in Iran? The Partial correlation coefficient (PCC) and Sobol’-Jansen methods are used for analyzing the effect and correlation of variables with the COVID-19 spreading rate. The result of sensitivity analysis shows that the population density, intra-provincial movement have a direct relationship with the infection outbreak. Conversely, areas with low values of wind speed, humidity, and solar radiation exposure to a high rate of infection that support the virus’s survival. The provinces such as Tehran, Mazandaran, Alborz, Gilan, and Qom are more susceptible to infection because of high population density, intra-provincial movements and high humidity rate in comparison with Southern provinces.
BACKGROUND: Cutaneous leishmaniasis (CL) is a dermal and parasitic disease.. The aim of this study was to determine the effect of environmental and climate factors on spatial distribution of CL in northeastern Iran by utilizing remote sensing from 20 March 2016 to 19 March 2017. METHODS: In this ecological study, the data were divided into two parts: The descriptive data on human CL cases were gathered from Communicable Diseases center of Iran. The remote sensing techniques and satellite imagery data (TRMM, MODIS-Aqua, MODIS-Terra and AMSR-2 with spatial resolution 0.25°, 0.05°, 5600m and 10km) of environmental and climate factors were used to determine the spatial pattern changes of cutaneous leishmaniasis incidence. RESULTS: The incidence of CL in North Khorasan, Razavi Khorasan, and South Khorasan was 35.80 per 100,000 people (309/863092), 34.14 per 100,000 people (2197/6,434,501) and 7.67 per 100,000 people (59/768,898), respectively. The incidence of CL had the highest correlation with soil moisture and evapotranspiration. Moreover, the incidence of disease was significantly correlated with Normalized Difference Vegetation Index (NDVI) and air humidity while it had the lowest correlation with rainfall. Furthermore, the CL incidence had an indirect correlation relation with the air temperature meaning that with an increase in the temperature, the incidence of disease decreased. CONCLUSION: As such, the incidence of disease was also higher in the northern regions; most areas of North Khorasan and northern regions of Razavi Khorasan; where the rainfall, vegetation, specific humidity, evapotranspiration, and soil moisture was higher than the southern areas.
BACKGROUND: Ensuring public health is crucial in any policy debate on climate change. Paris Agreement on climate change is a global contract, through which countries have committed themselves to a public health treaty. The agreement has laid the foundation for mitigation and adaptation. This study was conducted to provide an evidence-based framework for policy-making in the health system of Iran in order to reduce the adverse effects of climate change on public health and to increase the adaptation of the health system as a result. METHODS: This is a qualitative study. We first used Delphi method to extract the components of Paris Agreement on climate change that were related to the functions and policymaking of health system in Iran. Twenty-three experts in health and climate change were identified purposefully and through snowball sampling as participants in Delphi. Data collection instrument was a structured questionnaire. We used SPSS software version 25 for data analysis based on the descriptive indices including the mean, the percentage of consensus above 75%, and the Kendall coordination coefficient. RESULTS: Seventy-nine components classified within nine categories were extracted. The most important examples of the implementation of Paris Agreement on climate change in the health system of Iran were: participation in the formulation of strategies for mitigation and adaptation, identifying vulnerable groups, assessing vulnerability, increasing the capacity of health services delivery during extreme events, using early warning systems, using new technologies to increase the adaptation, evaluation of interventions, financial support, increasing the number of researches, increasing the knowledge and skills of staff, and finally public awareness. CONCLUSIONS: Evidence-based policy-making is pivotal to develop effective programs to control the health effects of climate change. This research provided policy translation and customization of micro and macro provisions of Paris Agreement on climate change, in line with the political context of health system in Iran. Our finding will pave the ground, we envisage, for further steps towards capacity building and enhancement of resiliency of the health system, adaptation interventions, and evaluation, identification of barriers and facilitators for adaptation and decreasing the adverse health effects caused by the climate change, in Iran and perhaps beyond.
Objective: To establish a spatial geo-database for scorpions in Iran, and to identify the suitable ecological niches for the most dangerous scorpion species under different climate change scenarios. Methods: The spatial distribution of six poisonous scorpion species of Iran were modeled: Hemiscorpius lepturus, Androctonus crassicauda, Mesobuthus eupeus, Hottentotta saulcyi, Hottentotta zagrosensis, and Odontobuthus (O.) doriae, under RCP2.6 and RCP8.5 climate change scenarios. The MaxEnt ecological niche model was used to predict climate suitability for these scorpion species in the 2030s and 2050s, and the data were compared with environmental suitability under the current bioclimatic data. Results: A total of 73 species and subspecies of scorpions belonging to 19 genera in Iran were recorded. Khuzestan Province has the highest species diversity with 34 species and subspecies. The most poisonous scorpion species of Iran are scattered in the semi-arid climates, at an altitudinal range between 11 m and 2 954 m above sea level. It is projected that O. doriae, Androctonus crassicauda and Mesobuthus eupeus species would be widely distributed in most parts of the country, whereas the most suitable ecological niches for the other species would be limited to the west and/or southwestern part of Iran. Conclusions: Although the environmental suitability for all the species would change under the two climate change scenarios, the change would be more significant for O. doriae under RCP8.5 in the 2050s. These findings can be used as basis for future studies in the areas with the highest environmental suitability for the most dangerous scorpion species to fill the gaps in the ecology of scorpion species in these areas.
