Medical Journal of The Islamic Republic of Iran (MJIRI)

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  Abstract

  Background : Noise is the most common hazard in the workplace and noise induced

  hearing loss considered to be the most common occupational disease as well.

  Cigarette smoking, in some studies, has been known to induce hearing loss. The purpose

  of this study was to evaluate the effect of contemporary exposure to occupational

  noise and cigarette smoking on hearing.

  Methods : 478 assembly workers of an automobile plant which were exposed to

  the noise more than TLV (threshold limit value) level included in this study. After

  considering the exclusion criteria, all participants according to the smoking status

  were divided in smoker and nonsmoker groups and compared for hearing impairment.

  Hearing impairment in this study was assessed with the offered method of

  American Academy of Otolaryngology (AAO).

  Results : Of 478 assembly workers, 225 persons were smokers and others non

  smokers. Prevalence of hearing impairment in smokers was significantly higher

  (p<0.001). Hearing impairment had a significant relation with smoking status even

  after adjusting for cofounders like age and duration of work (OR=8.23, 95%

  CI=3.63-18.66).

  Conclusion : The results of this study suggested that cigarette smokers had more

  hearing impairment than non smokers. According to these results we concluded that

  in working environments, especially in noisy ones, workers must be encouraged to

  quit smoking and regular audiometric tests, especially for smokers, must be applied.

  We must consider not only the noise, but indeed all effective elements of hearing impairment

  in working environment that could compromise the hearing.

 

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 Abstract

 Background: Research suggests that factors in the environment are major determinants of health behavior for populations. This cross-sectional study used a combination of quantitative and qualitative data collection methods to determine the prevalence of smoking and identify the possible associations between smoking and environmental variables among school pupils in Iran.

 Methods: A self-reported questionnaire was administrated and collected data from 2200, students15-18 from 100 high schools who agreed to take part in the research. The sample was selected from the Iranian Education System Database using a two-stage cluster sample based on a random sample of schools and pupils as a representative sample of this population. Almost 90% of respondents had completed the questionnaires. Examination of the test-retest answers over all questions among 70 students in two weeks interval revealed reliability coefficient ranges 0.72 to 0.98. The Adjusted Enter Logistic Regression Models were applied to significant variables identified through Chi square tests. In addition, 40 of the sample took part in focus groups exploring the facilitators and barriers to smoking behavior. Content analysis was also used to extract themes from the focus group discussions.

 Results: The effects of social environment variables including peers', mothers', and sisters' smoking on cigarette consumption among young people were explored in this study. Levels of cigarette availability and exposure, effects of parents' attitudes and supervision, legislation on tobacco control, expanding life opportunities and more options for leisure activities perceived as influencing factors on adolescent smoking were all highlighted in the focus group discussions.

 Conclusion: The qualitative and quantitative findings revealed the impact of social environment on smoking behavior among young people. This study provides strong evidence to support environmentally oriented smoking prevention programs targeting young people.

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  Background: Smoking has physical, psychological, and social impacts on women’s health and subsequently the community’s health. Therefore, it is important to have an estimation of smoking among Iranian women.

  Since comprehensive data are not available in this respect, the authors performed a systematic review and metaanalyzed all high-quality studies in this field.

  Methods: All available electronic papers were searched by certain keywords and were included in this study according to the inclusion criteria regardless of the publication year. Furthermore, non-electronic resources including the final report of research projects, dissertations, unpublished papers (grey literature) and books published by the Iranian ministry of health were also evaluated in the study. The materials were assessed for their quality and meeting the inclusion and exclusion criteria. Considering the high degree of variability in many selected

  studies, we used random effect method for meta-analysis.

  Results: The highest and lowest rates of cigarette smoking among women were 10.5% and 0.04%, respectively. The prevalence rates of smoking were different in various subgroups ranging from 0 to 0.4% in students, 1.1 to 3.1% in adults, and 1.4 to 8.7% in all subgroups. According to the meta-analyses performed for the subgroups, the mean age of participants, performing the study in urban or rural areas, and the year of paper publication were major sources of heterogeneity.

  Conclusion: The studies were highly different with regard to their findings, and it seems that there is an age and time trend for the findings. Furthermore, the prevalence of smoking was different in various regions of the country.

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Background: Smoking is considered as the second leading risk factor of early death and disability throughout the world.  Smoking is the second leading risk factor of early death and disability in the world. The workplace is an important setting for the implementation of cigarette smoking prevention and control interventions. This study aimed to determine the prevalence of cigarette smoking and related factors by focusing on ADHD and risk-taking behaviors among a sample of Iranian workers.
   Methods: This cross-sectional study was conducted on 2434 male workers of Kaveh Industrial City in Saveh. Random cluster sampling was used in the selection of workers.  All workers completed five sets of anonymous and validated questionnaires. ADHD was measured by Conner’s Adult ADHD Rating Scales. Data analysis was done using chi-square, independent t-test and logistic regression model in STATA 10. Also, P-value <0.05 was considered statistically significant.
   Results: The mean age of the workers was 32.80±7.05 years. The prevalence of cigarette smoking in the lifetime, last year, last month, and daily or almost daily  in the last month were 26.2%, 20.6% , 18.5%, and 13.1% respectively. After adjustment, age (OR=1.08), sensation seeking (OR=1.57), hookah smoking (OR=4.21), alcohol use (OR=2.51), sexual risk behaviors (OR=2.25), religiosity (OR=0.95) and self-esteem (OR=2.02) were associated with cigarette smoking.
   Conclusion: Our results showed that 13.1 % of workers were regular smokers (daily or almost daily). Specific programs in workplaces, including interventions to enhance self-steam and reduce anxiety, can be effective in lowering cigarette smoking prevalence. Also, comprehensive interventions to reduce or prevent different risk-taking behaviors can be considered as elements of preventive action plans.
 

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Background: There are relatively scant data to determine whether hospital visitors could serve as a proper source of controls in case-control studies of illicit drug use. The aim of this study was to evaluate using neighborhood versus hospital visitor controls in reporting opium use.
   Methods: We used data from 2 independent case-control studies of cancer in Iran. In the first study, controls were selected from neighborhoods of the patients. For the second one, controls were selected from among hospital visitors. In the latter study, hospital visitors were companions of the patients or others visiting the hospital for reasons other than disease treatment. We used stata (version 12; Stata Corp( for all analyses and with a significance level of 0.05.
   Results: Data from 616 of neighborhood controls and 414 of hospital visitor controls were analyzed. Opium point prevalence among men was significantly higher in hospital visitors than neighborhood controls (43.3% vs 32.2%; P = 0.047), while the prevalence of cigarette smoking was very similar in both control groups (46.3% vs 47.2%; P = .847). Using a logistic regression analysis, in an unadjusted analysis, neighborhood controls were less likely to report opium use in both genders, with (unadjusted OR = 0.77; 95% CI: 0.59,1). After adjusting for potential confounders, the differences of opium use between the 2 control groups became more pronounced (Adjusted OR = 0.26; 95% CI: 0.10, 0.69).
   Conclusion: Because of the similarity of reporting cigarette smoking among neighborhood controls but substantially lower reporting of opium use among them, we concluded that neighborhood controls underreport opium use—a sensitive question— and that using neighborhood control biases the findings in case-control studies. Hospital visitor controls may be more appropriate than neighborhood controls for case-control studies of illicit drugs.
 

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Background: Typically, blood pressure dips during sleep and increases during daytime. The blood pressure trend is affected by the autonomic nervous system. The activity of this system is observable in the low and high activity conditions. The aim of this study was to assess the effect of individual characteristics on systolic blood pressure (SBP) across day-night under low and high activity conditions.
   Methods: The samples were 34 outpatients who were candidates for evaluation of 24 hours of blood pressure with an ambulatory. They were admitted to the heart clinic of Farshchian hospital, located in Hamadan province in the west of Iran. The hourly SBP during 24 hours was considered as a response variable. To determine the factors effecting SBP in each condition, the hidden semi-Markov model (HSMM), with 2 hidden states of low and high activity, was fitted to the data.
   Results: Males had lower SBP than females in both states. The effect of age was positive in the low activity state (β=0.30; p<0.001) and negative in high activity state (β= -0.21; p=0.001). The positive effect of cigarette smoking on SBP was seen in low activity state (β=5.02; p=0.029). The overweight and obese patients had higher SBP compared to others in high activity state (β=11.60; p<0.001 and β=5.87; p=0.032, respectively).
   Conclusion: The SBP variability can be displayed by hidden states of low and high activity. Moreover, the effects of studied variables on SBP were different in low and high activity states.