Journal of Health and Safety at Work

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Introduction: Anesthetic gases used in hospitals include N2O and halogenated hydrocarbons (such as sevoflurane) which can be released through leakages and uncontrolled exhalation by the patient into the ambient air of clinical staff. These gases have greenhouse effect and damage to the ozone layer and serious risks such as reproductive, preterm delivery and fetal abnormalities and increased spontaneous abortion on the health of operating room personnel. Therefore, removal of these gases from the workplaces is essential especially in the treatment centers. The purpose of the present study was to investigate the adsorption of sevoflurane from air by using activated Charcoal and also the effect of acid modification on its performance.
 

Material and Method: In this study, two adsorbents of unmodified and modified activated charcoal with nitric acid were used to remove sevoflurane. After preparation, the adsorbents were characterized using XRD, FT-IR, BET and FE-SEM methods. After characterization, the breakthrough and adsorption capacity of sevoflurane on both adsorbents were determined using the modified wheeler equation.
 

Result: The results of characterization showed that acid modification did not affect the crystalline structure of activated charcoal and increased the adsorption and microporous of acid-modified activated charcoal in comparison with unmodified activated charcoal. It also reduces surface functional groups of the activated carbon. The results of determination of adsorption capacity indicated that the adsorption capacity of modified activated charcoal was improved in comparison with unmodified activated charcoal.
 

Conclusion: The results demonstrated that both adsorbents have the ability to absorb sevoflurane and modified activated charcoal have a better performance in this process. This effect may be due to the surface area of adsorption and volume of micro pores more than the unmodified activated charcoal.

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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: Prevention of heat-related diseases requires the participation of the workers. For this reason, the aim of this study was the development and validation of the tools for evaluating awareness and practice related to heat stress among the workers of warm workplaces.
Material and Methods: The various items and factors related to the awareness and practice of the workers were identified by the literature review. Then, several questions for evaluating these items were designed. In the next step, the reliability and validity of the questionnaires were appraised using calculating the content validity ratio (CVR) and content validity index (CVI), and Cronbach’s alpha coefficient, respectively. After that, these questionnaires were completed by 2338 employees of six industries in various regions of Iran. Finally, collected data were analyzed using SPSS software.
Results: In total, 77 questions, including 53 questions on awareness and 24 questions on practice in six groups of water and beverages, food, snacks and additives, heat exchange, thermal strain risk factors, clothing and heat protection equipment, and heat-related disorders and body reactions, were designed. The values of content validity index (CVI) of remained questions in the questionnaires of awareness and practice were equal to 0.954 and 0.824, respectively. The values of Cronbach’s alpha coefficients of these questionnaires were calculated by 0.755 and 0.716, respectively. The values of the chi-square divided by degrees of freedom (CMIN/DF) and root mean square error of approximation (RMSEA) in the construction of the awareness questionnaire were computed as 4.58 and 0.079, respectively. These values in the construction of the practice questionnaire were calculated by 2.33 and 0.084, respectively.
Conclusion: The results showed that the designed questionnaires had appropriate reliability and validity and could be used to evaluate the awareness and practice in warm workplaces.

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Introduction: Risk assessment matrix is a tool used in a project’s risk assessment process to identify the probability of risks and evaluate the potential damages caused by those risks. Generally, a risk assessment matrix is drawn in a two-dimensional form, with two factors: the severity of the accident and the probability of its occurrence. So, the purpose of this study is to develop a specific risk assessment matrix in a three-dimensional form by using the accident severity grade (ASG) rating system, the accident probability, and taking into account the preventive approach that helps occupational injury risk assessment in the automobile industry.
Material and Methods: This cross-sectional study was conducted in 1402 (2023) in one of the automobile assembly industries. One hundred cases were randomly selected by examining the reports of this industry’s past accidents. The ASG scoring checklist was designed and completed by the experts to assess the severity of accidents. Then, considering the ASG score, the frequency of the accident, and its preventability, a three-dimensional risk assessment matrix specific to this industry was presented.
Results: According to the findings of the accident analysis, a total of 658 accidents and 15,019 lost working days were recorded in this period. The most influential factor in the occurrence of accidents is related to “surface condition” (influence factor = 0.6), and the least of them belongs to the “weather conditions” (influence factor = 0.028). The results of the three-dimensional matrix show that when the ability to prevent accidents increases, the risk of accidents decreases.
Conclusion: Using the accident severity grade (ASG) and preventability in the proposed three-dimensional risk assessment matrix, the accident severity can be quantified immediately after the accident. This approach allows monitoring workplaces during the accident, leading to timely control and risk management implementation.