مجله دانشکده بهداشت و انستیتو تحقیقات بهداشتی
سال شانزدهم شماره 4 (پیاپی 64، زمستان 1397)

Condom use in extramarital sexual relations is a major tool, protecting the two partners against venereal diseases. Therefore, it is essential to investigate this matter. This study aimed to determine the reasons for using and not using the condom by the Iranian youth
in their extramarital sexual relations and the related cultural issues. This was a national cross-sectional survey using multistage sampling in 13 provinces in Iran, including 3246 participants 19-29 years old, conducted in 2014, using a questionnaire to collect data. The proportion of males in the sample was 51% and that of females 49%. On the whole, 19.5% of the participants (31.7% of the males and 6.9% of the females) had had extramarital sex relations. The proportions of the participants with a history of extramarital sex using the condom at every intercourse, almost at every intercourse, sometimes and never were 21.7%, 15.4%, 35.3% and 27.6%, respectively. The reasons for not using the condom regularly were unavailability of the condom, not liking it, its high price, it not being necessary and using other tools. The major reasons for not using the condom had cultural roots or were related to personal and cultural preferences. Encouraging condom use widely would require appropriate cultural policy-making

Drug abuse is a long-standing social and public health problem in Iran. Access to accurate, reliable and up-to-date data related to drug use is essential for planning and policy-making for prevention of, treatment of, and harm reduction related to, drug abuse. The purpose of this study was to access accurate data regarding drug abuse prevalence and substance use in Tehran Province population. This study was a cross-sectional household survey with a sample of 6024 individuals aged 15-64 years residing in Tehran Province. Data on demographic characteristics and drug use during the previous week, month and year and the whole lifetime were collected using a researcher-designed questionnaire. A total of 5646 individuals participated in the study. The lifelong prevalence of cigarette-smoking, hookah-smoking, alcohol consumption and drug use were 21.9%, 26.8%, 12.1% and 7.3%, respectively. The corresponding proportions during the previous week were 12.9%, 10.5%, 1.8% and 2.2%. The prevalence of cigarette-smoking, hookah-smoking, alcohol consumption and drug use is high in Tehran Province. The prevalence of lifelong cigarette and hookah smoking and alcohol consumption is higher, while that of drug use is lower, than the respective national averages.

Burn injuries cause severe devastating losses and early death. Care and treatment of burns patients is very costly. The purpose of this study was to calculate the economic burden of care and treatment of burn injuries in a hospital in Ahvaz, Iran. This descriptive and cross-sectional study was carried out in 2015 in Taleghani Hospital, Ahvaz, Iran. A total of 315 patients participated in the study. Data was collected, using a valid and reliable questionnaire, through interviews with patients or their relatives on the day of discharge and examining their medical records. Data analysis was done using standard statistical tests and the SPSS (V.22) software. The mean total cost of care and treatment of an inpatient with burns was 117,071,803.00 Iranian Rials (equivalent to US$ 4,063.00), the mean daily cost being 8,501,946.00 Iranian Rials (equivalent to US$ 295.00). Direct medical costs, direct non-medical costs and indirect costs accounted for 94.1%, 1.4% and 4.5% of the total cost, respectively. The patients’ out-of-pocket payment was 7.7% of the total direct costs. Surgery, drug and diagnosis costs accounted for the largest fraction of the total treatment cost. The total cost of care and treatment of burns patients in the hospital is very high, imposed on patients, their relatives, government and health insurance companies. The government and insurance companies should provide financial protection to facilitate the process of care and treatment of burns patients.

In the household appliances industry, due to doing such work operations as manually moving pieces, there is the probability of occurring musculoskeletal disorders and muscle fatigue. Therefore, this study aimed to investigate muscle fatigue and its relationship with the prevalence of musculoskeletal disorders among personnel of a household appliances factory. Data were collected and analyzed using descriptive statistical and logistic regression tests. This descriptive-analytical and cross-sectional study, including 150 employees of a household appliances factory, was conducted in 2016. Data about the prevalence of musculoskeletal disorders and muscle fatigue were collected using a standard Nordic and muscle fatigue assessment (MFA) questionnaire, respectively, and analyzed using the logistic regression test. The prevalence of musculoskeletal disorders in the lumbar region, knees and neck was 33.3%, 25.3%, and 21.3%, respectively. In addition, the results of MFA showed that reduction of the risk of muscle fatigue in the shoulders, wrists and arms needs corrective action as a top priority in 28.7%, 28%, and 26.7% of the employees, respectively. Statistical analysis showed no significant relationship between muscle fatigue and the frequency of musculoskeletal disorders. Considering disorders in the lumbar region and risk of fatigue in the shoulder region, the risk can be reduced by proper corrective actions, such as increasing the height of pallets, using tables with adjustable heights, and layout of the parts in a normal access range.

Congenital hypothyroidism is the most common metabolic disease and endocrine disorder in children and a major cause of mental retardation, which can be prevented only through early diagnosis and treatment. This study aimed to determine the prevalence of congenital hypothyroidism in newborns referred to Shahid-Ghodsi Health Center in Mashhad, Iran. This cross-sectional study, including 4484 newborns referred to Shahid-Ghodsi Health Center for congenital hypothyroidism screening, was conducted during the first six months of 2015. Data were collected from the screening forms and analyzed using the statistical software SPSS 21, the tests being the two-sample T-test, analysis of variance, Chi-square and Fisher's exact tests; in all the tests the significance level was 5%. Of the 4484 neonates screened, 51% and 48% were males and females, respectively. The recall rate was estimated to be 2.6% and prevalence of the disease 1 in 370 neonates. There were statistically significant associations between hypothyroidism on the one hand and birthweight, type of feeding (nutrition), primary and serum TSH levels of the neonate on the other. Based on the findings, the prevalence of congenital hypothyroidism in Mashhad is significantly higher than that national and global averages. It is essential to conduct more comprehensive research to determine the associated factors and design suitable interventions in order to prevent the disease.

Heavy metals in the surface soils of cities from various sources (traffic, industrial emissions, erosion from buildings, etc.) can accumulate through inhalation, ingestion and dermal contact in the human body and imperil health. The purpose of this study was to assess the ecological and human health risks caused by some heavy metals in roadside soil at the intersections of Ahvaz (Modares, Kharchar, Zargan, Behbahani, Golestan, Abadan, Khorramshahr, Susangerd and Andimeshk). In this study, the concentration of heavy metals in roadside surface soils in intersections of Ahvaz in the summer of 2016 was investigated. The sampling at each intersection was carried out at specified intervals of 1, 10 and 30 meters on the sides of the main road (6 samples from each intersection) from the surface soil (depth 0 to 20 cm); the total number of samples was 54. The samples were transferred to the laboratory and dried at 60 ° C in an oven. After digestion of the samples with an acid mixture, concentrations of heavy metals Zn, Pb, Ni, Cu, Cr, Cd and As were measured by inductive coupled plasma-mass spectrometry (ICP-MS). The contamination level was estimated based on potential ecological and human health risks of heavy metals. The average concentrations of Zn, Pb, Ni, Cu, Cr, Cd and As were 116.61 ± 49.42, 284.02 ± 166.91, 25.53 ± 4.47, 220.63 ± 87.75, 137.21 ± 84.80, 3.44 ± 3.23 and 8.65 ± 3.8 mg/kg, respectively. Isotope ratios indicated that emissions from automobiles/traffic and industrial emissions were the most important sources of lead in the samples studied. The average value of potential ecological risk (RI) in Andimeshk, Golestan and Susangerd intersections was low; that in Modarres, Behbahani and Zergan intersections was medium; and that in Chaharsir, Abadan and Khorramshahr intersections was high. Cr poses the highest risk of cancer in both children and adults, although the risk of carcinogenesis in children is higher than in adults. The results show that the source of contamination with the metals studied is anthropogenic, including road traffic and industrial activities, in the area investigated.

Distracted driving, specifically cell phone use while driving, has been found to be responsible for traffic accidents and road casualties throughout the world annually. The aim of this observational study was to determine the frequency of drivers' engagement in hazardous secondary activities on Mashhad urban roads, particularly cell phone use. This was a 3-month cross-sectional study. Data on drivers’ secondary task management on 17 randomly selected sites and 42 arterial and collector roads were obtained from Mashhad Traffic and Transportation Organization records and analyzed using the Pearson's chi-squared test. The rate of cell phone use was 5.27%, the most widely observed related task being handheld conversation (3.15%) followed by texting (1.83%) and hands-free use (0.28%). In addition, 1.75% of the drivers were engaged in other risky tasks such as eating, drinking beverages and smoking. Distracted female drivers and drivers aged 26-35 years were significantly more likely to be engaging in cell phone use, while drivers under 26 years old were the dominant group as regards texting. Further analysis of the data showed significant differences between male and female drivers as regards as behaviors while driving. Based on the findings it is concluded that there are serious problems related to drivers’ secondary activities while driving. Raising public awareness, educational interventions, law enforcement and tougher legislation will certainly minimize deaths due to car accidents, as well as financial and social damage, due to drivers’ distraction, in line with achieving a safe social environment.

Ticks are external parasites that can be vectors of several disease agents. This survey was carried out to determine distribution and biological diversity of hard tick species in Maraveh Tapeh County, Golestan Province, Iran in spring 2016. In 10 selected villages in the study area, about 29 cattle, 99 sheep, 62 goats and 11 camels were inspected for tick infestation. The ticks isolated were preserved in a solution of 70% alcohol and identified. The Margalef, Shannon-Wiener, Simpson and Evenness indices were used to measure the biodiversity. A total of 476 ticks were collected. Two hard tick genera (Hyalomma and Rhipicephalus) and twelve species were identified including Hyalomma anatolicum, Hy. scupense, Hy. aegyptium, Hy. marginatum, Hy. dromedarii, Hy. rufipes, Hy. asiaticum, Hy. excavatum, Hy. detritum, Rhipicephalus turanicus, R. bursa and R. sanguineus. Further analysis of the data showed that R. sanguineus and Hy. asiaticum were the most abundant species in the whole area and plateau areas, respectively, while R. sanguineus was most abundant in both hillside and mountainous areas. Based on the Margalef index, the species diversity was higher in foothill areas and it was lower in the goat host than other hosts, while based on the Shannon-Wiener index, the species diversity was higher in plateau areas and in the sheep host it was less than in other hosts. Ticks population dynamic studies and calculating their biodiversity indices are helpful in understanding the situation of vectors and the future situation of vector-borne diseases.