Iran Occupational Health Journal
سلامت كار ايران
ioh
Medical Sciences
http://ioh.iums.ac.ir
136
journal136
1735-5133
2228-7493
10.61186/ioh
fa
jalali
1399
8
1
gregorian
2020
11
1
17
1
online
1
fulltext
fa
توسعه روشی برای ارزیابی و مدیریت ریسک بیماری کووید -19 در محیط های کار: آنالیز سریع خطر کووید -19
Developing a Method for Assessing and Managing the Risk of Covid-19; Rapid Covid-19 Hazard analysis
ارزیابی و مدیریت ریسک
Assessment and risk management
كاربردي
Applicable
<strong>زمینه و هدف:</strong> محیطهای کار بهطور مداوم و تحت تأثیر عوامل متعدد تغییر ماهیت داده و خطرات جدیدتری پدید میآیند. فعالیتهای یادشده در قالب فرایند ارزیابی و مدیریت ریسک انجام میشود. با این نگاه ویروس کووید 19 و افراد آلوده به آن و یا مشکوک به آلودگی یک خطر محسوب میشود. با توجه به جمعیت ده ها میلیونی شاغلین کشور، رفتوآمد روزانه آنها بین محل کار وزندگی و ارتباط روزمره و نزدیک با خانواده و نزدیکان، لازم است، روشی مناسب جهت شناسایی، ارزشیابی و مدیریت خطرات مرتبط با ویروس کرونای اینگونه افراد طراحی و ارائه شود. در همین راستا مطالعه حاضر بهمنظور طراحی روش سریع ارزیابی و مدیریت ریسک افراد مشکوک به آلودگی با ویروس کرونا در محیطهای کار طراحی و اجرا گردید.<br>
<strong>روش بررسی:</strong> در این مطالعه ابتدا چارچوبی برای تعریف خطر تعیین شد. برای طراحی بخش شناسایی خطرات، معیارهای مناسب جمعآوری و بر اساس نظرات خبرگان غربالگری گردید. برای طراحی بخش ارزشیابی خطرات شامل تعداد پارامترهای برآورد و همچنین تعداد و تعریف طبقات، اقدام به جمعآوری پارامترهای معمول تشکیلدهنده ریسک و همچنین روشهای مرسوم ارزشیابی ریسک گردیده و بر اساس نظرات خبرگان غربالگری شد. در این مرحله نظرات صاحبنظران در مورد اهمیت هریک از معیارها با استفاده از آزمون <span dir="LTR">t</span> تک نمونه در نرمافزار <span dir="LTR">SPSS 21</span> معیارهای بااهمیت انتخاب شدند. در گام بعدی تکنیکهای مرتبط با ارزیابی و مدیریت ریسک خطرات بهداشتی متناسب با بیماری کرونا جمعآوری بر اساس معیارهای منتخب بررسی و تکنیکهای که بالاترین امتیاز را در پوشش معیارهای یادشده داشتند شناسایی گردیدند. سپس با بررسی دقیق تکنیکهای منتخب در گام قبلی، نقاط قوت و ضعف تکنیکهای منتخب شناسایی و بر اساس آن اقدام به طراحی تکنیک جدید گردید. تکنیک توسعهیافته درنهایت بنام روش آنالیز سریع خطر ویروس کووید – 19 در محیطهای کار نامگذاری شد. در گام نهایی تکنیک طراحیشده بهطور همزمان در شش واحد صنعتی و سازمان تست و پس از طرف ساختن نقاط ضعف تصدیق گردید.<br>
<strong>یافتهها:</strong> خروجی این مطالعه روش <span dir="LTR">RCHA </span>بود. در این روش شناسایی خطر با استفاده از ترکیبی از روشهای حس مهندسی، مدیریت دانش، گرفتن شرححال و مصاحبه با فرد، تب سنجی و بررسی پرونده شخصی صورت میگیرد. برای برآورد ریسک هر شخص از حاصلضرب سه پارامتر شدت پیامد، سطح نگرش بهداشتی فرد و احتمال ابتلا با وزنهای متناسب استفاده میشود. در برآورد سطح شدت پیامد، چهار عامل وضعیت زندگی شخصی، مشخصات محل کار و فعالیت، وضعیت سلامتی و نشانههای بیماری ارزیابی میگردد<span dir="LTR">.</span><br>
<strong>نتیجهگیری:</strong> هدف اصلی مطالعه حاضر معرفی یک تکنیک ساده، سریع، کمهزینه و درعینحال با دقت بالا جهت غربالگری افراد آلوده و یا مشکوک به بیماری کرونا در محیطهای کار بود. بدین منظور سعی گردید پس از انجام بررسی جامع متون و شناسایی معیارها و تکنیک­های مشابه اقدام به توسعه آن گردد. تست تکنیک معرفیشده در شش نوع صنعت در استانهای مختلف نشان داد که کارشناسان <span dir="LTR">HSE</span> صنایع قادرند با استفاده از تکنیک معرفیشده در حداقل زمان اقدام به شناسایی افراد مستعد و مشکوک نمایند.<br>
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تعارض منافع: نویسندگان هیچگونه تعارض منافعی نداشتهاند.<br>
<span dir="RTL">منبع حمایتکننده</span><span dir="RTL">:</span> <span dir="RTL">این مطالعه بر مبنای طرح شماره 9904031915 مصوب معاونت پژوهشی دانشگاه علوم پزشکی و خدمات بهداشتی درمانی همدان حمایت مالی شده است.</span><gdiv></gdiv>
<strong>Background and aims:</strong> Work environments are constantly changing under the influence of various factors and newer risks are introduced. Rapid changes in science and technology, increasing the complexity of the industry, increased system integration and other factors have been shown to increase total risk in the past few decades. As well, risk management becomes increasingly critical in decreasing incidents, improving safety, and related outcomes. Risk identification is known as the heart of a risk assessment and management process. Risk assessment is a concept that outlines the way in which you Identify hazards and risk factors that are likely to cause damage (hazard identification),and evaluating any associated risks within a workplace (risk analysis, and risk evaluation). Risk assessment and management consists of an objective evaluation of <a href="https://en.wikipedia.org/wiki/Risk" target="_blank">risk</a> in which assumptions and uncertainties are clearly considered and presented. This included identification of hazard (what can happen and why), the potential consequences, the <a href="https://en.wikipedia.org/wiki/Outcome_(probability)" target="_blank">likelihood of occurrence</a>, the detectability and acceptability of the risk, and ways to decrease or reduce the probability and severity of the risk. Basically, it also involves documentation of the hazard identification, related risk assessment and its results, implementation of control methods, and review of the assessment, coupled with updates when necessary. <br>
With this view, the COVID 19 coronavirus and people infected with it, or suspected of being infected is considered a hazard. This is because of such a person, in addition to endangering their own health, is able to infect others, and threatening their health, especially their colleagues. Given the huge population of workers in the country, their daily commute and close relationship with family and friends, and coworkers it is essentially a need to present a suitable method for identification, evaluation, and management of risks associated with such coronavirus. In this regard, the present study was designed and implemented in order to design a rapid method for assessing and managing the risk of people suspected of being infected with the coronavirus in the workplace.<br>
<strong>Methods: </strong>In this study, at first a framework for defining risk was introduced and appropriate criteria for hazard identification section were acquired using expert judgments. In the risk evaluation section, the number and nature of risk parameters, categorization, and descriptions of each of them with consideration to conventional risk evaluation and the opinions of experts were determined. At this stage, the opinions of experts on the importance of each criterion were collected. Then, using the single sample t-test in SPSS 21 software, important criteria were selected. Next, health risks assessment methods suitable for COVID 19 were collected and analyzed based on converging of selected criteria in hazard identification according to expert judgments and methods yielding the highest score was selected. To identify suitable accident analysis methods, related articles Searched in reputable databases such as Iran Medex, Science Database (SID)<span dir="RTL">،</span>Google scholar<span dir="RTL">، </span>Science Direct<span dir="RTL">، </span>PubMed<span dir="RTL">، </span>Scopus, and Web of Science. Keywords used included hazard identification, risk assessment and management, COVID 19, workplace, occupational, individual risk assessment, and health hazard analysis. In the following, by carefully examining the selected method and opinions extracted from experts, strengths and weaknesses of the selected methods were identified, and based on that, the proposed method "Rapid COVID Hazard Assessment", short for RCHA for workplaces application was developed. In the last step, the usefulness of the RCHA was examined by the successful application of it in six different workplaces.<br>
<strong>Results:</strong> The RCHA method was introduced as the outcome of this study. In this method data sources for hazards, identification include engineering senses, knowledge management, patient history, personal interview, fever measurement, and examination of personal files. In terms of hazard identification, the introduced method is very similar to methods that benefit from a primary database such as preliminary hazard list and preliminary hazard analysis with the same pros and cons viz. low cost for employment, no quantitative data is needed, the possibility of use in the early stages of system life (early stages of disease formation), and rapid implementation. In this method, the risk obtained of multiplying three parameters included the severity of consequences, Probability of infection, and Individual health attitude level. The consequences severity parameter has four dimensions included personal life, the nature and type of workplace, Individual health status, and symptoms of Covid-19. In this parameter, each dimension has six classes, which are signed with symbols 1 to 6. Two other parameters that constitute risk has four classes with symbols of 1 to 4. The use of the three-dimensional method in risk assessment in this technique is similar to the approach used in several studies. The 3D risk matrix of this method is similar to the ones used in many well-known methods. Currently, literature reflects the fact that increasing the number of risk parameters can increase the accuracy of evaluation and provide more precise prioritization of identified risks. In the present study, due to the nature of the hazard, the targets are may be different and this issue in the analysis of risk is considered. The variety of factors take into account in estimating the severity of COVID 19 exposure is similar to the results of studies. According to research the degree of importance and therefore the weight of the risk parameters are not equal. The findings of this study also showed that the importance weight of the consequence of exposure is greater than the other two parameters. According to opinions of experts (risk assessment stage), the identified risks categorized at three levels including acceptable (X≤4), “as low as reasonably practicable- ALARP (4<x≤40) and="" unacceptable="">40).In this study, 11 related methods were identified for the design of the RCHA technique. After the initial evaluations, the number of selected techniques reached 5 as follows: Health Hazard Analysis (HHA), Preliminary Hazard Analysis (PHA), Job Hazard Analysis (JHA), Healthcare Failure Modes and Effects Analysis (HFMEA) and Health Risk Assessments (HRAs). In the final step of the study, after performing the necessary training, the technique was tested separately and independently in two stages before and after in 6 units and organizations including the petrochemical industry, ceramic tile production, food production, steel, assembly of industrial parts and hospital.</x≤40)><br>
<strong>Conclusion: </strong>The main purpose of the present study was to introduce a simple, rapid, low-cost, and precise method for screening infected or suspected people to COVID 19 in the workplace. So, after the identification of associated criteria and methods through a comprehensive survey, the principals of that were envisaged. Application of the RCHA in six types of industry in different provinces showed that HSE professionals are able to use it to identify sensitive and infected people in the shortest (acceptable) time.<br>
<strong>Conflicts of interest:</strong> There is no conflict of interest.<br>
<strong>Funding:</strong> This study is supported by Hamadan University of Medical Sciences, Iran (grant No. 9904031915). <gdiv></gdiv>
ایمنی, ریسک , خطر, محیط کار
Safety, Risk, Hazard, Workplace
6
17
http://ioh.iums.ac.ir/browse.php?a_code=A-10-31-14&slc_lang=fa&sid=1
iraj
mohammadfam
ایرج
محمدفام
mohammadfam@umsha.ac.ir
13600319475328460038349
13600319475328460038349
No
Hamadan Med. Sci. Univ.
دانشگاه علوم پزشکی همدان
Mostafa
Mirzaei Aliabadi
مصطفی
میرزایی علی آبادی
Mirzaei@umsha.ac.ir
13600319475328460038350
13600319475328460038350
Yes
Science and Research Branch, Islamic Azad University
دانشگاه علوم پزشکی همدان