Burden of diseases attributed to traffic noise in the metropolis of Tehran in 2017.

Although road traffic noise is the most important source of environmental noise emission in large cities, little is known about health burden. The present study was conducted to estimate the burden of diseases attributed to traffic noise in the metropolis of Tehran in 2017. Using noise maps provided by the municipality of Tehran, we calculated population exposure distribution in term of Ldn and Lnight and the number of DALYs lost due to ischemic heart disease, hypertension, high sleep disturbance, annoyance and stroke endpoints based on the World Health Organization Environmental Noise Guidelines for the European Region. We applied published dose-response functions to estimate the traffic noise burden for high sleep disturbance and annoyance. We estimated 61,284 DALYs or 697 DALYs per 100,000 population attributed to traffic noise in Tehran for the reference year 2017. Highly sleep disturbance with a share of 58.74% of the DALYs was recognized as the most important contributor of disease burden, and noise annoyance with a share of 23.12% was ranked next. Ischemic heart disease (11.71%), stroke (5.12%), and hypertension (1.31%) were ranked third to fourth, respectively, in terms of the burden of disease caused by environmental noise. A considerable fraction of the population of Tehran lives in areas with an environmental noise higher than the standard level. The findings showed that traffic noise pollution is an important environmental risk factor in Tehran imposes the greatest burden on the community, mainly through highly sleep disturbance and noise annoyance endpoints.

Development and effectiveness assessment of a Persian-language smartphone application for celiac patients: A randomized controlled clinical trial.

OBJECTIVES: We aimed to design a Persian-language application for celiac patients and assess its effectiveness on patients` knowledge and adherence to a gluten-free diet (GFD). METHODS: In the present randomized controlled clinical trial, 60 patients were randomly assigned to receive education through a smartphone application (n = 30) or conventional clinical education (n = 30). The primary outcomes were assessing knowledge about celiac disease and GFD, and adherence to GFD that were assessed at baseline and three months after interventions. The knowledge and adherence were assessed by a valid author-designed knowledge questionnaire and the validated celiac disease adherence test (CDAT) respectively. RESULTS: The mean disease duration was 4.38 ± 3.27 years. The mean post-intervention score of knowledge about gluten-free foods was significantly higher in the intervention group compared with the placebo group after adjusting for baseline values and characteristics (p-value = 0.03). There was a significant difference in post-intervention CDAT values between the two groups (p-value = 0.01). CONCLUSION: The smartphone application had a significant effect on celiac patients` knowledge about gluten-free foods and adherence to GFD. PRACTICE IMPLICATIONS: The smartphone applications can be designed according to each country's particular circumstances and can be suggested by nutritionists and physicians to use by celiac patients.