Tibbi-i-kar

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Background: The Operation room personnel are exposed to anesthestic gases such as Isoflurane. The Chronic exposure to such substances will increase the risk of abortion as well as congenital malformations. In this research, we have determined the amount of exposure to isoflurane gas in operation room air and the breathing zone of operation room personnel. Methods: An analytical cross sectional study was done on the concentration of isoflurane in far & near zones in ear, throat and nose operation room of a hospital with OSHA103 method using charcoal tube and analyzed by gas chromatography devices with flame ionization detector (GC/FID). Results: The average concentration of isoflurane gas was 4.059±4.073 mg/m3, Its maximum was19.597 mg/m3, its minimum was 0.122 mg/m3. The result showed that in 47.9% of the samples in near area, 33.3% in far area and 40.6% of the total samples, the amount of contamination in breathing zone of operation room personnel was higher than the allowed concentration as proposed in national institute of safety and health The results showed that there are not differences between the measured concentration in far & near areas. Conclusion: Contamination of isoflurane anesthetic gas is high in studied operating room. On the other hand the study showed that depending on the type of surgery, the generation rate of contamination in different days can be varied up to 17 times. So control measurement such as setting of air conditioning system and appropriate and standard cleaning in room and periodic monitoring of them is essential.

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Background: Noise-induced hearing loss is a sensorineural hearing loss, which is associated with exposure to high levels of sound. Since train drivers exposed to high noise levels and the use of hearing protection devices is relatively difficult and they also need to hear the radio communications, this study examines the hearing status of train drivers of Yazd Railway Company. Methods: This is a descriptive - analytical cross sectional study, which was performed on 153 train drivers. The results were compared with a control group of 148 office workers. After examination and blood tests, audiometry was performed for each subject by an audiologist and the data was analysis with SPSS software (ver.19). Results: The mean age of the train drivers and control group were 35.8±8.3 and 35.3±6.3 years respectively. Prevalence of high frequency sensorineural hearing loss among train drivers was 21.3% (29 patients), that was significantly higher than the control group. Prevalence of high frequency notch in the right ear in train drivers was 9.6% (13 patients) and 2.9% (4 patients) in the control group (p-value <0.02) and prevalence of notch in left ear was 14% (19 patients ) and, 3.7% (5 persons) in train drivers and control group respectively (p-value<0.003). In train drivers average hearing thresholds of high frequencies was higher in the left ear than the right ear (p-value=0.02). Conclusion: The high level of noise in the train drivers' cabin increases average hearing thresholds at high frequencies especially at 6000 Hz. The results also show that in noisy environment, left ear is more sensitive than the right ear.

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Background: Various statistics of the incidence and prevalence of medical errors in hospitals have been published.is common.This study aimed to identify the initial state of the current level of risk management in the hospital was rahnemon. Methods: This descriptive-analytical study was performed on the nurses of shahid rahnemon hospital. Data collected by the census questionnaire given to all nurses and the number was 250. The 6 scale variable levels of risk management staff to identify, organize the risk management policies status, condition training, risk management, risk management, status monitoring and analysis, risk assessment and control of the 45 questions on a Likert scale of five options are examined. Data 16 SPSS software was analyzed using. Results: Knowledge workers to manage risk rating 2.40±/18, the state organize risk management rating 2.27±/13, the policies and procedures Score2.17±.0.02, Education Risk Management Rating2.18±./04, the position of Managing Risk Score2.65±./08, monitoring, analyzing, evaluating and controlling risk, rated 2.79±./05to themselves. Conclusions: According to the obtained scores 6 area of risk management component the overall risk was assessed as weak. Clinical governance systems, developing training programs, adopt and implement policies and procedures in line with current regulatory programs, risk management should be looking seriously at the hospital.

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Background: expert judgments in combination with exposure models are used extensively in estimation of inhalational exposures in occupational environments. However, their reliability is not as good as conventional air sampling methods. The aim of this study was to investigate the applicability, weaknesses and strengths of Bayesian analysis in combination with SSA (Structured Subjective Assessment Method) and MEASE (Material Estimated and Assessment of Substance Exposure) and its comparison with air sampling data. Methods: the analytical cross sectional –study performed on a weighting, mixing and packing task in an inorganic processing industry. Air samples were taken and analyzed by gravimetric methods. Inhalation exposures were estimated by 3 occupational hygienists. Descriptive and Bayesian analysis were performed on data. Results: all three methods guaranteed that the exposure is above exposure limit. There was no difference between means reported in methods (p=0.435). However, SSA had higher variability in comparison with sampling. There was no difference between direct sampling and MEASE variability. Use of SSA as a prior in Bayesian analysis gives more conservative than MEASE method (category 4: 0.74 vs. 0.54) Discussion: SSA is a good choice as a prior distribution in Bayesian analysis. MEASE has not good results in comparison with SSA in inhalation exposure assessment. It seems that MEASE needs more validation.

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Background: Nowadays the tendency of understanding how effective management practices and organizational factors have highly developed and activities mostly focus on safety culture and climate. Despite extensive studies in the field of safety climate in different countries, few attempts have been made in Iran which in most of them the toolkit of Loughborough university has been used. The aim of present study was safety assessment of an Iranian commercial port, which was for the first time, by Nordic questionnaire. Methods: In this cross-sectional study 75 workers, which had 7 different occupations in that port, were selected and completed the questionnaire. For determination of validity and reliability of the questionnaire, 25 copies were completed and the coefficient of internal consistency was calculated. Seventy five copies of the finalized questionnaire were given to the safety management section of the port to be completed by self reporting system. Results: The safety climate profile showed the average dimensions were in the range of 3.25 to 4.22. The highest score was for dimension of worker's trust in efficacy of safety systems (4.05) and the lowest was for dimension of workers' safety priority and non-acceptance risk (3.32). The highest and lowest score for safety climate were given by groups of cleaners (4.22) and staff (3.25) respectively. The differences of mean score between occupational groups were significant and between age, years of experience, and level of education groups were not significant. Conclusions: Because the worker's perception of safety does not depend on their age, years of experience, and level of education, then safety training is not implemented. Not significance of the average score of safety climate with the level of education means that the safety education in schools and universities is not good.

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Background: One of the ways of transmission of infectious diseases is person to person transmission which hairdressers have an important role in this field. The aim of this study was to determine the knowledge, attitude and practice of female hairdressers about health and diseases related to hairdressing profession in 1391 in Yazd. Methods: This study was a descriptive study that was done randomly on 60 female hairdressers (12% of total female hairdressers in Yazd). The tool of gathering data was a questionnaire that its reliability and validity was determined and after completing, was analyzed by using SPSS 16 and Excel. Results: Demographic data revealed that most hairdressers were less than 30 years old, diploma and have the experience more than 10 years. The results also showed that the age has not significant difference with the knowledge, attitude and performance of hairdressers (P>0.05), education level has a significant difference only with attitude. Work experience has a significant difference with attitudes and knowledge (P<0.05), so with increasing of work experience from less than 5 years to over 10 years, the knowledge and attitudes of hairdressers were increased. There was also a significant correlation between knowledge and attitudes about health and occupational diseases related to professional hairdressing, but there was not a significant correlation between knowledge and attitude with performance (P>0.05). Conclusion: The results of this study showed that the hairdressers have high knowledge, attitudes and performance.

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Background: The use of exhaled breath condensate (EBC) biomarkers to evaluate exposure and disease in recent years gained attention in toxicology and occupational medicine. However, use of standard sampling apparatus is missing element in this procedure. Methods: Initial design of sampler was selected based on the water condensation system. The effect of sampler length, sampling time and temperature were studied in the condensate collection system. Samples from both smokers and non-smokers were acquired to determine the amount of malondialdehyde in exhaled breath condensates. Samples were analyzed by high-performance liquid chromatography (HPLC). Results: Based on observed results, cooling at zero degree centigrade was selected for optimum sampling. However, 5°C temperature also had slightly less sample recovery in comparison with zero °C. A 25 cm length condenser also had the highest sampling efficiency in comparison with other condenser lengths (15 and 40 cm). EBC Malondialdehyde was measured by the constructed sampler in smokers and non-smokers. Smokers had higher amount of malondialdehyde in their EBC(p<0.05). Conclusions: In this study we designed, constructed and validated the simple and cost effective exhaled breath sampler for exhaled breath biomarkers study. Results indicated satisfactory repeatability and robustness. Smokers had higher level of EBC malondialdehyde as a marker of lipid peroxidation.

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Background: Studies have shown that dermal exposure to polycyclic aromatic compounds can lead to systemic health effects if the substance is absorbed by the skin. Epidemiologic reports of PAH-exposed workers have noted increased incidences cancer. Methods: According to the low vapor pressure this material, the major route of occupational exposure in some jobs is through dermal exposure. The more common methods of assessing dermal exposure to these compounds have been investigated. Results: There are Different results regarding the effectiveness of various methods of assessing skin exposure to this class of compounds. However, tend to use quantitative methods and semi quantitative reverse rising in this field. Discussion: Assessment methods have advantages and disadvantage that researcher can be used one or more of the methods according to facilities. However, more research is needed in this field

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Background: Spiritual intelligence is the ability to apply spiritual values and updated so that they improve daily functioning and the individual's physical and mental health. The purpose of this study was to investigate the relationship between spiritual intelligence components of burnout in teachers of Yazd city. Methods: The research method was descriptive– correlation. Population of this research consisted of female teachers. 133 teachers were selected by using cluster sampling. The instruments of this research were Spiritual intelligence questionnaire and Burnout Inventory. Results: The results showed that the frequency and intensity of emotional exhaustion and depersonalization frequency was negative and showed a significant relationship with spiritual intelligence (P<0.01) and there was a significant positive relationship between The frequency and severity of the personal function and spiritual intelligence however, no relationship was found between the frequency and intensity of conflicts with spiritual intelligence (P>0.05). Conclusion: The training component of spiritual intelligence can prevent some aspects of burnout in teachers.

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Background: Proper nutrition can affect the health status of next generation. Nutritional status of women workers is so important. This study has been done to determine energy, macro and micronutrient intakes and to compare with dietary standards. Methods: This descriptive cross sectional study has been done on 300 carpet weaver in Yazd. After measuring height and weight, dietary intake was determined using 3 day 24 h dietary recall questionnaire and analyzed by Nutritionist 4 software. Descriptive analysis and t-test were used by SPSS software. Results: After omitting over and under reporting, data of 170 workers were analyzed. Mean of body mass index was 23.39±3.84 Kg/m2. Mean of energy intake was 2536.4±473.7 Kcal/d while 55.65, 10.86, and 33.48 percents of energy have been supplied by carbohydrate, protein and fat, respectively. Dietary intakes of vitamin A and C were significantly lower than Dietary Reference Intakes (DRI). Energy excess was seen in 91.7 percent of women and 31.8 percent of them were obese or overweight. Conclusion: according to this study, micronutrient deficiencies are the issue in women in spite of energy excess.

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Introduction: Nowadays, air pollution, occupational and industrial harmful exposure caused the increasing prevalence of lung diseases. The pulmonary function testing such as spirometry plays an important role in the diagnosis and treatment of lung diseases. Due to the increasing use of the classification system in the prediction and detection based on the test samples, diagnosis the patients and non- patients according to their pulmonary performance without testing can be achieved relying on data-based prediction methods.

Method:In this study, a new method developed by fuzzy system was used to determine the restriction syndrome pulmonary disease to find workers in the tile industry. The fuzzy system designed considering the main factors affecting respiratory health in tile industry with the values of FVC and FEV1, which is the result of the spirometry test analysis in the workplace. These systems input include the staff occupational and environmental information, and the output is prediction of being sick or healthy.

Result: Among the used classification methods, the fuzzy method was achieved acceptable results because of the samples awarded degree in each cluster.According to the developed model in this study for predicting obstructive and restrictive pulmonary syndrome based on the analyzed test samples related to information of workers in 1394, the achieved accuracy was 0.71and 0.79, respectively.

Conclusion: Using the fuzzy systems for modeling and predicting on medical issues such as diagnosis the diseases recommended due to the appropriate performance of them in uncertain environment. The knowledge in fuzzy systems expressed as if-then rules, so the obtained knowledge is understandable by humans and can be refined by experts if necessary.

Keyword: Classification, Fuzzy, Fuzzy Rules, Spirometry

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Introduction: According to the high incidence of myofascial pains of trapezoid muscle in the computer users (employees), which leads to disability, absence from work, early fatigue and also reducing efficiency of employees due to frequent headaches associated with trigger points in the neck area, it is important to investigate the therapeutic methods to release myofascial trigger pain. Therefore, the aim of this study was to compare the effect of short-time massage using neuromuscular facilitation stretching exercises (NFE) on neck and shoulder pain in the subjects with myofascial trigger points in trapezoid muscle.

Methods: This study was a clinical trial, which was conducted on 42 patients (female and male employees of Mashhad University of Medical Sciences). The studied group included the patients with clinical symptoms and physical examination of trigger points in neck area. The subjects were matched for age, duration of symptoms, and the severity of pain. Then, they were randomly divided into 3 groups. Control, experimental 1(short-time massage) and experimental 2 (NFE exercises), respectively. Pain severity, neck pain, shoulder pain, shoulder disability, and shoulder disability and pain were measured after and before of therapeutic intervention and compared in within and among the groups by One-way ANOVA statistical method.

Results: After one short-time massage therapy and NFE exercises, there was found a significant reduction in pain (P<0.05). Also, the pain in neek, shoulders, and shoulder disability was significantly decreased (P<0.05). However, no significant differences were observed between the groups (P>0.05).

Conclusion: It seems that both of short-time massage and NFE exercise methods have a similar effect on treatment of trigger points in trapezoid muscle. According to a few studies, it needs to have more investigations

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Introduction: Inhalation exposure to dust is one of the most common adverse environmental factors that can have adverse effect on the health of employees. In this study, dust inhalation exposure of workers with different methods as well as GIS was investigated.

Methods: An analytical cross-sectional study was performed on the sample size based on results of homogeneous exposure groups (SEG). Environmental and personal exposure assessments were performed according to standard methods and personal and environmental sampling. The collected data were analyzed based on American industrial hygiene association (AIHA), and then analyzed by using GIS software for mapping the distribution.

Results: The average dust exposure by each individual among the workers within homogeneous exposure groups was 8.61 mg/m³. The highest exposure by each individual was 21.13 mg/m3 that belonged to pulverizer operator and the lowest was 1.97 mg/m3, which was belonged to fine wire operator. The lowest environment concentration was observed in the cutting salon (0.05 mg/m³), and the highest values found in powder salon (22 mg/m³). Exposure management based on AIHA methods showed that the powder, packing and preparation sections have the highest concentration, and cutting section has the lowest values. Exposure management based on GIS techniques showed higher number of at risk employees in comparison with common strategies.

Conclusion: Use of SEG practices in combination with GIS can enhance the quality of respiratory exposure assessment in occupational environments. GIS plays an important role in the screening of air pollution in the working environment by providing a set of services including the possibility of classification into different areas and creating a report based on the map

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Introduction: One of the most important challenges of health system in all countries is patient safety risks. That reduces ensures of patient safety. So, recognition of these incidents, categorize and prioritize them in order to formulate policy interventions should be considered.

Methods: This cross-sectional study was carried out in clinical wards of an Educational- Therapeutic Hospital in 2015. The study population consisted of 25 clinical hospital administrators and patient Safety Liaison. Data collection was conducted in three methods (Interviews, Focus Group and Distributor Questionnaire). The collected data were analyzed using AHP Model and Expert Choice.11 software.

Results: Among the incidents of internal ward, the highest priority related to needle stick (0.231) and the lowest related to wrong-patient Radiographs (0.028), respectively. Among the incidents of intensive care Unit, surgery and operating room, the highest priority related to failure in controlling the patients, level of consciousness (LOC) (0.316), lack of control of patients after surgery (0.199) and wrong type of blood transfusion (0.209), respectively.

Conclusion: According to the role of staff in incidents reduction, theoretical and practical training of staff about risk assessment methods should be done. Checklist for safe injection and safe surgery are performed and they were monitored by patient safety liaison. Also, integrated system of registration to record and report the error to identify upcoming events.

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Introduction: Diagnosis of various diseases in medicine is one of the area's most widely used data mining in recent years and many researches have been done about it. In this study, the diagnosis of prostate cancer using fuzzy system was assessed. The goal was to diagnose the prostate cancer and to predict the possibility of suffering from the disease.

Methods: In the proposed method, at first, based on available dataset, pre-processing and clustering operations were carried out. Then a zero-order Sugeno fuzzy system was designed for prediction. Each cluster, as the first item of a fuzzy rule, was considered and out of a rule, percentage of disease possibility in each cluster was considered. For each new sample, the membership degree to the each cluster was computed and then by combining outputs from each rule, possibility of disease in the sample was predicted. Finally, by having possibility and threshold for possibility, having or not having the disease for desired sample was diagnosed.

Results: The results showed that the system has good accuracy in predicting the possibility of disease.

Conclusion: The results of this study can be used to predict the risk of prostate cancer in young workers according to different jobs they are employed and the amount of exposure to risk factors in each job. If this possibility is high, they are known as the person at risk and in some cases there may need to change higher jobs.

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Introduction: Based on the results of some studies, concurrent exposure to organic solvents and noise in industrial areas can accelerate the amount of hearing loss. The aim of this study was to assess the effect of concurrent exposure to organic solvents and noise on high frequency hearing loss.

Method: This was a cross-sectional analytic study conducted on 1029 tire manufacturing company workers in 2013. After coordination with the factory authorities, required data including demographic, occupational and medical data and also audiometric records were derived from workers medical profile. Finally all gathered data were analyzed using SPSS version 13 software.

Results: After applying inclusion and exclusion criteria, 914 workers entered the study. The results of this study showed that, the workers including group 4 (workers exposed to impermissible levels of noise and organic solvents) had more severe high frequency hearing loss in comparison to group 1 (workers with no exposure to impermissible levels of noise and organic solvents) (OR= 1.74, 95% CI: 1.15-2.63) and the hearing loss was significant even after modification by logistic regression analysis.

Conclusion: Our study showed that the workers exposed to impermissible levels of noise and organic solvents had higher levels of high frequency hearing loss in comparison to workers with no exposure to impermissible levels of noise and organic solvents, thus we propose that workers with co-exposure to impermissible levels of organic solvents and noise may be benefited from shortening the interval between periodic audiometric evaluation.

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Introduction: Silica dust is one of the most dangerous substances in the workplaces inducing a respiratory disease. Inhalation of silica particles at high levels can cause silicosis, a special form of interstitial lung disease. One way to monitor and control the effects of silica dust on workers is the study of changes in spirometric parameters. This study aimed to investigate the changes in spirometric parameters of workers exposed to silica dust in a glass-manufacturing plant in a 3-year period.

Methods: In this study, spirometric parameters of 200 workers were assessed in three consecutive years (1391-1393). The effects of smoking as well as changes in FVC and FEV1 were examined in different working groups with different exposure levels. The data were analyzed by SPSS ver. 18.

Results: The results didn't show a significant difference among various working groups with different level of exposure during follow-up period. The changes between smokers and non-smokers were not significant as well.

Conclusion: It is concluded from the results of this study that the effect of silica dust on the spirometric parameters of the workers participating in this study was minimal.

Introduction: Silica dust is one of the most dangerous substances in the workplaces inducing a respiratory disease. Inhalation of silica particles at high levels can cause silicosis, a special form of interstitial lung disease. One way to monitor and control the effects of silica dust on workers is the study of changes in spirometric parameters. This study aimed to investigate the changes in spirometric parameters of workers exposed to silica dust in a glass-manufacturing plant in a 3-year period.

Methods: In this study, spirometric parameters of 200 workers were assessed in three consecutive years (1391-1393). The effects of smoking as well as changes in FVC and FEV1 were examined in different working groups with different exposure levels. The data were analyzed by SPSS ver. 18.

Results: The results didn't show a significant difference among various working groups with different level of exposure during follow-up period. The changes between smokers and non-smokers were not significant as well.

Conclusion: It is concluded from the results of this study that the effect of silica dust on the spirometric parameters of the workers participating in this study was minimal.

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Introduction: Occupational infection with blood borne pathogens is a major public health problem in the world and despite this fact, needle stick injuries are not important for many health care workers and they don’t follow them. The aim of this study was to determine the prevalence of injury with needle and cutting objects in the service personnel of educational hospitals in Yazd.

Materials and Methods: This cross-sectional analytical study was conducted in educational hospitals in Yazd. 170 service personnel were enrolled in this study. Data were collected using a questionnaire included demographic and background data, history of the injury with a needle or cutting objects and information on knowledge, attitude and performance of injury with a needle. Data were analyzed by SPSS software using Student's T test and logistic regression analysis.

Results: In this study, 45.5% of the personnel had experienced at least one injury with sharps; 78.1% of people reported that after exposure to these injuries, have visited a doctor. Comparison of knowledge in two groups showed that knowledge in subjects with injury was lower than subjects without injury. Although perceived risk in the group with injuries was more than the group without complications, but this difference was not significant. Needle stick injuries were lower in people with higher work experience than those with less experience.

Conclusion: Needle stick injuries were high in hospital service personnel. To prevent these injuries, educational programs should be a priority.

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Introduction: Noise-induced hearing loss (NIHL) is a major problem in industrialized and developing countries. Trend of industrialization and lack of proper protective equipment lead to an increased frequency of noise-related disorders especially NIHL. This study was conducted to investigate noise pollution and the frequency of NIHL in workers of one of the ceramic industries.

Materials and Methods: In a descriptive cross-sectional study, 155 tile workers were studied in 2015. Mean of age and working experience in participants was 29.45± 6.8 and 5.3 ±3.65 years, respectively. Sound pressure level  in different sections of ceramic industry were measured using Brüel & Kjær sound level meter. Pure tone audiometry of air conduction was performed in both ears at frequencies 0.5, 1, 2, and 4 kHz. Hearing threshold higher than 25 dB at different frequencies was defined as hearing loss.

Results: Mean of hearing threshold was 20.06 ±7.64 dB in right ear and 17.46 ±8.7 dB in left ear. Total hearing threshold was 17.9 ±8.04 db. About 18.7% of subjects suffered from NIHL in the right ear and 10.3% in the left ear. A significant relationship was found between work experience, job, lack of using proper protective equipment and hearing loss.

Conclusion: In conclusion, the rate of hearing loss among tile workers was high, hearing loss was more frequently seen in right ear than left ear.