Journal of Health and Safety at Work

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Introduction: Working with a computer and workplace conditions expose people to risk factors of musculoskeletal disorders (MSDs). This study aimed to assess posture, examine MSDs, and determine, weigh and prioritize the risk factors among computer users by a neural network algorithm. 
Material and Methods: This descriptive-analytical cross-sectional study was conducted in six phases on computer users in 2019. The status of MSDs was determined via Nordic musculoskeletal questionnaire (NMQ). The factors affecting these disorders were determined by the ROSA method, and then these factors were weighed by the neural network algorithm. The data were analyzed in IBM SPSS Modeler.
Results: The mean age and work experience of the users were 34 ± 6.9 and 1.5 ± 0.7 years, respectively. Most of years were observed at the lower back, neck, and upper back, respectively. The final mean scores of the chair, telephone-monitor, and mouse-keyboard were 3.7 ± 1, 3.6 ± 1.1, and 3.65 ± 1.2, respectively and the final mean score of ROSA was 4.4 ± 0.9. The greatest correlation with the ROSA score was observed in chair (R2 = 0.46), followed by telephone-monitor (R2 = 0.43), and mouse-keyboard (R2 = 0.42). The highest predictor importance of the effective factors based on the neural network algorithm prioritization belonged to the chair (48%), followed by telephone-monitor (28%) and mouse-keyboard (24%). The accuracy of the neural network algorithm in examining the effect of factors on musculoskeletal disorders was 98% based on the ROSA score.
Conclusion: Factors affecting years due to working with computers are the chair, telephone-monitor, and mouse-keyboard, respectively, as prioritized by the neural network algorithm. These disorders can be prevented by ergonomic modification of users’ chairs and correct placement of the monitor and telephone.

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Introduction: Previous studies have been conducted on the effects of exposure of industrial workers to high levels of noise and their association with mental health or exposure of people to harmful levels of environmental noise. In this study, we investigated the association between moderate noise levels and the symptoms of depression, anxiety, and stress in non-industrial workers.
Material and Methods: This study is a Cross-Sectional study that was conducted using the enrollment phase data of the Tehran University of Medical Sciences Cohort (TEC) study. The study population consisted of 3899 workers of Tehran University of Medical Sciences who were employed in seven occupational groups of the university, Office Workers, Healthcare workers, technical personnel, services workers, security guards, and radiology-radiation units. Exposure to moderate noise level was examined using the Leq10min index, and the Depression Anxiety Stress Scales were examined on the mentioned population by DASS-42 questionnaires.
Results: The results showed that the prevalence of severe to very severe symptoms of depression, anxiety and stress were 8.2, 7.9, and 11% respectively. Also, it was observed that 14.5% of the participants of the study were exposed to noises of more than 70 dB(A). Furthermore, the results indicated that the highest average noise was equal to 71.3 dB(A) for the technical staff group, and the lowest value with an average of 59.1 dB(A) was recorded for the office workers group. The symptoms of severe to very severe depression was associated with exposure to noises above 70 dB(A) (OR:5.22) anxiety (OR:1.16), stress (OR:1.17) and socioeconomic status (OR:1.84). The severe to very severe anxiety was associated with stress (OR: 1.25). On the other hand, the symptoms of severe to very severe stress was associated with variables of age (OR:0.99), gender (OR:0.46), socioeconomic status (OR:1.52), having job management position (OR:0.81) and having healthcare working job (OR:0.65).
Conclusion: Regarding the obtained results of the present study, it was concluded that exposure to moderate noise levels had positive and significant association with depression in non-industrial workers. In non-industrial work environments, exposure to moderate noise levels is and can be independently associated with depression.

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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: The formation and evolution of culture in organizations are related to the learning experiences of their members over time. In this regard, the present study was conducted to empirically investigate the correlation relationship between the Learning Organization (LO) and safety culture concepts in Iran’s nuclear and radiological industries.
Material and Methods: A theoretical model concerning the connections between seven facets of LO and safety culture was proposed. It was then empirically tested with a structural equation modeling PLS analysis of a survey data set of 388 observations, collected from the radiation workers of 45 organizations in 4 Iranian industrial groups i.e. medical radiation, industrial radiography, nuclear installations, and radiological installations. Yang’s DLOQ questionnaire in 2004 and IAEA’s SCPQ-LH questionnaire in 2017 were used to measure LO and safety culture, respectively.
Results: According to the findings of this study, being a LO could explain 52% of the variance in safety culture. Besides, it was observed that the strength of this relationship between four different subpopulations of Iran’s radiological and nuclear industries due to their different contexts, had significant differences and they vary from 34% for industrial radiography to 65% for nuclear installations.
Conclusion: The existence of LO conditions in the working environment is linked to high safety culture. Thus, the LO can be joined to the toolbox of consultants, managers, and other organizational developers attempting to advance the conditions for safety at work.

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Introduction: Job burnout is a kind of psychological exhaustion that is associated with psychological stress or job and workplace stress and can affect the general health of the individual.  Job burnout is more likely to occur in jobs offering health and social services. Considering the special problems of hospital staff due to high work sensitivity, this study was conducted to identify the relationship between job burnout and mental health among non-medical staff of general, specialty and sub-specialty hospitals affiliated to the Iranian oil industry.
Material and Methods: This research is descriptive-analytical which is of correlation type. Cluster random sampling was used to select 251 non-medical staff members of Oil Company’s hospitals in Abadan, Ahwaz, Mahshahr and Tehran. The instruments used included demographic checklist, Goldberg General Health Questionnaire and Maslach Burnout Questionnaire. The data were analyzed by Spearman, Mann–Whitney U test and Kruskal-Wallis correlation test at the level of 0.05.
Results: The findings showed that the mean and standard deviation of age of participants were 38.82±8.3. 49.5% of participants were female  The mean and standard deviation of mental health was 2.12 ± 0.405 and the mean and standard deviation of burnout was 28.4 ± 0.634. There is a meaningful and reverse relationship between burnout and mental health, mental health and emotional exhaustion and depersonalization and personal adequacy in non-medical staff in general, specialty and sub-specialty hospitals affiliated to the Iranian oil industry.
Conclusion: Based on the findings of the study, job burnout affects mental health. Burnout affects both male and female. The findings of this study can be used in planning preventive measures, and identifying groups which are exposed to risk in work environments.

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Introduction: Using backpacks has arisen complaints regarding musculoskeletal pains among students. The aim of this study is to investigate the relationship between demographic information and bag weight with Neck Disability Index (NDI), angles and head and neck postures among students.
Material and Methods: This descriptive-analytical and cross-sectional study was conducted among 80 students who were selected randomly. Demographic information and NDI questionnaires were used for data collection. The head and neck tilt angles and the amount of change in the forward head posture were determined using the photogrammetry method and Kinovea software.
Results: A negative and significant correlation was observed between head tilt angle with age (r = - 0.27) and neck tilt angle with body mass index (r = - 0.37). Also, a positive and significant correlation was observed between the amount of change in the forward head posture and body weight (r = 0.24). The head tilt angle was significantly different in male and female students at different educational levels. NDI (r = 0.23) and neck tilt angle (r = 0.26) also increased significantly with increasing bag weight.
Conclusion: Reviewing the standard weight of bag and changing the lifestyle can play an important role in improving the head and neck angles and postures.

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Introduction: The manufacturing, service professions, and other occupations commonly require their employees to spend more than 2 hours of their workday in an upright position which can potentially cause temporary or permanent health effects. The objective of this study is to determine the effect of anti-fatigue mats on leg muscle discomfort and muscle activity due to prolonged standing.
Material and Methods: A total of 100 workers were involved in the study. The control and experimental group stood for 2 hours in a controlled room with or without the anti-fatigue mat while sorting an assortment of mixed items.  Borg’s scale questionnaire and EMG signals were used to monitor the muscle discomfort and activity of the respondents.
Results: The discomfort ratings and muscle activity in the experimental group were always at lower levels compared to the control group, which meant there was a reduction in mean perceived exertion rating for the knees, calves, and feet, i.e., 1.8, 2.5 and 2.6, respectively. The results showed that there was a statistically significant (P < 0.001) difference in the Borg’s scale of discomfort ratings and leg muscle activity between both groups.
Conclusion: The anti-fatigue mat can have a positive effect in preventing muscle discomfort and reduce muscle activity among the respondents during prolonged standing.

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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.

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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.

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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.

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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.

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Introduction: Computer vision syndrome (CVS) is one of the most common health concerns associated with the extensive use of computers, particularly in the working environment. Since recent studies have shown the high prevalence of CVS, it is necessary to have an appropriate tool for assessing this prevalence. The present research aims to translate the CVS questionnaire and analyze its validity and reliability and assess the incidence of this condition among the staff members at Tabriz University of Medical Sciences.
Material and Methods: The translation of the main questionnaire into the Persian version was carried out in three steps. Two coefficients including the content validity ratio (CVR) and the content validity index (CVI) were used to evaluate the content validity of the questionnaire. The reliability of the questionnaire was examined using two methods including internal consistency (Cronbach’s alpha) and test-retest. In total, 240 participants were asked to fulfill the questionnaire in order to investigate the prevalence rate of CVS among the staff members of Tabriz University of Medical Sciences. After removing the ineligible ones, 219 questionnaires were examined.
Results: The internal consistency coefficient and Cronbach’s alpha coefficient were 0.91 and 0.89, respectively. Out of a total of 102 women and 117 men, only 19 women and 21 men did not have CVS. Among the studied symptoms, eye redness (78.1%), burning (76.7%), and headache (74%) were the most prevalent in the statistical population. No significant relationship was observed between the final score of CVS and gender.
Conclusion: In terms of validity and reliability, the questionnaire was found to be satisfactory. The prevalence of CVS among the staff members of Tabriz University of Medical Sciences was high (81%). To determine the etiologies, further research is needed.

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Introduction: Colored noises with acoustic and psychoacoustic characteristics have several biological effects on human or animal health. While studies on auditory effects focus on noise’s physical aspects, its psychoacoustic aspects can also result in health and safety risks. Therefore, this study aims to investigate frequency-based damages due to exposure to colored noise in an animal model.
Material and Methods: Twenty-four male Wistar rats were randomly divided into four groups (6 in each group). The groups included the control (no exposure) and three exposure groups (white, pink, and violet). The rats were exposed to 110 dB SPL for 4 hr/day for 14 consecutive days. Auditory brainstem responses (ABR) with click and tone-burst stimuli were recorded one day before (baseline), 7, and 14 days after exposure. Statistical analyses were conducted using ANOVA and repeated measures ANOVA.
Results: There was a statistically significant increase in ABR threshold values in exposure groups (p<0.05). Hearing threshold shifts in the white noise group showed a homogeneous pattern, violet noise showed an increasing pattern, and pink noise showed a decreasing pattern in low frequencies and a homogeneous pattern with increasing frequency. The highest shift in hearing threshold was observed in exposure groups from day 0 to 14. Additionally, the shift in hearing threshold in the second week was less than in the first one.
Conclusion: The current study observed that noise’s power spectral density affected hair cells’ damage severity. Accordingly, pink noise causes less damage to the cochlea compared to white and violet. Over time after noise exposure, cochlear pathogenesis gradually decreases and hair cell lesions become stable.

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Introduction: Many general indicators have been proposed to assess an organization’s safety performance. However, due to their holistic nature, these indicators may not always reflect safety-specific aspects of an organization’s performance. In other words, the nature of an organization’s activities necessitates the use of specific criteria to better reflect safety performance. This study aimed to identify and measure key safety performance indicators using the Delphi method in Alborz Province Electric Power Distribution Company.
Material and Methods: This descriptive, survey-based study utilized the Delphi method to collect the opinions of 11 safety experts in the electric power distribution industry. Opinions were gathered in four phases, and key indicators were determined in the last phase of the study. These indicators were subsequently used to evaluate the safety performance of Alborz Electric Power Distribution Company for three months.
Results: This study identified and documented 34 safety activities. The expert group proposed 20 indicators in the first phase of the Delphi method. In the second and third phases, four and one indicators were eliminated, respectively, because they did not receive the required score. The content validity ratio (CVR) and content validity index (CVI) were calculated for the remaining 15 indices in the fourth phase. The results revealed that the mean quarterly performance scores of Alborz Province electric power distribution districts and departments in 2016, including Nazarabad, Savojbolagh, Mehrshahr, Fardis, West, East, Taleghan, and Eshtehard, were 78.9, 54.7, 78.8, 75.9, 75.7, 80.8, 61, and 83.5 out of 100 points, respectively.
Conclusion: The Delphi method is useful for identifying key safety performance indicators. The indicators discovered using this technique are active indicators (pre-accident) that are crucial in determining Alborz Electric Power Distribution Company’s safety performance. These indicators are suggested for use in evaluating the safety performance of other electric power distribution companies.

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Introduction: In many occupations, users must sit for prolonged periods during their job activities. Prolonged sitting is associated with fatigue, leading to postural changes that can increase spinal loads. Despite the importance of this topic in terms of the extent of prolonged sitting and its subsequent adverse consequences, little attention has been given to this occupational activity. Hence, this study investigates changes in neck, trunk, and muscle activities and fatigue levels in prolonged sitting computer tasks.
Material and Methods: Twenty healthy subjects (gender-balanced) from the student community with at least five years of experience in computer work aged between 20-30 years were asked to randomly perform three types of computer tasks for 90 minutes (each task for 30 minutes). Electromyographic (EMG) activities of right and left cervical (ESCR and ESCL), thoracic (ESTR and ESTL), and lumbar (ESLR and ESLL) erector spine and upper trapezius (UTR and UTL) muscles were continuously recorded. Root mean square (RMS) and median frequency were extracted as EMG metrics. Subjects also rated their perceived discomfort using a Visual Analogue Scale (VAS). The effect of time, gender, and their interaction on muscle EMG activities, fatigue, and discomfort were explored.
Results: Time had a statistically significant effect on UTR, ESCR, and ESTR muscle activities. UTL and ESCR muscle activities significantly differed between male and female subjects. Further, the findings confirmed the interactive effect of time and gender on ESTR muscle activity. UTR, ESCR, ESCL, ESTL, and ESLL muscles’ fatigue index changed statistically over time.
Conclusion: The findings confirmed neck and trunk muscles’ fatigue by increasing muscular activity and reducing frequency contents over time, per the subjective rating of discomfort.

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Introduction: Prolonged sitting postures are among the risk factors for musculoskeletal disorders in occupational settings, leading to increased musculoskeletal discomfort in various body regions. This discomfort can negatively impact individuals’ health and impose high costs on society in terms of work absences, early disabilities, and reduced productivity. The purpose of this study is to investigate the effect of stretching exercises on the level of discomfort, muscle activity, and muscle fatigue in the neck and trunk region during prolonged sitting tasks.
Material and Methods: This experimental study was conducted among 20 healthy male and female participants under two test conditions: control and intervention. In the control condition, participants performed cognitive tasks (watching videos, typing, text editing, and nback cognitive test) without any intervention. In the intervention condition, participants performed stretching exercises before each task. The Visual Analogue Scale was used to assess perceived discomfort. Also, muscle fatigue was evaluated using an electromyography (EMG) device and RMS and MPF measures.
Results: Discomfort in hands and arms (p-value=0.04) and lower back (p-value=0.03) during video-watching was higher in the control condition than in the intervention. Regarding muscle activity, the activity of the right cervical erector spinae during the video-watching task was lower in the control condition than in the intervention. In the n-back cognitive test and text editing, the right lumbar erector spinae muscle activity was significantly higher in the control condition than in the stretching exercises intervention. Regarding the left cervical erector spinae, a significant difference was observed between fatigue in control and intervention conditions during the video-watching task. Also, right thoracic erector spinae fatigue in text editing was higher in the control condition than in the exercise intervention; however, for the n-back test, the level of fatigue was lower in the control condition compared to the intervention.
Conclusion: The perceived discomfort in seated computer tasks is generally lower in the exercise intervention compared to the control condition. The stretching exercises used in this study improved muscle activity and reduced fatigue in some of the trunk muscles, although the effects of the exercises depend on the type of task. Overall, muscle fatigue in two cognitive tasks, text editing and n-back, was more affected by stretching exercises than other tasks.

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Introduction: Many industries have multiple factors harmful to health, leading to simultaneous exposure of these factors to each other. Noise is one of the most common physical parameters in the work environment. On the other hand, heat is also increasing due to various energy processes in industries. Therefore, this study was conducted with the aim of determining changes in physiological parameters and visual-auditory attention in acute exposure to heat and noise.
Material and Methods: In this experimental study, 72 individuals (36 men and 36 women) aged between 23 and 33 years participated according to the inclusion criteria. In total, 12 different test modes were performed (3 temperature levels and 4 noise pressure levels). The test was conducted for each person in 4 steps during a specific day. The duration of exposure to each condition was half an hour, and a half-hour rest was given between each test condition. Saliva samples of each subject were collected before and immediately after exposure to noise and heat. Also, The Integrated Visual and Auditory (IVA) was recorded by the participants simultaneously.
Results: The results of combined exposure to noise and heat on visual and auditory attention showed that only two modes of combined exposure, SPL95+WBGT34 and SPL95+WBGT29, caused a significant increase (P < 0.05) in mental workload and a significant decrease (P < 0.05) in visual and auditory attention. In addition, the results showed that independent exposure to noise at the levels of 85 and 95 dB and exposure to heat at higher temperature levels of 34 and 29 degrees Celsius cause a significant increase (P < 0.05) in salivary cortisol after exposure. The results of the effect of combined exposure to noise and heat on salivary cortisol showed that three experimental modes of combined exposure (SPL85+WBGT34, SPL95+WBGT29, and SPL95+WBGT34) caused a noticeable and significant (P<0.001) increase in salivary cortisol.
Conclusion: Indeed, salivary cortisol can be recommended as a physiological index to evaluate noise and heat exposure. It’s also noteworthy that salivary cortisol is more affected by noise and heat exposure than cognitive performance.

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Introduction: Studies have demonstrated that teaching carries a substantial burden of health risks. Prevalent health issues among teachers include asthma, respiratory diseases, musculoskeletal problems, and mental disorders. These problems can be attributed to the specific attributes of their work environment. Consequently, this study aims to investigate the correlation between air quality within educational establishments and the overall health of teachers.
Material and Methods: This systematic review aims to examine the impact of temperature, humidity, and ventilation rates within educational environments on teachers’ health status and thermal comfort. Relevant studies were searched for using the PubMed and Web of Science databases, employing keywords such as teacher, temperature, humidity, ventilation, school, classroom, health symptoms, and thermal comfort (2000-2022). The inclusion criterion was that articles examined teachers’ health and comfort with temperature, relative humidity, and ventilation of the educational place.
Results: Out of the 103 articles found in the initial search, 13 articles were finally reviewed. Six studies investigated the voice abnormalities of teachers due to various factors (including temperature, relative humidity, and the ventilation rate of the educational place) and found that these abnormalities were affected by these factors. Two studies explored the relationship between the prevalence and exacerbation of respiratory symptoms and quality parameters of the indoor environment of educational places. Additionally, five studies investigated the relationship of air quality parameters of educational places with common non-specific symptoms among teachers.
Conclusion: Teachers frequently experience symptoms such as voice disorders, respiratory difficulties, allergies, and other nonspecific ailments, which may be associated with the quality parameters of the indoor environment in educational settings. These parameters include temperature, humidity, and ventilation rate. Consequently, controlling and regulating these parameters within the recommended values can help prevent the onset or exacerbation of these symptoms.

 

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Introduction: Musculoskeletal disorders (MSDs) have a multifactorial nature. Biomechanical factors are one of the most important factors. Consequently, the precise identification of effective factors plays a significant role in controlling and preventing these disorders. Therefore, the current study aimed to identify the awkward upper body postures and their effect on the prevalence of MSDs in office workers in both women and men groups by objective methods.
Material and Methods: In this cross-sectional study, the participants were 36 office workers (18 women and 18 men). The prevalence of musculoskeletal discomfort was evaluated using the Nordic questionnaire. The upper limbs posture, including the back, neck, and wrists, was evaluated continuously with an electronic inclinometer and an electrogoniometer for 30 min, followed by analyzing the collected data.
Results: The results revealed that the highest prevalence of musculoskeletal symptoms in both gender groups was in the neck (58.33%), trunk (52.77%), and wrist (47.22%), respectively. The results disclosed that the median trunk and neck flexion in both groups is over 20° and the posture angle in women is higher than that of men (P<0.05). The results showed that pain and discomfort in the trunk and neck in both gender groups have a significant relationship with the median posture angle (P<0.05). Also, the wrist posture in both gender groups during work was in extension and static condition.
Conclusion: Based on the results of this study, the prevalence of disorders in women was higher than in men. Although the tasks performed in both groups were similar, the assessment of postures disclosed that women office workers had more awkward postures in the trunk and neck than men. In both groups, the prevalence of musculoskeletal discomfort had a significant relationship with awkward postures in the trunk and neck. According to the results of the current study, ergonomic interventions are recommended to reduce awkward postures and to prevent MSDs, particularly among women office workers.