Document Type : Original Article

Authors

1 Department of Health in Disasters and Emergencies, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran

2 Department of Health in Disasters and Emergencies, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran Safety Promotion and Injury Prevention Research Centre, Shahid Beheshti University of Medical Sciences, Tehran, Iran, Department of Neurobiology, Care Sciences and Society (NVS), H1, Division of Family Medicine and Primary Care, Alfred Nobels Allé 23 141 83 Huddinge, Sweden

Abstract

BACKGROUND: The dust and sand storms (DSS) in Iran increased in recent years, which have
caused adverse health effects. Regarding the effects of DSS on the health indicators, the health
system plays a key role based on the mission and the services which it provides. The present study
was conducted, in Iran, to fill the existing knowledge gap and to understand the preparedness
challenges of the health system in response to the DSS.
MATERIALS AND METHODS: Twenty‑one semi‑structured interviews, in 2016–2017, were
undertaken. This study carried out using purposeful sampling with key informants in the Khuzestan
Province, national policymakers in Tehran, as well as people affected by this phenomenon.
A qualitative approach, using the conventional content analysis, was employed to analyze the
collected data.
RESULTS: Four main categories that appear to explain the preparedness challenges of the health
system for DSS include the risk assessment, knowledge management, organizational elements, as
well as monitoring and evaluation.
CONCLUSIONS: It is imperative that policymakers of the country pay special attention to the hazard
risk understanding and managing the various aspects of the beliefs and attitudes associated with
DSS. The development of early warning system, regular drills and exercises, as well as public and
specialized health promotion training related to this phenomenon are suggested.

Keywords

  1. Goudie AS. Desert dust and human health disorders. Environ Int
    2014;63:101‑13.
    2. Nourmoradi H, Khaniabadi YO, Goudarzi G, Daryanoosh SM,
    Khoshgoftar M, Omidi F, et al. Air quality and health risks
    associated with exposure to particulate matter: A cross‑sectional
    study in Khorramabad, Iran. Health Scope 2016; 5 (2): 1‑9.
    3. The World’s Cities with average annual PM10 Values of 150 and
    above (μg m − 3), processed from WHO. Available from: http://
    www.who.int/phe/health_topics/outdoorair/databases/en/.
    Last accessed by author May 20, 2016.
    4. Zhang X, Zhao L, Tong DQ, Wu G, Dan M, Teng B. A systematic
    review of global desert dust and associated human health effects.
    Atmosphere 2016;7:158.
    5. Coppola DP. Introduction to International Disaster Management.
    London: Elsevier; 2006.
    6. World Health Organization. Risk Reduction and Emergency
    Preparedness: WHO Six‑Year Strategy for the Health Sector
    and Community Capacity Development. Geneva: World Health
    Organization; 2007.
    7. Martinelli N, Olivieri O, Girelli D. Air particulate matter and
    cardiovascular disease: A narrative review. Eur J Intern Med
    2013;24:295‑302.
    8. Tao Y, An X, Sun Z, Hou Q, Wang Y. Association between dust
    weather and number of admissions for patients with respiratory
    diseases in spring in Lanzhou. Sci Total Environ 2012;423:8‑11.
    9. Tam WW, Wong TW, Wong AH, Hui DS. Effect of dust storm
    events on daily emergency admissions for respiratory diseases.
    Respirology 2012;17:143‑8.
    10. Khaniabadi YO, Daryanoosh SM, Amrane A, PolosaR, Hopke PK,
    Goudarzi G, et al. Impact of Middle Eastern dust storms on human
    health. Atmos Pollut Res 2017;8:606‑13.
    11. Maleki H, Sorooshian A, Goudarzi G, Nikfal A, Baneshi MM.
    Temporal profile of PM10 and associated health effects in one of
    the most polluted cities of the world (Ahvaz, Iran) between 2009
    and 2014. Aeolian Res 2016;22:135‑40.
    12. Marzouni MB, Alizadeh T, Banafsheh MR, Khorshiddoust AM,
    Ghozikali MG, Akbaripoor S, et al. A comparison of health impacts
    assessment for PM10 during two successive years in the ambient
    air of Kermanshah, Iran. Atmos Pollut Res 2016;7:768‑74.
    13. Al‑Taiar A, Thalib L. Short‑term effect of dust storms on the risk
    of mortality due to respiratory, cardiovascular and all‑causes in
    Kuwait. Int J Biometeorol 2014;58:69‑77.
    14. Miri A, Ahmadi H, Ghanbari A, Moghaddamnia A. Dust storms
    impacts on air pollution and public health under hot and dry
    climate. Int J Energy Environ 2007;2:101‑5.
    15. Neophytou AM, Yiallouros P, Coull BA, Kleanthous S, Pavlou P,
    Pashiardis S, et al. Particulate matter concentrations during desert
    dust outbreaks and daily mortality in Nicosia, Cyprus. J Expo Sci
    Environ Epidemiol 2013;23:275‑80.
    16. Asghar S, Alahakoon D, Churilov L. A comprehensive conceptual
    model for disaster management. J Hum Assistance 2006;1360:1‑15.
    17. Khan H, Vasilescu LG, Khan A. Disaster management cycle – A
    theoretical approach. J Manag Mark 2008;6:43‑50.
    18. Pelfrey WV. The cycle of preparedness: Establishing a framework
    to prepare for terrorist threats. J Homel Secur Emerg Manag
    2005;2 (1): 1‑21.
    19. Disaster Preparedness Cycle. Available from: http://www.fema.
    gov/prepared/index.shtm. Last accessed by author February 5,
    2016
    20. Corbin J, Strauss A. Basics of Qualitative Research: Techniques
    and Procedures for Developing Grounded Theory. Thousand
    Oaks, CA: Sage publications; 1998.
    21. Elo S, Kyngäs H. The qualitative content analysis process. J Adv
    Nurs 2008;62:107‑15.
    22. Graneheim UH, Lundman B. Qualitative content analysis in
    nursing research: Concepts, procedures and measures to achieve
    trustworthiness. Nurse Educ Today 2004;24:105‑12.
    23. Glaser BG, Strauss AL. Discovery of Grounded Theory: Strategies
    for Qualitative Research. New York : Routledge; 2017.
    24. Speziale HS, Streubert HJ, Carpenter DR. Qualitative
    Research in Nursing: Advancing the Humanistic Imperative.
    Philadelphia: Wolters Kluwer Health/Lippincott Williams &
    Wilkins; 2011.
    25. Schwandt TA, Lincoln YS, Guba EG. Judging interpretations: But
    is it rigorous? Trustworthiness and authenticity in naturalistic
    evaluation. New Dir Eval 2007;2007:11‑25.
    26. Lee H, Honda Y, Lim YH, Guo YL, Hashizume M, Kim H. Effect
    of Asian dust storms on mortality in three Asian cities. Atmos
    Environ 2014;89:309‑17.
    27. Jacks E, Davidson J, Wai H. Guidelines on Early Warning Systems
    and Application of Nowcasting and Warning Operations.
    Cover: Courtesy of the Shanghai Meteorological Bureau: World
    Meteorological Organization; 2010.
    28. Ardalan A, Kandi Keleh M, Saberinia A, Khorasani‑Zavareh D,
    Khankeh H, Miadfar J, et al. 2015 estimation of hospitals safety
    from disasters in I.R.Iran: The results from the assessment of 421
    hospitals. PLoS One 2016;11:e0161542.
    29. SlovicP, FischhoffB, LichtensteinS. Facts and Fears: Understanding
    Perceived Risk. Societal Risk Assessment. Boston:Springer; 1980.
    p. 181‑216.
    30. Nabilou B, Khorasani‑Zavareh D. The bridge between real and
    ideal: Students perception on quality gap in reality and their
    educational expectations. Iran Red Crescent Med J 2014;16:e14254.
    31. Sperling F, Szekely F. Disaster Risk Management in a Changing
    Climate. Vulnerability and Adaptation Resource Group (VARG);
    2005.
    32. Unisdr U, editor. Sendai Framework for Disaster Risk Reduction
    2015‑2030. 3rd United Nations World Conference on DRR.
    UNISDR Sendai, Japan; 2015.
    33. Khorasani‑Zavareh D. System versus traditional approach in
    road traffic injury prevention: A call for action. J Inj Violence Res
    2011;3:61.
    34. Khorasani‑Zavareh D, Khankeh HR, Mohammadi R, Laflamme L,
    Bikmoradi A, Haglund BJ. Post‑crash management ofroad traffic
    injury victims in Iran. Stakeholders’ views on current barriers and
    potential facilitators. BMC Emerg Med 2009;9:8.
  2. 35. Moret ES. Humanitarian impacts of economic sanctions on Iran
    and Syria. Eur Secur 2015;24:120‑40.
    36. Tabrizi A, Santini R. EU Sanctions against Iran: New wine in old
    bottles? ISPI Analysis 2012; 97:1‑7.
    37. Gorji A. Sanctions against Iran: The impact on health services.
    Iran J Public Health 2014;43:381‑2.
    38. Isdr U, editor. Hyogo Framework for Action 2005‑2015: Building
    the Resilience of Nations and Communities to Disasters. Extract
    from the Final Report of the World Conference on Disaster
    Reduction (A/CONF 206/6). Geneva: The United Nations
    International Strategy for Disaster Reduction; 2005.
    39. Blashki G, Armstrong G, Berry HL, Weaver HJ, Hanna EG, Bi P,
    et al. Preparing health services for climate change in Australia.
    Asia Pac J Public Health 2011;23:133S‑43.
    40. Frykberg E, Weireter L, Flint L. 10 questions and answers about
    disasters and disaster response. Bull Am Coll Surg 2010;95:6‑13.
    41. Klima DA, Seiler SH, Peterson JB, Christmas AB, Green JM,
    Fleming G, et al. Full‑scale regional exercises: Closing the gaps in
    disaster preparedness. J Trauma Acute Care Surg 2012;73:592‑7.
    42. Niska RW, Shimizu IM. Hospital preparedness for emergency
    response: United States, 2008. Natl Health Stat Report 2011;
    37:1‑14.
    43. Khankeh H, Ranjbar M, Khorasani‑Zavareh D ,
    Zargham‑Boroujeni A, Johansson E. Challenges in conducting
    qualitative research in health: A conceptual paper. Iran J Nurs
    Midwifery Res 2015;20:635‑41.