Iran Occupational Health

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  Background and Aims: Workplace violence is increasingly recognized as a problem in the health care system. Emergency medical technician students may be exposed to violent behavior during clinical training. However, no attention has been paid by researchers to this issue. The aim of this study was to determine the prevalence and risk factors for workplace

  Methods: In this descriptive study, 48 Emergency medical technician students were participated with censuses method. Data is collected using a questionnaire that its validity and reliability were tested with content validity and test-retest respectively.

  Results: In total, 47.91% and 20.08% of the respondents had been verbally abused and physically assaulted during their training program, respectively. Most of physical attacks and verbal abuses were happened by patients’ families. The most common causes of workplace violence were, delay in reaching the scene from the perspective of patients and their caregivers, and lack of knowledge about the role of the Emergency medical technician students.

  Conclusion: Emergency medical technician students are often exposed to violence during the course of their training programs. This group requires training on how to prevent and respond to workplace violence, and this important topic should be incorporated into their curriculum.

 

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  Background and aim: Occupational accident is an unplanned and harmful event which occurs in workplace environments. Among various occupations and activities, large metal industries are the most hazardous industries in the world. This study was designed in one of the Arak metal industries in order to determine the incidence rate of occupational accidents as well as its risk factors.

  Methods: Initially in an incidence study, 873 workers were followed historically to determine the number of accidents since 2005 to 2007. Then the cases were compared with a random sample of workers with no accident (251 workers) in a case control study. After data collection by a structured questionnaire, statistical analysis was conducted using chi-square test, t-test and logistic regression in SPSS software (V.16).

  Results: During these three years, 359 accidents had been occurred and the annual incidence rate of accident was equal to 137 per 1000 workers. There was a significant relationship between occurrence of accident and age, work experience, education level, height, and systolic blood pressure as well as shift work (p<0.05).The marital status and number of children were not significant risk factors. Moreover, unsafe practices was the first case of accident, age and educational level were remained in regression model as the most important predictors of incident of occupational accidents.

  Conclusion: Considering the high frequency rate of accidents and based on our findings, planning and implementation of safety training, modifying non-safe conditions, supplying workers with appropriate standard protective equipment and appropriate facilities are recommended.

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  Background and Aim : The aim of the present study was to examine the personality variables of morning-type, rigidity, neuroticism , extroversion, openness, agreeableness and conscientiousness as predictors of shift work tolerance in an industrial company in Ahvaz.

  Methods: The sample consisted of 245 shift workers which were selected by the use of stratified random sampling. At first the participants divided into two groups (low tolerance shift workers versus high tolerance shift workers) by using Survey of Shift workers. Then each group of participant s was evaluated by using NEO questionnaire. In order to analyze the data, the discriminate analysis and in the validation stage, the Pearson's Correlation Coefficient were applied.

  Results: Findings, confirm the hypothesis of this study. On the other hand, findings revealed that tolerance of shift work can be predicted from Personality variables.

  Conclusions: The results of this study showed the importance of morning-type, neuroticism , and rigidity as predictors of shift work tolerance. Therefore, in order to select people for shift work systems we recommend to rely on these variables.

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Background and aims: Sampling of toxic mercury vapors (Hg0) is necessary for determination of occupational exposure levels of workers exposed to this contaminant. Given the tendency of carbon nanotubes for mercury adsorption, carbon nanotubes can be expected to be suitable sampling media for mercury. The aim of this study was to compare the performance of multi-walled and single-walled carbon nanotubes (SWCNT, MWCNT) in absorption of mercury vapors in the air.

 Methods: In this experimental study, the efficiency of absorption and different variables that affected on adsorption of mercury vapor such as, adsorption efficiency, desorption mass amounts of mercury, adsorption capacity, the time and temperature of desorption, repeatability, and retention time of mercury were optimized. Statistical method, one way - anova, multiple linear regression and T - test were used for survey of results accuracy.

 Results: Capacity and adsorption efficiency of adsorbents related to mass amounts of adsorbents, type of carbon nanotubes and mass amounts of mercury. In this method, working range in SWCNT and MWCNT were 0.006 – 0.7 and 0.006 – 3 g respectively. The minimum of adsorption capacity in 80 mg of SWCNT and MWCNT was 0.006 g. The optimum time and temperature desorption for amounts of mercury were 10 minute and 250 °C respectively. The retention time of mercury adsorbed (90%) on carbon nanotubes was more than 3 weeks.

 Conclusion: Carbon nanotubes have the potential to be used for adsorption/ desorption of mercury vapors in the air.

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Background and aims: The present study was conducted to assess the role of sleepiness during the day (ESS) and sleep apnea in road accidents in Shahroud drivers.

Methods: In this cross-sectional study, 312 drivers of members of Shahroud's terminals were studied in 1392. Demographic, Pittsburgh Sleep Quality Index (PSQI) standard questionnaire with seven scales, Epworth Sleepiness Scale (ESS) questionnaire with 8 items and STOP BANG questionnaire with 8 questions were used. Data analysis was performed using SPSS statistical software version 18. 

Results: Nearly 16% of drivers had accident history in the past five years. The mean ± SD total score of sleep quality (PSQI) in drivers was 4/5 ± 2/85 and 27/5% of them had poor sleep quality. 5/6% of drivers had Epworth sleepiness scale over 10, which is clinically significant. 11/5% of drivers with STOP BANG> 3 were diagnosed in terms of respiratory disorders. ESS in drivers who had accident history in the past year (p= 0.004) and past five years (p= 0.003) and also perpetrate in accident (p= 0.012) was more than other drivers.

 Conclusion: Significant relationships were observed between ESS and perpetrate in accident and accident history in this study. However, this relationship between ESS and injury or death in accident was not observed. More than 10% of drivers with sleep apnea disorder were candidates for referral to sleep clinic.

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Background and and aims: In the last decades musculoskeletal disorders are increasing all over the world have been developed. This study aimed to determine the prevalence of musculoskeletal disorders in the lower limbs in order to achieve perfect results with high statistical power, meta-analysis was performed.

 Methods: In a systematic review and meta-analysis work-related musculoskeletal disorders data were investigated. Some keywords were searched in accessible databases and engineers including SID, Magiran, Google Scholar, Medlib, IranMedex, and PubMed. In general, 27 articles during 2001 to 2010 were gathered. I² index was used to evaluate heterogeneity of articles and ultimate data were analyzed using random effects models.

Results: The total sample size in the studies has done in Iran, was 6090 patients with a mean of 225 samples per study. Musculoskeletal disorders were studied at various jobs that are generally confidence level  (CL) 95%: lower back 50% (42.5–57.5), hips  and thighs 20.7% (16.4-25)، knees 42.1% (35.1–49.1) and Ankles and feet 27.7%(18.8–36.7), respectively.

Conclusion: Work related musculoskeletal disorders in the lower limbs, especially in lower back and knees in comparison with other similar studies were more. Occupational health and ergonomics training on prevention of these disorders, especially for these limbs among Iranian workers is recommended.

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Abstract:

Background and aims: The present study tests a model of the relationship between safety management practices with unsafe behaviors and with of mediation of safety motivation.

Methods: Research design was correlation through structural equation modeling (SEM) and the sample consisted of 265 employees of an industrial company who were selected by stratified random sampling method. Participants of this study completed safety management practices Scale, safety motivation scale and unsafe behaviors questionnaire. Reliability and validity all of questionnaires were accepted. Structural equation modeling (SEM) through AMOS-21 and SPSS-19 software packages was used for data analysis. In addition, Preacher and Hayes’ SPSS Macro program was used for testing mediation.

Results: The results showed that the proposed model fit the data properly. Safety management practices have direct effect on unsafe behaviors and safety motivation (p<0.0001). Also the mediating effect of safety motivation in relationship between safety management practices and unsafe behaviors was confirmed (p<0.0001).

Conclusion: Therefore, organizations can by increasing the safety management practices and also training to employees and supervisors to reinforce the safety motivation, reduce unsafe behaviors and followed to reduce occupational accidents.

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Background and aims: Hospital personnel are exposed to various occupational hazards because of their job circumstances. The aim of this study is to investigate the ergonomic problems of hospital from the perspective of human-system interface technology and to recommend the strategies for improvement.

Methods: In this qualitative study, the conceptual framework of hospital ergonomic problems was extracted through the literature review from the perspective of human-system interface technology. Eighteen staffs and experts were participated in the semi-structured interview and focus group discussion according to the conceptual framework. Theme analysis was used to extract the ergonomic problems and their corresponding solutions.

Results: In total, 14 ergonomic problems were categorized based on a human-system interface framework. Their corresponding solutions were extracted based on the hierarchy of controls, including elimination and substitution, engineering controls, administrative controls and PPE.

Conclusion: Some of the ergonomic problems related to working posture, shift work, workload, job satisfaction and personal relationships are more important problems. The control framework extracted from this study can be used to reduce the ergonomic problems and to recommend the strategies for improvement.

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Background and aims: Regarding high emission rates of volatile organic compounds in the atmosphere by different industrial and transportation sources and their adverse effects on human health and the environment, the need to remove these chemicals from gas streams using new technologies with low energy consumption and high efficiency has been more evident. In this study, the catalytic effect of AC-ZnO was investigated on the removal of these compounds (toluene) and their product distribution in a hybrid catalytic plasma system.

Methods: AC-ZnO catalyst was prepared using sol-gel method. Non-thermal plasma was generated utilizing a high voltage power supply and a dielectric barrier discharge reactor. Plasma and catalyst techniques were then combined in a two-stage configuration. Reactor influent and effluent air sample analysis was carried out using GC-MS and on-line gas monitoring devices.

Results: The results showed that there was a high synergistic effect between plasma and catalyst so that the total removal of toluene was obtained at specific input energy of 1000 J L^-1, while the removal percent was around 88% at the same energy delivery with plasma-alone system. The selectivity towards CO₂ was also increased over catalyst bed and some of the by-products such as NO, and NO₂ were totally removed and the effluent amount of O₃ was negligible.

Conclusion: It can be concluded that the plasma-catalyst hybrid technique is a new and promising method for the removal of volatile organic compounds causing the increase of removal efficiency, and the hazardous products and energy consumption reduction.  

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Background and aims: Feel job satisfaction is the most basic components of mental health and an important factor in career success. The aim of this study was identify of effective factors on job dissatisfaction of primary school teachers of Bojnord city.
Methods: In this descriptive – correlation study, the population were all primary school teachers that who were working in 2015 (N= 653). 200 teachers were selected by the use of multistage cluster sampling method. Participants in this study were measured by "measuring factors influencing  job dissatisfaction questionnaire". In order to analyze the data, the exploratory factor analysis with principal components by use software SPSS-22 and the confirmatory factor analysis by use software AMOS-22 were applied.
 

Results: Principal components analysis using varimax rotation yielded a three-factor solution of improper management (27 items), individual factors (12 items) and lack of welfare agents (9 items) that jointly accounted for 41.07 percent of the total variance. The next step to explain the concept, confirmatory factor analysis was performed. The results showed  job dissatisfaction questionnaire building from three construct latent. Indices of confirmatory factor analysis model showed that the model has an acceptable fit.

Conclusion: The results of this study showed the importance of improper management, individual factors and lack of welfare agents as the factors that influence on job dissatisfaction of primary school teachers in Bojnord city. Therefore, custodians of educational system in order to the micro and macro planning, should rely on these variables.

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Background and aims: One of the innovative technologies for air pollution control is non-thermal plasma. The dielectric barrier discharge reactor is one of the reactors that applied in non thermal plasma technology for air polluation control. In dielectric barrier discharge reactor, the distance between the electrodes for electric discharge is low and led to increasing space velocity of the pollutant in the discharge zone. This increase in the velocity results in a decrease in the probability of collision of the produced active species with pollutant molecules, which consequently decreases the efficiency of pollutant degradation. The aim of this study was to design a new dielectric barrier discharge reactor for increase the dischrge gap zone.

Methods: The non-thermal plasma reactor employed in this study was made of quartz as a rectangular cube shape. In this reactor, the expanded graphite was used as the discharge electrode which was poured uniformly in the bottom of the reactor and a copper plate was on the outer surface of the reactor applied to play the role of the earth electrode. Chloroform removal efficiency as a function of flow rate, concentration of pollutants and applied voltage was investigated in this reactor. In addition, it was observed that the exhaust gas from the reactor contains nitrogen oxides, chlorine, hydrochloric acid, phosgene, trichlorobenzaldehyde and trichloroacetaldehyde.

Conclusion: Results of the study showed that electrical discharge was created in larger discharge gap which resulted in space velocity decrease of pollutants in this region and caused to increase of chloroform degradation. Moreover, flow rate increase affected lightly on the degradation which is owing to the adsorption property of the expanded graphite as well as an increase in discharge gap region.

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Background and aims: Ethylbenzene (EB) is one of the most hazardous carcinogenic VOCs that is used or produced in various industrial, so it is important to reduce its use and control its emissions. The aim of this study is determine the effectiveness of MnO2/Al2O3/Fe2O3 nanocomposite coated on HZSM-5 Zeolite for the removal of ethylbenzene vapors.
Methods: Nanocomposite coated on HZSM-5 zeolite was synthesized by the sol-gel method, and its morphological characteristics were determined by XRD, FTIR, and SEM.
We investigated the effects of the initial concentration of contaminant, relative humidity, and residence time on the performance of the nanocomposite for the control of ethylbenzene .The Response Surface method was used to estimate the main effects and these variables and their interactions so that we could optimize the number of experiments. The experiments were designed using Design Expert software, version 9.
Results: The result showed that sizes of the nanocomposite particles were less than 80 nanometers.  Also, we found that the optimum conditions for the removal of EB were 50% relative humidity,19 s residence time and an initial concentration of EB of 300ppm. For these conditions the nanocomposite removed 98.95% of the EB vapors.
Conclusion: The nanocomposite  provided high efficiency removal of EB from the gas phase or the conditions at which the study was conducted. The advantages of using the nanocomposite for this purpose include the reaction at room temperature and the ability to remove high concentrations of contaminants. The results of this study showed coating nanocomposites on HZSM-5 Zeolite provide an effective adsorbent for the removal of EB from the gaseous phase.
 
 

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Background and aims: Considering that of musculoskeletal disorders and lack of mental health are two problems very important among working people. The present study was conducted to aim comparing the ROSA and RULA method in assessing the risk of musculoskeletal disorders and its relationship with mental health on computer users.

Methods: This study was descriptive - analytic that cross-sectional in time. 71 employees were studied of Medical Sciences University. Data collection was carried out in five stages as follows: 1) demographical data investigation 2) Prevalence investigation of musculoskeletal disorders with Nordic questionnaire, assessment of ergonomic factors risk among employees using 3) ROSA method 4) RULA method 5) Evaluation of mental health. The collected data were analyzed by SPSS 20 software.

Results: The highest prevalence of musculoskeletal disorders was in computer users in the back, neck, upper back, shoulders and the scapula. Average scores ROSA, RULA and mental health of 5.75 ± 0.92, 4.35 ± 1.2 and 24.89 ± 12.95 respectively.

Conclusion: ROSA and RULA though the final score is calculated in two ways may differ, but the end result of both direct and positive correlation with each other.

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Abstract
Background and aims: Work-related accidents each year have a significant impact on workers’ productivity and ultimately the economy of the society. It is estimated that each year two million workers around the world die due to work-related accidents. And approximately 100 million occupational accidents occur each year in the world. Risk perception as a subset of safety culture shows an instant image of people safety perceptions of organization. Because, as a fact, Researches has shown that occupational accidents risk perception affected safe behavior directly and indirectly, the aim of this study was to relationship between occupational accidents risk perception of fueling stations workers with the HSE management performance in fueling Stations in Ahvaz city in 2016.
Methods: By the Preliminary Hazard Analysis (PHA) technique identified 54 occupational dangerous position in gas stations. Then, occupational accidents risk perception questionnaire on 1-5 Likert scale was distributed in 92 gas station workers. Data were analyzed using the software SPSS19. Also, HSE management performance in gas Stations evaluated by the Balance Square Card (BSC) technique that analysis and investigate the relationship between occupational accidents risk perception with the HSE management performance used multivariate linear regression analysis.
Results: That results showed workers risk perception was a good level 72/2% and HSE management performance in gas Stations was a good level 65%. Finally it was found that the relationship between occupational accidents risk perception with the HSE management performance is a meaningful and positive relationship the people have a better understanding of risk and HSE management performance score will increase.
Conclusion: The results obtained showed that a positive risk perception was associated with reduced risks. Also HSE management can be effective on improving workplace risk perception. This study provides a framework for strategic planning HSE Managers to protect workers and prevention occupational accidents.
 
Keywords: Gas station, Preliminary hazard analysis, Occupational accident, Risk perception, Balance square card, Ahvaz.

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Background and aims:
Training process is any learning-based activity and experience, performed with the aim of causing relatively fixed and stable changes in people to improve their ability to do a job. In this regard, the apprenticeship course is one of the most important educational courses, especially for action-oriented or practical fields of studies of the universities. In these fields, apprenticeship is considered as an opportunity for experiential learning, acquiring skill, and practical training. This course involves learning during working, practice, practical training, and acquiring skill, which provides an opportunity for students to gain practical experience, apply their skills acquired in the university, improve their management and personal skills, and create new job opportunities. An apprenticeship period is suitable for trail and test under the supervision of academic educators and industry experts. It creates real conditions for the link between industry and university, and a young graduated person is prepared for work in the community. The essential part of the practical skills training occurs during this period. In general, apprenticeship leads to acquiring valuable practical experiences and improving behavior and attitudes. It also prepares them to enter the world of work in graduated people.
Evaluation is one of the most important steps in the training process and the correct implementation of it provides very useful information on the way of planning and implementing educational programs and can be a very useful basis for evaluating educational performance.  In fact, systematic evaluations and interventions based on the results of the evaluation have a direct impact on the improvement of the educational process and the achievement of the educational goals of a field of study.
 Apprenticeship, as other courses, requires evaluation, and it requires a standard and effective tool that can accurately measure the educational and expected goals.  By using such a valid tool, the success of interventional programs can be evaluated with more assurance to improve the efficiency of the apprenticeship period. Thus, the development of a standard evaluation tool and its psychometric properties is crucial. It can be developed by a group of experts of the same field of the study.
Professional health engineering is one of the important fields of medical sciences. At the bachelor level, apprenticeship is vital in this field of study. This course is considered an essential part of the bachelor level and bachelor students require acquiring special skills to perform their professional tasks to meet the needs and expectations of faculty members as well as employer and worker expectations. In this regard, the method of evaluation of apprentices is one of the most important concerns for apprentices and even professors in this field of study. One reason for the importance of this course is the number of its units (16 units), which has a significant effect on the final GPA of students. It is also a concern for other fields of medical sciences. Based on a research conducted by the research team using advice of experts and research resources, it was found that no study had been conducted so far on the evaluation of the apprentices of professional health engineering field of study in Iran. It might be due to the lack of a standard and valid tool to evaluate the apprentices.
 Problems and concerns related to the assessment of field internship course in field of occupation health engineering is one of the most important issues for the students and the proffessors.
This study aimed to development and validating a tool for assessing the field internship course in the field of occupational health engineering.
 
Methods:
This study was conducted in the occupational health engineering department of the Faculty of Health of Shahroud University of Medical Sciences during the second semester of 2016-2017 to the second semester of 2017-2018. Students of these two courses were evaluated using the designed evaluation tool. The dimensions and items of tool was developed based on curriculum of internship course in the field of occupational health engineering and using litreture review and panel discussions with the participation of occupational health professors and experts. Validity was assessed by Face validity, content validity ratio (CVR), content validity index (CVI) and Item Impact score (IS).  Reliability was evaluated through internal consistency (Cronbach’s alpha coefficient) and test–retest reliability analyses.
In this method used to extract opinions, ideas, and perceptions of a group of people with common characteristics on a particular topic, interviews and group discussions were used. Finally, three areas (dimensions) were defined, which a graduate of this field of the study should be trained based on them.
First area: educational and learning objectives: It includes the initial criteria to achieve educational objectives according to the headlines. It is in fact the science and technology that a bachelor student who is being graduated should learn.
Second area: Management and personal skills (behavioral objectives): it is a performance criteria of an apprentice in the behavioral and management section which includes the performances preparing a student for accepting management role of occupational health and related executive actions in the community. Skilled experts consider this area as conventional management and personal skills.
Third area: development of professional job and entrepreneurship competences and qualifications (management objectives): it is a combination of personal and personality traits, skills, characteristics and behaviors that directly affect the performance of an individual. This area is a state of a person's readiness to enter into a particular profession. In other words, it indicates if a person has the ability to do that work and if he or she is able to create value for new situations by creating various opportunities.
 Then, the comprehensive criteria in accordance to these three objectives were prepared. These criteria were determined based on the review of relevant literature, interviews and the use of the experiences of professors and educators in the field of professional health engineering, experts of professional health unit of health centers and professional health experts. These criteria were used as a conceptual framework for designing the items.  Then, in accordance to the conceptual framework and considering the frequency of criteria for each area, appropriate items were developed for all of them. The conceptual fit of each item with its measured dimension was maintained in the process of developing items for all of the dimensions. Finally, after evaluating the psychometric properties of the questionnaire, five-point Likert scale (very poor (1), poor (2), moderate (3), good (4) and excellent (5) was used to score the items. An excellent score was considered for very appropriate performance and without any need for guidance, a good score was considered for often satisfactory performance with minimum guidance, a moderate score was considered for in appropriate performance requiring guidance, a poor score was considered for inappropriate performance requiring guidance and supervision, and a very poor score was considered for extremely inappropriate performance requiring precise and thorough supervision and guidance.
 
Results:
Based on the three dimensions defined, in the first step, a three-dimensional questionnaire with 44 items was designed. Each of dimensions of educational and learning objectives, management and personal skills, and the development of professional job and entrepreneurship competencies had 14, 20 and 10 items, respectively. The effect score of the item showed that all designed items had a score of above 1.5. Thus, in this step, none of the items were eliminated and all of them were considered important and appropriate from the target ‘s point of view.
The final version of the tool contained 3 dimensions and 40 items. CVI was 0.85, CVR was 0.76, and IS all items were above 1.5, indicating good content validity from the experts’ points of view. The Cronbach’s alpha, intraclass correlation coefficients (ICC), and test-retest Pearson correlation coefficients for the final version of the tool were 0.835, 0.899 (P < 0.001) and 0.913 (P < 0.001), respectively.
Conclusion:
In general, the positive results of validity of the designed tool suggest the desirable psychometric property of the 40-item questionnaire of evaluation of the apprenticeship course in the field of professional health engineering with three areas of educational and learning objectives, management and personal skills, and the development of professional job and entrepreneurship competencies. This standard tool, in addition to evaluating the level of apprentices’ information and knowledge, can be a desirable tool for evaluating the expected job skills and competencies required in the health professional engineering field of study. This was a preliminary study and the authors of this research faced with various limitations. Thus, further studies are needed for more comprehensive application of the designed tool as well as reassessment of the psychometric properties and eliminating its defects and disadvantages in other professional health engineering departments of Iran’s medical universities. Finally, a complete and comprehensive tool for evaluating apprentices of this field of study is provided for academic community.
 The results indicated that the field internship course in the Field of occupational health engineering In three dimension, it includes the dimension of educational and learning objectives, the field of managerial and individual skills, as well as the development of professional qualifications and entrepreneurship assessment tool has good psychometric properties and can be used as a standard mseare for assessing the field internship course of student occupational health engineering. The scope of educational and learning objectives, the field of managerial and individual skills, as well as the development of professional qualifications and entrepreneurship.
Keywords: Questionnaire designs, Validity, Reliability, Occupational health.

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Background and aims: Work-related musculoskeletal disorders usually engage the lower back, cervical spine and upper extremities (shoulder, elbow, wrists, hands and fingers). According to reports from around the world, work- related musculoskeletal disorders are the most common occupational disorders and diseases. There is no accurate estimate of the prevalence of these disorders in Iran, but studies have reported a high prevalence. These disorders are the most important cause of absenteeism among workers. They also play a significant role in the premature disablement of workers. Disorders also induce economic losses in human societies due to the loss of working days, the cost of treatment and rehabilitation, reduction of quality of life of affected people and their families.  These disorders affect the individual, organization, and society. Studies have shown that musculoskeletal disorders are very costly, in such a way that they induce the highest suffering for the patient and among them, back pain has the highest rank. Many of these disorders are due to the failure to observe the ergonomic principles and the unfavorable and non-standard conditions governing the work environment and how to perform the job.  It can be clearly stated that the range of ergonomic problems in work environments is not limited to musculoskeletal injuries, but also include loss of productivity and efficiency, increased errors, fatigue, discomfort and environmental stress.  The risk factors for these disorders are multifactorial, and they are still not fully understood in some respects. The most important factors include occupational ones such as unfavorable work environment, manual work, heavy lifting, repetitive and heavy work. Agriculture, like mining and construction, is recognized as one of the three highly hazardous and high-risk industries in terms of health. National and international studies show that the physical needs of farming occupation can be a cause of work-related musculoskeletal disorders. Dairy plants is one of the subsectors of the agriculture and food. Dairy plants, and especially milking the cows, affects the musculoskeletal system of the workers in the industry due to physical needs, poor working posture and repetitive movements and tasks. Musculoskeletal disorders in the areas of waist, shoulders, hands, wrists and knees are one of the common problems in this industry. Cow-milking is one of the most hazardous sectors in terms of ergonomic risk factors in the livestock industry. According to studies, about one-third of workers in the milking sector often experience symptoms of pain in the shoulders and necks. Increased work time, milking more cows per hour, high physical activity and repetitive tasks are among the potential risk factors for work-related musculoskeletal disorders in this industry. This study aims at investigating the effects of ergonomic engineering interventions and management decisions on reducing the frequency of musculoskeletal disorders and improving work postures among milking workers in dairy plants.
Methods: This is an interventional study performed in a dairy plants with 240 personnel working in different parts of Isfahan. In the primary health and safety investigations in this industry, the hazardous milking sector was selected as the research environment because it produces the highest number of physical complaints by personnel, the highest number of occupational accidents and back injuries. All 48 workers of the milking sector were investigated. The purpose of the study and the methodology was fully explained to the participants in the study. They were assured that, firstly, their information would be completely confidential to the researchers. Secondly, participation in this study was entirely voluntary and if they were not willing to participate in the study, there were no consequences for them. After explaining the study, in case they were willing, the consent form was completed by the participants and the presence of the individual was confirmed. The procedure was carried out in 4 steps as follows. 1. Evaluation of the occupation of milking and determining the frequency of disorders among the workers. 2. Implementing intervention programs. 3. Re-evaluation of the occupation of milking and determining the frequency of disorders after completing the intervention program. 4. Comparing the results before and after the interventions. In order to evaluate musculoskeletal disorders, the Persian version of Cornell Musculoskeletal Discomfort Questionnaire (CMDQ) was completed by the participants. The questionnaire analyzes the frequency of discomfort, severity of discomfort and its impact on work power in the last week in twelve parts of the body. The CMDQ is a suitable tool for the evaluation of work-related musculoskeletal disorders. The ergonomic evaluation uses a quick exposure check (QEC) posture analysis method. This methodology allows assessing worker exposure to a wide range of risk factors for musculoskeletal disorders. In this method, part of the work is completed by the observer and the other part by the operator. The QEC methodology is used to assess a range of occupations including: manual handling, repetitive tasks, dynamic tasks, tasks involving sitting and standing. In the QEC posture analysis, psychosocial risk factors are considered in addition to physical risk factors. This method is also an appropriate method for evaluating interventional operations, because immediately and after intervention programs, the impact of interventions can be assessed by re-evaluating the work environment.
After the analysis, the results were discussed with the top management of the organization and officials from other sectors to determine intervention measures. At the end of the meeting, decisions were made to improve the ergonomic situation of the milking personnel, which include the engineering interventions, management interventions and implementation of educational programs. The time required for the implementation of the interventions and the authority responsible for their implementation was determined. After completing the intervention, the frequency of musculoskeletal discomfort among the participants and the ergonomic status of the milking occupation were re-evaluated using the CMDQ and QEC posture analysis. In the end, in order to investigate the effect of these interventions on decreasing musculoskeletal discomfort and improving personnel postures, the scores before and after the evaluation compared by use of paired t-test and their significance was examined.
Results: All participants in this study were men. 56.26% of the research population was under 30 years old and 66.66% had a work experience of under 4 years of age, indicating the low age and low experience of the population studied. The highest score of the CMDQ in terms of the frequency of discomfort was related to the lower back (364.5 before and 187.5 after intervention), shoulder (190.25 before intervention and 114 after intervention) and neck (164.5% before and 85.5 after intervention), respectively. Paired t-test showed that the scores of the CMDQ were significantly decreased after intervention in the three parts of frequency of discomfort, severity of discomfort, and its impact on work (p-value <0.05). There was no significant difference between the scores of the questionnaire in three areas: upper arms, hips/ buttocks and legs before and after the intervention (p-value> 0.05) but in other areas (neck, shoulder, upper back, lower back , forearm, wrist, thigh, knee and leg) (p-value <0.05). The final score of analysis of the work environment using the QEC posture analysis methodology has significantly decreased after completion of the interventions.
Conclusion: The results of this study showed that the prevalence of musculoskeletal disorders, especially in the lower back, neck and shoulders, is high among cow-milking workers, and corrective ergonomic measures are needed to prevent the disorders. Also, a careful examination of the milking occupation showed that the most important risk factors for the milking workers included: awkward postures, static position for long periods of time, high work hours, uniformity of duties due to the nature of the job and failure to observe the principles of occupational ergonomics at the work environment. Therefore, corrective measures to improve the ergonomic status of milking workers should be elimination of the risk factors identified. Findings of this study showed that the implementation of ergonomic training programs included the selection of the best physical condition with the lowest pressure on the body during milking operations, correct and ergonomic principles of manual handling, improving posture and reducing the risk of disorders (decreasing the score of QEC posture analysis). Also, the results of this study showed that the simultaneous implementation of ergonomic engineering interventions, management plans and training programs will result in a reduction in the frequency of work-related musculoskeletal disorders and the improvement of work posture. Considering that milking activity in dairy plants has the same procedures and equipment, corrective measures of this research are also useful for other dairy plants. One of the limitations of this study was that there is no control group and it is recommended that in future studies, taking into account the control group, the roles of each intervention should be separately reported and compared. For example, the role of ergonomic engineering interventions should be compared with training and management plans and the effectiveness of each one in the reduction of disorders is analyzed so that the measures are prioritized according to their impact. This prioritization can help managers who cannot implement all interventions simultaneously to select the most effective actions.
 

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Background and aims: Mining has always been recognized as one of the most hazardous occupations, and mining environments have been discussed as one of the most dangerous work environments. Thus, occupational safety and health is a major issue for the 13 million people or miners in the world, many of whom are working in surface mines.
Considering the slogan "Healthy humans are at the center of sustainable development" and given the need for maintaining the health of the workforce and protecting the environment, HSE management systems have currently been extended to most companies, organizations, industries, and mines to ensure workforce health and environmental protection. On the other hand, any organization and industry needs monitoring and auditing to determine the status and effectiveness of its HSE management system in order to identify and improve the strengths, weaknesses, and non-compliances of the system. So far, no comprehensive and coherent tool or mechanism has been provided for monitoring and auditing HSE in surface mines.
HSE audit is a systematic process used to assess the compliance with the guidelines, regulations, rules, and standard executive procedures developed in the field of HSE. The existence of a comprehensive HSE audit system makes it possible to identify and control all system defects before they may cause irreparable damage. In addition, regarding the importance of HSE in mines and despite the existence of the ISRS[1] for safety auditing in mines, as this method only deals with safety and does not address health and environment as well as the main issues on mining, and due to the lack of a comprehensive and specific tool in Iran for auditing health, safety and environment, the present study was conducted in 2019 to provide a valid audit tool for HSE management system for surface mines.
Methods: This analytical cross-sectional study was conducted in 3 stages:
A: Designing a preliminary checklist based on the HSE management system dimensions: Having reviewed the texts, standards, and regulations related to the health, safety and environment of the mines and also the related audit methods, the researcher developed the items for each dimension.
B: Checklist validity: Given that this study aimed to design a specific checklist for mines, face and content validity was evaluated. The convenience sampling method was used to ensure face validity, and 15 HSE experts (working in surface mines) were selected and invited to cooperate. Finally, according to the expertschr('39') opinions, the items were reviewed and corrected and a new draft was prepared.
To evaluate the content validity, qualitative and quantitative methods were used based on the Lawshe model. In a qualitative assessment of content validity, 15 HSE mining experts with work, research, and educational experiences were invited to participate as a panel group. They were then asked to read the checklist carefully and consider the issues such as the use of appropriate words, grammar, placement of items in their right place, and proper scoring, and to submit their corrective views in writing. Once the groupchr('39')s comments were collected, necessary changes were applied to the checklist.
To quantitatively examine the content validity, two indicators were used (content validity ratio and content validity index). Thus, the CVR[2] and CVI[3] were respectively used to ensure the selection of the most important and correct content and to ensure that the checklist items were best designed to measure the intended content.
C: Checklist reliability: Reliability shows how the measurement tool gives the same results under the same conditions. To determine the external reliability, the checklist was completed by HSE experts in 20 surface mines and was assessed using the test-retest method and correlation coefficient at a two-week interval.
Furthermore, the interclass correlation coefficient (ICC) was used to calculate the internal reliability (agreement between evaluators) of the checklist items. To this end, the checklist was completed by three auditors in 8 surface mines, and the results were analyzed using the ICC method.
Results: The results of this research are presented in the following sections: determining the items and designing the preliminary checklist, and evaluating the validity and reliability of the checklist.
A: Determining the items and designing the preliminary checklist: Having reviewed various texts and considering the opinions of the research team and experts, the researcher used the HSE management system dimensions to design the audit checklist of the HSE management system of surface mines. The dimensions included leadership and commitment; policy and strategic goals; organization, resources, and documentation; risk assessment and management; planning, implementation, and monitoring; and audit and review. In the next step, the items were designed for each dimension.
B: Checklist Validity: 1- Face Validity: Once the experts examined the sentences and items of the checklist in terms of appearance, word choice, and comprehensibility, necessary changes were applied. 2- Qualitative evaluation of content validity: After reviewing the checklist in terms of grammar, insertion of items in their right place, and proper scoring by the panel group (15 experts), the expertschr('39') opinions were collected and necessary changes were applied to the checklist. 3- Quantitative evaluation of content validity: The results of examining the content validity ratio (CVR) showed that 27 items of the checklist had a content validity ratio of < 0.49, and were removed from the audit checklist. Also, examining the content validity index showed that 191 items received a CVI score of >0.79, two items had a score of <0.70 and were removed from the audit checklist, and 3 items received a score of 0.70 - 0.79, which were corrected and revised and were then provided to 6 experts from the panel group. They were kept in the checklist with a score of >0.79.
C: Checklist reliability: To ensure the external reliability (reliability over time), the health, safety and environmental experts completed the checklist twice at a two-week interval in 20 surface mines, and the data were analyzed using the SPSS software. The interclass correlation coefficient (reliability over time) of the dimensions and the total score of the audit checklist were favorable (> 0.8). Thus, the lowest and highest correlations after two weeks were estimated to be 0.970 and 0.995, respectively, which were associated to the policy and strategic goals and the risk assessment and management dimensions, respectively. To determine the internal reliability (agreement between evaluators), the audit checklist was completed by three auditors in 8 surface mines, and the collected data were entered into the SPSS software. The interclass correlation coefficient (agreement between evaluators) of the dimensions and the total score of the audit checklist were also favorable (> 0.8). The highest and lowest internal reliability were associated to leadership and commitment (0.806) and risk assessment and management (0.967), respectively.
Conclusion: According to the results of this study, the CVI and CVR values for the whole audit checklist were 0.95 and 0.84, respectively. In other words, the audit checklist had an acceptable and appropriate validity index. Also, studying the reliability over time and the agreement between evaluators showed that the interclass correlation coefficient of the dimensions and the total score of the audit checklist were greater than 0.8. In other words, the auditors had given approximately the same answers to the questions and thus the dimensions of the audit checklist, which in fact confirmed the validity of the researcher-made checklist. Finally, after making necessary changes and removing inappropriate questions from the preliminary checklist during validity and reliability assessments, 194 questions remained in the audit checklist.
One of the strengths of this research is the comprehensiveness of the audit tool, which not only included safety, but also health and environment. It is also a specific tool for auditing the HSE management system of surface mines. In addition, the tool has high validity and reliability. One weakness of the tool is that it can only be used for surface mines and is not suitable for underground ones. It is recommended to improve the checklist for auditing the HSE management system for underground mines.
According to the results of this study, the checklist designed for surface mines had proper reliability and validity and could be used to audit the HSE management system of surface mines. Finally, the audit output of the HSE management system for mines could be used to improve the HSE management system, identify the risks and non-compliances in the whole HSE management system, management interventions to eliminate defects, and achieve compliance with standards and regulations.

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Background and aims: Considering the high prevalence and lack of standard treatment for the new coronavirus, the best way in the current situation is to avoid infection and prevent its spread. In occupational environments, especially industries, due to air pollution with dust, gases and vapors and allergens and irritants, workers are susceptible to COVID-19 infection. Respiratory exposure of workers to these contaminants can adversely affect the function of their respiratory system and predispose them to respiratory diseases. In some industrial environments, due to the nature of work, workers are forced to work close to each other or use common tools and devices, thereby increasing the risk of the coronavirus outbreaks. Due to the high population density in factories and companies, it is necessary to study the prevention of the coronavirus and application of control measures. Therefore, the present study aimed to investigate the prevention of coronavirus in industry.
Methods: This is a descriptive cross-sectional study that was performed after the pandemic of Covid-19 in April 2020. Three hundred and fifty Iranian industries were investigated in this study. In order to assess the status of Covid-19 prevention in industrial environments, a researcher-made questionnaire was used to perform the study. This study was conducted in three phases including checklist design, checklist validation and industry evaluation. The checklist questions were designed based on the latest recommendations offered by reputable international organizations. The initial questionnaire had 40 questions. To determine the validity, the questionnaire was checked carefully by a panel of experts, including 15 professors and experts in safety and emergency management. Content validity index (CVI) and content validity ratio (CVR) were also used to assess validity. Moreover, Cronbachchr('39')s alpha coefficient was used to determine the reliability of the questionnaire. After designing and validating the checklist, in order to maintain ethical issues and prevent theCovid-19 outbreak the completion of the checklists’ items, the checklists were prepared electronically and distributed in more than 50 social networks of occupational health professionals and HSE. The purpose of the study and how to answer the questions were fully explained to the occupational health and HSE officials. Next, the information was extracted and analyzed by SPSS software version 23.
Results: After checking the validity of the designed checklist, 13 questions were removed and 27 questions remained in total. The results of face validity showed that the transparency, appropriateness and overall simplicity of the questionnaire were equal to 0.90, 0.93 and 0.91, respectively. The lowest and highest values of validity index were 0.79 and 1, respectively. Also, the minimum and maximum content validity ratios were, respectively, equal to 0.65 and 1. Total CVI and CVR values of the questionnaire were determined to be 0.87 and 0.92. Furthermore, based on the results of completed questionnaires by the industries, the Cronbachchr('39')s alpha coefficient of the questionnaire was calculated to be 0.92. The findings of the evaluation showed that the commitment of management to the implementation of prevention programs in the industries is in good condition and most of the surveyed industries have a developed program to prevent of Covid-19. However, some areas such as telecommuting, distancing, and procuring some essential items were in poor condition. It was found that only 36.4% of the industries have taken action to strengthen local and general ventilation systems and more than 90% of them have held training programs for prevention. The most and the least supplied items were related to detergents (95.1%) and respirators (37.8%). Moreover, few industries have used the teleworking protocol (48.1%) and created an isolated room (26.1%) to isolate suspicious cases in emergencies.
Conclusion: The results of this study showed that the designed checklist has a high reliability and can help the management of the organization in assessing the current situation to manage the prevention of Covid-19. The results of the evaluation illustrated that the commitment of management to implement prevention programs in industries is in good condition and most of the industries surveyed have a developed program to combat Covid-19. However, some areas, such as teleworking, spacing, and the provision of some essential items, were in an unfavorable position, requiring the strengthening of discovered weaknesses.