Iran Occupational Health

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Background and aims: 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 risk in which assumptions and uncertainties are clearly considered and presented. This included identification of hazard (what can happen and why), the potential consequences, the likelihood of occurrence, 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. 
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.
Methods: 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)،Google scholar، Science Direct، PubMed، 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.
Results: 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 (440).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.
Conclusion: 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.
Conflicts of interest: There is no conflict of interest.
Funding: This study is supported by Hamadan University of Medical Sciences, Iran (grant No. 9904031915).

Keywords: Safety, Risk, Hazard, Workplace

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