Journal of Health and Safety at Work

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Introduction: The world is currently facing an all-out crisis over the coronavirus disease 2019 (COVID-19). This review study aimed to determine the applications of the assistive intelligent technologies of the Fourth Industrial Revolution (Industry 4.0) in occupational safety and health (OSH) and response to COVID-19.
Material and Methods: The given review was carried out from May to June 2020 and the search strategy was fulfilled in the databases of Google Scholar, PubMed, and Scopus. The keywords were collected from the Medical Subject Headings (MeSH) database and searched individually or in combination. Accordingly, the articles with the term “COVID-19” in their titles or abstracts and some other keywords such as “smart hospital, Industry 4.0, or intelligent technology” were selected and reviewed. Next, the titles, abstracts, and keywords of these studies were examined. To augment the sensitivity of the search, the keywords and the references of the selected articles were also surveyed. Then, the related studies were separated from the irrelevant ones and the duplicates were removed. Finally, the full texts of the selected articles were reviewed.
Results: In this resepct, a total number of 175 studies, published in the databases of Google Scholar, PubMed, and Scopus in 2020 were retrieved. According to the inclusion and exclusion criteria and qualitative screening, 30 articles were included in this review. The assistive intelligent technologies such as artificial intelligence (AI), the internet of things (IoT), big data, virtual reality (VR), holography, cloud computing, autonomous robots (autorobots), three-dimensional (3D) scanning, 3D printing, and biosensors were established as useful ones to respond to COVID-19. In addition, AI and autorobots could be the most significant technologies of Industry 4.0 in the incoming articles.
Conclusion: These technologies can thus help governments to identify, track, monitor, and treat patients and increase resilience in society and workplace environments during the COVID-19 pandemic.

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Introduction: Considering the importance of implementing occupational safety and health management systems for the prevention of various diseases in the workplace, as well as determining the notability and role of induction and implementation of occupational health management systems in controlling and reducing COVID-19 outbreak in work environments, as one of the most sensitive and important of society sectors, this study aimed to compare the prevalence of Covid-19 disease in two groups of industries with and without occupational health management systems and related management risk factors in several industries, in Iran.
Material and Methods: This cross-sectional study was performed in May 2020 during the outbreak of coronavirus in some industries under Shahid Beheshti University of Medical Sciences’ supervision. During the present study, 70 industries included 24 industries active in chemical products, 6 industries of automotive parts manufacturing, 14 industries of home appliance manufacturing, 16 industries of health and cosmetics products, 4 industries of metal products, and six service companies were studied. The studied population included two industries with an occupational health management system (33 industries) and industries without an occupational health management system (37 industries). In this study, a checklist was designed to collect study data based on the requirements and parameters of occupational health management systems, as well as information related to infectious diseases such as COVID-19, which included information on COVID-19 disease in two groups of studied industry, occupational medicine, biological hazards risk management, occupational health information management system, training, and employee participation, as well as the management parameters of COVID-19 outbreak. Statistical analysis of the study data was performed using the Chi-square test and Fisher’s exact test by SPSS. 23 software.
Results: The number of workers working in the two groups of industries with and without occupational health management systems was 673 and 708, respectively. Among 33 industries with occupational health management systems, 12.1% industries had health, safety, and environment management system (HSE-MS), 66.7% industries had OHSAS 18001:2007 standard, and 21.2% industries also had ISO 45001:2018 certification. It was found that the prevalence of Covid-19 disease in those industries without occupational health management systems was significantly higher (p <0.05). It has been found that Covid-19 outbreak in industries without occupational health management systems was significantly higher (p<0.05). The findings also showed that there was a significant difference between the parameters of occupational medicine, risk management of biological hazards, occupational health information management system, training and employee participation, as well as the management parameters of COVID-19 disease in the two groups of studied industries (p<0.05).
Conclusion: The findings of the present study indicated that there was a significant relationship between the scores of occupational medicine parameters and occupational health information management system, risk management of biological hazards, training and employee participation, management of COVID-19 and finally the prevalence of the disease among industries with or without occupational health management system. So, implementation and establishment of occupational health management systems can be an effective step in reducing the prevalence of viral and infectious diseases such as COVID-19.

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Introduction: Considering the importance of identifying and tracing primary sources of Covid-19 crisis in infection control, this study was carried out with the aim of identifying the occupational tasks effective in transmitting Covid-19 in the event of death of a female staff in medical record unit in Shafa Takestan Hospital (Qazvin Province).
Material and Methods: This case study was performed on the death of a 26-year-old married woman working in the medical records department of Shafa Takestan Hospital in March 2019. After identifying and completing the tasks, hazards analysis was performed and finally, various tasks and amount of the Covid-19 sources were determined.
Results: Covid-19 risk sources are classified into three groups of human resources with 51 cases (38.06%), office tools and equipment with 46 cases (34.33%) and paper with 37 cases (27.61%). Four tasks were identified as major tasks with a 59.90% of the total number of COVID-19 risk sources. In this study, two critical tasks were determined with the titles of “reply to requests of forensic medicine and insurance” and “reviewing patients’ surgical reports” that contained a total of 39.06% of the Covid-19 sources.
Conclusion: The results showed that the human resources in two major tasks were the most critical sources of Covid-19. So, the control of these critical tasks is of special importance. The results also showed that it is necessary to transfer the special and unusual tasks to the time after the crisis, in order to reduce the sources of Covid-19 contamination.

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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: The COVID-19 pandemic caused many businesses to face problems and created job insecurity, leaving many workers and employees stressed about losing their jobs. Therefore, the current research aimed to analyze the impact of workplace safety management measures on the behavior of organizational citizens concerning the role of job insecurity and the perceived risk of COVID-19 among the employees of Mashhad Social Security Organization.
Material and Methods: The current applied research is a descriptive survey. The research population is all 560 employees of the social security organization of Mashhad city. The sample size was estimated based on Morgan’s table using a convenience sampling method, with a total number of 225. The data collection instrument was Wu et al.’s (2022) standard questionnaire, used to check construct validity and confirmatory factor analysis. Cronbach’s alpha coefficient and composite reliability were used to measure reliability, and the results showed that the questionnaire was adequately valid and reliable. The data analysis also involved structural equation modeling conducted in Smart PLS.
Results: The results showed that workplace safety management measures have an impact on organizational citizenship behavior and the perceived risk of COVID-19. Also, the perceived risk of COVID-19 has a positive effect on perceived job insecurity. Yet, the perceived risk of COVID-19 does not influence organizational citizenship behavior and does not mediate the relationship between workplace safety management measures and organizational citizenship behavior. Workplace safety management measures have an impact on perceived job insecurity, and job insecurity has an impact on organizational citizenship behavior.
Conclusion: In light of the present findings, it can be concluded that workplace safety management measures are among the most important programs and strategies of organizations to increase citizenship behaviors, support employees, and provide safe conditions in an organization.

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Introduction: The COVID-19 pandemic has been a significant global health challenge. Primary care services, such as screening health centers, were crucial in identifying infected individuals. However, these centers were often crowded and posed a high risk to staff and non-COVID-19 patients. This study aims to assess the risk of airborne transmission of SARS-CoV-2 in such settings through simulation.
Material and Methods: In this study, waiting and sampling rooms of a COVID-19 healthcare center were simulated using different scenarios. Then, the Quanta emission rate was estimated using the viral load in the sputum of infected individuals. Finally, the airborne transmission risk of SARS-CoV-2 was determined using the Wells-Riley method for scenarios of wearing and without masks.
Results: The study showed that the Quanta emission rate in an unmodulated speaking activity was higher than other expiratory activities in both units (p <0.001). Also, the total amount of Quanta was slightly higher in the sampling room than in the waiting room, which was not statistically significant. On the other hand, the calculation of transmission risk showed that the probability of airborne virus transmission in the sampling room was higher (about 2 to 8%). In addition, wearing masks reduced the possibility of airborne transmission of the virus significantly (77 to 81%).
Conclusion: This study shows that the level of risk in the sampling and waiting rooms is moderate. Masks also significantly reduce the possibility of airborne transmission of SARS-CoV-2. Taking appropriate health and safety measures such as avoiding crowds, wearing masks, whispering, and monitoring social distancing can reduce the plausibility of airborne transmission of the SARS-CoV-2 virus.
 

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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. 

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Introduction: The prevalence of COVID-19 has significantly impacted work environments and the workforce. Therefore, identifying the most important preventive and control strategies, as well as assessing their effectiveness, is of paramount importance. Various studies have shown that machine learning algorithms can be used to predict complex and nonlinear issues, including predicting the behavior of various diseases such as COVID-19 and the parameters affecting it, and can be beneficial. The purpose of this study has been to examine the importance of preventive measures and hygiene behaviors in preventing COVID-19 in the oil refining industry using various machine learning models.
Material and Methods: For this purpose, demographic information and health behaviors of individuals were collected. Subsequently, a multi-layer perceptron (MLP), radial basis function (RBF), and support vector machine (SVM) models were compared to enhance the analysis of the effects of preventive measures on COVID-19 infection. Finally, the most influential factors affecting the likelihood of COVID-19 infection were determined using sensitivity analysis.
Results: The results showed that the accuracies achieved in predicting the impact of preventive measures and health behaviors on COVID-19 in occupational settings were 78.1%, 81.2%, and 78.1% by MLP, RBF, and SVM respectively. The RBF model was identified as the most accurate model for predicting the impact of health behaviors on COVID-19 disease Additionally, the level of social distancing with customers, handwashing frequency and disinfection, the availability of cleansing and disinfecting agents for hands and surfaces in the workplace, and gatherings for eating meals and snacks were identified as the most significant health behaviors influencing the prevalence of COVID-19 in the workplace.
Conclusion: Studies of this nature can underscore the importance of attention to preventive measures and health behaviors in unprecedented circumstances. Furthermore, the utilization of artificial intelligence models and tools such as DSS (Decision Support Systems) can serve as powerful tools for optimizing control measures in work environments.