مقالات رزومه دکتر محمود علی محمدی

 Outsourcing services to the private sector can be a step towards achieving the goals of community health promotion, job creation, better access to health services, and improving the quality of health services. In this regard, health service offices were established in Tehran to improve the health status of food preparation, distribution and sale centers and increase food safety based on government approval. This study aimed to evaluate the roles of health services offices on environmental health indicators. 

 In this descriptive-comparative study, nine health service offices supervised by Tehran University of Medical Sciences (located in South Tehran Health Center, Eslamshahr city, and Shahr-e Rey) were surveyed. Seven environmental health indicators measured in the years before the establishment of these Health Service Offices (2015-2017) were compared with those obtained after their establishment (2018-2019). The indicators data were analyzed using Excel, SPSS software, and statistical tests.

 The result showed no significant difference in public places and centers for food preparation and distribution offenders, public places with health criteria, percentage of employees with a health training certificate, health care, and percentage of inspection coverage before and after establishment of health service offices (p >0.05). However, the relationship between the food preparation indicators and distribution centers with health criteria and public places and closed food preparation and distribution centers were significant (p > 0.05).

 This study is one of the first researches conducted to evaluate the effectiveness of health services offices on health-safety indicators in Iran. Therefore, more comprehensive monitoring and studies should be done to evaluate these offices' performance quality and their related cost-benefit analysis.

The aim of this study was to evaluate the chemical and microbial quality of bottled water in Iran and to calculate the water quality index (WQI).

Different brands of bottled water (4 samples from 71 brands) were randomly collected from the market. Chemical and microbial characteristics of the samples were examined and determined. Finally, the calculations related to the WQI index were performed and the water samples were classified as excellent, good, poor, very poor and unsuitable.

None of the samples exhibited concentration of heavy metals beyond Iranian water standards, and the concentration of sulfate (SO4), chloride (Cl) and fluoride (F) did not exceed international standards. However, in some samples, nitrite (NO2) and nitrate (NO3) concentrations were higher than recommended standards. With Regard to other water quality parameters, 8% to 89% of the samples exhibited concentration higher than the values provided on the water bottle label. 5 species of different bacteria were found in 15 water samples. According to the WQI index, about 63% of the samples were of excellent quality. Also, the water quality of 34% and 3% of the samples fell in good and poor quality categories, respectively. None of the bottled water samples was of very poor quality.

The quality of bottled water investigated in this study was generally suitable, but due to the wide range of bottled water in Iran based on brand and seasons, continuous evaluation of water treatment methods in companies and careful monitoring of chemical and microbial quality of bottled water in all seasons is recommended.

Regular use of household cleaning products and cosmetics can result in adverse consequences for human health. Therefore, the knowledge of consumption pattern of these products can help to evaluate the effects and finally control the consequences of their inappropriate application. As there is not an appropriate tool for evaluating public use-pattern for these products in Iran, we studied the reliability and validity of a questionnaire designed for the use-patterns of these products.

In the present study, a questionnaire, which was previously applied in similar studies for this purpose, was first translated to Persian. Then, some changes were made in the questionnaire according to the studied population. In the next step, the assessment of both content validity and face validity of the instrument was performed. Finally, the questionnaire reliability was studied in two test-retest steps at a 14-day interval with 40 subjects older than 14 years old being resident in Tehran city.

Total Content Validity Index (CVI) of this questionnaire ranged 0.66-1 for all question items. Cronbach's alpha coefficient was 0.814. The correlation assessment of each question item based on the total correlation score showed that all questionnaire items had a direct and strong correlation with the total instrument score.

Given the acceptable validity and reliability obtained for the questionnaire in Persian in this study, it can be used in those investigations that evaluate use patterns or asses the exposure risks to chemical pollutants from cosmetic products or detergents.

Surface water and underground water quality in countries that facing dehydration have increased the interest of the community to use Household Water Treatment devices. The aim of this study was the evaluation of the quality of drinking water of Household Water Treatment devices and general distribution network in Garmsar, which is under the control of the water safety plan.

A descriptive cross-sectional study administered in 6 regions and 41 cities of Garmsar city in spring and summer seasons in 2018. Chemical tests performed according to the standard methods for the examination of water and wastewater, general measurements were performed using the multi-tube fermentation method and counting of heterotrophic bacteria by pour plate method. The results analyzed by using Excel and SPSS software.

The average values during two seasons were reported as: EC= 1507 (μS/cm), TDS= 786.8 (mg/L), F= 0.048 (mg/L), residual free chlorine= 0.67 (mg/L), pH=7.9, total coliform= 0.16 (MPN/100 mL), fecal coliform= 0.14 (MPN/100 mL) and HPC= 112 (CFU/mL). No significant difference found between the chemical and microbial parameters in the general distribution network and the output of the Household Water Treatment devices during the two seasons.

Household water treatment devices did not affect the microbial burden but caused a change in the amounts of some chemical parameters. Drinking water from the distribution network, with the proper application of the water safety plan, is of good quality.

Climate change in recent years has led to a crisis of drought in many countries around the world, including Iran. In such a situation, the supply of safe drinking water is very important and knowing the climate impacts on the chemical quality of these resources can play a significant role in their proper exploitation.

Using GIS geomorphology models, the effect of climatic factors including minimum and maximum temperatures, mean precipitation, evaporation, transpiration and vegetation index on the quality of groundwater resources of Varamin Plain include pH, electrical conductivity, total dissolved solid, anions and cations concentrations and total hardness were studied and their maps were produced. Correlation between these factors was investigated using spatial correlation analysis tool at a confidence level of 0.95 (p = 0.05).

The results showed that these parameters (except pH) along the plain are highly variable and the spatial distribution of data in this region is not normal around the mean, and the frequency of pixels with values ​​less than the spatial mean of the region is higher. Spatial distribution of the factors showed that their amounts (except pH) are low in the central area of ​​the plain and reach its peak in the western and northwest regions. The spatial distribution of pH was almost uniform in all the plain.

Correlation analysis showed that the quality of water resources is influenced by climatic factors and the maximum temperature has the highest impact

Nowadays, volatile organic compounds (TVOCs) are considered as one of the most well-known air pollutants, especially in the indoor environments. The aim of this study was to measure the amount of TVOCs in indoor and fresh air around the intended kindergartens and investigation the association between indoor and outdoor concentrations.
The measurement was done in four kindergartens in Ahvaz city in five days between 9 to 10 oclock in the morning. Overall, 40 samples were collected.The PhoCheck PID Detector portal device was used for activity sampling in this study. Also, the results were reported by SPSS16 Software and descriptive statistics.
The mean of measured TVOC in the indoor and outdoor air were 50 µg/m3 (SD= ±74) and 495 µg/m3 (SD= ±310) respectively. The analyses conducted by the paired-samples t-test and it indicated that the amount of fresh air is not effective on the indoor environment values.
The measured values in indoor air of these kindergartens depend on internal factors and appropriate ventilation is slightly had been effective.

Parallel to the growth of Population and increasing healthcare needs, the production of medical wastes is constantly increasing. Owing to the poor healthcare waste management, this study surveys the state of waste management in Shariati Hospital of Tehran using IRAT in 2015 as part of WHO's strategy. Matrial&This descriptive study recorded 70 questions asked from environmental health and waste authorities after inspection the implementation waste management law using the IRAT tool. The waste products for sectors were weighed for one month. The average weighing was 1911.68 kg waste production, which included 1.910.314 of infectious waste rate, 2.110.254 of domestic, 0.10.027 of Chemical/Pharmaceutical and 0.080.032 kg/b/d of sharp particles. According to the results, 18% of the bags and safety boxes with the capacity of more than 3/4 were collected with only 34 parts (72%) regular label waste bags. In addition, the hospital manager did not anticipate a specific budget to cover the costs of waste management. According to the IRAT analysis, the final score for the hospital was poor i.e. 50.71% which included 75.9% for separation, 78.9% for collection, 77.8% for transmission and storage and 81.7% for the treatment and disposal. The infectious waste rate, that is 47.27%, seems more than that recommended by WHO. So it is necessary to have more educational programs in the field of waste separation for reducing the source of infections and hazardous wastes. Legal measures should be done to make the authorities of health centers implement the waste management rules.

Doogh is considered as one of the traditional drink in Iran and other nations like Eastern Europe, Middle East and Asia. In the past the “doogh” was applied to a product which remained after dilution of full fat yoghurt with water and fat separation using the musk. Nowadays Doogh has have physical, chemical, physico-chemical, microbial and sensory characteristics and standards. In this study the microbial quality of four famous brands produced in Iran was assessed. This is a cross-sectional study. Totally, 126 samples were selected from the foodstuff suppliers using random sampling. In order to determine Staphylococcus aureus, Baird Parker Agar (recognition test) and coagulase test (confirmation test) were used. The results were analyzed using SPSS, and T-Test and one way ANOVA were performed. The results showed that in view of contamination there is Significant differences between the months, the brands and the types of doogh (p<0.05). According to the results and due to probable presence of Entrotoxin, the analyzed brands can be potent risk to consumer’s health.

Because of population growth, limited access to fresh water resources, the need to use bottled water, controlling microbial quality of bottled water is important. Microbiological quality of 24 brands of bottled water available in the town markets of Iran was studied Random. Samples were collected in summer and autumn, 2012. In each season, we collected two samples for each brand. In order to analyze Total coliforms, E-Coli, and HPC, MPN and Plate Count Methods were used. Data analysis was processed by SPSS software. Total coliforms were 2 MPN/100CC in two brands S18 and S20. Increased HPC levels were also observed in all brands. pH level of 6% from bottled waters were higher than the standard. Average of turbidity was 0.232 and 0.228 at the autumn and summer, respectively. the heterotrophic microorganisms were present in 100% of the samples. Total coliforms were also found in 12% of the samples. None of the samples contained E-Coli.

Staphylococcus aureus is a Gram-positive, non-sporulated, lack of capsule, immovable, aerobic and anaerobic and able to tolerate high levels of salt (up to 15 percent). Therefore, foods containing salt provides an ideal environment for bacterial growth. It is also one of the most important bacterial born of spoilable food products, especially in dairy products. Lighvan traditional cheese is consumed in many regions of Iran, especially consumption of these cheeses is very high in Tehran which in the manufacture of such cheeses, the unpasteurized and raw milk is used and the sanitary conditions during processing and subsequent storage are low. So, considering the importance of this issue in the release of poisoning, the coagulase-positive Staphylococcus aureus contamination in Lighvan cheese on Retail Stores was evaluated. In order to perform this study, 22 samples of traditional Lighvan cheese were collected randomly from Tehran stores and according to Iran national standards and by using of bird-parker, Cook Meat cultures and coagulase test were evaluated. Total of 22 samples, 14 samples (63/6%) were contaminated by S. aureus over standard and 5 (22/7%) were contaminated with Staphylococcus aureus coagulase positive. This study demonstrated that sanitary conditions should be observed during the production and Use of pasteurized milk in cheese production.