جستجوی مقالات مرتبط با کلیدواژه "Risk assessment" در نشریات گروه "پزشکی"

The interaction of household waste with many waste materials that are now used in various forms in industries and residential homes, and their lack of separation, has doubled the problems of garbage collection and disposal. This study aimed to assess the environmental risks associated with dry solid waste separation at a designated hall in District 10 of Karaj, Iran, utilizing the Failure Mode and Effects Analysis (FMEA) method.

The FMEA method was employed to identify and evaluate potential environmental hazards, including soil and groundwater pollution, air pollution, noise pollution, and reduced fuel resources. Risk Priority Numbers (RPNs) were calculated for each hazard based on severity, occurrence, and detectability.

The results indicated that soil pollution from salon washwater (RPN 504), air pollution from burning dry waste (RPN 441), and groundwater pollution from salon washwater (RPN 448) posed the highest risks. Other significant risks included soil pollution from spraying (RPN 288), groundwater pollution from pesticide spraying (RPN 294), and reduced fuel resources (RPN 280).

The findings emphasize the need for critical control measures, such as installing a standard septic tank, prohibiting the burning of waste, improving the hall's flooring and drainage system, and implementing proper waste disposal and disinfection practices. This study underscores the importance of a comprehensive risk assessment approach for effective waste management and environmental protection in urban areas.

Heart rate variability (HRV) is known to play a significant role in predicting poor prognosis after acute myocardial infarction. Nonetheless, its potential for predicting long-term adverse outcomes following revascularization procedures remains unclear. This study aims to elucidate this relationship.

This prospective cohort study included 258 consecutive patients undergoing elective isolated coronary artery bypass grafting (CABG). All patients required ICU referral before hospital discharge. A 3-week cardiac rehabilitation program with 24-hour ECG Holter monitoring was planned for all patients. HRV was analyzed by computer and manually over-read. During a follow-up period ranging from 1 to 3 years, patients were contacted via phone to assess long-term outcomes, including death and major adverse cardiovascular events (MACE), such as myocardial infarction, reoperation, or brain stroke.

Out of 258 patients (177 males and 81 females) with an average age of 58.80±9.60 years, 4.3% of patients died due to cardiovascular events, and 15.1% experienced long-term MACE. A comparison of HRV indicators between the non-surviving and surviving subgroups revealed significantly lower mean RR, mean standard deviation of normal-to-normal HRV interval (SDNN), and low and high-frequency values in the former group. However, when comparing HRV indicators between the subgroups with and without long-term MACE, no significant differences were observed. Cox proportional hazard analysis demonstrated that decreased HRV (SDNN) effectively predicted long-term mortality in patients who underwent CABG.

Lower postoperative HRV serves as a valuable predictor of long-term mortality after CABG in ICU patients, with reduced SDNN values particularly relevant for anticipating long-term adverse events.

This study aimed to update the current consumption database for dietary exposure assessment based on the 2019 browser version of FoodEx2 – the internationally recommended harmonization tool for food code assignment. The updated food consumption database was utilized to estimate the dietary exposure of Filipinos to sulfites, a widely used food additive. A total of 1,541 food items were re-coded using the new FoodEx2 catalog browser. The dietary exposure assessment indicated that Filipinos‟ sulfite exposure varies from 27% to 109% of the Allowable Daily Intake (0.7 mg kg-1) for mean and high-level per capita consumption, respectively. Water-based beverages were the main contributor to sulfite exposure across all ages and gender groups. In general, infants and children were highly exposed to sulfites compared with the adults due to their relatively low average body weight. An internationally harmonized national food consumption database in the Philippines was therefore developed, which can provide detailed food information that can assist in facilitating the national, regional, and international agricultural and food programs of food safety.

One of the main factors in achieving safety management and safety objectives is designing in addition, applying specific risk evaluation techniques. The present study takes this approach to manage the risks related to non-routine activities and hazardous work inOperation and Maintenance (O&M) project inan oilfield. This semi-quantitative and descriptive study was conducted at the Sarvak Azar oil field in Iran in 2023. A combination of the Hazard and Effect Management Process (HEMP) and the Hazard and Risk Prioritization Index (HARPI) are used to assess the risk of activities. Then, to simplify managers' decisions to implement control measures, final risk scores reported based on the Pareto principle. The results show that based on the conventional use of RPN, T11 (Desalters bypassing; 850), has the highest risk, and T1 (PSV installation on the off spec tank; 30) activity has the lowest calculated risk. However, based on the HEMI, T12 (Electrical substation commissioning; 749.7) has the highest calculated risk, and the lowest estimated risk score is associated with T7 (Loading chemical barrels and collecting pallets and empty barrels; 25.5). Furthermore, a survey of the standard deviation of the data shows that among the factors added to the risk assessment, involved people number (Pi), is more influential than other factors. The study showed we could optimize the conventional use of the risk priority number (RPN) with slight modifications. Changes made while maintaining the simplicity and applicability of the method can improve the accuracy of the priority set by the RPN.

The issue of environmental insurance has been raised since the early 1990s and has undergone extensive changes until today. The purpose of this research is to design a model for determining environmental insurance premiums related to maritime losses and pollution resulting from the oil and gas industry.

This study is applied and employs survey methodologies as well as expert panels. In order to analyze the data, SPSS 22 and Expert Choice 11 software were used while hierarchical analysis was used to prioritize the components of the model. The final model was designed based on the Environmental Failure Mode and Effects Analysis method (EFMEA), and its goodness of fit was determined through conformity factor analysis.

The research identified six categories of activities and four major types of accidents associated with the oil and gas industry. Moreover, five environmental aspects were determined. Fire and explosions in facilities, pipelines, and tanks (0.886), Pipeline breakage or corrosion (0.714), Maritime accidents and vessel collisions (0.656), and Operational disruptions in facilities (0.631) were prioritized respectively. The calculated Root Mean Square Error of Approximation (RMSEA) index was 0.068, indicating that the proposed model demonstrates an adequate fit.

Environmental pollution risks could be covered by commercial insurance by relying on international law within domestic, regional, or global insurance policies in compliance with the principles governing such policies.

The risk assessment of research projects provides a valuable approach for designing proper methodology, assuring data reliability, and accurately forecasting the resource requirements. Although X-ray irradiation has been globally recognized as a safe method for blood bag sterilization, it has not replaced gamma irradiation in Iran. To facilitate this replacement, a suitable methodology and the assessment of the intervening factors and the risks involved are required. Therefore, this study aims to evaluate the risks associated with X-ray and gamma irradiation using Failure Mode and Effects Analysis (FMEA) as a preliminary model applied in various scientific centers.

This interventional study uses FMEA to identify the failure modes in six primary processes. Severity (S), occurrence (O), and detection (D) scores were assigned to each failure mode, and their product, the Risk Priority Number (RPN), was calculated to rank the risk levels and compare the failure modes. Control and preventive measures were defined for the failure modes, and the RPN scores were re-evaluated six months later to assess their effectiveness.

Twenty-two failure modes with RPN scores ranging from 24 to 360 were identified and evaluated. Through defining control and preventive measures for all the analyzed failure modes, the overall risk level was reduced from a baseline RPN of 114.36 ± 94.97 to a re-scored RPN of 12.18 ± 7.64. This represents an approximately 89.45% reduction from the baseline. The reduction in RPN was primarily due to the changes in the occurrence and then detection.

FMEA is a robust tool for analyzing and mitigating risks in research projects, enhancing their quality before implementation. By this method, the risks associated with replacing gamma irradiation with X-ray irradiation for blood bags can be identified and controlled, leading to the elimination of irradiation limitations for blood bags nationwide.

Food contamination with mycotoxins is a global concern. Patulin, a mycotoxin secreted by molds, such as Penicillium expansum and Aspergillus clavatus, poses significant health risks. This study aimed to determine the presence of patulin in cow’s milk in Urmia, Iran, and to assess dietary intake of patulin and the associated Hazard Index.

A total of 30 individual cow milk samples were collected during the summer of 2020 from a village near Urmia, Iran. Patulin levels were measured using High Performance Liquid Chromatography-Diode Array. Data was analyzed through SPSS.

Incidence rate of patulin in milk was 43.3%, with the mean of 0.34 µg/L. The Provisional Maximum Tolerable Daily Intake exceeded the estimated dietary intake, which ranged from 0.000063 for adults to 0.00086 µg/L for children. The Hazard Index was below one, indicating no non-carcinogenic health hazards.

Patulin contamination was quantified in milk samples from Urmia, Iran. Given the potential health implications of patulin contamination, it is essential for government authorities and regulatory agencies involved in milk production to monitor mycotoxin residues and implement hazard control measures throughout the food supply chain.

Fournier’s gangrene (FG) is a type of necrotizing fasciitis affecting the external genitalia or perineum. The Geriatric Nutritional Risk Index (GNRI) has been reported as a prognostic factor to evaluate the outcomes of various diseases. This study aimed to investigate the utility of GNRI in predicting the mortality of FG patients.

This retrospective cross-sectional study evaluated the patients admitted to a referral hospital, during 14 years, with diagnosis of FG. The role of GNRI in predicting the mortality of these patients was studied. To further investigate the relationship of the GNRI score with patients’ prognosis, we controlled for the scores of Fournier’s Gangrene Severity Index (FGSI) and Charlson Comorbidity Index (CCI).

78 patients with the mean age of 60.79 ± 13.76 (range: 24 -85) years were included in the study (89.74% male). The mortality rate in this series was 23 (29.5%) cases. The survived cases had significantly higher GNRI score (p < 0.001), higher Albumin level (p < 0.001), higher weight (p = 0.04), and lower mortality risk based on FGSI score (p < 0.001). In patients with low mortality risk according to FGSI score (p = 0.036) and mild comorbidities based on CCI score (p = 0.030), the association between GNRI and final prognosis was significant. In contrast, in patients with high mortality risk according to FGSI score (p =0.074) and moderate (p = 0.118) and severe (p = 0.215) comorbidities by CCI score this association was not significant. The independent predictors of mortality in FG patients were GNRI score (OR: 1.242, 95%CI: 1.08, 1.41; p =0.001) and FGSI score (OR: 54.614, 95%CI: 6.89, 432.31; p < 0.001). The area under the receiver operating characteristic (ROC) curve of GNRI score in predicting themortality of FG patients was 0.84 (95%CI: 0.75 - 0.93). The sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, and negative likelihood ratio of GNRI score at the optimal cut-off point (78.5) were, 80%, 77.9%, 60.6%, 90.4%, 3.69, and 0.255 respectively.

Our findings indicate that among patients withmild FG, as assessed by FGSI score, and those with low comorbidities based on CCI score, the GNRI score in survivors was significantly higher than that in non-survived. Additionally, multivariate regression analysis demonstrated that the GNRI score serves as an independent predictor of patient outcomes.

Socio-technical systems are inherently complex, non-linear, uncertain, and dynamic. The complexity of the relationships between the components of these systems is unfathomable, and it is very difficult to predict, model, and analyze their components. In such systems, safety is not a linear and direct process. Thus, the purpose of this study was to identify emerging risks using the Functional Resonance Analysis Method (FRAM), which can provide a new perspective in completing traditional risk analysis methods.

The study analyzed the air separation unit process in a steel industry for performance resonance by collecting data through field studies and expert opinions. Using the FRAM method, risks associated with the unit process were evaluated and analyzed.

Ten essential functions of the system were identified. The results revealed that the two functions of "air compression" and "distribution and storage" had high variability, and a high resonance was observed in these two functions. The other functions also indicated moderate and low variability.

The study identified ten essential functions in an air separation unit, with “air compression,” “distribution,” and “storage” showing high variability and resonance. Improving their consistency and reliability could benefit the system. Other functions had moderate to low variability. Future work should focus on optimizing all functions, especially those with high variability, to address tight interactions and resonance issues. The analysis offers a functional map for targeted system improvements.

High blood pressure is a serious medical condition. Medical adherence is crucial to prevent complications. This study aimed to investigate the impact of a cardiovascular risk assessment and an educational intervention based on the Health Belief Model on medical adherence among hypertensive patients.

This semi-experimental study was conducted in three groups included risk assessment &education group, risk assessment group, and control group. Forty patients entered in each group. Patients’ risk assessment in two interventional groups were individually evaluated with using the Framingham model and the type of risk (low, moderate, or high risk) were interpreted for increasing perceived susceptibility and intervention personalizing. Also, the patients in risk assessment & education group received an educational booklet based on HBM constructs. All groups completed questionnaires included knowledge, HBM constructs, Moriski's medication adherence questionnaire, and treatment compliance (ratio of consumed to prescribed drugs) at the beginning and three months later. Data were analyzed using SPSS software version26.

The three groups were similar in terms of demographic variables. Comparing the groups over time indicated that the patients in risk assessment&education group had significant improvements in all constructs of the Health Belief Model. In contrast, the risk assessment group demonstrated improvements only in perceived barriers, perceived benefits, perceived self-efficacy, and awareness. Both interventional groups exhibited increased treatment compliance and medical adherence.

The study findings demonstrated that the integrated educational and risk assessment intervention was more effective in improving awareness and enhancing the constructs of the Health Belief Model compared to risk assessment alone.

The growing use of treated wastewater in farming has raised concerns about the potential impacts on public health.

This study assessed the levels of the heavy metals lead (Pb), cadmium (Cd), and arsenic (As) in plants watered in greenhouse settings using both well water and synthetic wastewater. Synthetic wastewater with As at concentrations of 0.1, 0.2, and 0.4 mg/L, Pb at 1, 3, and 5 mg/L, and Cd at 0.01, 0.03, and 0.05 mg/L, as well as well water were used to irrigate radish, coriander, and grass. In the end, 144 vegetable samples were gathered, and inductively coupled plasma-optical emission spectrometry (ICP-OES) was used to determine the heavy metal concentrations in the samples. Risk assessment for consumers was determined based on the measured levels of heavy metals in the vegetables.

Even though the concentrations of heavy metals in the wastewater were within the limits for irrigation, the risk assessment showed that consumption of vegetables irrigated with treatment wastewater could pose risks to individuals’ health. The maximum concentration of Pb in radish leaves was observed at the Pb concentration of 5 mg/L, and the maximum concentration of As in cress irrigated with As effluent at the As concentration of 0.02 mg/L.

The consumption of vegetables containing Pb can pose a significant non-carcinogenic risk to consumers. However, well water may also be dangerous in the long run. Therefore, it is important to ensure about food safety when using treated wastewater for irrigation.

Various tools and methods are available to assess the risk of musculoskeletal injuries in occupational settings, each considering different assessment criteria. While these methods have been previously studied, further comparative investigations are still needed.

This study aimed to assess the risk of musculoskeletal disorders (MSDs) in workers performing various tasks using different ergonomic and biomechanical risk assessment tools and to compare the outcomes of these tools.

This analytical and cross-sectional study was conducted in a sector of the SAIPA Automobile Part Manufacturing Factory in Iran. A total of 33 workers engaged in lifting, grinding, pushing, and lowering activities participated. Lifting activities involved handling parts weighing 36, 7.9, and 3.4 kg at three workstations. In total, six tasks were examined, and workers' discomfort levels were evaluated using the Cornell Musculoskeletal Discomfort Questionnaires (CMDQ). Fourteen biomechanical and ergonomic risk assessment tools were utilized and compared. Kendall's tau-b correlation coefficient and Cohen's kappa agreement coefficient were applied to determine relationships between different tools and to match the measurement of risk levels, respectively. Additionally, the mean and standard deviation of the data were calculated.

There was a high positive correlation between the outcomes of three biomechanical tools [3D static strength prediction program TM (3DSSPP), hand-calculation back compressive force (HCBCF), and JACK], with 3DSSPP and HCBCF being interchangeable for estimating lumbar spine loads. Ergonomic assessment tools showed a suitable correlation in assessing load-carrying tasks. Manual handling assessment charts (MAC) had perfect agreement with National Institute for Occupational Safety and Health (NIOSH), and SNOOK with Washington Industrial Safety and Health Act (WISHA). Among body posture evaluation methods, rapid upper limb assessment (RULA) and rapid entire body assessment (REBA) had the highest correlation. Lifting fatigue failure tool (LiFFT) correlated well with manual handling methods, and survival chance correlated better with body posture evaluation methods. Lowering activities were identified as the most hazardous.

Ease of use and accuracy are key considerations when selecting biomechanical risk assessment tools. Experienced assessors can effectively utilize JACK, 3DSSPP, and HCBCF. The MAC and NIOSH, as well as RULA and REBA tools, are interchangeable. Selecting appropriate tools requires consideration of their limitations and advantages.

Dental caries is a serious public health problem significantly affecting oral health. Though there have been many advancements in treating dental caries, complete prevention of dental caries is still beyond reach. Several risk factors are associated with caries formation and progression. Previous studies have been conducted on dental caries and the efficiency of diagnosis using subjective and objective methodologies. Hence, this study was conducted to assess the contradictions in results of subjective and objective interpretations. A descriptive study was carried out in the clinical setting of rural areas near Chengalpattu. Using convenience sampling, 285 samples were collected according to inclusion and exclusion criteria within the age range of 7–20 years. The subjects were selected from the Outpatient Department of Karpaga Vinayaka Institute of Dental Sciences. . American Dental Association (ADA) questionnaires were used for subjective caries risk assessment, unstimulated salivary samples were collected to measure salivary pH for objective caries risk assessment, and DMFT and def indices were measured for reference. After data collection, statistical analysis was performed using SPSS version 22. Chi-square and Pearson correlation tests were performed to find the statistical differences, and a correlation was found between subjective and objective assessment results. In this study, the correlation between objective risk assessment based on salivary pH and actual caries status was slightly better (r = 0.159) than other risk assessment methods (r = 0.050). Moreover, a negative correlation was found between subjective and objective caries risk assessment (r = - 0.062). The study findings show a negative correlation between subjective and objective assessment. Objective caries risk assessment using salivary pH was positively correlated with actual caries status.

Nitrate (NO3) is a necessary element for plant growth, but its excessive use in agricultural products causes different health problems. This study aimed to investigate the relationship between NO3 concentrations in vegetables and the prevalence of gastrointestinal cancers in Minab city, Iran.

This case-control study was conducted on 60 people with cancer as the case group and 120 healthy people as the control group in Minab city. Data were collected through a questionnaire and measuring NO3 concentration levels in vegetables. All samples were examined for NO3 by reverse-phase HPLC (RP-HPLC) method.

The concentration levels of NO3 in all vegetables ranged from 15.08 (onion) to 1143.55 mg/kg (spinach). There was no significant difference between the concentrations of NO3 in all vegetables among the different regions. The most common cancer in the case group was stomach cancer (61.7%). There was a significant difference between the amount of daily intake of NO3, through different vegetables, and the prevalence of gastrointestinal cancer between the case and control groups (P < 0.05). The results showed that increasing the consumption of vegetables increases the chance of getting gastrointestinal cancer (OR: 5.72; P < 0.001).

According to the results, there is a significant relationship between the NO3 concentration in vegetables and the prevalence of gastrointestinal cancers in the studied areas. It is highly recommended to closely monitor the cultivation, fertilization, and spray process of agricultural products, and frequent monitoring of NO3 levels in fruits and vegetables.