مجله تحقیقات نظام سلامت
سال سیزدهم شماره 1 (بهار 1396)

Benzoic acid and sodium benzoate are antimicrobial preservatives used in food. National regulatory organizations have determined the permitted levels of benzoic acid and sodium benzoate in different food products. This review article was performed to collect the results of researches in Iran on the concentration of benzoic acid and sodium benzoate in different food products. Furthermore, the reported benzoic acid and sodium benzoate concentrations were compared with maximum permitted levels based on national standards.
As the keywords of benzoic acid, sodium benzoate, food, and Iran were searched in national and international databases such as SID, Magiran, Google Scholar, PubMed, and ISI.
Findings: From among the 61 articles published from 2000 to 2016, 43 were eliminated and a total of 18 articles were studied. Sodium benzoate was evaluated in the 4 categories of dairy products, acidic food, beverages, and grains. Most of the studies had focused on dairy products and very few studies had focused on other categories. Incompatibility of the permitted amount of benzoic acid and sodium benzoate in different food products with the national standard was observed in 100% of articles on dairy products, acidic food, and grains as well as 80% of articles related to beverages.
The studies conducted in Iran reported 2 hypotheses on benzoic acid and sodium benzoate in food products. First, the Presence of benzoic acid and sodium benzoate in dairy products, acidic food, and grains may be due to natural interactions caused by microorganisms. Thus, the performance of scientific researches to define the natural amount of benzoic acid and sodium benzoate is necessary and revision of the national standards is recommended. Second, benzoic acid and sodium benzoate may be added to food products by food manufacturers. Therefore, the planning and management of continuous monitoring of benzoic acid and sodium benzoate amount in different food products by regulatory and health organizations are necessary.

In heat stress management, the reduction of body heat load is important. The purpose in this study was the examination of the cooling ability of an ice gel cooling vest in hot and dry conditions.
This interventional experiment was conducted on 12 healthy male students. The heat strain score index (HSSI), skin temperature, oral temperature, and heart beat were measured with and without the cooling vest and two exercise intensities of 2.4 and 4.8 km/hour during 30 minutes in a climate chamber. The air temperature and humidity in the climate chamber were 38.8 °C and 32.9%, respectively. Data were analyzed using the independent t-test and repeated measures.
Findings: The averages of chest skin temperature and HSSI with and without the cooling vest were significant in the speed of 2.4 km/hour (P The findings of the study indicated that the ice gel cooling vest can reduce skin temperature and HSSI in light activities compared to moderate activity in hot and dry climatic conditions.

According to the World Health Organization (WHO), the most effective way to prevent AIDS is health education. Adolescent girls are one of the high-risk groups in this regard. The aim of this study was to determine the effectiveness of educational interventions based on the health belief model (HBM) on the promotion of AIDS preventive behaviors in female high school students in Mashhad, Iran, in 2016.
This quasi-experimental study was conducted on 80 female high school students. The subjects were divided equally into case and control groups (n = 40). The educational intervention was performed in the form of lectures and group discussion in the experimental group. The data collection tool was a 3-part questionnaire consisting of demographic characteristics, and HBM knowledge and constructs. Collected data were analyzed using paired t-test, independent t-test, and chi-square in SPSS software.
Findings: In this study, no significant differences were observed between the two study groups in terms of demographic characteristics. Before the intervention, there were no significant differences between the two groups in terms of knowledge, perceived susceptibility, perceived severity, perceived benefits, perceived barriers, and self-efficacy (P > 0.05). However, after the intervention, there was a significant difference between the groups in the mentioned variables except perceived susceptibility (P The research findings demonstrated the effectiveness of the HBM on AIDS preventive behaviors. The results indicated that education based on the HBM improved knowledge, perceived severity, benefits, barriers, and self-efficacy and reduce perceived barriers among female students. Creating sensitivity in this age group requires long term intervention.

Obesity is one of the most crucial risk factors in the occurrence of non-communicable diseases. Its prevalence has increased even among health care personnel and could render them susceptible to a myriad of diseases, particularly cardiovascular disorders (CVDs). Diverse treatment methods have been devised in this regard, one of which is the consumption of green tea. Owing to this, the present study attempted to explore the effect green tea exerts on the body mass index (BMI), blood pressure, and pulse rate of operating room personnel.
The current before-and-after clinical trial was conducted on 24 operating room personnel at the Shahid Motahari Hospital in Isfahan, Iran, in 2015. After informed consent forms were obtained from the subjects, they were asked to consume 4 cups of green tea, containing 3 g of green tea leaves in 300 ml of boiled water at 80 ºC, daily for 8 weeks. Their BMI, blood pressure, and pulse rate were monitored before and after the consumption of green tea. Data analysis was carried out in SPSS software.
Findings: The results of the study demonstrated that systolic pressure and pulse rate had a considerable decrease after 8 weeks of consumption of green tea. Nevertheless, no effect was observed on BMI and diastolic pressure.
The consumption of green tea can cause a beneficial reduction in systolic blood pressure and pulse rate, and thus, improve the cardiovascular status.

Premenstrual Syndrome (PMS) is a combination of physical, neurological, and psychological disorders and negatively effects social adjustment, interpersonal relationships, normal activities, and quality of Life (QOL). Physical activity is an effective method of controlling the symptoms of PMS. Given the importance of the participation of the spouse in the promotion of reproductive health and women's health, the aim of this study was to determine the effect of educational intervention for the spouse on physical activity among women with PMS.
This quasi-experimental study was performed in 2015. The study subjects were 100 couples of reproductive age referring to health centers of Falavarjan, Iran. The participants were randomly divided into experimental and control groups. The subjects in the experimental group received training on the impact of physical activity on controlling PMS symptoms. Data were collected using the Premenstrual Syndrome Assessment (PSA) and Saba Questionnaire before and 3 months after the intervention and were analyzed in SPSS software.
Findings: After the intervention, a significant increase was observed in the physical activity of women in the experimental group (P It can be concluded that the spouses had acted well as an educational agent and encouraged women to perform physical activities, and thus, reduce the symptoms of PMS. It is recommended that educational sessions be implemented by the health care system for men to encourage women to exercise.

Treatment adherence is a major factor in the treatment of hypertension. Some studies have suggested that medication-related beliefs are effective on treatment adherence. Therefore, this study was conducted with the aim to determine the relationship between medication-related beliefs and treatment adherence in patients with hypertension.
This cross-sectional study was conducted on 300 patients with hypertension who referred to health care centers in Isfahan, Iran in 2015. The participants were selected using classified random sampling. Data were collected using a demographic characteristics questionnaire, the Beliefs about Medicine Questionnaire, and Morisky Medication Adherence Scale (MMAS).The reliability of the BMQ and MMAS has been, respectively, reported as 0.71 and 0.69 in Iranian studies. Data were analyzed using the Pearson correlation coefficient, Spearman’s correlation, and independent t-test in SPSS software. All P values of less than 0.05 were considered significant.
Findings: The mean age of participants was 58.55 ± 6.16 years and 68.3% of them were women. There was a significant correlation between medication-related beliefs and treatment adherence (r = 0.21, P = 0.001). The gender and age of patients did not have a significant relation with medication-related beliefs and treatment adherence (P > 0.050). Education level and occupation had significant relations with medication-related beliefs (P 0.050).
Medication-related beliefs can affect treatment adherence. Educational interventions in patients with hypertension can increase treatment adherence through emphasizing positive beliefs about medication use.

Due to increasing environmental problems caused by the waste produced by health care centers in recent years, the determination of the optimal method of hospital waste management with the consideration of the numerous conflicting criteria is of grave importance. This study aimed to evaluate different options for hospital waste management in Tehran, Iran, and prioritize them using multi-criteria decision analysis.
This descriptive survey was conducted in 2015. The study participants consisted of 46 specialists in this regard. The subjects were selected using purposive sampling method. A questionnaire was used to collect data. The face validity of the questionnaire was approved by experts and its reliability was 0.00256 and was approved based on the incompatibility rate of less than 1.0. Statistical analysis was conducted using Excel and Lingo software.
Findings: In this study, 12 different criteria of prioritization of waste disposal methods were obtained. The 3 criteria of treatment effectiveness, air residuals, environmental impacts, and public acceptance obstacles had the most weight and the 3 criteria of cost, odor, and release with health effects had the least weight. Finally, based on the above criteria, different methods of hospital waste disposal were, respectively, prioritized as steam sterilization (autoclave), incineration, landfill disposal, chemical disinfection, irradiation, and microwave.
The majority of the participants preferred methods that have minimum effects on the environment like autoclave, steam sterilization, and burial after neutralization. However, the financial aspects of hospital waste disposal should also be considered.

Swimming is an important exercise for the body and soul. Failure to comply with health standards can lead to health problems and the transmission of infectious diseases to swimmers. The aim of this study was to investigate the qualitative indicators of water in swimming pools in Shahinshahr, Iran, and compare them with the standards.
This descriptive-analytical and cross-sectional study was conducted in 2011-2012. From the 3 swimming pools in Shahinshahr, 288 water samples were collected during 4 months, once every 3 weeks. The parameters of residual chlorine, pH, turbidity, and temperature and microbial parameters such as heterotrophic bacteria, pseudomonas aeruginosa, total coliform, and fecal coliform were evaluated.
Findings: The results of the study showed that residual chlorine, pH, turbidity, and temperature were desirable in 36.11%, 13.88%, 52.77%, and 22.22% of samples, respectively. In addition, the population of total coliform, fecal coliform, heterotrophic bacteria, and pseudomonas aeruginosa were in desirable ranges in 88.88%, 88.88%, 72.22%, and 86.11% of samples, respectively.
According to the results, the parameters of residual chlorine, temperature, and pH had the least compliance with the standards. This shows the necessity of continuous monitoring of physical and chemical parameters and disinfection of water in swimming pools.

A major stage of human life is old age which is characterized by particular needs, desires, and concerns. The present study was conducted to investigate the role of social support in the general health of the elderly.
A survey method was adopted in this study and data were collected using a questionnaire. The study population consisted of all senior citizens of over 65 years of age in Mashhad, Iran, from among whom a sample of 265 individuals was selected. For the purpose of sampling, a mixture of stratified and multi-stage cluster sampling was used. The data were collected from 9 urban neighborhoods in the city of Mashhad in the year 2015. Moreover, regression test, Pearson correlation, and independent t-test were used for data analysis.
Findings: The results showed that the general health of the elderly was at an average level, with the highest level of general health belonging to the subscale of social health. Moreover, social support of the elderly was at an average level, with the greatest support belonging to the subscale of emotional support. The results of independent t-test showed that the general health of men was significantly higher than women. Among the various aspects of social support, the emotional dimension had the greatest impact on the general health of the elderly.
According to the results of this study, emotional support had the highest effect on the general health of the elderly, but it should be noted that other requirements of the elderly such as support service, financial support, and counseling should also be met.

Nutrition has been recognized as one of the most important factors affecting cognitive function. Zinc is a micronutrient element, the deficiency of which has irreversible complications in early life and reversible complications in later stages of life. The main objective of this study was to assess the correlation between serum zinc concentrations and cognitive function and educational performance in young girls in art schools.
In this cross-sectional study, 100 students were randomly assessed and their serum zinc status was assessed using flame atomic absorption spectrometry technique. Intelligence quotient (IQ), memory, and attention were measured using Raven’s Progressive Matrices (RPM), Wechsler Memory Scale (WMS), and Bonnardel’s accuracy/letter eliminating tests, respectively. Educational performance was assessed using the academic scores average. General linear model (GLM) was used to evaluate the effect of serum zinc levels on variation in IQ, memory, attention, and educational scores.
Findings: The mean ± standard deviation (SD) of zinc serum level was 105.51 ± 31 µg/dl. The mean ± SD of RPM, WMS, Bonnardel’s accuracy test and Bonnardel’s letter eliminating test scores, and academic scores average were 91.44 ± 11.80, 84.6 ± 11.2, 46.0 ± 0.6, 44.84 ± 5.20, and 14.15 ± 1.80, respectively. A significant positive relationship was detected between serum zinc levels and scores of RPM, WMS, and Bonnardel’s tests (P Serum zinc level has a positive relationship with IQ, memory, and attention in young female students. Thus, education regarding the use of zinc must be considered in order to improve educational performance in young female students.

Dye is one of the most important pollutants in textile industry wastewater and is often toxic, carcinogenic, and mutagenic. Thus, dye contaminants should be treated before discharge into the environment. This study was conducted to assess the efficiency of Glycyrrhiza glabra ash in Reactive Black 5 dye removal from aqueous solutions.
The present experimental study was performed at a laboratory scale. The adsorbent was prepared under laboratory conditions and pulverized using ASTM standard sieves. In this research, the effect of pH (2-12), initial dye concentration (20, 60, and 80 mg/l), absorbent dosage (0.3-2 gr/100 ml), and reaction time (10-180 minutes) were investigated.
Findings: The results showed that the efficacy of Glycyrrhiza glabra root ash in dye removal decreased with increase in pH and initial dye concentration, and increased with increase in exposure time during the initial 60 minutes. The results followed the Langmuir isotherm (R2 = 0. 9467).
The results showed that licorice root ash has desirable efficacy (98.48% removal at a concentration of 20 mg of pollutant) in the removal of Reactive Black 5 dye from aqueous solutions and textile industry wastewater.

The main consumption of natural gas in Iran is in domestic heating mostly by domestic gas heaters. Domestic gas heaters may have considerable effect on pollutant and greenhouse gas production due to their high number. The aim of this research was to investigate stack exhaust pollutants of domestic gas heaters and its relation with ýair temperature and total gas consumption in the country.
LANCOM III, as a portable stack gas analyzer, was used for the measurement of gas pollutants produced by a domestic gas heater during the 5 cold months in 2012-2013. Meteorological and total gas consumption data were gathered from the Meteorological Office and National Iranian Gas Organization (NIGC), respectively.
Findings: The average amount of carbon dioxide, sulfur dioxide, nitrogen dioxide, nitric oxide, and hydrocarbons emission were 10939.64, 0.091, 1.01, 6.99, and 172.996 ppm, respectively. A significant relation was observed between daily reduction of air temperature with increase in sulfur dioxide and hydrocarbons (P The increase in sulfur dioxide and hydrocarbons and decrease in carbon dioxide and nitrogen dioxide on cold days may be due to variation in gas characteristics. On cold days, the total gas consumption in the country is increased which results in changes in gas flow rate, velocity, and pressure in gas pipelines and gas quality (due to the transfer of sulfur sediments from pipelines to gas).

Today one of the tools readily available, inexpensive, and determining human health, physical activity and sport and the quality of life today is considered one of the important health consequences. The aim of this study was to determine the relationship between sports participation and quality of life of women in Isfahan.
This study is a descriptive-correlational survey. The population included all 919,399 women living in Isfahan in 2014. Using the stratified sampling and Morgan’s sample size Table 386 subject were randomly selected. To collect data, Quality of life questionnaire (WHOQOL-BREF) with the reliability of 0.92 and sports participation questionnaire of Karimian et al (2011) with the reliability of 0.88 were used.
Findings: The results showed a positive and significant correlation between sports participation and quality of life of women (P = 0.001= and R = 0.371) at (-0.05). Also the level of sports participation of women with an average of 3.03 and quality of life with an average of 3.22 was within the average range. Also based on the regression analysis, 29% of the quality of life can be predicted by sports participation.
Based on the results we can say that regular exercise and physical activity has a significant relationship with quality of life in women And it can be concluded that the increase in sports participation, increase and improve women's quality of life.

Detection of appropriate models for the distribution of property population is very important. In the present study, the combined mixture distributions and multi-level analysis with Bayesian approach were used to determine the relationship between shift work and Framingham Risk Score (FRS).
The model designed to evaluate the relationship between shift work and the Framingham score was utilized on the data obtained in a cross-sectional study on 3243 workers of Mobarakeh Steel Company, Iran, in the first 6 months of 2015.
Findings: The workers consisted of 1690 day workers with a mean age of 42.13 ± 6.13, 1356 routine rotating shift workers with mean age of 40.75 ± 6.09, and 197 weekly rotating shift workers with mean age of 41.60 ± 6.10. In this study, by controlling the confounding factors, shift work showed a statistical relationship with FRS.
According to the results of this study, the FRS was higher among shift workers than day workers. This result has been supported by previous studies.

Construction workers have the second rank in injuries due to musculoskeletal disorders (MSD). The purpose of this study was to evaluate the ergonomic status of construction jobs using the National Institute for Occupational Safety and Health Center to Protect Workers’ Rights (NIOSH-CPWR) checklist and Nordic Musculoskeletal Questionnaire (NMQ).
This descriptive-analytical and cross-sectional study was carried out on 106 construction workers in Ahvaz, Iran. The research instruments used in this study were the NMQ and NIOSH-CPWR checklist which includes 11 sections. The NMQ was completed for 106 construction workers. Data were analyzed in SPSS software.
Findings: Shoulder (3.61%), back (4.59%), and knee (7.54%) disorders had the highest prevalence among MSDs in the subjects. In addition, 5.74% of jobs had repetitive movements. Among the workers, 9.68% had to work on their knees more than an hour a day and 5.75% had to bend and twist their bodies during tasks. Most construction site surfaces were rough and tough for walking and working.
MSDs occur among construction workers shortly after they began their work. Thus, the use of tools and equipment designed according to ergonomic principles, managerial controls, instructions training, and compliance with the relevant standards by managers and systems monitoring construction activity and workers’ health are necessities in workplace health monitoring.

Exposure to excessive sound is considered as one of the health problems of workers all over the world. One of the most important ways to control sound is using absorbent material around the sound source in the form of a silencer. This study intended to determine the sound insertion loss of a polystyrene silencer and its structural changes in order to improve sound reduction.
The silencer was built as an enclosure using polystyrene foam in the form of a rectangle (with no floor) with a density of 20 kg/m3, thickness of 5 cm, and the size of 1 × 1 × 1.5 m. Moreover, the sound level of 100 dB was generated by a speaker, perpendicular to the ground, as the sound source and two microphones were used to collect sound. Then, sound reduction values were examined by changes such as increasing thickness and creating a hole on the walls.
Findings: According to the results, through the polystyrene silencer with a thickness of 5 cm and without a hole, the maximum sound reduction of 34.5 dB at 500 Hz frequency was achieved. Furthermore, increasing the thickness to 7 cm and adding a hole with a diameter of 2 cm caused higher sound reduction than the silencer without changes in frequencies of 250, 500, 1000, and 2000 Hz.
In order to increase the efficiency of a polystyrene silencer, considering economic conditions and the desired location, greater thickness of polystyrene can be used. In addition, correct design of the hole on the silencer walls results in an increase in sound insertion loss outside the silencer.

Although there is general information in the scientific literature regarding the concentration of fatty acids in milk, detailed information on the fatty acid pattern of thermally processed milk distributed in the Iranian market has rarely been released. This study was conducted in order to compare the raw milk fatty acid pattern and its modification as a result of commercial thermal processing during a 3-month study in the summer, 2015.
In this cross-sectional study, 72 samples including raw, pasteurized, and sterilized milk were randomly collected from 4 manufacturing units in Isfahan and Markazi Provinces, Iran, during 3 sampling times in the summer with 1 month intervals. The fatty acids pattern was determined using gas chromatography (GC) method. Data were analyzed in SPSS using two-way ANOVA test and LSD post hoc test.
Findings: The results showed that the concentrations of both saturated and unsaturated fatty acids in raw milk significantly decreased after thermal processing (P The results of this study showed that commercial thermal processing of milk results in substantial changes in milk fatty acid concentration. Despite the gentle thermal process in pasteurization compared with sterilization, the decrease in fatty acids in this process was clearly higher than that in sterilization. Considering the importance of pasteurized milk in the public food basket, it is necessary to consider the above changes in the food composition table.

Regular physical activity has an essential impact on community health protection and health promotion, but some studies have revealed a decline in physical activity among adolescents, especially in girls, and its cause is still unknown. This study aimed to assess the physical activity behaviors of students in the city of Omidiyeh, Iran, and its predictive factors based on the Pender’s health promotion model (HPM).
This cross-sectional and analytical study was conducted on 430 female high school students in Omidiyeh selected through random cluster sampling. Data were collected using a questionnaire based on Pender’s models, and data analysis was performed using correlation tests, ANOVA, and regression analysis tests.
Findings: Data showed that during the previous week, 25% of subjects had not performed any physical activity and only 4.4% had performed physical activity for 30 minutes between 6-7 days a week. Scores of most structures of the HPM model were in the attainable mean score range; however, plan of action and self-efficacy scores in half of the subjects were below the average attainable score. There were significant relationships among HPM structures and physical activity behavior (P The level of physical activity among adolescent girls is not suitable. This can be suggestive of the risk of increased chronic diseases in the future of this community. Most of the structures of Pender’s HPM were related with physical activity level. Thus, it can be the basis for designing effective interventions to increase this behavior in adolescents.

High nitrate concentration in drinking water will cause negative effects to human health. The aim of this research is synthesis and characterization of high purity carbonate cancrinite zeolite and its surface modification in order to remove nitrate anions from water.
High purity carbonate cancrinite zeolite was synthesized hydrothermally using kaolin. Synthesis time was reduced by using bath ultrasound aging. After characterization, cationic surfactant modified zeolite was prepared. Optimally modified zeolite was used for removing nitrate from water.
Findings: High purity carbonate cancrinite zeolite was synthesized at 200 ◦C using kaolin in a mixture of 6 molar NaOH and 0.05 molar Na2CO3. The synthesis time was reduced to less than half by using bath ultrasound aging for 90 min. high externalcation exchange capacity (ECEC) of the synthesized zeolite justifies its surface modification for anion removal from water. Based on Langmuir isotherm model, maximum monolayer nitrate adsorption capacity was predicted to be 35.33, 28.41, and 17.06 mg/g at 20, 30 and 40 ◦C, respectively.
High purity carbonate cancrinite zeolite with high ECEC can be synthesis using kaolin and using bath ultrasound aging considerably reduces the synthesis time. Surfactant modified synthesized zeolite can be effectively used for nitrate removal from water.

Arsenic and Chromium are heavy metals that are conventional pollutants of water and wastewater sources. Nanoscale Zero Valent Iron (nZVI) can remove these pollutants based on their high potency. The aim of present study was to removal of Arsenic (III) and Chromium (VI) from aqueous solutions using nZVI and determining adsorption isotherms.
The design expert software was used to determining and affecting different such as pH, initial concentration, nZVI dosage and contact time on Arsenic and Chromium removal. Final concentration of metals was measured using Inductivity Coupled Plasma (ICP). Finally, the best fitted adsorption isotherms were determined.
Findings: Results showed that Arsenic optimum removal was happened in initial concentration 10 mg/l, time 5 min, pH=7 and nZVI dosage 5 g/l. Arsenic removal followed up Langmuir isotherms in different concentrations with nZVI. The Arsenic response was occurred, rapidly, with nZVI high concentration in neutral environment. The Arsenic removal efficiency was inverse respect with concentration increase. The Chromium removal efficiency with nZVI was low.
Results showed that nZVI had high efficiency for Arsenic removal in aqueous solutions. Therefore, it could be used for removal of this metal from polluted water and industrial wastewater. Nevertheless, Chromium removal efficiency was low with nZVI.