Association of prolonged occupational co-exposures to electromagnetic fields, noise, and rotating shift work with thyroid hormone levels.

The purpose of this study was to determine the association of prolonged occupational co-exposure to extremely low-frequency electromagnetic fields (ELF-EMFs), noise, and rotating shift work with the levels of thyroid hormones (triiodothyronine (T3), thyroxine (T4), and thyroid-stimulating hormone (TSH). From 2016 to 2017, we enrolled all male workers without a history of thyroid disorders and followed them until 2020. To measure ELF-EMFs and noise exposures, we calculated the 8-hour equivalent sound pressure levels (Leq) and the 8-hour average of ELF-EMFs, respectively. Shift work schedules involved 8-hr fixed day and 8-hr clockwise 3-rotating night schedules. The participant's thyroid hormone levels were obtained from blood test results in their medical records. The percentage change in the levels of T3, T4, and TSH was estimated by using different mixed-effects linear regression models. The TSH levels were significantly elevated per a 10-dB increment of noise. The levels of T4 hormone were significantly changed per a unit increase in the levels of ELF-EMFs. Compared to the fixed-day workers, we observed workers exposed to shift work had a significantly lower T4 level. For T4 and TSH hormones, we found significant interactions among noise, ELF-EMFs, and shift work variables. In summary, this study warranted that prolonged exposure to ELF-EMFs, noise, and rotating shift work might be associated with thyroid dysfunction.

Independent, modified, and interacting effects of long-term noise, extremely low-frequency electromagnetic fields, and shift work exposures on liver enzymes.

To quantify long-term independent, modified, and interacting effects of noise, extremely low-frequency electromagnetic fields (ELF-EMFs), and shift work exposures on liver enzymes, a four-year repeated measures study was performed among male workers in a thermal power plant industry from 2016 to 2020. The 8-h equivalent sound pressure levels (Leq) were measured at weighting channels of Z, A, and C for octave-band frequencies. The 8-h time-weighted average of ELF-EMFs levels was measured for each participant. Shift work schedule was determined based on job titles, including 3-rotating night shift work and fixed day shift work schedules. The fasting blood samples were taken to determine liver enzymes (AST, Aspartate transaminase; ALT, Alanine transaminase). The percentage change (PC) and 95% confidence interval (CI) of AST and ALT enzymes were estimated by the different bootstrapped-mixed-effects linear regression models. Per 10-dB noise increase, we found a significantly higher PC (95% CI) of AST and ALT (only LAeq) levels in all regression models with the highest changes for LAeq. For the octave-band noise analysis, there was an upward trend from 31.5 Hz to 1 kHz frequencies and a downward trend from 1 to 8 kHz frequencies. Per 1 mG ELF-EMFs increase, we observed a significantly higher PC (95% CI) of AST and ALT enzymes in the main adjusted and the main adjusted + shift work models. The 3-rotating night than fixed day shift workers had a significant PC in the unadjusted model for AST enzyme and the fully adjusted and the main adjusted + ELF-EMFs models for ALT enzyme. Significant negative two-way or/and three-way interaction effects among the noise, ELF-EMFs, and shift work were observed for both AST and ALT enzymes. Our findings indicated long-term noise, ELF-EMFs, and 3-rotating night shift work exposures may be significantly associated with changes in the levels of liver enzymes.

Socioeconomic-related inequalities in self-rated health status in Kermanshah city, Islamic Republic of Iran: a decomposition analysis.

BACKGROUND: Socioeconomic-related inequalities in health are a major public health challenge in both developed and developing countries. Little evidence is available on socioeconomic-related inequalities in health in different regions of the Islamic Republic of Iran. AIMS: This study aimed to determine socioeconomic-related inequality in poor self-rated health in adults in Kermanshah city, western Islamic Republic of Iran. METHODS: This cross-sectional study with stratified sampling obtained data on socioeconomic status, demographic characteristics, behavioural risk factors and self-rated health of 2040 adults (≥ 18 years) in Kermanshah city. A self-administrated questionnaire was used to collect data from the participants. The concentration (C) index and C curve were used to determine the socioeconomic-related inequality in poor self-rated health. A decomposition analysis of the C index was done to identify the factors explaining socioeconomic-related inequality in poor self-rated health. RESULTS: The crude and age-adjusted prevalence of poor self-rated health was 13.8% and 18.1%, respectively. The estimated C for the whole sample was -0.295, indicating that poor SRH was concentrated in the poor. The decomposition results suggested that socioeconomic status (45.5%), having a chronic health condition (11.9%) and smoking (7.3%) were the main factors contributing to the concentration of poor self-rated health among those of lower socioeconomic status. CONCLUSION: The concentration of poor self-rated health among the poor in Kermanshah city warrants policy attention. Policies aimed at reducing inequality in wealth distribution and risky health behaviour and preventing chronic health conditions among the poor may mitigate socioeconomic-related inequalities in poor self-rated health in Kermanshah.

Impact of Smoking on Health-Related Quality of Life: A General Population Survey in West Iran

This study was aimed at assessing any association between smoking and health-related quality of life (HRQoL) among adults aged 18 years and above living in Kermanshah city, western Iran. A cross-sectional study was conducted on a total sample of 1,543 participants obtained by convenient sampling during the period from February 1st to May 30th, 2017. Data were collected using a self-administrated questionnaire. The HRQoL of the study participants was assessed with reference to the EuroQol 5-dimensions-3-level (EQ-5D-3L). The impact of smoking behavior of the participants on HRQoL with controls for potential confounders was examined by multiple regression. Out of the total of 1,543 participants, current smokers, past smokers, and never smokers accounted for 19.7%, 4.2% and 76.1%, respectively. The mean EQ-5D indices were 0.69 ±SD 0.20, 0.70 ± SD 0.22, and 0.78 ± SD 0.16. The highest proportion of self-reported problems (including both 'some' and 'severe') were related to current, heavy smokers, with high nicotine dependence. Regression analysis indicated that current smokers had a significantly lower HRQoL compared to past smokers and never smokers (p < 0.05). The heavy smokers also had a significantly lower HRQoL score than moderate and light smokers (p < 0.05) and there was an inverse relationship between the HRQoL score and nicotine dependence (p<0.05). The current smokers, heavy smokers, and high nicotine dependent smokers had lower HRQoL scores. These findings provide inputs for better understanding and for devising interventions for smoking cessation, reducing the number of cigarettes smoked per day and nicotine dependency.

Determinants of health-related quality of life in Iranian adults: evidence from a cross-sectional study.

OBJECTIVES: This study aimed to measure the level and determinants of health-related quality of life (HRQoL) in adults in Kermanshah, a city in the western region of Iran. METHODS: Convenience sampling was employed to obtain a sample of 998 adults aged 18 years and older (646 males and 352 females) in the city of Kermanshah. A 2-part self-administered questionnaire was used to collect data over the period between March 1 and May 30, 2017. The first part was designed to collect information on socio-demographic characteristics, socioeconomic status, and lifestyle factors (10 items). The second part consisted of the EuroQoL 5-dimensions (EQ-5D) EuroQoL-3-level and the EuroQoL visual analog scale (EQ-VAS) questions. A multiple linear regression model was used to determine the factors associated with the EQ-5D index and EQ-VAS score among study participants. RESULTS: The mean values for the EQ-5D index and the EQ-VAS score were 0.74 (standard deviation [SD], 0.19) and 80.9 (SD, 16.5), respectively. The highest percentage of self-reported problems ('some' and 'severe' problems) across the 5 dimensions of the EQ-5D index were associated with the dimensions of anxiety/depression (35.3%) and pain/discomfort (32.9%). The percentage of self-reported problems for the dimensions of usual activities, mobility, and self-care were 19.0, 12.8, and 8.9%, respectively. Our regression analyses indicated that there were statistically significant positive associations between being physically active, monthly household income per capita, and post-secondary education and the EQ-5D index and EQ-VAS score. In contrast, negative associations were found between older age, being married, having a chronic disease, and smoking and the EQ-5D index and EQ-VAS score. A negative association was also found between being uninsured and the EQ-5D index. CONCLUSIONS: Our findings suggest that interventions aiming to improve physical activity, to prevent chronic diseases, and to reduce the smoking rate among adults living in the city of Kermanshah may improve their HRQoL.