An analysis on control banding-based methods used for occupational risk assessment of nanomaterials.

Despite all benefits of nanomaterials, their unique characteristics made them an emerging hazard in workplaces, which need to be assessed for their potential risks. So, the aim of this study was to review all the studies conducted on the risk assessment of activities involving nanomaterials with CB-based methods.This study is based on a literature review on databases including Web of science, Scopus, PubMed, and SID. After reviewing and screening studies according to PRISMA, the collected data were meta-analyzed by Comprehensive Meta-Analysis Software. Also, Newcastle-Ottawa checklist was used for quality assessment of the studies. To determine similarity of methods, Cohen's Kappa was used. Sensitivity analysis was used to determine the role of each factor in the risk assessment by using the Crystal Ball tool.There are eight validated methods for risk assessment. Also, some authors used a self-deigned tool based on CB approach. The results of meta-analysis showed that the odds ratio for the risk of activities involved with nanomaterials was 0.654 (high risk). Results of simulation for Nanotool showed that the mean risk level of activities involved with nanomaterials, with a certainty of 95.07%, is moderate (RL3). Moreover, sensitivity analysis showed that the risk was depended on "Hazard band" in all methods except ISO method.The obtained results can be useful in improving existing methods and suggesting new methods. Also, there is a need to design and propose specific methods for risk assessment of incidental and natural nanomaterials.

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.

Asthma Management System in Primary Care Based on Global Initiative for Asthma and Snell's Drug Interaction: Accuracy and Usability.

Background: The two main pillars of asthma management include regular follow-up and using guidelines in the treatment process. Patient portals enable regular follow-up of disease, and guideline-based decision-support-systems can improve the use of guidelines in the treatment process. Based on the Global Initiative for Asthma (GINA) and Snell's drug interaction, asthma management system in primary care (AMSPC) includes the capabilities of both mentioned systems. This system was developed to improve regular follow-up and use GINA in the asthma management process. This study aimed to assess the accuracy and usability of the AMSPC based on the GINA and Snell's drug interaction. Materials and Methods: To assess the accuracy of the system, kappa test was used to calculate the degree of agreement between the suggestions made by the system and the physician's decision for a total of 64 patients selected through convenience sampling method. To assess usability, the Questionnaire for User Interface Satisfaction (QUIS) was used. Results: The scores of the Kappa for the agreements between the system and the physician in determining "drug type and dosage", "follow-up time", and "drug interactions" were 0.90, 0.94, and 0.94, respectively. The average score of the QUIS was 8.6 out of 9. Conclusion: Due to the high accuracy of the system in computerizing the GINA and Snell's drug interaction, as well as its proper usability, it is expected that the system be widely used to improve asthma management and reduce drug interactions.