Journal of Health and Safety at Work

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Introduction: In the interaction between man and machine, the human behavior plays a key role in the accidents occurrence and the risks. Safety culture models can be a base to safety culture assessments and may lead scientists toward effective aspects of organization safety. The aim of present study was to develop and offer a specific questionnaire for safety culture assessment according to the customized model in an automotive industry.

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Material and Method: In this cross-sectional analytical study, a questionnaire including 16 items and 37 questions was developed based on management, individual, and organizational factors. Then, the reliability and validity of the developed questionnaire, it were studied among 30 employees of an automotive company.

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Result: Concerning the reliability of the questionnaire, the Cronbach’s alpha was 0.855. In the context of validity of the questionnaire, the simplicity and clarification of contents were investigated by means of Expert Analysis. Moreover, in terms of the integral components of culture, according to the factorial analysis, this evaluation regarded to have ten main components.

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Conclusion: So far, there was no exclusive tool for evaluating safety culture based on a customized model. The findings of the present study showed that evaluating safety culture using the administered questionnaire is valid and reliable in the understudied industry.

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Introduction: Heat stress is considered as one of the hazardous occupational agents in hot environments. Working under heat stress condition may lead to individuals’ health problems. Several studies have been shown that stress in the working environments can elevate stress hormones such as cortisol. Since heat stress is one of the serious stresses in hot industries including melting, this study was done to investigate the effect of heat stress on the cortisol concentration of workers in one of the melting industries.
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Material and Method: In this cross-sectional study, 70 workers in two groups of case and control (35 people in case group from foundry unit and 35 people in control group from casting unit without heat stress) were investigated. First, a demographic questionnaire was complete for each subject. Then in order to evaluate the changes in cortisol level, blood samples were taken from the participants during their working hours (9:30 to 10 AM) and the obtained levels were compared with the normal level of cortisol, provided at 7 to 10 AM. In order to assess environmental condition, WBGT (Wet Bulb Globe Temperature) index was measured at three highest including feet, waist and head. Moreover, noise and lighting were measured at the workers work station. Data were analyzed using SPSS software version 16.
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Result: Regarding WBGT, it was shown that mean WBGT index were 33 C and 16.7 C in case and control groups, respectively. Additionally, cortisol concentration in case group was significantly higher than control group (P<0.001).
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Conclusion: Results of the present study indicate that physical stresses of working environment can lead to changes in physiology of human body. Thus, variations in hormone level in its consequences in hot environment should be considered in occupational hygine.

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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: High level of workload and its consequent cognitive failures are among factors which impact nurses’ behavior, performance, and efficiency. This study aimed to investigate the relationship between nurses’ cognitive failures and perceived workload.

Material and Method: This cross-sectional and descriptive-analytical study was carried out among 150 male and female nurses, working in different units of Emam Khomeini and Vali-e-Asr hospitals in Tehran in 2013. NASA task load index (NASA-TlX) and Cognitive Failure Questionnaire (CFQ) were used to assess workload and cognitive failures, respectively. Data were analyzed using Pearson Correlation, Independent sample t-test, and one-way ANOVA statistical tests with SPSS software version 20.

Result: Pearson and Spearman correlation coefficients test results showed a significant relationship between nurses’ mental workload and their memory for names (P-value<0.001). Moreover, there was significant association between physical workload and memory, attention and total cognitive failures (CFQ total) (P-value<0.05). Perceived frustration mong nurses was significantly correlated with memory, attention, motor functions and total cognitive failures (P-value<0.05).

Conclusion: The results showed a high level of workload among study nurses. Furthermore, the relationships between some dimensions of mental workload and cognitive failures were confirmed, so that an increase in workload dimension can lead to more cognitive failures while doing task.

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Introduction: One of the important consequences of globalization and development, especially in developing countries, are occupational accidents. As, today the economic burden due to these accidents is remarkable on the country’s economy. The aim of this study was financial estimate of the productivity loss due to work-related deaths in Iran in 2013.

Material and Method: In this study, occupational accident data were used registered in the environmental and occupational health center, in Iranian Ministry of Health and Medical Education. A formula used by the Centers for Disease Control and Prevention America (CDC) was used to estimate the productivity loss. Finally, after replacing the necessary parameters amount of productivity loss was calculated.

Result: The total lost years of life were calculated 1293.15 years due to the deaths caused by occupational accidents. The total amount of monetary loss due to the productivity loss in the country, was estimated 730513.06 Rials. The greatest loss was in the 59-50 years old age group.

Conclusion: The negative rate of productivity, the large quantity of the discount rate, low life expectancy in the country as well as the low wages of the workers, are the likely reasons for minimal negative impact of the workforce deaths on the country’s productivity.

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Introduction: Quality of Work Life (QWL) is a new form of job satisfaction which involves ones feelings about all aspects of their job. The aim of this study was to assess the psychometric properties of the Persian version of WRQoL-2 questionnaire for use in the nursing community.

Material and Method: In this study, backward translation method was used in order to verify the linguistics stability. Then, the cross-sectional study was conducted among 270 nurses working in a hospital, affiliated to Tehran University of Medical Sciences. Reliability and construct validity was investigated using test-retest and factor analysis, respectively. In addition, discriminant validity was assessed by comparing QWL mean scores of nurses satisfied with their salary and those who were dissatisfied.

Result: Regarding the reliability, it was observed that the repeatability coefficient were at an acceptable level for all dimensions of the WRQoL-2questionnaire. According to factor analysis, six components were identified with some questions in different groups compared to the original questionnaire. Considering discriminant validity, all components, except Stress at Work, obtained P-value less than 0.05.

Conclusion: Based on the acceptable level of reliability and validity of the WRQoL-2 questionnaire, use the questionnaire to assess the quality of work life of nurses is recommended.

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Introduction: Teaching has been reported stressful. Although, the majority of teachers aren’t anxious or unmotivated and they even consider their job valuable and satisfying. Job demands-resources (JD-R) is a comprehensive model in occupational stress domain that simultaneously examines the stressful and motivational aspects of occupations and their related outcomes. Accordingly, the objective of this paper is to investigate job characteristics of teaching (job demands and job resources) and their subsequent outcomes by utilizing proposed model.

Material and Method: This study was a cross-sectional design among 247 high school teachers in Tehran city who were selected by two-stage cluster sampling in spring and summer of 1391. Three aspects of job demands (pupil misbehavior, work-family conflict, and cognitive demand), 2 aspects of job resources (supervisory support and job condition), emotional exhaustion, vigor, teacher’s illness symptoms, and organizational commitment were assessed using job demands-resources model. The data were analyzed by means of SPSS 21 program and path analysis by using AMOS 23 program.

Result: According to the results, model fit indices were in acceptable range and all the coefficient paths were significant (p<0.001). Considering model, Job demands were a better predictor for emotional exhaustion (β=0.3) than job resources (β=0.2). However, they had an equal but opposite impact on vigor (β=±0.27). Moreover, we observed partial mediation relationships between job demands and illness symptoms and job resources and organizational commitment via emotional exhaustion and vigor respectively.

Conclusion: Based on the findings, fostering initiatives with priorities of firstly regulating job demands and secondly improving job resources can be effective strategies to reduce job related burnout and promoting job engagement, health and organizational commitment of teachers

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Introduction: Nursing is one of professions that employees are at risk of fatigue and work related musculoskeletal disorders, because of high physical workload and high job stress. Connecting serum set to serum solution is one of the repetitive tasks for nurses in their working times and it may cause pain and discomfort in their hand. The aim of this study was to design and ergonomic evaluation of a tool for connecting serum set to serum solution.

Material and Method: This experimental- interventional study conducted on 12 nurses (6 men and 6 women) in 3 phases. First phase was assessment of manual connecting of serum set to the bag by nurses, second phase was design and manufacturing of serum set connector and third was ergonomic assessment of the manufactured tool. In first and third phases, amount of perceived exertion by nurses was assessed using the Burg scale (CR10), and electromyography assessment for hand muscles activity was conducted during connecting serum set. Data of first and third phases compared with statistical tests.

Result: Mean score of perceived effort during manual connection of serum set was 5±1/2 (of 10) and while mechanical connection with designed tool was 2.3±0/49. There was significant difference between activity in 5 muscles (Flexor Digit Comonis, Flexor Carpi Radial, Biceps, Triceps and Deltoid) in manually and mechanically connection mode (P-value<0.05).

Conclusion: Use of serum set connector reduced the perceived effort and activity of hand and wrist muscles. This device can be used as an ergonomic tool for nurses to easing the inserting the serum set to serum solution

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Introduction: The Surgical Safety Checklist has been introduced by the World Health Organization (WHO) as a tool for reducing medical errors. Reviewing the results of the checklist application indicates significant reduction in mortality and complications in surgery. Thus, this study aimed to customize and validate surgical safety checklist in order to complying with the surgical protocol in Iran.
 

Material and Method: In this cross-sectional and descriptive study, the WHO Safety Surgery Checklist was first translated. Next, through interviews with specialists and direct observation of activities, those tasks that were susceptible to the incident, identified, prioritized and analyzed using Hierarchical Task Analysis (HTA) and the results presented in form of HTA charts. Then, using Tabulate Task Analysis (TTA) and based on the recommendation and modification commented by expert panel, some questions added to the checklist and a customized version of the Surgical Safety Checklist was provided.  Hence, the faced validity, content validity and reliability of the checklist have been evaluated.
 

Result: In the surgery, four major tasks identified for analyzing using the HTA chart. Accordingly, 41 subtasks obtained and analyzed by TTA. The Lavashe method was used to determine the content validity ratio (CVR) and the content validity index (CVI). The question from the checklist, in which, CVI was less than 0.79, modified and replaced with appropriate question. Also, the scores for 3 questions were less than 0.49, and they were removed from the checklist due to the low CVR score. In the reliability assessment, the intra-observer method is used, and the Kappa coefficient obtained was acceptable and it was higher than 0.6, which confirmed the validity of the checklist.
 

Conclusion: In this study, the surgical safety checklist customized in terms of content validity and reliability, in a field study. Considering the compliance of the checklist items with the surgical protocol in Iran, we hope to use it to improve the quality of teamwork and reduce the complications and mortality caused by surgical errors

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Introduction: Nowadays, working in any computer work stations, named visual display terminal (VDT), was widespread and has become popular in our lives. Due to the increasing trend of using computers in the administrative and social institutions, prevalence of eye-related signs of working with computers is still increasing and it is one of the most important health issues. Computer jobs are low-mobility and require little energy to do physical work, but require more cognitive processing and mental focus. Visual fatigue is an occupational hazard for people working with computers. Eye fatigue has symptoms such as headaches, job discomfort, and eye pain the purpose of this study was to have a systematic review on eye fatigue, dry eye and eye blink among people working with visual terminals.  
Material and Methods: Internet search databases and search engines were used to find articles with focusing on the impact of risk factors on eye indexes on computer users. In this study, related articles were obtained from websites, including: PubMed, Google Scholar, Scopus and Web of Sciences. The keywords were used to search in these websites were: computer user, eye fatigue, dry eye and eye blink. Accordingly, after finding 115 relevant articles from the related sites, 17 articles were finally selected.
Results: Findings show that using computer cause many problems in the eye. Duration of using the computer, the type of work with the computer, the mental load, the distance from the monitor, and also long-term use of the computer without break in during work can cause dry and fatigue eye in users, which is one of the most common ocular problems among computer users.
Conclusion: According to the finding and results recommended to reduce of dry and fatigue eye, distance of users from the monitors, be more than 50cm, use 20-20-20 law to rest user’s eyes, and  Positioning the monitor be 15-20 degrees below the user’s line of sight. Also, too much focus on the screen reduces blinking and resulting in dry eyes. In order to prevent dryness of the surface of the eye, it is recommended that the eyelid be optional even if possible. Increasing the contrast of the monitor can be helpful in reducing stress and strain on the eye while working with a computer and using glasses instead of lenses to correct refractive errors and one of the ways to control and improve dry eye is using artificial tears by computer users.

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Background: Industrial incidents are one of the major problems of today's societies. Studies in this field show that the main and most important cause of error occurrence is human factor. Therefore, the aim of this study was to identify and evaluate the risk of human error in the activities related to the operation of electrical installations of the Tehran Province Electricity Distribution Company.
Methods: This study is a qualitative and cross-sectional research was conducted by direct observation of the activities and documents, interview. Tasks and subtasks were selected and analyzed using Hierarchical task Analysis, (HTA).The results were presented in the form of  HTA. Finally, according to the instructions of SHERPA, the relevant worksheet was completed.
Results: The analysis of SHERPA worksheets showed that a total of 3399 errors were detected for 759 tasks as 39.57% of them were action errors, 32.4% review type, 7.32% recovery type, 19.64% communication type and 1.80% were selective errors. According to the results of risk assessment, 12.47% of the errors were unacceptable risks level, 59.57% were undesirable, and 20.2% were acceptable risks but need to be revised and the rest, 7.33% acceptable with no need for revision or safe ones.
Conclusion: According to the results, the most common type of error was action errors and in order to reduce this type of errors, using necessary corrective measures such as proper selection of people for occupations, training, monitoring, using smart machines, using tag out systems and checking at the suitable time and updating the instructions would be useful and effective countermeasures.

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Introduction: Assessing health, safety, and environment (HSE) performance based on up-to-date analytical models like resilience engineering, especially in automobile manufacturing companies, affected by the trilogy of HSE factors and functions, is of crucial importance. Therefore, this study was to review the factors effectively involved in HSE management performance assessment based on resilience engineering in automobile manufacturing industries.
Material and Methods: To collect and classify the data, many relevant articles and procedures published in journals or presented at seminars were researched and cited. In this study, reliable online databases, including Google Scholar, Web of Science, Scopus, and PubMed were searched to meet this purpose. Other databases in Farsi such as Magiran, CIVILICA, and Scientific Information Database (SID) were also employed. Accordingly, a total number of 211 articles were extracted and filtered in terms of content and topic by a team of four HSE senior experts, whereby irrelevant studies were deleted, the full text of each relevant article was more closely considered, and finally 18 studies were selected and thoroughly examined.
Results: The findings from these 18 articles revealed that the HSE would be influenced in various industries by factors such as organizational culture, learning and training, political-economic variables, workforce qualifications and skills, strategic and large-scale programs of organization plus its assets and financial resources. In automobile manufacturing industries as well, circumstances might emerge because of some extra-organizational threats and intra-organizational weaknesses, whereby the appearance of deficiencies in various processes and even the functions of the HSE as a whole would be impaired. Of the many external factors, one could mention economic sanctions, large-scale socioeconomic problems, and lack of materials and production equipment. The internal problems would also range from production reduction and cuts in budgets earmarked for different management departments to a rise in the number of accidents and diseases, soaring medical treatment costs, as well as growing expectations in employees, which together impact the HSE management performance.
Conclusion: Regarding the studies conducted on various models presented so far in the area of resilience, it was concluded that the HSE performance of organizations intended to prevent and control risk factors were by no means distinct from other management factors and strategic decision-making in an organization. Rather, the HSE indicators could be impacted by many extra- and intra-organizational factors. Based on the models surveyed, it would be essential to consider the concept of resilience in HSE management. The reason for this is that the idea of the HSE would appear to be an issue of less virtue and importance in various stages and situations in the lifecycle of an organization, which is not consistent with the HSE management system and does not keep pace with the influencing factors.

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Introduction: Designing behavioral modification interventions for the use of personal protective equipment (PPE) warrants the audiences identification and analysis. This study aimed to determine the predictive factors for using (PPE) based on Social Cognitive Theory (SCT) constructs among workers of Iran Aluminum Factory, 2018.
Material and Methods: In this descriptive analytical study with cross-sectional method, a researcher-made questionnaire including demographic information, knowledge questionnaire and designed items based on the SCT construct, was fulfilled by 188 workers employed in production line of Iran Aluminum Factory in Arak. The collected data was analyzed using descriptive statistics, Chi-square and logistic regression analysis on SPSS 24. The significance level was set at P< 0.05.
Results: Among the participants, 46.8% (n=88) and 52.2% (n=100) of workers had moderate and high level of knowledge, respectively. Demographic variables such as marital status, educational level, income, age, work experience and employment status (p <0.05), as well as all SCT constructs (p <0.05) had a significant relationship with knowledge. Logistic regression analysis revealed that the level of education and employment status with probability of 80.6% and self-control, environment and self-efficacy of perceived barriers constructs, with a 64% probability could explained workers in high-knowledge group.
Conclusion: The present study revealed that the variables such as level of education, employment status, self-control, environment and self-efficacy of perceived barriers could be effective in designing educational interventions to improve workers’ knowledge on using personal protective equipment.

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Introduction: Workers in car manufacturing industry are at risk of a high prevalence of musculoskeletal disorders, especially low back pain. Therefore, in the present study aimed to design and fabricate a portable device to evaluate the low back kinematics and to compare these variables in workers with and without low back pain (LBP) in assembly lines of an automotive industry.
Material and Methods: In the present research workers postures were assessed using OWAS direct observational method. Moreover, simultaneously, prevalence and intensity of low back pain were evaluated by Dutch Musculoskeletal Questionnaire (DMQ) and Visual Analogue Scale (VAS). After fabricating motion analysis device, a field study was conducted using the designed device among 16 volunteers to investigate low back kinematic variables in two groups of workers: LBP and non-LBP.
Results: The results showed that 62.1 percent of all working postures were high risk with corrective action levels of 3 and 4. On average, 86.1 percent of workers experienced LBP in the previous 12 months. Regarding comparison of kinematic variable in the two groups of LBP and non-LBP, workers without LBP had higher degree and duration (in second) of movements (forward flexion, lateral bending, extension, and twisting), as compared to those with LBP. However, only movement range of forward flexion in non-LBP group (mean: 64.29 and SD: 8.41), was significantly higher than those with LBP (mean: 58.97 and SD: 11.34).  
Conclusion: The device can be used as an effective tool in the ergonomics studies in the field of back pain, due to its potential to record the kinematics of the trunk, as well as its lightweight and non-interference with the task. Device’s validity was acceptable based on the comparison of the results of this device with those obtained from inclinometer.

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Introduction: Musculoskeletal disorders (MSDs) are prevalent in work settings and are associated with high rate of prevalence and costs. Musculoskeletal conditions have multifaceted nature, and occupational factors play an important role in their development. The aim of this study was to identify the risk factors of work-related musculoskeletal disorders in the working population in Iran during 2000 to 2015.
Material and Methods: Using the appropriate search terms, articles published in the journals, student thesis, and those presented at the conferences were searched through authentic English databases (Google Scholar, Scopus, PubMed) and Farsi ones (Magiran, SID, IranMedex, Irandoc). Following removal of duplicate citations and irrelevant studies, the full texts of the remaining publications were prepared and assessed for more detail.
Results: Perceived discomfort in low back region obtained the highest score in workers of industrial, administrative, service, and agricultural settings. However, in the handicraft and educational groups, the highest percentage of discomfort was belonged to neck (66.7%). Findings showed that the most commonly used techniques for evaluation of musculoskeletal disorders and risk factors were, respectively, Nordic questionnaire (NMQ) (76%) and REBA (13.9%). Moreover, all identified risk factors were classified into eleven groups including: biomechanical, work environment design, tools, equipment, temporal aspects of job design, job content, organizational aspects, economic and financial issues, social aspects, individual characteristics, and training.
Conclusion: Overall, a wide range of risk factors reported in the previous studies were categorized in the present review. The results are suggested to be considered by managers and decision makers as a framework to take measures for controlling musculoskeletal disorders to accomplish the goal of ergonomics, which is productivity and well-being.

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Introduction: Nowadays, excessive computer use in the workplace has raised concerns about the health status of VDT workers, particularly complaints about eye discomforts. Due to the importance of the eyelids and eye closure parameters on eye health during computer works and the direct effect of monitor height on these parameters, this study was aimed to examine the effect of different monitor heights adjustment on the eye indicators and eye discomfort among participants.
Material and Methods: In this study, any changes in the eye indicators including blink rate, the eye blink opening and closing time, the blink opening rate in three different monitor heights (standard, low, and high) were examined among 11 participants. The blink rate and the eye blink opening and closing time were measured and evaluated using videotaping and analyzing by an image processing software, developed in this study. Participants were also asked to complete a questionnaire for eye fatigue assessment due to daily computer uses.
Results: Results showed that the highest rate of eye blink was at the standard height of the monitor, and this rate was significantly different at three different heights of monitors (high, standard, and low) (p<0.05). The lowest blink rate was observed at low and high heights with an average of 7.3 and 7.8 and the highest blink rate at standard height with an average of 8.9 blink per minute, respectively. Meanwhile, image processing and analyzing of eye surface showed, in average, 16% decrease in the opening rate of the eye surface by decreasing the height of the monitor, and 15% increase by increasing it, relative to the standard mode of monitor.
Conclusion: To protect users from computer-related eye strain, it is recommended to correct monitors height to the standard height along with typing and data entry training for keyboarding skill development and minimizing working times as a result. What is more, a proper work-rest schedule when working with computer can be considered as an effective countermeasure to prevent from eye strain.

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Introduction: The noise could affect some aspects of human health, including the cognitive performance. In addition to sound pressure level and exposure time, the psychoacoustic features of noise may cause destructive effects on humans. A few recent studies have been conducted on effect of sound quality on cognitive performance. This study aims to find the noise loudness and sharpness levels as the most destructive effects on human cognitive performance.
Material and Methods: This was a cross-sectional study on 10 male students of Tehran University of Medical Sciences. The Noises were generated in two channels that the left channel produced the pink noise as a background noise. The pink noise loudness and sharpness were 19.7 sone and 2.49 acum, respectively. The right channel generated noises with different loudness and sharpness levels the noise loudness ranged from 8.87 to 67.9 sone and the noise sharpness ranged from 1.07 to 6.4 acum. Finally, ten noises with different loudness and sharpness were applied. The students were exposed to ten different types of noise and a silent condition. The Mathematical Problem Solving Task (MPST) test was performed to assess cognitive performance. The reaction time and the accuracy rate were measured after 5 minutes of noise exposure. Data were analyzed by SPSS (ver. 22). P< 0.05 was considered as significant level.
Results: The mean reaction time and the mean accuracy rate increased with the sharpness level.  However, alteration in the loudness and sharpness levels had no significant effect on the speed and accuracy of students. Performance speed increased in noise 3 with the highest loudness (L=67.9, SH=1.07) in comparison with the silent condition (p-value=0.05). The mean accuracy rate in exposure to the noise 9 reduced in comparison with silence (p-value=0.04)
Conclusion: Different levels of psychoacoustic features had no significant effect on the cognitive performance parameters. Although, the accuracy rate and the reaction time decreased in noises 9, the sharpest noise, and 3, the loudest noise, in comparison to the silence, respectively.

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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.

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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.