Reproductive outcomes among female health care workers.

OBJECTIVE: Occupational exposures may be associated with reproductive health and pregnancy outcomes. This study investigated the association between occupational exposures and reproductive health, pregnancy outcomes, and the lactation period among hospital staff. MATERIALS AND METHODS: Seven hundred thirty-three female healthcare workers from hospitals affiliated with the Tehran University of Medical Sciences were invited to participate in this cross-sectional study. The measurement method for fertility consequences was self-report. Demographic characteristics, occupational data, medical history, and reproductive history were collected via data collection form. Finally, reproductive outcomes were evaluated in different occupational hazard categories. RESULT: Chemical exposures (solvents) were a risk factor for stillbirth. Prolonged working hours were associated with spontaneous abortion and breastfeeding periods. Shift workers did not have a higher frequency of reproductive and pregnancy outcomes, but the breastfeeding period was significantly decreased in shift workers. Psychiatric disorders were associated with preterm labour, low birth weight, and stillbirth in sequence with nervousness, depression, and mood disturbance. Furthermore, depression affects the breastfeeding period. Moreover, we found a link between job titles and infertility. In addition, socioeconomic status was related to stillbirth and infertility. CONCLUSION: The study revealed that chemical and ergonomic exposures have associations with some reproductive outcomes. We also conclude that shift work could adversely affect the breastfeeding period. So, implementing some organizational strategies to control adverse health effects of occupational hazards and modifying shift work and working hours for nursing mothers is recommended.

PCB plasma level in different occupational groups in Iran.

Despite the ban of polychlorinated biphenyls (PCBs) some decades ago, concerns regarding their adverse health effects are continuing, because the workers employed for installation and repair of electrical equipment may be still exposed to PCBs. This study aimed to assess serum PCBs levels in workers in different industries. To do this, we determined the serum concentrations of 9 non-dioxin-like PCBs and 12 dioxin-like PCBs in 147 workers from seven occupational groups and 35 housewives. An electrical distribution company, paint manufacturer, and pesticide manufacturer were categorized as high probability exposure jobs, whereas turning and casting operations, polymer plastic manufacturing, professional driving, and office work were categorized as low probability exposure jobs. In addition, the average of PCB 138, 153, and 180 and PCB sums were observed to be significantly higher in paint manufacture workers compared to the another groups. In addition, the average PCB 118 level was higher in electrical distribution workers and housewives. Following the adjustment for age, blood lipid, residency place, and seafood in the regression model, the association of PCB 118 in electrical distribution workers and PCB 153 in paint manufacture workers remained significant. The results of this study served as further support for the hypothesis for an occupational basis for bioaccumulation of some PCB types. However, the plasma levels of almost all PCB congeners in Iran were found to be lower than many other countries.

The STOP-BANG questionnaire: reliability and validity of the Persian version in sleep clinic population.

PURPOSE: The snoring, tiredness, observed apnea, blood pressure, body mass index, age, neck circumference, gender (STOP-BANG) is a concise and effective obstructive sleep apnea (OSA) screening tool, part questionnaire (STOP), and part demographic or anthropometric measurements (BANG). The main purpose of this study was to translate this well-liked questionnaire into Persian and assess its reliability and validity in sleep clinic population. METHODS: Standard forward-backward method was used for translation. A sample of 603 patients, who admitted to the sleep clinic, completely answered to the STOP questionnaire and underwent in-laboratory polysomnography, included in this study. Height, weight, and neck circumference were measured by technicians for calculating BANG score. The apnea-hypopnea index (AHI) on the polysomnography was used as gold standard for OSA diagnosis: none (AHI < 5), mild (5 ≤ AHI < 15), moderate (15 ≤ AHI < 30), and severe (AHI ≥ 30). One hundred and forty one patients were answered to the STOP questionnaire twice at a time interval of 2-4 weeks for test-retest analysis. RESULTS: In reliability analysis, 124 (87.9 %) patients had same STOP score and 130 (92.2 %) patients were classified in same risk of OSA. Based on the polysomnography, 438 patients (72.6 %) had mild (n = 124, 20.4 %), moderate (n = 114, 18.9 %), and severe (n = 201, 33.3 %) OSA, whereas according to the STOP-BANG, 502 patients (83.3 %) were at high risk of OSA. The sensitivity and specificity of the STOP-BANG were found to be 91.6 and 45.2 %, respectively, at AHI ≥ 5, 97.1 and 35.2 %, respectively, at AHI ≥ 15, and 98 and 29.4 %, respectively, at AHI ≥ 30. The area under the curve of the STOP-BANG for identifying mild, moderate, and severe OSA was 0.805, 0.779, and 0.755, respectively. CONCLUSIONS: Persian version of the STOP-BANG performs similar to its original version and is an easy-to-use questionnaire which could be considered as a reliable and valid tool for OSA screening.

Traffic crash accidents in Tehran, Iran: Its relation with circadian rhythm of sleepiness.

PURPOSE: Road traffic accidents are one of main problems in Iran. Multiple factors cause traffic accidents and the most important one is sleepiness. This factor, however, is given less attention in our country. Road traffic accidents relevant to sleepiness are studied. METHODS: In this cross-sectional study, all road traffic accidents relevant to sleepiness, which were reported by police, were studied in Tehran province in 2009. RESULTS: The risk of road traffic accidents due to sleepiness was increased by more than sevenfold (odds ratio = 7.33) in low alertness hours (0:00-6:00) compared to other time of day. The risk of road traffic accidents due to sleepiness was decreased by 0.15-fold (odds ratio = 0.15) in hours with maximum of alertness (18:00-22:00) of circadian rhythm compared to other time of day. CONCLUSION: The occurrence of road traffic accidents due to sleepiness has significant statistical relations with driving during lowest point of alertness of circadian rhythm.

The Insomnia Severity Index: cross-cultural adaptation and psychometric evaluation of a Persian version.

PURPOSE: The main purpose of this study was to describe the cultural adaptation of a Persian version of the Insomnia Severity Index and to evaluate its psychometric properties by testing internal consistency, construct validity, discriminant validity, and concurrent validity. METHODS: Cross-cultural adaptation was carried out according to guidelines and included forward and backward translations, expert committee, and field test. A sample of 1,037 sleep clinic patients filled in a questionnaire package including the Persian version of the Insomnia Severity Index (ISI-P), the Pittsburgh Sleep Quality Index (PSQI), the Epworth Sleepiness Scale (ESS), and the Beck Depression Inventory (BDI). In addition, 624 of these patients were assessed by polysomnography (PSG). A group of 50 members of hospital staff responded to the ISI-P as the control group. Internal consistency with Cronbach's alpha, construct validity with principal component analysis, discriminant validity with assessing the ISI-P's ability to differentiate patients from control group and concurrent validity with exploring the spearman correlation with the PSQI, ESS, BDI, and corresponding parameters in PSG were followed to examine the psychometric properties of the ISI-P. RESULTS: The ISI-P showed acceptable internal consistency (Cronbach's alpha = 0.78) and a 2-factor solution in factor analysis. The ISI-P discriminated well between patients and control group (15.90 ± 6.12 vs 10.10 ± 5.76, P value <0.001). Items and total score of the ISI-P showed a weak correlation with the corresponding parameters in PSG. The ISI-P total score was significantly correlated with total score of the PSQI (r = 0.74, P value <0.001) and the BDI (r = 0.42, P value <0.001), while it was not significantly correlated with total score of the ESS (r = 0.12, P value = 0.72). CONCLUSIONS: Cross-cultural adaptation was successful, and the ISI-P has good psychometric properties. Using the ISI-P is recommended to evaluate insomnia in research and clinical settings in Persian-speaking people.

Prevalence of premenstrual syndrome and related factors among nurses.

Objective: Premenstrual syndrome (PMS) is a common condition among women during their menstrual cycle. PMS can negatively affect a woman's daily life and function. Nurses, as an important and substantial segment of healthcare staff, are affected by the demanding environment of work place. Since PMS, as a prevalent counterproductive condition, has not been studied in this population in Iran, we assessed the prevalence of PMS and its associated factors among nurses aged 23 to 49 in teaching hospitals of the Tehran province of Iran. Material and Methods: In this cross-sectional study from April 2021 to January 2022, 280 participants from teaching hospitals were enrolled. Simple random sampling was used to determine the sample size of the study. Two validated questionnaires and a data gathering sheet were used to collect information. The premenstrual symptoms screening tool was used to determine PMS severity and the Copenhagen Psychosocial Questionnaire to evaluate the associated job demands. Demographic data and work-related data included: night shift, shift type, monthly COVID-19 care and gynecologic and past medical history were gathered. Then data were analyzed using logistic regression analysis, chi-square and t-test. Results: The severity of PMS was: mild (42.5%); moderate (30%); and severe (27.5%). Regular menstruation and dysmenorrhea were reported by 84.6% and 72.3%, respectively. Moderate to severe PMS was associated with: monthly COVID shift (p=0.02); emotional (p<0.01) and quantitative (p<0.01) demands; regular caffeine intake (p=0.01); education level (p=0.005); regular exercise (p=0.003); regular fiber intake (p=0.08); and irregular menstrual cycles (p=0.007). In logistic regression only quantitative (p=0.003) and emotional (p=0.018) job demands were significant. Conclusion: Results showed that the prevalence of PMS was high among Iranian nurses and was associated with quantitative and emotional job demands. We suggest further studies focusing on preventative and effective interventions to diminish the consequences of PMS in this population. We also suggest investigating the practical application of the findings of this study for healthcare professionals and policymakers.

The Epworth Sleepiness Scale: translation and validation study of the Iranian version.

PURPOSE: The main purpose of this study was to assess the reliability and validity of the Iranian version of the Epworth Sleepiness Scale (ESS-IR). METHODS: This was a cross-sectional study of 507 suspicious patients either to obstructive sleep apnea (n = 466) or narcolepsy (n = 41) in order to carry out a psychometric evaluation of the ESS-IR by performing reliability, validity, and responsiveness analyses. Reliability of the ESS-IR was assessed by internal consistency and test-retest reliability. Validity of the instrument was assessed using several statistical approaches including construct validity (exploratory factor analysis), discriminant validity, and criterion validity. Responsiveness of the ESS-IR was assessed by comparing the ESS-IR total score before and after 6-9 months of continues positive airway pressure (CPAP) treatment in 16 patients with obstructive sleep apnea (OSA). RESULTS: The ESS-IR had an acceptable internal consistency and test-retest reliability. Factor analysis in both groups showed a two-factor solution for the ESS-IR, but the first factor showed statistically significant loads in all items. In addition, the ESS-IR discriminated well between patients with and without OSA. There is a fair correlation between the ESS-IR total score and multiple sleep latency test results that is not significant at all. Finally, the ESS-IR was found to be responsive to change where the total score was significantly decreased after CPAP treatment (P < 0.001). CONCLUSION: The findings suggest that the ESS-IR is a reliable and valid measure for evaluating daytime sleepiness and now can be used in research and clinical settings in Iran.

Occupational stress and job performance among Iranian hospital nurses: A cross-sectional survey.

BACKGROUND: Occupational stress is one of the most important factors affecting nurse performance. However, there is a lack of data about the association between occupational stress and performance. OBJECTIVE: The aim of this study was to determine the occupational stress level and its association with job performance in hospital staff. METHODS: This cross-sectional study was conducted among 400 hospital staff of Tehran University of medical sciences in 2018. Subjects completed the World Health Organization Health and Work Performance questionnaire (WHO HPQ) for demographic and occupational characteristics, and the Short Form of Copenhagen questionnaire. RESULTS: The demand and individual interface domain received the highest and the lowest score of occupational stress respectively. We found that the median for absenteeism distribution was 16 hours and, in our study, less than 10 % of the nurses had low performance. Working in intensive care units, fewer night shifts, higher income, higher levels of vitality, and social support could decrease absenteeism. In addition, staff who felt more supported and reported lower emotional demands had higher performance. CONCLUSION: Since higher levels of social support could have positive influences on reducing absenteeism and improving performance, it is recommended that hospital managers should be encouraged to use educational programs, coping behaviors, and effective interventions to improve social support. Financial incentives are a factor that could also be used to reduce absenteeism.

The Combined Effect of Noise and Solvent Exposure on Hearing Loss in the Tire Factory Workers.

Noise and organic solvents are common in many industries and both of them affect hearing. In this study, we estimated the concurrent effect of them on hearing by evaluating the existence of notch in audiograms of workers. The number of 540 persons were enrolled in this study after eliminating workers who had the exclusion criteria. We divided them into 4 groups based on their exposure status; no exposure, exposure to noise, exposure to solvent, exposure to both of them. The presence of notch in left, right, or both ears were assessed through Coles model. The rates of notch presence in both ears in the groups of noise and organic solvents exposure, noise exposure only, solvents exposure only were 11.72, 4.49, 1.86 times higher than the control group and sole solvent exposure didn't affect hearing significantly. The same pattern was seen for notch presence in left or right ear and the solvent-noise exposure group had the highest rate of notch presence. This study aims to show the synergic effect of noise and organic solvents exposure on hearing loss. Hence, we recommend implementing a hearing protection program and a higher frequency of audiological assessments in the industries involved with concurrent exposure to noise and organic solvents.

The association between job stress and metabolic syndrome among medical university staff.

BACKGROUND: The relationship between job stress and each component of metabolic syndrome has been previously suggested; however, this association is not consistent. The present study was conducted to assess the association between job stress and metabolic syndrome and its components in a group of Iranian workers affiliated with Tehran University of Medical Sciences. METHODOLOGY: This cross-sectional study was performed on 3,537 randomly selected staff in Tehran University of Medical Sciences including the staff of clinical, administrative, and service departments with at least one year of working experience. The overall frequency of metabolic syndrome was assessed based on the international diabetes federation (IDF) criteria. The Persian version of the Copenhagen Psychosocial Questionnaire (COPSOQ) was used to measure major domains of psychosocial factors in the workplace. RESULTS: The overall frequency of metabolic syndrome in the assessed personnel was estimated to be 22.1 % and there was a significantly higher rate of metabolic syndrome in office workers and service personnel compared to clinical staff (OR: 1.51, CI 95 %: 1.25-1.82 and OR: 1.74, CI 95 %: 1.41-2.14, respectively). Health and well-being as a major domain of COPSOQ was found to be significantly impaired by the presence of metabolic syndrome. According to the results of multiple logistic regression modeling, the relationship between metabolic syndrome and impaired health and well-being domain remained significant after adjusting for age, gender, marital status, educational level, and employment category. CONCLUSIONS: Our findings revealed a close association between job-related stress and the impaired well-being in the presence of metabolic syndrome among the medical university staff.

Association between type of physical activity and risk factors for cardiovascular disease, Islamic Republic of Iran.

BACKGROUND: Little is known about the role of occupational-related physical activity and risk factors for cardiovascular disease. AIMS: This study aimed to assess the association between different types of physical activity (work-related, transport-related, home-time and leisure-time) and risk factors for cardiovascular disease in a sample of Iranian workers. METHODS: This cross-sectional study was conducted from February to November 2018 among 415 workers of a rubber factory in Tehran province. Physical activity levels of the participants were measured using the International Physical Activity Questionnaire. Blood sample were analysed for cardiovascular disease risk factors (fasting blood sugar ≥ 100 mg/ dL, triglycerides ≥ 150 mg/dL, total cholesterol ≥ 200 mg/dL, systolic blood pressure ≥ 130 mmHg, diastolic blood pressure ≥ 85 mmHg and waist circumference ≥ 102 cm). Alanine aminotransferase and aspartate aminotransferase were also measured, as was body mass index (BMI). RESULTS: Risk factors for cardiovascular disease differed significantly according to type of physical activity. Fasting blood sugar ≥ 100 mg/dL and BMI ≥ 25 kg/m2 had a significant negative association with overall physical activity level (P < 0.001). In a logistic regression analysis, leisure-time physical activity had a significant negative correlation with all risk factors for cardiovascular disease after adjusting for age and smoking. CONCLUSION: Leisure-time physical activity has a more important role in reducing cardiovascular disease risk factors than other types of activity, including work-related physical activity.

Association between psychosocial factors and musculoskeletal symptoms among Iranian nurses.

BACKGROUND: While psychosocial factors have been associated with musculoskeletal symptoms among nurses in some countries, previous studies of Iranian nurses show little association using a demand and control questionnaire. The aim of this study is to assess and evaluate the prevalence of musculoskeletal symptoms and to assess their relationships with psychosocial factors among nurses in Iran. METHODS: In a cross-sectional study, 347 hospital nurses completed a self-reported questionnaire containing the Standardized Nordic questionnaire for musculoskeletal symptoms and the General Nordic questionnaire for Psychological and Social factors at work (QPS Nordic 34+ Questionnaire). RESULTS: Prevalence of low back pain, knee pain, shoulder pain, and neck pain were 73.2%, 68.7%, 48.6%, and 46.3%, respectively. Middle and high stress groups had higher crude and adjusted odds than the low stress group for all body sites. The association for neck, wrist/hand, and upper back and ankle/foot reports (adjusted odds ratio for high stress ranging from 2.4 to 3.0) were statistically significant. CONCLUSIONS: We observed a high prevalence of self-reported musculoskeletal symptoms at a number of body sites, which were associated with psychosocial factors and specifically stress as defined by the QPS Nordic 34+ Questionnaire.

Evaluating the quality and duration of sleep using actigraphy in petroleum industry shift workers.

INTRODUCTION: Increased use of shift work has led to more and more people working outside a traditional daytime schedule. Currently, approximately 20% of the labor force in developed countries is shift workers. Shift work can have devastating effects on employees' quality of life and sleep, leading to negative consequences for individuals and their families. This study evaluates the effect of different shift schedules (seven days/seven nights, fixed-day or fixed-night, and stand-by shift) on the sleep of oil rig shift workers. PARTICIPANTS AND METHODS: In this cross-sectional study, 43 offshore workers from the National Iranian Drilling Company were enrolled. Subjects were asked to complete a questionnaire package consisting of the Epworth Sleepiness scale and Pittsburgh Sleep Quality Index (PSQI). Changes in sleep patterns were measured using actigraphy for different shift schedules. RESULTS: The mean age of the participants was 35.9 ± 7.9 years and the mean tenure with the drilling company was 10 ± 6.8 years. The mean total sleep time was 353 ± 58 min. The seven day/seven night shift workers had less total sleep time than the other three groups of shift workers. The mean PSQI and Epworth Sleepiness scale scores were 6.77 ± 3.1 and 7.49 ± 4.3, respectively. Twelve shift workers (27%) were diagnosed with shift work disorder in the current study and 31 participants had poor sleep quality according to PSQI score (≥5). CONCLUSION: Poor sleep quality is common in oil rig shift workers. Further research is needed to evaluate sleep problems in oil rig shift workers.

Association of plasma levels of lipid and polychlorinated biphenyls in Iranian adult.

BACKGROUND: Exposure to Polychlorinated biphenyls (PCBs) continues over the world through seafood consumption and indoor exposure to building materials containing PCB. This study aimed to assess the relationship between plasma level of PCB congeners and lipid profile and Body Mass Index (BMI) as well. METHODS: The study population consisted of 181 Iranian adults. Data on BMI, plasma concentration of PCB congeners and serum level of lipid profile including Triglyceride, low-density lipoproteins and high-density lipoproteins, recruited from database of a project entitled "Occupational and environmental exposure to PCBs in Iran". Multiple linear regression analysis of associations between different quartiles of PCB congeners and various lipid fractions and BMI have been conducted. RESULTS: A linear increase in average serum Triglyceride and low-density lipoproteins (LDL) levels of participants in first, second, third and fourth quartiles of some PCB congeners was obtained. Following adjustment for age, gender, diet and other variables, only the association between different quartiles of PCB 138, PCB 153, PCB 118 and PCB sum and TG remained statistically significant. CONCLUSION: The study showed a significant positive relation between plasma PCBs concentrations and serum level of TG in the study population with normal PCBs levels.

Effect of extremely low frequency magnetic field on antioxidant activity in plasma and red blood cells in spot welders.

OBJECTIVE: The purpose of this study was to determine a possible relation between exposure to extremely low frequency magnetic field (ELF-MF) and the human antioxidant activity. METHODS: The total serum antioxidant status (TAS), red blood cells (RBCs) glutathione peroxidase (GPX) and superoxide dismutase (SOD) were measured in 46 spot welders who were occupationally exposed to ELF-MF (magnetic field strength = 8.8-84 microTesla (microT), frequency = 50 Hertz (Hz) and electric field strength = 20-133 V/m). The results were compared with a nonexposed ELF-MF control group. The correlation between magnetic field strength and antioxidant activity in RBCs and plasma was then assessed. RESULTS: No significant differences in TAS levels were observed (P value = 0.065). However, in RBCs of exposed group, a significant decrease in SOD and GPX activities was observed (P value = 0.001 and 0.003, respectively). This decrease was measured as 22 and 12.3%, respectively. Furthermore, a significant negative correlation between SOD/GPX activities and magnetic field intensity was observed (coefficients of SOD: -0.625, significance: 0.0001 and coefficients of GPX: -0.348, significance: 0.018). CONCLUSION: The results of this study indicate that ELF-MF could influence the RBC antioxidant activity and might act as an oxidative stressor. Intracellular antioxidant enzymes such as SOD and GPX were found to be the most important markers involving in this process. The influence of magnetic field on the antioxidant activity of RBCs might occur even at the recommended levels of exposure.

Pulmonary effects of spot welding in automobile assembly.

BACKGROUND: Spot welding is a type of resistance welding in which pieces of metals are pressed together and an electric current is passed through them. Spot welders are at risk of contact with some potentially hazardous agents but there are few studies about the respiratory effects of spot welding. AIMS: Our objective was to study lung function and respiratory symptoms among spot welders and office workers at an automobile assembly factory in Iran. METHODS: This was a cross-sectional study of 137 male spot welders and 129 office workers. We used a questionnaire to record demographic data, smoking habits, work history and respiratory symptoms. Spirometry was performed to assess lung function status. Metal fume samples from the respiratory zone of spot welders were analysed. RESULTS: The concentrations of metal fume were less than the American Conference of Industrial Hygienists (ACGIH) threshold limit values. There were significantly lower values for average forced expiratory volume in 1st second (FEV(1)), FEV(1)/forced vital capacity and 25-75% forced expiratory flow in spot welders compared to controls. There was also a significantly raised prevalence of respiratory symptoms (sputum and dyspnoea) in spot welders. Fifteen per cent of spot welders and 1% of controls had an obstructive pattern in spirometry. CONCLUSIONS: Our survey suggests that spot welders are at risk of developing respiratory symptoms and decreasing pulmonary function values despite their exposure to components of welding fume being within ACGIH guidelines.

Occupational Accidents in Iran: Risk Factors and Long Term Trend (2007-2016).

BACKGROUND: Although much is known about the distribution of occupational accidents in the world, less is known about occupational injuries in developing countries. Therefore, the aim of this study was to investigate the trend of occupational accidents during 10 years (2007-2016) and to find factors affecting the accident outcome. STUDY DESIGN: A cross-sectional study. METHODS: This study was done based on the data gathered by the Iranian Social Security Organization (ISSO), including demographic data (age, sex, marital status) and occupational accident characteristics (accident sector, cause, type, body part, location, time, month, and incident outcome). RESULTS: A decreasing pattern of occupational accidents was found from 2.95 per 1000 workers in 2007 to 1.46 per 1000 workers in 2016. The mean age of injured workers was 32.97 years. The most common cause and type of accidents were incaution and lack of attention and collision, and trapping, respectively. Limbs were the most affected body parts, and less than 1% of occupational accidents resulted in death. The highest incident was seen in the industrial sector during all years. More severe accident outcomes were seen at older ages and in the male gender, married subjects, winter season, agriculture sector, and outside of work place. CONCLUSION: These results provide a basis for further investigations regarding data collection and accident causes. Modification of some associated factors and implementation of safety prevention programs would be useful in reducing occupational accidents in Iran.

Frequency of metabolic syndrome and its associated factors in health care workers.

BACKGROUND: In recent decades, metabolic syndrome is one of the most important public health risk factors. Having this in mind, the present study was conducted to evaluate the frequency of metabolic syndrome and its associated risk factors in healthcare workers. METHOD: This study is a cross-sectional study conducted on 410 healthcare workers in a teaching hospital in Iran. Demographic, occupational, and psychosocial characteristics were assessed using questionnaire. Assessment of metabolic syndrome of hospital staff was performed at workplace during their medical examination. RESULTS: The frequency of metabolic syndrome was found to be 22.4%. This relationship was found among blood pressure and occupational stress, despite the fact that there was no significant relationship between metabolic syndrome and occupational stress. Higher age, having shift work, and inactivity were associated with metabolic syndrome. CONCLUSION: Considering the high frequency of metabolic syndrome among Iranian healthcare workers, it is advised that effective management should be employed to correct the occupational and psychosocial factors associated with this syndrome.

Efficacy and hypnotic effects of melatonin in shift-work nurses: double-blind, placebo-controlled crossover trial.

BACKGROUND: Night work is associated with disturbed sleep and wakefulness, particularly in relation to the night shift. Circadian rhythm sleep disorders are characterized by complaints of insomnia and excessive daytime sleepiness that are primarily due to alterations in the internal circadian timing system or a misalignment between the timing of sleep and the 24-h social and physical environment. METHODS: We evaluated the effect of oral intake of 5 mg melatonin taken 30 minutes before night time sleep on insomnia parameters as well as subjective sleep onset latency, number of awakenings, and duration of sleep. A double-blind, randomized, placebo-controlled crossover study with periods of 1 night and washouts of 4 days comparing melatonin with placebo tablets was conducted. We tried to improve night-time sleep during recovery from night work. Participants were 86 shift-worker nurses aged 24 to 46 years. Each participant completed a questionnaire immediately after awakening. RESULTS: Sleep onset latency was significantly reduced while subjects were taking melatonin as compared with both placebo and baseline. There was no evidence that melatonin altered total sleep time (as compared with baseline total sleep time). No adverse effects of melatonin were noted during the treatment period. CONCLUSION: Melatonin may be an effective treatment for shift workers with difficulty falling asleep.

Assessment of psychosocial factors in office and operational groups of employees of a Regional Electricity Distribution Company in Iran - A case study.

BACKGROUND: Many studies have shown an association between unfavorable psychosocial factors and personal and organizational outcomes. In recent years, psychosocial issues have received top priority between work environment factors. This study aimed to provide a first insight into psychosocial stressors in electricity distribution industry in Iran and compare the psychosocial factors between two job categories of office and operational workers. METHODS: The study population was employees of an electricity distribution company in Iran. The standard Persian medium size of Copenhagen psychosocial questionnaire (COPSOQ) was used in this study to measure psychosocial factors. The questionnaire comprised 5 domains and 26 scale. Mean and standard deviation of each scale and domain were obtained for office and operational workers separately and the results were compared. RESULTS: Higher scores were obtained in the domain of "job demands" of operational workers. In the domain of "job contents", More Unfavorable condition was obtained for office workers. No significant difference was seen in the domain of "inter personal relationship". More unfavorable scores for operational workers were obtained in the domain of work-individual interface" in a univariate analysis, but after adjusting the confounders including age, type of employment, directorship status and income, multivariate analysis did not show any significant difference. In the domain of "individual Health and well-being", higher scores were obtained for operational workers. CONCLUSION: This study provides support regarding the differences of psychosocial working environments between office and operational workers in electrical distribution industry. It is worth considering these differences of psychosocial factors at employees scheduling.