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: Musculoskeletal disorders are the most prevalent problem in the workplace. Unsafe manual material handling is amongst important causes of such disorders. Unsafe manual material handling can result in different musculoskeletal disorders such as acute physical injuries and increase of strain in back, shoulders and arms. United state society of orthopedic surgeons ranked back pain as the most costly disorder, which workplaces are considered to be responsible for most of them. Few studies compare related national and non-national standards in Iran. Therefore, the aim of the present study was to compare Iranian manual material handling regulation, NIOSH equation and MAC method in one of metal casting industries in Tehran, 2001.

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Material and Method: In this cross-sectional study, participants were randomly selected among men workers, working in industry. Data collection was done using MAC data sheet, NIOSH equation and Iranian MMH regulation. Data were Analyzed using stata software and P-value of 0.05 or less was considered significant.

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Result: Results showed an acceptable agreement between Iranian regulation and MAC method as well as Iranian regulation and NIOSH equation. However, no acceptable agreement was observed between MAC method and NIOSH equation.

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Introduction: Lead exposure is considered as a global health problem. The irreparable harmful effects of this heavy metal on human have been proven in various studies. Comparing to general population, workers in related industries are more exposed to lead. Several studies have investigated lead occupational exposure and its biological evaluation in Iran; however there is no overall estimate. Thus, the present study was conducted to determine the occupational exposure to lead and its biological evaluation in Iranian workers, using systematic review and meta-analysis.

Material and Method: This study was carried out based on information obtained from databases including Magiran, Iranmedex, SID, Medlib, Trials Register, Scopus, Pubmed, Science Direct, Cochran, Embase, Medline, Web of Science, Springer, Online Library Wiley, and Google Scholar from 1991 to 2016, using standard key words. All of the reviewed papers which met the inclusion criteria have been evaluated. Data combination was performed according to Random Effects Model using Stata software version 11.1.

Result: In the 34 qualified studies, the mean blood lead level (BLL) concentration in Iranian workers was estimated 42.8µg/dl (95% CI: 35.15-50.49). The minimum and maximum BLL were belonged to west (28.348µg/dl) and center (45.928µg/dl) regions of Iran, respectively. Considering different occupations, the lowest mean value was reported in textile industry workers (12.3 µg/dl), while the highest value was for zinc-lead mine workers (72.6 µg/dl). Mean breathing air lead level of Iranian workers reported in 4 studies was estimated 0.23 mg/m3 (95% CI: 0.14-0.33).

Conclusion: According to the high concentration of BLL and breathing air, it is recommended to increase protective measures and frequent screening. Scheduled clinical and paraclinical examination should also be performed for workers.

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Introduction: One of the important consequences of globalization and development, especially in developing countries, are occupational accidents. As, today the economic burden due to these accidents is remarkable on the country’s economy. The aim of this study was financial estimate of the productivity loss due to work-related deaths in Iran in 2013.

Material and Method: In this study, occupational accident data were used registered in the environmental and occupational health center, in Iranian Ministry of Health and Medical Education. A formula used by the Centers for Disease Control and Prevention America (CDC) was used to estimate the productivity loss. Finally, after replacing the necessary parameters amount of productivity loss was calculated.

Result: The total lost years of life were calculated 1293.15 years due to the deaths caused by occupational accidents. The total amount of monetary loss due to the productivity loss in the country, was estimated 730513.06 Rials. The greatest loss was in the 59-50 years old age group.

Conclusion: The negative rate of productivity, the large quantity of the discount rate, low life expectancy in the country as well as the low wages of the workers, are the likely reasons for minimal negative impact of the workforce deaths on the country’s productivity.

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Introduction: Safety is a significant part of the public transportation. Suitable safety climate has a positive effect on safety performance and reduces accidents rate. The aim of this study was investigating safety climate status of Tehran subway drivers in 2013.
Material and method:  The present study was a descriptive and cross-sectional study. In this study, statistical population was all drivers of 1, 2 and 4 lines of Tehran Urban & Suburban Railway Operation company. Also, a questionnaire arranged by one of our researcher was used to collect demographics data of subjects. Safety climate was also investigated using standard Vinod Kumar's questionnaire. Data were analyzed by descriptive statistics and T-Student and ANOVA tests using SPSS21 software.
Results: Overall, 293 questionnaires were analyzed. Among the participants, 38.8% were line 1 derivers, 31.1% line 2 drivers and 33.1% line 4 drivers. The mean and standard deviation of the safety climate was 146.53±49.44, which is less than 147 (median). The results indicated that safety climate had a relation with the age group and education levels (P<0.01), while had no significant relationship with the deriving experience, and also marital status (P>0.05).
Conclusion: Safety climate status among subway drivers is not desirable. Among the various factors, commitment and performance of management in the safety area had the weakest status. Strengthening the structure of the health, Safety and Environment (HSE) management system in the Tehran Urban and Suburban Railway Operation company can enhance the level of safety climate among staff of this organization.

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Introduction: Burnout dimensions include the emotional exhaustion (EE), depersonalization (DP) and personal accomplishment (PA).
Materials and Methods: The information was obtained from searching standard Persian and English keywords in accessible databases including: Scopus, Magiran, SID, Science Direct  and  PubMed from database commencement to April 2017. Data  Analysis was performed using Stata version 11.1., and p value was considered less than 0.05.
Results: In the systematic review 43 studies met the inclusion criteria, and 9456 people were evaluated. The prevalence of burnout was calculated in any of the three dimensions of burnout. The prevalence of the Emotional Exhaustion (EE) dimension of burnout was%36 (%95CI: 29-42), the Depersonalization (DP) dimension was%23 (%95CI: 18-29) and the Personal Accomplishment (PA) dimension was%46 (%95CI: 39-53). Based on the type of the job, the maximum prevalence of the EE, DP and PA dimensions was in librarians 67% (%95CI:40-93), university staff 51% (14-88) and dentists 72%(%95CI:65-79), respectively. Meta regression results showed that there was no significant relationship between the year of publication and the prevalence of burnout.
Conclusion: According to the prevalence of burnout in Iran and the high prevalence of the PA dimension, it is recommended to consider mediating strategies for reducing and controlling stressful occupational events and burnout in organizational schedule.

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Introduction: Musculoskeletal disorders (MSDs) are prevalent in work settings and are associated with high rate of prevalence and costs. Musculoskeletal conditions have multifaceted nature, and occupational factors play an important role in their development. The aim of this study was to identify the risk factors of work-related musculoskeletal disorders in the working population in Iran during 2000 to 2015.
Material and Methods: Using the appropriate search terms, articles published in the journals, student thesis, and those presented at the conferences were searched through authentic English databases (Google Scholar, Scopus, PubMed) and Farsi ones (Magiran, SID, IranMedex, Irandoc). Following removal of duplicate citations and irrelevant studies, the full texts of the remaining publications were prepared and assessed for more detail.
Results: Perceived discomfort in low back region obtained the highest score in workers of industrial, administrative, service, and agricultural settings. However, in the handicraft and educational groups, the highest percentage of discomfort was belonged to neck (66.7%). Findings showed that the most commonly used techniques for evaluation of musculoskeletal disorders and risk factors were, respectively, Nordic questionnaire (NMQ) (76%) and REBA (13.9%). Moreover, all identified risk factors were classified into eleven groups including: biomechanical, work environment design, tools, equipment, temporal aspects of job design, job content, organizational aspects, economic and financial issues, social aspects, individual characteristics, and training.
Conclusion: Overall, a wide range of risk factors reported in the previous studies were categorized in the present review. The results are suggested to be considered by managers and decision makers as a framework to take measures for controlling musculoskeletal disorders to accomplish the goal of ergonomics, which is productivity and well-being.

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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: Medical centers, as complex technical-social systems, are exposed to the risk of fire incidents. This study analyzes the causes and contributing factors of the fire accident at Sina Mehr Clinic to prevent similar accidents, resulting in 19 deaths and 14 injuries.
Material and Methods: The causes and contributing factors for accidents in medical centers are found through studies related to laws and regulations, official accident reports, expert reports of regulatory bodies, interviews with experts, and review of past studies, extraction, and categorization. Accident analysis methods included AcciMap and STAMP. Finally, experts’ opinions were used to confirm and strengthen the findings.
Results: The most critical root and hierarchical causes of the weakness of medical center management in the field of safety, dangerous conditions, fire accidents, and emergency response are the issuance of a legal building completion permit for a building that violates national building regulations and the issuance of a legal permit for a medical institution for a building with residential use, as well as the insufficiency of supervision by government and public institutions with horizontal relationships with each other and vertical relationships with universities of medical sciences, labor offices, and firefighting organizations, as the direct supervisors of medical centers.
Conclusion: The AcciMap and STAMP findings indicate that the priority is to amend the regulations for the establishment, operation, and activity of medical centers with an emphasis on safety regulations, as well as the frequency and shortening of feedback loops such as inquiring about the building completion permit from the municipality, announcing the establishment of a medical center to other governmental and public supervisory authorities, and the reporting of unsafe cases directly by supervisors to the Ministry of Health. Legal authorities are the most crucial cycle in the resilience of fire incidents and their consequences in medical centers.