الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Safety is an important topic in modern life. Home safety is significant for people of all ages. Home injury is a neglected area of research. This may be because that there is a general lack of appreciation of the size and gravity of the home injury problem. Also, the home is perceived to be a difficult setting to access for injury prevention purposes, because it is part of the private domain. The attention to these types of incidents appears to be more limited than is justified in terms of their importance as a public health problem. In Italy, the law lays down rules for the protection of health in the home and the introduction of insurance against domestic accidents.
Most homes contain wide range of potential hazards during everyday activities. The most frequent types of home injuries are falls, burns, poisoning, cuts, swallowing, fires and flames, and suffocation,...etc. All injury types have similar main causes and socioeconomic and environmental determinants. Most home unintentional injuries can be prevented by identifying their causes and removing or reducing people’s exposure to them. An efficient public health policy could promote and disseminate home safety culture; there is a need to create awareness about the effects of home injuries and educating families about protective measures to avoid them.
Homes can also contain many of air pollutants, with the entry of outside air pollutants. There are many indoor air pollutants, such as particulate matter (PM), volatile organic compounds (VOCs), CO, CO2, ozone, radon, heavy metals, aerosols, pesticides, biological allergens, and microorganisms, etc. These pollutants can be emitted into indoor due to various activities such as heating, cooling, cooking, smoking, and cleaning, as well as, the emissions from building products, materials used, etc. Air pollution poses a great threat to human health, and it has become a worldwide problem that needs to be urgently dealt with.
Many measures have been taken to reduce air pollution and improve air quality. These methods are generally costly and require special equipment. Plants can purify the air by the removal of air pollutants and habituated airborne microbes. They are used as an efficient cleaning system for the environment in a process known as “Phytoremediation”. They remove pollutants such as CO2 through photosynthesis, degrade VOCs through their leaves and then translocate them to their root zone, where microbes break them down. Most people spend (80-90%) of their time indoors, so indoor environment affects their health. Indoor plants can greatly improve Indoor Air Quality (IAQ) also add beauty to the environments and bring greater well-being, stimulating creativity and happiness.
The general objective of this study was to assess home safety and the efficacy of phytoremediation in improving indoor air quality in homes in Alexandria, Egypt. The specific objectives were to determine the incidence and characteristics of unintentional home injuries, to describe the related risk factors, to analyze the indoor air quality, to assess the effectiveness of plants interventions in improving indoor air quality.
210 households were selected randomly and distributed equally in the 3 geographic zones; east, middle and west of Alexandria. In each zone, 70 households (33.3%) were selected. As the study took place over one year, and due to the availability of plants; multiple plants were selected. Available plants in the nurseries were used according to each season. The study had two parts; Part I is for home safety and Part II is the intervention study.
A pre-designed structured interview questionnaire was used to collect data related to the socio-demographic characteristics, environmental living and housing conditions, personal characteristics and habits of family members, and characteristics of unintentional home injuries for the studied families. For each household only one participant was interviewed.
21 households, 7 households from each zone (the west, east and middle) selected randomly considering the different zones of Alexandria Participants who would accept interviews until the sample size is completed. A group of plants will be selected, especially those who are supposed to absorb VOCs and CO2. Must of indoor plants types were chosen based on National Aeronautics and Space Administration (NASA) clean air study,
Types of plants used during the course of the study include: Nephrolepis exaltata, Dracaena marginata, Spathiphyllum wallisii, Dypsis lutescens, Latania livistona, Epipremnum aureum. The characteristics for plants selection included number of plants, plants height, number of leaves in the plant, the leaf area of plants, the leaf area of plants, and plants ages. The plants were obtained from Burj Al - Arab and Montazah palace nursery, at Alexandria. Plants were placed and maintained in the living rooms of the apartments under study. NPK fertilizer was used to keep the plants in a good healthy condition.
The experiment was to test the effectiveness of plants to reduce CO2 and VOCs levels under real life conditions and in the living rooms of the apartments where the participants live. the number of potted-plants was defined according to the living room area in each home. Plants were distributed within the selected homes as (1plant for each 12 m2). The physical factors affecting the ability of plants to remove VOCs and CO2 included Temperature and relative humidity, and the level of illumination.
CO2 and VOCs concentration levels was monitored seasonally (indoor and outdoor), during the four seasons. In each season, CO2 was measured before using the plants and after using them for three successive months. CO2 was measured using direct-reading instruments. Miran 1A variable filter Gas Analyzer was measured. VOCs samples were collected by sampling train in each home. The flow rate of pump is about 0.12 L/min, calibrated by occupational health and air pollution research center - WHO collaborating center, and the pump was running for 60 minutes. Air was pumped into Adsorption technique (pump with sorbent tube made of Teflon tube filled with activated charcoal), and brought back to laboratory for weighting (mg). VOCS Enrichment factor was calculated to indicate indoor air quality (IAQ):
VEF=([ 〖∆C〗_VOCs / 〖∆C〗_CO2 ] t)/0.000419
Where: CVOCs and CCO2 are VOCs and CO2 concentrations increments in buildings above outdoor levels [indoor - outdoor concentrations] measured at time t.
A questionnaire designed to measure the attitude and opinions of households towards the use of plants for phytoremediation to improve the IAQ, promote health and performance and developing the environment. 5-Point Likert Scale was used to allow participants to express how much they agree or disagree with 10 particular statements covering the three sections.
The current study shows that the total number of families (N=210), the total numbers of families members were 829 member. The majority of the families consists of either 4 or 5 members (N=61, 29%) or (N=49, 23.3%) for 4 and 5 members per each family respectively. While that the minority of the families consists of either 7 or 8 members where the number of families is 7 (3.3%) or 1 (0.5%) for 7 and 8 members per each family respectively. There is a statistically significant difference between the total number of injuries and total number of family members (p=0.000). More than one half of the family members (N=441, 53.2%) are single, this is followed by the married (N=307, 37%), and the widowed (N=55, 6.6%), and finally the divorced (N=26, 3.1%). There is a statistically significant difference between total number of injuries and marital status of husbands (p=0.004), and wives (p=0.002).
The current study shows that the higher percentage of injuries occurred for the children less than 12 years old (22.9%). There is a statistically significant difference found between the total number of injuries and the number of sons aged 0-less than 6 (p=0.027). Considering the occupational status of parents; the highest percentage of wives are housewives. In return, there is no working-age husband who does not work, this is followed by those who work in engineering jobs (N=40, 25.6%) and (N=36, 18.8%) for husbands and wives, respectively. There is a statistically significant difference between occurrence of injuries among family members and the occupational status of husbands and wives (p=0.024), (p=0.008) respectively.
The current study declares that the about half of families had monthly income between 3000 - to less than 6000 pounds (N=111, 52.9%). There is no statistically significant difference between occurrence of injuries and each of the monthly income of family (p=0.427). The majority of families lived in buildings consists of 1- 5 floors (N=127, 60.4%). There is a statistically significant difference found between the total number of injuries and the number of building floors which the family members are living in (p=0.026). About two thirds of streets pavement condition was good (N=140, 66.7%). There is a statistically significant difference between occurrence of injuries and streets pavement condition (p=0.042).
The current study obvious that the higher percentage of unintentional injuries occurred in the East of Alexandria (N=100, 46.7%), followed by the Middle zone (N=60, 28%), and finally in the West zone (N=54, 25.2%). There is a statistically significant difference between the total number of injuries and the zone (p=0.006). About three quarters of the families suffer from indoor air pollution (N=159, 75.7%). In addition, more than one half of the families suffer from outdoor air pollution (N=122, 58.1%). There is a statistically significant difference between occurrence of injuries and the external air pollution (p=0.010).
The current study shows that the families who are using air fresheners excessively represent about 44% (N= 92), Otherwise, the families who are using household detergents excessively are 46 %( N= 96). About one half of the families have suffering from the presence of outdoor noise exposure (N=100, 48%). About the sources of outdoor noise pollution (N=185), the majority of the outdoor noise pollution sources are the street vendors (N=70, 37.8%), followed by the traffic (N=67, 36.2%), and the neighbors (N=44, 23.8%). While; the minor source is the industrial noise pollution (N=4, 2.2%). There is a statistically significant difference between occurrence of injuries and the external noise (p=<0.001).
According to the current study; about the types of energy used in cooking (N= 272), all families are using natural gas for cooking in their homes (N=210, 77.2%). In addition, the families may use other sources as the electricity (N=44, 16.2%), the coal / wood (N=12, 4.4%), and finally the kerosene (N=6, 2.2%). 40.5 % of the families smoke cigarettes (N= 85), followed by16% of them who smoke shisha (N=16); While, about half of them are non-smokers (N=109, 51.9%), There is a statistically significant difference between occurrence of injuries and shisha smoking (p=0.031).
According to the current study; about the types of sport (N=316), nearly a quarter of the families don’t exercise any sport (N=69, 21.8%). about favorite leisure time activities and hobbies (N=439), 44 of the families don’t have any time to entertain themselves (10%). The majority of the families have good eating habits including eating fresh vegetables and fruits (N=195, 92.9%), drinking enough water (N=163, 77.6%), eating three meals a day (N=157, 74.8%); and, eating meals at regular times (N=114, 54.3%). The families may have more than one good eating habit. In contrast; other families may have more than one bad eating habits such as eating too fast (N=40, 19%). About 65.7 % (N= 138) were sleeping for 7- 8 hours a day. Otherwise; about 46.7% (N= 98) were suffering from insomnia and difficulty in sleeping (N=98, 46.7%). In addition; it was obvious that 41% (N= 86) have many electrical and electronic appliances in the bedrooms (N=86, 41%). There is a statistically significant difference between occurrence of injuries and sleeping and waking up at regular times and early (p=0.009 & p=0.002) respectively.
The current study shows that the minority of families are raising pets and houseplants in their homes (N=69, 32.9%) & (N=87, 41.4%) respectively. The highest percentage of the families are raising cats (N=32, 39%), followed by poultry (N=22, 26.8%), ornamental birds (N=13, 15.9%), dogs (N=11, 13.4%), ornamental fish (N=3, 3.7%), and finally; the tortoise (N=1, 1.2%). There is a statistically significant difference between occurrence of injuries and raising pets (p=0.034).
The study shows that the majority of families complain from headaches (N=136, 95.1%). More than half of families suffering from stress and fatigue (N=119, 48.6%). The higher percentage of families have a weak vision (N=50, 40.3%), suffering from bone diseases (N=62, 74.7%), obesity (N=33, 58.9%), impairment in gait (N=34, 58.6%), balance difficulty (N=21, 36.2%), and urinary incontinence (N=6, 23.1%). There is a statistically significant differences between occurrence of injuries and some of complaints of family members include impairment in gait (p=0.025), and balance difficulty (p=0.000).
The current study shows that the most common types of the unintentional home injuries were falls, tripping, slipping (N=104, 48.6%), burning, scalding (N=57, 26.6%), cuts (N=17, 7.9%), poisonings (N=11, 5.1%), swallowing (N=10, 4.7%), fires, flames (N=5, 2.3%). The higher percentage of injuries occurred to family members were of minor severity (N=115, 53.7%), followed by moderate severity (N=91, 42.5%), and finally severe severity (N=8, 3.7%). The higher percentage of injured body parts was the leg (N=99, 35.4%), followed by the arm injuries (N=94, 33.6%), head (N=25, 8.9%). and back (N=23, 8.2%). The higher percentage of injured members was the wives (N=95, 44.4%), followed by the sons (N=52, 24.3%), the daughters (N=40, 18.7%), While; the lower percentage of injured members were the husbands (N=14, 6.5%), followed by grandfathers (N=7, 3.3%), and grand- mothers (N=6, 2.8%). the most hazardous locations in the home is the kitchen where approximately one-third of all injuries occurred (N=71, 33.2%), followed by living room (N=48, 22.4%), bathroom (N=31, 14.5%).
The current study shows that the agents that led to the unintentional injuries are mainly wet and slippery floors for falls (N=27, 26%), hot cooking oil and beverages (N=17, 29.8%), knifes (including blender knifes for cuts (N=8, 47.1%), medicines for poisoning (N=9, 81.8%), foreign bodies including a coin, ring, broken toy, fish bone, needle pin for swallowing (N=6, 60%), cigarettes & flammable chemicals, electric splitter, matches, and oil pan for fires and flames (N=5, 100%).
The current study declares that the main causes that led to the fall injuries are poor environmental living conditions (N=52, 50%), followed by health problems (N=43, 41.3%), then; unsafe acts (N=31, 29.8%). The higher percentage of the most important causes of burning and scalding are due to unsafe acts (N=29, 50.9%), for cuts injuries are inattention and doing things quickly while chopping fish and cutting meat and vegetables (N=8, 47.1%), for poisoning are leaving a dangerous substances within child’s reach including makeup, medicine, insecticide (N=7, 63.6%), for swallowing are leaving foreign bodies within reach of children , eating hard candy and hard food or a large piece of food in case of tooth loss and chewing difficulties among children and elderly with equal percentages (N=4, 40% for each), for fires and flames are leaving unattended oil pan on the cooker (N=2, 40%), Unsafe acts due to multitasking leading to doing things quickly, inattention, absence of parental control, negligence (N=31, 29.8%) is responsible for falls, slipping, tripping (N=104, 48.6%), and burning, scalding (N=57, 26.6%).
The removal efficiency of the plants was determined during the course of one year divided into three intervals; summer (May to August), winter (October to December), and spring (January to April). The first interval was conducted in the east of Alexandria, 1st building; the removing efficiency has ranged between (45.4 and 51.0 %), and (36.2 and 42.7%) with an arithmetic mean removal efficiency of 47.1 and 39.3% for CO2 and VOCs respectively using Nephrolepis exaltata (N=1), Dracaena marginata (N=1), Spathiphyllum wallisii (N=2), during summer season 2019, Table 4-72. The second interval was conducted in the west of Alexandria, 2nd building; the removing efficiency has ranged between (40.9 and 41.8 %), and (46.0 and 47.8%) with an arithmetic mean removal efficiency of 41.6 and 36.6% for CO2 and VOCs respectively using Dypsis lutescens (N=1), Latania livistona (N=1), during autumn season 2019, Table 4-73. The third interval was conducted in the west of Alexandria, 3rd building, middle of Alexandria, the removing efficiency has ranged between (35.6 and 38.6 %), and (32.0 and 34.3%) with an arithmetic mean removal efficiency of 36.8 and 33.0% for CO2 and VOCs respectively using Epipremnum aurums (N=1), during winter 2020, Table 4-74.
The present study concluded that home qualifications and activities were important for home safety. Phytoremediation was an important and valuable technique for improving Indoor air quality and promoting morale and health. In light of the results of the study, the following recommendations were suggested; improving environmental living conditions, addressing health problems, addressing Wrong practices, safety Performance issues, using safe products, home safety measures (If possible), and general recommendations for home safety, and home activities.
Conclusion
Based on the finding of the present study, it can be concluded:
The current study showed that the total number of families (N=210), the total numbers of families members were 829 member. There was a statistically significant difference between the total number of injuries and total number of family members (p=0.000).
The study showed that the higher percentage of injuries occurred for the children less than 12 years old (22.9%). There was a statistically significant difference found between the total number of injuries and the number of sons aged 0-less than 6 (p=0.027).
The current study showed that there was a statistically significant difference between occurrence of injuries among family members and the occupational status of husbands and wives (p=0.024), (p=0.008) respectively.
The study showed that there was no statistically significant difference between occurrence of injuries and each of the monthly income of family (p=0.427).
The current study showed that there was a statistically significant difference found between the total number of injuries and the number of building floors which the family members were living in (p=0.026).
The study showed that about two thirds of streets pavement condition was good (N=140, 66.7%). There was a statistically significant difference between occurrence of injuries and streets pavement condition (p=0.042).
The current study showed that the higher percentage of unintentional injuries occurred in the East of Alexandria (N=100, 46.7%), followed by the Middle zone (N=60, 28%), and finally in the West zone (N=54, 25.2%). There was a statistically significant difference between the total number of injuries and the zone (p=0.006).
The study showed that there was a statistically significant difference between occurrence of injuries and the external air pollution (p=0.010).
The current study showed that there was a statistically significant difference between occurrence of injuries and the external noise (p=<0.001).
The study showed that 40.5 % of the families smoke cigarettes (N= 85), followed by16% of them who smoke shisha (N=16); While, about half of them were non-smokers (N=109, 51.9%), There was a statistically significant difference between occurrence of injuries and shisha smoking (p=0.031).
The current study showed that there was a statistically significant difference between occurrence of injuries and sleeping and waking up at regular times and early (p=0.009 & p=0.002 respectively).
The study showed that there was a statistically significant difference between occurrence of injuries and raising pets (p=0.034).
The current study showed that there was a statistically significant differences between occurrence of injuries and some of complaints of family members include impairment in gait (p=0.025), and balance difficulty (p=0.000).
The study showed that the most common types of the unintentional home injuries were falls, tripping, slipping (N=104, 48.6%), burning, scalding (N=57, 26.6%), cuts (N=17, 7.9%), poisonings (N=11, 5.1%), swallowing (N=10, 4.7%), fires, flames (N=5, 2.3%).
The current study showed that the higher percentage of injuries occurred to family members are of minor severity (N=115, 53.7%), followed by moderate severity (N=91, 42.5%), and finally severe severity (N=8, 3.7%).
The study showed that the higher percentage of injured body parts was the leg (N=99, 35.4%), followed by the arm injuries (N=94, 33.6%), head (N=25, 8.9%). and back (N=23, 8.2%).
The higher percentage of injured members were the wives (N=95, 44.4%), followed by the sons (N=52, 24.3%), the daughters (N=40, 18.7%), While; the lower percentage of injured members were the husbands (N=14, 6.5%), followed by grandfathers (N=7, 3.3%), and grand- mothers (N=6, 2.8%).
The current study showed that the most hazardous locations in the home was the kitchen where approximately one-third of all injuries occurred (N=71, 33.2%), followed by living room (N=48, 22.4%), bathroom (N=31, 14.5%), around the home (N=20, 9.3%), bedroom (N=15, 7%), stairs (N=11, 5.1%), dining room (N=8, 3.7%), balcony/entrance (N=3, 1.4%), garden (N=2, 0.9%), corridors/roof (N=1, 0.5%).
The study showed that the wet and slippery floors were the most chief causal agent for falls (N=27, 26%), hot cooking oil and beverages (N=17, 29.8%) were the most chief causal agent for burning and scalding, the higher percentage of the most chief causal agents for cuts (N=14) were knifes (including blender knifes; n=8, 47.1%), The higher percentage of the chief causal agents for poisoning (N=11) were medicines (N=9, 81.8%). The higher percentage of the most chief causal agents for swallowing injuries (N=10) were foreign bodies including a coin, ring, broken toy, fish bone, needle pin (N=6, 60%), the higher percentage of the chief causal agents for fires and flames (N=5) were cigarettes & flammable chemicals, electric splitter, matches, and oil pan.
The current study showed that the approximately a half of fall injuries are due to poor environmental living conditions causes (N=52, 50%), the higher percentage of the most important causes of burning and scalding were due to unsafe acts including multitasking, doing things quickly, inattention (N=29, 50.9%), the higher percentage of the most important causes of cuts injuries were inattention and doing things quickly while chopping fish and cutting meat and vegetables (N=8, 47.1%), the higher percentage of the most important causes for poisoning were leaving a dangerous substances within child’s reach including makeup, medicine, insecticide (N=7, 63.6%), the higher percentage of the most important causes of swallowing were leaving foreign bodies within reach of children , eating hard candy and hard food or a large piece of food in case of tooth loss and chewing difficulties among children and elderly with equal percentages (N=4, 40% for each), the higher percentage of the most important causes of fires and flames were leaving unattended oil pan on the cooker (N=2, 40%).
Phytoremediation was an important and valuable technique for improving indoor air quality and promoting morale and health.
Recommendation
In light of the results of the study, the following recommendations were suggested:
Improving environmental living conditions:-
Mopping any liquid substance is spilt on the floors; it must be wiped off right away.
Install grab bars next to the toilet, sink and the shower or bathtub.
Place a bath mat with non-skid backing on the floor just outside the shower or bathtub.
Doing home modifications to reduce fall hazards, redesign and repair of stairs, thresholds and unpaved streets.
Improving lighting and putting a nightlight in the bathroom and in the hallways.
Creating a safe play environment for young children.
Addressing health problems:-
Encouraging exercise to avoid falls by keeping fit and improve strength and balance.
Encouraging and following healthy eating habits to maintain the strength, vision, and bone.
Encouraging good sleep habits for its positive effects on health through recognizing and treating sleep-related problems.
Addressing Wrong practices:-
Learning and following the correct method for lifting and handling heavy loads can help prevent injury and avoid back pain. Using tools and techniques that can make it easier to move heavy burdens with less strain and less chance of personal injury.
Keeping toys where young child can reach them without climbing on furniture.
Clear the home of clutter.
Never leave food unattended on a stove to avoid burns or smoke inhalation and cooking fires.
Children should not have access to matches, cords, electric lines, sockets and switches. All outlets should be covered with socket protectors.
Children should not have access to hazardous materials as medicines, chemicals and should storing up high in a locked cupboard, safely out of them sight and reach to avoid poisonings.
Safety Performance issues:-
Avoiding multitasking overload.
Plan and prioritize. Set aside time to focus on specific tasks.
Slow down and think things through before acting.
Eliminate as many distractions as possible.
Trying not to rush.
Pay particular attention while performing any actions or movements.
Continuous cooperation between family members.
Young children need to be supervised by careful adults, adequate supervision of children.
Using safe products:-
Avoid baby walkers as they can over-turn easily and cause serious head injuries.
Young children should not be allowed to sleep on the top bunk bed.
Proper placement of shelving, using of safely sturdy step stools when getting things in the kitchen or out of closets. Apply proper storing and handling.
Wearing suitable shoes when exercising.
Home safety measures (If possible):-
Smoke detectors
Plan your escape route.
Fire extinguisher.
Fire blanket.
Smoke alarm.
Fire escape ladders.
Carbon monoxide alarms.
General recommendations for home safety:
Creating awareness among kindergarten children by allocated programs to increase their knowledge about health and safety risks to avoid them, as well as educating their parents about preventive measures to reduce unintended home injuries.
As well as in the different stages of education and universities, such as in related departments such as work environment health, home economics and kindergarten.
In the field of public health in the role of home safety must providing competencies of home safety specialists who can check homes and create safe home environments, to reduce the burden of home injuries.
In the role of consumer protection, unsafe and non-conforming products must be withdrawn from markets.
In the field of media must promote and disseminate home safety culture.
Educating the community about what to do when accidents and injuries occur, and how to reduce the severity of injury, by spreading awareness programs on first aid.
Granting health insurance to housewives when they are exposed to home injuries.
Owning a pet may contribute to improved health, as well as promoting the human, moral, and scientific side of adults and children.
General recommendations for improving indoor air quality in the homes:
Using of improved fuels, cook stoves, or heaters, and improved ventilation can reduce household air pollution and improve human health.
No smoking indoors to avoid household air pollution.
Avoid excessive use of detergents and air fresheners.
Plants are needed in our lives, different numbers and types of plants can be used in the home to achieve many benefits such as:
Improve indoor air quality at home; Houseplants are an effective and affordable way to improve indoor air quality.
Promote health and performance; Houseplants give a sense of calm and reduce the feeling of fatigue and stress, houseplants led to increased interests, mental skills and performance.
Develop the environment; Houseplants increase the home aesthetics, houseplants made living environment more attractive.