Effect of Lipid Profile Parameters on Noise Induced Hearing Loss.

Background: Noise induced hearing loss (NIHL) is an irreversible occupational disease among industrial workers. Recent studies have reported that changes in some metabolic factors such as the serum level of sugar and lipids might have a role in suffering from NIHL among workers exposed to noise. We designed this study to assess the association between lipid profile changes and NIHL occurrence among noise-exposed workers. Methods: This case-control study has been conducted according to noise-exposed workers registry data in one of the Iranian automobile factories between 2007 and 2017. We classified study workers into the NIHL and control groups. We assessed the impact of lipid profile parameters across the study groups using the independent samples t-test, chi-square, and regression. Results: The mean serum level of cholesterol was significantly higher in the NIHL group than in workers of the control group (215.27 ± 60.30 vs 204.49 ± 63.69 mg/dL; P = 0.041). Moreover, the serum level of HDL was significantly lower in workers in the NIHL group compared with the control group (35.21 ± 6.87 vs 37.43 ± 7.28 mg/dL; P < 0.001). Although other lipid profile parameters (LDL, TG, LDL/HDL ratio) were higher among workers of the NIHL group, their differences were not significant. Conclusion: A cholesterol level lower than 200 mg/dL is known as a protective factor and an HDL level lower than 40 mg/dL is an NIHL risk factor. More attention should be paid to controlling serum levels of cholesterol and HDL.

Early Failure of Arteriovenous Fistula (AVF): The Effect of Diabetes and Hypertension in a Cross-Sectional Study.

Background: Identification and control of clinical predictors of arteriovenous (AVF) failure can improve the long-term outcome of hemodialysis patients. The effects of these factors on the outcome of AVF are not still clear. So, we aimed this study to compare the effect of hypertension and diabetes on early failure of AVF. Methods: In this retrospective study, we evaluated 400 patients with ESRD referred to our clinic for the creation of the first AVF from July 14, 2001, through August 7, 2018. One month after AVF creation, the patients were referred to the clinic for patency control. Demographic characteristics, previous history of diabetes and hypertension, and laboratory data of all patients were recorded preoperatively. Data were entered to SPSS v.24 and Study data were analyzed with chi-square and independent student t-test. Then, early failure of AVF and its relationship with a history of diabetes and hypertension were assessed. Results: There was no statistically significant relationship between the history of diabetes and early AVF failure risk in ESRD patients (OR, 0.78; 95% CI, 0.25 to 2.43). Furthermore, the history of hypertension was significantly lower in the early failure of AVF group (OR, -2.82; 95% CI, -1.42 to -5.59). Although, this effect faded when using regression analysis (OR, -2.67; 95% CI, -0.97 to -7.36). There was a higher Body mass index in the non-early failure group (p = 0.041). There was no significant difference in age (p = 0.512), gender (p = 0.091), history of smoking (p = 0.605), treatment with insulin (p = 0.683), oral antidiabetic agents (p = 0.734), duration of diabetes (p = 0.384), and duration of hypertension (p = 0.093). Conclusion: We reported that the history of diabetes was not higher in the early failure group, while there was a lower risk of AVF failure in patients with a previous history of hypertension.

Work-related stress and quality of life among Iranian blue-collar workers with self-reported low back pain.

Background: Impairment in quality of life and mental health had been reported in the previous studies as the results of musculoskeletal disorders among workers. Mental health has a wide concept and contains different disorders including anxiety, depression or even decreased quality of life, all of which having challengeable impacts on work- related characters such as work productivity and absensism. The present study aimed at evaluating work- related stress and quality of life among Iranian blue-collar workers of Fars ABFA Company with selfreported low back pain. Methods: In the present study, we focused on the low back pain among 451 blue-collar workers and assessed their work- related stress and quality of life status using DASS-21 and short form questionnaire (SF-36), respectively. Independent sample t-test was used to compare the qualitative variables, and chi-square test was utilized for statistical analysis of the qualitative variables. Results: Mean of the total score of quality of life among workers with low back pain was significantly lower than in those workers without low back pain. The mean of work- related stress score was significantly higher in workers with low back pain than in workers without low back pain. The mean quality of life subdomains in patients with low back pain was significantly lower than in workers without low back pain. Conclusion: Findings of the present study revealed that workers with low back pain had lower quality of life score and higher work- related stress score. These findings should be considered in designing preventive programs rather than controlling the pain.

The role of work- related physical and psychological factors on prevalence of neck/shoulder complaints among nurses: A multicentric study.

Background: Identifying the predisposing factors of neck and shoulder complaints and finding solutions to avoid them could improve the occupational health condition of the nurses. In this study, we aimed at determining the role of psychological and physical occupational factors in developing neck and shoulder complaints among the participants. Methods: This analytic cross-sectional study was conducted on the nurses of main hospitals of Tehran. To study the prevalence of neck and shoulder pain, the Nordic questionnaire was used, and job content questionnaire was used to assess the psychological and physical occupational factors. Data were analyzed using SPSS and statistical methods. Independent sample t-test was used to compare the qualitative variables, and chi-square test was utilized for the statistical analysis of the qualitative variables. Results: Prevalence of neck and shoulder complaints among the nurses with high physical workload was significantly higher than in those nurses with low physical workload. Unlike physical workload, the prevalence of neck and shoulder complaints was not significantly different between the nurses with low or high psychological workload. Prevalence of neck and shoulder complaints among the female nurses was significantly higher than in the male nurses. In our study, only female nurses with high physical workload had been known as independent predictors of neck and shoulder complaints. Conclusion: Those nurses who had more workload, especially physical workload, had a higher prevalence of neck and shoulder complaints, and this fact could affect their work tasks.

The effect of work- related stress on development of neck and shoulder complaints among nurses in one tertiary hospital in Iran.

Background: There are some challenges about the role of work- related stress on development of musculoskeletal complaints. The present prospective study was conducted on nurses of Milad hospital in Tehran (Iran) to assess the role of work- related stress on development of neck and shoulder pain among nurses. Methods: From the 1,900 nurses who completed the registry forms, 1,450 nurses met the inclusion criteria. We divided the participants into exposed and unexposed groups according to their DASS-21 scores. We collected the data of neck and shoulder pain among the nurses at two points of the first and the second year after the study, using the Nordic Questionnaire. Qualitative and quantitative variables were compared between the exposed and unexposed variables with chi-square and independent sample t-test, respectively. Results: One year after the commencement of the study, 62 (9.1%) nurses in the exposed group and 36 (4.7%) in the unexposed group had been reported as new cases of neck and shoulder pain, respectively. The incidence of the new cases of neck and shoulder pain was significantly higher in the exposed group compared to the unexposed group (p= 0.001). Two years after the start of the study, at the second follow-up point, 135 (19.8%) nurses in the exposed group and 76 (9.9%) in the unexposed group had been reported as new cases of neck and shoulder pain, respectively. The incidence of new cases of neck and shoulder pain was significantly higher in the exposed group compared to the unexposed group (p<0.001). Conclusions: The incidence of neck and shoulder pain was higher in those nurses with high level of workrelated stress. According to our results, more attention should be paid to mental health as well as physical symptoms and limitations of the healthcare workers when they refer to occupational health services with musculoskeletal pain complaints.

The role of ergonomic training interventions on decreasing neck and shoulders pain among workers of an Iranian automobile factory: a randomized trial study.

BACKGROUND: Ergonomic training had been implemented for prevention or reduction of neck and shoulder complaints among workers. The purpose of the present study was to assess the role of ergonomic training intervention on decreasing the prevalence of neck and shoulder complaints among workers of an automobile factory. METHODS: Within the present randomized clinical trial, the role of three ergonomic training methods on the prevalence of neck and shoulders pain among 503 workers of an automobile factory (Response rate: 94.23%) was assessed. The eligible workers were randomly allocated into the following three interventional (pamphlet, lecture, workshop) groups and one control group. The Nordic questionnaire was used to assess the prevalence of neck and shoulder complaints. We followed and assessed the prevalence of neck and shoulders complaints among the study employees before and one year after the intervention. We used chi-square and Mann-Whitney tests to compare the prevalence of neck and shoulder complaints between the trial and control groups. A two-tailed P-value less than or equal to 0.05 was considered statistically significant. RESULTS: The prevalence of neck and shoulders complaints among the study employees at the recent week (p= 0.002) and year (p= 0.02) had been significantly decreased in the study employees after participating in the study workshop. The prevalence of neck and shoulders complaints at the recent week and year did not significantly changed in the study employees after receiving the pamphlet and lecture as ergonomic trainings. CONCLUSION: Workshop as an ergonomic training method had an effective and powerful role on decreasing the prevalence of neck and shoulders complaints among workers.

Symptomatic metastasis prediction with serial measurements of CA 15.3 in primary breast cancer patients.

BACKGROUND: CA 15.3 is elevated in most patients with distant metastatic breast cancer who had prognostic information. The present study was performed to estimate predictive ability of CA 15.3 in assessment of symptomatic metastasis in patients with breast cancer. MATERIALS AND METHODS: During five years, 159 primary breast cancer patients were evaluated. A total of 2226 determination of serum CA 15.3 (14 per patient) were performed. We performed contemporary clinical examinations with CA 15.3 measurements at the time of diagnosis, end of chemotherapy, every three months in the first two years and every six months in the second two years of follow-up period. Imaging studies were performed if clinical or laboratory examinations (abnormal serum levels of CA 15.3) suspected symptomatic metastasis. Metastasis in participants was confirmed by imaging study in symptomatic patients. RESULTS: There was no significant increase in CA 15.3 tumor markers during chemotherapy (P = 0.08). There was a significant relationship between CA 15.3 positive results and metastasis situation (P = 0.00). Mean of maximum CA 15.3 level in metastatic patients (52.72±27.09) was significantly higher than non-metastatic patients (27.58±13.46; P = 0.00). CA 15.3 abnormality (OR, 1.07; 95% CI: 1.04-1.11; P value, 0.01) and abnormal lymph nodes remained as predictor of metastasis (OR: 1.16; 95% CI: 1.05-1.28; P value < 0.0001). CONCLUSION: CA 15.3 is one of the predicting factors for symptomatic metastasis.

Impact of two ergonomics training on prevalence of upper and lower extremity complaints among nurses.

BACKGROUND: Musculoskeletal disorders (MSDs) were known as one of the main occupational problems among health-care workers. However, we had some limitations and difficulties for transferring ergonomic concepts to the health-care workers, especially nurses due to heavy work task and insufficient time for that. This study compares the impacts of two ergonomic training methods (lecture and pamphlet) in nurses of an Iranian tertiary hospital on prevalence of their upper and lower extremity complaints. MATERIALS AND METHODS: In the present randomized clinical trial with parallel groups, 1140 nurses were randomly selected and allocated to the control and two interventional groups. In the interventional groups, nurses revived a training program and pamphlet as ergonomic training methods about work-related MSDs and related ergonomic concept to MSDs prevention and nurses in the control group, did not receive any ergonomic training methods. Upper and lower extremity complaints measure among study nurses with Nordic MSDs before 6 months and 1 year after trial intervention. Statistical analysis including the Kolmogorov-Smirnov goodness-of-fit, Chi-square test, and independent sample t-test was performed using SPSS version 22. A two-tailed P ≤ 0.05 was considered statistically significant. RESULTS: At the first and second parts of the study follow-up, the prevalence of upper and lower extremities significantly improved in the interventional groups in comparison with the control group. Moreover, between the two trial groups, the frequency of MSDs in upper and lower extremities significantly improved among nurses of the pamphlet group in comparison with the lecture group. CONCLUSION: Findings of the study showed that we can use pamphlet as a suitable tool for describing ergonomic concepts in comparison with lecture among nurses.

Determination of a Cut-off Point for Exhaled Nitric Oxide in the Diagnosis of Asthma in an Iranian Population.

BACKGROUND: Asthma is a major source of global social and economic burden; thus, its early detection is important. Measurement of fractional exhaled nitric oxide (FENO) has been used recently considered a good indicator of asthma and also a sensitive and non-invasive method for monitoring airway inflammation. This study was conducted to determine the cut-off point of FENO for the diagnosis of asthma in the studied population. MATERIALS AND METHODS: The subjects of this cross-sectional diagnostic study were assessed by the FENO test, spirometry, and methacholine challenge test. The best cut-off point of the FENO for the diagnosis of asthma was determined. The data were analyzed by SPSS 20 using student t-test, and Chi-square test and the ROC curves were also drawn. RESULTS: The mean FENO in asthmatic and non-asthmatic subjects was 43.5±33.41 and 17.5±21.48 ppb, respectively (P <0.001). The best cut-off point of the FENO based on the overall sensitivity and specificity was 39.5 ppb. CONCLUSION: According to the results of this study, symptomatic patients with FENO higher than 39.5 ppb could be considered as asthmatic.

Photobiomodulation for spinal cord injury: A systematic review and meta-analysis.

In recent years, photobiomodulation therapy (PBMT) has found many applications in various medical fields. Studies of PBMT on spinal cord injury (SCI) have mostly used laser sources in experimental animal models. The purpose of this study was to summarize studies that have employed PBMT for various kinds of SCI in animals. A thorough search in databases including MEDLINE, EMBASE, SCOPUS, and Web of Science, with the removal of unrelated articles, yielded 16 relevant articles. The meta-analysis showed that PBMT was effective in improving post-SCI movement in the first 14 days (MD = 1.593 (95% CI: 1.110 to 2.075; p <0.001, I2 = 51.9%) and this improvement became even greater thereafter (MD = 2.086 (95% CI: 1.570 to 2.603; p = <0.001. I2= 90.3%). Time of irradiation (<300 sec or >300 sec), gender (male or female), injury model (contusion or compression, radiation protocol (<14 days or ≥14days), laser wavelength (<800nm or >800nm) and injury severity (moderate or severe) were found to be factors that can affect PBM efficacy for SCI treatment. PBMT has an anti-inflammatory effect, is effective in reducing the size of spinal cord lesions and helps to absorb administrated proteins and stem cells to the lesion site.

Assessment of Pulmonary Function Parameters, Signs, and Symptoms in the Employee of a Dairy Products Company in Tehran, Iran.

BACKGROUND: Workers in dairy products companies are exposed to different respiratory hazards. The current study aimed at investigating and comparing the prevalence of pulmonary function parameters, signs, and symptoms in the exposed workers and office staff. MATERIALS AND METHODS: The current cross sectional study was conducted in 2015 on 864 employees working in a dairy products company in Tehran, Iran. The subjects included 646 employees exposed to respiratory hazards at the production line and the other group consisted of 218 staff not exposed to respiratory hazards in the production line as the unexposed group. Demographic characteristics and the presence of respiratory symptoms and signs were gathered using a checklist. Spirometric indices including FEV1, forced volume vital capacity (FVC), and FEV1/FVC were measured for the study participants. RESULTS: Although exposure to the respiratory hazards among participants of the exposed group was lower than permitted limits, the frequency of respiratory signs and symptoms were significantly higher than those of the unexposed staff. In the current study, mean percentage of FVC, FEV1/FVC, and FEV1 were significantly less than the predicted amount in the exposed group than in the unexposed group. CONCLUSION: Although the frequency of respiratory signs and symptoms was lower than those of other similar studies, abnormal spirometric patterns were common; hence, it can be pointed out that even in the work environments, such as dairy products industry with below the permissible exposure limit of respiratory risks, multiple spirometric disorders can be observed. In other words, the absence of respiratory signs and symptoms are insufficient and application of different pulmonary function tests, such as spirometry, seem essential for assessment.

Assessment of Pulmonary Function Parameters and Respiratory Symptoms in Shipyard Workers of Asaluyeh City, Iran.

BACKGROUND: Workers in shipyard companies are exposed to different respiratory hazards. The present case-control study was designed to evaluate pulmonary function tests and respiratory symptoms among shipyard workers in Asaluyeh city in Southwest Iran. MATERIAL AND METHOD: Between March and October 2015 we recruited participants from two separate populations: shipyard workers as cases and office workers from the same shipyard company, who are not exposed to the same respiratory hazards, as controls. History was obtained from all participants and they all underwent physical examination and spirometry. RESULTS: Respiratory signs and symptoms were present in a significantly higher number of shipyard workers compared to the unexposed office workers. Similarly, there were significant spirometric differences between cases and controls. CONCLUSION: It seems that workplace hazards play a more significant role than other factors such as air pollution in development of respiratory diseases, and future studies for investigating respiratory symptoms, pulmonary function parameters, biological monitoring and measurement of respiratory hazard need to be performed.

Role of occupational stress and burnout in prevalence of musculoskeletal disorders among embassy personnel of foreign countries in iran.

BACKGROUND: Occupation is one of the major parts of our daily lives that might cause a great amount of stress. Stress and job burnout are linked together. The association between musculoskeletal disorders (MSD) and burnout syndrome as a psychosocial factor was investigated previously. OBJECTIVES: The aim of this study was to identify the role of occupational stress and burnout in musculoskeletal complaint among diplomatic employees of different embassies in Iran. MATERIALS AND METHODS: In a cross-sectional study, we assessed 200 employees of the foreign countries embassies in Iran. The participants were selected randomly from all the embassy personnel. Study questionnaires were delivered to the participants and finally 161 questionnaires were returned to the researchers (response rate: 80.5%). An assessment of burnout and MSD were made using the Maslach Burnout Inventory (MBI) and Nordic questionnaires. The work place stress was measured by the work place stress questionnaire. RESULTS: Mean occupational stress was significantly higher among embassy personnel with MSD than among the personnel without this syndrome during the preceding week (17.18 ± 3.42 and 16.06 ± 2.19, respectively; P = 0.02) and the preceding year (17.17 ± 3.11 and 16.74 ± 3.03, respectively; P < 0.01) to the study. Only smoking and occupational stress were identified as independent predictors of MSD among embassy personnel. CONCLUSIONS: It seems that association between musculoskeletal complaints and burnout syndrome was more complex than being attributed to only occupation stress. Further studies are recommended to determine other related factors to this association.