Journal of Health and Safety at Work

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Introduction: Covid-19 pandemic has imposed a significant effect on mental health of the health care workers. The present systematic review and meta-analysis aimed at determining the pooled prevalence of anxiety and depression among Iranian health care workers during the Covid-19 pandemic.
Material and Methods: To conduct this systematic review and meta-analysis, Web of Science, Scopus, Medline (PubMed), Embase, SID, Magiran databases and Google Scholar search engine were investigated to find studies over the prevalence of anxiety and depression among health care workers during the Covid-19 pandemic from December 2019 to June 10, 2021. Quality of the primary studies was assessed using the Newcastle-Ottawa tool and the random effects model was applied to estimate the pooled prevalence. Furthermore, χ2 test and I2 index were used to evaluate the degree of heterogeneity among the studies. The pooled prevalence of anxiety and depression in different subgroups was reported based on the severity of anxiety and depression, assessment tools, and staff jobs.
Results: Of 488 articles obtained as a result of the initial search, 10 related studies were identified and entered into the systematic review and meta-analysis. The pooled prevalence of anxiety was 42% (95% CI: 25-75) and the pooled prevalence of depression was 35% (95% CI: 19-55). The pooled prevalence of anxiety was 54% (95% CI: 39-70) in the occupational group of nurses and 29% (95% CI: 17-44) among all health care workers. The pooled prevalence of depression was 46% (95% CI: 30 to 63) and 17% (95% CI: 10 to 26) among nurses and all health workers, respectively.
Conclusion: According to the findings, a high prevalence of anxiety and depression was observed among the health care workers of Iran during the Covid-19 epidemic. The authorities are required to plan for preventive and therapeutic interventions to reduce the psychological burden of the epidemic.

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Introduction: Health workers, especially nurses, are facing a high risk of contracting the COVID-19 and consequent mental disorders such as stress, anxiety and depression. We aimed to study the relationship between anxiety, stress and the protective behavior of nurses during the Covid-19 pandemic.
Material and Methods: This cross-sectional study was conducted on nurses working in COVID -19 referral hospitals in Qazvin, Iran, in 2020. Out of 645 nurses working in two hospitals, 260 of them were selected randomly. Three questionnaires including demographic and contextual information, COVID-19 anxiety, stress and precautionary behaviors against COVID-19 were used. Descriptive statistical methods, Pearson correlation, t-test and one-way analysis of variance and binary logistic regression analysis were applied at 95% confidence interval.
Results: The prevalence of anxiety symptoms in nurses was 32.08%, the mean score of protective behavior was 18.45+5.66 and the maximum score was 22.06+4.7. The negative relationship between anxiety and nurses precautionary behavior) β=-0.36, P<0.05) and the significant effect of COVID-19 stress on nurses’ behavior) β=-0.22, P<0.05) were confirmed. Furthermore, adding stress as an interfering factor, affirmed the mediating role of stress in the relationship between anxiety and nurses’ precautionary behavior (β=-0.18, P<0.05). Nurses under 35 years of age were more likely (OR=1.62, P=0.004) to follow the protective rules; those with 6 to 10 years of hospital experience were respectively 32 times and 37 times more probable to use personnel protective equipment (PPE) (OR=1.32, P=0.002) .
Conclusion: The probability of effective use of PPE and observance of protective guidelines among nurses with severe and very severe anxiety levels was less than their counterparts. While in those with controlled level of stress level such obedience was much more probable. Therefore, all health service providers, need to develop supportive programs to emphasize on the promotion of employees’ mental health.

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Introduction: People’s risk perception in an emergency situation affects how they behave. During the pandemic of a disease like COVID-19, the fear of the disease and its consequences causes people to deal with anxiety. The present study was conducted with the aim of determining the relationship between the perception of the risk of COVID-19 and the experience of anxiety caused by it among workers in manufacturing industries. 
Material and Methods: The present descriptive-analytical study was conducted cross-sectionally in 2022 among 545 workers of manufacturing industries located in Tehran, Mazandaran and North-Khorasan provinces. In the study, data collection was conducted using three questionnaires: a demographic information questionnaire, the COVID-19 Disease Anxiety Scale (CDAS), and the COVID-19 Risk Perception and Psychological Predictors against COVID-19 questionnaire. Data analysis was done using descriptive (mean and standard deviation) and analytical statistics (Canonical Correlation Coefficients or CCC) in SPSS V25 software.
Results: The mean ± SD of the workers’ age was 35.98 ± 7.58 years, while the scores for risk perception and anxiety were 12.89 ± 3.31 and 4.51 ± 1.51, respectively. The Concordance Correlation Coefficient (CCC) between risk perception and anxiety caused by the COVID-19 disease in the first Canonical point was 0.734, and in the second Canonical point, it was 0.229. The corresponding p-value was found to be less than 0.01. Psychological symptoms (Canonical loading = -0.725) and physical symptoms (Canonical loading = -0.421) played a significant role in predicting the variability of the risk perception of COVID-19.
Conclusion: The perception of risk related to the COVID-19 disease resulted in a decrease in anxiety, having a more pronounced effect on psychological symptoms compared to physical symptoms. Therefore, in times of pandemic outbreaks similar to COVID-19, implementing measures that enhance workers’ awareness and understanding of the disease risks can prove effective in managing anxiety.