Investigating human error in Iran's copper mines using the CREAM based on human cognitive reliability analysis.

Objectives Human error has been recognized as one of the top causes of most accidents in mines. This study aimed to identify and assess cognitive errors among copper miners using the cognitive reliability and error analysis method (CREAM). Methods. This cross-sectional study was carried out in one of the copper mines in Iran. First, all tasks were analyzed by hierarchical task analysis (HTA). Then cognitive errors were assessed using the CREAM. Results. With respect to the basic CREAM results in the operational units, including extraction, crushing and processing, human error probability (HEP) was obtained as 0.056, 0.0315 and 0.0177, respectively. Based on the results of the extended CREAM, the types of errors identified for all tasks in the three operational units were mainly associated with execution (53.4%), observation (40%), interpretation (5%) and planning (1.6%). Also, the cognitive errors were related to execution, monitoring, observation, communication, diagnosis, recording and planning, respectively. Conclusion. The results showed that human error is very high in the operational units of the mine. Therefore, immediate actions are needed to improve safety performance in the mine units, which determine the role of various factors in human errors and can provide the possibility of implementing more effective interventions.

Exploring individual factors influencing human reliability among control room operators: a qualitative study.

Identifying the individual factors is a major issue in determining the likelihood of human error and ultimately human reliability. In current human reliability assessment methods, this is determined based on a list of performance shaping factors and experts' judgment. This was a qualitative content analysis study, in which the participants were selected using purposive sampling from combined cycle power plant control rooms. Semi-structured interviews were performed and collected data were analyzed. A total of 32 operators (20 module controllers, eight head operators and four managers) were interviewed. Five categories were extracted, namely 'mental condition', 'consciousness at work', 'professional competence', 'communication skills' and 'quick reactions and decision-making capabilities'. Accordingly, it is suggested to taken into account such factors as professional competence and speed of reactions and to pay more attention to their important factors in the reliability of operators in combined cycle power plant control rooms.

Identification of factors that influence occupational accidents in the petroleum industry: A qualitative approach.

BACKGROUND: Exploring experiences of individuals for barriers they confront relating to safety could help to design safety interventions with an emphasis on the most safety influencing factors. OBJECTIVE: This study strived to present an empirical exploration of individuals' experiences across the petroleum industry at different levels of the organizational structure for factors that influence occupational accidents. METHOD: Based on accidents history, face-to-face semi-structured interviews were conducted with individuals who engaged in fatal activities, as well as authorities responsible for managing safety. The qualitative content analysis of 46 interview transcripts was conducted using MAXQDA software. RESULTS: A three-layer model comprising organizational, supervisory and operator level influencing factors with 16 categories were found influence factors of occupational safety. The results highlighted the role of organizational factors, including inappropriate contract management, inadequate procedures, and issues relating to competency management and the organizational climate. Moreover, defects relating to the monitoring and supervision system were identified as important causes of accidents. CONCLUSIONS: The findings demonstrated that the qualitative approach could reveal additional latent aspects of safety influencing factors, which require consideration for the appropriate management of occupational safety. This study can guide the planning of preventive strategies for occupational accidents in the petroleum industry.

A probabilistic approach for economic evaluation of occupational health and safety interventions: a case study of silica exposure reduction interventions in the construction sector.

BACKGROUND: Construction workers are at a high risk of exposure to various types of hazardous substances such as crystalline silica. Though multiple studies indicate the evidence regarding the effectiveness of different silica exposure reduction interventions in the construction sector, the decisions for selecting a specific silica exposure reduction intervention are best informed by an economic evaluation. Economic evaluation of interventions is subjected to uncertainties in practice, mostly due to the lack of precise data on important variables. In this study, we aim to identify the most cost-beneficial silica exposure reduction intervention for the construction sector under uncertain situations. METHODS: We apply a probabilistic modeling approach that covers a large number of variables relevant to the cost of lung cancer, as well as the costs of silica exposure reduction interventions. To estimate the societal lifetime cost of lung cancer, we use an incidence cost approach. To estimate the net benefit of each intervention, we compare the expected cost of lung cancer cases averted, with expected cost of implementation of the intervention in one calendar year. Sensitivity analysis is used to quantify how different variables affect interventions net benefit. RESULTS: A positive net benefit is expected for all considered interventions. The highest number of lung cancer cases are averted by combined use of wet method, local exhaust ventilation and personal protective equipment, about 107 cases, with expected net benefit of $45.9 million. Results also suggest that the level of exposure is an important determinant for the selection of the most cost-beneficial intervention. CONCLUSIONS: This study provides important insights for decision makers about silica exposure reduction interventions in the construction sector. It also provides an overview of the potential advantages of using probabilistic modeling approach to undertake economic evaluations, particularly when researchers are confronted with a large number of uncertain variables.

Impact of a Caregiver-Friendly Workplace Policies Intervention: A Prospective Economic Evaluation.

OBJECTIVE: We estimate the potential cost-benefit of a caregiver-friendly workplace policies (CFWPs) educational intervention to facilitate uptake of supports for carer-employees (CEs) at a post-secondary institution. METHODS: We identified CEs through a voluntary survey and estimated the economic burden of caregiving activities from the CEs' and employer's perspective. The latter is used as the baseline of comparison for evaluating the cost-benefit of the intervention. RESULTS: The economic cost of caregiving-related activities for the "no intervention" scenario was estimated at $33,841,789 ($32,922 per-case) and $8,916,342 ($8,674 per-case) from the CEs' and employer's perspectives, respectively. We find the educational intervention is a cost-beneficial program with the net benefit ranging from $48,010 to $676,657, based on six scenarios of effectiveness. CONCLUSION: This study provides practical information for human resources and operations management decision-making in terms of a CFWPs educational intervention.

The effect of simultaneous exposure to cigarette smoke and noise on distortion product otoacoustic emissions in rats.

Cigarette smoking is a possible risk factor for hearing loss. However, the impact of simultaneous exposure to noise and smoke on hearing has remained controversial. This study investigated the combined effect of exposure to cigarette smoking and noise on hearing loss. Three groups of male Wistar rats (275 ± 25 g) were subjected to white noise (102 ± 0.5 dB), cigarette smoking (20 cigarettes), and both cigarette smoking and noise for 8 h and 10 days inside the exposure chamber. The control group was exposed to neither noise nor smoke. Distortion product otoacoustic emissions (DPOAE) were measured before any intervention, and it was repeated 1, 7, and 21 days after the last exposure. One-day postexposure to noise, cigarette smoking, and both cigarette smoking and noise, the mean of DPOAE amplitudes decreased significantly ( p < 0.05) between, respectively, 5.7-30.7, 1.5-7.5, and 5.2-32.6 dB within the frequency range of 4620-9960. Temporal DPOAE change in rats exposed to noise or both cigarette smoking and noise was not significantly different ( p > 0.05). DPOAE amplitudes returned to the baseline values in the group subjected to smoking 21 days postexposure. The most permanent change was observed in rats exposed to both cigarette smoking and noise. Accordingly, simultaneous subacute exposure to noise and cigarette smoking increases the effect of noise on permanent hearing loss. Therefore, smoking workers exposed to noise might be at a greater risk of developing hearing loss, and it is recommended that authorities in charge take note of this evidence.

Validity and consistency assessment of accident analysis methods in the petroleum industry.

Background. Accident analysis is the main aspect of accident investigation. It includes the method of connecting different causes in a procedural way. Therefore, it is important to use valid and reliable methods for the investigation of different causal factors of accidents, especially the noteworthy ones. Objective. This study aimed to prominently assess the accuracy (sensitivity index [SI]) and consistency of the six most commonly used accident analysis methods in the petroleum industry. Methods. In order to evaluate the methods of accident analysis, two real case studies (process safety and personal accident) from the petroleum industry were analyzed by 10 assessors. The accuracy and consistency of these methods were then evaluated. The assessors were trained in the workshop of accident analysis methods. Results. The systematic cause analysis technique and bowtie methods gained the greatest SI scores for both personal and process safety accidents, respectively. The best average results of the consistency in a single method (based on 10 independent assessors) were in the region of 70%. Conclusion. This study confirmed that the application of methods with pre-defined causes and a logic tree could enhance the sensitivity and consistency of accident analysis.

The economic burden of occupational non-melanoma skin cancer due to solar radiation.

Solar ultraviolet (UV) radiation is the second most prevalent carcinogenic exposure in Canada and is similarly important in other countries with large Caucasian populations. The objective of this article was to estimate the economic burden associated with newly diagnosed non-melanoma skin cancers (NMSCs) attributable to occupational solar radiation exposure. Key cost categories considered were direct costs (healthcare costs, out-of-pocket costs (OOPCs), and informal caregiver costs); indirect costs (productivity/output costs and home production costs); and intangible costs (monetary value of the loss of health-related quality of life (HRQoL)). To generate the burden estimates, we used secondary data from multiple sources applied to computational methods developed from an extensive review of the literature. An estimated 2,846 (5.3%) of the 53,696 newly diagnosed cases of basal cell carcinoma (BCC) and 1,710 (9.2%) of the 18,549 newly diagnosed cases of squamous cell carcinoma (SCC) in 2011 in Canada were attributable to occupational solar radiation exposure. The combined total for direct and indirect costs of occupational NMSC cases is $28.9 million ($15.9 million for BCC and $13.0 million for SCC), and for intangible costs is $5.7 million ($0.6 million for BCC and $5.1 million for SCC). On a per-case basis, the total costs are $5,670 for BCC and $10,555 for SCC. The higher per-case cost for SCC is largely a result of a lower survival rate, and hence higher indirect and intangible costs. Our estimates can be used to raise awareness of occupational solar UV exposure as an important causal factor in NMSCs and can highlight the importance of occupational BCC and SCC among other occupational cancers.

Protective Effects of N-Acetyl-L-Cysteine on the Density of Spiral Ganglion Cells and Histological Changes Induced by Continuous Noise Exposure in Rats.

BACKGROUND: Noise exposure causes loss of cochlea hair cells, leading to permanent sensorineural hearing loss, and initiates pathological changes to the bipolar primary auditory neurons (ANs). This study focuses on the effects of N-acetyl-l-cysteine (NAC) in protecting the density of spiral ganglion cells and in histological changes induced by continuous noise exposure in rats. METHODS: Twenty-four male Wistar rats were randomly allocated into four experimental groups to receive NAC, saline, noise, or both noise and NAC. Noise exposure continued for ten days. Saline and NAC were injected daily during the noise exposure, and 2 days before and after the noise exposure. Evaluation of cochlear histopathology and the density of spiral ganglion cells was performed 21 days after exposure. RESULTS: In the animals exposed to noise, a reduction in the density of spiral ganglion cells was evident in both the basal and middle turns of the cochlea. This improved on receiving NAC treatment (P = 0.046). In the histopathology evaluation, some histological changes, such as disorganised architecture of the outer hair and supporting cells and a slightly thickened basilar membrane, were found in the basal turns in the noise group. CONCLUSION: NAC offered partial protection against noise exposure by improving the density of spiral ganglion cells and reducing morphological changes.

Multiple dimensions of work-related risk factors and their relationship to work ability among industrial workers in Iran.

OBJECTIVES: The present study was designed to investigate the simultaneous effects of physical, psychosocial and other work-related risk factors on the work ability index (WAI) score among industrial workers. METHODS: This study used a cross-sectional design with a questionnaire survey. A total of 280 workers were included in the study. Data were collected using three questionnaires including the Persian version of the WAI, the Persian version of the job content questionnaire and an author-developed measure (to assess work-related factors, health-related factors and socio-demographic characteristics). RESULTS: The majority of the participants were young, but they had poor WAI scores (mean 37.3 ± 6.4) and 44.3% of them had poor or moderate work ability. Occupational accidents and injuries were found to be the strongest predictors of WAI scores. Additionally, there was a strong association between WAI scores and supervisor support, skill discretion, occupational training, sleep quality, work nature and educational level. CONCLUSIONS: Intervention programs should focus on improving supervisor support, sleep quality, job skills and knowledge and on decreasing physical and mental work demands. Additionally, implementing a comprehensive occupational health and ergonomics program for controlling and reducing hazardous working environments and occupational injury rates should be considered.

A New Microwave Shield Preparation for Super High Frequency Range: Occupational Approach to Radiation Protection.

BACKGROUND: Widespread use of X-band frequency (a part of the super high frequency microwave) in the various workplaces would contribute to occupational exposure with potential of adverse health effects.  According to limited study on microwave shielding for the workplace, this study tried to prepare a new microwave shielding for this purpose. METHODS: We used EI-403 epoxy thermosetting resin as a matrix and nickel oxide nanoparticle with the diameter of 15-35 nm as filler. The Epoxy/ Nickel oxide composites with 5, 7, 9 and 11 wt% were made in three different thicknesses (2, 4 and 6 mm). According to transmission / reflection method, shielding effectiveness (SE) in the X-band frequency range (8-12.5 GHz) was measured by scattering parameters directly given by the 2-port Vector Network Analyzer. The fabricated composites characterized by X-ray Diffraction and Field Emission Scanning Electron Microscope. RESULTS: The best average of shielding effectiveness in each thickness of fabricated composites obtained by 11%-2 mm, 7%-4 mm and 7%-6 mm composites with SE values of 46.80%, 66.72% and 64.52%, respectively. In addition, the 11%-6 mm, 5%-6 mm and 11%-4 mm-fabricated composites were able to attenuate extremely the incident microwave energy at 8.01, 8.51 and 8.53 GHz by SE of 84.14%, 83.57 and 81.30%, respectively. CONCLUSIONS: The 7%-4mm composite could be introduced as a suitable alternative microwave shield in radiation protection topics in order to its proper SE and other preferable properties such as low cost and weight, resistance to corrosion etc. It is necessary to develop and investigate the efficacy of the fabricated composites in the fields by future studies.

Relationship between organisational safety culture dimensions and crashes.

Knowing about organisational safety culture in public transportation system can provide an appropriate guide to establish effective safety measures and interventions to improve safety at work. The aim of this study was investigation of association between safety culture dimensions (leadership styles and company values, usage of crashes information and prevention programmes, management commitment and safety policy, participation and control) with involved self-reported crashes. The associations were considered through Spearman correlation, Pearson chi-square test and logistic regression. The results showed an association among self-reported crashes (occurrence or non-occurrence) and factors including leadership styles and company values; management commitment and safety policy; and control. Moreover, it was found a negative correlation and an odds ratio less than one between control and self-reported crashes.

Assessment of accident severity in the construction industry using the Bayesian theorem.

AIM: Construction is a major source of employment in many countries. In construction, workers perform a great diversity of activities, each one with a specific associated risk. The aim of this paper is to identify workers who are at risk of accidents with severe consequences and classify these workers to determine appropriate control measures. METHODS: We defined 48 groups of workers and used the Bayesian theorem to estimate posterior probabilities about the severity of accidents at the level of individuals in construction sector. First, the posterior probabilities of injuries based on four variables were provided. Then the probabilities of injury for 48 groups of workers were determined. RESULTS: With regard to marginal frequency of injury, slight injury (0.856), fatal injury (0.086) and severe injury (0.058) had the highest probability of occurrence. It was observed that workers with <1 year's work experience (0.168) had the highest probability of injury occurrence. The first group of workers, who were extensively exposed to risk of severe and fatal accidents, involved workers ≥ 50 years old, married, with 1-5 years' work experience, who had no past accident experience. CONCLUSION: The findings provide a direction for more effective safety strategies and occupational accident prevention and emergency programmes.

Analysis of Occupational Accident Fatalities and Injuries Among Male Group in Iran Between 2008 and 2012.

BACKGROUND: Because of occupational accidents, permanent disabilities and deaths occur and economic and workday losses emerge. OBJECTIVES: The purpose of the present study was to investigate the factors responsible for occupational accidents occurred in Iran. PATIENTS AND METHODS: The current study analyzed 1464 occupational accidents recorded by the Ministry of Labor and Social Affairs' offices in Iran during 2008 - 2012. At first, general understanding of accidents was obtained using descriptive statistics. Afterwards, the chi-square test and Cramer's V statistic (Vc) were used to determine the association between factors influencing the type of injury as occupational accident outcomes. RESULTS: There was no significant association between marital status and time of day with the type of injury. However, activity sector, cause of accident, victim's education, age of victim and victim's experience were significantly associated with the type of injury. CONCLUSIONS: Successful accident prevention relies largely on knowledge about the causes of accidents. In any accident control activity, particularly in occupational accidents, correctly identifying high-risk groups and factors influencing accidents is the key to successful interventions. Results of this study can cause to increase accident awareness and enable workplace's management to select and prioritize problem areas and safety system weakness in workplaces.

Are Supplementation of Omega-3 and Ascorbic Acid Effective in Reducing Oxidative Stress and Depression among Depressed Shift Workers?

BACKGROUND: This study assessed the effect of supplementation of omega-3 fatty acids and ascorbic acid alone and in combination on the level of lipid peroxidation (malondialdehyde, MDA concentration), total antioxidant capacity (TAC) and depression scores in depressed rotational shift workers in the Tehran Shahid Tondgoyan Oil refinery. MATERIAL AND METHODS: In this randomized, double-blind, placebo-controlled trial, 136 men who met the inclusion and exclusion criteria and had a Beck Depression Inventory (BDI) score ≥ 10 were selected. Among the participants, 33 received omega-3 fatty acid soft gel (1000 mg twice daily) with vitamin C (250 mg twice daily) (group 1), 31 took omega-3 fatty acid supplements and vitamin C placebo (group 2), 30 took omega-3 fatty acid supplement placebo and vitamin C (group 3), and 32 received omega-3 fatty acid supplement placebo and vitamin C placebo (group 4) for 2 months. Measured were serum MDA, TAC concentrations, and BDI scores at baseline and after 2 months. RESULTS: This study showed that the BDI score was reduced significantly in all 4 groups, however, the level of decrease was more in the omega-3 fatty acid (alone) supplementation group (mean 6.29 score decrease) (p < 0.001). MDA level decreased significantly in groups with omega-3 fatty acids (mean 0.78 µmol/L ± 1.64 µmol/L decrease) (p = 0.014) or vitamin C supplementation alone (mean 0.74 µmol/L ± 1.55 µmol/L decrease) (p = 0.014), but not in combination. CONCLUSIONS: Supplementation of omega-3 fatty acids alone and not in combination with vitamin C had a better impact on depression and MDA level pronounced in depressed male shift workers.

Modeling the factors affecting unsafe behavior in the construction industry from safety supervisors' perspective.

BACKGROUND: There can be little doubt that the construction is the most hazardous industry in the worldwide. This study was designed to modeling the factors affecting unsafe behavior from the perspective of safety supervisors. METHODS: The qualitative research was conducted to extract a conceptual model. A structural model was then developed based on a questionnaire survey (n=266) by two stage Structural Equation Model (SEM) approach. RESULTS: An excellent confirmed 12-factors structure explained about 62% of variances unsafe behavior in the construction industry. A good fit structural model indicated that safety climate factors were positively correlated with safety individual factors (P<0.001) and workplace safety condition (P<0.001). The workplace safety condition was found to play a strong mediating role in linking the safety climate and construction workers' engagement in safe or unsafe behavior. CONCLUSIONS: In order to improve construction safety performance, more focus on the workplace condition is required.

Building a model using bayesian network for assessment of posterior probabilities of falling from height at workplaces.

BACKGROUND: Falls from height are one of the main causes of fatal occupational injuries. The objective of this study was to present a model for estimating occurrence probability of falling from height. METHODS: In order to make a list of factors affecting falls, we used four expert group's judgment, literature review and an available database. Then the validity and reliability of designed questionnaire were determined and Bayesian networks were built. The built network, nodes and curves were quantified. For network sensitivity analysis, four types of analysis carried out. RESULTS: A Bayesian network for assessment of posterior probabilities of falling from height proposed. The presented Bayesian network model shows the interrelationships among 37 causes affecting the falling from height and can calculate its posterior probabilities. The most important factors affecting falling were Non-compliance with safety instructions for work at height (0.127), Lack of safety equipment for work at height (0.094) and Lack of safety instructions for work at height (0.071) respectively. CONCLUSION: The proposed Bayesian network used to determine how different causes could affect the falling from height at work. The findings of this study can be used to decide on the falling accident prevention programs.

Oxidative Stress and Depression among Male Shift Workers in Shahid Tondgouyan Refinery.

OBJECTIVE: The aim of this study was to determine the oxidative stress; serum level of Total Antioxidant Capacity (TAC)and Malondialdehyde (MDA) level and the depression score among the depressed rotational shift workers in Shahid Tondgouyan Refinery in Tehran (Iran). METHODS: A cross-sectional study was conducted among all the 189 shift workers in Shahid Tondgouyan oil refinery who were eligible to participate in the study. They did not take any antidepressants for two months or any supplements for two weeks prior to the study entry. Written consent was obtained from the participants. 21- Item Beck Depression Inventory was used to measure the depression level. Furthermore, body weight, height and systolic and diastolic blood pressure were collected from all the participants. The levels of Total Antioxidant Capacity (TAC) and Malondialdehyde (MDA) were measured by 8 ml fasting blood sample. MDA was determined by thiobarbituric acid reaction. Serum total antioxidants were measured using the spectrophotometric ABTS. In the ABTS test, 2,2'-azinobis (3-ethylbenzthiazoline-6-acid) (ABTS) is converted into its radical cation (ABTS•+) by addition of sodium persulphate. This blue-green radical cation absorbs light at 734 nm. ABTS•+ is reactive towards most antioxidants. Descriptive statistics, ANOVA, ANCOVA and regression tests and correlation were used to analyze the data using SPSS software version 16. RESULTS: The age of the participants ranged from 21 to 52 years. The mean age of the participants was 30.58 year (±6.97yr). Of all the participants, 28% (n= 53) had no depression symptoms (depression score between 0 and 9), 65.1% (n=123) were categorized as having mild depression (depression score between 10 and 18) and 6.9% (n=13) were categorized as having moderate depression (depression score between 19 and 29). The participants' BMI ranged from 15.9 to 34.3; the mean BMI of the participants was 24.82 kg/m(2) (+ 3.81 kg/m(2)). The mean of the serum TAC level was 2.51 (± 0.56) mg/dl, and the mean serum MDA level was 3.67(± 1.08) µmol/l. There was a significant difference in the mean TAC concentration between the non-depressed group and the group with mild depression (p=0.029). CONCLUSION: Depression was associated with reduced mean TAC concentration and an increase in MDA level. There was a linear relationship between the depression score and shift work experience among the rotational shift workers, which showed a high level of stress and depression among the shift-workers.

Cardiac Strain between Normal Weight and Overweight Workers in Hot/Humid Weather in the Persian Gulf.

BACKGROUND: In hot weather, overweight and obesity are considered as significant risk factors for the incidence of cardiac strain in workers. This study was aimed to compare cardiac strain among overweight and normal-weight workers in hot, humid conditions in the south of Iran. METHODS: This cross-sectional study was conducted on 71 workers in the south of Iran in summer 2010. The heart rate was measured at rest and at actual work. Cardiac strain based on working heart rate (WHR), the relative cardiac cost (RCC), the net cardiac cost (NCC), load relative cardiovascular (CVL), and heart rate reduction was analyzed in 35 normal-weight people (body mass index (BMI) <25 kg/m(2)) and 36 overweight people (BMI >25 kg/m(2)) using descriptive statistics. RESULTS: In 42% of the total workers, BMI was >25 kg/m(2). The average of Wet Bulb Globe Temperature Index (WBGT Index) in the two groups was not significantly different. The mean WHR in the two groups was 101 ± 20.3 and 112 ± 18.9, respectively (P = 0.026). Percentages exceeded the acceptable limits in the parameters NCC, RCC, WHR, CVL, and Brouha index, which were significantly higher in overweight people than in those with normal weight. CONCLUSIONS: Based on the study results, it is concluded that the severity of cardiac strain was higher in overweight workers compared with that in normal weight workers. Hence, in order to decrease the cardiac strain, selecting overweight individuals for these jobs should be avoided and also some vital intervention for losing weight should be implemented such as nutrition education and encouraging them regarding physical activity.

Effect of omega-3 and ascorbic acid on inflammation markers in depressed shift workers in Shahid Tondgoyan Oil Refinery, Iran: a randomized double-blind placebo-controlled study.

UNLABELLED: The present study aimed to assess the effect of supplementation of omega-3 and/or vitamin C on serum interleukin-6 and high sensitivity C-reactive protein concentration and depression scores among shift workers in Shahid Tondgoyan oil refinery. The study design was randomized, double-blind, placebo-controlled, parallel trial. Totally 136 shift workers with a depression score ≥10 in 21-item Beck Depression Rating Scale were randomly assigned to receive omega-3 (180 mg eicosapentaenoate acid and 120 mg docosahexaenoic acid) or/and vitamin C 250 mg or placebo twice daily (with the same taste and shape as omega-3 and vitamin C) for 60 days in four groups. Depression score, interleukin-6 and high sensitivity C-reactive protein were measured at baseline and after 60 days. This study showed that supplementation of omega-3 plus vitamin C is associated with a decrease in depression score (p<0.05). Supplementation of omega-3 without vitamin C, is associated with a reduction in depression score (p<0.0001) and high sensitivity C-reactive protein concentration (p<0.01). Therefore omega-3 supplementation showed a better effect on reducing depression score and high sensitivity C-reactive protein, but supplementation of vitamin C along with omega-3 did not have significant effect on change in C-reactive protein level compared to omega-3 alone. ( REGISTRATION NUMBER: IRCT201202189056N1).