Journal of Health and Safety at Work

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Introduction: IBioaerosols are usually defined as aerosols or particles with microbial, plant or animal origin. Textile industries are of the working environments in witch workers are exposed to bioaerosols. In textile industry, the highest contamination concentration is the belonged to carding step. Since, textile industry in iran is native and a large number of employers are working in this industry, this study was undertaken to assess bacterial bioaerosols concentration in a textile in industry in iran.
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Material and Method: In cross-sectional study was done in different units and also outdoor environment of a cotton textile plant. The concentration of bioaerosols were sampled and measured according 0800 method presented by NIOSH, during summer. Diagnosis of type of colonies and bactories, grown on blood agar, was done using gram staining.
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Result: The mean bioaerosols concentration obtained the highest and lowest values in outdoor environment (94±9.5 CFU/m3) and unit 2 (Ring site) (64±18.0 CFU/m3), respectively. The mean difference of bioaerosols concentration in unit 1 (Carding sites) and unit 2 (Ring site), was statistically significant in this study. The highest number of bioaerosols colony was for staphylococcus Epiderms (N=1743) and the lowest number was for streptococcus pneumonia (N=64) in the whole plant.
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Conclusion: Although the bioaerosols concentration obtained in the present study is lower than those reported in other studies, these values are above the threshold recommended.

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Introduction: The most common standards being used for predicting the health risks of whole body vibrations are ISO 2631- and BS 6844, presenting frequency weighting anfd different coefficients for different sensivities in variuse axes. In yhis study, vibration was measured about 900 minutes on 9 trains in one of the active lines of tehran metro with the aim of comparing the mentioned standards in evaluating whole body vibation.

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Material and Method: In this research, in addition to evaluation of different kinds of vibration indicators, the differences of ISO 26331-1 and BS 6841 Standards have also been investigated. The amounts of r.m.s., vibration dose and daily vibration dose were measured in x, y and z axes for drivers seat and x axis for drivers back rest separately according to the instruction of the two standards.

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Result: The mean calculated values of r.m.s and vibration dose on a basis of 135 6841 standard were lower than those values calculated according to ISO 2631 standard. Moreover, the results showed that 3 cases, based on the ISO standard, had risk level of higher than 17 m/s1.75 and 3 cases, had risk level of higher than 15 m/s1.75 value, provided by BS 6841.

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Conclusion: Calculation according to the ISO 2631-1 standard show higher values. Indeed, ISO 2631-1 can provide a more secure criterion company to BS 6841, although the 15 m/s1.75 in BS is lower than the highest level of health guidance caution zone in ISO. Additionally, the association between r.m.s and vibration dose values in ISO 2631 is relatively lower than this association in BS 6841.

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Introduction: Manual material handling (MMH) is the most common cause of work-related Musculoskeletal Disorders (MSDs). Prevention of MSDs is highly critical. The aim of this study was to assess risk of carpets manual handling by retail workers, and to implement ergonomic interventions in order to reduce risk of MSDs.

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Material and Method: This interventional study was conducted among 36 workers in 19 retailer sites of a textile corporation. Ergonomics assessment of the retailers was done using the comprehensive risk assessment model of the British Carpet Foundation. Moreover, the Nordic Musculoskeletal Questionnaire was used to determine the prevalence of workers’ MSDs. Reassessment was conducted after implementation of the ergonomics interventions.

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Result: The mean age and work tenure of participants were 36.28 and 16.2 years, respectively. The results of Nordic Questionnaire before intervention showed that overall 37.8% of the workers had experienced pain at least once during the past year, with the highest frequency belonged to the lower back (75%), shoulder (61%), and neck and upper back (55%), respectively. After implementing the interventions, the prevalence of MSDs reduced to 23.5%. The results of risk assessment before and after the interventions showed that of the 19 retailer sites, six sites were improved from poor to average state, and one site showed improvement from average to good condition.

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Conclusion: By implementing ergonomics interventions in carpet delivery sites, the risk factors of MSDs, induced by manual carpet handling, were reduced and safety and ergonomic conditions of the retailers were improved, compared to the previous conditions.

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Introduction: Working in hot and inappropriate climate condition is one of the most common problems of occupational health which can lead to heat induced diseases and even death. Heat stress may impair the cognitive processes involved in decision-making and converting simple tasks to complex ones. The aim of present study was to assess selective attention and reaction time among workers in a casting unit of a car manufacturing industry and to investigate the effects of heat stress on mentioned variables.

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Material and Method: In this retrospective cohort study 70 workers from a hot industry were selected in two of exposed and control groups. First, demographic questionnaire was completed for each of the participants and noise and light were measured as the likely confounding factors. Stroop test 1, 2, and 3 were done before and during the work in order to determine the effects of heat on selective attention and reaction time. Besides,WBGT were measured at the ankle, waist, and head levels. Data were analyzed using SPSS software, version 18.

Result.: WBGT measurements showed that the mean WBGT were 33 and 16.7 for the exposed and not exposed groups, respectively. Moreover, no significant relationships were observed between test duration, reaction time, and number of errors in Stroop tests 1 and 2 and the level of heat (P-value<0.0001). However, the mentioned variables had a significant positive correlation with Stroop test 3. Additionally, for exposed group variables of test duration, reaction time, and number of errors in Stroop 3 were significantly higher than those of control group.

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Conclusion: According to the findings in present study, heat stress causes an increase in reaction time and a decrease in selective attention. Thus, heat can be assumed as a stressor in hot work environments and the heat should be taken into account while design of job and tasks which needed selective attention or reaction time.

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Introduction: Volatile organic compounds such as xylene are one of the main air pollutants. Adsorption method are of the most common methods used in the control of volatile organic compounds. The aim of this study was to investigate the xylene removal from air through nano activated carbon adsorbent in comparison with NIOSH approved carbon adsorbent.
 

Material and Method: Xylene adsorption tests on nano activated carbon and activated carbon in static mode (batch) were done in glass vials with volume of 10 ml. Gas chromatography with FID detector was used for analysis. Various variables including contact time, amount of adsorbent, concentration of xylene, and temperature were studied.
 

Results: Absorption capacity of xylene at ambient temperature (25° C) in static mode and duration of 10 minutes for activated carbon and nano activated carbon was obtained 349.8 and 435 mg/g, respectively. Results of Scanning Electron Microscope (SEM) images of nano activated carbon showed particle size pf less than 100 nm. Furthermore, Transmission Electron Microscope (TEM) pictures showed particle size of 30 nm. XRD images also showed cube structure of nano activated carbon adsorbent.
 

Conclusion: The results showed that adsorption capacity at constant humidity increased by raising in temperature and contact time. What is more, nano activated carbon absorbent showed greater absorption capacity for xylene removal compared to activated carbon absorbent

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Introduction: Choosing maintenance strategy is one of the most complex and essential processes that can affect the safety and cost of equipment. The main aim of this study was to determine a risk-based maintenance policy for improvement of the safety and maintenance indices.

Material and Method: According to literature reviews and constraints associated with the studied industry, a number of safety and maintenance indices were selected and their values were measured. Next, in order to promote the selected indices, the best policy was implemented on nine critical machines of the company based on criteria such as cost, risk and availability in the framework of the fuzzy network analysis process. Finally, after six months period, the indices were re-measured. The Wilcoxon test was used to assess the changes in the indices.

Result: In the implementation of the model, condition based maintenance was more effective than other strategies. Following the intervention, the improvement of safety and maintenance indices was statistically significant. The statistical analyses demonstrated that indices like reliability, availability, mean time between failures, and the number of dangerous failures all were improved significantly (P<0.05).

Conclusion: The results showed that the simultaneous use of three criteria, i.e. cost, risk and availability in maintenance planning could reduce equipment-related accidents. Finally, the recommended model can improve the efficiency and competitiveness of organizations by increasing availability and reducing equipment costs

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Introduction: Skin disease caused by exposure to the chemicals is one of the major health-related problems in the workplaces. This study has done to prioritize the strategies for skin exposure with chemical in a painting company.
Material and Method: In this analytical cross-sectional study 7 criteria and 8 selection control methods were initially chosen by surveying the existing records and through the assessments of expert panel and checking the result of previous studies. Subsequently, control strategies were prioritized according to the criteria using Fuzzy Analytical Hierarchy process & Topsis.
Result: Results of the paired comparison showed that the safety of the control strategy (w=0.298) and it’s up to date (w=0.0138) were the most and least important criteria for skin control strategies. Among skin control strategies for chemical exposure, the highest and lowest importance were for training (w=0.817) and work-rest schedule (w=0.233), respectively.
Conclusion: In this study, training was determined as the best control strategies for skin chemical exposure in the studied painting company according to the investigated criteria. This decision-making process could be applied for promotion of the skin health among workers.

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Introduction: Errors are a byproduct of human information processing or cognitive functioning. Although everyone is disposed to an error while performing various activities, individual differences in cognitive abilities can lead to various types and rates of errors committed in similar situations. Human errors are one of the most important challenges in work environments, including health care systems, wherein such errors are abundantly occurring. Errors in the delivery of correct medications due to the resemblance in appearance and name are thus one of the cognitive errors that come about in health care systems. The main purpose of this systematic review was to evaluate evidence and approaches recently practiced to reduce medication errors caused by the use of look-alike-sound-alike (LASA) medications.
Material and Methods: The study was conducted on August 30, 2018, through searches in the databases of PubMed and Embase, all available years, using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) instructions. The searches were done in the titles or abstracts of the articles using the intended terms and the Medical Subject Headings (MeSH) index in combination. These studies were selected based on the inclusion and exclusion criteria and then categorized based on the type of interventions and outputs. Finally, the data were analyzed descriptively.
Results: The research designs and methods varied widely among the studies. There were also discrepancies in the number of participants, number of tests, type of medications, and test conditions. The approaches examined in these studies were tall-man lettering, color-coding, label background variations, and use of signs and symbols. Accordingly, 11 studies had utilized tall-man lettering and the most important reported in all articles were “error rate” and “response times”. As well, a wide range of medication names had been tested. It should be noted that medication
Conclusion: errors have different dimensions, but the errors caused by the look-alike-sound-alike (LASA) medications and the effect of tall-man lettering of medication name were only investigated in the present study. Laboratory studies in this respect have shown that tall-man lettering contributes to mitigating the rate of errors, which might be due to the better legibility of labels, but evaluations in real work environments are needed to reinforce this conclusion. There is also insufficient evidence to support color-coding, as well as several other approaches such as use of signs and symbols. Because of the novelty of the studies in this field, no uniform mechanism has been so far introduced.

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Introduction: Occupational injuries are considered as the most common work-related risk factors among the medical sciences students. Medical sciences students are mostly exposed to needle stick injuries and sharp objects when training in the clinical environment due to lack of enough experience. This study aimed at investigating the frequency of these injuries and the related causes of its occurrence among the students in various disciplines of medical sciences.
Material and Methods: This descriptive cross-sectional study was performed on the students of Fasa University of Medical Sciences in 2017. All medical, nursing, operating room, anesthesiology, and medical emergencies students were recruited to this stud using census method. Then, a questionnaire was distributed among them. The data collection tool in this study was a researcher-made questionnaire consisting of two parts of demographic characteristics and the related causes of the occurrence of injuries. After completing the questionnaire by the students, data management and analysis was performed using statistical tests and SPSS 22.
Results: The results of this study showed that 74 students (24.3%) had reported being injured caused by sharp objects at least once over their studying period of time. Twenty-six students (35.1%) described their carelessness as the main cause of the injuries. Intramuscular injection with 20 cases (27%) was the most important procedure leading to needle stick exposure. Chi-square statistical test showed that there was a statistically significant difference between the frequency of injuries caused by sharp objects and gender, so that the exposure frequency was more reported by the male students (P <0.05).
Conclusion: The results showed that injuries caused by needle stick and sharp objects are high in medical sciences students. Due to this high prevalence, in educational programs, and especially in the clinical setting, accurate and precise training and arrangements are highl recommended with the emphasis on safety measures. Also, the use of personal protective equipment (PPE), before and during working with the patient is essential for medical sciences students. In addition, due to disability of injured students, making a planning program for training them about the potential risk of these injuries is necessary.

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Introduction: Nosocomial infection (NI) is an infection occurring in a patient after 48 hours of hospitalization or up to 72 hours after discharge from the hospital, which was not present or incubating at the time of admission.  Hospital accreditation standards have a significant impact on the prevention and control of NI. Nevertheless, Iran’s hospital accreditation standards face challenges. The aim of this study was to compare the accreditation standards of NI prevention and control in Iran and leading countries.
Material and Methods: This research was conducted using the comparative review method in 2020. Hospital infection prevention and control (IPC) standards of Iran Hospital Accreditation Program was compared with those of international accreditation programs in the United States, Canada and Australia. Thematic analysis method was used to analyze the qualitative data.
Results: Iran and the United States had the highest share of nosocomial IPC standards. The Iranian Hospital IPC standards approximately comply with 62.1%, 46.6% and 49.9% of Hospital IPC standards of the United States, Canada and Australia, respectively. A hospital infection management system including constructs of NI leadership and management, NI planning, NI education, employee management, patient management, resource management, process management and outcomes is necessary for IPC. Iran Hospital Accreditation Program places great emphasis on process and resource management and less importance to leadership and management, planning, employee management, patient management and outcomes.
Conclusion: The Iranian Hospital Accreditation Program is progressing. However, its IPC standards need to be reviewed and updated. Using a systems approach including structures, processes and results in the development of hospital accreditation standards, leads to the optimal use of hospital resources and achieving better results.

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Introduction: Occupational fatigue is one of the harmful factors in many work environments, including health centers, which can have adverse effects on the health and safety of staff. This study was designed and conducted to determine the relationship between occupational fatigue and elements of the systems engineering model for patient safety in nurses.
Material and Methods: This descriptive correlational study was conducted with the participation of 457 nurses of Shahid Beheshti University of Medical Sciences in 2018. Dimensions of fatigue were assessed by a Multidimensional Fatigue Inventory (MFI) and Systems Engineering Initiative for Patient Safety (SEIPS) model’s elements using the SEIPS model’s questionnaire. Validity was examined using the Lawshe method; calculating Content Validity Ratio (CVR) and Content Validity Index (CVI) was approved through the confirmation of experts. Reliability was assessed using the intraclass correlation coefficient (ICC) and Cronbach’s alpha. Data analysis was performed using SPSS version 21
Results: The findings of this study indicated that the highest score of fatigue was related to the general fatigue dimension with an average of 12.86 and SD of 3.23, and the lowest score was related to the reduction of the motivation dimension with an average of 9.11 and SD of 3.66. In this study, no significant relationship was observed between demographic characteristics and fatigue dimensions, but a significant relationship was observed between the dimensions of fatigue with the element of organization, task, technology/tools, and physical environment.
Conclusion: The results of this study showed that fatigue in nurses was moderate, and the factors of the work system play a greater role in the occurrence of fatigue than demographic factors. Therefore, planning to improve the work system can help reduce fatigue in nurses.