Journal of Health and Safety at Work

Strategic Planning in the Occupational Health Department

Farideh Golbabaei

Introduction: Universities play a key role in creating a knowledge-based society and its sustainable development. Strategic planning by strategically analyses internal and external environments of the organization, forecast its future, identifying its strategic direction, and strengthening organizational structures, processes, and outcomes, creates and sustains competitive advantages. This study aimed to formulate a strategic plan for the Occupational Health Engineering (OHE) department of School of Public Health (SPH) at Tehran University of Medical Sciences (TUMS).
Material and Methods: In this participatory action research, a strategic planning committee was formed. The strategic planning committee used the strength, weakness, opportunity and threat (SWOT) matrix to evaluate the internal and external environments of the OHE department. Then, the mission, vision, values, goals and objectives of the OHE department were defined. Finally, the operational plan including actions to achieve the goals and objectives were formulated.
Results: Experienced professors and staff, specialized laboratories, professional journals, and high ranked postgraduate students were the most important strengths; and theoretical and non-practical courses, lack of educational protocols, poor communication with industries, lack of resources, and low motivation of employees were some of the weaknesses of the OHE department. The support of senior managers of TUMS, industry liaison council at school and university, facilities of the university faculties, comprehensive research laboratories of the university, capacities of the private sector and increasing the demand for research in the industry were the opportunities. High inflation, political sanctions, the absence of consulting engineering companies and the uncertainty of research priorities of industries were important threats to the OHE department. Therefore, the OHE department is in a conservative strategic position. The strategic direction of the department, including the mission, vision, values and goals, until 2025 was determined. Improving the structures, working processes and performance of the occupational health department were determined as objectives and 81 actions were formulated to achieve these objectives.
Conclusion: The educational departments, schools and universities must have a strategic plan for progress. The strategic plan of the occupational health department of TUMS was formulated in line with the four-year plan of the university and coordinated with the operational plans of the educational, health and research deputies of TUMS and school of public Health. Proper implementation of this comprehensive and evidence-based strategic plan will improve the performance of the occupational health department.

A Review of Safety Economics Studies and Cost of Occupational Accidents in Iran from 2000 to 2021

Mostafa Pouyakian

Introduction: Due to occupational accidents, many costs are annually lost from the countries’ Gross Domestic Product (GDP). Estimating these costs can be essential for optimal investments and establishing appropriate policies in many countries, such as Iran. The present study aimed to review the studies conducted on the safety economics and the costs of accidents in Iran from 2000 to 2021.
Material and Methods: The reliable databases “Web of Science”, “Embase”, “IranDoc”, “SID”, “Magiran”, “Google Scholar”, “PubMed” and “Scopus” were used to conduct this research. Articles in these databases were searched and extracted by searching for keywords such as “accident”, “cost of accidents”, “occupational accidents” and “Iran” in Persian and English from 2000 to 2021.
Results: Among the 66 identified articles, 19 were selected as final articles, of which 11 studies were carried out in the transportation industry and eight in other industries. Among these studies, nine studies only examined and stated the total costs, and six studies separately examined and stated the direct, indirect, and total costs. Four other studies also investigated and expressed the costs caused by accidents in other ways. Most notably, in three studies, the number of direct costs is higher than indirect costs. Similarly, only six studies estimated the damage to the GDP, ranging from 0.03% to 6.46% of the GDP.
Conclusion: The results of the review of studies showed that occupational accidents cause the loss of a significant part of Iran’s GDP. It is recommended to carry out further studies on the relationship between investment in the safety sector and reducing the costs of accidents concerning the grouping of jobs, mainly in the process, service, and production industries, to prevent wasting such heavy costs.

Developing a Method for Identifying Emergencies in Process Industries

Omid Kalatpour

Introduction: One of the essential and critical elements for efficient and effective management of emergencies is anticipation and identification of possible types of emergencies. As such, a framework for anticipating and identifying emergencies was designed and tested in two process industries in the form of a case study.
Material and Methods: At first, methods for identifying emergency preparedness and their evaluation criteria were extracted and prioritized with a two-stage fuzzy approach. A fuzzy inference system was then used to calculate the weight of the experts’ opinions. To prioritize the methods, the inputs related to the second fuzzy system were estimated and the final score of the methods was calculated by entering the mentioned variables into the fuzzy system.
Results: The findings pertaining to the final ranking of the methods indicated that, “list of catastrophic accidents and near-misses of the organization’s lifespan”, “MIMAH” and “risk assessment and management” had the highest scores among the identified methods with the final scores of 0.754, 0.750 and 0.725, respectively.
Conclusion: Using this approach will help in more accurate identification of potential emergencies. Consequently, this will lead to the prevention of imposed damages caused by the situation as well as making the wrong investments by eliminating low-priority emergencies.

The Impact of Chisel Shape and Length on Hand-Arm Vibration Transmitted from Electrical Demolition Hammer Handle on Concrete Surfaces

Mohammad Reza Monazzam

Introduction: This study aims to determine the amount of hand-arm vibration transmitted from heavy electric destruction tools and the effect of using chisel with different lengths and shapes when demolishing concrete surfaces.
Material and Methods: To evaluate the magnitude of hand-arm vibration on the left and right handles of two powerful electric demolition hammers commonly applied in Iranian construction work and urban services, 323 measurements were made (RONIX and NEC). The demolition procedure was carried out by two experienced users on 49 concrete slabs of the same grade (20 C) with thicknesses of 10 and 15 cm while utilizing standard tools, such as hammers with two different chisel head shapes (flat and point) and lengths (40 and 60 cm). Utilizing two SVANTEK vibration meters concurrently on each hammer handle, measurement and evaluation were according to the ISO 5349:1, 2 procedures.
Results: The mean effective (frequency weighted root mean square) acceleration (awrms) for the Vector Sum Values (VSV) in the hammer handles were 15.71 m/s². The primary vibrational axis transmitted to the handle of tool was the vertical axis, at 13.60 m/s². When employing flat and point chisel, the mean awrms were 16.59 m/s² and 14.82 m/s², respectively. The difference between the results of 60 and 40 chisel was a little more than 2m/s2. The dominant and harmonic frequencies of the tools were generally in the range of 25 Hz to 80 Hz and 200 Hz to 400 Hz
Conclusion: The mean results generally indicated that point chisel with shorter lengths (40 cm) accelerates at a lower rate than flat chisel with longer lengths (60 cm). In the frequency range below 40 Hz, the RONIX hammer produced a larger acceleration than the NEC hammer indicating that the NEC hammer had a higher safety competitive advantage compared to the another hammer.

Development and Validation of Macroergonomic Factors Based on the Holden and Karsh Model: A Case Study in Automotive Industry

Adel Mazloumi

Introduction: Complex sociotechnical systems, such as automotive industry, require a proper macro-ergonomic approach to design and implement the work system at micro-ergonomic level. The purpose of this study was to develop and validate effective macroeconomic factors to improve productivity, health and safety of employees in the automotive industry based on Holden & Karsh model.
Material and Methods: At the first step, relevant documents were reviewed, and then experts were interviewed to identify macro-ergonomic factors. The identified factors were categorized into four groups based on Holden & Karsh’s model. In the follow-up phase of the study, then, the content validity of the factors was calculated using Delphi technique in the form of an expert panel. Finally, validity acceptance was assessed using mean content validity index, and agreement between experts was evaluated using modified kappa coefficient
Results: 28 main factors were identified and categorized into four subgroups, including personnel, unit /department, organization and environment factors. 19 main factors were selected as the effective macro-ergonomic factors to improve employee’s productivity, health, and safety. The content validity index and the modified kappa coefficient were calculated as 0.901 and 0.90, respectively.
Conclusion: Macro-ergonomic factors identified in this study can be considered to improve employee’s productivity, health, and safety in the automotive industry. These factors can be used as specific context-based criteria for an ergonomic evaluation in the automotive industry, or even be generalized to other industries, organizations and companies.

The Psychometric Properties of the Persian Version of the Affinity for Technology Interaction (ATI) Scale

Mohammad Babamiri

Introduction: Affinity for Technology Interaction (ATI) refers to the users’ tendency to actively interact with a digital system. ATI is a personal characteristic affecting many aspects of human-technology interaction. The present study aimed to assess the psychometric properties of the Persian version of the ATI scale.
Material and Methods: The Persian version of the scale was developed in accordance with the forward-backward translation approach. The construct validity of the scale was assessed using exploratory and confirmatory factor analyses. The correlation of the scale with the Big-five personality traits, need for cognition (NFC), age, gender, and field of study was also investigated.
Results: In contrast to the original scale, the Persian ATI had two components, confirmed by the exploratory and confirmatory factor analyses. The first component contained eight items and the second contained one item, item 3. So, this item was removed from the scale. The 8-item scale demonstrated excellent reliability (coefficient=0.90). The Persian ATI was not significantly correlated with extraversion, agreeableness, conscientiousness, and neuroticism (p>0.05). In contrast, it was significantly correlated with openness to experience (0.175, p<0.01) and NFC (0.36, p<0.01). The Persian ATI score for men was higher than for women. Various age groups were not significantly different in terms of the Persian ATI score.
Conclusion: In contrast to the original version, the Persian version of ATI is composed of eight items. Other characteristics, including unidimensionality and correlation with other personality traits, are similar to the original version.

Diagnostic Biomarkers of Heat Stress Induced- DNA in Occupational Exposure: A Systematic Review

Farideh Golbabaei

Introduction: Climate change and hot processes in the workplaces has led to an increase in the effects of heat stress on employed people, which has become a major concern, especially in tropical and subtropical countries. Early detection of biomarkers in induction of heat stress-related DNA damage can be used in the identification and evaluation of health and safety, including occupational health professionals, as well as to prevent serious diseases caused by heat stress in various occupations with the nature of hot processes or to help different warm seasons of the year. Therefore, this review study was conducted to identify diagnostic biomarkers heat stress induced- DNA damage in occupational exposure.
Material and Methods: Databases such as PubMed, Scopus, Google Scholar, and Web of Science were systematically searched to meet the study’s goals. Moreover, references to relevant publications were examined. Finally, suitable articles were selected and analyzed using the inclusion (studies on different occupations, different biomarkers in hot work environments, all articles published without time limit until the end of April 2022 , and English and Persian language) and exclusion criteria.
Results: The results of search in databases showed that 9234 articles were found in the initial search. After removing duplicate and unrelated articles, 2209 eligible articles were selected. Based on abstract full-text screening, 7166 studies were excluded, and based on abstract full-text screening, 21 studies were not accessible. Finally, seven articles were selected to be reviewed. The evidence showed that diagnostic biomarkers included the measurement of 8-hydroxy-2-deoxyguanosine (8-OHdG), micronuclei semen quality, heat shock proteins (HSP70), and leukocytes were extracted to heat stress induced- DNA damage in occupational exposure.
Conclusion: Based on a review of studies, biomarkers identified are suitable for heat stress induced- DNA damage as a result of occupational exposure to extremely high heat climate conditions. Understanding and identifying appropriate biomarkers in inducing DNA damage can help health and safety professionals determine the amount and magnitude of heat stress responses in occupational exposure to different temperatures and take appropriate measures and interventions to control and reduce the hazard effects of thermal stress. This study can also be considered as a preliminary study for research in the future.

Study of the Role of key risks in the trip gas sweetening unit by using Structural Equation Modeling: A case study in the Gas Refinery

Mahnaz Mirza Ebrahim Tehrani

Introduction: Unit risk management is a critical component of gas refining management, as risks that are not well-managed may lead to trip production failures. The present study aimed to provide a structural model for investigating the role and effect of different variables on stopping the gas production process in the gas refinery.
Material and Methods: This study was a retrospective cross-sectional and systematic analysis, which was carried out on key risks in the trip gas sweetening unit in a gas refinery industry located in Asaluyeh, Iran. The systems analysis was applied by using Fishbone Diagram, and then data modeling was prepared by Structural Equation Modeling (SEM) for an incident that occurred during gas sweetening production. Tools for the data analysis included the SPSS 24 and Smart PLS 2 software.
Results: Results of this research indicate that “Environment Risk” with a path coefficient of 0.943 and T- Value of 103.791; “Cost Risk” with a path coefficient of 0.937 and T- Value of 95.168; “Implementation of management system Risk” with a path coefficient of 0.847 and T- Value of 35.23; “Accident Risk” with path coefficient of 0.577 and T- Value of 25.410; “Time Risk” with path coefficient of 0.758 and T- Value of 15.121; “Human Error Risk” with path coefficient of 0.712 and T- Value of 11.215 had the most important coefficients of the paths respectively, that are effective in stopping production concerning other risks. Also, by comparing the path coefficients of the risks we can see that the impact of each of the risks on stopping production is different.
Conclusion: The findings of the present study revealed that a combination of variables can affect stopping production in the gas industry. Therefore, the role of these risks in losses in the refinery system should be investigated.

Assessment of Cognitive Emotion Regulation Scale Scores among Control Room Operators

Seyed Abolfazl Zakerian

Introduction: Cognitive emotion regulation (CER) strategies define as cognition-based responses according to emotion-eliciting experiences that can change the type and severity of individuals’ reactions and behaviors. This modification may positively or negatively affect cognitive performance and therefore, it is a defining issue in the workplace. Notably, industries such as combined cycle power plants need to hire staff with a high cognitive ability to perform their duties in a highly efficient way. Since CER is of great importance for overall health and cognitive performance, we aimed to evaluate the state of CER among control room operators (CROs) in the Fars combined cycle power plant.
Material and Methods: The CER questionnaire (CERQ) measures nine cognitive coping strategies (i.e., self-blame, other-blame, rumination, catastrophizing, positive refocusing, planning, positive reappraisal, putting into perspective, and acceptance) that are followed when an individual confronts negative events. The CERQ (short version) was administered to 57 male CROs at the Fars combined cycle power plant. The questionnaire also collected demographic data. Statistical analyses were performed using SPSS Version 25.0. For the normality test, Shapiro-Wilk was the method of choice.
Results: Results of the CERQ scoring showed that the median with interquartile range (IQR) in appropriate and inappropriate categories were 3.50 (3.30-4.00) and 2.62 (2.25-3.06), respectively. Of note, age (39.07 ±6.19) and work experience (14.49±6.26) were not significantly correlated with the results of CERQ.
Conclusion: Taken together, adaptive cognitive strategies (acceptance, positive refocusing, planning, positive reappraisal, and putting into perspective) were reported to be used more often than less adaptive strategies. In general, staff strategies were appropriate while facing a negative event. Although assessing CER in high-demand workplaces is necessary, factors such as managerial styles, job engagement, job satisfaction, and larger sample size should be further studied.

Improving the Calculation of RPN in the FMEA Method by Combining a Nonlinear Model with Revised TOPSIS and Fuzzy Logic

Alireza Shahraki

Introduction: Failure Mode and Effects Analysis (FMEA) is a structured way to find and understand the states of a system’s failure and to calculate the resulting effects. In this method, which has been criticized by many researchers, the risk priority number is obtained for each failure mode based on the multiplication of the three parameters of occurrence (O), severity (S) and detection (D). In order to overcome the disadvantages of the traditional method of FMEA, such as ranking the failure and weighting the parameters, this research proposes a model in the fuzzy set.
Material and Methods: The model proposed in this paper is a nonlinear model for weighting the parameters of the FMEA and the revised TOPSIS method for ranking the failures, which is used for the first time to improve the FMEA method.
Results: The proposed model was presented in the Copper Complex of Shahr-e-Babak to assess safety risks. Based on the results of the study, it was found that in this proposed model, the weights of severity and detection were 0.479 and 0.186, respectively, and the results of the ranking showed that the risks of falling from height and getting stuck between objects had the highest and lowest priorities, respectively.
Conclusion: In the proposed model, based on Logarithmic Fuzzy Preference Programming and the revised TOPSIS method, the definite weights of the parameters were presented without any fuzzy number ranking and risk ranking with more criteria, respectively. Therefore, the proposed model has a higher ability compared to the traditional FMEA, and its application can be recommended to determine the ranking of risks.

Estimation of Sound Absorption Behavior of Combined Panels Comprising Kenaf Fibers and Micro-Perforated Plates below 2500 Hertz

Samaneh Salari

Introduction: Natural materials are more efficient and attractive than synthetic materials. In this study, the sound absorption behavior by natural kenaf composite and Micro-Perforated Panel (MPP) at low and medium frequency region was investigated.
Material and Methods: Initially, the results of kenaf fibers with a thickness of 10 mm were validated by the Finite Element Method (FEM) based on COMSOL Multiphysics 5.3a. The studied combined panel is consisting kenaf fibers with micro-perforated plates and an air layer. This study examined the varying arrangement of the behind layers of the MPP, the different thickness of the layers, and the structural parameters of MPP. The structure with the best absorption coefficient was chosen for the following stage and was considered constant at each stage.
Results: The arrangement of composite layers indicated a strong direct effect on the sound absorption performance; as we discovered that kenaf fibers behind MPP led to better performance in frequencies below 2500 Hz. In addition to the chamber depth behind the MPP, the material and macroscopic properties of the layers, at the same depth, are also important determinants of the exact point of the resonant frequency. Furthermore, configurations in which air layer depth is more than the absorption layer, with the same diameter (hole) and depth (chamber), maximum resonant absorption peak is achieved.
Conclusion: Low-frequency sounds can be successfully dissipated by combining MP plates with kenaf fibers as reinforcing absorber in combined panel. In general, choosing the optimum structural parameters (Composite panel according to structure A with 0.5 mm hole diameter and 2% perforation percentage) allows a significant absorption at a specific frequency range. In this context, the use of numerical estimation to assess the sound absorption behavior can be meticulously substituted the difficult methods and laboratory costs.

Explaining Oncology Nurses’ Experiences with Workplace Violence: A Qualitative Study

Leila Joybari

Introduction: Workplace violence against nurses is regarded as a continuing and prevalent problem across the world. The purpose of this study was to explain oncology nurses’ experiences with workplace violence.
Material and Methods: The present study was fulfilled using qualitative content analysis in 2017 based on purposive sampling method. To this end, semi-structured interviews were performed with 23 oncology nurses from two teaching hospitals located in two neighboring provinces in the North of Iran. Then, the interviews were recorded, transcribed, encoded, classified, and subsequently analyzed according to qualitative content analysis developed by Graneheim and Lundman. The criteria proposed by Guba and Lincoln were further utilized to strengthen this research study.
Results: Two main themes and four sub-themes were elicited from data analysis including “imbalance in care supply-demand” and “conflict resolution efforts” with sub-themes of “demand for special care”, “supply of task- focused care”, “aggressive behaviors”, as well as “conflict prevention”.
Conclusion: The study findings revealed that failure to meet patients’ care needs could bring about aggression and demonstration of violent behaviors. Given the understanding of patients’ conditions, the nurses also tried to resolve the conflicts mostly via forgiveness and negligence techniques.

A Qualitative Study of Organizational Excellence in Hospitals Affiliated with Medical Sciences Universities of Iran

Ruhollah Alikhan Gorgani

Introduction: A hospital is one of society’s most important social institutions; however, poor organizational performance results in delayed treatment, disease progression, or patient mortality. This qualitative study seeks to investigate organizational excellence in Iranian medical sciences universities from the perspective of hospital managers.
Material and Methods: The present qualitative study was conducted in hospitals affiliated with medical sciences universities in Iran in 2021. Data were acquired using the purposive sample method through in-depth interviews with 15 hospital managers and analyzed using MAXQDA software. After transcription, concepts and components were extracted from in-depth interviews using the grounded theory (GT) method.
Results: Organizational excellence in hospitals has different elements that can be classify in the form of parameters of the grounded theory paradigm model (causal conditions, contextual conditions, intervening conditions and consequences). In causal conditions, it may include leadership, human resources, and strategies; in contextual conditions, resources and facilities; in intervening conditions, processes; and in consequence conditions, patient and family satisfaction, employee satisfaction, community satisfaction, and health system satisfaction. The findings revealed that leadership and human resources were the two most important factors in achieving hospital organizational excellence.
Conclusion: Further emphasis should be made on leadership and human resources to achieve organizational excellence in Iranian hospitals affiliated with universities of medical sciences. By recruiting specialized human resources, managers can consider various leadership styles to improve the current situation and deliver desirable services.

Human Error Assessment in City Gate Stations of Isfahan Natural Gas Company Using the System for Predictive Error Analysis and Reduction Framework

Ali Karimi

Introduction: Human factor analysis has been identified as the most common cause of accidents in natural gas transportation and distribution facilities. The occurrence of accidents at these systems, especially gas reduction stations located in residential and industrial areas, has had catastrophic consequences. Therefore, this study aimed at analyzing critical tasks and human error assessment using the system for predictive error analysis and reduction (SPEAR) method and providing the appropriate framework for error management in the operation and maintenance of city gate stations.
Material and Methods: This descriptive cross-sectional study was conducted using the SPEAR framework and safety critical task analysis guideline to evaluate errors in gas pressure reduction stations. First, critical tasks were screened and evaluated, followed by performing task analysis by the hierarchical task analysis and detecting performance-influencing factors (PIF). Then, human errors were predicted and assessed based on the predictive human error analysis. Finally, error management was developed at three process, equipment, and training improvement levels.
Results: In general, out of 23 operations and 164 sub-tasks, 12 critical tasks were identified based on the results. Criticality level percentages were about 67% high risk, 25% moderate, and 8% low risk. In addition, 134 errors were identified which were mostly related to action (42.53%) and checking (39.55%) errors, respectively. Eventually, communication, retrieval, and selection errors were 8.96, 5.22, and 3.74%, respectively.
Conclusion: The results revealed that action and checking errors had the highest percentages. This method can be applied to appropriate the systems approach to error reduction using the PIF assessment output. The privilege affecting factors include preparing standard operation procedures, implementing a comprehensive training program, and controlling environmental hazards.