Iranian Journal of

Background and Objective: Despite the significant improve in air quality in Tehran in 2018 and reducing the average concentration of most pollutants, compared to previous years, air quality is still far from the WHO air quality guideline level and national air quality standards. The purpose of this study was to estimate the effects of air pollution on health in Tehran by considering the spatial distribution of particulate matter 2.5 micrometers or less in diameter (PM_2.5) and population in determining exposure levels.
Materials and Methods: In this study, while introducing the GEMM concentration–response function and BenMAP-CE software, the mortality attributed to PM_2.5 in Tehran and its distribution for 2017 and 2018 was calculated. Hourly PM_2.5 from monitoring stations used to estimate the mean PM_2.5 for 349 Tehran neighborhoods.
Results: The results showed that the average population weighted PM_2.5 concentrations in Tehran in 2017 and 2018 was estimated to be 31.8 and 26.2 µg/m³ respectively. Using the GEMM function, about 7,377 (95% CI: 6,126-8,581) total mortality attributed to PM_2.5 was estimated in adults in 2017 (> 25 years) and the figure for 2018 was estimated as 6,418 (95% CI: 5,918-6,753).
Conclusion: The spatial distribution of deaths attributable to PM_2.5 showed that the total mortality rate per 100000 in the districts 16 and 18 of the Tehran municipality were higher than other districts and the lowest rate observed in the district 1.

Background and Objective: In this study, we aimed to assess Iran’s position and trends for environmental health status among the countries of “Iran’s perspective document in 1404” according to the indicators used in Environmental Performance Index (EPI) report in 2018.
Materials and Methods: The score of indicators in environmental health area; air quality (including household solid fuels, exposure to PM_2.5, and PM_2.5 exceedance), water and sanitation (including drinking water and sanitation) and heavy metals (including lead) were extracted for all studied countries as well as for the last and baseline (generally ten years prior to last report) years from EPI 2018 database. According to EPI scores, the performance of the studied countries in each indicator was ranked. The percent change in the score of each indicator from baseline to current year was calculated and compared with the mean percent change for all studied countries.
Results: Iran ranked 7^th regarding air quality in 2016. Also, it ranked 6^th, 8^th, and 9^th in terms of household solid fuels, exposure to PM_2.5, and PM_2.5 exceedance, respectively. The EPI score for Iran regarding water and sanitation was 54.4 in 2005 and 58.74 in 2016 (percent change=7.98%). Iran ranked 21^st in 2005 regarding lead exposure index. Although this index showed a growth of 100% in 2016, which is very desirable compared to the average growth of all countries (34.47%), but only leads to one step up in the ranking of Iran and was ranked 20^th in comparison with other countries.
Conclusion: Totally, according to EPI 2018, Iran ranked 6^th in the field of environmental health issues among 23 countries of “Iran’s perspective document in 1404”. However, there is uncertainty in the accuracy of the EPI raw data used for calculating index scores. Hence, caution should be exercised in their interpretation.

Background and Objective: Given the nature of many development projects, it is necessary to evaluate their effects on human health. Due to the lack of a specific model, the purpose of this study was to provide a tool to prioritize the effects of construction and operation (C&O) of a combined cycle power plants (CCPPs) on physical health.
Materials and Methods: By reviewing the documents and interviewing 15 experts, the variables affecting physical health in the C&O of the CCPPs were identified. Then, the content validity of the variables was assessed and the enumerated questionnaire was provided to the experts to determine the range, duration, probability, magnitude and extent of health effects using a multiple-choice Likert scale. Finally, with an innovative method, high priority variables were determined to evaluate the physical health effects on individuals.
Results: According to expert’s comments, 480 variables affecting physical health in the C&O of the CCPPs were selected and 41 variables were rejected based on the content validity index. The obtained results showed that diseases attributed to particulate matter (PM_2.5 and PM₁₀), SO₂ and nitrogen oxide, under normal and emergency conditions, highly contributed to the physical health problems during the construction of CCPPs.
Conclusion:  The method presented in this study is applicable to (1) identifies the factors affecting physical health, (2) determines the range of each physical health- associated factor and (3) prioritizes influencing criteria that might affect human health status during the construction and operation of a combined cycle power plant.

Background and Objective: pesticides are essential to protect plants from pests and diseases. Extensive and unsafe use of pesticides by farmers pose various risks to human health and the environment. Therefore, the present study evaluates farmers' knowledge, attitudes, and behaviors regarding pesticides use and the health problems associated with their use.
Materials and Methods: In this human-research survey the target population consisted of 6170 farmers and fruit growers in Galogah County, Mazandaran province, were included. Multi-stage cluster sampling was used to select samples within 2 sub-districts and 13 villages, and the information was collected through 379 questionnaires. Statistical tests such as Mann-Whitney U, Kruskal-Wallis H, Spearman Correlation and Linear Regression were used to analyze the obtained data.
Results: The respondents have no sufficient knowledge regarding the safe use of pesticides. Respondents' attitudes toward the impacts of pesticide use were positive. The safety measures were less considered by majority of respondents. Moreover, the results revealed that personal protective equipment (mask, gloves and, goggles) and safe disposal of pesticide residues are not fully taken into consideration. The dizziness, skin problems, headache and vomiting were the most common symptoms of pesticide-related illnesses. The findings of regression analysis showed that wide range of knowledge and proper attitudes about the safe use of pesticides are beneficial and can act as the promoting factor in farmers' safety behavior regarding pesticides use.
Conclusion:  In conclusion, providing pesticide users with sufficient knowledge, safety information and effective personal equipment such as wearing masks, goggles and gloves should be given highest priorities.

Background and Objective: Heavy metal (HM) pollution of settled dust on the interior surfaces of elementary schools may affect the health of young students; hence, the health risk of such pollution should be assessed. Therefore, the aims of this study were to measure the content of heavy metals in the settled dust in the indoor of elementary schools in Bandar Abbas and to assess the attributed health risks.
Materials and Methods: In this study, dust samples were collected from the interior surfaces of elementary schools in Bandar Abbas. Settled dust samples were digested using aqua regia solution and then their metals contents were measured using ICP-OES. To assess the health risk attributed to this pollution, daily intake doses through ingestion, inhalation and skin absorption routes were estimated. Then, non-carcinogenic and carcinogenic risks were calculated considering the daily intake doses and toxicity factors.
Results: The average concentrations of arsenic, cadmium, cobalt, chromium, nickel and lead in settled dust were 5.45, 0.58, 11.44, 69.72, 83.95 and 66.72 mg/kg, respectively. The non-carcinogenic risk level for all metals was below threshold, while the carcinogenic risk level for arsenic (2.18×10^-6) exceeded the threshold.
Conclusion: This study showed that the settled dust in elementary schools of Bandar Abbas is polluted with various levels of heavy metals. Health risk assessment showed that the exposure to dust containing heavy metals in the elementary schools of Bandar Abbas does not pose significant non-carcinogenic risk, but the carcinogenic risk of As exceeded the threshold limit and should be considered.

Background and Objective: Changes in the quantity and quality of waste produced as a result of compliance with health protocols are the result of the COVID-19 outbreak. The present study aimed to determine the quantity of personal protection equipment produced in Tehran and people’s knowledge of its management.
Materials and Methods: The present cross-sectional and descriptive-analytical study was carried out on 2560 participants in Tehran through an online survey in spring 2020. Based on the percentage of using masks and gloves, the amount of produced waste was calculated, and Mann-Whitney and Kruskal-Wallis statistical tests were run to explore the relationship between the variables.
Results: The overall Cronbach's alpha coefficient of the questionnaire was 0.94, and the rate of mask and glove use was 90.7% and 65.7%, respectively. 70.3% and 52% of the population used two masks and one pair of gloves on a daily basis. The number of daily produced masks and pairs of gloves was 14530407 and 5262666, respectively. Mann-Whitney U-test showed a statistically significant difference between gender and marital status with people’s knowledge of waste management (p <0.05). Kruskal-Wallis test showed a significant difference between the economic status and people’s knowledge of separating the produced waste (p <0.05). People with an increasing income tended to separate the waste more.
Conclusion: Due to the high volume of personal protective wastes and the lacking knowledge of one-third of the participants about the transmission of the virus through contaminated waste, it is necessary to raise awareness of breaking the virus transmission chain.

Background and Objective: By accurately identifying environmental issues, individuals can acquire skills to better solve environmental problems. To this end, the most appropriate method is to assess the educational needs of individuals to pave the way for the promotion of environmental knowledge. The present study aims to assess the need for training courses to empower professionals to increase their knowledge of environmental issues and educate others to take an important step in improving environmental health in society.
Materials and Methods: The present study was a descriptive needs assessment study using Delphi technique. In the first stage, the designed questionnaire was given to 150 people (faculty members, experts and students) to express their opinions in the proposed areas. In the second stage, a supplementary questionnaire entitled General needs for faculty members, specialized needs for experts and general and specialized needs for students were provided to individuals and the importance of the issues from their point of view was examined. Finally, the most important issues were prioritized by experts. Data analysis was performed using SPSS-26 software.
Results: The total number of educational needs extracted from the first stage of Delphi was 120 items, of which 31 items related to general needs (11 teaching and evaluation areas, 10 research areas and 10 communication and personal development items) and 89 items related to specialized needs. (27 cases of air pollution, 23 cases of waste management, 17 cases of wastewater treatment and reuse of wastewater, 10 cases of water treatment and pollution and 12 cases of soil pollution and its removal methods). In the second and third rounds, the importance of these items was determined by the target groups by scoring, and at the end, the first five priorities of each item were identified.
Conclusion: The results of this study, considering the comprehensive review of three target groups and determining and prioritizing the needs for each group, can increase the level of environmental awareness and empowerment of experts, which ultimately enhance the efficiency of the system and is an important step for environmental educational planning.

Background and Objective: Among greenhouse gases, CO₂ has a crucial role; thus, its impact on health indicators such as life expectancy is of great importance. Hence, one of the most important challenges in the health sector has been the impact of the environmental pollutants emission, namely CO₂, on life expectancy of men and women.
Materials and Methods: This is a descriptive-analytical and applied design with the health economics approach. The present paper examined the impact of pollutant emissions, namely CO₂, per capita income, death rate and birth rate, separately on Iranians’ life expectancy. This analysis was conducted using Quantile regression with EViews10 software during the period 1960 - 2019. In this study, first, the impact of pollutant emissions on life expectancy of all Iranians was calculated. Then, the impact of CO₂ on life expectancy of Iranian men and women in different quantiles was estimated.
Results: The results confirm the impact of carbon dioxide emissions per capita on total life expectancy was -0.133 and the impact of this pollutant emission on life expectancy obtained -0.170 and -0.127 for men and women, respectively. Both effects were estimated as negative and significant. This effect on life expectancy of men was 0.43% higher than that of women. Furthermore, the impact of death on life expectancy was negative, while the effect of per capita income on life expectancy was positive. Also, birth rate had a positive impact on women's life expectancy, whereas, it showed a negative impact on men.
Conclusion: The study revealed that CO₂ emissions had a negative impact on total life expectancy of both men and women. Thus, in order to increase life expectancy in Iran, pollutants emission, namely CO₂, should be controlled. These results can be a good guide to decision makers and macro-policy makers in Iran to control environmental pollutants to increase life expectancy.
 

Background and Objective: 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. 
Materials and Methods: 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.
Results: 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).
Conclusion: 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.
 

Background and Objective: The aim of this study was to investigate the concentration of potentially toxic elements (arsenic, lead, copper, cadmium and mercury) in black tea imported to southern Iran and to assess the risk of carcinogenic and non-carcinogenic exposure to consumers.
Materials and Methods: For this purpose, 94 samples of black tea from 15 brands imported from India in 2021 were selected. Heavy metals concentrations were measured using an atomic absorption spectrometer (GBC model SAVANTAA). After determining the concentration of heavy metals in black tea samples, health risk assessment was determined using Montocarlo simulation technique.
Results: According to the results, the average concentrations of heavy metals namely arsenic, lead, copper, cadmium and mercury were 0.03±0.02, 0.02±0.16, 15.67±7.69, 0.02±0.01 and 0.006±0.005 mg/kg, respectively. The hazard quotient (HQ) of the heavy metals arsenic, lead, copper, cadmium and mercury were 1.07×10^-2, 6.37×10^-3, 3.45×10^-5, 2.05×10^-2 and 7.19×10^-4, respectively.
Conclusion: Therefore, according to the findings, it can be concluded that the concentrations of potentially toxic elements (arsenic, lead, copper, mercury and cadmium) in black tea were consistent with the standard level of Iran and World Health Organization. Additionally, the average carcinogenic risk index for arsenic metal was 4.49×10^-6, which is much lower than the acceptable level of carcinogenic risk (10^-6). Therefore, the concentrations of five potentially toxic elements in the studied black tea did not show any significant risk for consumers.
 

Background and Objective: Increasing the level of health awareness of food preparation and distribution staff can have a direct impact on improving the level of public health in the community. Education can change people's knowledge, attitudes, and practices. Health education courses that provide integrated education as well as to other education systems, include educational inputs, processes, and outputs. The objective of this research is to evaluate these elements of the educational system of health education courses in Shiraz.
Materials and Methods: The current study evaluated the educational input, process, and output of 7 current health education institutions in Shiraz. Factors that influence the input of educational courses were evaluated using an inspection checklist of health education courses, the educational process was measured employing a satisfaction survey, and the educational output was assessed through a checklist of inspection of Article 13 of the Regulations. The health performance of 160 guild health certified units and 160 uncertified education units was analyzed as a criterion for effectiveness. Data were analyzed using the IBM SPSS21 software. Data related to the assessment of the input and educational process were analyzed using the Spearman correlation coefficient. Mann-Whitney and Kruskal-Wallis non-parametric statistical tests were also used for cross-group comparisons of output evaluation data.
Results: The findings of the educational input evaluation showed a strong correlation and a significant relationship between the overall evaluation score of the educational courses and the "observation" (0.96) "educational course principal" (0.94). Also, in the process evaluation, the "educational environment" and "general educational programs" with correlation coefficients of 0.99 and 0.84 had the most correlation with the overall process evaluation score. In all the health fields studied, there was a significant difference (p = 0.001) between the average score obtained for educational courses with and without certificates. There was a significant difference (p <0.0001) between the mean score obtained by public health with and without health certification. The average score obtained by the certified public and non-public places was 91.81 and 70.71, respectively.
Conclusion: Health education can have a major impact on people's health performance. Some of the elements that make up the educational output have a greater impact on achieving the desired educational output. For example, the revision and updating of the educational content and the development of the educational program according to all groups of learners can improve the performance of the learning process and the satisfaction of learners.
 

Background and Objective: In some villages of Mazandaran, drinking water may be polluted with various pollutants, especially heavy metals (HMs), due to the shallow depth of drinking water sources and the proximity of these sources to farmlands. Therefore, this study aimed to measure the HM pollution level of drinking water in some villages of Mazandaran province and to assess the attributed health risks.
Materials and Methods: HMs content of drinking water in 30 villages with separate water sources in Mazandaran province was measured. Concerning the HMs concentration and toxicity, and exposure route through water drinking, carcinogenic and non-carcinogenic risks were assessed using a Monte-Carlo simulation-based method.
Results: The concentration values of arsenic, cadmium, chromium, nickel and lead in water were <1/0-4.26, < 0.05, <0.15-3.74, <0.3-10.89, and <0.8-4.68 µg/L, respectively. The hazard index (HI) values for non-carcinogenic risk due to the exposure to HMs through drinking of water in various age groups ranged from 3.04E-04 to 9.94E-04. Values of cumulative excess lifetime cancer risk (ELCR_T) for As and Cr were 9.72E-08 and 6.13E-08, respectively.
Conclusion: The results of this study showed that, fortunately, the concentration of metals in drinking water in the studied area was much lower than the national standards and the attributed health risk. Therefore, the drinking water sources in the studied villages had acceptable quality. However, due to the existence of rice paddies in some villages of Mazandaran province, continuous monitoring of pollution levels in the drinking water sources of these areas is essential.
 

Background and Objective: Nowadays, the demand for seawater desalination plants (SDPs) has risen worldwide. However, there is a lack of knowledge on the effects of discharging the SDPs brines into the Persian Gulf marine environment and its aquatics health. Therefore, this research was performed to examine the effects of SDPs brines discharged from this facility in the ecosystem of the Persian Gulf on survival and electrolytes in the Blue swimmer crab, Portunus segnis (Forskal,1775) under laboratory conditions.
Materials and Methods: Brines of two types of active SDPs in Hormozgan were collected; then,75 crabs of (P.segnis), with mean (±SD) carapace width of 9.71±2.18 cm and total weight of 61.22±1.04 g, were collected and transported to the laboratory from the Bandar Abbas coast. As a completely randomized design, the samples were tested in 5 treatments (with three repetitions). Mortality was recorded, and at the end of the experimental period (60 days),the level of some electrolytes of the hemolymph (sodium, calcium, magnesium, and potassium) was measured.
Results: Crabs' survival percentage in treatments containing SDPs effluent decreased compared to control (86%), which was more evident in RO 100% and MED 100% treatments with 46.7% and 40%, respectively (p <0.01). The examined electrolyte levels in treatments containing SDPs brine increased compared to control, which were more significant for RO 100% and MED 100% treatments (p <0.01).
Conclusion: This study showed that the SDPs brines would have physiological consequences on aquatic organisms. In nature, the synergy of SDPs effluents with other sources of ecological stress will have severe impacts. Therefore, the necessary regulations and actions should be taken to minimize the environmental effects of SDPs.
 

Background and Objective: Due to the presence of heavy metals (HMs), sludge produced in industrial wastewater treatment plants (WWPT) is classified as special waste and can cause adverse health effects. The present study aimed to identify special wastes and assess the risk associated with the presence of HMs in the sludge of WWTP from an Industrial City.
Materials and Methods: Identifying the special wastes was conducted using a checklist, and classification was performed in accordance with the Basel Convention. Ecological risk assessment was done by determining the geo-accumulation and ecological indexes. The estimation of health risk was done by determining HQ and ELCR indexes.
Results: The highest amount of special waste was allocated to sludge with a value of 3900.0 kg/month. Chromium was detected in the highest concentration (95.89 ± 52.15 mg/kg). The level of chromium and nickel pollution was evaluated in the low range, and cadmium was very severe. The ecological risk of lead was estimated in a significant range and was very high for cadmium. The HQ was less than 1, and the ELCR for inhalation and dermal exposure was estimated to be lower than the acceptable risk level of WHO.
Conclusion: The present study showed that the largest amount of special waste is dedicated to sludge. Although the concentration of  HMs was lower than the acceptable limits, the sludge had a high ecological risk level. Therefore, the accumulation and transfer of sludge must be carried out under the provisions of the Basel Convention and environmental considerations.

Background and Objective: Considering the significant number of injured people in spas, the main goal of this research is to provide a model for measuring and managing risk in spas.
Materials and Methods: To prepare the conceptual model of risk, four steps were taken, which include determining the general outline of the model, identifying the parameters, evaluating and scoring the parameters based on the questionnaire, using the hierarchical analysis method, and evaluating and determining the final risk of the pools. According to the allowed standard range of each parameter, five ranges for each parameter were obtained based on the obtained weights, health, safety and environmental risk classes. Finally, by summing up these parameters, the final score of the risk of using each pool is obtained. In order to evaluate the presented model, the risk value of hot mineral water pools in Ardabil province was obtained with the innovative method of this research.
Results: According to the results, according to the risk score, Gutursoi and Gamish-Goli spas have an unacceptable risk level, while Qainarjeh, Shabil, Barjelo and Sablan spas are at a high-risk level.
Conclusion: The presented model was validated with the evidence of forensic events. According to the results of the conceptual model of risk and the score obtained for each component and sub-components, appropriate solutions were presented, including the need to modify the current standards in each spa.

Background and Objective: Microplastics enter the food chain of aquatic animals; they cause damage to the digestive system, disruption of the reproductive cycle, and finally their death. The present study was conducted to investigate the microplastic pollution in the digestive system of Vanami shrimps cultivated in some shrimp farms in Bushehr, Khuzestan, and Hormozgan provinces.
Materials and Methods: Sampling was done from two shrimp farms in each port including Bandar Rig in Bushehr province, Bandar Choebdeh in Khuzestan province, and South Tiab located in Hormozgan province. 90 shrimp samples were randomly collected from each breeding farm from June to October 2019. The identification method of microplastics was done by FT-IR spectrophotometer.
Results: The highest frequency of microplastics related to farmed shrimps was 41.11% in the fields of Khuzestan province, and a lower amount of microplastic pollution was observed in Hormozgan and Bushehr provinces with 28.88% and 17.70%, respectively. According to one-way ANOVA, the mean of microplastics in the digestive tract of shrimp had a significant difference in the studied stations (p<0.05). The most type and colors of microplastics in the digestive system of shrimps in the farms of all provinces belonged to fiber and black color. Polypropylene and polystyrene were detected in microplastics found in the digestive system of shrimps.
Conclusion: Microplastics were observed in some of digestive tracts of the shrimps of the breeding farms examined in this research in all three provinces of Bushehr, Khuzestan, and Hormozgan. The highest frequency of microplastics in the digestive tract of shrimps is related to the breeding farms of Khuzestan province, and Hormozgan and Bushehr respectively have a lower amount.

Background and Objective: Understanding the area of study stimulates the student. Therefore, students should pick their field of study with more information so that they get more engaged in it to complete the responsibilities assigned in the future as well as possible. The purpose of this study was to ascertain the attitude of Shiraz University of Medical Sciences environmental health students regarding their field of study and potential future careers.
Materials and Methods: This study was a cross-sectional, descriptive research study on medical education. In this study, 120 students studying environmental health engineering at Shiraz University of Medical Sciences had their attitudes and knowledge assessed using a questionnaire created by the University of Minnesota, America, and the results were then analyzed using chi-square and t-tests.
Results: According to the research's findings, more than 80% of students chose their field of study without having any prior knowledge of it, more than 90% did not place it among their top priorities, and 80% claimed that their field of study depended on whether or not their employment position is acceptable.
Conclusion: According to the data, the majority of students had an unfavorable perception about entering this field. As a result, it is necessary to thoroughly present this discipline to students before they begin studying it, as well as to update its subject headings to better meet societal demands.

Background and Objective: Due to the presence of infectious diseases and parasitic contamination in kindergartens, it is very important to observe the health points in these centers. This cross-sectional analytical study was conducted to investigate the environmental health status of Saveh kindergartens in 2020.
Materials and Methods: A checklist with 133 questions was designed, including 57 questions specific to the conditions of the coronavirus, taken from the instructions for the second step of the fight against the coronavirus and 76 questions from regulation 150/920318. All active kindergartens (9 cases) in the study were included, and the answers to the questions as yes, no, and not applicable were recorded and using SPSS software, independent T, chi-square, and one-way ANOVA was analyzed.
Results: The results obtained from the analysis of the checklist showed that the compliance of the health status of all kinds of kindergartens with the regulations of 150/920318 has a percentage of total desirability that includes personal hygiene (81/4%), food hygiene (63%), tools and equipment hygiene (66/5%), building hygiene (78%), health education (90%), considerations regarding disinfectants and disinfectants based on alcohol (92%) and considerations regarding bleaches (94%). There was no significant relationship between the per capita of each child and the different items on the checklist (p>0/05).
Conclusion: This study showed that the general environmental health status of kindergartens in Saveh was favorable and only two variables of hygiene of tools and equipment (66/5%) and food hygiene (63%) were the least desirable among the studied factors that should be considered.

Background and Objective: One of the basic strategies to reduce the prevalence of diseases among people in society, especially children and adolescents, during the epidemic of COVID-19 disease, is to observe hygiene and personal protection behaviors. The present study was conducted to determine the level of compliance with health protocols in primary schools of Ilam city during the outbreak of the SARS-CoV-2 in 1400-1401.
Materials and Methods: This descriptive-cross-sectional study was conducted in primary schools of Ilam city with a statistical sample of 49 schools (25 girls' schools and 24 boys' schools). In this study, the 2019 new coronavirus disease care and control checklist was used in schools, which has 15 questions with a total score of 100. Data with Kolmogorov-Smirnov and T-Test statistical tests using SPSS software. V21 was analyzed.
Results: The results of this study showed that the highest and lowest scores are respectively related to the parameters of school health assessment before reopening (100 percent) and screening of people in terms of vaccination by PCR test (zero percent). The average score of compliance with the checklist was 74.3 in girls' schools and 74.38 in boys' schools. Also, the results of the T-Test showed that there is no significant relationship between the mean scores of girls' and boys' schools (p<0.05).
Conclusion: The results of the present study showed that the score obtained for compliance with the checklist parameters of all schools in Ilam city is less than 85 points, and the main reason for this is the non-compliance of the screening parameter of people in terms of vaccination/PCR test in schools.