Iran Occupational Health

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  Background and aims

  The present study aimed at exploring the relationships between the subscales of burnout and psychological wellbeing .in this study resiliency and gender were  controlled among two groups were compared on the subscales of burnout and wellbeing.

  Methods

  For sampling, 127 teachers of elementary schools in Tehran were selected using multistage cluster sampling who answered Maslach and Jakson burnout inventory (MBI), GHQ and CD-RISC.

  Results

  Findings indicates male teachers had a better status in anxiety, physical symptoms and depression subscales of general health questioner (GHQ). The comparison of male and female  teacher in the subscales of burnout showed there was a significant difference between the two

  groups only in the subscales of emotional exhaustion, and woman had a weaker performance in comparison to men. Findings also indicated there was appositive and significant relationship between the component of burnout and mental health problems (including anxiety, physical

  symptoms and depression and social function) after controlling for resiliency and gender.

  Conclusion

  The result of regression analyzes showed that mental health of teacher in general could predict their burnout.

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Background and aim: In the hot workplaces, the increase of body core temperature is induced in result of exposure to high air temperature and metabolism heating due to worker activity. Heat exposure can affect how well chemicals are absorbed into the body. Core temperature change can alter absorption, distribution, metabolism and excretion of the toxicants. Increases in respiration can cause further toxicant exposure through inhalation, while increases in sweat and skin blood and pulmonary ventilation flow can make more efficient transcutaneous absorption of toxicants. Therefore, the amounts of xenobiotic absorbed through the lungs and the skin during heat exposure can be raised significantly in result of higher pulmonary ventilation and cutaneous blood flow. Animal studies which are investigated the effects of thermal stress on chemical toxicity showed that heat exposure plays a role on toxins absorption. However, it is difficult to interpret these findings when trying to compare differences between humans and the animal models. It is observed that workers exposure in some work environment suggests that concomitant exposure to heat stress and chemicals is likely to increase the absorption and effects of certain xenobiotics. Tetrachlorethylene is a particular chemical compound is often used for laundry. The main route for human exposure to tetrachlorethylene is via inhalation, but the compound is also adsorbed by mouth contact. As mentioned, most of what is known on the effect of heat exposure on absorption of chemicals comes from animal studies. With regard to the importance of analyzing how thermal stresses can effect on toxicity response of chemical agents and moreover, need to better understanding of its related mechanisms in humans, the present study aimed to investigate the relation of body heat strain level with Tetrachlorethylene concentration in exhaled air among laundry workers in Hamadan city.
Method: This descriptive analytical study was conducted in two steps of winter and summer in 2017. Twenty-four healthy workers employed in laundry workrooms located in the city of Hamadan, Iran, were enrolled in the study. Their age, height and weight were respectively 32.1 ± 5.16 year, 173.7±11.5 cm, 70.3±16.5 kg. The participants were screened using a self-reported questionnaire in terms of their state of mental and physical health. Before initiation of the tests, a written informed consent form was signed by the subjects participating in this research. Based on ISO 9920 (2007), clothing insulations (Clo unit) of the participants were 1 Clo and 0.75 in winter and summer, respectively. Ambient air samples of laundry workroom were obtained using 150 mg coconut shell charcoal tubes (20/40 mesh) SKC and using SKC personal sampling pumps model 222 calibrated to a flow rate of 100 cc/min. The air samples were analyzed by the NIOSH method no 1003 recommended for Tetrachlorethylene. Desorption of Tetrachlorethylene from activated charcoals was done with 1ml of carbon disulfide. After 30 minutes an aliquot of the resultant solution (1 µl) was injected into Shimadzu 2010 gas chromatograph equipped with a flame ionization detector (F.I.D) and Rtx-1 column. One ml volume of the sample was injected into the gas chromatograph with a Hamilton gas—tight syringe. The instrumental temperatures were as follows: injector temperature, 250C; initial oven temperature, 70C (held for 5 min), increased to 120C at a rate of 10C min-1, held for 5 min. For exhaled air samples of the same participants, individuals were asked to exhale normally into a 3 liter Tedlar air bags (SKC) until it was filled. Measuring Tetrachlorethylene in exhaled air was conducted through integrating NIOSH 1003 and NIOSH 3704 methods through optimizing analysis parameters using analytical device GC-FID.  Thermal strain of exposed workers was measured based on oral temperature, heart rate and respiratory rate in accordance standard method ISO 9886:2004. The heart rate was measured using a heart rate device (Beurer PM100). Statistical analysis of the data was performed using the SPSS software version 20. The significance level of the tests was considered 0.05.
Results: The mean of dry temperature, natural wet bulb temperature and globe bulb temperature were 29.42°C, 23.96°C and 30.77°C, respectively. The mean of Tetrachlorethylene concentrations in ambient air of laundry workplace in summer and winter were 45.91 ppm, 50.64 ppm, respectively. The mean values of the thermal strain indexes included oral temperature, heart rate, and pulmonary ventilation in summer and winter were 37.3°C and 37.1°C, 99.95 and 90.95 beats per minute, 26 and 20.5 breath rate per minute, respectively. The mean values work metabolism in summer and winter were 110.86 and 108.73 kcal/h, respectively. The mean of Tetrachlorethylene concentration in exhaled air in summer and winter is 3.18 and 2.23 ppm, respectively, which were higher and lower than national occupational exposure limit (3 ppm). The significant difference was observed between the mean Tetrachlorethylene concentrations in exhaled air in summer and winter (p<0.05). Paired sample t-test was not showed a significant difference between the mean Tetrachlorethylene concentrations in ambient air samples in two steps (p>0.05). According to the results of paired sample t-test, core temperature, heart beat rate and pulmonary ventilation of workers were significantly increased in summer compared to winter (p<0.05). The results showed that correlation between Tetrachlorethylene concentration in the exhaled air and ambient air samples in winter (p= 0.003, r = 0.58) and summer (p= 0.023, r = 0.46) were statistically significant.
Conclusion:
Few quantitative data has been published on this subject, and hence, this study aimed to investigate the interaction of coexposure to heat and chemical agents in real work condition.
The present study confirmed that the Tetrachlorethylene concentration was increased in the workers̕ exhaled air in result of thermal strain in the laundry workrooms. It can be confirmed that workers who are exposed to extreme heat may be at risk for increased absorption of chemicals into the body. The quantities of Tetrachlorethylene absorbed via the pulmonary routes during work in the studied environment could significantly increase due to the elevation in pulmonary ventilation rate. It should be note that, the increase in skin temperature and skin blood flow as well as the presence of sweat on the skin surface may also promote the cutaneous absorption of chemicals during concomitant exposure to heat. It is suggested to empirically investigate workers skin absorption of chemical agents in exposure to high air temperature compared with natural condition in future studies. 

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Introduction: This study aimed to compare the effect of a vocational rehabilitation program with CBT- based career counseling on career issues of persons with bipolar disorder.
 Methods and Materials: To; compare the effectiveness of the vocational rehabilitation program after sampling, the intervention was performed for people with bipolar disorder. The sampling method was purposeful in the first and available second stages. The effectiveness of the vocational rehabilitation program was compared with the control group waiting with CBT-based career counseling in three settings: pre-test, post-test, and follow-up. To evaluate the research data, descriptive statistical indicators (mean and SD) and inferential statistical methods, multivariate analysis of variance test with repeated measures, were used.
Results: The results showed that the vocational rehabilitation program was effective on career issues (p <0.0001) of people with bipolar disorder, and the effectiveness was also continuous after one-month follow-up (p <0.0001). CBT-based career counseling also on career issues (p <0.86) was ineffective.
Conclusion: It seems that the vocational rehabilitation program has a lasting effect on improving the career issues of people with bipolar disorder, and this approach can be used to develop the career of people with bipolar disorder.
 

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Introduction: Examining the model of career issues of people with bipolar disorder and formulating a vocational rehabilitation program based on it for these people was the aim of the present study.
Methods and Materials: This research consisted of two parts. The first part was to discover the career issues of people with bipolar disorder, which was extracted from three sources (articles published on the subject of career issues of people with bipolar disorder (N=34), interviews with people with bipolar disorder(N=48), and interviews with experts who have worked in this field(N=11)), which were extracted using a qualitative method (exploratory meta-synthesis). Then, based on these extracted factors, in the second part of the research, the model of career issues was designed, and finally, based on this model, the vocational rehabilitation program for people with bipolar disorder was prepared and formulated.
Results: Based on the findings of the research in the career issues model of people with bipolar disorder; the conditional factors lead to the emergence of factors, developing career issues, and these factors also exacerbate the disorder symptoms and after the worsening of the disorder symptoms, the factors that accelerate career issues lead to the formation of career issues in the two areas of poor work performance and feeling work insecurity. Also, the findings showed that the occupational rehabilitation program for people with bipolar disorder includes three levels of intervention on people in the workplace, family members, and the person with bipolar disorder. Conclusion: Discovering career issues and developing rehabilitation programs for bipolar disorder are necessary for improving the career and mental health of persons with bipolar disorder.