Iran Occupational Health

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  Background and aims

  Musculoskeletal disorder is one of the biggest occupational health problems in workplaces of industries. According to the national statistics, the proportion of musculoskeletal diseases of all occupation diseases in the United States is 44% (Bureau of Labor Statistics, 1996). On the basis of report of National Institute Occupational Safety and Health of USA(NIOSH), WMSDs is in the second place between the work-related diseases. Poor working  postures constitute one of the main risk factors for musculoskeletal disorders. Recognition,  evaluation and control action for prevention of occur disorders is important to protect and  promotion of workers health. For evaluation of WMSDs risk factor, various methods have been  presented. Two practical methods for analyzing and controlling poor working postures in  workplaces are REBA and RULA.

  Methods

  This research is a cross-sectional study that was conducted in order to survey of  correlation between two evaluation methods of WMSDs risk factors REBA& RULAin one of the ophthalmic lens manufacture factory.At first, jobs were surveyed and all subtasks of jobs recognized and 40 jobs out of 77 were selected. Then REBA& RULAmethods were carried out  for this jobs. Also, The final scores and action levels were determined.

  Results

  The result revealed that: there was a significant correlation between final score of two  methods (r = 0.781) and action levels of two methods (r=0.821). Compare to action levels, two  methods in all jobs showed that There was no significant difference between action levels at jobs  (p = 0.16) also between action levels of two methods in any of workplaces separately.  Result of REBA& RULAmethods revealed that risk level of lower arm, upper arm and wrist was  higher than trunk, neck, and legs because of awkward posture of the mentioned parts. Result of  RULAand REBAtechnique indicated that, action levels of all jobs were not acceptable.

  Conclusion

  On the basis of mentioned result above, this study indicated that, there was no  significant correlation between two methods and methods have a strong correlation in identifying  critical work site and determining critical limb. Therefore, both methods are recommended for

  evaluation of work-related musculoskeletal disorders risk factors in industries

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Background and Aims

Occupational accidents are one of the main health and economic problems of developing countries including Iran. Death due to occupational accidents causes significant economic losts and hardware losses.

Methods

This research performed in Tehran province in 2002. The subjects included all of people insured which their death was due to occupational accident. The Excel software package was used for data analysis.

Results

231 fatal occupational accidents happened in Tehran over three years research. This research showed that 7552 years of life and more than 777 billion Rails has been lost because of the occurrence of occupational accidents.

Conclusion

According to current research, to decrease the occupational accidents risk,implementation of a comprehensive recording and reporting system and using of proactive safety approach is necessary.

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  Background and Aim

  The oxides of sulphur are among those chemical substances that are increasingly used and their consumption is even growing in different places everyday. Sulphuroxides are used in chemical industries, paper manufacturing, printing rollers, recovering burned (consumed) coal, supplying and producing sulphuric acid, and in bleaching liquids. Determination and evaluation of the accumulation rate of sulphor oxides and sulphoric acid mists through personal breathing zone, and sources emission from occupational areas of the petrochemical complex.

  

  Methods

  Sampling (NO=32) was done from the working places and ambient using ASTM D4490 method for the measurement of source pollutants and the standard method of NIOSH.  Appendix VIII for pollutants measurement of the breathing zone. Measurement and evaluation of the samples from the occupational areas were performed during the two working shifts (morning and the afternoon) at the ground floor and the first floor of the building.

  

  Results

  The average concentrations for sulphur dioxides at the ground floor over the working   time of both shifts (in the morning and in the afternoon) were 0.011 PPM and 0. 015PPM,  respectively. In addition, the average concentrations for the same shifts at the first floor of the

  building were 0.019PPM and 0.014PPM, respectively. The average concentrations of sulphuric acid mists at the ground floor for the morning and afternoon shifts were 0.36 mg/m 3 and 1.47 mg/m 3 and at the first floor they were 0.66 mg/m 3 and 1.35 mg/m 3 ,respectively. The results of measurements for sulphur dioxides gas revealed that contact with this gas in the Units of 300 and 600 was less than the permitted limit from NIOSH for the exposed workers to permissible exposure limit contacts (PEL TWA= 2PPM). Further, the rate of working contact had a significant correlation with each of the indicators of both shifts and the place where this contact accured (P<0.001).The measurement results of sulphoric acid mists also revealed that the rate of contact with the mists for the workers being exposed to the gas in the Units of 300 and 600 in the morning shift was less and in the afternoon shift was more than the permissible limit from NIOSH (PEL TWA= 1 mg/m 3 ) . In addition, the rate of working contact with sulphoric acid mists in terms of the working time and place showed a significant correlation (P<0.001).

  

  Conclusion

  It is concluded that the assumption " the amount of sulphur dioxides is beyond PEL in the breathing zone of workers "is disproved and also the assumption that" the rate of sulphuric acid mist concentration is more than the permissible limit in the workers breathing zone in the afternoon shift is confirmed while in the morning shift is disproved

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Background and Aims

Biological hazards exist throughout all healthcare settings and include airborne and blood borne pathogens. Health care workers are also subject to exposure to hazardous chemicals such as disinfectants and sterilizing agents. In addition to the traditional aforementioned categories of occupational hazards, health care workers experience the stress of being directly responsible for the care of very sick and dying patients, which, coupled with  increasing workloads, can seriously threaten their health and well-being.

Methods

The study population was all hospital staff (# 207), of whom198 health care workers eventually participated in the study. The questionnaires were administered to doctors, nurses and ward orderlies in Shahid Sadoughi Teaching Hospital Yazd, Iran. Data were analyzed by SPSS

11.5 software using Fisher's exact and Chi square tests.

Results

The common occupational health hazards were work-related stress (60.1%), bloodstains on skin (51%), needle-stick injuries (42.9%), assault from patients (21.2%), skin reaction (19.2%), sleep disturbance (15.2%), stew blood on mucosal (3.1%) and use of drugs (4.5%). Nearly 4.5% of the staff used tranquilizers to cope with the work stress. A greater percentage of doctors compared to nurses and ward orderlies used safety precautions such as gloves, facemasks and aprons. 70.2% staff employed regular hand-washing after various procedures 68.2% of staff adopted regularly proper disposal of needles and sharps into separate puncture resistant containers. About 55.6% of the staff recap used needles.

Conclusion

In according to frequent types of occupational related dangers, corporation between chiefs and members of health care center to decrease these seems wishful and we recommend preparing and distributing necessary guidelines with related awareness among these groups.

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  Background and aims

  There are numerous types of health hazards in every workplace which threaten the health and well-being of employees. Therefore, various types of engineering and  administrative control approaches have been developed in industry. Control of hazardous agents can be difficult in most conditions due to economical and technical limitations. However, certain types of administrative control methods can be implemented in these cases instead of engineering or process controls. Since creating a safe environment with zero chance of occupational exposures to hazardous agents is practically impossible, it can be expected that every employee may have a certain level of exposure to one or more of hazardous agents. The probability and extent of these  exposures will depend on job's demands or work environment's conditions. Under this condition,  a "job severity score" as a quantitative value can be determined in order to choose and employ the  best possible control methodology and also to create a long-term occupational health plan.

  Methods

  In this study, the main goal is to develop a questionnaire as a model for assessment of job severity and tasks harmfulness. This questionnaire has five sections in which there are numbers  of questions each with a specified quantitative score.  These scores have been identified according to the brainstorming among the some experienced  experts in the fields safety, occupational health, and industrial psychology. When the final  questionnaire was completed, two well-known industrial sectors were selected as pilot plants for final verification of questionnaire in order to obtain valid questions.

   Results & Conclusion

  The result of this study was providing a questionnaire which might be used in similar studies for determination of job severity level at any industrial plants.

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  Background and aims

  Occupational burnout is considered as side effects of occupational  stress. It includes some mental, functional, and personal characteristics in which a person has some symptoms of them. Occupational burnout can be caused in all jobs..it diminishes performance and utilization,

  depression and disease. Due to the important role of managers, this study was carried to asses the  occupational burnout in industry managers in Kashan.

  Methods

  The industrial managers of Kashan at high managerial levels were enrolled in the  survey. Burnout data collected by standard questionnaire of Maslach Burnout Inventory (MBI) was then analyzed using SPSS-13 software and statistical methods of chi-square, t-test, ANOVA,

  and regression analysis.

  Results

  Between 100 different industrial managers that were involved in this study, 90 persons responded to questionnaire, Include: 16 persons (17.8%) were employer,26 persons top manager(28.9%),36 persons (40%) middle-manager,12 persons (13.3%)high managers.97% were men and mean of age, work hours in week, work years duration respectly were 40.3(±8.26)years, 53.4(±20.6) hours, 15.7(±8.7) years. It seems that most people under study had  mild occupational burnout. sever occupational burnout was observed in emotional exhaustion(

  3%in severity and10.9% in frequency)and depersonalization( 6.8%in severity and7.8% in  frequency).according to this study age, region, kind of management, month earn didn't relation with burnout . work years duration and number of workers had reveres relation with burnout . direct relation with burnout and work hours was founded.

  Conclusion

  Despite the low rate of moderate or severe burnout among the managers, further effort is advised to reduce stress in this group and probe them in psycho mental disorders.

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Background and aims

Nursing provides a wide range of potential workplace stressors as it is  a profession that requires a high level of skill, teamworking in a variety of situations and provision  of 24-hour delivery of care .Occupational stress is a major factor of Staff sickness an  absenteeism.This study investigates the main occupational stressors in nursing profession in the  hope of identification and reducing it.

Methods

In this study a questionnaire consisting of three parts:demoghraphic data,the nurses  background and questions about occupational stress from Revised index fulfilled by 140 nurses.

Results

Lack of reward for work well done(48/6%), Heavy workload(46/4%) ,lack of Participation in decisions (39/3%) , poor Control of work place(38/4%)and lack of job  development (36/4%) have been the main sources of Occupational stress for nurses.chronic  diseases, Night Shift working and working hours were positively associated with occupstional  stress.

Conclusion

 Analysis indicated that effects of work factors on occupational stress are more than demoghraphic data. The findings of this study can assist health service organisations to provide an attractive working climate in order to decrease side effects and consequences of occupational stress. Furthermore, understanding this situation can help to develop coping strategies in order to reduce work-related stress.

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Background and aims

Carpal tunnel syndrome (CTS) is one of the most common peripheral neuropathies. Common risk factors of CTS include hand repitetive movements, awkward posture of wrist and forceful exertions. In Iran, little study has been conducted to determine occuopations associated with high prevalence of CTS. Since many manual occupations involve repititive hands and fingers motions, high prevalence rate of CTS is predicted. This epidemiological study was carried out to determine sex, age, occupation and prominant hand distribution of CTS among patients with CTS refering to Chamran and Nemazi hospitals, Shiraz.

Method

In a passive survaillance, data were collected from 305 files of patients with CTS refering to Chamran and Nemazi hospitals from 2002 to 2006. Age, sex, address and phone number of the patients were taken from their files. In the next stage, they were contacted either

 by person or by telephone and detailes about their occupations and tasks were asked.

Results

Among 305 studied cases, 224 were female (73.4%) and 81 were male (26.6%). Patients' age ranged from 14 to 81 years with mean of 43±14.38 years. Totaly, 286 of paitients were contacted. Among contacted cases, 169 were housewives (59.1%), 45 were office employees (15.7%), 43 were workers (15%), 16 were weavers (5.6%) and 10 were taylors (3.5%). Number of CTS cases in right, left and both hands were 176 (60.1%), 77 (26.3%) and 40 (13.7%), respectively. Surgical procedure were conducted on 194 of cases. Other types of treatments were administrated for the remain 11 cases.

Conclusion

Since 74% of CTS cases were observed in female, it could be declared that due to physical body condition and execution of precise repititive tasks, women were more at risk of CTS. Among occupations, 60% of cases occured in housewives. Based on the results, in order to prevent CTS occurence, it is recomended to pay more attention to women and desiging appropriate hand tools (particularly hand tools used in kitchen).

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  Background and aims

  Dentists are occupationally exposed to elemental mercury from placements of mercury-containing amalgam. Although many studies have been conducted on mercury intoxication, there is still widespread concern about possible ill effects of chronic low-level mercury exposure on dentists. The present study examined the effects of occupational exposure to low levels of mercury by a group of dentists.

  Methods

  In this historical cohort study, subjects consisted of 106 dentists and 94 general practitioners (referent group), from private and public clinics in Shiraz city. Subjects were requested to complete a questionnaire on demographic variables, symptoms experienced and work practices. Additionally, using standard methods, atmospheric and urinary concentrations of mercury were measured. The data were analyzed by appropriate statistical tests. In univariat analysis, Chi-Square test was used to compare the prevalence of symptoms among both groups. Independent sample t-test and Mann-Whitney’s U-test were used to compare the mean and median of quantitative data of both groups. Multivariate logistic regression analysis was used to adjust for potential confounders.

  Results

  Both groups were similar as far as most demographic and socioeconomic variables, but age and number of personal amalgam fillings, were concerned. Median of atmospheric concentration of mercury was found to be 3.35 μg/m³. Likewise, the urinary concentration of mercury in dentists was estimated to be 3.22 μg /g.creatinine. This value was significantly higher than that of the referent group. Additionally, analysis of the data revealed that subclinical symptoms of intoxication were more prevalent in dentists.

  Conclusion

 Our findings indicate that occupational exposure to mercury by dentists, even at low levels, is associated with a significant increase in the prevalence of subclinical symptoms of intoxication.

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  Background and Aims: Soldering is one of the most common activities in metal industries. Lead is used in soldering process and has considerable toxic effects. The aim of this study, therefore, was biological and environmental monitoring and investigating the effects of exposure to lead in soldering unit workers at an automobile industry.

 

  Methods: In order to evaluate biological and environmental exposure to lead, a case-control study was accomplished on 60 workers in soldering unit (case group) and 60 workers in official unit (control group). Demographical and medical information were gained by a questionnaire. Blood samples were collected and analyzed using the NIOSH 8003 method and Atomic Absorption Spectroscopy (AAS) respectively and air samples were collected and analyzed using the NIOSH 7300 method and Inductively Coupled Plasma Atomic Emission Spectroscopy (ICP-AES) respectively.

 

  Results: The obtained results shown that, with the increasing of age and work experience, the blood lead level is also increased.(p=0.033)(p=0.003) In exposed group, the blood lead mean value was significantly higher than the control group (p-value<0.001). Prevalence of digestive, nervous, respiratory, dermal, kidney disorders, anemia diseases, and disorder in bone metabolism in exposed group were higher than the control group. The amount of lead level was negatively correlated with hemoglobin (r=-0.287p=0.026) and hematocrit (r=-0.336p=0.009) but There was no significant correlation between air and blood lead level.

 

  Conclusion: The blood lead level may be increased in lead exposure due absence of personal protective equipment and poor personal hygiene. Increased lead level in blood can be resulted to various diseases and decrease in hemoglobin and hematocrit levels in blood.

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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: Hypertension (HTN) is a common disease with various complications for health. A number of studies suggested that some organic solvents can affect blood pressure and usually workers in work environments expose to mixtures of solvents. We decided to survey the effects of a mixture of organic solvents on blood pressure in workers of a car manufacturing company.

 Methods: In a cross-sectional study, systolic and diastolic blood pressure (SBP&DBP) of 179 workers of a car manufacturing plant was measured. Workers in the repair location as non-exposure group and workers in the paint location as exposure group were compared in terms of systolic and diastolic blood pressure (SBP&DBP) and prevalence of hypertension and pre - hypertension.

 Results: There were no statistically significant differences between groups in the variables, age, employment duration, smoking and other confounding factors (p<0.05). The mean values of SBP and DBP was significantly higher in exposure group than non-exposure group ( p<0.001 ). After logistic regression analysis with adjustment of confounding variables, prevalence of pre-hypertension and hypertension was significantly higher in exposure group than non-exposure group (p<0.05). Further , in this study there was a significant association between hypertension and variables such as age, smoking, body mass index, regular exercise and shift work (p<0.05).

 Conclusion: Our results suggested that, exposure to mixture of organic solvents can increase prevalence of hypertension in car manufacture workers. Therefore, more attention should be paid to such workers by prevention and periodic monitoring of blood pressure .

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  Background and aims: To date, there is not enough information about the toxic effects of dolomite. The purpose of this study was to assess the extent to which digging and excavating workers involved in constructing a dam in Fars province were exposed to dolomite dust and to evaluate the possible effects of this exposure on the prevalence of respiratory symptoms, functional impairments and radiographic abnormalities of the lungs.

  Methods: This cross sectional study was carried out at the constructing site of a dam in Shiraz, south of Iran. The study population consisted of thirty nine male workers with current exposure to dolomite dust and 40 healthy male unexposed employees. To determine the prevalence of respiratory symptoms, respiratory symptoms questionnaire were used. Personal dust samplers were used to assess the exposure concentrations. Additionally, subjects underwent lung function tests and chest X-ray.

  Results: Atmospheric concentrations of dolomite dust exceeded current permissible levels. Exposed workers had significantly higher prevalence rates of respiratory symptoms than their referent counterparts (P<0.05) . Similarly, decrements were noted in most parameters of pulmonary functions of exposed workers, although the difference was only significant for FEV1/FVC ratio (P<0.05) . No significant differences were noted between exposed and referent subjects as far as their chest radiographs were concerned.

  Conclusions: The findings of this study indicate that medium term exposure to very high concentration of dolomite dust is likely to be associated with respiratory symptoms.

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  Background and Aims : Employee examinations are one of the components of occupational health surveillance and the second level of disease prevention. The aim of this study is to determine the prevalence of general and likely occupational diseases among workers referred to an occupational medicine center in Mashhad and the role of theses examinations in early diagnosis of diseases.

  Methods : This descriptive study was done on the 3248 participants were referred to Shahid Ghodsi occupational medicine center. In this study, subjects were examined by a general physician and based on their exposure para- clinical tests were requested. Then the people who had an abnormality in these tests, were asked about their awareness or unawareness .
Finally, all the information was recorded in the standard examinations form and data were analyzed using SPSS software version 18.

  Results: In this study 81.9% of participants were male and18.1%were female. The mean of age and BMI was 31.18 and 22.7 respectively.The20.9% of the subjects had a history of smoking. In this study, the most common diseases were dyslipidemia (34.3% cholesterol and 14.6% triglyceride elevation), visual acuity reduction (22.9%) and hearing loss (21%).The 84.6% of participants with sensor neural hearing loss, 64.6% of participants with visual acuity reduction and 87.7% of participants with hyperlilipidemia were unaware of their disease.

Conclusion: The findings of this study show that most of participants were unaware of their disease, so pre employment examinations is effective in early detection of diseases of workers

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  Background and aims: Accidents and injuries are a cause for concern for all countries in the world. Cognitive failures can be defined as cognitive-based errors on simple tasks that a person should normally be able to complete without fault these mistakes include problems with memory, attention or action. The present study was designed to investigation of relationships between occupational cognitive failures and safety performance among bus drivers.

  Methods: In this descriptive analytical study, 129 bus drivers completed an occupational cognitive failure questionnaire (OCFQ) and the DBQ as well as answered questions on accident involvements. Correlation and regression analysis were used for data processing.

  Results: Occupational cognitive failures have a significant direct positive effect on all driving unsafe behaviors including intended and unintended violations, slips and mistakes.

  Conclusion: For assessment of safety performance in occupational driving jobs, we must use a valid instrument. The cognitive failures can predict bus drivers’ engagement in safe or unsafe behaviors.

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  Background and aims: Fatigue is the risk factor of musculoskeletal disorders and the aim of ergonomics is prevention from it. Decline in employee’s performance, safety and health are consequences of fatigue. The assessment of fatigue is necessary for its control. This study is going to provide valid and reliable Persian version of Swedish Occupational Fatigue Inventory for measuring occupational fatigue.

  Methods: This analytical study population was 77 filling-station operators in Hamadan. Concordance among ergonomic experts and validity of the Persian version of Swedish Occupational Fatigue Inventory were assessed with Cohen's Kappa coefficient and content validity, respectively. To determine structures and principles of inventory, exploratory factor analysis was used. Cronbach’s alpha coefficient was used to determine the reliability of SOFI-translated Inventory. SPSS.16 software was used for data analysis.

  Results: In Persian version of SOFI ) P-SOFI ( , Cohen Kappa agreement coefficient among experts was 0.812, with 95% CI: 0.622, 0.974. In exploratory factor analysis after oblimin turning, three factors were extracted from the Inventory. Reliability coefficient of each 3 factors [functional, physical, conceptual] in Persian version was at least 0.899 and a reliability of 0.921 was determined for total inventory. Internal consistency coefficient of the inventory was 0.894.

  Conclusion: The result indicated that P-SOFI has a fair validity and reliability. Whereas 3 obtained factors [functional, clinical and psychological] define the 72% of the total inventory variance, the appropriateness of the factors is reliable. This inventory can be applied for the prevention of fatigue and programming of health-related interventions in workplace.

 

  Keywords: Occupational fatigueInventory, Ergonomics, Validity and Reliability

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  Background and aims: The knowledge of the rate and causes of occupational hazards occurring in hospitals may be effective in formulating policy aimed at prevention as well as reducing related accidents and cost. The aim of this study was to investigate the characteristic factors responsible for the occupational hazards occurrences among the employees of teaching hospitals of Qazvin University of Medical Sciences.

  Methods: This study was a descriptive analysis of 258 employees of Qazvin teaching hospitals in 2012.In this study, samples were chosen using a stratified multi- stages method. A researcher-made questionnaire was used for collection of data. The data obtained were analyzed using SPSS software and presented as count, frequency and percentages. Categorical data were analyzed using t- test as well as Anova.

  Results: The highest level of occupational hazards’ occurrences was due to skin contact with blood or other body fluids while the lowest level was because of assaulting by patients or their families. There was a significant relation between the variables of age, gender, work experience, job title, and marital status as well as the hospital itself and the rate of occupational hazards. P<0/05).There was no significant relation between the mean duration of absence from work and the rate of occupational hazards (P>0/05).The most important cause of occupational hazards from the employees’ point of viewwas the overload working.

  Conclusion: Based on our results, it was found that the major factors influencing occupational Hazards’ development were included: overload working, personnel indiscretions as well as working condition. Therefore, increasing the number of employees proportional to the required job activities, training the employees regarding their occupational characteristics and monitoringof standard precautions are crucial factors for the prevention of occupational hazards.

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 Background and aims: Among different types of occupational accidents in the construction industry, falls and falling objects accidents (group I) account for 44% of construction accidents. Hit by vehicle, electric shock, collapse in the excavation and fire or explosion accidents (group II), while are only 7% frequent, make up about 26% of all fatalities and total disabling accidents. The aim of this study is to investigate these two groups of accidents and to discuss the obtained results in order to identify the potential hazards of construction industry.

 Methods: Data mining methods are employed to analyze data in this research. Hence, 21864 data records which were provided by Social Security Organization (SSO) and were related to construction accidents of the whole country between 2007 and 2011 were analyzed using decision tree and association rule methods.

 Results: In the first group of accidents, the frequency of accidents at night shift is less than the others, and injury to the head, back, spine and lower extremities are more prevalent. The final result is similar to other accidents. In the second group, the frequency of accidents among married and older workers is more than single and young workers. There was a higher frequency in the evening and especially night shifts as well as during the weekends. The injuries to the head, face and neck are greater than the other accidents in this group.

 Conclusion: The results of this study confirm the results of the past research. Hence, utilizing data mining methods has been successful. Policy makers, managers of construction industry and managers of insurance companies can propose preventive actions against accidents using such patterns.

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Background and aims: Fatigue has a high prevalence in working population and associated with psychological stress in work environment, strongly. Occupational fatigue has negative effects on human errors and performance. Self report fatigue and hormonal change are fatigue assessment tools. This study aimed to evaluate acute fatigue and Urinary Free Cortisol level of carpet weavers in working and non-working day.

 Methods: This cross-sectional study conducted for 12 carpet weavers in 2013. Three Urine sample and 3 fatigue rating are collected in working and non-working days. Urinary free Cortisol measured by ELISA method and occupational fatigue level determined by valid and self-report scale (VAS-fatigue index). Data were analyzed by STATA 11 software.

 Results: Cortisol level in working day (176.77) was higher than Cortisol level in non-working day (133.80). Important cause of significant difference in Cortisol level between working day and non-working day (p=0.001) is awaking Cortisol level. Fatigue changes in working day were significant (p=0.001), but were insignificant in non-working day. Cortisol level and fatigue in working days have a weak reverse correlation, but in non-working days wasn’t observed significant correlation.

Conclusion: The study reported significant differences between morning Cortisol secretion and fatigue level in working and non-working days that indicate work-related stress have substantial impacts on workers. Acute fatigue hasn’t strong and effective factor on Cortisol level and application of Cortisol change for fatigue assessments is not recommended.

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  Background and aim: Dermal exposure is one of the prominent exposure routes in automotive repair. Exposure to polycyclic aromatic hydrocarbons can lead to adverse effects like cancers. Accordingly, it is necessary to evaluate these exposures .

  Methods: In this study, application of DREAM method in three automotive repair jobs were investigated Dermal exposure through deposition, emission and transmission routes in all part of human body were calculated. Results for potential and actual exposure was evaluated in terms of jobs and grouped in different exposure groups were examined .

  Results: The highest emission exposure (μ = 31.97, SD = 27.28) and transition (μ = 8.79, SD = 6.3) was observed in the gearbox workers. Deposition was only observed in Electrician (μ = 0.54, SD = 0.94). Gearbox workers had highest potential and actual exposure via transmission route. Actual and potential exposure was highest in hand region. However, electricians had the highest degree of exposure in rest of body. Emission exposure was the main route of exposure in all groups .

  Conclusion: DREAM can be used to evaluate dermal exposure causes and also assess the effectiveness of protective equipment. It also can identify areas that need improvement in protection. In this study there was no difference in actual and potential dermal exposure. It means that factors such as bad housekeeping, inappropriate use of protective equipments are the main causes and should be corrected