Tibbi-i-kar

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Abstract Background: Periodic examinations for employees serve as one of the main parts of health surveillance in these persons, and there is a legal obligation to perform it. Although there isn't any quality control criteria and standards for its monitoring. So quality of the examinations may decline, and the main objective of the examinations, maintaining and improving employees' health, may not be achieved. This research has been accomplished to assess the quality of occupational medical examinations. Materials and Methods: A questionnaire was designed to evaluate the quality of the examinations according to scientific and legal measures. To fulfill the questionnaire, we used medical files of the employees in each plant. The study is cross-sectional and descriptive, and 333 employees were selected by cluster sampling. Results: Recording the specifications of the employees and their medical histories was appropriate in 98.6% and 94.6%, respectively. The interval between examinations was inappropriate in 62.5% of cases. Recording of occupational history, recording of the specifications of the occupational exposures, performing and recording physical examinations, spirometry, audiometry, chest X ray, specific occupational and general health paraclinic tests was appropriate in 69%, 36% 26.3%, 30%, 29%, 0%, 15.9%, and 19%, respectively. The final comment of the industrial hygienist was acceptable in 23% of cases. 40% of surveyed files required referring or intervention, but final comment of the examining physician was incorrect in 100% of cases. Conclusion: In present time, occupational medicine examinations has not an appropriate quality. In order to correct this condition, there is a need for proper training and enacting obvious guidelines and laws in the connection of performing and auditing occupational health examinations.

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Abstract Background: Accidents are one of the most important health problems worldwide. According to world health organization (WHO), 3.5 million people die from unintentional injuries each year. Occupational injuries are the subject for the new challenges in the world. Economic burdens of occupational diseases and injuries compared to other diseases such as cancer, cardiovascular diseases, Alzheimer disease and AIDS are very high. Materials and Methods: This is a one-year prospective survey of accidents among injured Bam farmers referring to health center (2005-2006). Data concerning demographic variables, accident conditions, and injury characteristics were collected using a questionnaire. The data were analyzed using SPSS and Excel. Parametric and non-parametric tests were used to compare groups. Results: A total of 70 injuries reported. Mean age was 37.2 years. The results showed that fall from palm trees was the most common mechanism of injury (41.4%). Legs and hands were the main injured area (61.4%). Most of the injuries occurred in the September and March (25.7% and 14.3%), respectively. Conclusion: Training, use and access to personal protective equipment especially safety belt, are important in prevention of accidents among Bam farmers to help with reducing of accidents and resulting injuries.

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Abstract Background: Occupational Asthma is characterized by reversible airway obstruction, either spontaneously or with treatment, airway inflammation and increased airway responsiveness due to workplace exposure. It is the most common occupational lung disease in developed countries. One of causative agent is metal fume that may be encountered in steel industries. In this study we determined occupational asthma prevalence in one steel factory and then we classified results according to various workshops. Methods: In this cross sectional study we determined workshops for 450 workers of steel industry by questionnaire. Then cross shift spirometry was done in all of them. Results: In cross shift spirometry we detected 14 occupational asthma cases. Highest prevalence was in catering (25%) and other workshops according to prevalence were welding (10%), construction (7%), scrap (5%), roller and lathes and melting (3%). Conclusion: There is great variability for occupational asthma in different workshops of steel industry. Highest prevalence was in catering that its exposures is different from other workshops in steel industry .It seems that this kind of exposures is more asthmogen than metal fumes

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Abstract Background: Occupational injury involves thousands workers worldwide especially in developing countries every years that could lead to workers disability and costly events for industrial cycle of the country. Thus, the aim of this study was to demonstrate status of work injuries and main pattern of work related trauma. Methods: All documents of the miners who had documented between 2003 and 2009 were assessed, and work related injuries were recorded. Demographic data, pattern of trauma were obtained and distributions of the patterns were addressed among age subgroups. Results: According to the result, work related injuries of kicked and contusions were the most common types of accidents. All types of fractures were in second position among other patterns. Age could not variant the rate of pattern in a descriptive view. Conclusion: The results in agreement with were same results from the other researches. This study evaluated trauma patterns in more prescribe than the other same researches.

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Abstract Background: Noise is a harmful environmental factor which may cause hearing loss, hypertension, and higher rates of occupational accidents and reduced production. Considering the various intensities and frequencies produced by industrial equipments, we assessed the effects of noise on hearing of tile industry workers. Methods: This cross-sectional study was done on 372 workers exposed to noise level of ≥85 dB in a tile factory in Yazd. After clinical examination and completing the questionnaire, audiometry was done by an audiologist for all. Data was then analyzed using SPSS software. Results: Our data showed mean age and work duration was 32.2 ± 6.9 and 9.5 ± 6.4 years respectively. Mean hearing thresholds for both ears were higher in 4000 and then 8000 Hz, as well as in higher frequencies rather than lower ones. Also, left ear showed more sensitivity than right ear. There was a significant relationship between hearing threshold and age and work duration (p<0.001). Conclusion: Our findings showed that exposure to noise in tile industry increases mean hearing thresholds in higher frequencies especially for 4000 Hz, while age and work duration are important factors.

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Abstract Background: Workـ related traumas could involve thousands of workers worldwide, especially in developing countries. These injuries may lead to incapacitation of work forces and ultimately impose a large economic load on industry. Due to the lack of statistics about the orbital trauma incidence among Iranian workers, we decided to evaluate the effects of age on the incidence of the ophthalmic trauma. Methods: In a retrospective descriptive study, all medical files of the miners between 2003 and 2008 were assessed, and workـ related injuries were recorded. These with ophthalmic trauma entered the study. Finally the relationship between age and incidence of the trauma was evaluated. Chi- square was used for analysis. Results: From 7100 occupational accidents, 377 cases (5.3%) suffered from ophthalmic trauma. Ophthalmic trauma had been most frequently occurred among 50-59 year old. Subjects (25.3%) and subjects under 20 years old were the second group (20.4%). The lowest frequency observed in subjects older than 60 year old. These wasn't any statistically significant difference in the frequency of ophthalmic injuries in different years (P>0.05). Accidents had been occurred mostly in the summer and between 8-10 A.M. Chi-square analysis showed a significant association between the age and frequency of trauma among miners (P<0.05). Conclusion: More frequent ophthalmic trauma in aforementioned age groups may be due to lower physical strength in older ages and lower job experience in year ages. These were no reduction in the frequency of trauma in different years which may be due to failure in the development of safety in the workplace.

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Abstract Background: This study was designed as an epidemiologic survey on occupational accidents in Marvdasht, Arsanjan and Passargad in a 6 year period. Methods: This was a cross-sectional study which was conducted on occupational accidents occurred between 2005-2010 in all industrial and producial units in Marvdasht, Passargad and Arsanjan. The frequency of accidents was calculated according to the type of accident, time of accident, job, sex, age, marital status, educational status, employment duration, insurance status, nationality and type of activity. Data was analyzed using chi square test. Results: The highest frequency of accidents occurred in 25-29 years age group (29.75%), the most important cause of accidents was fall (36.82%), the job with the highest frequency of accidents was construction (38.6%), the most frequent time of accidents was in 7-10 AM (31.7%), the most frequent organ involved was hand (29.26%) and the most frequent outcome was injury-fracture-toxicity (65.7%). Conclusion: According to the results employers and managers should implement research-based educational programs about health, job and management in order to observe the effects of industrial hygiene on the reduction of occupational accidents in the workplace.

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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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Abstract Background: Occupational accidents are a non-separable part of workplaces especially industrial settings. These accidents lead to long-term off-work periods, impairment and disability among experienced workers and eventually affect industrial productivity. This study was designed to assess registered occupational accidents in different industries in Yazd. Methods: In a retrospective cross-sectional study on the files of registered occupational accidents in a 1-year period from March 2007 till March 2008, 533 occupational accidents were evaluated. Results: Among all industries, metal and construction had the highest frequency of accidents (24.7%). Accidents mostly occurred in the morning (65.7%). The most frequent type of accidents was entrapment (32%). These accidents had led to death (10.8%), and permanent impairment (9.3%). Conclusion: According to the results of this study a considerable amount of occupational accidents lead to impairment and disability, so more attention to worker training, safety measures and using appropriate personal protective devices is recommended.

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Introduction: Emergency personnel are usually exposed to needle stick injuries (NSI) and contamination with HBV, HCV & HIV. The cost of health and psychological effects of such injuries demonstrates the importance of evaluating its risk factors and preventing it. One of these factors is job stress. Methods: A cross-sectional study was conducted among emergency personnel of 4 university hospitals in Tehran in 2008 - 2009. A triplex questionnaire was used including demographic features, Nordique psychological stress questionnaire and SPSS (Ver. 11) was used for analysis of the data. Results: Tree hundred and fifty respondents including 162 (46.3%) males and 188 (53.7%) women, with an average age of 30±5.6 years including 146 residents (41.7%),43 interns (12.3%) & 161 nurses (46%) entered the study. Sixty nine persons (19.7%) reported a history of NSI and 99 persons (28.3%) had Blood and Body fluid exposure during last 3 months.158 persons (45.1%) were classified as low, 158 (45.1%) as moderate and 34 (9.8%) as severe stress level. there was not any significant difference between the proportion of NSI in different stress levels (P=0.374), but there was a significant difference in NSI proportion between nurses, and interns, residents (P=0.002). Conclusion: This study demonstrates that the frequency of NSI & BBFE in emergency personnel is significant, especially in residents. So it’s necessary to have a program for reducing it. The stress level didn't influence the rate of NSI. We suggest doing a survey to study the relationship between NSI and job stress factors (such as workload, role ambiguity) separately.

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Introduction: In previous studies the appearance of vitiligo following occupational exposure has been defined. This study evaluates high risk occupational exposures before the onset of disease among patients with vitiligo Methods: All vitiliginous patients refered to dermatologic clinic of Imam Hospital, were asked about age of onset, recent and previous occupations, risky occupational exposures, autoimmune systemic disease and family history. Laboratory evaluation about diabetis melitus and thyroid disease was performed. Results: Of 135 patients included in the study, 70 (51.85%) patients had an occupation and 65 (48.14%) were unemployed. Of 70 occupational cases, 23 (32.9%) had a risky occupational exposure. The most prevalent risky occupational exposures were exposure to detergents, oil colour, print dye and pesticides. Occupational cases were divided into two groups: with risky occupational exposure and without risky exposure. In risky occupational exposure group, the ratio of men to women was significantly higher. There was a significant difference in distribution of the disease between two groups and extremities were significantly more involved in risky exposure group. Age at onset was significantly lower in non-risky exposure group. None of the patients with risky occupational exposure used skin protction. Conclusion: High prevalence of risky occupational exposure may indicate it as a risk factor for vitiligo. Knowledge about these risky chemicals and prevention, may reduce occupational vitiligo.

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Background: Flour dust is one of the allergens in the workplaces and its occupational exposure can cause respiratory impairments. The purpose of this study was to investigate the respiratory effects of exposure to flour dust in flour mill workers. Methods: This cross-sectional study was carried out at 6 flour producing factories in Razavi and South Khorasan provinces, Iran. Study subjects included 180 males (90 male workers with current exposure to flour dust and 90 male non-exposed employees). Determination of dust concentration was carried out with personal dust sampler at all production units of studied industries. Respiratory symptoms were investigated with American Thoracic Society questionnaire (Persian version). Lung function tests were done by a calibrated spirometer. The data were analyzed using SPSS (version 16). Results: Mean of age and work experience of exposed group was 36.8±9.03 and 12.0±5.6 years, respectively. This result, for non-exposed group was 37.3±8.1 and 12.58±5.5 years, respectively. Atmospheric concentrations of respirable and inhalable dust were 13.3±2.38 and 38.77±3.6 mg/m3, respectively. Results indicated that prevalence of respiratory symptoms in exposed subjects was significantly higher than non-exposed workers. Likewise, pulmonary function parameters were significantly lower in exposed than reference group (p<0.05). Conclusions: The findings of this study showed that occupational exposure to flour dust and age could be important factors predicting the prevalence of respiratory symptoms and functional impairment of the lungs

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Introduction: occupational stress identified as imbalance between occupational needs with individual’s abilities & demands. Occupational stress has somatic, psychological and behavioral effects. It seems that medical students have more severe degrees of occupational stress because of long period of education and mandatory presence in clinical and hospital environment. The goal of this study was evaluate of occupational stress and influencing factor in medical students of Iran University of medical science in two major categories of basic science and clinical medicine. Methods: A cross-sectional survey was conducted on 516 medical students with history of at least 3 months of medical education in 2010. Evaluation of occupational stress was conducted using osipow questionnaire (ά=0.83). Results: From 650 students that entered the study, 516 student answered to questionnaire (response rate=80%). The average of stress score is 132 in basic science and 157 in clinical group. We have increasing total stress scores in students with higher education levels. Stress in older students was higher than younger students. Also, Stress was higher in smokers’ students and who have history use of sedative drugs. The stress was increased significantly based on educational years. Conclusion: According to higher levels of total stress score in students with higher levels of education, establishment of stress management courses in faculty of medicine and familiarization of medical students with occupational stress and coping methods may be useful for modification of occupational stress in these students

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Background: Lead is one of the most toxic heavy metal which its toxicity and poisoning symptoms in workers of different industries (such as battery industry due to heavy use) is completely known. Important effects of this toxic metal are paralyzed wrist (nerve effects) as well as bone disease. The scope of this study is to evaluate the occupational exposure of workers of a battery industry to these pollutants. Methods: In this study the exposure to lead metal was evaluated. Twenty four workers were selected as the exposed group and breathing zone air samples were taken from them. For sampling of particulates, sampling pump model SKC made in UK and cellulose ester membrane filter with 0.8-μm pore size, and 37 mm diameter were used. The whole sampling process and analysis of samples were performed according to the 7300 NIOSH method. The pump flow set to 2 L/min and the filter was fixed to the collar of worker by cassette filter holder. After sampling, the filters transferred to the laboratory and were digested in the mixtures of HNo3 and HCLo4. Then, they analyzed by ICP-AES instrument. Results: The results are analyzed using SPSS18 with T-test and showed that 9 stations of 12 stations have higher results than mean average exposure to lead in this plant (75% of total sample), and the results of ELBACK station were more than others. The T-TEST showed a higher mean average exposure to lead in this plant. (Mean= 0.33mg/m3 S.D =0.48 P Value= 0.008) Conclusion: The findings showed that health status of workers in these industries is at risk due to unauthorized amounts of this toxic metal. To reduce occupational exposure, using appropriate engineering controls (air conditioning), administrative management (eg reducing exposure time) are necessary.

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Background: Provide a review of occupational medicine history in world and Iran Methods: Many books, papers and sites on the occupational medicine history were reviewed. Results: Occupational medicine have been shaped by the forces that shape work itself, social evolution, changing modes of production, shifting economic powers, and demographic changes in the workforce. Hippocrates emphasized the relation between environment and health, although he has less to say about the non-military work environment. The impact of work on health could be traced to the Edwin Smith Surgical Papyrus, written approximately 1700 BC. The earliest occupational physicians served military forces, and Galen was physician to Roman gladiators. Finger and wrist guards worn by Bronze Age archers represent early Personal Protective Equipment (PPE). Writers mention diseases and hazards of miners, and Pliny (1st century AD) mentions veils to cover the face. Paracelsus and Agricola were prominent, figures in the 15th century, with an emphasis on mining and health. Ramazzini's (c1700) work was widely translated in ensuing decades and is now well-known to all. In Iran, Rhazes included occupation in his case studies (9th century). Many other men like Avicenna, Jorjani, and others conducted many works and wrote many books about occupational and environmental medicine. The emergence of a public health movement in the mid-1800s focused attention on the abominable conditions of many factories and on the living conditions, poor nutrition, high stress, poverty and ill health of the new factory working class, while paying scant attention to specific workplace hazards.

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Background: In the foam industries, workers are exposed to various chemicals and working with these chemicals without considering occupational safety and health considerations could lead to different harmful symptoms. Consequently, in order to control measures and reducing risk to acceptable level, it is necessary to assess the health risk of exposure to harmful chemicals by implementation of specific risk assessment techniques in the process industries. The purpose of this study was to assess the health risks arising from chemical exposures in a foam industry in order to identify high-risk occupations and provide guidelines to reduce the risk of employment. Methods: This cross-sectional study was conducted in the polyurethane foam industry in 2012. In this study 13 men were examined: the mixer operator jobs (4 men), the operator Cutter (6 men) and repairs and maintenance (3 men). In order to assess the health risks of chemicals the proposed method by Singapore Institute of Occupational Safety and Health was used. First, job tasks and work process were determined and then different chemicals in each task identified and risk ranking was calculated in each job task by using of hazard and exposure rate. Finally, the risk level for each of the materials was obtained by interaction of these two parameters in the equation. Results: The result showed that workers are exposed to 7 chemicals including toluene diisocyanate, polyethylene glycol, polypropylene glycol, ethylene diamine, tin acetate, methylene chloride, and calcium carbonate during their work in plant. Out of these 7 chemicals, the highest risk level was determined for toluene diisocyanate in the foam production operators (Cutter Operator). (risk=3.67) Conclusion: Results showed that workers in the production unit exposed to high levels of toxic vapors of toluene diisocyanate and this leads to change in their spirometry parameters, especially decrease in the FVC and FEV1. Moreover, health risk assessment of harmful chemicals a applied, and appropriate method for job ranking by their risk level was used. These methods could be used for appropriate implementation and prioritization for control measures and reducing risk level to acceptable level.

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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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Introduction: Empowerment and training are so delicate and important factors via that human capital changes in to sustainable capital. Retention and development of labor needs to learning and use the safety and agricultural professional healthy receptions in risky agricultural situation. The main purpose of this study was to analysis the effectiveness of safety and agricultural professional healthy courses which carried out for farmers. Methods: First step of this study was survey about farms educational needs by descriptive - survey method in non experimental research. Effective assessment step done by experimental method with control and experimental groups. Statistical population consisted of 213 farm families from Mahidasht who 140 families selected as sample base on Morgan Sampling table and after need assessment 61 farmers participated in second step of research (experimental plan). Research instrument was questioner that its' Reliability confirmed by Choronbach Alpha coefficient calculation (it was 0.77) and questionnaire's validity confirmed by experts (content validity). Data were analyzed by t and F tests in SPSS 11.5 software. Results: Results showed that the mean of the pretest and posttest of experimental group relatively was 6/62 and 18/88. Also Results of t tests showed there was significant difference between pre-test and post - test in examination group which shows the relative effectiveness of the educational course. Conclusion: According to the results, there was significant difference between score of farmer's knowledge before and after of educational course. Therefore it is necessary to maintain the desired level of farmer's knowledge to pay more attention to the education and with training courses awareness of farmers can be promote.

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Background: Pesticides are chemical compounds used against vectors of human and animal diseases as well as plant pests. This study was undertaken to assess pulmonary reactions, if any, associated with occupational exposure to pesticides. Methods: This was a cross sectional analytical study in which a group of 86 exposed (employees of a pesticide producing company) and 75 unexposed referent subjects (Paper board recycling factory workers) were investigated. A standard questionnaire used to determine the prevalence of respiratory symptoms. Additionally, the parameters of pulmonary function were measured at the first day of workweek before and after shift, and several days after exposure. Results: Significant decrements were noted in some parameters of pulmonary function after exposure. Similarly, mean values of all parameters of pulmonary function, both prior to and after exposure were significantly lower than those of referent individuals. The prevalence of respiratory symptoms such as cough, phlegm and wheezing in the exposed group was significantly higher than those of referent subjects. Conclusion: Significant, chronic, irreversible, and acute, partially reversible, decrements in parameters of pulmonary function of exposed subjects observed in this study indicate that exposure to pesticides is associated with ventilatory disorders and reduced pulmonary capacities.

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Introduction: Benzene, Toluene, Ethyl Benzene and Xylene (BTEX) are Volatile Organic Compounds (VOCs) with similar physical and chemical characteristics. BTEX existing in gasoline releases to the air in result of the gasoline evaporation and the staffs are exposure to it in gasoline stations. The main goal of this project is to determine the risk of occupational exposure to BTEX compounds among workers in selected gasoline stations in Kerman and calculate the quantitative cancer and non cancer risk values of these defined compounds. Methodology: To achieve this goal, the air sample of 54 workers in 6 gasoline stations (the suburbs and downtown) were collected in three times morning, noon and night (that the fuel is discharged from the fuel tanker to the gasoline tank, in one of these three times) by sampling pumps. The samples were then transferred to the laboratory and analyzed by Gas Chromatography (GC) with a Flame Ionization Detector (FID). Result: The findings represent that the average concentration of BT during discharging the fuel from the tanker to the gasoline tank is higher than the average concentration of BT in the rest of sample. The Cancer risk for workers exposed to benzene is estimated in the range of 1.11×10- 2 – 8.22×10- 4. A quantitative non-cancer risk values for benzene, Toluene is also calculated in the range of 134-9.83, 0.699- 0.217. Conclusions: The results shows that the average concentrations of benzene in the air is higher than permissible limit proposed by Technical Committee of Occupational Hygiene (0.5 ppm or 1,600 μg/m 3), While Toluene are less than the permissible limit. As well, it is shown that the cancer risk benzene is high among workers in studied gasoline stations.