Hassan Amini1, Mansour Shamsipour2, Mohammad Hossein Sowlat3, Mahboubeh Parsaeian4, Amir Kasaeian5, Mohammad Sadegh Hassanvand6, Homa Kashani2, Reza Saeedi7, Mohammad Mosaferi8, Parviz Nowrouz9, Elham Ahmadnezhad10, Katayoun Rabiei11, Alireza Mesdaghinia12, Masud Yunesian13, Farshad Farzadfar14. 1. Kurdistan Environmental Health Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran. yunesian@tums.ac.ir, f-farzadfar@tums.ac.ir. 2. Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. 3. Center for Air Pollution Research (CAPR), Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran. 4. Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran, Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran. 5. Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Med. 6. Center for Air Pollution Research (CAPR), Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences. 7. Department of Public Health, Faculty of Health, Safety and Environment, Shahid Beheshti University of Medical Sciences, Tehran, Iran. 8. Center for Water Quality Research (CWQR), Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran. Department of Environmental Health Engineering, School of Health, Tabriz University of Medical Sciences, Tabri. 9. Department of Environmental Health Engineering, School of Public Health, Shahid Beheshti University of Medical Science, Tehran, Iran. 10. Department of Disaster and Emergency Health, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Department of Disaster and Emergency Health, National Institute of Health Research, Tehran University of Medical Sciences, Teh. 11. Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran. 12. Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran. Department of Public Health, Faculty of Health, Safety and Environment, Shahid Beheshti Univers. 13. Center for Air Pollution Research (CAPR), Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran Uni. 14. Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran. Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Research Institute.
Abstract
BACKGROUND: Development of national evidence-based public health strategies requires a deep understanding of the role of major risk factors (RFs) and the burden of disease (BOD). In this article, we explain the framework for studying the national and sub-national Environmental Burden of Disease (EBD) in Iran as a part of the National and Sub-national Burden of Disease (NASBOD) study. METHODS: The distribution of exposures to environmental RFs and their attributable effect size over 1990-2013 will be estimated through comprehensive reviews of either published or unpublished sources. Statistical modeling will be used to impute missing data in the distribution of RFs exposures for each district-year. National and sub-national BOD attributable to these RFs will be estimated in the following metrics: Prevalence, death, years of life lost due to premature death (YLL), years of life lost due to disability (YLD), and disability-adjusted life years lost (DALYs). The BOD attributable to the current distribution of exposures will be compared with a counterfactual exposure distribution scenario-here, the theoretical-minimum-risk exposure distribution. Inequalities in the distribution of exposure to RFs will be analyzed and manifested nationwide using geographic information systems. DISCUSSION: The EBD study aims to provide an official report to Iranian Ministry of Health and Medical Education, to publish a series of articles on the exposure trends of the selected environmental RFs, to estimate the BOD attributable to these RFs, and to assess inequalities and its determinants in the distribution of exposure to RFs. Iran's territory is large with diverse population, socioeconomic, and geographic areas. Results of this comparative risk assessment study may pave the way for health policy makers to plan more comprehensive and cost-effective evidence-based strategies.
BACKGROUND: Development of national evidence-based public health strategies requires a deep understanding of the role of major risk factors (RFs) and the burden of disease (BOD). In this article, we explain the framework for studying the national and sub-national Environmental Burden of Disease (EBD) in Iran as a part of the National and Sub-national Burden of Disease (NASBOD) study. METHODS: The distribution of exposures to environmental RFs and their attributable effect size over 1990-2013 will be estimated through comprehensive reviews of either published or unpublished sources. Statistical modeling will be used to impute missing data in the distribution of RFs exposures for each district-year. National and sub-national BOD attributable to these RFs will be estimated in the following metrics: Prevalence, death, years of life lost due to premature death (YLL), years of life lost due to disability (YLD), and disability-adjusted life years lost (DALYs). The BOD attributable to the current distribution of exposures will be compared with a counterfactual exposure distribution scenario-here, the theoretical-minimum-risk exposure distribution. Inequalities in the distribution of exposure to RFs will be analyzed and manifested nationwide using geographic information systems. DISCUSSION: The EBD study aims to provide an official report to Iranian Ministry of Health and Medical Education, to publish a series of articles on the exposure trends of the selected environmental RFs, to estimate the BOD attributable to these RFs, and to assess inequalities and its determinants in the distribution of exposure to RFs. Iran's territory is large with diverse population, socioeconomic, and geographic areas. Results of this comparative risk assessment study may pave the way for health policy makers to plan more comprehensive and cost-effective evidence-based strategies.
Authors: Mohammad Miri; Hamideh Ebrahimi Aval; Mohammad Hassan Ehrampoush; Amir Mohammadi; Ali Toolabi; Ali Nikonahad; Zahra Derakhshan; Ali Abdollahnejad Journal: Environ Sci Pollut Res Int Date: 2017-05-29 Impact factor: 4.223