Summary Background Elevated blood pressure and glucose, serum cholesterol, and body mass index (BMI) are risk factors for cardiovascular diseases (CVDs); some of these factors also increase the risk of chronic kidney disease (CKD) and diabetes. We estimated CVD, CKD, and diabetes mortality attributable to these four cardio-metabolic risk factors for all countries and regions between 1980 and 2010. Methods We used data on risk factor exposure by country, age group, and sex from pooled analysis of population-based health surveys. Relative risks for cause-specific mortality were obtained from pooling of large prospective studies. We calculated the population attributable fractions (PAF) for each risk factor alone, and for the combination of all risk factors, accounting for multi-causality and for mediation of the effects of BMI by the other three risks. We calculated attributable deaths by multiplying the cause-specific PAFs by the number of disease-specific deaths from the Global Burden of Diseases, Injuries, and Risk Factors 2010 Study. We propagated the uncertainties of all inputs to the final estimates. Findings In 2010, high blood pressure was the leading risk factor for dying from CVDs, CKD, and diabetes in every region, causing over 40% of worldwide deaths from these diseases; high BMI and glucose were each responsible for about 15% of deaths; and cholesterol for 10%. After accounting for multi-causality, 63% (10.8 million deaths; 95% confidence interval 10.1–11.5) of deaths from these diseases were attributable to the combined effect of these four metabolic risk factors, compared with 67% (7.1 million deaths; 6.6–7.6) in 1980. The mortality burden of high BMI and glucose nearly doubled between 1980 and 2010. At the country level, age-standardised death rates attributable to these four risk factors surpassed 925 deaths per 100,000 among men in Belarus, Mongolia, and Kazakhstan, but were below 130 deaths per 100,000 for women and below 200 for men in some high-income countries like Japan, Singapore, South Korea, France, Spain, The Netherlands, Australia, and Canada. Interpretations The salient features of the cardio-metabolic epidemic at the beginning of the twenty-first century are the large role of high blood pressure and an increasing impact of obesity and diabetes. There has been a shift in the mortality burden from high-income to low- and middle-income countries.
Iran has developed an extensive network of PHC facilities with good coverage in most rural areas, but there are still few remote areas that might suffer from inadequate services. It seems that there is still no transparent policy to collaborate with the private sector, train managers or provide a sustainable mechanism for improving the quality of services. Finally, strengthening national policies for health at work, promotion of healthy work and work environment, sharing healthy work practices, developing updated training curricula to improve human resource knowledge including occupational health professionals are recommended.
Background:Air pollutants of iron- and steel-making operations have historically been an environmental and health hazard. These pollutants include gaseous substances such as sulfur oxide, nitrogen dioxide, and carbon monoxide. The Iran National Steel Industrial Group beam rolling mills factory has two production lines viz. line 630 and line 650, with different beam production capabilities and is capable of producing different types of beams.Materials and Methods:A retrospective cross-sectional study on 400 workers in different exposure levels to environmental pollution was performed during 2005 to determine the mean value of respirable particulate matter (RPM) concentrations and its effects on the health status of workers. To elicit information regarding the health status of the worker, the National Institute for Occupational Safety and Health standard questionnaire was used. Fisher's exact test was performed to assess the relative risk (RR) of exposure to air pollution on cardiovascular diseases, chest tightness, cough, difficulty in retention, i.e. loss of memory, tension, occupational fatigue, and occupational stress in exposed workers.Results:There was significant difference in RPM pollution level between two product lines. The RR of exposure to air pollution on cardiovascular diseases, chest tightness, cough, difficulty in retention, i.e. loss of memory, tension, occupational fatigue, and occupational stress in exposed workers were 2.78, 2.44, 2.15, 1.92, 1.57, 3.90, and 2.09, respectively.
Abstract. The increases in air pollution over the metropolitan cities are a threat to human health and environment. An attempt has been made to evaluate the health consequences of indoor air pollution induced by Beam Rolling Mills Factory at Ahwaz (Iran). A questionnaire was prepared to obtain information on health of 481 workers, out of which 200 each were selected from exposed and non-exposed category by stratified randomized method. Fisher exact test and chi-square test were used to calculate the values. The study concludes that more than 80% of the workers have high exposure risk to diseases. Analysis of the health impacts reveals that exposed workers are more prone to various diseases as compared to the non-exposed workers. It is also observed that exposure to air pollutants might be the causative factor for various diseases among the smokers but also nonsmoking workers. The analysis also reveals that there is higher relative risk in occupational fatigue and cardio-vascular disease. Further, the study found that percentage of workers having various diseases is much higher in the indoor environment as compared to the outdoor environment
Workers of iron and steel factories are exposed to a wide range of pollutants depending on the particular process, the materials involved, the effectiveness of monitoring and the control measures. Adverse effects are determined by the physical state and propensities of the pollutant involved, the intensity and duration of the exposure, the extent of pollutant accumulation in the body and the sensitivity of the individual to its effects. The main aim of this study is to assess the levels of the indoor respirable particulate matter (RPM) and to compare the health condition of exposed workers, with nonexposed employees group. Line 630 has only one furnace of 40 tons and line 650 has two furnaces of 20 and 40 tons capacity due to which the mean of the RPM concentrations in the breathing zone was significantly different (P < 0.05) in line 650 but not in line 630 as compared with National Institute for Occupational Safety and Hygiene's (3 mg/m3). The average of the RPM concentrations in production line 650 is higher than that of production line 630, with the 95% confidence interval in saw cabin station number 1 of production line 650.
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