Tibbi-i-kar

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Abstract Background: There are many risk factors that predispose nurses to sleep disorders. In one hand, sleep disorder affects health and safety of nurses and patients and on the other hand, risk factors of this occupations raise the prevalance of sleep disorders and their complications. Materials and Methods: this study was done cross-sectionally on 190 nurses of Imam Khomeini hospital in Tehran, Iran. We used sleep impairment index for insomnia, Epworth sleepiness scale for excessive daytime sleepiness, Martinez method for obstructive sleep apnea syndrome, and sleep disorder was defined as insomnia or hypersomnolance. Results: prevalence of sleep disorders, insomnia, excessive daytime sleepiness, obstructive sleep apnea syndrome, and narcolepsy was, 83.8%, 81.5%, 33.1%, 12.1%, 3.7%, respectively. Using multivariable model, just shift work was significantly effective on prevalence of sleep disorders. Conclusion: We determined the prevalence of important subtypes of sleep disorders in nurses by standard self-report questionnaires and physical exam. Many risk factors that other studies in western countries have shown their importance, can't affect the prevalence of sleep disorders in Iranian nurses. To find the true reason for this issue, we suggest that a study must be done to compare occupation definition, Job, and task of Iranian nurses with western nurses.

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Abstract Background: Noise, as the most common industrial hazard, besides hearing loss may have adverse effects on other body systems. Many studies have demonstrated the adverse effects of noise on the cardiovascular system. Using personal protective devices is one of the methods for reducing noise exposure. Controlling noise exposure by means of personal protective devices theoretically reduces condiovascular effects of noise, but there isn't any study about this effect. We decided to examine the effects of using personal hearing protective devices in a noisy environment on the systolic & diastolic blood pressure and heart rate. Materials and methods: In an interventional study, 30 workers exposed to 85dB sound or more for 8 hours per workday were assessed. First, after sitting at workplace for 5 minutes, their blood pressure and heart rate was measured three times between 10 and 11 AM, observing the standard conditions. Then, after recommending to wear the earplugs and giving the necessary relevant instructions, all of the workers supervised for wearing the ear-plugs. During 2 weeks of using earplugs, the blood pressures and heart rates were measured again. Results: The mean systolic blood pressure decreased 5.70 mmHg after using the ear-plugs (P=0.004) the mean diastolic blood pressure decreased 2.13 mmHg after using the ear-plugs (P=0.05) and the difference between the heart rate before and after wearing the ear-plugs was not statistically significant (0.635). Conclusion: The abserved difference in blood pressure before and after wearing earplugs, though may not be important clinically, is statistically significant .Thus recommending the workers to use personal protective devices in noisy environment, besides decreasing the effects of noise on hearing, can also reduce the effects of noise on cardiovascular system and can be significant clinically.

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Abstract Background: Occupational exposure to styrene can lead to various psychological and somatic complaints including color vision disorder that can occur even in low concentrations. Color vision disease is an early clue for effect of styrene on human, which can be used as an appropriate screening method in workers exposed to styrene. Materials and Methods: Working in waxy foundry is a job with exposure to styrene. This study has been performed to evaluate color vision of workers who work in this factory. When considering inclusion and exclusion criteria, 35 waxy foundry workers and 62 workers unexposed to styrene were assessed. To determine color confusion Index we used Launtony D15 d test to discover yellow-blue color vision disorder. Urinary mandelic acid in end shift of the first workday was measured as biologic exposure monitoring. Results: There was no difference in age between cases and controls (P=0.2). Color confusion index in cases was significantly higher than control group (P=0.017). Urinary mandelic acid of cases was in the range of 1000-1400 mg/l that indicate daily exposure to more than 50 ppm (OSHA PEL) of styrene. There was no significant correlation between uric mandelic acid and color vision disorders (P=0.93). There was no correlation between age and color vision disorders too (CC=-0.01). Conclusion: Exposure to styrene in a concentration above permissible limit can cause color vision disorders.

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Abstract Introduction:Excessive daytime sleepiness and other sleep disorders are receiving much attention as a cause of work accidents. Sleep disorders can disturb sleep and waking alertness. While the pilots and other flight crews suffer from sleep disorders, they will be unable to monitor airplane systems. This will reduce the safety of the flight. The aim of this study is assessment and analysis of prevalence,severity, and predictive factors of sleep disorders (insomnia, excessive daytime sleepiness) among flight crews. Methods:The sample was composed of 550 flight crews.Subjects were derived from a random sample of flight crews. They anonymously answered a questionnaire on their demographics, sleep habits, and work characteristics. Furthermore, they were asked to answer to standard questionnairesabout sleepiness and insomnia. Excessive daytime sleepiness was considered in them with indexes 10 or more in the ESS Results:Mean number of sleep hour per day was 6.8 ± 1.5 39% Slept lower than 6 hours. Other major findings were as follows: 56.1 % of the flight crews had difficulty in falling asleep, 41.6% Had difficulty in staying asleep, and 58.6% had problem with waking up too early. Overall, 45.5% were dissatisfied with sleep patterns and 51.9 % had an abnormal ISI (≥8). Conclusion: Our results showed a high prevalence of excessive daytime sleepiness, and insomnia in flight crews.

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Abstract Background:Mother's physical activity and occupationare two factors thatare supposed to have a role in producing low birth weight and premature birth. Severe physical work is an independent risk factor for premature infants. Thisstudywas designed to evaluate the effect of shiftworkandthe amountof physical activityduring pregnancy on birth weightandgestational age. Methods:In a cross-sectional study,considering inclusion criteriawe selected 540 persons from employed womenwho were referredto hospitals for delivery in Tehran during a year.After delivery, allrequired datawas gatheredby interview andpatient records.We analyzed data by SPSS (ver. 18) using chi square,t test, one-way-ANOVAand logistic regression. Results:The mean mother's age, Newborn's birth weight, and gestational age was 25.3years, 2726±457 g, and 36.9±2.4 weeks, respectively. Inthisstudy, a significant correlation between thefrequency ofnewbornswithlow birth weight and mother's shiftwork wasobserved (p= 0.001)butthis correlation was not observed forfrequency of preterm infants. Conclusion:During pregnancy, shift work has a significant role in causing low birth weight.

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Abstract Background:The cost of stress related diseases like storks, hypertension, and depression is very high and absenteeism, disability and preterm death duo to them threaten the productivity. So interaction between stress and cardiovascular disease must be cleared. Methods: This research was done on the 224 male workers of a transportation terminal in Tehran. We use the OSIPOW questionnaire to measure the job stress and the cardiovascular risk factor obtained from the results of periodic exam of the workers in workplace. Results: 0.4% was in low stress category, 17% in low-moderate, and 78% in moderate-severe and 4.5% in severe stress category. There was no statistically meaningful correlation between stress and FBS, TG, CHOL, pack years of smoking, BMI. There was only a weak correlation between job stress and diastolic blood pressure. Conclusion: great majority of work force were in high stress categories. There are two explanations for no correlation we found: relatively young study population, healthy worker effect.

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Abstract Background: Nowadays, working long hours and shift work are inevitable, even though these working schedules are associated with several physical and mental effects. Gastrointestinal complaints are common among their physical effects. Recent studies have shown organoprotective effect of melatonin in gastrointestinal tract. In this study we investigated gastric mucosal damage due to partial sleep deprivation and the possible role of melatonin in this damage. Methods: 24 male rats were assigned in two groups: 12 rats in control group with normal sleep and 12 rats in partial sleep deprivation group. For partial sleep deprivation, we used a slowly rotating cylindrical cage, which was rotating 23 hours a day for 14 days. Animals were food deprived in the last 24 hours of study. Finally, their stomachs were assessed grossly and histologically. We also performed ELISA assay for measurement of their serum melatonin. Results: Mucosal damage was seen to some extent in both groups. Damage severity was significantly higher in partial sleep deprivation group (P<0.001). In addition, serum melatonin was significantly lower in partial sleep deprivation group (P<0.001). Conclusion: We conclude that partial sleep deprivation could induce gastric mucosal damage in rats. Even though serum melatonin was lower in partial sleep deprived rats. So we could propose that decreased serum melatonin might have a role in this damage.

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Abstract Background: Asthma is a common respiratory disease that causes occupational disability. Specific occupations may be related to induction or exacerbation of asthma. The objective of present study was descriptive evaluation of occupations in asthmatic patients. Methods: In this cross ـsectional study, 339 asthmatic patients older than 17 years were evaluated regarding their occupations. One hundred and seventy nine patients had at least one occupation. Their occupations were classified based on Standard Occupational Classification 1991(SOC-91) and frequency of asthmatic patients was determined for each occupational group. Results: The most frequent occupation in our asthmatic patients was trades, transport and equipment operators and related occupations (66 cases, 36.87%). In this occupational group, the most frequent occupation belonged to taxi driving (13 patients, 7.2%). After that, sales And service occupations such as hairstylists and barbers, bakers and food service providers were frequent occupations (39 cases, 22.3%). The less frequent occupations in our asthmatic patients were management occupations (2 cases) and health occupations (one case). Conclusion: Asthma may be more frequent in some occupations such as trades, transport and equipment operators and related occupations and after that sales and service occupations. Evaluation of worsening asthma symptoms in mentioned occupations is recommended.

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Background: Although one of the most important occupational hazards in cement industry is the effect of cement dust exposure on respiratory system, there is controversy about the relationship between exposure to cement dust and respiratory symptoms and pulmonary function impairment. Our aim was to assess the effects of cement dust exposure on respiratory symptoms and lung capacities of cement workers more thoroughly. Methods: In this retrospective cohort study, a total of 182 cement workers in two groups exposed to cement dust (case group) and non-exposed to cement dust (control group) were assessed. For exposure assessment, environmental samples of total dust were collected. For all workers after physical exam and filling ATS standard questionnaire, spirometry was done in accordance with ATS/ERS guidelines. Results: The measured total dust levels contained a mean concentration of 17.36 mg/m3 for exposed group and 0.86 mg/m3 for non-exposed group. According to the results of this study, the prevalence of respiratory symptoms included wheezing, dyspnea and cough in the exposed group was significantly more than control group. A statistically significant reduction in average percent of PEF, FEV1, FEF25-75 and FEV1/FVC was seen in the workers exposed to cement dust (P value<0.05). The highly exposed workers had a significantly higher prevalence for obstructive respiratory disease. Conclusion: Our survey suggests that cement production workers with exposure to cement dust are at risk of developing respiratory symptoms and reduced spirometric indices.

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Background: Sleep disorders in pilots due to its impact on the flight safety and the flight staff and passenger’s health are important. This study evaluates the frequency of sleep disorders in pilots by standard questionnaires and comparison with ground staff. Methods: This was a cross–sectional study on flight crew and other workers of private flight airline. The cases were selected randomly. All participants were asked to fill 2 standard questionnaires: ISI (Insomnia Severity Index) and ESS (Epworth Sleepiness Scale). Excessive daytime sleepiness and insomnia were considered by ESS>10 and ISI>8, respectively. Results: The frequency of insomnia and sleepiness in flight crew was 66% and 24%, respectively comparing 60% and 27% in other workers. Conclusion: It is proved in this study that the excessive day time sleepiness has high frequency in the pilots and also insomnia is the most complication in this group.

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Background: The effect of depression upon life quality, especially upon those suffering from sleep disorders, is of considerable importance, hence in this study we have undertaken the study of depression in persons suffering from sleep disorders, on the basis of polysomnography test and have dealt with some of its important factors. Methods: This study is a cross-sectional study which was conducted upon patients visiting the sleep disorder clinic of the Baharloo hospital, during the years 1388-1391. Polysomnography was conducted upon them and their sleep disorder was diagnosed on this basis, commencing the study on them. Every subject was then given a data collection sheet, and some of the sleep disorder questionnaires, and then the Beck questionnaire were filled up for them. After collection of this data for the patients and also for the control group, the data was analyzed and evaluated with the help of statistical software. Results: The mean age of the patients suffering with breathing disorder during sleep was 50.22±12.13 and significantly higher than the mean age of patients suffering from insomnia 44.20±17.76 (P=0.02). Also, no significant statistical difference was noticed in this study in the Beck questionnaire scores between the two groups diagnosed for sleeplessness and obstructive apnea during sleep (P>0.05). Conclusion: In the present study we noticed that the Beck depression score for patients suffering from sleeplessness was higher than those suffering from obstructive apnea during sleep, although this difference was not significant. This can be due to the insufficient number of sleep disturbance patients observed in this study. Hence, it is suggested that another study be conducted by taking a higher number of subjects belonging to this group.

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Introduction: obstructive sleep apnea is a common disease that is recognized as the leading cause of occupational injuries and accidents. Proper assessment and treatment of employees affected by this disease can reduce the numerous side effects if the methods used to identify and treat these patients are evidence based and are applicable in our country.

Methods: In order to standardize the clinical services provided to patients, after studying the available guidelines, according to the conditions and possibilities of our country, the clinical guideline for Manual titration of CPAP and BPAP in patients with obstructive sleep apnea was provided.

Results: This guideline contains recommendations for the diagnosis of patients with obstructive sleep apnea, recommendations for CPAP and BPAP titration studies, and acceptable PAP titration study. The level of evidence is specified for each recommendation. “Standard” is a generally accepted strategy and reflects a high degree of clinical certainty, “guideline” reflects a moderate degree of clinical certainty, “option” has less evidence and agreement was reached in a standardized consensus. Those recommendations that were not based on published parameters are labeled as “consensus”.

Conclusion: Considering that the most important problem for the use of CPAP is patient intolerance, a standard protocol for titration increases the patient compliance and treatment efficacy.

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 Sleep medicine is one of the new and leading branches of medical knowledge. During the past two decades, it has got a special position in the countries' health programs due to the development and identification of more effective diagnostic and management methods, and the identification of the adverse consequences of overlooked sleep disorders on the community's health. It is included in many countries' health programs in industrialized and developed countries such as the United States, South American countries, Australia, Europe, and China.
Sleep disorders with a variety of more than 80 types of diseases constitute complicated, high-risk, and costly diseases that affect the public health system. The prevalence and adverse consequences of these disorders could be reduced by implementing sleep health and appropriate preventive measures. Furthermore, it should be noted that if patients with these disorders are diagnosed correctly and on time, there would be effective management modalities in the world and the country (1). This letter had explained the importance of sleep health and its association with non-communicable diseases, associated consequences, and the urgent need to pay attention to sleep health and sleep disorders in the public health system.