Journal of Health and Safety at Work

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Introduction: Throughout the world, many efforts have been made to provide suitable tools for achieving sustainable urban development and the achievement of a sustainable city. Establishing a Health, Safety and Environment Management System (HSE-MS) is one of the tools for achieving sustainable urban development. Measuring the performance of an organization in the HSE area is a precondition for continuous improvement, which is the spirit of the new HSE management systems. Therefore, the main purpose of this research was to provide a practical model for quantitative ranking of different areas of Tehran municipality in terms of HSE performance with using of multi-criteria decision-making method.  
Material and Methods: In this descriptive-applied study, after determining functional axis and performance evaluation indicators related to each of them (29 functional axis and 154 performance evaluation indicators), through designing a questionnaire and based on the views of the expert group, weight of functional axis and performance indicators were determined using a hierarchical process analysis technique.
Results:  In this study, the weighted value for functional axis of the process based HSE in comparison to the result based HSE were higher. “Commitment and Leadership” and “HSE Certificate of Occupations” for the process based HSE, “Safety” and “Health” for the result based HSE, and “Economic Sustainability” and “Architecture and Urbanism” for urban management had the higher and lowest weighted values.
Conclusion: The results of assessment and validation of selected indicators and functional axis showed that in designing and determining the HSE performance assessment model of municipalities, in addition to the axises and indicators of the HSE domain, factors affecting urban management can have a significant impact on the performance of municipalities in the field of HSE.

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Introduction: Road traffic accidents (RTAs) have always a major concern and human factor has been recognized as their leading cause. Since taxi drivers play a significant role in accidents, the main purpose of this study was to provide a valid and reliable version of the Dula Dangerous Driving Index (3DI) for taxi drivers working in the city of Zanjan, Iran.
Material and Methods: Based on the convenience sampling method, 316 taxi (including taxi, internet taxi, etc.) drivers were recruited in this descriptive study. The 3DI contained 28 items within three factors related to dangerous driving behavior. After linguistic validation, qualitative and quantitative face validity was determined for the given questionnaire. Consequently, content validity index (CVI) and content validity ratio (CVR) were assessed by a panel of 10 experts. Internal reliability was further calculated based on Cronbach’s alpha coefficient and test-retest method.
Results: The results revealed that face validity (1.60-3.82.), CVR (0.8-1), and CVI (0.891-1) were acceptable. Cronbach’s alpha coefficient was also 0.896 for the total reliability of the instrument and 0.95, 0.89, and 0.94 for each factor, respectively. In addition, Spearman’s rank correlation coefficient was 0.871 (P-value<0.001).
Conclusion: The results ultimately demonstrated that the Persian version of the 3DI had adequate reliability, as well as, face and content validity. However, construct validity remains.

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Introduction: Determining methods for assessing heat stress in different work environments is one of the major challenges for researchers in this field. The purpose of this study was to validate WBGT index and heat pressure assessment (HPA) by some physiological responses in Iranian South Oil Company.
Material and Methods: This descriptive-analytical study was carried out on 154 employees of Kharg, Asalouyeh and Mahshahr oil terminals recruited from three different working conditions including indoor, outdoor and rest environments in the summer. The amount of heat stress in the workplace was evaluated by WBGT index HPA method. To meet this purpose, the environmental parameters i.e., temperature, wet temperature, radiation temperature, relative humidity, water vapor pressure and air flow rate were determined. In addition to the direct reading method by the WBGT meter, ISO 7243 was used to calculate the WBGT index. In order to validate the heat stress indicators, physiological parameters of oral temperature, tympanic temperature and work metabolism were measured.
Results: The results of paired sample t-test showed a significant difference between WBGT index and HPA in indoor and outdoor environment (P<0.05). Moreover, there was a significant difference between the physiological indices of oral and tympanic temperatures and work metabolism in the indoor and outdoor environment (P<0.05). Furthermore, the correlation test was significant between WBGT index as an independent variable and HPA as a dependent variable (P<0.05)  and showed a high correlation (R2=0.914) between WBGT index with oral temperature and tympanic temperature . Also, the rate of work metabolism was significantly related with the aforementioned parameters (P<0.05) and was equal to R2=0.423, R2=0.335, R2=0.552, respectively. The correlations were also significant between HPA with Oral temperature, tympanic temperature and work metabolism (P<0.05)and were equal to R2=0.632, R2=0.605, R2=0.557, respectively. The results showed also that the correlation rate between the HPA with physiological parameters is stronger than that between physiological parameters with the WBGT index.
Conclusion: This study showed that WBGT and HPA methods are useful for assessing the heat stress of Iranian South Oil Company. Also, the HPA method is more reliable for assessing heat stress in these regions.

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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: Work-related musculoskeletal disorders (WMSDs) are a prevalent occupational health concern, influenced by both physical and psychosocial factors. Valid questionnaires offer a cost-effective and efficient means of evaluating WMSDs. This study aimed to validate the Persian version of the MDRF questionnaire, assess its applicability in Iran, and investigate the prevalence of WMSDs among employees in an automotive industry.
Material and Methods: This descriptive cross-sectional study was conducted among 100 employees (50 production line workers and 50 office workers) in Kerman province. The linguistic validity of the questionnaire and its translation were ensured using the Backward-Forward method. Content validity was assessed through CVI and CVR indexes. To evaluate the questionnaire’s reliability and agreement, Cronbach’s alpha and ICC were employed. User responses from the first and second series of the questionnaires were validated using Kappa and Spearman’s tests.
Results: Results indicated high reliability which was achieved by Cronbach’s alpha and ICC values of 0.960 and 0.925, respectively. The questionnaire’s validity was acceptable based on CVR and CVI tests. The prevalence of WMSDs was the highest in the lower back for both production line and office workers over the past year. The job satisfaction factor exhibited the highest risk level among the questionnaire’s four subgroups. Approximately 85% of participants were classified as having a high or very high-risk level, reflecting concerning conditions among the employees. The prevalence of WMSDs in different body parts significantly correlated with all physical and psychosocial stress factors.
Conclusion: This research highlights the influence of diverse physical and psychosocial risk factors on the occurrence of WMSDs among both occupational workers and office employees. Also, the MDRF questionnaire, whose high applicability in assessing the WMSDs risk factors was proven in this study, is an effective tool for prioritizing, planning, and executing educational and preventive measures within the workforce community to mitigate and prevent WMSDs. 

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Introduction: Despite advancements in road safety and vehicle design, road accidents remain prevalent, a quarter of which are caused by driver distraction. This issue is particularly critical in the public transport sector, especially among urban bus drivers, as distraction can lead to serious injuries and fatalities. Accordingly, this study explored the factors influencing distraction among urban bus drivers through a qualitative approach and a macroergonomics perspective.
Material and Methods: In this study conducted in 2024 in Tehran, 18 urban bus drivers were selected through cluster sampling. The participants included 10 drivers from bus rapid transit (BRT) system and 8 drivers from non-BRT services. Data were collected through semi-structured interviews with the drivers as well as on-site observations. Subsequently, a directed qualitative content analysis approach, based on the balance theory model, was used to analyze the collected data.
Results: The findings revealed that the primary sources of distraction belonged to six levels of the work system, the most cited of which were environment, tasks, and organization. Specifically, inappropriate behavior of other street users as an environmental factor and the driver’s interactions with passengers as task-related factors were identified as key sources. Additionally, organizational factors such as interactions with supervisors and colleagues, as well as salary issues, were significantly important. The participants very limitedly expressed using mobile phone while driving as a main distractor to their driving.
Conclusion: The current study identified various influential factors, spanning different levels of the work system, affecting bus drivers’ distraction, including generic factors that impact all urban drivers and specific factors that uniquely affect bus drivers. Addressing these factors through providing appropriate education for both passengers and street users along with implementing management strategies in the organization to enhance intra-organizational relationships and organizational support can lead to the safety of the bus drivers.