An estimation of Hospital shirazadmissions- 2015 respiratory disease attributed to sulfur dioxide exposure in , southwest

Mohammad Javad Mohammadi 1,2,3* , Gholamreza Goudarzi4, Sahar Geravandi5,3, Esmaeil Idani6, Shokrollah Salmanzadeh7,3, Farid Yousefi7,3

1student research committee, Department of Environmental Health Engineering, School of Public Health AND Environmental Technologies Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran- presentation* 2Abadan school of Medical Sciences, Abadan, Iran 3Razi Teaching Hospital, Clinical Research Development Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran 4Environmental Technologies Research Center, Department of Environmental Health Engineering, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran 5M.SC student of Nursing, Department of Nursing, Islamic Azad University, Medical Sciences Branch, Tehran, IR Iran 6Department of Internal Medicine, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran 7Health Research Institute, Infectious and Tropical Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran

INTRODUCTION RESULTS In the recent years, effects of air pollutants on human health, Based on result this study, the yearly average sulfur their damage to the environment and the rate of death in the dioxide concentrations during 2011-2013 were 157, 160 public in the world has increased (1,2). Sulfur dioxide can be and 189 μg/m3, respectively. Total numbers of hospital absorbed into your body through the nose and lungs, its reaction admissions respiratory disease attributed to sulfur dioxide with the moisture in the nose and nasal cavity, and entering the circulatory system directly through the airways. Hospital were respectively 24, 25 and 30 during 2011-2013. The admissions respiratory disease is represented by number of results showed that there is a strong correlation between patients who visited specialist pulmonary hospital with visits to a hospital due to hospital admissions respiratory symptoms of respiratory disease (2). Transportation, disease and sulfur dioxide emission in Ahvaz city. urbanization, industries, economic development, domestic fuel Approximately 7.1 % of hospital admission for respiratory burning, and vehicles in megacities are the main sources of disease happened when the sulfur dioxide concentrations generation and emission of Sulfur dioxide (3,4). In recent years, was more than 20 μg/m3.

several epidemiological studies have shown a relationship 40 2011(RR=1.008) 2012(RR=1.008) 2013(RR=1.008) between the air pollution, typically from Sulfur dioxide , in urban 30

air and diseases, pulmonary damage, and mortality among 20

general population (5,6). The most important damage from Sulfur 10

dioxide is penetration into the respiratory system (7,8). The aim (persons) 0

Cumulative cases of Cumulative of this study was to estimation the relationship between air admissions Hospital pollution exposures associated with Hospital admissions sulfur dioxide conc(microgram / cubic meter) respiratory disease in Ahvaz was studied. Fig2. Relationship between cumulative of Hospital admissions related to Sulfur dioxide 2011 to 2013

METHODS The present study is an epidemiological study. We processed sulfur DISCUSSION dioxide data by the use of Excel software and Air Q model. Nowadays air pollution is one of several important issues that Sampling was done in 4 stations in Ahvaz for measuring air threaten the public health. The finding of this study showed that pollutants. Sampling and analysis were performed according to total mean of dioxide was higher than standard concentration. EPA guideline. In this study, data from 175200 (4×24×365×5) air The higher percentage of hospital admission perhaps could be sampling during 2011 to 2013 were obtained from ADE. Raw data the result of higher average sulfur dioxide in Ahvaz. The result analysis process encompassed temperature and pressure of this study showed that number of Hospital admissions modifications. Finally, data were converted as input file to the Air respiratory disease in 2013 Ahvaz was more than another years Q model. Attributable proportion was multiplied by baseline study due to sulfur dioxide . The number of cases Hospital incidence and divided by 105 (5). It was defined as the fraction of admissions respiratory disease had adverse trend. Also by the health outcome in a certain population attributable to exposure defining several scenarios using Air Q model, the linear to a given atmospheric pollutant. Obtained value then was pattern obtained which showed the relationship between any multiplied by population (106) (6). AP is proven causative change in sulfur dioxide concentration and the health outcome. correlation between health consequences and air pollutant Results of our study showed that AP during 2011 to 2013 was exposure. We used default model that attributes cases of Hospital increase, and this can be due to increase in concentration of admissions respiratory disease to exposure to sulfur dioxide sulfur dioxide. High percentage of the observed health endpoints Description of study area in this study was associated with high concentration of Sampling was performed hourly in 4 stations: Downtown measured sulfur dioxide and heavy industry such as oil, “Naderi”, Old School of Public Health “Behdasht Ghadim”, petrochemical and steel in Ahvaz. Bureau of Meteorology “Havashenasi” and Head office of ADE “Mohit Zist”.

Refrences 1. zallaghi E, Goudarzi G, Geravandi S, Salmanzadeh S, Mohammadi M. An estimation of respiratory deaths and COPD related to SO2 pollutant in , northwest of Iran (2011). Razi Journal of Medical Sciences. 2015;22(131):44-50. 2. Geravandi S, Goudarzi G, Babaei AA, Takdastan A, Mohammadi MJ, Vosoughi Niri M, et al. Health Endpoint Attributed to Sulfur Dioxide Air Pollutants. Jundishapur J Health Sci. 2015;7(3):e29377. Epub 2015-07-25. 3. Hajat S, Vardoulakis S, Heaviside C, Eggen B. Climate change effects on human health: projections of temperature-related mortality for the UK during the 2020s, 2050s and 2080s. Journal of epidemiology and community health. 2014;68(7):641-8. 4. Kim K-H, Kabir E, Kabir S. A review on the human health impact of airborne particulate matter. Environment international. 2015;74:136-43. 5. Geravandi S, Goudarzi G, Mohammadi MJ, Taghavirad SS, Salmanzadeh S. Sulfur and Nitrogen Dioxide Exposure and the Incidence of Health Endpoints in Ahvaz, Iran. Health Scope. 2015;4(2):e24318. 6. Goudarzi G, Geravandi S, Foruozandeh H, Babaei AA, Alavi N, Niri MV, et al. Cardiovascular and respiratory mortality attributed to ground-level ozone in Ahvaz, Iran. Environmental monitoring and assessment. 2015;187(8):1-9. 7. Gschwind B, Lefevre M, Blanc I, Ranchin T, Wyrwa A, Drebszok K, et al. Including the temporal change in PM 2.5 concentration in the assessment of human health impact: Illustration with renewable energy scenarios to 2050. Environmental Impact Assessment Review. 2015;52:62-8. Figure 1. Location of the study area and sampling stations in 8. Madronich S, Shao M, Wilson S, Solomon K, Longstreth J, Tang X. Changes in air quality and tropospheric composition due to depletion of stratospheric ozone and interactions with changing climate: Implications for (Ahvaz city), southwest f Iran human and environmental health. Photochemical & Photobiological Sciences. 2015;14(1):149-69. .