Exploring the relationships among safety leadership, safety climate, psychological contract of safety, risk perception, safety compliance, and safety outcomes.

Background: Recently, two types of safety compliance behaviors including deep compliance and surface compliance were differentiated. The current study aimed to investigate the relationships among safety leadership, safety climate, psychological contract of safety (PCS), risk perception, and deep compliance and surface compliance behavior of workers. In addition, the effects of both deep and surface compliance on safety outcomes were considered. Methods: Workers' perceptions in terms of safety leadership, safety climate, PCS, risk perception, deep compliance, and surface compliance were measured by appropriate questionnaires. Three questions were asked to measure undesired safety outcomes. Structural equation modeling and correlation analysis were applied to examine the research model and relationships among variables. Results and discussion: The results of the current study showed that deep compliance was positively predicted by safety leadership, safety climate, and PCS and negatively predicted by risk perception. Surface compliance was positively predicted by safety leadership and safety climate and negatively predicted by risk perception. Surface compliance is not significantly predicted by PCS. With regard to the adverse safety outcomes, the results showed that both deep and surface compliance were negatively associated with adverse safety outcomes, however, deep compliance had a stronger negative correlation with adverse safety outcomes than surface compliance.

Differences in perception of the importance of process safety indicators between experts in Iran and the West.

INTRODUCTION: The importance of safety in high-risk industries such as oil and gas facilities has been reported previously. Process safety performance indicators can provide insight into improving the safety of process industries. This paper aims to rank the process safety indicators (metrics) by Fuzzy Best-Worst Method (FBWM) using the data gathered through a survey. METHOD: The study uses a structured approach considering the UK Health and Safety Executive (HSE), the Center for Chemical Process Safety (CCPS), and the IOGP (International Association of Oil and Gas Producers) recommendations and guidelines to generate an aggregate set of indicators. It calculates the level of importance of each indicator based on the opinions of experts from Iran and some Western countries. RESULTS: The findings of the study demonstrate that some lagging indicators such as the number of times processes do not proceed as planned due to insufficient staff competence and the number of unexpected disruptions of the process due to failure in instrumentation and alarms are important in process industries in both Iran and Western countries. Western experts identified process safety incident severity rate as an important lagging indicator, whereas Iranian experts considered this as relatively unimportant. In addition, leading indicators such as sufficient process safety training and competency, the desired function of instrumentation and alarms, and proper management of fatigue risk play an important role in enhancing the safety performance of process industries. Experts in Iran viewed permit to work as an important leading indicator, while experts in the West focused on fatigue risk management. PRACTICAL APPLICATIONS: The methodology used in the current study gives a good view to managers and safety professionals in regard to the most important indicators of process safety and allows them to focus more on important process safety indicators.

Traffic climate, driver behaviour and dangerous driving among taxi drivers.

Traffic accidents are considered a major public health problem in many countries. The aim of this study was to explore the relationships between traffic climate factors (i.e., external affective demands, functionality and internal requirements), driver behaviours, dangerous driving behaviours and traffic accident involvement among taxi drivers. A total of 450 male taxi drivers participated in the study. The traffic climate scale (TCS), the driver behaviour questionnaire (DBQ), the positive driver behaviours scale (PDBS) and the Dula dangerous driving index (DDDI) were used to measure driving behaviours and traffic conditions. The results showed that there was a significant negative correlation between functionality (of the TCS) and the number of accident involvement. Further analysis demonstrated that the effect of risky driving (of the DDDI) on accident involvement was significant. Taken together, these findings suggest that functional traffic systems and driving environments play important roles in traffic accident involvement.

Assessment of occupational safety, health, and ergonomics issues in agriculture in some cities of Iran.

BACKGROUND: Iran has a variety of climates which support agriculture in different seasons. Hence, a significant proportion of people, especially in rural areas, are engaged in farming. Agriculture is considered one of the most insecure job sectors in developing and developed countries. OBJECTIVE: Since there is no comprehensive study on safety, health, and ergonomics issues in Iran's agriculture, it is necessary to use checkpoints to assess occupational safety, health, and ergonomics issues in Iran's agriculture. METHODS: In this study, 430 villages from seven provinces of Iran were selected to study safety, health, and ergonomics in agriculture using ergonomic checkpoints. The checkpoints were collected with the help of rural health centers. RESULTS: The results of the study showed that the villages of Kurdistan Province had the best safety, health, and working conditions (66.12%); and Khuzestan province villages had the worst safety, health, and working conditions (38.16%). Among the ergonomic checkpoints in agriculture, the control of hazardous chemicals (CHC) index with 71.41% and work organization and work schedule (WOWS) index with 35.25% represented the best and worst ergonomic conditions of the study villages, respectively. Furthermore, the general index of ergonomics in agriculture for the study villages was 53.64%. Therefore, Khuzestan Province and the WOWS index top the priorities for corrective actions to improve the safety, health and working conditions in agriculture. CONCLUSIONS: The ergonomics indices in Iranian agriculture are important, and should be prioritized for corrective actions.

An intelligent algorithm for assessing patient safety culture and adverse events voluntary reporting using PCA and ANFIS.

BACKGROUND: Patient safety culture (PSC) as a main component of the organizational culture plays a key role in providing safe, effective and economic cares and services in healthcare organizations. PSC provides a way to assist hospitals in order to improve patient safety and prevent medical errors. OBJECTIVE: The present study aimed to measure PSC and healthcare professionals' attitude towards voluntary reporting of adverse events in two hospitals in Iran and to develop a hybrid intelligent approach for modeling PSC grades. METHODS: The Hospital Survey on Patient Safety Culture (HSOPSC) questionnaire and a two-part questionnaire were used for examining the PSC and healthcare professionals' attitude towards voluntary reporting of adverse events, respectively. Principal component analysis (PCA) was applied to extract of the main components in the HSOPSC questionnaire and to construct 12 dimensions of patient safety culture. The overall grade of patient safety culture was modeled using adaptive neuro-fuzzy inference systems (ANFIS) as a classification problem. RESULTS: Almost half of the participants have experienced a medical error and adverse events. The PSC grade was acceptable from the point of view of 55.5% and 50% of participants in hospital No.1 and hospital No.2, respectively. The overall accuracy of ANFIS in modeling overall grades of patient safety culture in both study hospitals was 0.84. Of those individuals gave an acceptable grade on patient safety culture in both study hospitals, more than 50% believed that all medical errors and near misses should be reported. CONCLUSIONS: The ANFIS algorithm was proposed for modeling and predicting of PSC for healthcare organizations. The results confirm the capability of the proposed model to predict patient safety grades in healthcare settings.

An Experimental Study of the Effects of Combined Exposure to Microwave and Heat on Gene Expression and Sperm Parameters in Mice.

OBJECTIVES: Separate exposure to microwaves (MWs) or heat had effects on expression levels of Bax and Bcl-2 and sperm parameters in studied group. AIMS: The objectives of this research were to determine the effects of separate and combined exposure to 900-MHz MW (as representative of cell phone radiation) and heat on gene expression and spermogram of male mice. SETTINGS AND DESIGN: This experimental animal study was conducted in the school of public health. MATERIALS AND METHODS: The study was done on 12 male mice randomly divided into four groups (21-23 g): control, test group 1 with separate exposure to 900-MHz MW, test group 2 with separate exposure to hot and sultry climate, and test group 3 with simultaneous whole body exposures to 900-MHz MW and hot and sultry climate. In all studied groups, gene expression and sperm parameters were measured. RESULTS: Tissue samples in all test groups showed integrity of the seminiferous tubule followed by all types of germ line cells. Significant increases in the number of dead sperms in mice with separate exposure to heat were observed in comparison with the other studied groups (P < 0.05). The ratio of Bax expression was elevated to 0.015 ± 0.006 in mice after combined exposures to 900-MHz MW and heat. CONCLUSION: Separate and combined exposure to 900-MHz MW and heat may induce adverse effects on sperm parameters and gene expression of studied male mice.

Respiratory Effects of Simultaneous Exposure to Respirable Crystalline Silica Dust, Formaldehyde, and Triethylamine of a Group of Foundry Workers.

BACKGROUND: Foundry workers are occupationally exposed to hazardous substances such as silica dusts and toxic gases. The aim of this study was to examine the effects of simultaneous exposure to complex mixtures of silica dust, formaldehyde, and triethylamine on lung function parameters. STUDY DESIGN: A cross-sectional study. METHODS: This study was conducted on 55 male workers of core making unit of a foundry plant (the case group) and 55 workers in a food industry were enrolled as a control group in 2015. Workers were monitored for personal exposure to crystalline silica respirable dust, according the NIOSH method No.7602. The concentrations of formaldehyde and triethylamine were measured using a PID instrument. Lung function tests were performed according to the ERS/ATS standards. RESULTS: The mean concentrations of personal exposure to silica dust, formaldehyde, and triethylamine in the core making workers were 0.23 mg/m3, 2.85 ppm, and 5.55 ppm and respective exposures of control subjects were less than the LOD (limit of detection). There were significant associations between exposure to silica dust and decreases in FVC (Forced vital capacity) values (P<0.05). The findings showed a statistically significant synergistic effect of silica dust and triethylamine on FVC values (P<0.05). CONCLUSIONS: The mean exposure of all studied substances was higher than occupational exposure limits. Synergistic effects of exposure to silica dust and triethylamine on some lung function parameters were observed. Simultaneous exposure of foundry workers to silica dust and triethylamine could impair lung function.

The effects of heat stress on a number of hematological parameters and levels of thyroid hormones in foundry workers.

The objective of this research was to determine the effects of heat stress on some hematological parameters and thyroid hormones among foundry workers. This study was performed on 25 heat-acclimated subjects while 10 office workers were selected as the control group. Wet bulb globe temperature (WBGT) was determined to estimate the heat stress. Blood sampling was conducted before and after the daily work shift. The mean value of the WBGT index was 35 °C. The levels of plasma osmolality (p = 0.04) and white blood cells (p = 0.03) in the case group (before exposure to heat) were significantly higher than those in control group. No significant differences were observed between the average levels of T3 (p = 0.79) and T4 (p = 0.17) hormones between two groups. A positive relationship was found between the variation of some hematological parameters and thyroid hormones with WBGT index and air temperature.

Risk Assessment of Exposure to Silica Dust in Building Demolition Sites.

BACKGROUND: Building demolition can lead to emission of dust into the environment. Exposure to silica dust may be considered as an important hazard in these sites. The objectives of this research were to determine the amount of workers' exposure to crystalline silica dust and assess the relative risk of silicosis and the excess lifetime risk of mortality from lung cancer in demolition workers. METHODS: Four sites in the Tehran megacity region were selected. Silica dust was collected using the National Institute for Occupational Safety and Health method 7601 and determined spectrophotometrically. The Mannetje et al and Rice et al models were chosen to examine the rate of silicosis-related mortality and the excess lifetime risk of mortality from lung cancer, respectively. RESULTS: The amount of demolition workers' exposure was in the range of 0.085-0.185 mg/m(3). The range of relative risk of silicosis related mortality was increased from 1 in the workers with the lowest exposure level to 22.64/1,000 in the employees with high exposure level. The range of the excess lifetime risk of mortality from lung cancer was in the range of 32-60/1,000 exposed workers. CONCLUSION: Geometric and arithmetic mean of exposure was higher than threshold limit value for silica dust in all demolition sites. The risk of silicosis mortality for many demolition workers was higher than 1/1,000 (unacceptable level of risk). Estimating the lifetime lung cancer mortality showed a higher risk of mortality from lung cancer in building demolition workers.

Effect of Ventilation on Occupational Exposure to Airborne Biological Contaminants in an Isolation Room.

BACKGROUND: Airborne pathogens play an important role in a hospital air quality. Respiratory infections are the most common occupational disease among the health care staff. The aim of this study was to determine the effect of ventilation system parameters and patient bed arrangements on concentration of airborne pathogens in indoor air of an isolation room. MATERIALS AND METHODS: A single-bed room was considered in which a patient diagnosed with tuberculosis had been admitted. Five different ventilation types, each at four different capacities were installed in the room while two different locations for the patient's bed were assessed. A direct-impact sampling method (blood agar plate) was used in order to determine the intensity of the bio-aerosols in indoor air of the isolation room. RESULTS: The results showed that when the air was supplied through a circular vent located on the northern wall and the vented air was exhausted via a linear vent located on the southern wall, the average concentration of the bio-aerosols in the air, (with 12 air changes per hour) was reduced to 25 colonies per cubic meter (cfu/m(3)) (in the range of 25-88 cfu/m(3) and a 95 percent confidence interval). In accordance with the analysis applied upon the two different locations of the bed, no significant difference was observed (P>0.05). CONCLUSION: Installation of ventilation systems as determined by the study is recommended for tuberculosis isolation rooms.

The effects of occupational noise on blood pressure and heart rate of workers in an automotive parts industry.

BACKGROUND: One of the most important impacts of industrial noise is physiological and psychological effects. The increases in workers' blood pressure and heart rate were detected during and after exposure to high levels of noise. The objectives of this research were to determine whether the noise exposures have any effects on blood pressure and heart rate of workers in the automotive parts industry. METHODS: This case study was done in 2011 at different units of an automotive parts manufacturing in Tehran. Sound pressure level was measured at different units of the factory with a calibrated instrument. Demographic features of workers were gathered with an appropriate questionnaire. Heart rate and blood pressure were measured twice in a day in the start time of work day (before exposure to noise) and middle shift hours (during exposure to noise) in the occupational physician office. For analyzing data, chi-square, independent sample t-test, paired t-test, and analysis of covariance (ANCOVA) were used. P < 0.050 was considered statistically significant. RESULTS: The average age of workers in the case and control groups was 35.71 ± 8.10 and 33.40 ± 10.41 years, respectively. There was no difference between the average age of case and control groups (P = 0.436). The results of ANCOVA revealed the significant differences between the mean changes of heart rate F (1, 37) = 26.68, P < 0.001, systolic blood pressure F (1, 37) = 21.70, P < 0.001, and diastolic blood pressure F (1, 37) = 26.20, P < 0.001 of workers in the case and control groups. CONCLUSION: Exposure to industrial noise may increase the heart rate of workers. Although rises in heart rate, systolic, and diastolic blood pressure of workers in the case group were observed after exposure to noise, the values of heart rate, systolic, and diastolic blood pressure were in the normal range. Further experimental investigations are needed to determine the relationships between these variables.

Occupational stress and mental health among nurses in a medical intensive care unit of a general hospital in Bandar Abbas in 2013.

BACKGROUND: Many nurses have reported experiencing high levels of occupational stress in their work environment. Stress, as an outcome of stressful workplaces and tasks, affects nursing behavior in hospital wards. The objectives of this research were to determine the prevalence of occupational stress and mental health problems in nurses in the intensive care unit (ICU) at Shahid Mohammadi Hospital in Bandar Abbas in 2013 and to determine the relationship between occupational stress and mental health. METHODS: This cross-sectional study was conducted in 2013 on all of the nurses working in ICU at Shahid Mohammadi Hospital located in Bandar Abbas, Iran. Seventy-two nurses were selected as the population for this study, and all of them were female. Two questionnaires were used in this study, i.e., General Health Questionnaire-28 (GHQ-28) for assessing mental health and an occupational stress test for assessing job stress. Furthermore, the relationship between occupational stress and mental health was examined. One-way analysis of variance (ANOVA), independent samples t-test, and Pearson's product-moment correlation test were used to analyze the data. RESULTS: High and moderate levels of occupational stress were experienced by 83.9% and 10.7% of ICU nurses, respectively. The prevalence of mental disorders, somatic symptoms, anxiety, social dysfunction, and depression were 58.9, 60.7, 62.5, 71.4, and 10.7%, respectively. The findings of the independent samples t-test showed that somatic symptoms had significant relationships with age and working experience (p = 0.01). According to the independent samples t-test, there were no significant differences between somatic symptoms and working different shifts (p > 0.05). CONCLUSIONS: There was a high prevalence of occupational stress among ICU nurses. There was a significant relationship between occupational stress and mental health. Future interventions are needed to codify a comprehensive health program in this field to reduce occupational stress and enhance nurses' levels of mental health.

The impacts of pesticides on the health of farmers in Fasa, Iran.

BACKGROUND: With the growing global population, it is becoming increasingly difficult to ignore the demands for food and energy. A major portion of the food and energy is produced via agriculture and livestock activities. The objectives of this research are to gather information regarding the demographic features of farmers, previous poisoning, and the extent of farmers' knowledge in the use of pesticides and associated hazards in different counties and villages in Fasa, a city located in the Fars province of Iran. METHODS: This cross-sectional study was carried out from March to July 2012 in the Nobandegan and Sheshdeh counties, and villages including Miandeh, Fedshkuyeh, Senan, Rahimabad, and other places in the Fasa suburban countryside. To collect data, an appropriate questionnaire was designed and implemented. RESULTS: A total of 200 farmers participated in the study. We found that 55% of farmers were illiterate. Approximately 86% of used pesticides were organophosphorus compounds. Around 30% of the farmers used no protective equipment while working with pesticides, and only 22% of farmers had read and understood the instructions on the pesticide containers. CONCLUSION: Given the toxicity and hazards of pesticides and their adverse effects on farmers' health, effective measures should be adopted to decrease the amount of pesticides used. Conducting training programs for farmers may help to reduce pesticide exposure risks.

Personal Exposure to Polycyclic Aromatic Hydrocarbons in Newsagents in Tehran, Iran.

BACKGROUND: Vehicle exhaust is a major source of exposure to Polycyclic Aromatic Hydrocarbons (PAHs) found in the urban atmosphere. Newsagents usually work close to heavy traffic flow. The purpose of this study was to assess the breathing zone exposure of newsagents to PAHs found in the urban atmosphere of Tehran City during summer and autumn seasons and comparing the levels of exposure in both seasons. METHODS: Fifteen non-smoking newsagents were randomly selected from north, south, east, west, and center of Tehran. Particle and gas phases PAHs were collected on polytetrafluoroethylene (PTFE) filter and XAD-2 adsorbent. Gas chromatography-mass spectrometry (GC/MS) was used to determine PAHs concentrations in newsagent's breathing zone samples. RESULTS: The highest and lowest values of exposures during summer and autumn in all sampling stations were recorded for benzo[a]anthracene and benzo[ghi]perylene, respectively. Mann-Whitney test results showed that seasonal variation had significant influence on concentrations of all studied PAHs (P= 0.001) except benzo[ghi]perylene (P= 0.089). An increase in concentrations of PAHs was observed in autumn. CONCLUSION: The workers of the newsstands in the south area of Tehran City were experiencing higher levels of exposures to PAHs. Newsagents' breathing zone exposures to PAHs during the cold period were two to three folds higher than those during the warm period were. The levels of exposures in all sampling stations were below the OSHA and NIOSH's recommended exposure limits.

Association of Sick Building Syndrome with Indoor Air Parameters.

BACKGROUND: Energy crisis in 1973 led to smaller residential and office buildings with lower air changes. This resulted in development of Sick Building Syndrome (SBS). The objective of this study was to assess the association of SBS with individual factors and indoor air pollutants among employees in two office buildings of Petroleum Industry Health Organization in Tehran city. MATERIALS AND METHODS: The association between personal and environmental factors and SBS symptoms was examined by a reliable and valid combined questionnaire. Environmental parameters were measured using calibrated instruments. RESULTS: The results suggested that SBS symptoms were more common in women than men. Malaise and headache were the most common symptoms in women and men. Throat dryness, cough, sputum, and wheezing were less prevalent among employees in both offices. Light-intensity was significantly associated with some symptoms such as skin dryness (P = 0.049), eye pain (P = 0.026), and malaise (P = 0.043). There were no significant differences in prevalence of SBS symptoms between female workers of the two offices (P>0.05). CONCLUSION: The main causes of SBS among the employees were recycling of air in rooms using fan coils, traffic noise, poor lighting, and buildings located in a polluted metropolitan area.

Occupational Exposure and Health Impairments of Formaldehyde on Employees of a Wood Industry.

BACKGROUND: Occupational exposure to formaldehyde may decrease white blood cell counts and change blood concentration. In this study, the influences of occupational exposure to formaldehyde on the number of white blood cells and blood concentrations were studied. METHODS: This case-control study was conducted in June of 2012 at North Wood Factory, Golestan Province, Iran. The US-NIOSH method No. 2541 was used to determine the occupational exposure of 30 workers of the production line (case group) and 30 administrative staffs (control group) to formalde-hyde. The number of white blood cells and blood concentration were determined using the normal blood count method and related indices. Demographic features as well as the symptoms of being exposed to formaldehyde were collected using a standard questionnaire. RESULTS: The occupational exposure of case group ranged from 0.50 ppm to 1.52 ppm. The prevalence of all studied symptoms from formaldehyde exposure in workers (2

Knowledge, attitudes, and practice of drivers towards traffic regulations in Bandar-Abbas, Iran.

INTRODUCTION: Traffic injuries are among the leading causes of death and disability in many countries. The knowledge, attitudes, and practice of drivers towards traffic regulations are key factors in decreasing traffic injuries and deaths. The objectives of this research were to study the knowledge, attitudes, and practice of taxi drivers towards traffic regulations in Bandar-Abbas, Iran, and to determine the relationships between demographic features and knowledge, attitudes, and practice of taxi drivers towards traffic regulations. METHODS: This cross-sectional study was done in 2014 in Bandar-Abbas, Iran (Hormozgan Province). To study the knowledge, attitudes, and practice of 241 intra-city taxi drivers towards traffic regulations, researchers developed questionnaires and a checklist. The chi-squared test was performed to determine the relationships between knowledge, attitude, and practice of drivers towards traffic regulations and demographic features. RESULTS: Among the 241 drivers, 50 of them (20.7%) thought that the seat belt could cause discomfort while driving, and 107 (44.4%) did not wear a seat belt while driving. The study determined that there was a significant difference between the knowledge and work experience of the drivers (p = 0.014). The 94 drivers (43.5%) in the 31-40 year age group had positive attitudes towards traffic regulations (among 216 drivers expressed positive attitudes) and 92 (44.4%) of the drivers in this age group had safe practices towards traffic regulations (among 207 drivers with safe practice). CONCLUSION: Many of the taxi drivers in Bandar-Abbas had inadequate knowledge, less positive attitudes, and risky practices towards traffic regulations. Implementation of effective intervention programs may increase the taxi drivers' knowledge, attitudes, and practices towards traffic regulations.