Journal of Health and Safety at Work

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Introduction: Train driving is a high responsibility job in railway industry. Train drivers need different cognitive functions such as vigilance, object detection, memory, planning, decision-making. High level of fatigue is one of the caused factor of accidents among train drivers. Numerous factors can impact train drivers’ fatigue but high level of workload is a key factor. Therefore, the aim of the present study was to investigate workload and its relationship with fatigue among train drivers in Keshesh section of Iranian Railway Company.

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Material and Method: This descriptive analytical study was done among 100 train drivers in Keshesh section of Iranian Railway industry. They were selected by simple random sampling. The NASA-TLX workload scale and Samn-Perelli fatigue scale were respectively used to investigate workload and fatigue. Data were analyzed by Paired t-test and Spearman correlation coefficient.

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Result: According to the NASA-TLX results, effort and mental workload with the mean score of 74/22 and 73/31 were respectively the most important attributes of workload among train drivers. No significant relationship was observed between workload and level of fatigue before departure and half an hour before reaching the destination station (P>0.05). However, the relationship between of workload and level of fatigue half an hour before the end of shift (on the way back to the origin station) was statistically significant (P=0.048) among the sample population.

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Conclusion: Effort and mental workload were the most important attributes of workload among train drivers. By focusing on these two variables and adopting fatigue management programs, fatigue and workload can be controlled and the efficiency of the whole system can be enhanced accordingly.

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Introduction: Control room is one of the most important working environments that require optimal performance of individuals to minimize errors. Lighting is one of the environmental factors affecting the operation of the control room operators. Providing optimal lighting in the control room is very important. The purpose of this study was to determine the effect of light on workload, sleepiness, eye fatigue, and satisfaction of individuals from light conditions.

Material and Method: This was an interventional study conducted in a control room of a power plant. Intervention in the control room lighting was performed with two lighting systems including fluorescent lamps (4000 Kelvin, 200 lux) and LED lamps (4,000 Kelvin, 400 lux). Sixteen operators were evaluated under the two lighting systems in terms of workload, sleepiness, eye fatigue and satisfaction of individuals from light conditions.

Result: According to the results, eye fatigue significantly decreased after intervention (p (0.004>. Also, the higher light intensity, significantly decreased the level of sleepiness (p <0.001). In the study of workload, the amount of mental workload (p <0.001) and effort (p <0.03) decreased significantly, after intervention and the increase in the intensity of light; but physical demand, temporal demand, performance and frustration had no significant difference with the results before intervention.

Conclusion: In general, a combination of fluorescent and LED lighting systems, with 400 lux intensity, can provide optimal functional and mental conditions for control room operators. The illumination intensity of 400 lux in terms of workload, sleepiness, eye fatigue and the degree of satisfaction of individuals from light conditions provides a much better environmental condition than 200 lux.

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Introduction: Examining the effect of bus drivers’ demographic characteristics as well as workplace conditions on their traffic behavior and performance is important not only for drivers’ health and safety, but also for the safety of bus passengers. The aim of this study was to investigate the relationship between demographic variables and work shift schedule on the behaviors pertaining to “hazard monitoring”, “relax driving”, “fatigue proneness”, and “thrill seeking” among intercity bus drivers.

Material and Method: In this cross-sectional study a sample of 321 bus drivers were randomly selected from Tehran intercity bus terminals. The BDRI questionnaire was used to collect data. The Pearson’s correlation coefficient and the ANOVA and Tukey’s HSD tests were used to analyze the data.

Result: In general, the findings showed that age, driving experience and rest time period positively correlate to lower fatigue, lower thrill seeking and more relaxed driving. Drivers with higher vehicle age were found to perform worse than others in hazard monitoring and to be more prone to the stress and fatigue. Also, fatigue and relaxed driving were significantly related to the marital status and cigarette usage. In addition, drivers who were college graduate or above were found to perform worse than other drivers considering all of the four factors. Furthermore, those who drive in mountainous routes were found to perform worse than other drivers in hazard monitoring and fatigue proneness.

Conclusion: Since the age and driving experience were found to influence fatigue proneness, hazard monitoring and relaxed driving, thus, setting up specific training courses for different driver age groups aiming to enhance their awareness concerning on managing these factors might help drivers improve their performance in these factors. Furthermore, regarding the effect of rest period and route type on the drivers’ fatigue and hazard monitoring ability, appropriate regulations are needed to mitigate the effect of these factors on the performance of drivers.

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Introduction: Nowadays, working in any computer work stations, named visual display terminal (VDT), was widespread and has become popular in our lives. Due to the increasing trend of using computers in the administrative and social institutions, prevalence of eye-related signs of working with computers is still increasing and it is one of the most important health issues. Computer jobs are low-mobility and require little energy to do physical work, but require more cognitive processing and mental focus. Visual fatigue is an occupational hazard for people working with computers. Eye fatigue has symptoms such as headaches, job discomfort, and eye pain the purpose of this study was to have a systematic review on eye fatigue, dry eye and eye blink among people working with visual terminals.  
Material and Methods: Internet search databases and search engines were used to find articles with focusing on the impact of risk factors on eye indexes on computer users. In this study, related articles were obtained from websites, including: PubMed, Google Scholar, Scopus and Web of Sciences. The keywords were used to search in these websites were: computer user, eye fatigue, dry eye and eye blink. Accordingly, after finding 115 relevant articles from the related sites, 17 articles were finally selected.
Results: Findings show that using computer cause many problems in the eye. Duration of using the computer, the type of work with the computer, the mental load, the distance from the monitor, and also long-term use of the computer without break in during work can cause dry and fatigue eye in users, which is one of the most common ocular problems among computer users.
Conclusion: According to the finding and results recommended to reduce of dry and fatigue eye, distance of users from the monitors, be more than 50cm, use 20-20-20 law to rest user’s eyes, and  Positioning the monitor be 15-20 degrees below the user’s line of sight. Also, too much focus on the screen reduces blinking and resulting in dry eyes. In order to prevent dryness of the surface of the eye, it is recommended that the eyelid be optional even if possible. Increasing the contrast of the monitor can be helpful in reducing stress and strain on the eye while working with a computer and using glasses instead of lenses to correct refractive errors and one of the ways to control and improve dry eye is using artificial tears by computer users.

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Introduction: Stressfull innate of the operating room, unpredictable types of activities, and prolonged standing during surgeries cause chronic fatigue in surgical technologists, resulting in reduced quality of care. It is essential, therefore, to provide especialized methods to reduce the surgical technologists’ fatigue severity.. This study was conducted to evaluate the effect of concomitant exercise and inhalation of lavender fragrance on surgical technologists’ fatigue severity.
Material and Methods: Ninety seven surgical technologists were recruited  in this clinical trial study, working in the operating rooms of Tabriz educational hospitals. They were randomly divided into three groups (Exercise, Lavender & Control) after fulfilling informed consent ,. The instruments for data collection included demographic information form as well as a multidimensional fatigue inventory questionnaire. In the experimental groups, concomitant exercise training and Lavender inhalation were both used for a period of six weeks while no intervention was given to participants in the control group. Statistical analyses were carried out using SPSS 20 as  well as  ANOVA and repeated measurement tests.
Results: No significant difference was observed between Exercise, Lavender, and Control groups regarding demographic characteristics (P>0.05). The mean score of fatigue between exercise and control groups and between Lavender and control groups showed a significant decrease (P<0.05). However, the results showed no significant difference statistically between the exercise and Lavender groups (P>0.05).
Conclusion: The concomitant exercise and Lavender fragrance in the operating room positively affect and reduce the fatigue severity in surgical technologists. Planning to implement similar interventions in the operating room is recommended.

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Introduction: Nowadays, excessive computer use in the workplace has raised concerns about the health status of VDT workers, particularly complaints about eye discomforts. Due to the importance of the eyelids and eye closure parameters on eye health during computer works and the direct effect of monitor height on these parameters, this study was aimed to examine the effect of different monitor heights adjustment on the eye indicators and eye discomfort among participants.
Material and Methods: In this study, any changes in the eye indicators including blink rate, the eye blink opening and closing time, the blink opening rate in three different monitor heights (standard, low, and high) were examined among 11 participants. The blink rate and the eye blink opening and closing time were measured and evaluated using videotaping and analyzing by an image processing software, developed in this study. Participants were also asked to complete a questionnaire for eye fatigue assessment due to daily computer uses.
Results: Results showed that the highest rate of eye blink was at the standard height of the monitor, and this rate was significantly different at three different heights of monitors (high, standard, and low) (p<0.05). The lowest blink rate was observed at low and high heights with an average of 7.3 and 7.8 and the highest blink rate at standard height with an average of 8.9 blink per minute, respectively. Meanwhile, image processing and analyzing of eye surface showed, in average, 16% decrease in the opening rate of the eye surface by decreasing the height of the monitor, and 15% increase by increasing it, relative to the standard mode of monitor.
Conclusion: To protect users from computer-related eye strain, it is recommended to correct monitors height to the standard height along with typing and data entry training for keyboarding skill development and minimizing working times as a result. What is more, a proper work-rest schedule when working with computer can be considered as an effective countermeasure to prevent from eye strain.

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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: Occupational fatigue is one of the harmful factors in many work environments, including health centers, which can have adverse effects on the health and safety of staff. This study was designed and conducted to determine the relationship between occupational fatigue and elements of the systems engineering model for patient safety in nurses.
Material and Methods: This descriptive correlational study was conducted with the participation of 457 nurses of Shahid Beheshti University of Medical Sciences in 2018. Dimensions of fatigue were assessed by a Multidimensional Fatigue Inventory (MFI) and Systems Engineering Initiative for Patient Safety (SEIPS) model’s elements using the SEIPS model’s questionnaire. Validity was examined using the Lawshe method; calculating Content Validity Ratio (CVR) and Content Validity Index (CVI) was approved through the confirmation of experts. Reliability was assessed using the intraclass correlation coefficient (ICC) and Cronbach’s alpha. Data analysis was performed using SPSS version 21
Results: The findings of this study indicated that the highest score of fatigue was related to the general fatigue dimension with an average of 12.86 and SD of 3.23, and the lowest score was related to the reduction of the motivation dimension with an average of 9.11 and SD of 3.66. In this study, no significant relationship was observed between demographic characteristics and fatigue dimensions, but a significant relationship was observed between the dimensions of fatigue with the element of organization, task, technology/tools, and physical environment.
Conclusion: The results of this study showed that fatigue in nurses was moderate, and the factors of the work system play a greater role in the occurrence of fatigue than demographic factors. Therefore, planning to improve the work system can help reduce fatigue in nurses.

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Introduction: Given the high prevalence of low back pain in manual handling activities, its known relationship with spinal loads, and the role of muscular fatigue and the body’s adaptive mechanisms to counteract fatigue, this study investigated the effect of repetitive lifting tasks on trunk muscular fatigue and the kinematics of the spine and load-in-hand.
Material and Methods: Eighteen male volunteers lifted a box from the floor to their waist height at a pace of ten lifts per minute until they could no longer continue the task and reported the highest level of exhaustion. Kinematic data and muscle electromyographic activity were simultaneously recorded using a motion capture system and an electromyography device. In this study, average trunk flexion angle and trunk angular velocity were calculated as trunk kinematic variables, while average box vertical travel distance, average box horizontal displacement from L5-S1, and average box vertical displacement velocity were considered as box kinematic variables. The median frequency of electromyographic signals from selected muscles was quantified as a muscle fatigue indicator. Since subjects performed different lifting cycles, the total number of cycles was divided into five distinct blocks for data analysis.
Results: The results showed significant effects of lifting trial blocks on trunk angle (p=0.004) and vertical box displacement (p<0.001). Median frequency was significantly affected by lifting blocks for right (p=0.016) and left erector spinae (p=0.014), right (p=0.021) and left multifidus (p<0.001), right latissimus dorsi (p=0.001), and left rectus abdominis (p=0.039).
Conclusion: Overall, the results highlight variations in most kinematic parameters and a reduction in the frequency content of EMG signal spectra. These changes serve as indices of the central nervous system’s control over lifting behavior under dynamic conditions. A better understanding of these central nervous system adaptations could have practical applications in interventions such as workstation design, exoskeleton development, and worker training to manage musculoskeletal disorders.

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Introduction: Physical fatigue is one of the major risk factors for work-related musculoskeletal disorders and has many life and financial costs. The impact of physical/biomechanical, psychosocial, environmental, and individual risk factors on muscle fatigue is undeniable. The aim of this study is to model the phenomenon of muscle fatigue (as output) in the hand in work environments based on these risk factors (as input) using soft computing methods.
Material and Methods: In the first step, associated risk factors of fatigue for 156 subjects (in three job categories) were assessed using Copenhagen environmental, psychosocial, demographic, and Man-TRA tools. Then, the Roman-Liu equation and mean square amplitude of acceleration waves were used to measure fatigue with a dynamometer and a three-axis accelerometer, respectively. Finally, according to the nature of risk factors and the phenomenon of fatigue, six categories (24 methods) of supervised machine learning (SML) based on classification were selected. MatLab software (MatLab R2017b, The Mathworks Inc., MA, U.S.A.) was used to fit the models using SML.
Results: The best-fitted models in the first and second half of the work shift were obtained using support vector machine methods. Physical risk factors had a significant impact on physical fatigue. After filtering low-priority risk factors, in the first half of the work shift, the most optimal model had an accuracy of 71.8%, precision of 72.5%, sensitivity of 76.9%, specificity of 70.8%, and discrimination power equal to 73%. In the second half of the work shift, the accuracy, precision, sensitivity, and specificity of the optimized model were 60.3%, 57.5%, 50%, and 46.9%, respectively, and the discrimination power was obtained at about 62%.
Conclusion: The fitted models for hand fatigue had acceptable performance in both sections of the shift but can still be optimized. Therefore, it is necessary for future studies to improve the quality of input and output data and include other dimensions affecting fatigue such as cognitive workload and type of work shift in future models.

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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: Compared to other hospital departments, emergency department (ED) nurses experience higher levels of occupational fatigue. However, despite the importance of fatigue in EDs, limited studies have investigated the issue. Therefore, the present study aimed to identify factors affecting ED nurses’ fatigue with a systemic approach and provide a comprehensive model of fatigue.
Material and Methods: The present study was the first phase of a mixed-methods study with an exploratory sequential design that was conducted qualitatively. Data was collected using a semi-structured interview technique among ED nurses in TUMS hospitals in Tehran. The data was analyzed with a systematic approach and qualitative content analysis method. To check the credibility and trustworthiness of the study results, Goba and Lincoln criteria, including transferability, peer review, and member check, were used.
Results: Extensive factors were identified in the four levels of nurses’ work system, including individual factors, work unit, organization, and extra-hospital factors that could facilitate or prevent nurse fatigue. Specifically, the categories that were mentioned the most by the nurses were aggression and conflict with visitors, ED workload, understaffing, crowding and noise, obligatory overtime, acknowledgement, visitor’s expectations, reporting (paperwork), and clients’ distrust of nurses. Finally, based on the qualitative results, a conceptual model of factors affecting occupational fatigue of ED nurses in Tehran was presented.
Conclusion: Traditionally, fatigue management programs in hospitals only consider issues related to work shifts and sleep hygiene. However, the results of the present study revealed other fatiguing factors in the work system of ED nurses. These findings can help health system decision makers and HFE experts in designing effective fatigue risk management systems in Iranian hospitals, especially in emergency departments.

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Introduction: Fatigue, caused by prolonged standing activities, affects postural stability through disrupting somatosensory system functions. The application of sub-threshold mechanical vibration can enhance the sensitivity of the mechanical receptors in the sole of the feet. Improved sensory function leads to better movement control and balance. Therefore, this study investigated the effectiveness of vibration-based active insoles in reducing the impacts of fatigue on postural stability among military forces.
Material and Methods: Each of the 20 healthy male participants of the study completed three standing balance tests: 1) on both legs, 2) on one leg, and 3) on one leg with a cognitive secondary task for two states of the vibration system (on and off), before and after a fatigue protocol, on a force plate. The activity of leg muscles was also monitored by electromyography (EMG). The mean as a linear index (amount) and the sample entropy (SaEn) as a non-linear index (structure) related to the resultant distance of the body’s center of pressure (CoPRD) displacements, as well as the normalized percentage of the muscle activity level (linear envelope), were used for statistical analyses.
Results: Significant changes in most of the postural and muscular parameters were recorded after the fatigue protocol for the off-mode of the vibration system. Meanwhile, running the vibration system of active insoles was accompanied with no significant differences in the amount and structure of the CoPRD displacements, as well as the activity level of the lateral gastrocnemius and soleus muscles after fatigue, compared to the measurements before fatigue.
Conclusion: The findings confirm the effectiveness of applying sub-threshold mechanical vibration to the sole of the foot in improving standing balance by reducing the negative effects of fatigue on postural stability parameters. Therefore, it is suggested that the use of active insoles can be an effective, feasible, and accessible ergonomic intervention to address fatigue among military forces. 

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Introduction: Considering the abundance and the large number of workers employed in micro and small industrial workshops in Iran and the importance of workers’ health, the present study aimed to investigate the mediating role of chronic fatigue in the relationship between mental workload and work ability with cognitive failure using path analysis.
Material and Methods: This study was conducted using a cross-sectional design on a sample of workers employed in micro and small industrial workshops in the city of Eghlid. Data were collected utilizing various measures, including demographic and occupational information questionnaires, the NASA Task Load Index (NASA-TLX), the Work Ability Index (WAI), and questionnaires for chronic fatigue and cognitive failure. The correlation test and path analysis modeling were used in SPSS (version 24) and AMOS softwares to investigate the relationship between variables.
Results: The mean scores of mental workload, work ability, chronic fatigue, and cognitive failure  
were 69.63, 35.20, 15.58, and 53.30, respectively. The values of the goodness of fit indices lead to  
the confirmation of the conceptual model by the research data. Also, based on the findings of the path analysis, the current research model has a good fit (CFI=1.00, GFI=0.998, NFI=0.999, AGFI=0.98 and RMSEA=0.003(0.00,0.169)).
Conclusion: The path analysis results indicate that chronic fatigue plays a significant mediating role  
in the relationship between mental workload and work ability with cognitive failure. A better understanding of the mediating mechanisms and complex effects of these relationships can contribute to improving the management of chronic fatigue and enhancing cognitive performance in the workplace.
 

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Introduction: Heat stress is a common environmental risk factor for many occupations, which can lead to increased fatigue during cognitive tasks. Fatigue is a multifactorial phenomenon that is affected by various environmental, physiological, and psychological factors, and can affect biomechanical, physiological, and psychological components. This study focuses on the impact of environmental, individual, and physiological factors, and burnout on general fatigue.
Material and Methods: This descriptive-analytical study was conducted among 189 employees of the Iran Oil Company at both indoor and outdoor workstations. Heat stress was measured using the (WBGT) index, and thermal strain risk was evaluated. Variables such as skin temperature, ear temperature, blood pressure, and heart rate were also monitored. To assess general fatigue and occupational burnout, (MFI) and the Maslach Burnout Inventory were completed by the employees.
Results: The results revealed that 79.9% of the employees were exposed to heat stress, with repair workers experiencing the highest levels of emotional exhaustion (23/38), depersonalization (15/34), general fatigue (10/00), and physical fatigue (9/05).  Statistically significant relationships were found between heat stress and fatigue and decreased motivation, between all components of burnout and general fatigue, and between core temperature, blood pressure, and general fatigue (p<0.05). Notably, demographic factors such as marital status, smoking status, and education level did not significantly influence fatigue scores.
Conclusion: Fatigue is strongly associated with heat stress, physiological variables such as body temperature and blood pressure, burnout, personal habits such as sleep duration and exercise, and the type of job. These findings suggest that in hot work environments, monitoring physiological variables and environmental factors can help identify and address fatigue issues.

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Introduction: Commercial trucking is one of the most challenging occupations, with long work hours, short rest periods, and substantial psychological pressures that contribute to fatigue and deterioration at work. Since regular physical activity is one of the pillars of healthy life and can improve physical and mental functioning, the present study investigated the relationship between physical activity and driver performance with occupational fatigue as a possible mediator.
Material and Methods: The study population was intercity commercial truck drivers in several cities of Razavi Khorasan Province. Using Green’s formula, we calculated a sample size of 140 participants. Data were collected with the Swedish Occupational Fatigue Inventory, the Sharkey Physical Activity Questionnaire, and the Driver Performance Questionnaire (unsafe behaviors). Statistical analyses included Pearson correlation coefficients and multiple regression analyses.
Results: Our results showed a significant positive correlation between occupational fatigue and driver performance problems (P=0.001). Both the correlation between physical activity and work fatigue, and the correlation between physical activity and driver performance were significant negative correlations (P=0.001). In addition, the indirect link between physical activity and driver performance via occupational fatigue was also significantly negative (P=0.001).
Conclusion: Based on our research results, enhanced physical activity contributes to enhanced driver performance (decreased unsafe behaviors) of commercial truck operators, directly and indirectly through decreased occupational fatigue. This study provides scientific evidence for the development of safety policy in the transportation industry of Iran.