The Role of Environmental Disruptor Chemicals in the Development of Non Communicable Disease.

The increasing prevalence of non communicable diseases (NCDs) poses main challenges to global public health. Various environmental exposures to different chemicals and pollutants might interact with genetic and epigenetic mechanisms resulting in the development of NCDs. Among these environmental exposures, endocrine disrupting chemicals (EDCs) consist of a group of compounds with potential adverse health effects and the interference with the endocrine system. They are mostly used in food constituents, packaging industries and pesticides. Growing number of in vitro, in vivo, and epidemiological studies documented the link of EDC exposure with obesity, diabetes, and metabolic syndrome, which are the underlying factors for development of NCDs. Prevention of exposure to EDCs and reduction of their production should be underscored in strategies for primordial prevention of NCDs.

Development of a simple and valid method for the trace determination of phthalate esters in human plasma using dispersive liquid-liquid microextraction coupled with gas chromatography-mass spectrometry.

A new method was developed for the trace determination of phthalic acid esters in plasma using dispersive liquid-liquid microextraction and gas chromatography with mass spectrometry analysis. Plasma proteins were efficiently precipitated by trichloroacetic acid and then a mixture of chlorobenzene (as extraction solvent) and acetonitrile (as dispersive solvent) rapidly injected to clear supernatant using a syringe. After centrifuging, chlorobenzene sedimented at the bottom of the test tube. 1 µL of this sedimented phase was injected into the gas chromatograph for phthalic acid esters analysis. Different factors affecting the extraction performance, such as the type of extraction and dispersive solvent, their volume, extraction time, and the effects of salt addition were investigated and optimized. Under the optimum conditions, the enrichment factors and extraction recoveries were satisfactory and ranged between 820-1020 and 91-97%, respectively. The linear range was wide (50-1000 ng/mL) and limit of detection was very low (1.5-2.5 ng/mL for all analytes). The relative standard deviations for analysis of 1 µg/mL of the analytes were between 3.2-6.1%. Salt addition showed no significant effect on extraction recovery. Finally, the proposed method was successfully utilized for the extraction and determination of the phthalic acid esters in human plasma samples and satisfactory results were obtained.

The relationship of exposure to air pollutants in pregnancy with surrogate markers of endothelial dysfunction in umbilical cord.

BACKGROUND: This study aims to investigate the association of exposure to ambient air pollution during pregnancy with cord blood concentrations of surrogate markers of endothelial dysfunction. METHODS: This population-based cohort was conducted from March 2014 to March 2015 among 250 mother-neonate pairs in urban areas of Isfahan, the second large and air-polluted city in Iran. We analyzed the association between the ambient carbon monoxide (CO), ozone (O3), nitrogen dioxide (NO2), sulfur dioxide (SO2), particular matter 10 (PM10), and air quality index (AQI) with cord blood levels of endothelin-1, vascular adhesion molecule (VCAM), and intercellular adhesion molecule (ICAM). Multiple regression analysis was conducted after adjustment for potential confounding factors and covariates. The regression coefficient (beta), standard error of the estimate (SE), and 95% confidence intervals for each regression coefficient (95% CI) are reported. RESULTS: Data of 233 mother-neonate pairs were complete, and included in the analysis. Multiple regression analyses showed that AQI, CO and O3 had significant correlation with cord blood ICAM-1 [Beta (SE), 95%CI: 2.93 (0.72), 1.33,5.54; 2.28(1.44), 1.56,5.12; and 2.02(0.01), 1.03,2.04, respectively] as well as with VCAM-1 [2.78(0.91), 1.69,4.57; 2.47(1.47), 1.43,5.37; and 2.01(0.01),1.07,2.04, respectively]. AQI, PM10, and SO2 were significantly associated with Endothelin-1 concentrations [Beta (SE), 95%CI: 10.16(5.08),7.61,14.28; 9.70(3.46), 2.88,16.52; and 1.07(0.02), 1.03,2.11, respectively]. CONCLUSIONS: The significant associations of air pollutants with markers of endothelial dysfunction during fetal period may provide another evidence on the adverse health effects of air pollutants on early stages of atherosclerosis from fetal period. Our findings underscore the importance of considering environmental factors in primordial prevention of chronic diseases.

A randomized controlled trial on the effects of jujube fruit on the concentrations of some toxic trace elements in human milk.

BACKGROUND: This study aims to investigate the concentrations of lead, cadmium, and arsenic in the human milk, and to assess the effect of jujube fruit consumption by lactating mothers in reducing the concentration of these heavy metals in their milk. MATERIALS AND METHODS: This randomized controlled trial was conducted in 2014 among forty postpartum mothers in Isfahan, the second largest and polluted city in Iran. Mothers were randomized into two groups; the intervention group received 15 g/day of fresh jujube fruit, and the controls received routine care for 8 weeks. RESULTS: In the beginning, the concentrations of lead, cadmium, and arsenic were high, without significant difference between groups. The mean (standard deviation) concentrations of lead, cadmium, and arsenic were 29.49 (16.6), 4.65 (3.51), and 1.23 (0.63) µg/L, respectively. The smoothed empirical distribution of environmental pollutants showed that in both groups the mean values and variance of toxic metals decreased after 8 weeks, with a sharper decline in the intervention group. Quantile regression analysis showed that in the intervention group, lead concentration decreased by 2.54 µg/L at the 90th quintile, and cadmium decreased by 0.19 µg/Lat 75th quintile; without significant change in arsenic level. The corresponding figures were not significant in the control group. CONCLUSION: The concentrations of heavy metals were high in human milk, and the consumption of jujube fruit had some beneficial effects in reducing these harmful elements. Pregnant and lactating mothers should be advised to reduce their exposure to environmental pollutants, and consumption of some natural medicinal foods can be useful in reducing the concentration of pollutants in human milk. Because of numerous benefits of breast milk, in spite of the existence of some toxic trace elements, breastfeeding must be encouraged because such contaminants are also found in water and formula. The impact of the current findings on the primary prevention of chronic disease should be determined in future longitudinal studies.

Trends in health burden of untreated water and insanitary environments in Iran, 1990-2010: Findings from the global burden of disease study 2010.

Background: Water, sanitation and hygiene have a very important role in public health. Poor sanitation is the cause of water contamination, which causes many types of diseases. The aim of this paper was to present the attributable death and disability adjusted life year (DALYs) of untreated water and insanitary environments from 1990 to 2010 in Iran. Methods: In the Global Burden of Disease 2010 study, using the comparative risk assessment, the proportion of death and DALYs attributable to untreated water source and insanitary environment has been calculated in 1990 to 2010. The certain outcomes were intestinal infectious diseases for both untreated water source and insanitary environments. Estimated attributable deaths and DALYs were reported with 95% uncertainty interval (UI). Results: DALY number for untreated water source and insanitary environments was 5838 (95% UI: 198- 14837) in 1990, which decreased to 326 (95% UI: 9-863) in 2010 and the percent of decrease was 94.42%. In addition, DALY rate was 5667 (95% UI: 192-14402) DALY per 100,000 in 1990, which decreased to 453 (95% UI: 13-1199) DALY per 100,000 in 2010 and the percent of the reduction was 92.01%. The greatest percentage of decrease in the attributed number of deaths was also found in the late neonatal age group (95.45%). Conclusion: A significant decrease has occurred in a number of DALYs and deaths between 1990 and 2010, which was attributed to the development of new water systems and environmental sanitations in Iran.

Association of geographical distribution of air quality index and type 2 diabetes mellitus in Isfahan, Iran.

OBJECTIVES: Air pollution is a hazardous environmental problem with several adverse health effects including its impact on the development of chronic diseases as diabetes mellitus. This study aimed to investigate the association of geographical distribution of air quality index (AQI) and type 2 diabetes mellitus in an air-polluted city by using geographic information system (GIS). METHODS: This cross-sectional study was conducted in Isfahan, Iran. The records that have been registered from 2009 to 2012 in major referral public diabetes clinics were gathered; they included data of 1467 diabetic patients. Their living area was represented with spots in the city map. AQI data were also interpolated from monitoring stations spreading around the city. The GIS maps of air pollutants and diabetes were developed and the associations were determined. RESULTS: The density of diabetic population was higher in highly polluted areas compared with areas with the lower levels of air pollution. No significant correlation was documented between the distribution of diabetic patients and air pollution level throughout the city. CONCLUSION: Although the density of diabetic patients was higher in areas with higher air pollution, but the lack of association between AQI and the prevalence of diabetes might be because the air of different parts of the city was highly polluted, and we could not compare the prevalence of diabetes in areas with clean and polluted air.

A systematic review on the effects of environmental exposure to some organohalogens and phthalates on early puberty.

BACKGROUND: Early puberty is a common worldwide problem. Different parameters as genetics, metabolic diseases, obesity, as well as environmental factors may affect the age of puberty. This systematic review aims to survey the related literature on the effects of environmental pollutants and especially organohalogens and phthalates on early puberty. MATERIALS AND METHODS: A systematic review of papers published in the English language was completed in January 2014. Studies on the associations of organohalogens and phthalates with the puberty time were included. A literature search was conducted in EMBASE, PubMed, Scopus, ISI Web of Science, and Cochrane Library from 1995 to January 2014; moreover manual search through references of relevant manuscripts was considered. The literature search identified 212 papers, of which 13 papers fulfilled the inclusion criteria of the current study. Two reviewers independently identified relevant papers for potential inclusion and assessed the methodological quality. RESULTS: This review included 6572 participants in nine countries from three continents (Europe, North America, and Asia). Different studies determined the effects of pollutants on maturation signs and pubertal stages and confirmed the association of organohalogens and phthalates with early puberty. CONCLUSION: Based on the studied literature, environmental pollutants surround and accumulate in human societies and their adverse health effects are well documented. It can be concluded that organohalogens and phthalates are disturbing the normal process of puberty timing; especially their influence on early maturation in girls should be underscored.

Systematic review on adverse birth outcomes of climate change.

BACKGROUND: Climate change and global warming have significant effects on human health. This systematic review presents the effects of the climate changes on pregnancy outcomes. MATERIALS AND METHODS: The search process was conducted in electronic databases including ISI Web of Knowledge, PubMed, Scopus, and Google Scholar using key words of "environmental temperature" "pregnancy" "low birth weight (LBW)" "pregnancy outcome," "climate change," "preterm birth (PTB)," and a combination of them. We did not consider any time limitation; English-language papers were included. The related papers were selected in three phases. After quality assessment, two reviewers extracted the data while the third reviewer checked their extracted data. Finally, 15 related articles were selected and included in the current study. RESULTS: Approximately all studies have reported a significant relationship between exposure variable and intended outcomes including eclampsia, preeclampsia, cataract, LBW, PTB, hypertension, sex ratio and length of pregnancy. According to conducted studies, decrease in birth weight is more possible in cold months. Increase in temperature was followed by increase in PTB rate. According to most of the studies, eclampsia and preeclampsia were more prevalent in cold and humid seasons. Two spectrums of heat extent, different seasons of the year, sunlight intensity and season of fertilization were associated with higher rates of PTB, hypertension, eclampsia, preeclampsia, and cataract. CONCLUSION: Climate change has unfavorable effects on eclampsia, preeclampsia, PTB, and cataract. The findings of this review confirm the crucial importance of the adverse health effects of climate change especially in the perinatal period.

Is air quality index associated with cardiometabolic risk factors in adolescents? The CASPIAN-III Study.

OBJECTIVE: This study aims to evaluate the association of air quality index (AQI) with cardiometabolic risk factors in a nationally representative sample of healthy adolescents. METHODS: This nationwide survey was conducted among a stratified multi-stage probability sample of students, aged 10-18 years, from 27 provinces of Iran. Those students with history of any acute or chronic diseases, any medication use, as well as active or passive smoking were not included to the current study. Dietary and physical activity habits were documented by valid questionnaires. Physical examination and blood sampling were conducted under standard protocols. AQI data were obtained from air pollution monitoring sites from the entire country by considering air pollutants concentration, which includes all provincial counties containing different clusters. RESULTS: The study participants consisted of 1413 students (48.8% boys) with a mean (SD) age of 14.81±2.48 years. The mean AQI level was 285.37±30.11 at national levels. After adjustment for confounding factors including age, sex, and anthropometric measures, as well as for dietary and physical activity habits, multiple linear regressions based on correlation of coefficients of the AQI with cardiometabolic risk factors showed significant positive correlations of AQI with systolic blood pressure, fasting blood glucose, total cholesterol, LDL-cholesterol, and triglycerides, as well as significant negative correlations with HDL-cholesterol. After adjustment for abovementioned confounding factors, binary logistic regressions analyses showed that AQI increased the risk of abnormal levels of some risk factors as elevated levels of systolic blood pressure, total cholesterol, and triglycerides. CONCLUSION: The associations of low air quality with some cardiometabolic factors in the current survey, although not strong, might be considered as an evidence of the adverse cardiometabolic consequences of exposure to air pollutants in the pediatric age group, and predisposing them to earlier development of non-communicable diseases.

Expression of cord blood cytochrome P450 1A1 gene according to the air pollution level of the maternal residence area.

BACKGROUND: This study aimed to compare the cytochrome P450 1A1 (CYP1A1) gene expression in the cord blood of infants born from mothers living in low- and high-air polluted areas. MATERIALS AND METHODS: The study was conducted in Spring 2012 in Isfahan, the second large and air-polluted city in Iran. The study comprised 60 neonates, consisting of 30 infants born from mothers residing in areas with high levels of air pollution and an equal number of infants born in areas with a lower air pollution level. The umbilical cord blood sample was taken immediately after birth. The relative gene expression levels of CYP1A1 were examined using real time-polymerase chain reaction method. RESULTS: CYP1A1 gene expression level was 3.3-fold higher in the group living in areas with higher pollution level than in the other group (P = 0.01). No significant difference existed in the mean values of maternal age, gestational age, the newborns' birth weight, and the gender distribution between the two groups. CONCLUSION: This study provides confirmatory evidence of prenatal health hazards of ambient air pollution and highlights the need for pollution prevention programs to protect women of childbearing age and their children. The clinical implications of this study finding should be confirmed in future longitudinal studies.

First report on path analysis for cardiometabolic components in a nationally representative sample of pediatric population in the Middle East and North Africa (MENA): the CASPIAN-III Study.

BACKGROUND/AIMS: This study aimed to test a potential model of the relationship between various cardiometabolic risk factors including obesity, unhealthy diet, low physical activity, dyslipidemia, and high blood pressure in a large population-based sample of children and adolescents. METHODS: In this nationwide study, a representative sample of 5,528 students aged 10-18 years was selected by multistage random cluster sampling from 27 provinces of Iran. Demographic, anthropometric, biological, and biochemical factors were determined. Structural equation modeling (path analysis) was applied to evaluate the causal relationship between these variables. RESULTS: The mean age of study participants was 14.7 ± 2.41 years and the mean body mass index (BMI) was 19.4 ± 4.1. Higher socioeconomic status was directly associated with unhealthy diet, low physical activity and BMI in both sexes. Age had a positive direct effect on low physical activity in both sexes. BMI showed the greatest direct effect on total cholesterol, triglyceride, low-density lipoprotein cholesterol, and mean arterial pressure in comparison with the direct effects of unhealthy diet and low physical activity. BMI was associated negatively with high-density lipoprotein cholesterol in both groups. CONCLUSIONS: No previous study has used path analysis for determining the interactions examined in this study among a nationally representative sample of children in the Middle East and North Africa (MENA). The results of this study underline the imperative need for the weight loss and lifestyle change from childhood as the first-line preventive strategy for metabolic syndrome and noncommunicable diseases.

Relation of air pollution with epidemiology of respiratory diseases in isfahan, Iran from 2005 to 2009.

BACKGROUND: National Institute of Environmental Health Sciences (NIEHS) scientists shows that long-term exposure to air pollutants increases the risk of respiratory diseases such as allergies, asthma, chronic obstructive pulmonary disease, and lung cancer. Children and the elderly are particularly vulnerable to the health effects of ozone, fine particles, and other airborne toxicants. Air pollution factors are considered as one of the underlying causes of respiratory diseases. This study aimed to determine the association of respiratory diseases documented in medical records and air pollution (Map distribution) of accumulation in Isfahan province, Iran. By plotting the prevalence and spatial distribution maps, important differences from different points can be observed. MATERIALS AND METHODS: The geographic information system (GIS), pollutant standards index (PSI) measurements, and remote Sensing (RS) technology were used after entering data in the mapping information table; spatial distribution was mapped and distribution of Geographical Epidemiology of Respiratory Diseases in Isfahan province (Iran) was determined in this case study from 2005 to 2009. RESULTS: Space with tracing the distribution of respiratory diseases was scattered based on the distribution of air pollution in the points is an important part of this type of diseases in Isfahan province where air pollution was more abundant. CONCLUSION: The findings of this study emphasis on the importance of preventing the exposure to air pollution, and to control air pollution product industries, to improve work environmental health, and to increase the health professionals and public knowledge in this regard.

The impact of an after-school physical activity program on health-related fitness of mother/daughter pairs: CASPIAN study.

OBJECTIVE: To examine the effectiveness of parental support and involvement in a low-cost intervention for the improvement of health-related fitness of high school girls through an after-school physical activity (PA) program. METHODS: This multi-site study was conducted in 2006-2007 in 7 provinces in Iran. The study population comprised of two groups of children. The first group consisted of 206 children who were randomly selected from female students (7th-10th grade) and their mothers (n=204). Another 60 children (without their mothers) were randomly selected as the control group. Overall, during 12 weeks, 24 sessions of after-school aerobic exercise were held. Health-related fitness data were collected pre- and post-intervention. RESULTS: The findings are based on 470 participants. The after-school PA significantly improved body mass index, resting heart rate, cardiorespiratory fitness, flexibility and muscle strength and endurance in children in both groups, and in mothers. Improvement in the physiological measures of the children in the mother/daughter group was significantly better than the control group. CONCLUSION: The findings suggest that after-school PA may provide an effective model for improving the health-related fitness of high school girls and their mothers. Our data show that family support, including mother's participation, contributes to enhanced health-related achievements in adolescent girls.

First growth curves based on the World Health Organization reference in a Nationally-Representative Sample of Pediatric Population in the Middle East and North Africa (MENA): the CASPIAN-III study.

BACKGROUND: The World Health Organization (WHO) is in the process of establishing a new global database on the growth of school children and adolescents. Limited national data exist from Asian children, notably those living in the Middle East and North Africa (MENA). This study aimed to generate the growth chart of a nationally representative sample of Iranian children aged 10-19 years, and to explore how well these anthropometric data match with international growth references. METHODS: In this nationwide study, the anthropometric data were recorded from Iranian students, aged 10-19 years, who were selected by multistage random cluster sampling from urban and rural areas. Prior to the analysis, outliers were excluded from the features height-for-age and body mass index (BMI)-for-age using the NCHS/WHO cut-offs. The Box-Cox power exponential (BCPE) method was used to calculate height-for-age and BMI-for-age Z-scores for our study participants. Then, children with overweight, obesity, thinness, and severe thinness were identified using the BMI-for-age z-scores. Moreover, stunted children were detected using the height-for-age z-scores. The growth curve of the Iranian children was then generated from the z-scores, smoothed by cubic S-plines. RESULTS: The study population comprised 5430 school students consisting of 2312 (44%) participants aged 10-14 years , and 3118 (58%) with 15-19 years of age. Eight percent of the participants had low BMI (thinness: 6% and severe thinness: 2%), 20% had high BMI (overweight: 14% and obesity: 6%), and 7% were stunted. The prevalence rates of low and high BMI were greater in boys than in girls (P < 0.001). The mean BMI-for-age, and the average height-for-age of Iranian children aged 10-19 years were lower than the WHO 2007 and United states Centers for Disease Control and Prevention 2000 (USCDC2000) references. CONCLUSIONS: The current growth curves generated from a national dataset may be included for establishing WHO global database on children's growth. Similar to most low-and middle income populations, Iranian children aged 10-19 years are facing a double burden of weight disorders, notably under- and over- nutrition, which should be considered in public health policy-making.

Obesity and metabolic syndrome among a representative sample of Iranian adolescents.

Metabolic syndrome (MetS) increases the risk of developing many chronic diseases and originates early in life; its prevalence varies by population. The present study investigated the prevalence of MetS and the association between MetS and obesity in a population of adolescents in northern Iran. A total of 450 Iranian high school students (50% boys), aged 15-18 years, were enrolled in the study. Physical examination and biochemical analyses were conducted according to standard protocols; MetS was defined according to the modified NHANES III criteria. The prevalence of MetS among subjects was 3.3%. Eight percent of subjects had a body mass index (BMI) >75th percentile, and 10.5% had a BMI >85th percentile. Overall, 42.1% of students did not have any components of MetS. Waist circumferences (WC), Body Mass Index (BMI), serum level of triglycerides (TG) and high density lipoprotein-cholesterol (HDL-C) were significantly higher among girls than boys. Systolic blood pressure (SBP) and fasting blood sugar (FBS) were significantly higher among boys than girls. The associations between a BMI > or = 85th percentile and MetS (OR 6.97; 95%CI 2.41-20.16) and between a BMI > or = 75th percentile and MetS (OR 6.74; 95%CI 2.10-21.57) were statistically significant. The association between an increased WC and MetS was also statistically significant (OR 21.64; 95%CI 6.7-69.81). This study confirms the high prevalence of components of MetS among apparently Iranian adolescents, even among those not overweight. The high prevalence of MetS among adolescents with generalized and abdominal obesity underscores the need for primary prevention of MetS in early life.

Evaluation of musculoskeletal disorders in sewing machine operators of a shoe manufacturing factory in Iran.

INTRODUCTION: A 15-year research conducted in USA showed that compensation expenses paid to workers for musculoskeletal disorders (MSDs) of back exceeded 128 million Dollars calculated on the basis of 0.97 Dollars per hour of work. In addition, according to the latest studies carried out in relation with disease burdens with risk factors in Iran, DALYs indices for low back pain, knee arthrosis and other musculoskeletal disorders have been reported to be 307772, 291305 and 872633 respectively, which have caused the work related diseases to occupy the second position in the country, after cardiovascular diseases. On the other hand, in accordance with occupational health indices of Iranian health ministry, 37% of all working population had had poor work postures with 15% of all working population had been working with inappropriate working tools in the year 2009. METHODS: This was a case study comparing exposed workers with control group using Standard Nordic Questionnair in sewing machine operators of a shoe manufacturing factory in Iran. In this study, the mentioned questionnaires were filled out for the exposed group (25 sewing machine operators with average age of 43.5 years with work records of 16.8 years) and control group (15 employees from administrative department with average age of 39.8 years with work records of 13.4 years) which both were selected through simple random method. RESULTS: There were statistically significant differences in age between musculoskeletal disorders of right elbow (p = 0.033), thigh (p = 0.044), both knees (p = 0.019) and ankles (p = 0.039). There were also statistically significant association between gender and musculoskeletal disorders of right elbow (p = 0.028), thigh (p = 0.026) both knees (p = 0.011); right shoulder disorders (p = 0.018) and work records; disorders of both knees (p = 0.031) and number of cigarettes smoked. CONCLUSIONS: In general, prevalence of disorders of cervical area, shoulders with hands, vertebral column, back, knees, thigh with feet were higher in exposed group due to poor work posture. Meanwhile, female workers were inflicted more than males. On the other hand, these disorders were seen more with increased work records and age in which, improvement of work postures, training for better execution of tasks and conducting periodic screening tests are being recommended.

Association of particulate air pollution and secondhand smoke on endothelium-dependent brachial artery dilation in healthy children.

BACKGROUND: This study aimed to determine the association of particulate matters with endothelial function, measured by flow mediated dilation (FMD) of brachial artery, in children with or without exposure to secondhand smoke. METHODS: This cross-sectional study was conducted from January to March 2011 in Isfahan, which is the second large and air-polluted city in Iran. The areas of the city with lowest and highest air pollution were determined, and in each area, 25 prepubescent boys with or without exposure to daily tobacco smoke in home were selected, i.e. 100 children were studied in total. RESULTS: FMD was significantly smaller in those living in high-polluted area and those exposed to secondhand smoke. Multiple linear regression analysis, adjusted for age and body mass index, showed that both passive smoking status and living area in terms of particulate air pollution were effective determinants of the brachial artery diameter. The standardized coefficient of passive smoking status was -0.36 (SD = 0.09, P < 0.0001) showing negative association with percent increase in FMD. Likewise, the percent increase in brachial artery diameter was lower in passive smoker children. Similar relationship was documented for PM(10) concentration with a regression coefficient of -0.32 (SD = 0.04, P < 0.0001). Without considering passive smoking variable, PM(10) concentration has significant independent effect on FMD level. CONCLUSION: Our findings provide evidence on the association of environmental factors on endothelial dysfunction from early life. Studying such associations among healthy children may help identify the underlying mechanisms. The clinical implications of environmental factors on early stages of atherosclerosis should be confirmed in longitudinal studies.

Synergistic effects of genetic polymorphism and air pollution on markers of endothelial dysfunction in children.

BACKGROUND: This study aims to determine the association of some genetic polymorphisms in the relationship of air pollutants on the serum levels of thrombomodulin (TM) and tissue factor (TF) in a population-based sample of children and adolescents. MATERIALS AND METHODS: This cross-sectional study was conducted among 110 participants (52.8% girls) with a mean age of 12.7 + 2.3 years, in Isfahan, Iran. Genotypes of TM G33-A and + 5466A > G polymorphisms were determined by the polymerase chain reaction - restriction length fragment polymorphism method (PCR-RFLP). The enzyme-linked immunosorbent assay (ELISA) was used for measurement of serum TM and TF. RESULTS: THE FOLLOWING GENOTYPES WERE IDENTIFIED FOR TM: GG in 69.2%, GA in27.2%, and AA in 3.6% of the participants. Considering TF, 108 participants were homozygous for the + 5466A allele, and two subjects had + 5466AG genotype. The mean pollution standards index (PSI) value was at a moderate level; the mean particulate matter measured up to 10 µm (PM(10)); and ozone (O(3)), nitrogen dioxide, and sulfur dioxide were considerably high. The mean serum TF and TM levels were not significantly different among the participants with the aforementioned genotypes. Among participants exposed to high quartiles of O(3), PM(10), and PSI, the TM-33G / A polymorphism (GA + AA genotype) increased the Odds ratio (OR) of the low serum TM level. There was no statistically significant association in the areas of low pollution. CONCLUSION: The findings of our study support the synergistic effect of the TM-33G / A polymorphism and air pollutants on factors associated with the onset of the atherosclerosis. This might be confirmatory evidence for gene-environment interaction, and related effects on atherogenesis from early life.

The association between spatial distribution of common malignancies and soil lead concentration in Isfahan, Iran.

BACKGROUND: Malignancies are primarily environmental diseases mostly attributed to environmental factors. By plotting the prevalence and spatial distribution maps, important differences can be observed in detail. This study aimed to determine the association between map distribution of malignancies and the geological phenomena of lead (Pb) accumulation in soil in the province of Isfahan, Iran. METHODS: Spatial distribution maps of malignant diseases were plotted by using data recorded during 2007 to 2009 in the Isfahan Cancer Registry Program. Data on Pb accumulation in soil was obtained from the National Geological Survey and Mineral Exploration. Pb concentrations were documented in three parts of agricultural, non-agricultural, urban, and industrial land. The geographical mapping of cancers and soil Pb were then incorporated into a geographic information system (GIS) to create a spatial distribution model. RESULTS: The spatial distributions of ten common malignant diseases in the province, i.e. skin cancers, hematological malignancies, and breast cancers, followed by other malignancies were scattered based on Pb distribution. In fact, common cancers were more prevalent in the parts of the province where soil Pb was more abundant. CONCLUSION: The findings of this study underscore the importance of preventing Pb exposure and controlling industrial production of Pb. The data is also important to establish further effects modeling for cancers. Moreover, physicians and health professionals should consider the impact of environmental factors on their patients' health.

Prevalence study of clinical disorders in 6-year-old children across Iranian provinces: Findings of Iranian national health assessment survey.

OBJECTIVE: To assess the national prevalence of clinical disorders in 6-year-old Iranian children before school entry using a national health assessment survey. MATERIALS AND METHODS: In a cross-sectional nationwide survey, all Iranian children entering public and private elementary schools were asked to participate in a mandatory national screening program in Iran in 2009 in two levels of screening and diagnostic levels. RESULTS: The study population consisted of 955388 children (48.5% girls and 76.1% urban). Of the whole children, 3.1% of the 6-year-old children had impaired vision. In addition, 1.2, 1.8, 1.4, 10, 10.9, 56.7, 0.7, 0.8 and 0.6% had color blindness, hearing impaired, speech disorder, height to age retardation, body mass index extremes, decayed teeth, having disease with special needs, spinal disorders, and hypertension, respectively. The distribution of these disorders was unequally distributed across provinces. CONCLUSIONS: Our results confirmed that the prevalence of clinical disorders among 6-year-old children across Iranian provinces was not similar. The observed burden of these distributions among young children needs a comprehensive national policy with evidence-based province programs to identify the reason for different distribution among provinces.