Iran Occupational Health

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 Background and aims: Nature of the work in control rooms is such that it can be classified as sophisticated with high-cognitive load jobs and, therefore, the prevention of human error seems to be necessary. A nalysis of cognitive tasks is the first and important step for designing preventive programs. This study was conducted to identify, quantify and compare the cognitive requirements of different occupations in the control rooms of a petrochemical industry.

 Methods: In this cross-sectional and descriptive-analytical study, Cognitive Task Analysis (CTA) and Fleishman Job Analysis Survey (FJAS) methods were used. The samples were 20 expert control room operators from leaders, board operators and site operators with 40.9 ± 6.98 years of old and 17.05 ± 6.25 years of work experience, which voluntary participated in this study. The One-Way ANOVA and Tukey HSD tests were used for Statistical data analysis via SPSS version 17.

 Results: Based on the results of HTA –as the first CTA phase- 8 subtasks in leadership, board operator and site operator tasks were recognized. In addition, 12 cognitive requirements were defined for studied tasks via CTA. The FJAS scores indicated that 70% of recognized requirements in CTA are in moderate to high levels (the FJAS mean score higher than 4) which obligates a relatively high cognitive ability to operators. The Tukey HSD test results revealed no significant difference in cognitive requirements level of leadership and board operator tasks, as well as board operators and site operators. However, it was significantly different between leadership and site operator tasks (P value <0.05).

 Conclusion: This study indicated numerous and relatively, high level cognitive requirements of tasks in petrochemical control rooms, especially, among board operators. Moreover, due to the ability of scaling and analyzing various parameters, FJAS can be considered not only as a complementary but also as an alternative for CTA.

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Background and aims: The importance of clinical laboratories work and test results is clearly related with the community health. This study aimed to evaluate the variety and rate of Pre and Post-Analytical errors among reception staff in clinical laboratories of governmental, private and military hospitals.

Methods: In this cross-sectional descriptive study, 183 of reception staff of clinical laboratories in governmental, private and military hospitals from Tehran and Tabriz Cities were enrolled. The required data was collected using a self-designed specific form (voluntary human error reporting Form). At first, the CTA (Cognitive Task analysis) method was used to elicit the cognitive task demands and identify the probable human errors. The data collection form was designed based on the obtained results and distributed in study population. After 6 months, the fulfilled forms were collected and the reported data were analyzed using some statistical tests such as chi-square. .

Results: According to the results, the study population was young (mean age 33.86 ± 6.92 years) with a relatively low experience (7.75± 6.72 years). 14 various human errors were identified in studied tasks via CTA method. The 93% of subjects reported at least one error during study period and a total of 1188 errors were reported by individuals. The error report rate in pre and post- analytical phases were 57.4% and 42.6%, respectively.

Conclusion: Because of the relatively high variety and rate of reported errors and also, the importance of laboratory errors in the medical diagnosis and treatment, it is necessitate to record, analysis and control of human errors in medical laboratory tasks.

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Background and aim: For prevention of accidents in chemical processes, the use of multiple layers of protection is essential. In this regard, the analysis of adequacy and use of protective layer resistance is a necessity. In this study the level of protection layers security of Cephalexin Crystals production unit of one the pharmaceutical companies is examined.

Methods: In this descriptive study the existing hazards in Cephalexin Crystals production unit of one the pharmaceutical companies assessed LOPA technique. Therefore, with visiting and inspecting the Cephalexin Crystals production unit which Cephalexin Crystals production occurs in four reactors, using HAZOP technique the risks were identified. Then, using LOPA technique that is an analysis and risk assessment technique, protective layers were analyzed and finally the risk number calculated.

Results: Using this method the 104 scenarios were identified. Of the 104 Scenarios the 102 Scenarios were at acceptable levels and only two scenarios needed to management's judgment to determine whether further reductions are needed or not.

Conclusion: LOPA technique is a useful method for assessing the adequacy of the independent protective layers in the Cephalexin Crystals production unit of the pharmaceutical company. The results showed that calculation of the some initiating event frequency using specific tables is not possible. Therefore, expert judgment and the exchange of experiences are emphasized. Because of the direct involvement of experts in risk assessment, the skill of the team in determining the authenticity and accuracy of the results is very important and hence calibration and evaluation procedures are also important.

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Background and aims: Just culture is conceptualized as a rational approach to human error and its fallibility. A good evaluation of just culture in an organization is needed to effectively design and implement of preventive measures to reduce the events and injuries. This study aimed to evaluate the psychometric features of the Persian language version of just culture questionnaire (JCQ).

 Methods: JC questionnaire contains 27 questions in six dimensions of JC. The Persian version of JC questionnaire was prepared by the standard method, forward-backward translation. In order to evaluate the content validity, the questionnaire was sent to 28 ergonomists and the content validity index (CVI) and content validity ratio (CVR) were calculated. The reliability of questionnaire was determined when 221 questionnaires were fulfilled by hospital nurseries.

Results: the initial evaluations by experts partial revisions in some subscales to approve the CVR. By revisions, the validity of all subscales and consequently the JCQ were confirmed. The Cronbach's alpha coefficient for JCQ dimensions was ranged from 0.65 to 0.89. The total coefficient for the JCQ showed that the questionnaire has high internal consistency in all dimensions measured (α = 0.894).

Conclusion: This study showed that the validity and reliability of the Persian version of JCQ are acceptable and it is applicable for assessment of just culture in Iranian organizations and workplaces.

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 Background and aims: Occupational accidents and review them in the field of industrial safety are the most important issues. If these accidents are investigated and analyzed, there will be the possibility of reducing their occurrence. This review aims to provide valuable information for researchers and reviewers of occupational accident.

Methods: In this study Persian-language academic journals were studied systematically. The aim was finding, classifying and analyzing the articles were published in these journals since the beginning of 1380 until the end of 1393 on occupational accidents. At the first list of scientific journals (59 journals) and then, the articles related to occupational accidents (Article 106) were selected. A criterion for the selection of the journals was existence at least one article in the field of occupational accidents published in them. Articles were analyzed according to publication year, journal and field survey.

Results: The results showed that most studies were about healthcare (19.80%), manufacturing (16.98%) and epidemiology (11.32%) respectively. Also in the first six years of study, only 12 articles (11.32%) have published in the field of occupational accidents while in the six years at the end of study, 73 articles (68.86%) were published. 42 journals published only one article and 17 journals published more than one article in the field of occupational accidents. The Journal of Occupational Medicine and Iran Occupational Health were assigned of 19.80% of the articles.

Conclusion: This study can be used as a scientific resource for researchers and specialists in occupational health and safety field and help to Improving researches in the field of occupational accidents in Iran.

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Background and aims: Organizations are defined as a group with a specific structure and play an important role in the social, economic, and ecological systems. Disasters, accidents, and crises are complex and controversial issues for industries and organizations. Accidents and occupational injuries cause severe and significant economic losses in developing countries and result in the loss of millions of working days per year. With increasing disaster statistics in world, the ability to survive and thrive in turbulent times, such as recessions, disasters, crises, and wars, is a major concern for organizations and industries over the recent decade. Organizations must manage crises such as recessions, large-scale defective production, supply chain failures, major industrial accidents, and employee problems. The system should be designed in such a way which based on the results of past organizational disasters use a method to prevent and minimize accidents and their losses. Resilience in these types of events and crises is often less pronounced and manifested through an organizational culture. Organizational resilience is an effective objective that constantly contributes to the organization's performance during business, disasters and critical situations. In other words, resilience enables organizations to manage complex challenges in the organization. To create resilience, organizations need to be consistent and highly reliable. Resilience is defined as the ability of a system to recover after an emergency. According to the resilience model presented, thirteen dimensions of organizational resilience include leadership, employee engagement, situational awareness, decision making, innovation and creativity, effective participation, knowledge utilization, organizational island failure, internal resources, goal unity, inactivity status, planning strategies and stress testing programs. Considering the importance of organizational factors and the criticality of large industries, appropriate and important dimensions and areas for measuring corporate resilience should be identified. Then, by weighing and prioritizing the identified dimensions, useful information should be provided to managers and decision makers of organizations. Managers will use this information in planning to reduce risk and increase safety and resilience of organizations. In previous studies, 13 dimensions of organizational resilience were not combined and their weighting was not performed. Therefore, this study aimed to weight and prioritizes the 13 dimensions of organizational resilience in the face of major crises and major events in large industries.
Methods: The present study is a descriptive-analytical-applied study conducted in large industries (in three major industries including: a heavy machinery manufacturing company, a car parts manufacturing and assembly company, and a petroleum industry) is done. In the first step, the concept of organizational resilience and its dimensions were examined through a review of previous studies and opinion of the relevant experts in the subject. An extensive study was conducted to examine the literature. Therefore, the literature on organizational resilience including theses, conferences, and papers published between 2000 and 2019 was reviewed. After the initial screening, which included reviewing titles and eliminating duplicate and unrelated cases, a determined number of articles^, abstracts and dissertations were reviewed. Accordingly, many article full texts were prepared to evaluate the dimensions, the methods and tools of the studies, the gaps and weaknesses of the studies, as well as the identified indicators and factors affecting resilience. After reviewing the literature and indicators extracted by the research team, 13 important and relevant resilience indicators were selected to design the tool, namely: management commitment, just culture, learning culture, knowledge of status, preparedness, use of knowledge and experience, communication and teamwork, creativity and innovation, leadership and decision making, planning and targeting strategy, effective participation, resources and responsibility.
In the second step of the present study, the panel of experts was selected. Members of the panel of experts were selected based on cognitive criteria and scientific qualifications from experts in crisis management, occupational health and ergonomics. The final list consisted of 11 specialists (persons with relevant Ph.D. degree and one year of relevant work experience) in this field.
In the third step of the study, the identified dimensions and domains for measuring the level of organizational resilience were provided to experts in the form of a paired comparative questionnaire (AHP questionnaire). They then presented their comments on pairwise comparisons between dimensions and between items of each organizational resilience questionnaire. It should be noted that for the representation of the pairwise comparisons matrix, a 9-Saati scale was used to determine the relative importance of each dimension in relation to others. After collecting the questionnaires, weighting of dimensions and organizational resilience scales were performed using AHP method and Super Decisions software.
Results: The highest value of normal weight among dimensions of organizational resilience was related to leadership and decision making (0. 20583) and the least was related to resources (0.01246). In other words, the first and thirteenth priority among the 13 organizational resilience dimensions in this study are related to leadership and decision making dimensions and resources, respectively. It is worth mentioning that the areas of  knowledge and experience utilization and management commitment along with the leadership and decision making dimension have the relatively high weight (weight difference over the other ten areas of the questionnaire) and the dimensions of preparedness and responsibility and resources have relatively less weight. It is also worth noting that the inconsistency rate (0.0138) was less than or equal to 0.1 which is indicating the validity of the pairwise comparisons and thus the results of the weights can be trusted. Also, considering the results related to weighting the items related to each of the dimensions of the organizational resilience questionnaire (to show the importance of the items specific to each domain of the organizational resilience questionnaire, it can be stated that all the obtained incompatibility rates were less than or equal to 0.1. As a result, it can be said that the pairwise comparisons are correct and that the weights assigned to all the items can be trusted.
 Conclusion: Given the importance of organizational resilience and the criticality of the industries under study, appropriate dimensions and indicators should be identified to measure organizational resilience. Then by providing weighting and prioritizing indicators and areas of organizational resilience, useful information is provided to managers and decision makers and it can be used in planning to reduce risk and increase the level of safety and resilience of the organization. In other words, critical industries and organizations (characterized by high complexity and vulnerability and susceptible to major disasters) can focus on priority-influenced indicators to improve safety and resilience management. Modifying and improving effective performance indicators will improve the safety and resilience of the organization. According to the findings of the research, leadership and decision-making dimensions, the use of knowledge and experience and the management commitment are more effective than other components in organizational resilience. Therefore, it is necessary to make arrangements for organizations to become more familiar with the issues and benefits of safety and resilience and to rely on the support and commitment of managers as well as the knowledge and experience of employees to make the right decisions. These dimensions must be taken into consideration when developing measures to improve organizational resilience.
The behaviors of managers in any organization, which should take the lead and make decisions, influence the thoughts, feelings, and desires of their supervised employees, which motivate and guide their behavior. Therefore, leadership and decision-making style as a facilitator and motivator have a direct and indirect impact on the efficiency of organizations as well as on the creation of organizational culture and safety culture. The results also showed that the dimensions of knowledge utilization, experience and management commitment were more relative to leadership and decision making. This important finding highlights the importance of these two dimensions in helping to promote organizational culture and thereby enhancing the level of organizational resilience.
The results also indicated that among the 13 dimensions of organizational resilience, resource dimension is the top priority in terms of importance and weight gained. Whereas from the expert panel's perspective, the concept of resources refers more to the financial resources and equipment in the organization and the impact of human resources (managers and employees) is more represented in other areas of organizational resilience. Therefore, with this perspective, the levels of personal, safety and organization culture due to the lack of staff involvement in resources is reduced.
 

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Background and aims: In recent decades, the essence of work was changed because of the great evolutions in several parts of manufacturing and industry. Increasing global competitive marketing was a cause of these changes. Generally, changes in work include: mechanization, automation, information technology, organizational restructuring, work-related modification and staff multitasking. According to these changes, the need to learn and develop new skills led to increased psychosocial factors including job stressors. Almost, the majority of people experience job stressors at work. Job stress occurs when there is no balance between job demands and worker’s capabilities. In several studies, job stress is identified as an important and effective factor that effects on health, performance and industrial safety. Usually, workers exposed to several stressors in the workplace, including: relationships and tensions among employees, high workload, long work hours, poor job design, role ambiguity or conflict, weak support from management and coworkers, high-speed work and so on. Job demands like workload, physical factors of the workplace and job control manner are the most effective stressors on the workers' life. Fatigue is a significant negative consequence of these stressors. For example, high job demands lead to impaired cognitive functioning and tired feeling that those are the fatigue symptoms. As regards the fewer studies about stress among industrial workers in Iran and there is no study on the relationship between job stressors and fatigue among Iranian workers, this survey was performed to study relationships among job stressors, especially job demands and job control, with fatigue; also, assessing the fatigue changes during the working day according to the job stressors was the other aim of this study.
Methods: This survey was a cross-sectional study that gathered from three hundred and thirty-eight industrial workers from the big industries of Tabriz city. The purpose of the study was explained with clarity to all participants. Only those who agreed to participate in the study and who had more than one-year working experience, healthy people (Who didn’t suffer from diabetes, asthma, blood pressure and anemia) and those who worked in day shift, were enrolled. Participants were selected by a convenient method for this study. A valid job stress HSE questionnaire, a demographic factors questionnaire and fatigue checklist were used to conduct data. At first, to study and evaluate of fatigue in time, a designed checklist was used. According to the aim of this study, we designed a checklist that measures worker’s acute fatigue in every time of working day. By this checklist, the participants rated their fatigue in the range of 0-10 (0= there is no fatigue feeling, 10=there is an excessive fatigue feeling), at specified hours during the working day from 7:00 to 18:00. Then, the demographic questionnaire and fourteen items of job stress questionnaire to evaluate job demands and job control were provided to participants. The scoring of job stress questionnaire was ranked from 0 to 4 (no to more) in this study. To data analyses, the working day was divided into three times, time 1 was from 7:00 to 10:00 (7:00, 8:00, 9:00 and 10:00), time 2 was from 11:00 to 14:00 (11:00, 12:00, 13:00 and 14:00) and time 3 was from 15:00 to 18:00 (15:00, 16:00, 17:00 and 18:00). Then, the average of fatigue was computed for each time. The variables of job demands and job control were adjusted between two groups (little and more) at the start of the study. The normality of quantitative data was evaluated by K-S test, identity of the covariance matrix was checked by Mauchly's W test and the Nested Repeated Measure and Controlling Covariates test was used to investigate fatigue among three time periods by SPSS Software Version 25. At the end, the Controlling Covariate test was used by Minitab Software Version 18.1 to control of confounding variables. The results include three P-values for comparing groups between three times. The first was P-value (Group) for comparing between three groups, the second was P-value (Time) for comparing between three times (time 1, time 2, and time 3), and the third P-value (Level) was computed for comparing fatigue in each depression levels. The level of significance was set at P-value < 0.05. All results were expressed as Mean ± SEM (standard error of the mean).
Results: According to the results, the mean age of workers was 37.04±0.4 years; and the mean working experience of workers was 11.45 ± 0.35 years. Also, the majority of the participants were male workers. About 52 percent of workers had more than 11 years of work experience and 62 percent of participants were fixed shift workers. The workers worked on average 203.65±1.8 hours in month. They had a mean 30.57±1.4 minutes rest-time in a day. Fifty and three percent of workers believed that they had a moderate income while the others were dissatisfied with their income, and they considered it inadequate. Results showed that job demands variable was significantly related to fatigue in time (p<0.001) and fatigue was increased by increasing of job demands (p<0.001). According to the results, by increasing job demands level from low to high, the severity of fatigue has increased. Also, the significant relationship between job control and fatigue was showed in results (p<0.001). According to the results, by decreasing job control level from high to low, the severity of fatigue has increased (p<0.001). At the end, the mean of fatigue had a positive trend from the start of working day and was increased by spending of time; fatigue score was increased by changing time from time 1 to time 2 and from time 1 to time 3 (p<0.001).  
Conclusion: The job stressors, especially job demands and job control, have adverse effects on several aspects of human life; fatigue is one of these negative consequences. According to the results, fatigue is a gradual process that increases by spending time from the starting of job activities. If so, the level of job control is low, or the job demands are higher than the capacity of workers in an organization, the severity of fatigue will increase. The importance of these findings is in the planning and implementation of necessary actions to reduce fatigue and its related incidents. So, it is recommended that industry managers and relevant authorities take proceedings to reduce the effects and severity of fatigue by reducing the time pressure, work speed, and workload and increasing the power of decision-making and application of work skills. Organizations also can reduce fatigue by decreasing the long hours of work and dedicating enough time for the rest of the workers.