The Effect of Electromagnetic Waves on the General Health of Zahedan Gas Power Plant Personnel بررسی تاثیر امواج الکترمغناطیسی بر سلامت عمومی پرسنل نیروگاه گازی زاهدان 2 1 چکیده مقدمه: با پیشرفت روزافزون تکنولوژی و افزایش کاربرد نیروهای برق فشار قوی در محیط های صنعتی، نگرانی ها نیز درباره ی اثرات مخرب امواج الکترومغناطیس بر سلامت انسان افزایش یافته است. لذا مطالعه حاضر قصد دارد تاثیر امواج الکترومغناطیس را بر سلامت عمومی پرسنل نیروگاه گازی زاهدان مورد بررسی قرار دهد. روش کار: این مطالعه از نوع توصیفی-تحلیلی مقطعی است که در یک نقطه زمانی وضعیت سلامتی افراد را تعیین و میزان مواجهه آنها را با امواج الکترومغناطیسی در همان زمان مشخص می کند. ابزار جمع آوری اطلاعات در این پژوهش، پرسشنامه سلامت عمومی 28 سوالی (GHQ-28) بود. پس از اندازه گیری امواج الکترومغناطیسی در فواصل 1، 5/1 و 3 متر در پست های فشار قوی و استخراج داده ها، اطلاعات وارد نرم افزار SPSS گردیده و با استفاده از آزمون های آماری توصیفی، تی تست و کای اسکوار تجزیه و تحلیل شد. یافته ها: در این مطالعه، متغیرهای سن و سابقه کاری در دو گروه اختلاف معنی داری نداشتند (p>0.05). بیشترین میزان میدان های مغناطیسی در پست های فشار قوی در فاصله 1 متری مربوط به پست خط 607، (mG1/28)و در واحدهای کاری بخش ابزار دقیق (mG03/7) بود. نتایج نشان داد که بعد علایم افسردگی و سلامت عمومی کل در بین دو گروه مواجهه دار و عدم مواجهه دارای اختلاف معنی دار بوده است(p=0.04) در حالی که در ابعاد عملکرد جسمانی، اضطراب و عملکرد اجتماعی اختلاف معنی دار نبود(p>0.05). نتیجه گیری: علیرغم پایین تر بودن میزان مواجهه شغلی کارکنان از حد مجاز کشوری، با توجه به معنی داری سلامت عمومی کل و بعد افسردگی در دو گروه می بایست تحقیقات بیشتری انجام گیرد. همچنین می توان با کاهش مدت زمان مواجهه و افزایش آگاهی افراد گام مهمی در جهت کاهش پرتوگیری افراد و کاهش عوارض حاصله از آن برداشت. 2 Abstract Introduction: With ever improving technology and increasing the use of high voltage power in industrial environments, concerns about the destructive effects of electromagnetic waves on human health have increased. Thus the present study aims to evaluate the effects of electromagnetic waves on the general health of Zahedan gas power plant personnel. Materials & Method: The present case-control study investigated the health of people at one point of time and their amount of exposure to electromagnetic waves at the same time. The data collection tool in this study was 28-item general health questionnaire (GHQ-28). After measuring the electromagnetic waves at distances of 1, 1.5 and 3 meters at high voltage power substations and data extraction, the data were entered to SPSS software and analyzed by descriptive statistics, t-test and chi-square. Results: In this study, the age and experience variables were not significantly different in two groups (p> 0.05). The highest magnetic fields in high voltage power substations was at a distance of 1 meter in the substation 607 (28/1 mG) and in precision tool work units (7.03 mG). The results showed that the depressive and general health symptoms were significantly different between the exposed and unexposed groups (p = 0.04), however the difference was not significant in terms of physical performance, anxiety and social performance (p> 0.05). Conclusion: although the level of exposure was lower than standard level determined in Iran, the significant difference of the general health and depression between the two groups, explains the necessity of conducting more studies in this regard. Also by reducing the exposure time and increasing people’s awareness it is possible to take important steps to reduce exposure and complications. 149 157 2016/03/17 1394/12/27 2016/06/7 1395/3/18 فریدون لعل Fereydoon Laal Faculty member, Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran fereydoonlaal@gmail.com الهام احمدی Elham Ahmadi Birjand University, Birjand, Iran. رویا اربابی Roya Arbabi Zahedan University of Medical Sciences, Zahedan, Iran. مهدی محمدی Mahdi Mohammadi Faculty member, Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran نسیمه جمیل Nasimeh Jamil Zahedan University of Medical Sciences, Zahedan, Iran. Eectromagnetic Waves General Health Power Plant Power Substation امواج الکترومغناطیس سلامت عمومی نیروگاه پست برق 1. Barregard L, Jarvholm B, Ungthum E. Cancer Among Workers Exposed to Strong Static Magnetic Fields. The Lancet, 1985;(19), 892.##2. Parvari K, Nabiuni M, Golestanian N, et al. Effect of low frequency electromagnetic fields. Journal of Cell & Tissue. 2011;2(1): 47-56.##3. Mansourian M, Mohammad S, Firoozabadi P, et al. Magnetic fields with frequency of 217 Hz can reduce cell apoptosis caused by electro chemo-therapy. Electromagnetic biology and medicine 2013; 32:70-8.##4. Vena JE, Freudenheim JL, Marshall JR, et al. Risk of premenopausal breast cancer and use of electric blankets. American Journal of Epidemiology. 1994;140(11):9749.##5. Gamberala F, Scand J. Physiological and psychological effects of exposure to extremely low-frequency electric and magnetic fields on humans. Work, environment, health. 1990;1(16 Suppl):51-4##6. Pearce NE, Conroy DM, Henning MA, et al. Psychological effects of chronic exposure to 50 Hz magnetic fields in humans living near extra-high-voltage transmission lines. Bio electromagnetics, 2001;18(8):584-94##7. Wijngaarden EV, Savitz DA, Kleckner RC, et al. Exposure to electromagnetic fields and suicide among electric utility workers. Occupational and environmental medicine. 2000; 57(4):258-63##8. Zamanian Z, KhajeNasiri F, Gharepoor S, et al. Evaluate the effect of ultra-low-frequency magnetic fields on the status of mental health staff employed in gas power plant in Shiraz, Iran Occupational Health, 2008;7(3), 25-31. [Persian].##9. Goldberg DP, Hillier VF. A scaled version of the General Health Questionnaire. Psychological medicine, 1979;9(01), 139-145.‌##10. Taghavi MR. Check validity and reliability of General health Questionnaire, Journal of Psychology, 2001; 381-398. [Persian].##11. Holaday industries. ELF Survey meter user's manual. USA: Holaday Industries; Available from: http://www.etslindgren.com/specs/HI-3604##12. American Conference of Governmental Industrial Hygienists (ACGIH). Threshold limits value for chemical substances and physical agents and biological exposure indices. ACGIH WORLDWIDE 2005.##13. Institute of Standard and Industrial research of Iran, Electromagnetic Radiation and Fields, Threshold Limit Values, Extremely Low Frequency, 2006, 280/13,8567.[Persian].##14. National Institute of Environmental Health Sciences. Electric and magnetic fields associated with the use of electric power, 2002; NIEHS/DOE EMF RAPID Program. ##15. De Vocht F, Van Drooge H, Engels H, et al. Exposure, Health Complaints and Cognitive Performance among Employees of an MRI Scanners Manufacturing Department. Journal of Magnetic Resonance Imaging 2006;23: 197–204.##16. Franco G, Perduri R, Murolo A. Health effects of occupational exposure to static magnetic fields used in magnetic resonance imaging: a review. La Medicina del lavoro. 2008; 99(1):16-28.##17. Chakeres DW, De Vocht F. Static magnetic field effects on human subjects related to magnetic resonance imaging systems. Progress in biophysics and molecular biology. 2005; 87(3):255–65.##18. Touitou Y, Lambrozo J, Oise Camus, et al. Magnetic fields and the melatonin hypothesis: a study of workers chronically exposed to 50-Hz magnetic fields. American journal of physiology. Regulatory, integrative and comparative physiology. 2003; 284:1529-1535.##19. International Commission on NonIonizing Radiation Protection(ICNIRP), Guidelines for limiting exposure to timevarying electric, magnetic and electromagnetic fields(up to 300GHz). Health Physics. 1998; 74(4):494523.##20. IARC Working Group on the Evaluation of Carcinogenic Risks to Humans. Nonionizing radiation, Part 1: static and extremely low frequency (ELF) electric and magnetic fields. IARC monographs on the evaluation of carcinogenic risks to humans. 2002;80:1395.##21. Karpowicz J, Gryz K. Health Risk Assessment of Occupational Exposure to a Magnetic Field from Magnetic Resonance Imaging Devices. International Journal of Occupational Safety and Ergonomics (JOSE) 2006; 12(2): 155–167.##22. Martin L. ELF magnetic in a city environment. Bio electromagnetics. 2001; 22(2):87-90.##23. Korpinen LH, Paakkonen RJ. Occupational exposure to electric and magnetic fields during work tasks at 110 kV substations in the Tampere region. Bio electromagnetics. 2010;31(3):252-4.## ##

Epidemiological Pattern and Mortality Rate Trend of Road Traffic Injuries in Kermanshah Province (2009-2014) میزان و الگوی اپیدمیولوژیک مرگ و میر ناشی از سوانح ترافیکی در استان کرمانشاه طی سال های 93-1388 2 1 چکیده مقدمه : از جمله مهم ترین و قابل توجه ترین خطراتی که زندگی افراد را در کشورهای مختلف جهان تهدید می کند، افزایش سوانح ترافیکی است. مطالعه حاضر با هدف تعیین میزان و الگوی اپیدمیولوژیک مرگ و میر ناشی از سوانح ترافیکی انجام گردید. روش کار: در این مطالعه مقطعی از اطلاعات مربوط به موارد مرگ ناشی از سوانح ترافیکی پزشکی قانونی استان کرمانشاه، طی یک دوره 6 ساله و به صورت سرشماری استفاده گردید. طبقه بندی افراد براساس علت خارجی مرگ با استفاده از کدهای دهمین طبقه بندی بین المللی بیماری ها صورت گرفت. جمعیت استان نیز برای سال های مختلف از استانداری کرمانشاه بدست آمد. تجزیه و تحلیل داده ها با استفاده از نرم افزار Stata 11انجام شد. برای بررسی روند مرگ و میر و معنی داری آن از رگرسیون دو جمله ای منفی استفاده شد. نتایج : میانگین سنی 3231 فرد فوت شده در اثر تصادف، 27/21± 83/39 سال بود. 4/78% (2534 نفر) از افراد مرد و بقیه زن بودند. علت نهایی فوت در بیشتر فوت شدگان ضربه به سر بود (6/71%). بیشترین علت خارجی مرگ در تصادف خودروهای سواری بدست آمد. میانگین 6 ساله میزان مرگ و میر ناشی از سوانح ترافیکی در استان کرمانشاه 8/27 مرگ در هر صدهزار نفر بدست آمد. میزان مرگ و میر ناشی از سوانح ترافیکی در استان کرمانشاه از 13/33 به 5/22 در هر صدهزار کاهش یافته و به ازای هر واحد افزایش در سال، میزان مرگ و میر بطور متوسط 6% کاهش می یابد ( 002/0- ,11/0- CI: ;06/0- β=). نتیجه گیری : با توجه به نتایج و علی رغم کاهش میزان مرگ و میر ناشی از سوانح ترافیکی در چند سال اخیر هنوز نسبت به کشورهای دیگر در حد بالایی قرار دارد، بنابراین در این حوزه کشور به بازنگری، تغییر و تحولات جدی نیاز دارد. 2 Abstract Introduction: The increasing rate of road traffic injuries have turned into a noticeable and critical danger threatening lives of people in different countries around the world. This study is done to determine epidemiological pattern and mortality rate trend of road traffic injuries. Methodology: In this cross-sectional study, the epidemiological pattern of mortality related to road traffic injury was determined in a 6-year-period data gathering by Kermanshah Forensic Medicine Center’s census. The external cause of death was classified using ICD-10 codes. The population of Kermanshah was provided by the Governor General’s Office. Data were then analyzed using Stata 11 software. To examine the mortality trend and its significance, the negative binomial regression was utilized. Results: The average age of 3231 death cases of road traffic injuries was 39.83±21.27and 78.4% of the subjects were males. The most important cause of death was head concussion (71.6%). The highest number of external causes was related to cars/van crashes. The mean mortality rate of road traffic injuries in Kermanshah province in this 6-year period was 27.81 deaths per hundred thousand people. The rate of mortality due to road traffic in Kermanshah has decreased from 33.13 to 22.58 cases per hundred thousand people and mortality rate decreases by 6% on average in proportion to every unit of increase in year (β= -0.06; CI: -0.11, -0.002). Conclusion: According to the results and despite the decrease in traffic injuries' mortality in recent years, this rate is still higher than that of other countries; therefore, this area of interest should be reviewed, changed, and even revolutionized. 158 168 2016/03/172016/08/29 1395/6/8 2016/06/72016/08/29 1395/6/8 ندا ایزدی Neda Izadi HSR Unit of Treatment Deputy, Kermanshah University of Medical Sciences, Kermanshah, Iran ملیحه خرم داد Maliheh KhoramDad Noncommunicable Diseases Unit of Health Deputy, Kermanshah University of Medical Sciences, Kermanshah, Iran m.khoramdad@yahoo.com پرستو جمشیدی Parastoo Jamshidi Faculty of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran علیرضا زنگنه Ali Reza Zanganeh Social Development and Health Promotion Center, Kermanshah University of Medical Sciences, Kermanshah, Iran جبار شفیعی Jabbar Shafiei Department of Statistics and Epidemiology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran علی رضا فیروزی Alireza Firouzi Candidate of General Linguistics, Allameh Tabtaba’i University, Tehran, Iran Epidemiological pattern Mortality Road Traffic Injuries الگوی اپیدمیولوژیک مرگ و میر سوانح ترافیکی 1. Hashemi Nazari S, Kazemian M, Hosseini F. Trend of Five Years Traffic Accident Mortality in Khuzestan Province (2006-2010). Legal Medicine Journal. 2011;17(2):123-29 [Persian]. Available from :http://en. journals.sid.ir/ViewPaper.aspx?ID=285222.##2. Maracy MR, Tabar Isfahani M. The Burden of Road Traffic Injuries in Isfahan, Iran in 2010. Journal of Kerman University of Medical Sciences. 2013;20(5):505-19 [Persian]. Available from : http://www. kmusjournal.ir/english/abstract.asp?articleID=4575.##3. Sim T, Ng K. Childhood injuries: prevention is always better than cure. Singapore Medical J. 2005;46(3): 103-5.##4. World Health Organization. Injuries and Violences: the Facts. Geneva, Switzerland: World Health Organization; 2010. Available from : http://apps.who.int/iris/bitstream/10665/44288/1/9789241599375_ eng.pdf.##5. World Health Organization. Global Status report on Road Safety 2013. Available from : http://www. who.int/violence_injury_prevention/road_safety_status/2013/en/. Accessed Feb 1,2016.##6. Yazdani J, Ahmadi E, Ghadami M. Classification map of registered deaths due to truck accidents in Mazandaran Province (2007-2010). Journal of Mazandaran University Medical Sciences. 2012;22(97):50-8 [Persian]. Available from: http://jmums.mazums.ac.ir/article-1-1759-fa.html.##7. Koptis E, Cropper M. Traffic fatalities and economic growth. Accident Annual Prevention. 2005;37 (1):169-78. Available from : http://www.sciencedirect.com/science/article/pii/S0001457504000685.##8. Izadi N, Najafi F, Khosravi A, et al. Estimation of mortality and calculated years of lost life from road traffic injuries. Journal of Mazandaran University Medical Sciences. 2014;24(112):51-8 [Persian]. Available from : http://jmums.mazums.ac.ir/files/site1/user_files_0d0bf0/nedaizadi-A-10-1932-3-c5ac010. pdf.##9. Bahadorimonfared A, Soori H, Mehrabi Y, et al. Trends of fatal road traffic injuries in Iran (2004–2011). PloS one. 2013;8(5):e65198. Available from : http://dx.doi.org/10.1371/journal.pone.0065198.##10. Zhang L, Li Z, Li X, et al. Study on the trend and disease burden of injury deaths in Chinese population, 2004–2010. PloS one. 2014;9(1):e85319. Available from : http://dx.doi.org/10.1371/journal.pone.0085319.##11. World Health Organisation. Racioppi F, Eriksson L, Tingvall C, et al. Preventing road traffic injury: a public health perspective for Europe. 2004. Available from : http://www.euro.who.int/__data/assets/ pdf_file/0003/ 87564/E82659.pdf.##12. Lagarde E. Road traffic injury is an escalating burden in Africa and deserves proportionate research efforts. PLoS Med. 2007;4(6):170. Available from : http://dx.doi.org/10.1371/journal.pmed.0040170.##13. Jha N, Srinivasa D, Roy G, et al. Epidemiological study of road traffic accident cases: A study from South India. Indian J Community Med. 2004;29(1):20-4. Available from : http://medind.nic.in/iaj/t04/i1/iajt04i1 p20o.pdf.##14. Ghosh P. Epidemiological study of the victims of vehicular accidents in Delhi. Journal of the Indian Medical Association. 1992;90(12):309-12. Available from : http://www.ncbi.nlm.nih.gov/pubmed/13040 14.##15. Odero W, Garner P, Zwi A. Road traffic injuries in developing countries: a comprehensive review of epidemiological studies. Tropical Medicine & International Health. 1997;2(5):445-60. Available from : http://www.ncbi.nlm.nih.gov/pubmed/9217700.##16. Orsi C, Bertuccio P, Morandi A, et al. Trends in motor vehicle crash mortality in Europe, 1980–2007. Safety science. 2012;50(4):1009-18. Available from : http://www.sciencedirect.com/science/article/pii/ S0925753511003213.##17. Sadeghian F, Khosravi A, Emamian M, et al. Pattern of traffic accidents and injuries related factors in Shahrood. Payesh. 2008;7(3):225-33 [Persian]. Available from : http://en.journals.sid.ir/ViewPaper.aspx? ID=112098.##18. Taravatmanesh S, Hashemi-Nazari S, Ghadirzadeh M, et al. Epidemiology of fatal traffic injuries in the Sistan and Baluchistan Province in 2011. Journal of Safety Promotion and Injury Prevention. 2015;3(3):161-68 [Persian]. Available from : http://journals.sbmu.ac.ir/en-spip/article/view/10937.##19. Kumar A, Lalwani S, Agrawal D, et al. Fatal road traffic accidents and their relationship with head injuries: An epidemiological survey of five years. The Indian Journal of Neurotrauma. 2008;5(2): 63-7. Available from : http://medind.nic.in/icf/t08/i2/icft08i2p63.pdf.##20. Jha N, Agrawal CS, editors. Epidemiological study of road traffic accident cases. A study from Eastern Nepal. Regional Health Forum WHO South-East Asia Region; 2004 . Available from: http://apps.searo.who.int/pds_docs/B0031.pdf##21. Monsef V, Asadi P, Maleki ziabari S. Mortality due to road traffic injuries in Guilan Province in 2011-2012. Journal of Safety Promotion and Injury Prevention. 2015;3(2):97-102 [Persian].##22. Maracy M, Tabar Isfahani M. The Burden of Road Traffic Injuries in Isfahan, Iran in 2010. Journal of Kerman University of Medical Sciences. 2013;20(5):505-19[Persian].##23. Yousefzadeh S, Dafchahi MA, Maleksari HM, et al. Epidemiology of Injuries and their Causes among Traumatic Patients Admitted into Poursina Hospital, Rasht. J Kermanshah Univ Med Sci. 2007;11(3).##24. Menon A, Pai VK, Rajeev A. Pattern of fatal head injuries due to vehicular accidents in Mangalore. Journal of forensic and legal medicine. 2008;15(2):75-7.##25. Odero W, Khayesi M, Heda P. Road traffic injuries in Kenya: magnitude, causes and status of intervention. Injury control and safety promotion. 2003;10(1-2):53-61.##26. Yates PJ, Williams WH, Harris A, et al. An epidemiological study of head injuries in a UK population attending an emergency department. Journal of Neurology, Neurosurgery & Psychiatry. 2006;77(5):699-701.##27. Khorasani-Zavareh D, Haglund BJ, Mohammadi R, et al. Traffic injury deaths in West Azarbaijan Province of Iran: a cross-sectional interview-based study on victims' characteristics and pre-hospital care. International Journal of Injury Control and Safety Promotion. 2009;16(3):119-26.##28. Monsef V, Asadi P, Maleki Ziabari SM. The Epidemiologic of the Traffic Accidents Helped by EMS, Guilan 2011-2013. 2014;20(2):55-60 [Persian].##29. Chalya PL, Mabula JB, Dass RM, et al. Injury characteristics and outcome of road traffic crash victims at Bugando Medical Centre in Northwestern Tanzania. Journal of trauma management & outcomes. 2012;6(1):1.#### ##

Study of Contamination and Risk Assessment of Heavy Metal in Fish (Otolithes ruber) and Sediments from Persian Gulf بررسی آلودگی و ریسک فلزات سنگین در ماهی شوریده(Otolithes ruber) و رسوبات خلیج فارس 2 1 مقدمه: الودگی فلزات سنگین از جدی ترین مسائل زیست محیطی در سطح جهان است. در تحقیق حاضر غلظت فلزات سنگین در رسوبات و ماهی شوریده (Otolithes ruber) در خلیج فارس مورد مطالعه قرار گرفت. مواد و روش: برای بررسی غلظت فلزات سنگین آهن، سرب، نیکل، روی و کادمیوم در رسوبات و اندام عضله ماهی شوریده هشت ایستگاه در شمال تنگه هرمز (خلیج فارس) انتخاب شد. آماده سازی نمونه ها با استفاده از استاندارد MOOPAM انجام شد. آنالیز غلظت فلزات سنگین با استفاده از طیف سنجی نشری پلاسمای نوری ICP(OES) انجام شد. یافته ها: بررسی ریسک اکولوژیک فلزات سنگین در رسوبات نشان داد که بیشتر ایستگاههای مورد مطالعه در تنگه هرمز دارای ریسک کم می باشند. با توجه به غنی شدگی عناصر کادمیوم، روی، نیکل، سرب و آهن بیشتری غنی سازی به سرب تعلق گرفت. میانگین غنی سازی بدست آمده برای تمام عناصر بین عدم غنی شدگی و غنی سازی متوسط می باشد. نتیجه گیری : میانگین غلظت عناصر سنگین بجز سرب و کادمیوم در قسمت خوراکی ماهی شوریده از مقادیر مجاز پیشنهاد شده توسط استانداردهای NOAA، FAO ، WHO بیشتر نبوده و بنابراین برای مصرف انسانی مناسب می باشد. 2 Introduction: Heavy metal pollution is one of the most serious environmental issues globally.In this research we were studied the heavy metal concentrations in sediment and fish in Persian gulf. Materials & Methods For determination of heavy metal concentrations in sediments 8 sampling stations were selected to measure Cd, Zn, Ni, Pb and Fe in the sediments and in the muscle tissue of Otolithes ruber from the northern part of the Hormuz strait )Persian gulf). Samples for metal analysis are prepared according to MOOPAM. Heavy metal concentrations were analyzed using inductively coupled plasma-optical emission spectrometry (ICP-OES) Results: Analysis of the potential ecological risk of sediment heavy metal concentrations showed that most sample sites in the northern part of the Hormuz strait (Persian Gulf) presented a low ecological risk. Regarding enrichment of Cd, Zn, Ni, Pb and Fe the highest EF belongs to Pb. The obtained mean enrichment factor (EF) values for various metals were between no enrichment and moderate enrichment. Conclusion: The concentrations of heavy metal in the edible part of O. ruber did not exceed the permissible limits proposed by NOAA, FAO and WHO standards and are suitable for human consumption, except for Pb and Cd. 169 181 2016/03/172016/08/292016/03/18 1394/12/28 2016/06/72016/08/292016/06/7 1395/3/18 حبیب جنادله Habib Janadeleh Department of Environmental science, Ahvaz Branch, Islamic Azad University, Ahvaz, Iran habib.janadele@gmail.com صدیقه جهانگیری Sadigheh Jahangiri Department of Environmental management, Islamic Azad University, North Tehran Branch, Tehran, Iran JENADELEH1300@GMAIL.COM Heavy metal sediment ecological risk Persian Gulf fish فلزات سنگین رسوبات ریسک اکولوژیک خلیج فارس ماهی Manahan SE. Environmenal chemistry. 7th ed, Boca Raton, FL: Lewis. 2000; 898##2. Chaudhari PR, Gupta R, Gajghate DG, et al. Heavy metal pollution of ambient air in Nagpur City. Environmental monitoring and assessment. 2012;184(4):2487-2496.##3. Pekey H, Karakaş D, Ayberk S, et al. Ecological risk assessment using trace elements from surface sediments of Izmit Bay (Northeastern Marmara Sea) Turkey. Marine Pollution Bulletin. 2004;48(9):946-953.##4. Soares H, Boaventura R, Machado A, et al. Sediments as monitors of heavy metal contamination in the Ave river basin (Portugal): multivariate analysis of data. Environmental Pollution. 1999;105(3):311-323.##5. Yi Y, Yang Z, Zhang S. Ecological risk assessment of heavy metals in sediment and human health risk assessment of heavy metals in fishes in the middle and lower reaches of the Yangtze River basin. Environmental Pollution. 2011;159(10):2575-2585.##6. Fox WM, Connor L, Copplestone D, et al. The organochlorine contamination history of the Mersey estuary, UK, revealed by analysis of sediment cores from salt marshes. Marine Environmental Research. 2001;51(3):213-227.##7. Bellucci LG, Frignani M, Paolucci D, et al. Distribution of heavy metals in sediments of the Venice Lagoon: the role of the industrial area. Science of the Total Environment. 2002;295(1):35-49.##8. Zonta R, Zaggia L, Argese E. Heavy metal and grain-size distributions in estuarine shallow water sediments of the Cona Marsh (Venice Lagoon, Italy). Science of the Total Environment. 1994;151(1):19-28.##9. Storelli M. Potential human health risks from metals (Hg, Cd, and Pb) and polychlorinated biphenyls (PCBs) via seafood consumption: estimation of target hazard quotients (THQs) and toxic equivalents (TEQs). Food and Chemical Toxicology. 2008;46(8):2782-2788.##10. Alam M, Tanaka A, Allinson G, et al. A comparison of trace element concentrations in cultured and wild carp (Cyprinuscarpio) of Lake Kasumigaura, Japan. Ecotoxicology and environmental safety. 2002;53(3):348-354.##11. Demirak A, Yilmaz F, Tuna AL, et al. Heavy metals in water, sediment and tissues of Leuciscus cephalus from a stream in southwestern Turkey. Chemosphere. 2006;63(9):1451-1458.##12. Elhakeem A, Elshorbagy W, Chebbi R. Oil spill simulation and validation in the Arabian (Persian) Gulf with special reference to the UAE coast. Water, Air, and Soil Pollution. 2007;184(1-4):243-254.##13. de Mora S, Fowler SW, Wyse E, et al. Distribution of heavy metals in marine bivalves, fish and coastal sediments in the Gulf and Gulf of Oman. Marine Pollution Bulletin. 2004;49(5):410-424.##14. Forstner U, Traceability of sediment analysis. Trends in Analytical Chemistry. 2004;23:217-236##15. Abdolahpur Monikh F, Hosseini M, Kazemzadeh Khoei J, et al. Polycyclic Aromatic Hydrocarbons Levels in Sediment, Benthic, Bentho pelagic and Pelagic Fish Species from the Persian Gulf. International Journal of Environmental Research. 2014;8(3):839-848.##16. Vaezi A, Karbassi A, Valavi S, et al. Ecological risk assessment of metals contamination in the sediment of the Bamdezh wetland, Iran. International Journal of Environmental Science and Technology. 2015;12(3):951-958.##17. Karbassi A, Monavari S, Bidhendi GRN, et al. Metal pollution assessment of sediment and water in the Shur River. Environmental monitoring and assessment. 2008;147(1-3):107-116.##18. Giri S, Singh A. Human health risk and ecological risk assessment of metals in fishes, shrimps and sediment from a tropical river. International Journal of Environmental Science and Technology. 2014:1-14.##19. Ghrefat H, Yusuf N. Assessing Mn, Fe, Cu, Zn, and Cd pollution in bottom sediments of Wadi Al-Arab Dam, Jordan. Chemosphere. 2006;65(11):2114-2121.##20. Chen C-W, Kao C-M, Chen C-F, et al. Distribution and accumulation of heavy metals in the sediments of Kaohsiung Harbor, Taiwan. Chemosphere. 2007;66(8):1431-1440.##21. Karbassi A. Geochemistry of Ni, Zn, Cu, Pb, Co, Cd, V, Mn, Fe, Al and Ca in sediments of North Western part of the Persian Gulf. International journal of environmental studies. 1998;54(3-4):205-212.##22. Yang Z, Wang Y, Shen Z, et al. Distribution and speciation of heavy metals in sediments from the mainstream, tributaries, and lakes of the Yangtze River catchment of Wuhan, China. Journal of hazardous materials. 2009;166(2):1186-1194.##23. Bowen HJM. Environmental chemistry of the elements: Academic Press. 1979.##24. Alomary AA, Belhadj S. Determination of heavy metals (Cd, Cr, Cu, Fe, Ni, Pb, Zn) by ICP-OES and their speciation in Algerian Mediterranean Sea sediments after a five-stage sequential extraction procedure. Environmental monitoring and assessment. 2007;135(1-3):265-280.##25. Ennouri R, Chouba L, Magni P, et al. Spatial distribution of trace metals (Cd, Pb, Hg, Cu, Zn, Fe and Mn) and oligo-elements (Mg, Ca, Na and K) in surface sediments of the Gulf of Tunis (Northern Tunisia). Environmental monitoring and assessment. 2010;163(1-4):229-239.##26. Farsad F, Karbassi A, Monavari SM, et al. Development of a New Pollution Index for heavy metals in sediments. Biological trace element research. 2011;143(3):1828-1842.##27. Fernandes LL, Nayak G. Heavy metals contamination in mudflat and mangrove sediments (Mumbai, India). Chemistry and Ecology. 2012;28(5):435-455.##28. Pekey H. The distribution and sources of heavy metals in Izmit Bay surface sediments affected by a polluted stream. Marine Pollution Bulletin. 2006;52(10):1197-1208.##29. Salem DMA, Khaled A, El Nemr A, et al. Comprehensive risk assessment of heavy metals in surface sediments along the Egyptian Red Sea coast. The Egyptian Journal of Aquatic Research. 2014;40(4):349-362.##30. Storelli M, Storelli A, Marcotrigiano G. Heavy metals in the aquatic environment of the Southern Adriatic Sea, Italy: macroalgae, sediments and benthic species. Environment International. 2001;26(7):505-509.##31. Ramanathan A, Subramanian V, Ramesh R, et al. Environmental geochemistry of the Pichavaram mangrove ecosystem (tropical), southeast coast of India. Environmental Geology. 1999;37(3):223-233.##32. Panagos A, Papadopoulos N, Alexandropoulou S, et al .Geochemical study of sediments from the Astakos Bay, Greece. Proceedings of the Conference “Environmental Science and Technology” Lesvos, Greece. 1989:231-242.##33. Madiseh SD, Savary A, Parham H, et al. Determination of the level of contamination in Khuzestan coastal waters (Northern Persian Gulf) by using an ecological risk index. Environmental monitoring and assessment. 2009;159(1-4):521-530.##34. Long E, MacDonald D. Recommended uses of empirically derived, sediment quality guidelines for marine and estuarine ecosystems. Human and Ecological Risk Assessment. 1998;4(5):1019-1039.##35. Macdonald DD, Carr RS, Calder FD, et al. Development and evaluation of sediment quality guidelines for Florida coastal waters. Ecotoxicology. 1996;5(4):253-278.##36. Smith SL, MacDonald DD, Keenleyside KA, et al. A preliminary evaluation of sediment quality assessment values for freshwater ecosystems. Journal of Great Lakes Research. 1996;22(3):624-638.##37. Al-Saad H, Mustafa Y, Al-Imarah F. Distribution of trace metals in tissues of fish from Shatt Al-Arab estuary, Iraq. Mar Meso. 1997;11:15-25.##38. Hosseini M, Nabavi SMB, Nabavi SN, et al. Heavy metals (Cd, Co, Cu, Ni, Pb, Fe, and Hg) content in four fish commonly consumed in Iran: risk assessment for the consumers. Environmental monitoring and assessment. 2015;187(5):1-7.##39. Alahverdi M, Savabieasfahani M. Metal Pollution in Seaweed and Related Sediment of the Persian Gulf, Iran. Bull Environ ContamToxicol 2012; 88:939–945##40. Janadeleh H, HosseiniAlhashemi A, Nabavi SMB. Investigation on concentration of elements in wetland sediments and aquatic plants. Global J. Environ. Sci. Manage 2016 2(1): 87-9##41. Mortazavi MS, Sharifian S. Mercury Bioaccumulation in Some Commercially Valuable Marine Organisms from Mosa Bay, Persian Gulf. International Journal of Environment Research. 2011 5(3):757-762##42. FAO. Compilation of legal limits for hazardous substances in fish and fishery products. . FAO Fishery Circular No 464,5–10 Rome: Food and Agriculture Organization of the United Nations. 2000;464:5-10.##43. WHO. Health criteria other supporting information. In Guidelines for Drinking Water Quality.;vol. 2, 2nd ed., 2000; 31-388.##44. NOAA. Guidelines for consumer of sea food.;vol. 2, 2nd ed., 2009;45-211.#### ##

Efficiency of Coagulation and Flocculation Process Combined with Chemical Sequestration in Removal of Organic and Inorganic Contaminants from Aautomotive Industry Sewag بررسی کارایی فرایند انعقاد و لخته سازی همراه با جداسازی شیمیایی در حذف آلاینده های آلی و معدنی از فاضلاب صنعت خودرو 2 1 مقدمه: مهمترین مشکل زیست محیطی صنایع خودروسازی، فاضلاب تولیدی ناشی از فرایندهای مختلف آن است. کواگولاسیون و فلوکولاسیون همراه با ترسیب شیمیایی از جمله فرایندهای مهم در حذف آلاینده ها از فاضلاب است. هدف از این مطالعه بررسی کارایی فرایند انعقاد و لخته سازی توام با ترسیب شیمیایی در حذف آلاینده های آلی و معدنی از فاضلاب صنعت خودروسازی است. روش بررسی: مطالعه از نوع تجربی- کاربردی است. حذف مواد آلی و معدنی توسط فرایند انعقاد و لخته سازی توام با ترسیب شیمیایی در راکتورهای ناپیوسته انجام شد. پارامترهای کدورت، غلظت فلزات سنگین، رنگ، فسفات، غلظت مواد منعقد کننده، زمان تماس ، TSS، pH و COD مورد بررسی قرار گرفت. غلظت رنگ و فلزات سنگین باقیمانده با استفاده از دستگاه اسپکتروفتومترUV- و جذب اتمی تعیین شد. یافته ها: نتایج این تحقیق نشان داد که درصد حذف فلزات کروم، نیکل، سرب و روی توسط سولفات فریک توام با آهک در pH برابر10 و زمان تماس 100 دقیقه به ترتیب 65/52، 3/96، 27/3 و 100 بود و درصد حذف آنها توسط سولفات آلومینیوم توام با آهک به ترتیب 65/52، 8/97، 37/3 و 81/99 مشاهده شد. همچنین درصد حذف، TSS، COD، رنگ، کدورت، فسفات توسط سولفات فریک به ترتیب 9/68، 83، 94، 84 و 2/47 بود و این میزان حذف توسط سولفات آلومینیوم به ترتیب62، 80، 94، 5/73 و 48 درpH خنثی و غلظت ماده منعقدکننده mg/L 150 بدست آمد. نتیجه گیری: با توجه به نتایج بدست آمده، کاربرد فرایند انعقاد و لخته سازی توام با ترسیب شیمیایی در حذف آلاینده های آلی و معدنی موجود در فاضلاب صنعت خودروسازی تحت شرایط بهینه بدست آمده بسیار موثر بوده و میتوان از آن در تصفیه فاضلاب صنعت خودروسازی استفاده نمود. 2 Introduction: The most important environmental problem of automotive industries is the produced wastewater due to its various processes. The flocculation and coagulation along with chemical sequestration are among important processes for removing contaminants from wastewaters. The aim of this study is to investigate the efficiency of coagulation and flocculation process along with chemical sequestration in the removal of organic and inorganic pollutants from automotive industry sewage. Study Method: This study is an applied-experimental study. The removal of organic and inorganic substances by coagulation, flocculation process combined with chemical sequestration was carried out in batch reactors. The parameters turbidity, heavy metals' concentration, color, phosphate, coagulants concentration, exposure time, TSS, pH and COD were studied. The concentration of color and residue of heavy metals were determined using spectrophotometer -UV and atomic absorption. Results: The research results showed that the removal percentage of Cr, Ni, Pb and Zn by ferric sulfate combined with lime at a pH equal to 10 and the exposure time of 100 minutes were 52.65, 96.3, 3.27 and 100 respectively, and percentage of removing them by aluminum sulfate combined with lime was 52.65, 97.8, 3.37 and 99.81 respectively. the removal percentage of TSS, COD, color, turbidity, phosphates ferric sulfate was also 68.9, 83, 94, 84 and 47.2 respectively, and this amount of removal by aluminum sulfate was 62, 80, 94, 73.5 and 48 respectively at neutral pH and concentration of coagulant was obtained equal to 150 mg / L. Conclusion: According to the results, the use of coagulation and flocculation process combined with chemical sequestration in the removal of organic and inorganic pollutants in wastewaters of automotive industry achieved under optimal conditions is very effective and can be used in water treatment of automotive industry. 182 194 2016/03/172016/08/292016/03/182016/04/21 1395/2/2 2016/06/72016/08/292016/06/72016/06/7 1395/3/18 محمد ملکوتیان Mohammad Malakootian Environmental Health Engineering Research Center and Environmental Health Department, School of Public Health, Kerman University of Medical Sciences, Kerman Iran xv@yahoo.com علی طلوعی Ali Toolabi Environmental Health Engineering, Environmental Science and Technology Research Center, Department of Environmental Health Engineering, Shahid Sadoughi University of Medical Science, Yazd, Iran atoolabi17@gmail.com زهرا درخشان Zahra Derakhshan Environmental Health Engineering, Environmental Science and Technology Research Center, Department of Environmental Health Engineering, Shahid Sadoughi University of Medical Science, Yazd, Iran d.z.derakhshan@gmail.com محمد تقی قانعیان Mohammad Taghi Ghaneian Environmental Health Engineering, Environmental Science and Technology Research Center, Department of Environmental Health Engineering, Shahid Sadoughi University of Medical Science, Yazd, Iran mtghaneian@yahoo.com coagulation flocculation chemical sequestration heavy metals automotive industry sewage انعقاد و لخته سازی ترسیب شیمیایی فلزات سنگین فاضلاب صنعت خودروسازی 1. Ansari F, Pandey Y, Kumar P. Performance evaluation of effluent treatment plant for automobile industry. International journal of Energy and Environment. 2013;4(6): 1079-1086 ##2. Khezri S, Gerdi E. Recovering of Titanium dioxide from solvent- based paint sludge (case study, Iran khodro company). Journal of color Science and technology. 2012; 6: 241-246.[Persian]##3. Streitberger HJ, Dossel KF. Automotive paints and coatings. second ed. vol 507. germany: wiley-vch.2008.##4. Aly OHI . A new development of wastewater treatment unit for paint shop in vehicle industry.International Journal of Sciences Basic and Applied Research (IJSBAR). 2015;21(1): 15-25.##5. Sridhar N, Senthilkumar JS, Subburayan MR. Removal of toxic metals (lead &copper) from automotive industry waste water by using fruit Peels. International Journal of Advaced Information and Communication Technology. 2014;1(2): 188-191.##6. Ahmet O, Gulbeyi D. Removal of methylene blue from‌ ‌aqueous solution by dehydrated wheat ‎bran carbon. Journal of Hazardous Materials. 2007; 146: 262-269.##7. Fu Y, Wang Y, Su M. Hydrolysis performance of poly-al-fe containing zinc (pazf) coagulant and its removal of color and organic matters. Journal of Water Process Engineering. 2014; 4: 58-66.##8. Golka K, Kopps S, Myslak ZW. Carcinogeneicity of azo colorans:influence of solubility and ‎ bioavailability.Toxicology Letters. 2004; 151: 203-210.##9. Zhang YR, Shen SL, Wang SQ, et al. A dual function magnetic nanomaterial modiﬁed with lysine for removal of organic dyes from water solution. Chemical Engineering Journal. 2014; 239: 250- 256.##10. Satapanajaru T, Chompuchan C, Suntornchot P,et al. Enhancing decolorization of Reactive Black 5 and Reactive Red 198 during nano zerovalent iron treatment. Desalination. 2011; 266: 218-230.##11. Asadi A, Nateghi R, Nasseri S, et al. Direct poly azo dye decolorization using nanophotocatalytic uv/nio process. Journal of Water and Wastewater. 2012;23(3): 78-84.##12. Paul T, Dodd M, Strathmann T. Photolytic and photocatalytic decomposition of aqueous ciproﬂoxacin: Transformation products and residual antibacterial activity. Water Research. 2010; 44(10): 3121-3132.##13. Halnor S. Removal of Heavy metals from wastewater: a review. International journal of application or innovation in engineering & management (IJAIEM). 2015; 4 (10): 19-22.##14. Wirojanagud W, Tantemsapya N, Tantriratna P. Precipitation of heavy metals by lime mud waste of pulp and paper mill. Environmental & Hazardous Management. 2004; 26(1): 45-53.##15. Prepared by the toxicology department CRCE PHE.Nickel toxicological overview. Public Health England. 2009.##16. Arbabi M, Hemati S, Amiri M. Removal of lead ions from industrial wastewater: A review of Removal methods. International Journal of Epidemiologic Research. 2015; 2(2): 105-109.##17. Hua M, Zhang Sh, Pan B,et al. Heavy metal removal from water/wastewater by nanosized metal oxides: A review. Journal of Hazardous Materials. 2012; 211- 212: 317- 331.##18. Pui Yee Shak K, Wu TY. Optimized use of alum together with unmodiﬁed Cassia obtusifolia seed gum as a coagulant aid in treatment of palm oil mill efﬂuent under natural pH of wastewater. Industrial Crops and Products. 2015; 76: 1169-1178.##19. Wang Z, Ma Y, Hao X, et al. Enhancement of heavy metals removal efﬁciency from liquid wastes by using potential-triggered proton self-exchang eeffects. Electrochimica Acta. 2014; 130: 40-45.##20. PuiYee Shak K, Yeong Wu T. Coagulation–ﬂocculation treatment of high-strength agro-industrial wastewater using natural cassia obtusifolia seed gum: treatment efﬁciencies and ﬂocs characterization. Chemical Engineering Journal. 2014; 256: 293-305.##21. Hamawand I. Review of wastewater treatment chemicals and organic chemistry alternatives for abattoir effluent. Australian Meat Processor Corporation. 2015.##22. Barakat M. New trends in removing heavy metals from industrial wastewater. Arabian Journal of Chemistry 2011; 4(4): 361-377.##23. Ismail IM, Fawzy AS, Abdel-Monem NM, et al. Combined coagulation flocculation pre treatment unit for municipal wastewater. Journal of Advanced Research. 2012; 3(4): 331-336.##24. Amuda OS, Amoo IA, Ipinmoroti KO, et al. Coagulation / flocculation process in the removal of trace metals present in industrial wastewater. Journal of Applied Sciences and Environmental Management. 2006; 10(3): 159- 162.##25. Awaleh M, Soubaneh Y. Waste Water Treatment in Chemical Industries: The Concept and Current Technologies. Hydrology Current Research. 2014; 5(1): 1 - 12.##26. Zazouli M, Yousefi Z. Removal of heavy metals from solid wastes leachates coagulation- flocculation process.Journal of Applied Sciences. 2008; 8(11): 2142 - 2147.##27. Ayeche R. Treatment by coagulation-flocculation of dairy wastewater with the residual lime of national algerian industrial gases company (nigc-annaba). Energy procedia. 2012; 18: 147-156 ##28. Sahu OP, Chaudhari PK. Review on Chemical treatment of Industrial Waste Water. Journal of Applied Sciences and Environmental Management. 2013; 17(2): 241-257 ##29. López-Maldonado EA, Oropeza-Guzman MT, Jurado-Baizaval JL,et al. Coagulation–ﬂocculation mechanisms in wastewater treatment plants through zeta potential measurements. Journal of Hazardous Materials. 2014; 279: 1-10.##30. Daud Z, Awang H, Aziz AbdulLatif Ab, et al. Suspended solid, color, cod and oil and grease removal from biodiesel wastewater by coagulation and flocculation processes. Procedia - Social and Behavioral Sciences. 2015; 195:2407–2411#### ##

Knowledge, Attitude, and Performance of Nurses' Crisis Management in Natural Disasters in Yazd City بررسی آگاهی، نگرش و عملکرد پرستاران شهر یزد نسبت به مدیریت بحران در بلایا و حوادث طبیعی 2 1 چکیده مقدمه: بلایای طبیعی به عنوان حوادثی که خارج از کنترل انسانها میباشند در نظر گرفته شده اند و معمولا به مرگ و میر و آسیبهای متنوعی منتج می شوند ووضعیت بهداشت و سلامت عمومی مردم را به طور مشخص متأثر میسازند بلایا به طرق مختلف زندگی مردم را تحت تأثیر قرار میدهند، آنها ممکن است اثرات عمیق، آشکار و نتایج نامعلومی داشته باشند. حوادث ناشی از بلایای طبیعی ممکن است به طور مستقیم سبب صدمات و مرگ و میر شوند و یا به صورت غیرمستقیم منجر به انتقال بیماریهای واگیر گردد.یکی از گروه هایی که بیشترین نقش رادر پیشگیری وکنترل بلایا دارند ،پرستاران می باشند لذا دراین بررسی تصمیم گرفتیم تا آگاهی،نگرش و عملکرد پرستاران شهر یزد نسبت به مدیریت بحران در بلایا وحوادث طبیعی رامورد بررسی قراردهیم. روش بررسی: این مطالعه از نوع توصیفی –مقطعی بودکه که تعداد 220 نفر از پرستاران بیمارستانهای دولتی از طریق نمونه گیری طبقه ای تصادفی انتخاب شدند. داده ها توسط پرسشنامه ای محقق ساخته انجام شد که با استفاده از مطالعات مشابه در زمینه پرستاری تهیه شده است که روایی آن با نظر متخصصین مربوطه وپایایی آن با آلفا کرونباخ 0.83 تایید شداین پرسشنامه از دو قسمت تشکیل شده بود.قسمت اول شامل سوالاتی در خصوص متغیرهای زمینه ای(سن-جنس-وضعیت تاهل- میزان تحصیلات-سابقه کار-نوع مسئولیت و......)بود. بخش دوم شامل سوالاتی در خصوص آگاهی, نگرش وعملکردبود که بخش آگاهی مشتمل بر16سوال بوده است عبارات مربوط به نگرش 11 سوال بود وعبارات مربوط به عملکرد 19سوال بوده است . داده ها پس از جمع آوری بر طبق کد بندی های معین ،‌در نرم افزار آماری SPPS.Win 16 وارد گردیده و پس از پردازش مورد ارزیابی قرار گرفت. در سطح تحلیلی از آزمونهای همبستگی‌اسپیرمن ، آزمونهای مقایسه میانگین ها در سطوح مختلف متغیرهای مستقل ( من – ویتنی ، کروسکال والیس و یا t تست وهم چنین از آزمون مقایسه میانگین داده های وابسته(غیر پارامتریک) استفاده شد. نتایج: میانگین آگاهی در پرستاران24/5± 05/13ازمحدوده نمره 22-0 می باشد. نمره نگرش پرستاران 39/3±94/28از محدوده 33-11 می باشد. همچنین میانگین نمره عملکرد افراد 5/6 ±88/45 از محدوده 57-19 می باشد.پرستاران در این مطالعه دارای میانگین سنی 94/33 سال وسابقه کار 5/10 سال داشتند. بحث: با توجه به افزایش تعداد دفعات وقوع و پیامدهای بلایا و نقش ویژه خدمات سلامتی در قبل، حین و بعد از وقوع چنین حوادثی، آمادگی مناسب کارکنان ارائه دهنده ی خدمات سلامتی بسیار ضروری می باشد و پرستاران به عنوان بزرگترین گروه ارائه دهنده ی خدمات بهداشتی درمانی به افراد آسیب دیده می باشند ولازم است که اطلاعات وعملکرد آنها سنجیده شود که از اهداف این بررسی بود. 2 Abstract: Introduction: Natural disasters are considered as events that are beyond human control and usually result in death and different injuries; they also significantly affect public health. The lack of proper sanitation and communal life creates numerous problems. The aim of this study was to determine the knowledge, attitudes, and performance of nurses (since nurses work more than others in disasters) in disaster management. Materials & Methods: This was a cross–sectional and descriptive study. The 220 participants of this study were selected by stratified random sampling method. Data was collected by questionnaire taken from similar studies in the field of nursing whose reliability was confirmed by the relevant specialists and its validity was confirmed by Cronbach's alpha (0.83). Data analyses included Spearman test, analysis of different levels of the independent variables (Mann-Whitney, Kruskal-Wallis test) or t- test, and comparing means as well as the related data (non-parametric). Results: In this study, the average age of staff was 33.94±6.4 and years of their work experience was 10.5 ±7.14. The nurses' average level of knowledge about crisis management was 13.05±5.24 out of 22. The mean grade scores of attitude to crisis management was 28.94±3.39 out of 33, further, their function in crisis management was 45.88±6.5 out of 57. Discussion: Due to the increased frequency of occurrence and consequences of the disaster and the special role of health care services before, during, and after the occurrence of such incidents, the results were not suitable. Then, it was concluded that proper preparation is essential for nurses as the largest providers of information and health services to people, so their performance must be measured which is the objective of this study. 195 201 2016/03/172016/08/292016/03/182016/04/212016/09/13 1395/6/23 2016/06/72016/08/292016/06/72016/06/72016/09/13 1395/6/23 طاهره سلطانی Tahere Soltani Faculty of Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran محمدحسین باقیانی مقدم Mohammad Hossein Baghianimoghadam Department of Health Services, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Baghianimoghadam @yahoo.com محمدحسن احرامپوش Mohammad Hassan Ehrampoush Department of Environmental Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran نجمه باقیان Najmeh Baghian Health policy research center, Faculty of Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran عبدالخالق جعفری Abdolkhalegh Jafari Office of Performance Evaluation, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Crisis management Knowledge Attitude Perfromance Nurses. بحران پرستاران آگاهی نگرش وعملکرد. 1- Parmar NK. Disaster Management: an Overview.NewDehli: JAPEE Publication; 2003:1-15.##2- Sharma, R , Sharma G.NaturalDisaster.New Delhi: APH publishing corporation ;2005: 1-5##3- Malaki MR, Shojaie P. Hospitals preparation in disasters: Security.Journal of Health Administration. 2007;10 (28): 65‐ 70 [Persian].##4- Jahanbakhsh M, Tavakoli N, Hadadpour A. Designing disaster victims' medical record, a step toward crisis management. Journal of Health Information Management 2011; 7(4):400‐409 [Persian].##5- Imani E, HosseiniTeshnizi S, Leila Bonyani, et al. Nurses´ Knowledge about Crisis Management and its Related Factors. Journal of Health & Care. 2011;13(4):10-18 [Persian]. ##6- Ghanbari V, Maddah SS, Khankeh HR, et al. The Effect of a Disaster Nursing Education Program on Nurses’Preparedness for Responding to Probable Natural Disasters. Iran Journal of Nursing (IJN). 2011; 24 (73) :72-80##7- Barbara JA, Macintyre AG, Baebard J, et al. Hospital: Emergency Preparedness and Response. 1ed. Jane’s Information Group. Spiral edition , 2003##8- Langan JC, James DC. Preparing nurses for disaster management: Prentice Hall; 2005##9- Magnaye B, Muñoz M, Lindsay S, et al. The Role, Preparedness and Management Of Nurses During Disasters. E-International Scientific Research Journal. 2011; 3(4):269-285.##10- Littleton-Kearney MT, Slepski LA. Directions for disaster nursing education in the United States. Critical care nursing clinics of North America. 2008;20(1):103-109.##11- Jennings-Sanders A. Teaching disaster nursing by utilizing the Jennings Disaster Nursing Management Model. Nurse education in practice. 2004;4(1):69-76.##12- Report to congressional committee Hospital preparedness. GAO Washington DC: A gust (8),2003##13- Hagilo M, A survey about knowledge and attitudes of managers and supervisors of hospitals in Zanjan in relation to crisis management in 2009.A tesis of Payam Nour university 0f Tehran, Faculty of Social Sciences and Economy.##14- Hajavi A, ShojaeiBaghini M, Haghani H, Azizi A. Crisis Management in Medical Records Department in Kerman and Borujerd Teaching Hospitals 2006 (Providing Model) . Journal of Health Administration. 2009; 12 (35) :9-16. [Persian]##15- . Mesdaghinia A, Yunesian M, Naseri S, et al . The knowledge of Tehran citizens on environmental pollutions, related health effects and their information sources. Yafte. 2007; 9 (1) :3-13. [Persian]##16- Vosoughi Nayyeri M, Marzieh Asgari M, Jahed khaniki GH, et al. Investigation of knowledge and attitudes of students in Tehran University of Medical Sciences on Health actions in emergencies. Quarterly Scientific Research Journal of Rescue & Relief. 2012;4(2):43-51. [Persian]##17- Heshmatinabavi F,Pourghaznin T, Movafaghi Z. Nursing student abilities concerning their performance in nursing disaster. Journal of qualitative Research in Health Sciences. 2011; 10 (2) :42-46.## ##

A Survey of Transitional Shifts in Physical Activity Behavior among Birjand Universities Employees Based on Transtheoretical Model: A longitudinal study of Iran, 2014 بررسی تغییرات انتقالی در رفتار فعالیت بدنی کارکنان دانشگاه‌های بیرجند بر پایه مدل فرانظری، مطالعه طولی- سال 93 2 1 زمینه و هدف: یکی از الگوهایی که به تببین رفتار فعالیت بدنی می‌پردازد مدل فرانظری است. از انتقادات وارده بر این مدل این است که اکثر مطالعات انجام شده بر پایه آن، به صورت مقطعی هستند که در نشان دادن ماهیت پویا تغییر با شکست مواجه می‌شوند. به این منظور مطالعه حاضر با هدف تعیین تغییرات انتقالی در رفتار فعالیت بدنی کارکنان دانشگاه‌های بیرجند بر پایه مدل فرانظری انجام شد. روش تحقیق: این مطالعه آینده نگر با دوره پیگیری 6 ماهه بر روی 200 نفر از کارکنان معاونت‌های آموزشی و پژوهشی دانشگاه‌های بیرجند انجام شد. 179 نفر از شرکت کنندگان پرسشنامه‌های هر دو بررسی اولیه و پیگیری را تکمیل نمودند. ابزار گردآوری داده‌ها پرسشنامه‌ای مشتمل بر اطلاعات دموگرافیک و سازه‌های مدل فرانظری بود که به روش خود گزارش‌دهی تکمیل گردید. داده‌های گردآوری شده وارد نرم‌افزار 16-spss شد و در سطح معنی‌داری 05/0>α مورد تجزیه و تحلیل قرار گرفت. یافته‌ها: تغییرات انتقالی در رفتار فعالیت بدنی در 4 الگو نشان داده شد: بی‌تحرک پایدار (3/26 %)، فعال پایدار (1/39%)، اتخاذکنندگان (12%) و ترک‌کنندگان (6/22%). گروه‌ فعال پایدار کاهش معنی داری را در میانگین نمره فواید درک شده نشان داد. اتخاذکنندگان افزایش معنی‌داری را در میانگین نمره فواید درک شده و خودکارآمدی نشان دادند. کاهش معنی‌داری در میانگین نمره فرآیندهای رفتاری، فرآیندهای شناختی و خودکارآمدی ترک کنندگان مشاهده شد. میانگین نمره فواید درک‌شده، خودکارامدی و فرایندهای رفتاری و شناختی در شروع مطالعه و همچنین در پیگیری اختلاف معنی‌داری را بین این 4 الگو نشان داد. نتیجه‌گیری: نتایج این مطالعه حمایت نسبی از اعتبار درونی مدل فرانظری فراهم آورد. به نظر می‌رسد مداخلات مبتنی بر این مدل بتواند در اتخاذ و حفظ رفتار فعالیت بدنی موثر باشد. 2 Introduction: Transtheoretical model (TTM) is one of the models applied to assess the physical activity behavior. From critiques to this model is that the majority of the studies based on the transtheoretical model have employed cross-sectional designs so that it fails to show the dynamic nature of change. Thus, the aim of the current study was to investigate transitional shifts in Physical Activity Behavior among Birjand universities employees Based on Transtheoretical Model. Materials & Methods: This prospective study with 6 month follow-up was conducted on 200 employees of Research and Education departments of Birjand university of medical sciences. 179 of participants’ completed questionnaires at two time periods at baseline and follow-up 6 month later. The instrument for data collection was a questionnaire included demographic variables and constructs of Transtheoretical model which completed by using the self-reported method. Results: Transitional shifts in physical activity behavior were shown in 4 patterns: stable sedentary (26.3%), stable active (39.1%), exercise adopters (12%) and exercise relapsers (22.6%). Stable active group had a significant decrease in mean score of pros. exercise adopters had a significant increase in the mean scores of self-efficacy and pros. Also, significant decreases were observed in the mean scores of behavioral processes, cognitive processes, and self-efficacy among exercise relapsers. Mean scores for the pros, self-efficacy, behavioral and cognitive processes at baseline and at follow-up showed significant differences between the 4 patterns. Conclusion: The results of this study provide partial support for internal validity of ttm. It seems that interventions based on this model can be effective in adopting and maintaining physical activity behavior. 202 210 2016/03/172016/08/292016/03/182016/04/212016/09/132016/04/30 1395/2/11 2016/06/72016/08/292016/06/72016/06/72016/09/132016/06/7 1395/3/18 فاطمه رخشانی زابل Fatemeh Rakhshany zabol Health education & promotion, Social determinants of health research center, Birjand University of Medical Sciences, Birjand, Iran. f_rakhshany@yahoo.com غلامرضا شریف زاده Ggholamreza Sharifzadeh Epidemiology, Social determinants of health research center, Assistant Professor, School of Health, Birjand University of Medical Sciences, Birjand, Iran. rezamood@yahoo.com میترا مودی Mitra Moodi Health education & promotion, School of Health, Birjand University of Medical Sciences, Birjand, Iran mitra_m2561@yahoo.com Transtheoretical model Stage of change model Physical activity behavior behavior change Transitional shifts مدل فرانظری مدل مراحل تغییر فعالیت بدنی تغییر رفتار تغییرات انتقالی WHO. Health topics, physical activity. Available from: http://www.who.int/topics/physical_activity/en/##2. Esteghamati A, Khalilzadeh O, Rashidi A, et al. Physical Activity in Iran: Results of the Third National Surveillance of Risk Factors of Non-Communicable Diseases (SuRFNCD-2007). Journal of Physical Activity and Health. 2011;8:27-35.##3. Nikpour S, Rahimiha F, Haghani H. Comparing the Status of Sport Activities in Women and Men Working at Iran University of Medical Sciences and Health Services. Journal of Iran University of Medical Sciences. 2006;13(52):205-16. persian##4. Jalilian F, Emdadi S, Mirzaie M, et al. The Survey Physical Activity Status of Employed Women in Hamadan University of Medical Sciences: The Relationship Between the Benefits, Barriers, Self- Efficacy and Stages of Change. Toloo e Behdasht. 2011;9(4):89-98. persian##5.Jalilian M, Darabi M, Sharifirad GH, et al. Interventional Program based on Trans-Theoretical Model to Promote Regular Physical Activity in Office Workers. Journal of Health System Research. 2013;9(2):188-95. persian##6. Prochaska JO, Evers KE, Castle PH, et al. Enhancing multiple domains of well-being by decreasing multiple health risk behaviors: a randomized clinical trial. Population Health Management. 2012;15(5):276-86. ##7. Prapavessis H, Maddison R, Brading F. Understanding exercise behavior among New Zealand adolescents: a test of the transtheoretical. Journal of Adolescent Health. 2004;35(4):346 e17-27.##8. Plotnikoff RC, Hotz SB, Birkett NJ, et al. Exercise and the transtheoretical model: a longitudinal test of a population sample. Preventive Medicine. 2001;33(5):441-52.##9. Plotnikoff RC, Lippke S, Johnson ST, et al. Physical activity and stages of change: a longitudinal test in types 1 and 2 diabetes samples. Annals of Behavioral Medicine. 2010 Oct;40(2):138-49. ##10. Moeini B, Jalilian M, Hazavehei SM, et al. Promoting Physical Activity in Type 2 Diabetic Patients: A Theory-Based Intervention. Health System Research. 2012;8(5):824-33. persian##11. DiClemente CC, Nidecker M, Bellack AS. Motivation and the stages of change among individuals with severe mental illness and substance abuse disorders. Journal of Substance Abuse Treatment. 2008;34:25-35.##12. Schumann A, Kohlmann T, Rumpf HJ, et al. Longitudinal relationships among transtheoretical model constructs for smokers in the precontemplation and contemplation stages of change. Annals of Behavioral Medicine. 2005;30(1):12-20.##13. Levy SS, Li KK, Cardinal BJ, et al. Transitional shifts in exercise behavior among women with multiple sclerosis. Disabil Health Journal. 2009;2(4):216-23.##14. Shafakhah M, Moattari M, Sabet Sarvestani R. Assessing Stages of Exercise Behavior Change, Self Efficacy and Decisional Balance in Iranian Nursing and Midwifery Students. World Academy of Science, Engineering and Technology. 2013 (73):1034-9.##15. Castle PH. Transtheoretical model relationships across multiple health behaviors: A longitudinal analysis [Ph.D]. Ann Arbor: University of Rhode Island; 2011.##16. Jordan PJ, Nigg CR, Norman GJ, et al. Does the transtheoretical model need an attitude adjustment?: Integrating attitude with decisional balance as predictors of stage of change for exercise. Psychology of Sport and Exercise. 2002;3(1):65-83.##17. Armitage C. Can variables from the transtheoretical model predict dietary change? Journal of Behavioral Medicine. 2010;33(4):264-73.##18. Cardinal BJ, Lee JY, Kim YH. Predictors of Transitional Shifts in College Students’ Physical Activity Behavior. International Journal of Applied Sports Sciences. 2010;22(1):24-32.##19. Nigg CR. Explaining adolescent exercise behavior change: a longitudinal application of the transtheoretical model. Annals of Behavioral Medicine. 2001;23(1):11-20. ##20. Callaghan P, Khalil E, Morres I. A prospective evaluation of the Transtheoretical Model of Change applied to exercise in young people. International journal of nursing studies. 2010;47(1):3-12. ##21. Barrett BS. An application of the transtheoretical model to physical activity: ProQuest Information & Learning; 1998.##22. Marcus BH, Simkin LR, Rossi JS, et al. Longitudinal shifts in employees' stages and processes of exercise behavior change. American Journal of Health Promotion. 1996;10(3):195-200.##23. Marcus BH, Selby VC, Niaura RS, et al. Self-Efficacy and Stage of Exercise Behavior Change. Research Quarterly for Exercise and Sport. 1992;63(1):60-6.## ##

The Effect of Breast Self Examination Educational Program on the Knowledge and Performance of Women in Yazd بررسی تأثیر آموزش خودآزمایی پستان بر آگاهی و عملکرد زنان در این زمینه 2 1 چکیده مقدمه: سرطان پستان شایع‌ترین سرطان و یکی از عوامل عمده مرگ‌ومیر ناشی از سرطان در زنان می‌باشد. تشخیص زودرس این بیماری، باعث کاهش قابل‌ملاحظه‌ای در مرگ‌ومیر ناشی از سرطان پستان می‌شود. تشخیص به‌موقع در مراحل اولیه شانس درمان آن را افزایش داده و موجب بالا رفتن طول عمر افراد مبتلابه این سرطان خواهد شد. مطالعه حاضر باهدف تعیین تأثیر آموزش در مورد خودآزمایی پستان بر آگاهی و عملکرد زنان 60-20 ساله شهر یزد در مورد خودآزمایی پستان انجام شد. روش بررسی: در این مطالعه 100 نفر از زنان 60 -20 ساله تحت پوشش مراکز بهداشتی – درمانی شهر یزد که ازنظر شرایط فرهنگی، اجتماعی و اقتصادی تقریباً همسان بودند انتخاب شدند. طی یک مطالعه نیمه تجربی، جمع‌آوری اطلاعات از طریق پرسشنامه در دو مرحله قبل و بعد از آموزش انجام شد. داده‌ها پس از گردآوری با استفاده از نرم‌افزار آماری SPSS (نسخه 18) و آزمون‌های تی و آنالیز واریانس مورد تجزیه‌وتحلیل قرار گرفت. در این مطالعه سطح معنی‌داری 05/0 در نظر گرفته شد. یافته‌ها: نتایج به‌دست‌آمده از آزمون‌های آماری نشان داد که بین نمره آگاهی قبل و بعد از آموزش و نیز نمره عملکرد قبل و بعد از آموزش اختلاف معنی‌داری وجود داشته است (05/0>p). در این بررسی بین سن، وضعیت تأهل، سطح تحصیلات، سابقه شیردهی و مدت آن با سطح آگاهی و بین وجود سابقه خانوادگی سرطان پستان و عملکرد آنان ارتباط معنی‌داری مشاهده شد (05/0>p). نمره عملکرد زنان در قبل و دو ماه بعد از برنامه آموزش در گروه باسابقه فامیلی منفی، تفاوت معنی‌داری مشاهده شد (05/0> p). نتیجه‌گیری: با توجه به نتایج حاصله و تأثیر مثبت آموزش برافزایش آگاهی و عملکرد افراد توصیه میشود برنامه‌های آموزشی مدونی درزمینهٔ سرطان پستان و روش‌های غربالگری آن در همه سنین برگزار شود و در جهت ارتقاء سلامت زنان از دوران بلوغ تا بعد از یائسگی به امر پیگیری و آموزش توجه بیشتری مبذول گردد. 2 Abstract Introduction: Breast cancer is the most common cancer and one of the major causes of cancer deaths in women. Early diagnosis leads to significant reduction of mortality from breast cancer, in other words it can increase the lifespan of people with this cancer. This study aimed to determine the effect of education on knowledge and performance of 20-60 year old women in Yazd city about Breast Self Examination (BSE). Materials & Methods: In this study, 100 women aged from 20 to 60 years old who referred to Yazd health centers were selected. They were matched in terms of cultural, social, and economical aspects. In this quasi-experimental study, data was collected through administration of questionnaires before and after training in two stages. The collected information were then analyzed using the statistical software SPSS (version 18) by T-tests and ANOVA. The significance level was set at 0.05. Results: The results of statistical analyses revealed a significant difference between participants' knowledge and performance scores before and after training (0.05> p). In this study, age, marital status, education level, history of breastfeeding, and its duration had a significant relationship with participants' knowledge; also, positive family history of breast cancer had a significant relationship with their performance (0.05> p). Between the subjects' performance was a significant difference in two groups with negative and positive family history of Brest cancer before and after two months of educational program. (0.05> p). Conclusion: According to the achieved results and the positive impact of education on the increase of knowledge and performance, educational programs in the field of breast cancer and its screening methods are recommended to be held for all age groups. In order to promote women's health from puberty to menopause more attention should be paid to the follow-up and training. 211 219 2016/03/172016/08/292016/03/182016/04/212016/09/132016/04/302016/06/12 1395/3/23 2016/06/72016/08/292016/06/72016/06/72016/09/132016/06/72016/09/13 1395/6/23 نوشین یوشنی Nooshin Yoshany Social Determinants of Health Research Center, Shahid Sadoughi University of Medical Sciences,Yazd, Iran nooshin.yoshany@yahoo.com حمیده میهن پور Hamideh Mihanpour Workplace & Occupational Health and Safety Research Center, Shahid Sadoughi University of Medical SciencesYazd, Iran. h.mihanpour@gmail.com خیرمحمد جدگال Khair Mohammad Jadgal Department of Health Education & Health Promotion, Shahid Sadoughi University of Medical SciencesYazd, Iran. jadgal_kh@yahoo.com مریم دری Maryam Dori Shahid Sadoughi hospital, Shahid Sadoughi University of Medical Sciences,Yazd, Iran nooshin.yoshany@gmail.com Education Breast self examination Knowledge Performance. کلمات کلیدی: آموزش خودآزمایی پستان آگاهی عملکرد. Tazhibi M, Babazadeh SH, Fazeli Z, et al. The study of age trend of breast cancer patients referred to radiotherapy and oncology department of Isfahan hospitals after screening and awareness. Iranian Journal of Breast Disease. 2011; 4(3) :47-51[Persian]##2. Shirazi FHS. Breast cancer. Tehran: nezame parastari; 1389. [Persian]##3. Novak E, Berek JS. Berek & Novak's gynecology: Lippincott Williams & Wilkins; 2007.##4. Demirkiran F, Balkaya NA, Memis S, et al. How do nurses and teachers perform breast self-examination: are they reliable sources of information? BMC Public Health. 2007;7(5):96.##5. Harirchi I, Karbakhsh M, Kashefi A, et al. Breast cancer in Iran: results of a multi-center study. Asian Pacific Journal of Cancer Prevention. 2004;5(1):24-7.##6. Dündar P, Özmen D, Öztürk B, et al. The knowledge and attitudes of breast self-examination and mammography in a group of women in a rural area in western Turkey. BMC cancer. 2006;6(1):1.##7. Biglu MH. Breast Cancer inIran: the trend of Iranian researchersâ€™ studies in MEDLINE database. Basic & Clinical Cancer Research. 2014;6(1):22-32.##8. Koroltchouk V, Stanley K, Stjernswärd J. The control of breast cancer a World Health Organization perspective. Cancer. 1990;65(12);2803-2810##9. Karimi H, Sam S. Effect of breast self-examination (BSE) education on increasing women’s knowledge and practice, Ramsar. Journal of Babol University of Medical Sciences. 2005;7(3):61-8.[Persian]##10. Bibb SC. Access and late-stage diagnosis of breast cancer in the military health system. Military medicine. 2000;165(8):585.##11. Isara A, Ojedokun C. Knowledge of breast cancer and practice of breast self examination among female senior secondary school students in Abuja, Nigeria. Journal of preventive medicine and hygiene. 2011;52(4);186-190.##12. Sadeghnezhad F, Niknami S, Ghaffari M. Effect of health education methods on promoting breast self examination (BSE). Journal of Birjand University of Medical Sciences. 2009;15(4):38-48. [Persian]##13 Didarloo A, Pourali R, Gharaaghaji R, et al. Comparing The Effect Of Three Health Education Methods On The Knowledge Of Health Volunteers Regarding Breast Self-Examination. Journal Of Urmia Nursing And Midwifery Faculty. 2014;12(2):0[Persian].##14. Gorman C. The search for smaller tumors. Breast-cancer studies could lead to better tests and earlier detection. Time. 2000;155(26):50-.##15. Mahmood A, Ramazani A. Study of knowledge, attitude, and practice of presenting women to Zabol health centers with regard to breast self examination by Using health belief model (in 2009). Modern Care Journal. 2011;8(2):65-72. [Persian]##16. Maurer F. A peer education model for teaching breast self-examination to undergraduate college women. Cancer nursing. 1997;20(1):49-63.##17. Miller AB, To T, Baines CJ, et al. Canadian National Breast Screening Study-2: 13-year results of a randomized trial in women aged 50–59 years. Journal of the National Cancer Institute. 2000;92(18):1490-9.##18. Jarvandi S, Montazeri A, Harirchi I, et al. Beliefs and behaviours of Iranian teachers toward early detection of breast cancer and breast self-examination. Public Health. 2002;116(4):245-9.##19. Avci IA. Factors associated with breast self-examination practices and beliefs in female workers at a Muslim community. European Journalof Oncology Nursing. 2008;12(2):127-33.##20. Miller AM, Champion VL. Attitudes about breast cancer and mammography: racial, income, and educational differences. Women & Health. 1997;26(1):41-63.##21. Firoozeh F, Tabeshian T, Karimabadeh N, et al. The Effect of Instruction on Students’ Knowledge and Attitude towards Breast Self-Examination. Qom Univ Med Sci J . 2011; 4 (4) :21-2. [Persian]##22. Shokraniyan N. Knowledge and practice of female teachers in early detection of breast cancer in the city of Lar. Hormozgan Medical Journal.1999.3(4):5-9. [Persian]##23. Akhtari-Zavare M, Ghanbari-Baghestan A, Latiff LA, et al. Knowledge of breast cancer and breast self-examination practice among Iranian women in Hamedan, Iran. Asian Pacific Journal of Cancer Prevention. 2014;15(16):6531-4.##24. Akhtari-Zavare M, Juni MH, Said SM, et al. Beliefs and behavior of Malaysia undergraduate female students in a public university toward breast self-examination practice. Asian Pacific Journal of Cancer Prevention. 2013;14(1):57-61.##25. Andsoy II, Gul A. Breast, cervix and colorectal cancer knowledge among nurses in Turkey. Asian Pacific journal of cancer prevention: Asian Pacific Journal of Cancer Prevention. 2013;15(5):2267-72.#### ##

Analysis of Potentials to Increase Iranian life Expectancy with Removing the Leading Causes of Mortality in 2010 تجزیه پتانسیل افزایش امید زندگی کشور با حذف علل اصلی مرگ و میر2010 2 1 مقدمه و هدف: مطالعات اخیر در مورد مرگ‌ومیر در ایران آشکارا بر این نکته تأکید کرده‌اند که طی سه دهه گذشته بیماری‌های قلبی- عروقی، حوادث غیر عمدی و سرطان‌ها به عنوان سه علت عمده‌ی کاهش عمر ایرانیان، نقش‌آفرینی کرده‌اند. این مقاله در تلاش است تا چنین نقشی را در الگوی مرگ‌ومیر کشور در سال 1389 مطالعه کند. روش کار: تعداد موارد مرگ ثبت‌شده بر حسب سن و جنس و توزیع مرگ بر حسب علت در کشور برای سال 1389 از نظام ثبت مرگ وزارت بهداشت اخذ شده و برای کسب اطلاع از جمعیت در معرض، از جمعیت پیشبینی شده توسط مرکز آمار استفاده شده است. تحلیل داده‌ها به وسیله جدول عمر چندکاهشی و روش تجزیه کیتاگاوا انجام شده است. نتایج: یافته‌ها نشان می‌دهد که سه علت عمده مرگ، مسؤول کاهش حدود 13 سال از عمر مردان و زنان است. نتایج جزیی‌تر، بیان‌گر این است که بیماری‌های قلبی- عروقی، سرطان ها و سپس حوادث غیر عمدی سهم بیش‌تری در این کاهش داشته‌اند و نقش حوادث غیر عمدی در کاهش امید زندگی مردان، پررنگ‌تر از زنان است. در مورد حوادث غیرعمدی، سهم گروه های سنی میانی مخصوصا در مردان در این کاهش مهم است، اما در بیماری های قلبی عروقی و سرطان ها، سهم گروه های سنی پایانی چشم گیر است. نتیجه‌گیری: توجه ویژه به عوامل خطر مربوط به بیماری‌های قلبی- عروقی در هر دو جنس و حوادث غیر عمدی در سطح مردان برای کاهش سطح مرگ‌ومیر و در نهایت افرایش امید زندگی کشور ضروری است. 2 Introduction: Recent studies on Iranian mortality clearly underscore the role of cardiovascular diseases, unintentional injuries, and cancers as three leading causes of reduced life expectancy during the last three decades. The purpose of current study is to measure the effect of these causes on 2010 life table for Iran. Materials & Method:The number of registered death by age and sex and death distribution by cause for Iran in 2010 are obtained from death registration system operated by the Ministry of Health and to know more about the population at risk population forecast information of the Statistical Centre of Iran (SCI) is used. The obtained data are analyzed using Multiple Decrement Life Table and Kitagava analysis method. Results: The results show that three leading causes of death are account for 13 years potential lost life of Iranian men and women. More detailed results indicate that cardiovascular diseases, cancers, and unintentional injuries play larger roles in this regard while men are more likely to die by unintentional injuries than women. Life expectancy of middle aged men are more affected by unintentional injuries while old aged women are more affected by cardiovascular diseases. Conclusion: Particular consideration of risk factors of cardiovascular diseases of both sexes and males death by unintentional injuries is of utmost importance in reducing mortality rate and increasing life expectancy as a result. 220 231 2016/03/172016/08/292016/03/182016/04/212016/09/132016/04/302016/06/122016/05/3 1395/2/14 2016/06/72016/08/292016/06/72016/06/72016/09/132016/06/72016/09/132016/06/7 1395/3/18 محمد ساسانی پور Mohammad Sasanipour Department of Demography, School of Social Science, Yazd University, Yazd, Iran. sasanipourm@gmail.com امیر حسین هاشمیان Amir Hossein Hashemian Research Center for Environmental Determinants of Health (RCEDH), Kermanshah University of Medical Sciences, Kermanshah, Iran. Department of Demography, School of Social Science, University of Tehran, Tehran, Iran. dr.ahashemian@kums.ac.ir مصیب محبی میمندی Mosaieb Moheby Meymandi Department of Demography, School of Social Science, University of Tehran, Tehran, Iran mo.mohebbi@gmail.com سعیده شهبازین Saeedeh Shahbazin Department of Demography, School of Social Science, Yazd University, Yazd, Iran. saeedehshahbazin2@gmail.com Life expectancy at birth Aged-based analysis Cardiovascular diseases Unintentional injuries Neoplasms. امید زندگی در بدو تولد تجزیه یر حسب سن بیماری‌های قلبی-عروقی حوادث غیر عمدی سرطان‌ها 1. Pourmalek F, Abolhassani F, Naghavi M, et al. Direct estimation of life expectancy in the Islamic Republic of Iran in 2003. East Mediterr Health Journal 2009; 15(1): 76-84.##2. Mirzaie M, Alikhani L. Estimation of the level and determinants of mortality and an observation on epidemiological changes in the city of Tehran during the last thirty years. Journal of Population Association 2007; 3: 30-60[Persian]##3. Motlagh ME, Safari R, Karami M, et al. Life Expectancy at Birth in Rural Areas Based on Corrected Data of the Iranian Vital Horoscope. Iran J Public Health 2012; 41(9): 18–24.##4. Khosravi A, Taylor R, Naghavi M, et al. Mortality in the Islamic Republic of Iran, 1964-2004. Bull World Health Organ 2007; 85(8): 607-614.##5. Koosheshi M, Sasanipour M. A study on the Contribution of Unintentional Accidents in Mortality and their Demographic Consequences in Iran, Journal of Population association of Iran 2013; 11(6): 85-113. [Persian]##6. Mirzaee M, Sasanipour M, Moheby Meymandi M. Why do men die in greater numbers: an analysis of sex differences in mortality with emphasis on cause of death in Iran. Journal of Population Association of Iran 2013; (14): 1-16. [Persian]##7. Yavari P, Abadi A, Mehrabi Y. Mortality and changing epidemiological trends in Iran during 1979-2001. Journal of Hakim 2003; 6(3): 7-14. [Persian]##8. Naghavi M, Jafari N. Mortality profile for 29 provinces of Iran (2004). Tehran: Iranian Ministry of Health and Medical Education-Deputy of Health 2007. [Persian]##9. Preston SH, Heuveline P, Guillot M. Demography: measuring and modeling population processes. Oxford: Blackwell Publishers 2001.##10. Keyfitz N. Caswell H. Applied Mathematical Demography. Springer Texts in statistics. New York: Springer–Verlag 2005; 3rd ed.##11. Coale AJ, Demeny P, Vaughan B. Regional model life tables and stable populations. New York, Academy Press 1983; 2nd ed.##12. Chiang CL. The life table and its applications. Malabar (Florida): RE Krieger Publishing 1983. ##13. Arriaga E. Measuring and explaining the change in life expectancy. Demography 1984; 21(1): 83-96.##14. Koosheshi M, Khosravi A, Sasanipour M, et al. Identification of the Impact of Major Causes of Death on Life Expectancy in Fars Using the Multiple Decrement Life Table Method. Iranian Journal of Epidemiology 2014; 9(4): 57-66. [Persian]## ##