A comprehensive study on the spatial and temporal variation of BTEX and asbestos in the northwest of Iran: Human risk assessment.

Substances like asbestos and other air pollutants, such as BTEX (benzene, toluene, ethylbenzene, and xylene), are hazardous compounds due to their adverse effects on human health. This study aims to investigate the levels, seasonal variations, spatial distribution, potential sources, and associated health risks associated with BTEX compounds and asbestos fibers in the ambient air of Tabriz. Air samples were taken at 16 different locations during the 2020-2021 period. Glass containers with charcoal were used for sample collection, and the BTEX content was determined using the GC-FID method. Phase-contrast microscopy (PCM) analysis was conducted with a low-volume peripheral pump for asbestos fiber sampling. The results showed that the average concentration of ∑BTEX was 37.94 and 27.98 µg/m3 in autumn and spring, respectively. The same parameter was 2.26 and 1.68 f/L for asbestos in the autumn and winter, respectively. The contribution of BTEX to ozone formation potential (OFP) in the research area showed that xylene and toluene were the major contributors to ozone production in different seasons. The risk of exposure to benzene compounds was 24 × 10-4 in children and 55.9 × 10-4 in adults, while the risk of exposure to ethylbenzene was 3.78 × 10-4 in children and 3.25 × 10-4 in adults. The estimated lifetime cancer risk was found to be the highest for benzene, followed by ethylbenzene. The estimated cancer risk for benzene and ethylbenzene exceeded the threshold values set by EPA, which signals a significant carcinogenic risk due to exposure to these substances in the ambient air of Tabriz. According to the EPA guidelines, the low carcinogenicity risk levels are between 10-4 and 10-6. According to the findings for the exposure to asbestos fibers, the maximum values of excess cancer risk (ECR) and estimated lifetime cancer risk (ELCR) were observed in the 16-30 age range across all locations, suggesting increased exposure to asbestos fibers compared to other age groups.

Investigating PM2.5 toxicity in highly polluted urban and industrial areas in the Middle East: human health risk assessment and spatial distribution.

Exposure to particulate matter (PM) can be considered as a factor affecting human health. The aim of this study was to investigate the concentration of PM2.5 and heavy metals and their influence on survival of A549 human lung cells in exposure to PM2.5 breathing air of Ahvaz city. In order to assess the levels of PM2.5 and heavy metals, air samples were collected from 14 sampling stations positioned across Ahvaz city during both winter and summer seasons. The concentration of heavy metals was determined using ICP OES. Next, the MTT assay [3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide] was employed to ascertain the survival rate of A549 cells. The findings from this research demonstrated that average PM2.5 of the study period was (149.5 µg/m3). Also, the average concentration of PM2.5 in the urban area in winter and summer was (153.3- and 106.9 µg/m3) and in the industrial area this parameter was (191.6 and 158.3 µg/m3). The average concentration of metals (ng/m3) of urban areas against industrial, Al (493 vs. 485), Fe (536 vs. 612), Cu (198 vs. 212), Ni (128 vs. 129), Cr (48.5 vs. 54), Cd (118 vs. 124), Mn (120 vs. 119), As (51 vs. 67), Hg (37 vs. 50), Zn (302 vs. 332) and Pb (266 vs. 351) were obtained. The results of the MTT assay showed that the highest percentage of cell survival according to the exposure concentration was 25 > 50 > 100 > 200. Also, the lowest percentage of survival (58.8%) was observed in the winter season and in industrial areas with a concentration of 200 µg/ml. The carcinogenic risk assessment of heavy metals indicated that except for Cr, whose carcinogenicity was 1.32E-03, other metals were in the safe range (10-4-10-6) for human health. The high concentration of PM2.5 and heavy metals can increase respiratory and cardiovascular diseases and reduce the public health level of Ahvaz citizens.

Pesticides residues determination and probabilistic health risk assessment in the soil and cantaloupe by Monte Carlo simulation: A case study in Kashan and Aran-Bidgol, Iran.

Cantaloupe is a popular agricultural product in the hot season of Iran. On the other hand, the frequent use of pesticides in cantaloupe fields is the most important threat to the health of farmers and consumers. Therefore, the present study aims to measure the concentration of diazinon (DZN), chlorpyrifos (CPF), and malathion (MLT) in cantaloupe cultivated in Kashan and Aran-Bidgol (Iran) and to estimate the possible oral and dermal risk of these pesticides by Monte Carlo simulation (MCS). 36 cantaloupe samples, 18 samples before, and 18 samples after the latent period were collected from different places of cantaloupe cultivation from April to May 2021. After measuring the pesticides using the QuEChERS approach, oral and dermal risk assessments were calculated.The mean and standard deviation of the concentrations of chlorpyrifos, malathion, and diazinon in 18 cantaloupe samples, after the latent period, were (30.39 ± 13.85), (18.361 ± 1.8), and (21.97 ± 0.86) µg kg-1, respectively. Concentration of Malathion, diazinon, and Chlorpyrifos in the soil were 0.22, 0.25, and 0.3 mg kg-1, respectively, and pesticide cumulative risk assessment in soil was obtained 0.011 for Malathion, 0.05 for diazinon and 0.03 for Chlorpyrifos. Target Hazard Quotient (THQ) according to the cantaloupe consumption and dermal exposure in children and adults, was safe range. Although non-cancerous dermal and oral risk of cantaloupe is low, constant exposure can be harmful. Therefore, the findings of this study play an important role in increasing the understanding of the negative health consequences of pesticide contamination in cantaloupe for consumers, especially local residents, and can help by adopting remedial strategies to reduce environmental concerns.

PAHs pollution in the outdoor air of areas with various land uses in the industrial city of Iran: distribution, source apportionment, and risk assessment.

Shahryar city regions with various land uses had their outdoor air concentrations of PM2.5-bound PAHs determined. Totally, 32 samples were taken - eight samples from the industrial region air (IS), eight samples from the high-traffic urban regions air (HTS), eight samples from the air of commercial regions (CS), and eight samples from residential areas (RS), which were analyzed by GC-MS. According to the study's findings, in the outdoor air of IS, HTS, CS, and RS, there were mean Æ©PAHs concentrations of 23.25 ± 20.22, 38.88 ± 26.53, 6.97 ± 4.26, and 4.48 ± 3.13 ng/m3, respectively. As comparison to CS and RS, mean concentration of Æ©PAHs in samples from HTS and IS was substantially greater (p < 0.05). Using the Unmix.6 receptor model, sources of PAHs in the air of Shahryar were allocated. The model's results show that 42% of PAHs come from diesel vehicles and industrial activities, 36% from traffic and other transportation sources, and 22% from heating sources and coal burning. The carcinogenicity suffering resulting from exposure to PAHs was as follows: This value for children of the ingestion, inhalation pathways and dermal contact is (1.90 × 10-6-1.38 × 10-4), (5.5 × 10-11-2.67 × 10-9) and (2.36 × 10-6-1.72 × 10-4), respectively. Also, for adults were (1.47 × 10-6 - 1.07 × 10-4), (1.14 × 10-10 - 5.27 × 10-9) and (3.68 × 10-6- 2.87 × 10-4), respectively. In general, the analyzed region's carcinogenicity risk estimates fell within the range of acceptable limit.

Assessment of the risk of Legionella pneumophila in water distribution systems in hospitals of Tehran city.

When a sensitive host inhales aerosols containing these bacteria, Legionella infection occurs. Therefore, monitoring and assessing Legionella in the environment and water distribution systems of such places are critical due to the prone population in hospitals. However, the health risks of Legionella bacteria in the environment are not adequately evaluated. In this study, for hospitalized patients, we performed a quantitative health risk assessment of Legionella in selected hospitals in Tehran city using two scenarios of shower and toilet faucet exposure. This study identified Legionella in 38 cases (38%) out of 100 samples collected from toilet faucets and showers in 8 hospitals. The information gathered was used for quantitative microbial risk assessment (QMRA). The microbial load transmitted by inhalation was calculated using the concentration of Legionella in water. Other exposure parameters (inhalation rate and exposure time) were obtained using information from other studies and the median length of hospital stay (3.6 days). The exponential model was used to estimate the risk of infection (γ = 0.06) due to Legionella pneumophila (L. pneumophila) inhalation for each exposure event. For the mean concentration obtained for Legionella (103 CFU/L), the risk of infection for toilet faucets and showers was in the range of 0.23-2.3 and 3.5-21.9, respectively, per 10,000 hospitalized patients. The results were compared with the tolerable risk level of infection determined by the US EPA and WHO. The risk values exceeded the WHO values for waterborne pathogens in hospitals in both exposure scenarios. As a result, our QMRA results based on monitoring data showed that despite using treated water (from distribution networks in the urban areas) by hospitals, 38% of the samples were contaminated with Legionella, and faucets and showers can be sources of Legionella transmission. Hence, to protect the health of hospitalized patients, the risk of Legionella infection should be considered.

Characterization, possible sources and health risk assessment of PM2.5-bound Heavy Metals in the most industrial city of Iran.

Air pollution associated with particulate matters results in different types of disease including allergy, lung destruction, heart failure, and related problems. This study has been designed and performed to examine the concentration of PM2.5-bound heavy metals, risk assessment, possible sources and effect of meteorological parameters on 17 sites of the air of the most industrial city of Iran (Karaj) in 2018-19. For this purpose, four samples were taken from every point of Karaj air over one year using a pump (Leland Legacy (SKC)) with flow rate of 3 L/min on PTFE filter for 24 h. Overall, 68 samples of PM2.5-bound heavy metals were collected. Note that during the sampling, atmospheric parameters including temperature, pressure, humidity, and wind speed were regularly recorded using PHB318 portable device. In examining the chemical composition of these particles, the concentration of metals (Al-Zn- Ar-Cd-Cr-Cu-Fe-Hg-Mn-Ni-Pb) was determined after digestion of the collected samples and through injection into ICP-OEC device. The results indicated that the mean annual concentration of PM2.5 particles range from 21.84 to 72.75 µg/m3. The mean concentration of heavy metals lied within the range of 25.63 to 336.27 ng/m3. Among heavy metals, the maximum concentration belonged to aluminum (277.95 ng/m3) and iron (336.27 ng/m3), which are known as elements with a ground source (sources such as car fuels, exhaust gases, decorative materials, batteries, indoor smoking, the paint used for painting walls, erosion and corrosion of rubber of cars). Meanwhile, there was a positive relationship between heavy metals and temperature(r: 0.418, p < 0.019), pressure (r: 0.184, p < 0.0.402), as well as wind speed (r: 0.38, p < 0.017), while an inverse relationship was observed with relative humidity (r: -0.219, p < 0.018). The ecological risk of the metals calculated was very notable, with the maximum environmental risk being related to cadmium in children (6.61) and manganese in adults (0.82). The largest HQ in children and adults was associated with Cr. Finally, ILCR values for cadmium in both children (1.19 E-04) and adult (4.81 E-04) groups indicated high risk of developing cancer in humans.

A global systematic review, meta-analysis and health risk assessment on the quantity of Malathion, Diazinon and Chlorpyrifos in Vegetables.

It is widely believed that an increasing trend in the production and consumption of vegetables has led to a dramatic rise in the use of pesticides potentially threatening the health of consumers around the world. This systematic study along with meta-analysis has mainly centered on the evaluation of the quantity of three well-known pesticides namely, Malathion (MLT), Diazinon (DZN) and Chlorpyrifos (CPF) in vegetables. In this regard, a comprehensive literature search has been performed over the last decade (January 1, 2011 to June 21, 2020) within the scientific databases including PubMed, Web of Science, and Scopus. Of 1239 articles identified through the database screening, 22 plus 37 data report were retained and included in the meta-analysis phase. Additionally, the probabilistic human health risks for the consumers due to the intake of CPF, DZN and MLT from eating vegetables were estimated by the Monte Carlo Simulated (MCS) method. According to the findings, the maximum quantities of MLT, DZN and CPF in the vegetables were observed in Pakistan (222 µg/kg, 95%CI = 214.94-229.08), Thailand (245.00, 95% CI = 235.2-254.8) and South Korea (440 µg/kg, 95% CI = 437.19-442.81), while the lowest concentration levels were reported in China (1.7 µg/kg, 95% CI = 1.56-1.84), Poland (0.57, 95% CI = 0.46-0.68) and Poland (5.78 µg/kg, 95% CI = 4.40-7.12), respectively. The results of the Egger's and the Begg's tests revealed that no bias with regard to the potential publication was observed. Finally, non-carcinogenic risk assessment results demonstrated that the exposure to the studied pesticides thorough vegetables consumption could not threaten the health of consumers.

Spatio-seasonal variation, distribution, levels, and risk assessment of airborne asbestos concentration in the most industrial city of Iran: effect of meteorological factors.

Like other dangerous pollutants in the air, asbestos has negative and adverse effects on human and animal health. The present study is designed to determine the concentration of asbestos in the air of the most industrial city of Iran (Karaj) in 2018-2019. For this purpose, 4 samples were taken from different areas of the air of Karaj during a year with an SKC pump and flow of 6 L/min for 8 h and in 45 days, and a total of 68 samples of asbestos fibers were collected. Then, the samples were analyzed by phase-contrast microscope (PCM) and scanning electron microscopy (SEM). Eventually, the health effects of asbestos fibers were evaluated by the IRIS EPA method. The average concentration of asbestos fibers was 1.84 f/L PCM and 18.16 f/L SEM. Also, the results of statistical correlation analysis indicated that asbestos fibers are positively correlated with wind speed but negatively correlated with the other three parameters (temperature, relative humidity, and pressure). On the other hand, the average annual risk of asbestos fiber in the ambient air of Karaj for all samples was in the range of 4.32 × 10-6 to 1.81 × 10-4 which in some places had more danger than the recommended risk range. According to the EPA guidelines, carcinogenicity acceptable levels are in the range of 10-4 and 10-6. Values higher than 10-4 have more carcinogenic risk and values lower than 10-6 have a lower carcinogenic risk.

Occurrence, spatial distribution, seasonal variations, potential sources, and inhalation-based health risk assessment of organic/inorganic pollutants in ambient air of Tehran.

The present study evaluated the concentrations, spatial distribution, seasonal variations, potential sources, and risk assessment of organic/inorganic pollutants in ambient air of Tehran city. Totally, 180 air samples were taken from 9 sampling stations from March 2018 to March 2019 and were analyzed to determine the concentrations of organic pollutants (BTEX compounds and PM2.5-bound PAHs) plus inorganic pollutants (PM2.5-bound metals and asbestos fibers). The results revealed that the mean concentrations of ∑ PAHs, BTEX, ∑ heavy metals, and asbestos fibers were 5.34 ng/m3, 60.55 µg/m3, 8585.12 ng/m3, and 4.13 fiber/ml in the cold season, respectively, and 3.88 ng/m3, 33.86 µg/m3, 5682.61 ng/m3, and 3.21 fiber/ml in the warm season, respectively. Source apportionment of emission of the air pollutants showed that PAHs are emitted from diesel vehicles and industrial activities. BTEX and asbestos are also released mainly by vehicles. The results of the inhalation-based risk assessment indicated that the carcinogenic risk of PAHs, BTEX, and asbestos exceeded the recommended limit by The US environmental protection agency (US EPA) and WHO (1 × 10-4). The risk of carcinogenesis of heavy metal of lead and chromium also exceeded the recommended limit. Thus, proper management strategies are required to control the concentration of these pollutants in Tehran's ambient air in order to maintain the health of Tehran's citizens.

Exposure to heavy metal contamination and probabilistic health risk assessment using Monte Carlo simulation: a study in the Southeast Iran.

The rice contamination to heavy metals and its associated health risks have been less addressed in the southeast of Iran. In the present study, in the mentioned region, we assessed the concentration of nine elements in rice, and the health risk related to the measured elements was determined using the data which were gathered by a questionnaire. For this purpose, 36 samples of the 12 most widely consumed rice brands were collected. Using ICP-MS, the concentrations of Ni, Cr, Hg, Sr, Mn, Fe, Se, Ba, and Zn were measured in the studied samples as 0.599 ± 0.124, 0.483 ± 0.28, 0.0157 ± 0.005, 0.85 ± 1.307, 11.5 ± 1.97, 178.46 ± 67.27, 0.212 ± 0.083, 0.845 ± 0.62, and 8.416 ± 1.611 mg/kg, respectively. We found that, regarding the other studies, the levels of Ni, Cr, Hg, Fe, and Ba were higher. Besides, using 258 distributed questionnaires among citizens, the daily rice consumption was determined to be 295.66 ± 171.005 g/person/ day. Based on this consumption rate and Monto Carlo uncertainty simulation, Fe (0.741 ± 0.54 mg/kg/day) and Se (8.95E-04 ± 6.33E-04 mg/kg/day) showed the highest and lowest daily intake, respectively. Also, using Hazard Quotient (HQ), the non-carcinogenic risk effects of the surveyed elements were estimated. The obtained results of HQ revealed that Fe (2.48) and Mn (1.06) could pose non-carcinogenic health risks to consumers. Moreover, the calculated hazard Index showed that the overall health risk of the surveyed elements is in an unsafe range.

Effect of micro-aerobic process on improvement of anaerobic digestion sewage sludge treatment: flow cytometry and ATP assessment.

Micro-aeration as a pretreatment method improves the efficiency of anaerobic digestion of municipal sewage sludge and consequently promotes the methane production. In this study, adenosine triphosphate (ATP) and flow cytometry (FCM) were employed to monitor the performance of the micro-aerobic process and investigate the survival of bacterial cells within the process. At first, the effect of air flow rate (AFR) (0.1, 0.2, 0.3 and 0.5 vvm) on hydrolysis of mixed sludge in 5 aeration cycles (20, 30, 40, 48 and 60 hours) was examined. Then, the effects of the micro aerobic process on methane (CH4) production in anaerobic digestion were surveyed. The highest VSS reduction was 30.6% and 10.4% for 40 hours in the reactor and control, respectively. Soluble COD also fluctuated between 40.87 and 65.14% in micro-aerobic conditions; the highest SCOD was achieved at the time of 40 h. Microbial activities were increased by 597%, 170% and 79.4% for 20, 30 and 40 h pretreatment with the micro-aerobic process, respectively. Apoptosis assay showed that micro-aerobic pre-treatment at 20, 30 and 40 h increased the percentage of living cells by 57.4, 62.8 and 67.9%, respectively. On the other hand, FCM results showed that the highest percentage of viable bacteria (i.e., 67.9%) was observed at 40 h pretreating which was approximately 40% higher the ones for the control. Variation in cumulative methane production shows that methane production was increased by 221% compared to anaerobic digestion (control group). Therefore, ATP and FCM can be employed as two appropriate, accurate, relatively specific indicators for monitoring the process and bacteria viability.

Comparative health risk assessment of in-vehicle exposure to formaldehyde and acetaldehyde for taxi drivers and passengers: Effects of zone, fuel, refueling, vehicle's age and model.

This study aimed to assess the carcinogenic and non-carcinogenic risks of in-vehicle exposure in Tehran, Iran to formaldehyde and acetaldehyde for different models of taxis, and to explore the effects of city zone, taxi vehicle type, the taxi's age (<1, 1-5, 5-10), fuel type (gasoline, CNG, and LPG), and refueling activities on the estimated health risks based on previously measured concentrations. The overall and age-specific carcinogenic and non-carcinogenic risks of these compounds for taxi drivers and passengers were estimated separately using Monte Carlo simulations. Three scenarios of exposure frequency were defined for taxis commuting in different zones of city: Restricted Traffic Zone (RTZ) and Odd-Even Zone (OEZ) as two plans to reduce air pollution, and no-restriction zone (NRZ). The carcinogenic risks for drivers and passengers, the average risks of formaldehyde and acetaldehyde for most cases were above the 1 × 10-4. The health risks were greater in Restricted Traffic Zone (RTZ) and Odd-Even Zone (OEZ) in comparison to no-restriction zone (NRZ). The carcinogenic risk from formaldehyde exposures were higher than those for acetaldehyde in all cases. Taxis fueled with LPG showed lower cancer risks for both acetaldehyde and formaldehyde. Refueling increased the carcinogenic risk from both compounds. For non-carcinogenic risks from acetaldehyde, the average hazard ratios for both drivers and passengers were >1, indicating a non-negligible risk. Cancer and non-cancer risks for the taxi drivers were greater than the passengers given the higher time of occupancy. The present study showed that transportation in taxis can impose significant long-term health risks to both passengers and drivers. Development and investment in cleaner choices for public transportations are required.

Monitoring of airborne asbestos fibers in an urban ambient air of Shahryar City, Iran: levels, spatial distribution, seasonal variations, and health risk assessment.

Asbestos, as with other pollutants in the air, has adverse effects on the health of human beings and animals. Today, the relationship between presence of asbestos fibers in the air breathed by humans and developing serious diseases such as lung cancer (asbestosis) and mesothelioma has been proven. This study was designed and conducted within the time period of August 2017 and June 2018 to determine the concentration of asbestos fiber in the ambient air of Shahryar City and to evaluate their health effects for the general population of the city. For this purpose, samples were taken from four points, and overall 32 air samples were taken along the year. The samples were then analyzed by the phase contrast microscopy (PCM) method. Also, to investigate the type of asbestos and for more accurate counting of fibers, SEM analysis was utilized. Finally, based on the EPA IRIS method, the health effects resulting from asbestos risks were also evaluated. The results of this study indicated that the mean annual concentration of asbestos fiber in the ambient air of Shahryar City was obtained as 0.0019 f/ml PCM and 0.0072 f/ml SEM. Furthermore, the most polluted point was S1 point (0.0119 -0.0026 f/ml, PCM), while the lowest concentration was related to S4 point (0.001 f/ml PCM-0.0021 f/ml SEM). The mean annual risk resulting from airborne asbestos fiber in the ambient air of Shahryar City for all samples was obtained as 1.72 × 10-6 to 2.2 × 10-4, which was higher than the recommended risk range in some points.

Correction to: Indoor and outdoor concentrations of BTEX and formaldehyde in Tehran, Iran: effects of building characteristics and health risk assessment.

The original publication of this paper contains a mistake. The correct name and affiliation of the 3rd Author is presented in this paper.

Indoor and outdoor concentrations of BTEX and formaldehyde in Tehran, Iran: effects of building characteristics and health risk assessment.

BTEX (benzene, toluene, ethylbenzene, xylene) and formaldehyde are toxic compounds that can induce adverse health effect in humans. This study measured in-home and ambient concentrations of BTEX and formaldehyde across Tehran, Iran. These pollutants were sampled from the indoor and adjacent outdoor air of 45 houses (9 in each city zone) during the winter of 2015. Sampling was repeated three times for each house. The analyses were performed according to NIOSH procedures. The effect of flooring material, wall covering, ventilation system, heating system, height above ground, presence of attached garages, and distance from highways was evaluated. In addition, carcinogenic and non-carcinogenic risks of these compounds were assessed. The average indoor concentrations of benzene, toluene, ethylbenzene, xylene, and formaldehyde were 53.2, 21.5, 14.4, 21.1, and 17.9 µg/m3, respectively. The average outdoor concentrations of benzene, toluene, ethylbenzene, xylene, and formaldehyde were 43.5, 26.2, 10.0, 19.1, and 6.9 µg/m3, respectively. Separate regression models showed that wall coating, ventilation system, heating system, flat level, and distance from highways explained 29, 60, 16, 60, and 59% of the BTEX concentrations, respectively. Houses with oil painted walls and parquet flooring had higher concentrations of BTEX and formaldehyde, respectively. The health risk assessment found that the carcinogenic risks of benzene and formaldehyde exceeded 1 × 10-4 and represent a definite risk. New buildings can be designed based on the results of this study to use better materials and optimum building designs to reduce exposure to these toxic air pollutants.

Fine particulate matter (PM2.5) in a compost facility: heavy metal contaminations and health risk assessment, Tehran, Iran.

The aim of this study was to evaluate the concentration of PM2.5 particles, potential sources, and determination of health risk assessment of heavy metals in various parts of composting facilities of Tehran's Kahrizak. A total of 60 PM2.5 particle samples were collected every 3 days from January to March 2016. To analyze the heavy metals, inductively coupled plasma atomic emission spectroscopy (ICP-AES) was applied. SEM-EDX analysis indicated that metals of Al, Si, Mg, Na, Au, S, Ca, K, and Co were dominant in the structure of particles. The concentration of PM2.5 was found to be the highest in the final processing site (c), followed by primary processing site (a) and the aerated site (b). The mean concentrations of Al and Fe in all sampling sites of a, b, and c were 7.46 ± 2.73, 1.48 ± 0.59, 24.30 ± 8.23 µg/m3 and 4.97 ± 2.83, 1.33 ± 0.48, 16.48 ± 7.36, respectively. The enrichment factor order of the trace elements was as follows: Cd > As > Pb > Zn > Cu > V > Cr > Ni > Mn > Fe > Al, with the highest EF value exceeding 10,000 for Cd at the a site. For all sampling sites in composting facilities, the cancer risk was more than > 1 × 10-4 as posed by the total of five carcinogenic metals (Pb, Cr, As, Ni, and Cd), indicating that risk factors were not negligible.

Demand for medical care in the urban areas of Iran: an empirical investigation.

This paper adapts a multinomial logit model to obtain the parameter estimates of demand with multiple choices for medical care services in the urban areas of Iran. The objective is to verify the effectiveness of the cost recovery policy by the Medical Services Insurance Organization of Iran. The results suggest that an out-of-pocket fee increase will not be conducive to the cost recovery and any increase in price would have a serious negative impact on the likelihood of healthcare utilization. Income appears to have a significant positive effect on the decision to seek medical care and the choice of facilities. Patients from wealthy families seem to seek more health care and prefer private facilities.