Iran Occupational Health

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Background and aims: Recently, the respiratory acute syndrome or Covid-19 disease has been become as one of the most important concerns in the national and global level. Covid-19 disease is caused by the virus SARS-CoV-2 or Covid-19. Covid-19 virus is spreading through saliva drops or nasal discharge when coughing or sneezing. Covid-19 disease not only has significantly negative affect on the general health of the society but also on job activities of the people like business, economy and industries activities so that outlook of this disease create stress and concern for the workers and employees about the affecting this disease in the workplace and this stress can be transferred to other workers, family and customers.  Occupational Health and Safety Administration (OSHA) has classified the workplaces into 4 categories in terms of potential of disease: very high risk, high risk, intermediate risk and low risk. Jobs classification include: 1. Very high exposure risk jobs are those with very high potential to meet the discovered cases or suspected of Covid-19 disease during medical cares, after death or during clinical experiments like healthcare stuff and laboratories stuff. 2- High exposure risk jobs: jobs with high potential and lower than previous class jobs to meet the discovered cases or suspected of Covid-19 disease like healthcare and support services employees, medical transportation and funeral workers. 3. Medium exposure risk jobs: jobs where workers are in repeated contact with other workers, public or in close contact with people those possibly with Covid-19 disease but are not diagnosed as suspected ill. These jobs include schools, some crowded retails and activities with high population density. 4. Low exposure risk jobs:  jobs where workers are not in close and continuous contact with other works, public or people suspected of Covid-19 disease.
The work international organization announced people who are affected to Covid-19 in the workplace must have access  to healthcare and treatment services including usual medical cares, specialized cares( inside and outside of the hospital) pharmaceutical , hospital and medical rehabilitation services. On the other hand, since no vaccine or certain treatment is known for this disease till now, the best way to prevent and decrease this disease is to raise the awareness and information about this virus, how this disease is created and how it spreads.so, the present study was conducted with the aim of determining the hygienic performance and effect of training in order to confronting with the Covid-19 virus in the metal industries staff
Methods: This analytical-descriptive study is cross-sectional in terms of time. 5 metal industries were studied by the census method in Isfahan province (3 industries) and Chaharmahal and Bakhtiari province (2 industries). The studied units include employers and directors, administrative, production, Facilities (Technical) and services stuff. To collect data, researcher-made checklist was used to evaluate the personal hygienic of stuff and to evaluate the industry environment and building, environment checklist was used. Totally 569 stuff and 11 checklists were studied to consider environmental health status in the studied industries buildings. Research team was composed of 2 experts. One expert was required to study the personal health of stuff and buildings environments hygiene and the other was responsible to teach stuff. The education subjects included properties of Covid-19 virus, symptoms of affecting to disease, disease transmission methods, methods of preventing the spread of the disease and importance to observe the personal health and the correct method to use the mask and gloves. After studying the personal health by the checklist, stuff specially who did not observed the personal health were trained for 10-15 minutes. Training was performed face to face while observing the hygienic protocols and standard physical distance. In order to study the effect of training in the personal health observance, the studied industries were referred after 3 weeks and personal health checklist was completed for all workers participating in the research. Data analysis was performed by the    SPSS 21 software and paired-samples T-test.
Results: The total studied stuff was 569 persons, 7.38% were women and 92.62% were men. The age average of stuff was 36.7± 8.31 years and 81.27% were married. Before training, 23.73% of stuff used mask and gloves and 30.93% just used mask. Also 78.21% observed the appropriate distance with others and 76.8% observed using personal devices or common surfaces disinfectant solution and 31.46% had hand disinfectant solution. But after training, the personal health observance was raised significantly so that the significant relation (P_Value<0.001) was obtained between before and after training personal health observance. Table 1 shows the results of studying stuff personal health after and before of training.
Table 1. Results of studying stuff personal health after and before of training

variable         amount	Using the personal protection devices (n=569)				Observance of physical distance (n=569)		Personal devices (pencil, pen, etc.) (n=569)		Hand disinfectant solution (n=569)
	Only mask	Only gloves	Mask and gloves	None	Distance observance	Lack of observance	use	Lack of use	Having personal solution	No having personal solution
Frequency percentage (frequency) before the training	30.93 (176)	28.64 (163)	23.73 (135)	16.7 (95)	78.21 (445)	21.79 (124)	76.8 (437)	23.2 (132)	31.46 (179)	68.54 (390)
Frequency percentage (frequency) After the training	47.62 (271)	4.38 (25)	37.1 (211)	10.9 (62)	81.9 (466)	18.1 (103)	87.7 (499)	12.3 (70)	59.23 (337)	40.77 (232)
PValue	<0.001	0.003	<0.001	0.002	<0.001		<0.001		<0.001

 
Results of the environmental health study suggested that cases like 1. Personnel fever test when coming factory, 2. Installment of Covid-19 dealing with disease training poster and stand, 3. Training personnel about this disease, 4. Instruction installation of washing hands in WC, 5. Preparation of enough detergents, disinfectants and cleaning equipment, 6. Existence of ventilation system in WC, 7. Preventing presence of workers suspected of Covid-19, 8. Use of special personnel as responsible for cleaning and disinfection, 9. Using mask, gloves, and work cloth of personnel when cleaning and disinfecting, 10. Observance of method of cleaning and disinfecting instruction, 11. Separation of napkin bucket and cleaning and disinfecting supplies from other devices and parts, 12. Discharge of buckets at the end of work shift, 13. Using of personal items for prayer, 14. Existence of liquid soap piping system with contained having hand washing liquid, 15. Keep doors and windows open, 16. Deactivating finger presence and absence system in more than half of studied saloons were observed. While other cases of observing environmental health including 1.workers' blood oxygen test when entering the factory (9.1%), 2. Installment of dealing with Covid-19 environmental control guide (18.2%), 3. Daily Cleaning and disinfecting (45.45%), 4. Collecting rubbishes in the pedal bucket with lid (45.45%), 5. Availability of first aid box (27.27%), 6. Removing water coolers (0), 7. Placing hand disinfecting solution in the entrance of buildings and next to elevators (36.36%), 8. Existence of smart toilet or foot pedal faucet (9.1%) was less observed.
Conclusion: More than half of workers observed the personal health but increasing their information about these diseases, methods of transmission and preventing outlook of it caused workers to pay more attention to preventive actions and follow personal health instructions seriously. Also environmental health actions in the studied industries buildings were observed but were not observed in some cases due to lack of awareness or economic problems of industrial factory. So, to achieve the best performance in control and decreasing the Covid-19 disease, 3 essential actions are required: 1. Preparation of health supplies (like: mask, gloves, disinfectant solution) and delivering the health supplies to the workers daily 2.  Training workers about the correct method of using the health supplies 3. Supervising use of the health supplies and implementation of health protocols. It should be noted that since Covid-19 disease is a new and unknown disease, training about this disease should be continuously performed and according to updated information.

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Background and Aims: Awareness of a disease can affect people's attitudes and practices, and wrong attitudes and practices directly increase the risk of infection. The aim of this study was to determine the status and relationship between knowledge, attitude and practice of industry employees about personal protection measures effective in preventing covid-19 infection in Kaveh Industrial City.
Methods: In this cross-sectional study, which was conducted to assess the knowledge, attitude and practice of individuals about effective personal protection measures to prevent COVID-19 in Iran in the summer of 2020, a researcher-made questionnaire was used. In this study, after selecting 24 factories in Saveh Industrial City, 500 questionnaires were distributed among the employees by quota sampling. After collecting and reviewing them, 461 questionnaires were fully answered and studied. Finally, the scores related to all three parameters were calculated and Pearson correlation coefficient was used to examine their relationship.
Results: The average age of participants in this study was 36.4 ± 6 and had a work experience of 12.66± 6.6 years. It was determined that the score related to the awareness of the virus nature was greater than the awareness of personal protective measures. It was deduced that, while 88.9% of individuals are well aware of the nature of the virus, 71.8% were in the subgroup of taking protective measures. The highest level of desirable score was related to their attitude, which accounted for 92.4%. In terms of preventive practice, 80.3% of participants exhibited moderate adherence to good practices towards preventing Covid-19 infection
Conclusion: individuals had heightened awareness towards the nature of Covid-19 virus, however they had little awareness towards preventive health measures. consideration that majority of people have received concerned information via television, its essential to give accurate and timely information in order to increase community’s awareness as well as optimal behavior in preventing Covid-19

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Background & Objectives: The COVID-19 pandemic significantly effects on health of workforce as the most important source of manpower in maintaining business and the community economy. Therefore, this study aimed to investigate the knowledge, attitudes and practices related to COVID-19 and its effective factors among industry practitioners in industrial areas.
Methods: A cross-sectional study was conducted in Tehran industrial city from October to December 2020. Data from 494 practitioner’s industry were collected through survey questionnaire including demographic and a 35-item questionnaire to assess the status of knowledge, attitude and practices to the COVID-19 prevention guidelines. The content validity of the questionnaire was confirmed by the experts of Occupational health and Epidemiology and performed by two relative content validity coefficients, the Content Validity Ratio (CVR) and Content Validity Index (CVI), which were 0.78 and 0.85, respectively. Additionally, reliability was proved through a pilot study to calculate Cronbach’s alpha and determined to be 0.81. Descriptive analyses and chi-square tests and Pearson rank correlation analyses were performed to determine factors associated with knowledge, attitudes, and practices towards COVID-19. Data analysis was performed using STATA software version 17 with a significance level of P <0. 05.
Results: The mean and standard deviation of practitioner’s knowledge was 19.68 ± 3.55, their attitude was 14.74 ± 3.45 and their performance was 7.97 ± 0.91. Educational level (r=0.19, p=0.015) and marital status as employees (r=0.24, p=0.042) were directly correlated with attitude and practice, respectively. Also, the results of Pearson correlation test showed that there is a positive and significant correlation between knowledge and attitude (r = 0.11, P = 0.01) and attitude and practice (r = 0.98, P = 0.001).
Conclusion: The results of the present study showed the need to increase awareness through training courses and positive attitude of the studied practitioner in order to strengthen suitable practices and motivate them to take appropriate preventive measures against COVID-19.
 

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Background and aims: With the epidemic of the Covid-19 virus and the increasing development of information and communication technology, an opportunity has emerged for medical and therapeutic service providers to develop telemedicine services. In the current research, the authors tried to explain people's turn to this technology by expanding the Unified Theory of Use and Acceptance of Technology 2 (UTAUT2) and adding the features of telemedicine services. Method: The current research is applied from the point of view of the objective, and in terms of data collection, it is considered to be descriptive research, which is carried out by the correlation-causal method. The data collection tool is a standard questionnaire with a Likert scale, distributed by random sampling among the population with a history of using telemedicine services in Ahvaz city. Finally, 407 usable questionnaires were analyzed using SPSS and Smart PLS. Results: The results show that performance expectancy, effort expectancy, facilitating conditions, hedonic motivation, perceived product advantage, and perceived security have a significant and positive effect on the intention to use telemedicine. Also, the moderating role of innovativeness and gender was confirmed. Conclusion: UTAUT2 and some characteristics of telemedicine services can well explain the intention to use this technology in the context of Covid-19. Also, considering the moderating role of personal innovation and gender in some relationships between the model and product features confirmed, it is necessary to pay attention to the individual characteristics of people using these technological services in the design of telemedicine services.

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Abstract
Background and aims: The biggest threat to human health and life is the Covid-19 virus in these days, and until today no cure has been identified for it. Compliance to preventive behaviors is the best and only way to control and prevent its spread. The present study was done with the aim of investigating the predisposing factors of nursing studentchr('39') compliance of preventive behaviors of COVID-19 based on health belief model.
Methods : This descriptive cross-sectional study conducted in the period from September to October 2016, with the participation of 225 nursing students from a medical university with a census sampling. The tool of study was   seven questionnaires that completed   through cyberspace. Data were analyzed with descriptive statistic and   Prediction was also performed based on the Health Belief model with simple regression and adjusted with the softwar SPSS _v23.
Results: Most of the samples were undergraduate students (83.6%) and women (67.1%). The mean age of students was 24.73 (SD = 8.28) years and the mean score of nursing studentschr('39') compliance of Covid-19, was 39 (SD = 4.5). Univariate regression showed that the variables of age, gender, educational status, economic status, and cues to action, perceived benefits and self-efficacy were predictors of   compliance to preventive behaviors of Covid 19. In multivariate regression, only the variables of gender (<0.001), cues to action (0.032) and perceived benefits (0.033) remained as the final predictors. These variables predicted a total of 22.6% of changes in compliance of preventive behaviors
Conclusion: Gender, cues to action and perceived benefits were strongest predictors of student behavior from compliance to Covid-19. Therefore, more attention to male students as well as planning based on the Health Belief Model with emphasis on strengthening the cues to action and perceived benefits in order to improve preventive behaviors of Covid-19 in nursing students is recommended.    
 
 

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Abstract
Background and aims: Nurses are one of the most important elements of health care system that have been in a stressful situation during the Covid-19 pandemic. The aim of this study was to investigate the prevalence and sources of nurses' occupational stressand identify related factors during this period.
Methods: This cross-sectional study was performed on 392 nurses of Rasht educational and medical centers in January to March 2021 selected with stratified random method. Demographic and occupational stress data (by Expanded Nursing Stress Scale questionnaire) werecollected. Data analyses performed by descriptive statistics and multiple regression models with SPSS software version 26.
Results: The mean age of nurses were 37.8±8.8 years old. Stress was mild in 62% of nurses, moderate in 20% and severe in 2%. Death and dying situation (1/78±0/74), uncertainty concerning treatments (1.71±0.72) and workload (1.69±0.68), expressed higher occupational stress. Working in the intensive care units or emergency ward, higher education, excessive hours of work and female gender were independently predictors of more occupational stress and these characteristics determined 15% of the variance of stress scores.
Conclusion: Stress related to the job during the Covid-19 pandemic is high, and stress in the workplace, especially in intensive care units and emergency ward, should be reduced and standard work shifts should be developed. Furthermore, training of stress management in situations of patients’ death and dying, high workload and uncertainty concerning treatment in pandemic conditions for at risk population of nurses should be done.
 

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Introduction: In the COVID-19 pandemic, nurses were subjected to stressful conditions, which necessitated the need for psychological-supportive interventions. The aim of this study was to determine the effectiveness of the educational-therapeutic package based on psychological flexibility on the quality of work life and general health of COVID-19 nurses.
Materials and methods: This study was a single-blind clinical trial. Based on the clinical interview, 30 people were selected from the population of 120 nurses working in Isa Bin Maryam Center for Covid-19 Hospital in Isfahan city in the winter of 2019 and were randomly assigned to two control and intervention groups. The study tools were Walton's Quality of Work Life Questionnaire and General Health Questionnaire (PHQ) and psychological safe exposure educational-therapeutic package based on psychological flexibility. The data were analyzed in SPSS 24 statistical software with univariate analysis of covariance method.
Findings: The average scores of the quality of life and general health of the two groups before the study had no statistically significant difference (p>0.05). After the intervention, the average quality of life scores of the experimental and control groups were 74.7 and 72.6, respectively, which did not have a statistically significant difference, but the average scores of the general health of the experimental and control groups were 31.7 and 38.8, respectively, which was a statistically significant difference.
Conclusion: the application of the therapeutic educational package based on psychological flexibility has been able to have a positive and significant effect on the general health components of nurses; Therefore, it is suggested to pay attention to these educational packages in educational planning and nursing management policies.