Journal of Occupational Health and Epidemiology

198-204

Authors: A Firoozi Chahak , MH Beheshti * , M Poursadeghiyan

Background: Today, with the development of technology, the presence and role of human resources has been highlighted in industrial environments. Hence, the importance of safety culture is growing. Mining is the one of the most dangerous occupations. Therefore, this study was performed to determine the effect of health, safety, and environment management system (HSE-MS) on safety climate in one of the mines in Yazd Province, Iran, in 2014. Materials and Methods: The study population consisted of 32 employees of the operations unit working in one of the mines in Yazd Province. The standard 20-item Safety Climate Questionnaire (α = 0.77) which was valid and reliable was used to evaluate the safety culture at the unit. In this questionnaire, the items were scored based on a 5-point Likert scale. Data were collected before and 2 months after the HSE-MS training courses. The inclusion and exclusion criteria were willingness to participate in the project, at least 1 year of work experience, and the lack of specific and neurological diseases. The collected data were entered into SPSS statistical software. Results: In this study, 28.1% of the study population was single and 71.9% married. The average score of the safety climate dimensions of managerial commitment, safety communications, safe environment, responsibility of managers, perception of risk, job satisfaction, and knowledge and awareness of safety issues was 11.09 ± 2.66, 7.50 ± 2.36, 8.09 ± 1.92, 6.56 ± 1.58, 8.43 ± 1.56, 4.59 ± 1.58, and 4.25 ± 1.27, respectively. The dimension of understanding of risk and knowledge and awareness of safety issues were predictors of job satisfaction in workers. Conclusions: It can be concluded that attitudes of the examined miners toward safety climate were at a moderate level, and that the level of their attitudes increased after the HSE-MS training course. Therefore, safety climate can be greatly improved with HSE-MS training course.

213-222

Authors: M Ghiyasi , HA Abedi * , A Khodadadizade

Background: Due to the increasing number of stressful life events among the elderly and the rapid spread of diabetes among them, the present study compared the stressful life events of diabetic elderly with those of non-diabetic elderly. Materials and Methods: This descriptive, cross-sectional study was conducted on 240 senior citizens of over 60 years of age (120 diabetic patients and 120 non-diabetics) of Rafsanjan, Iran. They were chosen through convenience sampling from among visitors of the Diabetes Clinic and Ali Ebne Abitaleb Laboratory in Rafsanjan. The data collection tool used was the questionnaire designed by Pickel et al. This questionnaire consists of two parts; one part is related to demographic information and the other to stressful life events. To analyze the data, Mann-Whitney test, chi-squared, Fisher’s exact test, and independent t-test were employed in SPSS software. Results: The frequency of psychological stresses caused by familial, personal, and environmental factors was higher among the diabetic elderly (P < 0.05). In addition, the frequency of psychological stresses caused by social stressful factors was higher among the non-diabetic elderly. The number of occupational-financial and environmental stressful factors was more among male diabetic patients, and the number of personal stressful factors was more among female patients (P < 0.05). The number of occupational-financial stressful factors was significantly higher among non-diabetic men than women (P < 0.05). Conclusions: According to the results, stressful factors play a major role in the onset of diabetes. By recognizing the sources of stress with the assistance of patients, and their family and medical team, effective steps can be taken to prevent and control its probable effects and side effects.

229-240

Authors: AA Safaei * , M Azad , F Abdi

Background: In recent years, there has been an increase in the amount and variety of data generated in the field of healthcare, (e.g., data related to the prevalence of contagious diseases in the society). Various patterns of individuals’ relationships in the society make the analysis of the network a complex, highly important process in detecting and preventing the incidence of diseases. Therefore, it would be helpful to propose a model for storing and processing related data which is especially designed for such an application. Materials and Methods: In this paper, a data model is proposed for the management of data for individuals infected with contagious diseases. This data model has the ability to efficiently detect the path of infectious diseases and the probable epidemicity. The proposed model is based on the graph data model, a type of NoSQL data model. In order to design this data model, essential requirements and queries were determined based on the needs of experts in this field. Results: The proposed data model was experimentally evaluated using Neo4j, a well-known graph data management system. It is shown in this paper that the proposed data model has a better performance than the traditional relational model in terms of system utilization and performance (i.e., data storage space, complexity and the time of finding the shortest infection path between two individuals, traversing the graph, finding at risk individuals, and etc.). Conclusions: The management of data for epidemic detection of HIV infection requires an appropriate data model that can provide the required functionalities and features with an acceptable quality. Graph data models are suitable NoSQL models for some of these features (e.g., epidemic detection via traversing of the graph). The proposed graph-based data model provides the main functionalities and features while outperforming performance and utilization metrics.

252-259

Authors: A Ghanbary Sartang , M Ashnagar * , E Habibi , I Nowrouzi , H Ghasemi

Background: Today, obesity is considered as a health problem that increases the risk of some diseases. Therefore, identifying the effective factors on obesity is of great importance. Shift work is one of the indicators for increased risk of obesity in society and also shift work may cause various health problems for workers in military organizations. The current study aimed to investigate the relationship between shift work, and body mass index (BMI) and waist-hip ratio (WHR) among military personnel in 2016. Materials and Methods: This cross-sectional study was carried out on 100 male military personnel in Southern Iran in June-July 2016. The participants were divided into two groups based on their working schedule; shift work (50 personnel) and day work (50 personnel). The two groups were similar in terms of type of work. The subjects were selected through ‎simple random sampling. The data collection tools consisted of a tape measure and a digital balance. Data analysis and comparison of BMI and WHR in the two groups were performed using descriptive statistics, one-way ANOVA, and Pearson correlation in SPSS. Results: The findings revealed that mean body weight, waist circumference, hip circumference, BMI, and WHR were higher in shift workers than day workers. The findings of the current study showed that 81.6% of shift workers had a BMI of higher than 25 kg/m2 and 80.3% of shift workers had a WHR of higher than 0.90 m. Moreover, 86.2% of day workers had a BMI of less than 25 kg/m2 and 83.1% of days workers had a WHR of less than 0.90 m. The Pearson correlation coefficient for BMI (r = 0.71) and WHR (r = 0.64) in shift workers were higher than day workers. Conclusions: The findings of this research showed that shift work increased the risk of overweight and obesity. Increased BMI and WHR are the cause of disease and require intervention measures (job rotation, sports activities, and avoidance of long duration of shift work) among shift workers.

131-138

Authors: MH Beheshti , A Firoozi Chahak * , AA Alinaghi Langari , M Poursadeghiyan

Background: The agricultural sector is one of the most important sectors in production. The safety and health of farmers are important factors that can cause a significant increase in efficiency and productivity. The aim of this study was the assessment of musculoskeletal disorders (MSDs) using the OVAKO Working Posture Analysis System (OWAS) and evaluation of the effect of ergonomic training on posture of farmers. Materials and Methods: In this study, 400 farms were evaluated in 5 major activities including gathering of pistachios by men, gathering of pistachios by women, spading, gathering of pistachio waste, picking of wheat, and fertilizing regarding MSDs using the Nordic Musculoskeletal Questionnaire (NMQ) and OWAS. Then, the required ergonomic training was presented as face-to-face to farmers and again evaluation was performed after the intervention. Results: Low back pain and knee problems had the highest frequency and can be caused by standing or sitting for long periods of time, displacement and manual material handling, and undesirable workstations. A significant relationship was found between age and work experience, and MSDs (P ˂ 0.001). Risk level in pistachio and wheat gathering tasks was lowered significantly after the ergonomic interventions and required training compared to before the intervention (P ˂ 0.050). However, no significant change was observed in the spading and fertilizing tasks. Conclusions: The results showed that the prevalence of MSDs was relatively high in the studied farmers. Moreover, the level of risk that was obtained according to the OWAS indicated that the working conditions and environment in this industry are harmful. Therefore, taking corrective actions in order to improve the working conditions is necessary.

146-153

Authors: A Ahmadi , R Mirzayee * , H Ansari

Background: Today, the prevention of work-related musculoskeletal disorders (MSDs) is considered as a vital issue and one of the highest national priorities. This study was conducted with the aim of evaluating occupational postures and the prevalence of MSDs among porcelain industry workers of the city of Rasht, Iran. Materials and Methods: This cross-sectional study was done in 2015 on 66 workers, active in different factory units and chosen through stratified random sampling. To determine the frequency of MSDs symptoms in different body parts of the workers, the Nordic Musculoskeletal Questionnaire (NMQ) and Job Content Questionnaire (JCQ) were used. To evaluate the risk of MSDs, the Rapid Entire Body Assessment (REBA) method was utilized. Descriptive statistics, chi-square test, independent t-test, and logistic regression were used for data analysis. Results: Based on the data obtained through the questionnaires, 36% of the studied population had experienced pain at least in one body part in the last 12 months. The frequency of pain in the waist, hand and wrists, and neck was the most. According to the data collected through JCQ, the total score of job content had a statistically significant relationship with subjects’ age and their occupational background (P < 0.001, r = -0.549, and r = -0.704, respectively). Mean REBA scores of workers suggested that printing, carpentry, engineering, and material supplement units (scores: 6-6.5) were the most dangerous units, and the enameling unit (score: 4) had the least amount of risk in the porcelain industry. Conclusions: The present study indicated that, in the studied industry, work posture correction with the help of correction stations and appropriate training is absolutely necessary.

163-175

Authors: A Zaranejad , O Ahmadi *

Background: Fire and explosion hazards are extremely important in processing units. This study was performed to identify the risk centers, the potential damage caused by fire and explosion, and the days of production cessation in the processing company. Materials and Methods: The present qualitative case study was conducted using Dow’s index in 2015. The fire and explosion hazard index and level were calculated for the processing units after collecting the required data. In addition, hazard radius and level, damage factor (DF), actual maximum probable property damage (MPPD), and the maximum probable days’ outage (MPDO) were determined by analysis of the collected data. Results: The results indicated that the fire and explosion hazard level was high in 82% of the studied processing units. Moreover, the potential fire or explosion could cause financial damage of 51 million dollars and production cessation of 296 days. Conclusions: The results of this study showed a variety of possible fire and explosion hazards in the studied processing units. By determining several weakness points in these units, serious engineering controls were suggested to decrease the determined hazard levels. Furthermore, Dow’s fire and explosion index (F&EI) was approved as an efficient technique for assessing the risk of fire or explosion in addition to their damage levels.

182-189

Authors: A Shokufamanesh , R Vazirinejad , M Mirzaei , H Ahmadinia , M Rezaeian *

Background: Every year, eating, exercise, work, and travel patterns change during the holidays and these behavioral changes at a larger scale may cause death due to cardiovascular disease (CVD). Considering the importance of CVD, the present study was conducted for the first time in Iran to determine the differences in the ratio of deaths due to CVD on holidays and working days. Materials and Methods: This was a descriptive study. The study population consisted of all hospitalized cases of CVD in the city of Rafsanjan, Iran, during the years 2010-2014. Data on individuals were collected through electronic systems available at Ali-ibn Abi Talib Hospital, Rafsanjan. Holidays were specified using the official Iranian calendar and the number of deaths caused by CVD on holidays and working days were extracted. Finally, the collected data were entered into SPSS software and were analyzed using independent t-test, chi-square, and logistic regression model. Results: Within 5 years, about 11124 cases of hospitalizations due to CVD were studied. Among the total hospitalized cases, 993 deaths were reported. Of these cases of death 3.5% occurred on Iranian New Year holidays, 4.5% on Islamic and National holidays, 11.5% on Fridays and 80.5% on the ordinary days of the year (P< 0.001). The results of logistic regression model have revealed that after considering the effects of other variables the odds ratio of death due to CVD was 1.913, 1.477 and 1.572 respectively in Iranian New Year holidays, Islamic and National holidays and Fridays compared with the ordinary days of the year. Conclusions: The results of this study showed that the holidays in Iran may have an additive effect inض relation to deaths from cardiovascular disease.

70-75

Authors: MH Beheshti , A Firoozi chahak * , AA Alinaghi Langari

Background: Taxi drivers have the most important role in the public transport services. They are exposed to various harmful agents and occupational hazards. Noise is a harmful occupational factors and hearing loss is its most important effect. Protection of drivers against hearing loss is essential. This study was performed to determine the prevalence of hearing loss among taxi and agency drivers. Materials and Methods: This cross-sectional study was performed on 95 drivers (43 taxi drivers and 52 agency drivers) who were selected via simple random sampling. The threshold of drivers' hearing was measured by an audiometer. After data extraction, data were analyzed using Kruskal-Wallis test to compare the average level of hearing between the left and right ears and drivers. Results: The average age of taxi drivers and agency drivers was 43.5 ± 10.8 and 40.7 ± 8.3 years, respectively. In addition, the average work experience of taxi drivers and agency drivers was 9.5 and 6.5 years, respectively. The average of hearing threshold level in right and left ears of agency drivers was 12.96 ± 4.2 and 12.74 ± 4.64 dB and of taxi drivers was 12.53 ± 5.16 and 15.61 ± 12.7 dB, respectively. A hearing threshold of less than 25 dB in each ear illustrates the lack of hearing loss; thus, the studied drivers did not have hearing loss. Conclusions: The results showed that the drivers hearing status was satisfactory. Furthermore, the prevalence of hearing loss in taxi drivers was higher than agency drivers.

84-91

Authors: F Amani , F Daroghe , K Akharbeen , A Ahmadi Asour *

Background: Studies show that most students do not have sufficient scientific spirit and motivation and usually do not have the right attitude toward their chosen field of study. The aim of this study was to investigate the attitudes of students in occupational and environmental health at Ardabil University of Medical Sciences, Iran, toward their disciplines. Materials and Methods: This cross-sectional study examined the attitudes of 150 students of environmental and occupational health in relation to their field of study. The participants consisted of students who were studying at Ardabil University of Medical Sciences between 2010 and 2013. Data collection was conducted using a questionnaire. Data were analyzed using SPSS software and P values of less than 0.05 were considered as significant. Results: The mean and standard deviation score of attitudes of occupational and environmental health students toward their field of study and their future career were 39.6 ± 8.7 and 44.5 ± 8.5 (Total: 42), respectively. The mean score of environmental health students was close to the acceptable limit; however, the mean score of occupational health students was less than the acceptable limit. Mean score of attitude among male students was 43.2 ± 9.9, while it was 41.3 ± 8.3 among female students, indicating that the mean score of female students was below the acceptable limit and was not significant (P = 0.213). Mean score of attitude among single students was 42.6 ± 8.7, while it was 39.9 ± 9.2 among married students. The mean for married students was below the acceptable limit and this relationship was not significant (P = 0.015). Conclusions: Although the attitudes of environmental health students toward their major were positive, occupational health students’ attitudes were negative. Thus, the Ministry of Health and Medical Education can accommodate students’ admission to these majors considering the needs of the labor market. Moreover, these majors’ curricula should be based on the real needs of society and creating new job markets should be a high priority.

101-106

Authors: N Zia Sheikholeslami , M Rezaeian , A Heidarpoor , M Hadavi , M Tashakori *

Background: Nosocomial infections are an important cause of hospital mortalities. Staphylococcus aureus (S. aureus) carriers among medical staff are an important source of nosocomial infections. The purpose of this study was to investigate the prevalence of the nasal carriers of S. aureus and antibiotic resistance in staff of Nikuee Hospital, Qom, Iran. Materials and Methods: In this cross-sectional study, 152 health care workers (HCWs) were assessed to determine the frequency of nasal carriage of S. aureus, the rates of methicillin-resistant S. aureus (MRSA), and their antibiotic resistance profiles in Nikuee Hospital in 2012. Clinical samples were cultured and S. aureus was detected using conventional bacteriologic methods. Antimicrobial susceptibility patterns against penicillin, vancomycin, erythromycin, clindamycin, cefazolin, co-trimoxazole, and doxycycline were evaluated using the Kirby-Bauer disk diffusion technique. Methicillin resistance was confirmed by oxacillin disk diffusion test. Data were analyzed in SPSS software using chi-square test and independent two-sample t-test. Results: Among the processed samples, 34.2% illustrated nasal carriage of S. aureus, and among them, 23.5% were carriers of MRSA. None of the isolates were resistant to vancomycin. However, 96.1%, 33.3%, 27.5%, 19.6%, 9.8%, and 15.7% resistance to penicillin, erythromycin, clindamycin, cefazolin, co-trimoxazole, and doxycycline were observed. There was no significant relationship between sex, age, and number of years of healthcare service and positive nasal carriage. Conclusions: Data obtained in this study revealed high prevalence of nasal carriage of S. aureus (34.2%) in HCWs at Nikuee Hospital. Therefore, it can be concluded that the role of the hospital staff in Nikuee Hospital as a source of staphylococcal infections is prominent. Thus, to prevent nosocomial infections, we recommend the identification and treatment of the carriers among the staff of other hospitals.

116-124

Authors: MH Beheshti , E Boroumand Nejad , B Bahalgerdy , F Mehrafshan * , A Zamani Arimy

Background: Heat stress is one of the harmful factors present in many workplaces. It can lead to performance loss and low functionality of the labor force. Therefore, the aim of this study was to evaluate exposure to heat stress and its consequent performance loss among workers functioning in indoor high-temperature workplaces. Materials and Methods: This descriptive, analytical study was conducted on indoor high-temperature occupations in spring 2014. This study was conducted on 15 bakeries, 11 restaurants and kitchens, and 2 industries with heating processes in Gonabad city, Iran. In total, 1450 individuals worked on the investigated sites and were exposed to thermal stress. The inclusion criterion for this study was working in an environment that included a heating process and the exclusion criterion was unwillingness to participate in the study. Heat stress was measured based on wet-bulb globe temperature(WBGT) and the ISO 7243standard. The graph of performance loss versus thermal stress proposed by Kjellstrom et al. was used to determine the performance loss caused by thermal stress.All individuals and managers were informed of the aims of the project and were assured of the confidentiality of the data. Statistical analyses were performed using SPSS software. Results: The mean exposure to heat stress in Barbari, Sangak, and Lavash (three types of bread) bakeries were 29.73, 27.89, and 29.43 °C, with a mean performance loss of 65%, 23%, and 64%, respectively. In some cases, the performance loss in Lavash bakeries was as high as 98%. The mean exposure to heat stress in refractory brick and porcelain manufacturing industries were 32.04 ºC and 32.35 °C, leading to a concomitant performance loss of 89% and 92%, respectively. The mean WBGT in the kitchens was 31.88, which could lead to a performance loss of 80%. Conclusions: In addition to a host of diseases and complications caused by heat stress, extreme heat in the workplace can significantly reduce the performance of the labor force, and consequently,their production. Through appropriate planning and control of heat stress in the workplace, not only are many diseases prevented, but also the performance and efficiency of workers are greatly improved.

1-8

Authors: MH Beheshti , A Firoozi Chahak * , AA Alinaghi Langari , S Rostami

Background: Chemical contaminants present in the work environments include gases, vapors, and solid and liquid suspended particles. The number of factories producing chemicals has increased significantly. Each year, new products are introduced into the market. Consequently, the number of employees at risk of exposure to these materials is increased. Hazardous chemicals are used in the petrochemical industry that is one of the major industries in the country's economic development. Therefore, the aim of this study was a semi-quantitative risk assessment of health exposure to hazardous chemical agents in a petrochemical plant. Materials and Methods: This was a descriptive analytical study for assessing the sanitary risks of hazardous chemical factors in the work environment through a risk assessment method provided by the Occupational Health Department of Singapore. Thus, initially, occupational tasks and processes were determined. Subsequently, all hazardous chemical factors were detected, and then, the degree of risk, the degree of exposure, and risk rating were determined. Results: In total, 24 tasks were examined and risk assessment was performed for 19 hazardous chemical substances in this study. Among these materials, benzene and xylene had the highest risks and were used in various occupations. In this study, mean and standard deviation of age and experience of participants were 30.28 ± 7.87 and 5.98 ± 5.66, respectively. Moreover, 25.3% of participants in this study were single and 74.7% were married. Conclusions: It can be concluded that 81% of chemicals used in this industry are rated at moderate and high risk. In order to control the identified risks, this study recommended programs and control measures based on the hierarchy of elimination, substitution, engineering controls, administrative controls, and use of personal protective equipment.

19-25

Authors: A Esmaeilli , Z Salem * , M Shikh Fatholahi , M Rezaeian , S Ebrahiminejad

Background: Health-promoting lifestyle is one of the determination criteria for health factors and the prevention of health-threatening factors. According to the available statistics, 53% of deaths are related to lifestyle. The aim of this study was to evaluate health-promoting lifestyles in medical students of Rafsanjan University of Medical Sciences (RUMS), Rafsanjan, Iran. Materials and Methods: This was a descriptive study conducted in 2014 on 262 volunteer medical students. To collect data, a demographic information questionnaire and the Health-Promoting Lifestyle Profile II (HPLP-II) were used. Minimum and maximum scores of HPLP-II were 48 and 192, respectively. Data analysis was conducted using t-test, one-way ANOVA, Tukey's multiple comparison test, and non-parametric Kruskal-Wallis test. Results: In this study, 58.8% of the participants were women. The mean age of the participants was 22.50 ± 2.16 years. The mean and standard deviation of the HPLP-II score of the medical students was 109.74 ± 18.65. There was a significant relationship between health-promoting lifestyle and variables of age (P = 0.007), university entrance year (P < 0.001), mother’s education level (P = 0.003), and father’s education level (P = 0.011). However, no relationship was observed between health-promoting lifestyle and parental occupation and place of residence (P > 0.050). Conclusions: This study showed that the status of health-promoting lifestyles in medical students of RUMS was at a moderate level, but it is still at a great distance to the optimal level. Therefore, it is necessary to implement programs to promote a healthy lifestyle in order to maintain health in the youth until graduation.

34-42

Authors: AR Koohpaei , M Khandan *

Background: The physical and psychological health of bus drivers is a critical factor in public driving performance. Any impairment can have dire consequences for passengers and the company. Thus, research on the mental health status of public bus drivers is a critical issue in reducing road accidents, decreasing passengers’ injuries, and ensuring the safety of the operation. Materials and Methods: A descriptive cross-sectional study was carried out in 2014 and the 28-item General Health Questionnaire (GHQ-28) was used for the psychological health measurement of 214 consenting bus drivers in Qom Province of Iran. In addition, a demographic questionnaire was applied. Data were analyzed in SPSS software. Results: All drivers (except one) were men with a mean age of 34.25 ± 7.49 years. The majority of the participants (207; 96.7%) were married. Based on the average scores obtained from GHQ-28 (21.45 ± 12.88), general psychological morbidity was 35.98%. Moreover, the components of somatic symptoms, sleep disorders and anxiety, social dysfunction, and depression were experienced by 33.64%, 40.65%, 50.93%, and 13.08% of bus drivers, respectively. The questionnaire data indicated that age (P < 0.05) and marital status (differences were not significant) played an important role in influencing mental health among the bus drivers. Conclusions: It can be concluded that drivers' physical and mental health are areas of concern that need to be addressed alongside the development of specific methodologies for permanent monitoring of these factors at specific times as permanent training and evaluation are necessary. The data obtained in the present study showed that prevention strategies such as routine evaluations, recording, and analysis of mental health status among drivers must be effective and applicable.

50-56

Authors: A Firoozi chahak , MH Beheshti * , AA Alinaghi Langari Mr, F Laal

Background: The workers of mines, during a working day, are exposed to stress and psychological pressure that certainly affect the efficiency of their work. This study aimed to determine the level of stress, anxiety, and depression in workers of one copper mine in Kerman Province, Iran. Materials and Methods: In this cross-sectional study, 250 workers of the operation unit of one copper mine in Kerman Province were examined in 2014. Sampling was done using census method and data were collected using the Depression, Anxiety and Stress Scale (DASS), the validity and reliability of which has been approved. This questionnaire consists of 21 questions that are divided into 3 subscales on depression, anxiety, and stress each containing 7 questions. Data analysis was performed in SPSS software using the Pearson correlation, Spearman’s correlation, and regression tests. Results: The mean age and work experience of subjects were 31.82 ± 8.61 and 6.67± 5.79 years, respectively. Moreover, the education level of 45 individuals (18%) was below diploma, 85 (34%) diploma, 46 (18.4%) associate degree, and 74 (29.6%) bachelor's degree or higher. Furthermore, 194 subjects (65%) were married. In addition, 135 subjects (54%) worked only on day shifts and 115 (46%) of them had shift work. In this study, 98 (39.2%), 88 (34.8%), and 88 (35.2%) employees suffered from depression, anxiety, and moderate and severe stress, respectively. A statistically significant difference was observed between subjects who worked on day shifts and those who had shift works in terms of stress, depression, and anxiety. In addition, significant relationships were observed between stress, depression, and anxiety in the 4 study groups (P ˂ 0.005). Conclusions: The results of this study showed that the rate of stress, anxiety, and depression was high among the examined mine workers.