Background: The operation of petroleum refineries and petrochemical plants is associated with the emission of organic compounds into the atmosphere, causing local and regional pollution that is harmful to people's health. Objectives: The present study aimed at determining and evaluating personal exposure to hazardous compounds in ambient air of petrochemical complex in south of Iran. Methods: A total of 716 air samples were collected at 18 complexes of an Iranian petroleum complex. A charcoal desorption tube was used to obtain samples from VOCs, and a gas chromatography equipped to flame ionization detector (GC-FID) was used for analyzing the compounds. A gas chromatography-mass spectrophotometer (GC-MS) was used to determine the quantity of the compounds. Results: More than 40 VOCs were detected in all samples and high concentrations of benzene were observed in 12 complexes, but the concentrations of non-carcinogen compounds were below the occupational exposure limit. The greatest amount of exposure to the VOCs occurred in the groups of operators, site workers, analyzers, mechanics, samplers, and site men. Other possible carcinogenic compounds such as epichlorohydrin ethylbenzene were above the occupational permissible exposure limits in a few petrochemical complexes. The mean ratios of benzene to toluene (B/T), (benzene to xylenes) B/X, ethylbenzene to toluene (EB/T), and ethyl benzene to xylene (EB/X) were, respectively, 1.2, 1.9, 0.12, and 1.2 during the summer and were less than the same ratios in the winter. Conclusions: The results of this study revealed that benzene is a major pollutant in workplaces and is distributed throughout petrochemical complexes by wind. Thus, there is an urgent need to control the spread of benzene through air. Photochemical reaction is also an important factor in pollution in different seasons of the year.

Background: Protecting people from catastrophic health payments is widely recognized as an integral component of health systems and universal health coverage. Objectives: This study aimed to measure the financial protection against catastrophic health expenditure among hospitalized patients in Kermanshah, western Iran, after the implementation of the health sector evolution plan of Iran. Methods: This was a cross-sectional study. A total of 544 patients were selected using the proportional allocation to population size technique. A translated version of the world health survey questionnaire was used to collect data. Catastrophic health expenditure was calculated using WHO recommended methodology. Data were analyzed using STATA v.13. The statistical test performed included descriptive statistics and logistic regression. Results: About 4.8% of households with hospitalized patients were faced with catastrophic health expenditures. The total mean out-of-pocket (OOP) medical expenditures of being hospitalized was 819,220 Rials per patient. Mean OOP in patients with catastrophic payment was 2,220,500 Rial. Major determinants of catastrophic payment were associated with surgical cost (OR: 8.09 P Value = 0.000), chronic disease (OR: 2.78 P Value = 0.025), household size (> 6) (OR: 6.70 P Value < 0.036), and economic status of households (Quintile 5; OR: 0.005 P Value = 0.000). Conclusions: The Health Sector Evolution Plan should target and extend aids especially for chronically ill patients, those who need surgery, and those at poorest quintile due to the fact that they are more vulnerable to catastrophic health expenditure. These groups should be the priorities in the health sector evolution plan revision to achieve a more desired outcome.

Background: The education presented to the clients by the health care personnel can guarantee the well-being of the individuals and stimulate sound health care behaviors in them. Recognizing the barriers to health education enhances the understanding and knowledge of preventive services. Objectives: The present study aimed at investigating the perspective of health care providers about barriers of instructional programs in Iran. Methods: This qualitative study was conducted in the urban health care centers of Sanandaj, West of Iran, in 2016. Using purposive sampling, 15 experienced employees in charge of health care education were included in the study. Data were collected through individual interview and group discussions, observation and field notes, were and analyzed by conventional content analysis. To confirm the accuracy and strength of the data, credibility, confirmability, and transferability components were taken into account. Results: The results of data analysis yielded 5 major categories: (1) health center related problems; (2) lack of preparation for education; (3) clients’ problems; (4) personal problems of the personnel; and (5) organizational factors. The participants reported the significance of intra- and intersectoral cooperation and coordination in implementation of health care education programs and the need for further attention from authorities to health care education. Conclusions: The findings revealed that presentation of health care education is a complicated issue, which is influenced by various factors. Also, the success of educational programs in health care centers is not merely an intrasectoral enterprise rather it requires the cooperation of the public media and related organizations, support of the society and attention of families and authorities to health education.

Background: Overcoming the challenge of human error occurrence in the healthcare section and patient safety improvement is impossible without understanding the nature of human error and without considering the fundamentals of human factors and ergonomics in designing and implementing sociotechnical systems. Therefore, the first step is to identify medical errors and their causes, using standard methods. Objectives: The aim of this study was to identify and evaluate human errors among nurses in the women’s infectious diseases ward in an educational hospital in the city of Qom in 2015. Methods: This cross-sectional study was performed to identify the medical errors among sixteen female nurses working in the women’s infectious diseases ward, using SHERPA. Hierarchical task analysis (HTA) was performed; errors were identified by checklist and risk assessment was then carried out. Results: One hundred fifty-nine errors were identified and evaluated in 89 tasks. Most of the detected errors were of the action type (74.21%) and the least errors were of the selection type (0.63%). The least number of the errors’ risk level was placed in the undesirable, and the highest was in the unacceptable level. Conclusions: Since the majority of the errors were of the action type, proper measures should be taken to prioritize them in disease control. In addition, designing a treatment process based on human factors and ergonomic principles is highly recommended to enhance the quality of services, improve patient safety and reduce errors. With respect to task analysis, the SHERPA is a good technique to evaluate and monitor medical errors.

Background: Volatile organic compounds (VOCs) removal like toluene is an important concern for health of humans and the environment. Objectives: In this study, the efficiency of heterogeneous catalytic ozonation process (COP) with MgO nanoparticles for toluene degradation in aqueous solutions was investigated. Materials and Methods: Response surface methodology (RSM) using central composite design (CCD) was applied to study the interactions between critical operating factors and to find their optimum levels. Four independent factors namely pH, catalyst dosage, ozonation time and concentration of toluene were transformed to coded values and consequently a second order quadratic model was prepared for responses prediction. Results: The analysis of variance (ANOVA) of the toluene degradation by COP/MgO nanoparticles showed F-value of 19.53 for the quadratic model indicating that the prepared model is significant. The predicted result showed that maximum degradation of toluene (~99.99%) could be achieved at pH 12, MgO dose 0.5 g, ozonation time of 50 minutes and initial toluene concentration of 10 mg/l. The correlation coefficient (R2 = 0.9480) indicates a good correlation between the experimental and predicted values. Conclusions: According to the results, COP is an efficient and rapid method for removing of toluene from aqueous solutions.

Background: Air pollution is an important issue and public concern throughout the world. Sulfur dioxide is one of the pollutants that can lead to many adverse effects on human health, animal and plant life. Objectives: Our study aimed to estimate excess hospitalization cases due to chronic obstructive pulmonary disease (COPD) and acute myocardial infarction (AMI) disease due to short-term exposure to SO2 during years 2011 to 2012, in six major cities of Iran including Tehran, Mashhad, Tabriz, Isfahan, Shiraz and Urmia. Methods: First, hourly air pollution data related to SO2 were obtained from the department of environmental in six major cities of Iran. Next, required parameters were calculated and imported to AirQ software after data analysis and processing. Finally, output results of the number of excess hospitalizations attributed to SO2 was presented in the form of tables and graphs. Results: The total cumulative numbers of hospital admissions due to COPD (HA-COPD) were estimated in six Iranian major cities, which were 243 in central relative risk in a year. For hospital admission due to Acute Myocardial Infraction (HA-AMI), the highest impact of SO2 exposure was for Urmia with attributable proportion (AP) of 4.56%, corresponding to 41 excess cases in this city. Conclusions: Although relative risk per 10 µg/m3 is low and sometimes mortality and morbidity attributable to pollutant seems slight because of sensitive and large population exposed to air pollutants, burden of disease associated with air pollution will be great. Therefore, authorities should apply necessary actions and efforts based on comprehensive scientific researches in order to control air pollutants and abate their negative effects on human health.

Context: The worldwide production and application of pesticides, especially organochlorine in agriculture can have adverse environmental pollution and human health risks. Thus, this review evaluated and summarized the toxicological data on the existence and concentrations of organochlorine compounds in Caspian sea fish tissues. Evidence Acquisition: The data were collected from published articles in PubMed, ISI, SID, Google Scholar and so on. Results: The review showed that nine studies were recorded in databases about pesticide residues in Caspian sea fish tissues. These studies reported that there is limited evidence of organochlorinated compounds in Caspian sea fishes. All researchers detected organochlorine contaminants in examined fishes in the studied area, however DDTs was the predominant pesticides. Heptachlor, Polychlorinated Biphenyls (PCBs) and Linden were ranked next, respectively. Conclusions: In conclusion, toxicological studies showed that, although contamination level in Caspian sea fishes was relatively low, the present status might pose a risk about food chain contamination.

Background: Breast cancer is the most common cancer diagnosed in women throughout the world and the leading cause of cancer-related deaths in women Objectives: The current study aimed to investigate the effect of eight weeks of training on IL-6, TNF-α and hCRP in postmenopausal breast cancer survivors. Patients and Methods: Twenty-seven postmenopausal breast cancer survivors with mean age of 44.1 ± 4.6, mean height of 158 ± 5.9 cm and mean Body Mass Index (BMI) of 30.2 ± 3.2 kg/m2, were randomly divided to three groups; continuous, interval and the control groups. Inflammatory markers, anthropometric variables and VO2 peak were measured before and after the eight weeks. Statistical analysis of the data was carried out using the Kruskal-Wallis and Wilcoxon test at a significance level of P 0.05). The human C-Reactive Protein (hCRP) levels showed a significant reduction in the continuous group (P = 0.015), and the reductions in Tumor Necrosis Factor alpha (TNF-α) and Interleukin6 (IL-6) were also greater in this group than in the other two groups. No significant differences were observed between the two exercise groups in their inflammatory markers. Conclusions: Exercise can improve anthropometric variables, body composition and VO2 peak and reduce some inflammatory markers in breast cancer survivors.

Recently, we published an article in the Health Scope journal entitled “Mental Health Status of Patients with HIV/AIDS in the South of Iran” (1). We are regret to inform that we missed referencing the following sentence from the paper written by Haghdoost et al. (2011) (2): “It is suggested that by 2014 about 106000 individuals in Iran will be living with HIV infection and there are estimated to be approximately 7,000 new cases annually.” We contacted the publisher of this journal with email and telephone contacts to add the missed reference to the article, however it was impossible as the article was recently published. Authors very much apologize authors of this paper and also the Health Scope journal for this discomfort.

Background: The presence of excess ammonia nitrogen in aqueous environments has caused various problems such as eutrophication, oxygen depletion and aquatic toxicity. Hence, it is necessary to have special consideration in the discharge of ammonia to environment. Objectives: The aim of this study was to study kinetic of ammonia degasification at a short-time (6 hours) with relatively constant pH and temperature. Materials and Methods: Ammonia degassing was carried out using a diffused air stripper. The unit consisted of 1 L cylindrical column with dimension of 30 × 8 cm. The flow rate was set at 2 L/minute at 6 hours. The operating parameters such as ammonia, nitrate, nitrite, electrical conductivity (EC), the oxidation-reduction potential (ORP), and pH were analyzed according to standard methods. Results: According to obtained results, the maximum removal efficiencies were determined 17%, 35.5%, 31%, 66%, and 85.5%, for 50, 100, 200, 500 and 1000 mg/L ammonia concentrations, respectively. A first-order kinetic model was adopted to represent the ammonia degassing. Conclusions: The ammonia degassing is a simple and suitable technology for ammonia removal at high concentration. Undesirable removal efficiency (17%, 35.5% and 31%) can be occurred in suitable pH 11 in the presence of lower ammonia concentrations (50, 100 and 200 mg/L).