National and subnational mortality and disability-adjusted life years (DALYs) attributable to 17 occupational risk factors in Iran, 1990–2015

Abtahi, Mehrnoosh; Koolivand, Ali; Dobaradaran, Sina; Yaghmaeian, Kamyar; Khaloo, Shokooh Sadat; Jorfi, Sahand; Keshmiri, Saeed; Nafez, Amir Hossein; Saeedi, Reza

doi:10.1016/j.envres.2018.04.023

Cited by 19 publications

(10 citation statements)

References 28 publications

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“…It is further supported by coincidence The western provinces in China have the highest death and DALY rates attributable to occupational risks. The spatial inequality of disease burden for occupational hazards is similar to previous studies on environmental and occupational burden of diseases in Iran [28,32], which Fig. 2 Age-standardized death rates (per 100,000) attributable to total occupational risks, occupational carcinogens, occupational asthmagens, occupational PGFs, and occupational injuries in the provinces of China grouped by SDI, 2017.…”

Section: Discussionsupporting

confidence: 83%

The disease burden attributable to 18 occupational risks in China: an analysis for the global burden of disease study 2017

Yin

Wang

et al. 2020

Environ Health

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Background China has more than 18% of the global population and over 770 million workers. However, the burden of disease attributable to occupational risks is unavailable in China. We aimed to estimate the burden of disease attributable to occupational exposures at provincial levels from 1990 to 2017. Methods We estimated the summary exposure values (SEVs), deaths and disability-adjusted life years (DALYs) attributable to occupational risk factors in China from 1990 to 2017, based on Global Burden of Disease Study (GBD) 2017. There were 18 occupational risks, 22 related causes, and 35 risk-outcome pairs included in this study. Meanwhile, we compared age-standardized death rates attributable to occupational risk factors in provinces of China by socio-demographic index (SDI). Results The SEVs of most occupational risks increased from 1990 to 2017. There were 323,833 (95% UI 283,780 - 369,061) deaths and 14,060,210 (12,022,974 - 16,125,763) DALYs attributable to total occupational risks in China, which were 27.9 and 22.1% of corresponding global levels, respectively. For attributable deaths, major risks came from occupational particulate matter, gases, and fumes (PGFs), and for the attributable DALYs, from occupational injuries. The attributable burden was higher in males than in females. Compared with high SDI provinces, low SDI provinces, especially Western China, had higher death rates attributable to total occupational risks, occupational PGFs, and occupational injuries. Conclusion Occupational risks contribute to a huge disease burden in China. The attributable burden is higher in males, and in less developed provinces of Western China, reflecting differences in risk exposure, socioeconomic conditions, and type of jobs. Our study highlights the need for further research and focused policy interventions on the health of workers especially for less developed provinces in China to reduce occupational health losses effectively.

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Section: Discussionsupporting

confidence: 83%

The disease burden attributable to 18 occupational risks in China: an analysis for the global burden of disease study 2017

Yin

Wang

et al. 2020

Environ Health

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“…Throughout these periods, emphasis was also placed on achieving quality health services and effective referral system. Major achievements (which have been attributed to a well-performing PHC system) [17], include the decline in population growth from about 3.9% during 1976–86 to 1.3% during the period of 2006–2011. Again, total fertility rate decreased from 7.0 children to below-replacement-level during the same period.…”

Section: Introductionmentioning

confidence: 99%

Policy analysis of the Iranian Health Transformation Plan in primary healthcare

Doshmangir

Moshiri

Mostafavi

et al. 2019

BMC Health Serv Res

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Background Health systems reform is inevitable due to the never-ending changing nature of societal health needs and policy dynamism. Today, the Health Transformation Plan (HTP) remains the major tool to facilitate the achievements of universal health coverage (UHC) in Iran. It was initially implemented in hospital-based setting and later expanded to primary health care (PHC). This study aimed to analyze the HTP at the PHC level in Iran. Methods Qualitative data were collected through document analysis, round-table discussion, and semi-structured interviews with stakeholders at the micro, meso and macro levels of the health system. A tailored version of Walt & Gilson’s policy triangle model incorporating the stages heuristic model was used to guide data analysis. Results The HTP emerged through a political process. Although the initiative aimed to facilitate the achievements of UHC by improving the entire health system of Iran, little attention was given to PHC especially during the first phases of policy development – a gap that occurred because politicians were in a great haste to fulfil a campaign promise. Conclusions Health reforms targeting UHC and the health-related Sustainable Development Goals require the political will to improve PHC through engagements of all stakeholders of the health system, plus improved fiscal capacity of the country and financial commitments to implement evidence-informed initiatives.

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“…The gender distribution of the participants was 46.2% women versus 53.8% men. The average age and gender distribution of the participants were different from those of the workforce in the country (to be 39.4 ± 12.0 y and 18% women versus 82% men) ( Abtahi et al, 2018 ). The education levels of the participants were 5.0% lower than diploma (lower than 12 y of education), 12.8% diploma, 6.8% associate's degree, 43.8% bachelor's degree, 24.7% master's degree, and 7.0% doctorate degree or higher.…”

Section: Resultsmentioning

confidence: 90%

An innovative index for assessing vulnerability of employees of different occupations from the COVID-19 pandemic in Iran

Abtahi

Gholamnia

Bagheri

et al. 2021

Environmental Research

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The vulnerability of employees of different occupations from the Coronavirus disease 2019 (COVID-19) pandemic in Iran was assessed using an innovative index. The vulnerability index was developed in five steps as follows: (1) determining the principles and components of employees' susceptibility and resilience, (2) weighting the principles and components, (3) converting the levels of components to the sub-index values, (4) introducing the aggregation functions, and (5) characterizing the vulnerability index values in five categories as very high (80–100), high (65–79), medium (50–64), low (30–49), and very low (0–29). The average values of susceptibility, resilience, and vulnerability index of the employees were determined to be 35.2 ± 15.0, 73.9 ± 17.0, and 32.9 ± 12.7, respectively. The average resilience of the employees was more desirable than their average susceptibility. The distribution of the employees into the vulnerability index categories was 46.3% for very low, 41.9% for low, 3.6% for medium, and 8.2% for high. The worst cases of susceptibility and resilience principles were exposure to contaminated surfaces (59.1 ± 22.8) and top management commitment (66.6 ± 23.1). The elderly staff (especially over 50 years old), employees with low education levels, and employees in private and self-employment sectors were significantly more vulnerable ( p value < 0.01) from the COVID-19 pandemic. The principles with significant incremental effects on the vulnerability index ( p value < 0.05) were respectively top management commitment (+1.78), exposure to COVID-19 patients at work (+1.36), exposure to contaminated surfaces (+0.82), installing clear shields and wearing PPE (+0.59), observance of social distancing (+0.48), and just culture (+0.22). An especial plan to support the more vulnerable employees with an emphasis on the principles with the most incremental effects on the vulnerability index can efficiently control the inequality between the employees as well as occupational transmission of the COVID-19 in Iran.

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National and subnational mortality and disability-adjusted life years (DALYs) attributable to 17 occupational risk factors in Iran, 1990–2015

Cited by 19 publications

References 28 publications

The disease burden attributable to 18 occupational risks in China: an analysis for the global burden of disease study 2017

The disease burden attributable to 18 occupational risks in China: an analysis for the global burden of disease study 2017

Policy analysis of the Iranian Health Transformation Plan in primary healthcare

An innovative index for assessing vulnerability of employees of different occupations from the COVID-19 pandemic in Iran

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