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بررسی همبستگی نتایج حاصل از پرسشنامه اختصاصی مچ و دست نوردیک با پرسشنامه DASH Investigation of correlation result of NORDIC questionnaire (wrist & hand) with DASH questionnaire 1 1 مقدمه: اختلالات اسکلتی عضلانی مرتبط با کار بیشتر در اندامهای فوقانی میافتد و موجب ناتوانی میگردد. زمانی که درک افراد از تواناییهایشان مدنظر باشد، پرسشنامه ها ابزاری مفید و با ارزش محسوب میگردند. پرسشنامه ها میتواند برای سنجش علائم بیماریها و ناتوانیها موثر واقع گردند. لذا برآن شدیم که به بررسی همبستگی نتایج حاصل از پرسشنامه اختصاصی مچ و دست نوردیک با پرسشنامه DASH بپردازیم. روش اجرا: این پژوهش یک مطالعه مقطعی میباشد که به روش نمونه گیری تصادفی روی 82 نفر خانم مونتاژکار انجام شد. برای بررسی همبستگی نتایج حاصل از پرسشنامه اختصاصی مچ و دست نوردیک با پرسشنامه DASH از آزمون کای دو و اسپیرمن استفاده شد. تحلیل داده ها با استفاده از نرم افزار20 SPSS انجام و 05/0  P value <معنادار تلقی گردید. یافته ها: در این مطالعه، نتایج پرسشنامه DASH با متغیرهای مورد مطالعه، مشابه نتایج پرسشنامه اختصاصی مچ و دست نوردیک شد. ضمنا در اکثر سوالات بین این دو پرسشنامه رابطه معناداری یافت گردید(05/0 P value <). میانگین نمره DASH 85/14±60/19 بدست آمد و 9/ 65 %  افراد دارای مشکل خفیف در اندام فوقانی بودند. ضمنا، 8/76% شرکت کنندگان، دچار ناراحتی در ناحیه مچ دست شده که از این تعداد 3/46% ناراحتی خفیفی را تجربه کرده بودند. نتیجه گیری: نتایج  بیانگر کاربردی بودن پرسشنامه DASH در زمینه صنعتی و شغلی می باشد. بنابراین،  به دلیل رابطه نزدیک بین دو پرسشنامه می توان از پرسشنامه DASH به جای پرسشنامه اختصاصی مچ و دست نوردیک استفاده کرد.   2 Background: Work-related musculoskeletal disorders occur predominantly in the upper limbs and cause disability. When is it comes to the perception of people as for their abilities, Questionnaires are useful and valuable tools. Questionnaires can be used to measure the symptoms of disease and disability. We decided to evaluate correlation result of NORDIC questionnaire (wrist & hand) with DASH questionnaire in the female assembly workers. Methods: The study was a descriptive -analytic and cross-sectional one and was carried out among 82 female assembly workers. In order to evaluate the correlation result of NORDIC questionnaire (wrist & hand) with DASH questionnaire, by chi squire and spearman have been used. Data analysis was carried out by using SPSS 20. It is noteworthy to mention that P value <0.05 was considered significant. Results: In this study, the results of the DASH questionnaire with the studied variables were similar to the results of the NORDIC questionnaire (wrist & hand). Moreover, in the majority of questions, there was a significant relationship between the two questionnaires (P value <0.05). The average score of DASH was obtained 19.65 ± 14.85 and 65.9% of the people had a mild upper limb. Moreover, 76.8% of the participants had distress in the wrists area, among which, 46.3% had a mild discomfort. Conclusion: According to the results the DASH questionnaire is a useful tool for industrial and occupational issues. Therefore, due to the high relationship between two questionnaires, the DASH questionnaire could be used instead of the Nordic Questionnaire (Wrist and Hand).   1 9 2022/11/8 1401/8/17 2022/11/12 1401/8/21 زهرا اردودری Zahra Ordudari دانشگاه علوم پزشکی اصفهان ایران zordudari@yahoo.com احسان الله حبیبی Ehsan Habibi دانشگاه علوم پزشکی اصفهان ایران ordz88@yahoo.com NORDIC DASH Upper Limb Wrist & Hand نوردیک DASH اندام فوقانی مچ و دست 1. Nunes IL. FAST ERGO_X–a tool for ergonomic auditing and work-related musculoskeletal disorders prevention. Work. 2009;34(2):133-48.##2. Masâ E, Fatmawati W, Ajibta L. Analisa Manual Material Handling (MMH) dengan Menggunakan Metode Biomekanika untuk Mengidentifikasi Resiko Cidera Tulang Belakang (Musculoskeletal Disorder)(Studi Kasus pada Buruh Pengangkat Beras di Pasar Jebor Demak). Majalah Ilmiah Sultan Agung. 2022;45(119):37-56.##3. Fredriksson K, Bildt C, Hägg G, Kilbom Å. The impact on musculoskeletal disorders of changing physical and psychosocial work environment conditions in the automobile industry. International Journal of Industrial Ergonomics. 2001;28(1):31-45.##4. Van Eerd D, Irvin E, Le Pouésard M, Butt A, Nasir K. Workplace Musculoskeletal Disorder Prevention Practices and Experiences. INQUIRY: The Journal of Health Care Organization, Provision, and Financing. 2022;59:00469580221092132.##5. Lei L, Dempsey PG, Xu J-g, Ge L-n, Liang Y-x. Risk factors for the prevalence of musculoskeletal disorders among Chinese foundry workers. International Journal of Industrial Ergonomics. 2005;35(3):197-204.##6. Abledu J, Abledu G. Multiple logistic regression analysis of predictors of musculoskeletal disorder and disability among bank workers in Kumasi. Ghana J Ergon. 2012;2:111-5.##7. Kitis A, Celik E, Aslan UB, Zencir M. DASH questionnaire for the analysis of musculoskeletal symptoms in industry workers: a validity and reliability study. Applied ergonomics. 2009;40(2):251-5.##8. Palikhe S, Lee JY, Kim B, Yirong M, Lee D-E. Ergonomic Risk Assessment of Aluminum Form Workers’ Musculoskeletal Disorder at Construction Workstations Using Simulation. Sustainability. 2022;14(7):4356.##9. Cheshmehgaz HR, Haron H, Kazemipour F, Desa MI. Accumulated risk of body postures in assembly line balancing problem and modeling through a multi-criteria fuzzy-genetic algorithm. Computers & Industrial Engineering. 2012;63(2):503-12.##10. Kennedy CA, Beaton DE. A user's survey of the clinical application and content validity of the DASH (Disabilities of the Arm, Shoulder and Hand) outcome measure. Journal of Hand Therapy. 2017;30(1):30-40. e2.##11. Southam M, Driessens S, Burton C, Pope R, Thurnwald P. A retrospective cohort study of QuickDASH scores for common acute trauma conditions presenting for hand therapy. Journal of Hand Therapy. 2017;30(1):41-8.##12. Hong X, Lee Y, editors. Prevalence of Musculoskeletal Symptoms Among Construction Workers. International Conference on Man-Machine-Environment System Engineering; 2023: Springer.##13. Dahl AG, Havang S, Hagen K. Reliability of a self-administrated musculoskeletal questionnaire: The fourth Trøndelag health study. Musculoskeletal Science and Practice. 2022;57:102496.##14. Dawson AP, Steele EJ, Hodges PW, Stewart S. Development and test–retest reliability of an extended version of the Nordic Musculoskeletal Questionnaire (NMQ-E): a screening instrument for musculoskeletal pain. The Journal of Pain. 2009;10(5):517-26.##15. Ramlagan S, Peltzer K, Phaswana-Mafuya N. Hand grip strength and associated factors in non-institutionalised men and women 50 years and older in South Africa. BMC research notes. 2014;7(1):8.##16. Mousavi SJ, Parnianpour M, Abedi M, Askary-Ashtiani A, Karimi A, Khorsandi A, et al. Cultural adaptation and validation of the Persian version of the Disabilities of the Arm, Shoulder and Hand (DASH) outcome measure. Clinical rehabilitation. 2008;22(8):749-57.##17. Luc D. The DASH questionnaire and score in the evaluation of hand and wrist disorders. Acta Orthopaedica Belgica. 2008;74(578):81-5.##18. Karl K, Henrike K, Katrin K. Ergonomics: how to design for ease and efficiency. New Jersey; 2001.##19. Choobineh A, Lahmi M, Shahnavaz H, Khani Jazani R, Hosseini M. Musculoskeletal symptoms as related to ergonomic factors in Iranian hand-woven carpet industry and general guidelines for workstation design. International journal of occupational safety and ergonomics. 2004;10(2):157-68.##20. Taghizadeh S, Haghighat F, Piroozi S, Karimi A, Khanali Nejad D. The Survey and Comparison of Musculoskeletal Disorders of Shoulder, Arm and Hand in Taxi and Bus Drivers in the City of Shiraz in 2016. Archives of Rehabilitation. 2018;19(1):64-75.##21. Jester A, Harth A, Germann G. Measuring levels of upper-extremity disability in employed adults using the DASH Questionnaire. Journal of Hand Surgery. 2005;30(5):1074. e1-. e10.##22. Habib RR, Hamdan M, Nuwayhid I, Odaymat F, Campbell OM. Musculoskeletal disorders among full-time homemakers in poor communities. Women Health. 2006;42(2):1-14.##23. Shuval K, Donchin M. Prevalence of upper extremity musculoskeletal symptoms and ergonomic risk factors at a Hi-Tech company in Israel. Int J Ind Ergon. 2005;35(6):569-81.##24. Holmström E, Engholm G. Musculoskeletal disorders in relation to age and occupation in Swedish construction workers. Am J Ind Med. 2003;44(4):377-84.##25. Yari S, Fallahasadi A. Quantitative and Qualitative Evaluation of musculoskeletal disorders of workers and its relationship with the BMI in a paper making industry in 2015. Iran Occupational Health. 2017;13(5):88-96.##26. Choobineh A, Daneshmandi H, Poor AF, Fard HR. Ergonomic assessment of musculoskeletal disorders risk level among workers of a petrochemical company. Iran Occupational Health. 2013;10(3).## ##

رویکرد به موارد شغلی مسمومیت با سرب Approach to occupational cases of lead poisoning 1 1 مقدمه : سرب فلزی سمی است که در پوسته زمین یافت می‏شود و به علت چگالی، شکل‌پذیری، مقاومت بالا و نقطه ذوب پایین، از 7000 سال پیش مورداستفاده بشر بوده است. استفاده وسیع از این فلز در صنعت، علاوه بر مواجهه شاغلین، منجر به آلودگی گسترده محیط‏‏‏زیست‏ و بروز مشکلات سلامت عمومی در بسیاری از نقاط جهان شده است. با توجه به گستردگی استفاده از سرب در مشاغل مختلف و اهمیت عوارض ناشی از آن، درمان شاغلین دارای علائم مواجهه با این ماده اهمیت خاصی در طب کار و سلامت شغلی کشورها داشته است، لذا در این مقاله، به مروری بر رویکرد به علائم ناشی از مواجهه با سرب  شاغلین دارای مسمومیت با سرب می‌پردازیم. روش بررسی : در این مطالعه باهدف بررسی درمان‌های موجود جهت کنترل عوارض ناشی از مواجهه با سرب در محیط‌های کاری، بانک‌های اطلاعاتی GoogleScholar, PubMed, Scopus از سال 1980 تا 2021 و همچنین دستورالعمل‌های CDC, ACOEM, OSHA, WHO  و ATSDR با روش جستجوی موضوعی بررسی شد.تعداد 19 مقاله و 5 دستورالعمل انتخاب و در نگارش این مقاله مورداستفاده قرار گرفت. یافته‌ها : بررسی‌ها نشان داد که در شاغلین در تماس با سرب در ارزیابی‌های دوره‌ای توجه به سیستم‌های مختلف بدن و انجام اقدامات تکمیلی در صورت شک به مسمومیت به سرب لازم است. نتیجه‌گیری : در شاغلین دارای تشخیص مسمومیت با سرب می‌بایست علاوه بر درمان عوارض موجود و شلاتوتراپی، آموزش‌های لازم جهت کاهش مواجهه با سرب نیز داده شود.   2 Introduction: Lead is a toxic metal that is found in the earth's crust and has been used by humans since 7000 years ago due to its density, malleability, high resistance and low melting point. The wide use of this metal in the industry, in addition to the exposure of workers, has led to widespread environmental pollution and public health problems in many parts of the world. Due to the widespread use of lead in various occupations and the importance of its complications, the treatment of workers with symptoms of exposure to this substance has been of particular importance in the occupational medicine and occupational health of countries, therefore, in this article, it was reviewed the approach to the symptoms caused by lead exposure inworkers with lead poisoning. Materials and Methods: In this study, with the aim of investigating the available treatments to control complications caused by exposure to lead in the workplace, Google Scholar, PubMed, Scopus databases from 1980 to 2021, as well as CDC, ACOEM, OSHA, WHO and ATSDR guidelines with the method Thematic search was reviewed. The number of 19 articles and 5 instructions were selected and used in writing this article. Results: The investigations showed that it is necessary to pay attention to different body systems and perform additional measures in case of suspicion of lead poisoning in periodical evaluations of those working in contact with lead. Conclusion: In addition to the treatment of existing complications and chelatotherapy, the workers diagnosed with lead poisoning should be given the necessary training to reduce exposure to lead. 10 15 2022/11/82022/09/4 1401/6/13 2022/11/122022/11/17 1401/8/26 محمدحسین داوری Mohammad hosein Davari دانشگاه علوم پزشکی شهید صدوقی یزد ایران Ddmhdavari@gmail.com مجاهده سلمانی Mojahede Salmani دانشگاه علوم پزشکی شهید صدوقی یزد ایران mojahede@gmail.com مرجان غروی Marjan Gharavi دانشگاه علوم پزشکی شهید صدوقی یزد ایران marjangharavi@yahoo.com مژگان پیری اردکانی Mojgan Piri Ardakani دانشگاه علوم پزشکی شهید صدوقی یزد ایران mojgan.piri67@gmail.com lead work environment treatment chelator therapy سرب محیط کار درمان شلاتورتراپی 1. Lessler MA. Lead and lead poisoning from antiquity to modern times. Ohio journal of science. 1988; 88(3):78-84.##2. ATSDR. Toxicological Profile for Lead. US Department of Health & Human Services, PublicHealth Service, Agency for Toxic Substances and Disease Registry, Atlanta, GA 2007. Available at: http://www.atsdr.cdc.gov/toxprofiles/tp.asp?id=96&tid=22 (Accessed on February 05, 2019).##3.Kosnett MJ, Wedeen RP, Rothenberg SJ, et al. Recommendations for medical management of adult lead exposure. Environ Health Perspect 2007; 115(3):463-71.##4.Calello DP, Henretig FM. Lead. In: Goldfrank's Toxicologic Emergencies, 11th ed, Nelson LS, Howland MA, Lewin NA, et al (Eds), McGraw Hill Education, New York 2019. p.1292.##5.Cullen MR, Robins JM, Eskenazi B. Adult inorganic lead intoxication: presentation of 31new cases and a review of recent advances in the literature. Medicine (Baltimore) 1983; 62(4):221-47.##6.Friedman LS, Simmons LH, Goldman RH, Sohani AR. Case records of the MassachusettsGeneral Hospital. Case 12-2014. A 59-year-old man with fatigue, abdominal pain, anemia,and abnormal liver function. N Engl J Med 2014; 370(16):1542-50.##7. Frith D, Yeung K, Thrush S, et al. Lead poisoning--a differential diagnosis for abdominalpain. Lancet 2005; 366(9503):2146.##8.Kosnett MJ. Lead. In: Critical Care Toxicology, Brent J, Burkhart J, Dargan P, et al (Eds), Springer International Publishing, Switzerland 2016;1-7.##9.Goldman RH, Weissmann L. A Diagnosis to Chew On. N Engl J Med 2019; 381(5):466-473.##10. Hu H. Bone lead as a new biologic marker of lead dose: recent findings and implicationsfor public health. Environ Health Perspect 1998; 106 Suppl 4:961-7.##11.Hu H, Rabinowitz M, Smith D. Bone lead as a biological marker in epidemiologic studies ofchronic toxicity: conceptual paradigms. Environ Health Perspect 1998; 106(1):1-8.##12. Barbosa F Jr, Tanus-Santos JE, Gerlach RF, Parsons PJ. A critical review of biomarkersused for monitoring human exposure to lead: advantages, limitations, and future needs.Environ Health Perspect 2005; 113(12):1669-1674.##13.Hu H, Shih R, Rothenberg S, Schwartz BS. The epidemiology of lead toxicity in adults:measuring dose and consideration of other methodologic issues. Environ Health Perspect2007; 115(3):455-62.##14. Lead in the Workplace: A Guide to Working with Lead Revised January 18, 2019##15.Balbus-Kornfeld JM, Stewart W, Bolla KI, Schwartz BS. Cumulative exposure to inorganiclead and neurobehavioural test performance in adults: an epidemiological review. OccupEnviron Med 1995; 52(1):2-12.##16. Chia SE, Chia HP, Ong CN, Jeyaratnam J. Cumulative blood lead levels andneurobehavioral test performance. Neurotoxicology 1997; 18(3):793-803.##17.National Toxicology Program. Health effects of low-level lead evaluation. Research Triangle Park, NC: US Department of Health and Human Services; 2012. http://ntp.niehs.nih.gov/pubhealth/hat/noms/ lead/index.html (Accessed on August 11, 2019).##18. National Research Council. Potential Health Risks to DOD Firing-Range Personnel from Recurrent Lead Exposure, The National Academies Press, Washington, DC 2012##19.Levin SM, Goldberg M. Clinical evaluation and management of lead-exposed constructionworkers. Am J Ind Med 2000; 37(1):23-43.##20. Fischbein A, Hu H. Occupational and environmental exposure to lead. In: Environmental and Occupational Medicine, Rom WN, Markowitz SB (Eds), Lippincott Williams & Wilkins, Philadelphia 2007. p.958.##21.Council of State and Territorial Epidemiologists (CSTE) Occupational Subcommittee. Management guidelines for blood lead levels in adults. June 12, 2013. http://c.ymcdn.com/sites/www.cste.org/ resource/resmgr/OccupationalHealth/ManagementGuidelinesforAdult.pdf (Accessed on March 06, 2016).##22.Grandjean P, Jacobsen IA, Jørgensen PJ. Chronic lead poisoning treated withdimercaptosuccinic acid. Pharmacol Toxicol 1991; 68(4):266-9.##23. George T, Brady MF. Ethylenediaminetetraacetic Acid (EDTA) [Updated 2021 Jul 18]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi. nlm.nih.gov/books/NBK565883/##24.Chandran L and Cataldo R, “Lead Poisoning: Basics and New Developments,” Pediatr Rev, 2010, 31(10):399-406.## ##

بررسی رابطه معماری محیط‌های کاری با ظهور مشکلات سلامتی ناشی از سر و صدا: ساختمان‌های ناسالم Examining the relationship between the architecture of workplaces and the emergence of health problems caused by noise: unhealthy buildings 1 1 مقدمه: محیط‌کاری از مهمترین محیط‌هایی است که افراد بخش اعظمی از وقت خود را در آن سپری می‌کنند. فقدان آسایش صوتی یکی از مهمترین عواملی است که همه روزه سلامت و رفاه کارکنان را در این محیط‌های کاری تهدید می‌کند. هدف این مطالعه ضمن شناسایی علائم ناشی از مشکلات صوتی در بین کارکنان، شناسایی پارامترهای اصلی و بررسی نقش معماری در گسترش محیط‌های کاری ناسالم است. روش بررسی: این مطالعه در بین کارکنان سه ساختمان اداری شهر ارومیه )راه و شهرسازی، نظام مهندسی و فرودگاه( انجام شد و حجم نمونه 226 از 309 نفر از کل کارکنان،‌ براساس جدول مورگان مورد نظرسنجی قرار گرفت. داده‌‌های لازم از‌ طریق پرسشنامه جمع‌‌آوری شده و با استفاده از آمار توصیفی (فراوانی، درصد، میانگین و انحراف معیار) و آزمون فریدمن، به‌کمک نرم‌‌افزار SPSS-25  تجزیه و تحلیل شدند. یافته‌ها:  میانگین رتبه‌های علائم نشان داد که خستگی (62/4)، مشکلات شنوایی (05/6)، سردرد (30/6)، دردهای عضلانی (01/7)، استرس زیاد (41/8)، عصبانیت سریع (55/8) و حواس پرتی و تمرکز ضعیف (58/8)، از مهمترین علائم ناشی از سر و صدا در بین کارکنان بودند. همچنین مزاحمت‌های ناشی از مکالمات سایرین (22/59%) و ازدحام زیاد و فقدان حریم گفتاری فردی (99/41%)، از مهمترین پارامترها با تعدد شکایت از سر و صدا بودند. نتیجه‌گیری: نتایج بررسی‌‌ نشان داد که طراحی ناکارآمد محیط و عدم انعطاف‌پذیری فضاها، جانمایی نامناسب و عدم عایق‌کاری صوتی سطوح درکاربری‌های پر سر و صدا، تراکم بالا در محیط و فقدان فضای کافی برای کارکنان، عدم تعمیر سیستم‌های تاسیساتی، از مهمترین دلایل تعدد شکایات از سر‌ و ‌صدا بودند. 2 Introduction: The workplace is one of the most significant environments where people spend most of their time. Lack of acoustic comfort is one of the most important factors that threatens the health and well-being of employees in these workplaces every day. The purpose of this study, while identifying the symptoms caused by noise problems among employees, is to identify the main parameters and to investigate the role of architecture in the expansion of unhealthy workplaces. Method: The current study was conducted among the employees of three administrative buildings in Urmia city (Road and Urban Development, Construction Engineering Organization and Airport) and a sample size of 226 out of 309 employees was surveyed based on Morgan's table. The required data were collected through a questionnaire and analyzed using descriptive statistics (frequency, percentage, mean and standard deviation) and Friedman test by SPSS-25 software. Results: The average ranks of the symptoms showed that fatigue (4.62), hearing problems (6.05), headache (6.30), muscle pains (7.01), high stress (8.41), quick anger (8.55) and distraction and poor concentration (8.58), were among the most important symptoms caused by noise among employees. Also, disturbances caused by other people's conversations (59.22%) and overcrowding and lack of individual speech privacy (41.99%) were among the most important parameters, having frequent complaints about noise. Conclusion: The results of the investigation indicated that the inefficient environment design and lack of spaces flexibility, inappropriate placement and lack of acoustic insulation of surfaces inside noisy uses, high environment density and lack of sufficient space for employees, lack of installation systems maintenance, were among the most important reasons for frequent complaints about noise. 16 25 2022/11/82022/09/42022/07/7 1401/4/16 2022/11/122022/11/172022/08/25 1401/6/3 سولماز تابع افشار Solmaz Tabe Afshar دانشگاه آزاد اسلامی تبریز ایران s.tabeafshar@gmail.com سحر طوفان Sahar Toofan دانشگاه آزاد اسلامی تبریز ایران shr.toofan@gmail.com آرش ثقفی اصل Arash Saghafi Asl دانشگاه آزاد اسلامی تبریز ایران ash.saghafi.asl@gmail.com Healthy buildings Workplaces Indoor Environmental Quality (IEQ) Noise Architectural evaluation Physical factors ساختمان‌های سالم محیط‌های کاری کیفیت محیط داخلی سر و صدا ارزیابی معماری عوامل فیزیکی References:##1-Seppanen, O., W. J. Fisk, and Q. H. Lei. Effect of Temperature on Task Performance in Office Environment. Berkeley. CA: Lawrence Berkeley National Laboratory. 2006.##2- Redlich, C.A. Sparer, J. Cullen, M.R. Sick-building syndrome. Lancet 1997; 349, 1013–1016.##3 - Al Horr, Y. Arif, M.; Katafygiotou, M. Mazroei, A.; Kaushik, A. Elsarrag, E. Impact of indoor environmental quality on occupant well-being and comfort: A review of the literature. Int. J. Sustain. Built Environ. 2016, 5, 1–11.##4- Sterling E, Sterling T. The impact of different ventilation levels and fluorescent lighting types on building illness: An experimental study. Can J Public Health. 1983; 74(6):385–392.##5- Environment and Health, Budapest, Hungary, 23–25 June 2004; WHO Regional O_ce for Europe: Copenhagen, Denmark, 2004.##6- Cox, C. Health Optimisation Protocol for Energy-E_cient Buildings Pre-Normative and Socio-Economic Res. 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بررسی میزان تاثیر فاکتورهای روانی اجتماعی، ارگونومی، محیطی و دموگرافیک بر شیوع اختلالات اسکلتی عضلانی در میان کارکنان اداری Investigating the impact of managerial, environmental and demographic factors on the prevalence of musculoskeletal disorders among office workers 1 1 مقدمه: اختلالات اسکلتی عضلانی یکی از مشکلات اصلی صنایع و همچنین مشاغل اداری است که عوامل مختلفی در ابتلا به آن نقش دارد. هدف از مطالعه حاضر تعیین نقش هر یک از عوامل فردی، فیزیکی، روانی اجتماعی و محیطی در ایجاد اختلالات اسکلتی عضلانی می‌باشد تا با شناسایی و کنترل آن‌ها گام مهمی در کاهش و پیشگیری از این اختلالات برداشته شود. مواد و روش‌ها: مطالعه حاضر یک مطالعه مقطعی بر روی 342 نفر از کارکنان شاغل در ادارات مختلف دولتی شهر ساوه در سال 1400 می‌باشد. در این مطالعه به‌منظور بررسی شیوع اختلالات اسکلتی عضلانی از پرسشنامه خلاصه نوردیک و چک‌لیست ROSA استفاده شد. همچنین به‌منظور بررسی عوامل فردی و روانی اجتماعی محیط کار پرسشنامه اطلاعات فردی و پرسشنامه عمومی نوردیک بکار برده شد. علاوه براین ارزیابی شرایط محیطی کار توسط دستگاه‌های لوکس متر Hagner مدل E1، دستگاه سنجش استرس حرارتی مدل  TIS10 و صداسنج TES1358 صورت پذیرفت.درنهایت تمام داده‌های حاصل وارد نرم‌افزار SPSS شدند و پس از کدبندی مورد آزمون قرار گرفتند. یافته‌ها: نتایج نشان داد شاخص توده بدنی و جنسیت در ابتلا به اختلالات اسکلتی عضلانی تأثیر معناداری دارند(p-value<0/05). نتایج آزمون همبستگی پیرسون مشخص کرد بین گزارش درد یا ناراحتی در ناحیه‌ی گردن با نمره‌ی ریسک صفحه‌نمایش- تلفن ، مچ / دست با نمره‌ی ریسک کیبورد- موس همچنین شانه، بالای کمر، آرنج و پایین کمر با نمره‌ی ریسک صندلی ارتباط معناداری وجود دارد (p-value<0/05). بعلاوه بین گزارش درد یا ناراحتی در نواحی گردن، شانه و مچ / دست با نمره‌ی کلی ROSA   ارتباط معناداری دیده می‌شود. همچنین بین شیوع اختلالات اسکلتی عضلانی و سطوح نیازهای شغلی، سطوح کنترل شغلی، سطوح تعاملات اجتماعی، سطوح رهبری، سطوح جو سازمانی، سطوح رضایت از کار و سطوح استرس تفاوت معناداری دیده می‌شود (p-value<0.05). نتیجه‌گیری: نتایج این مطالعه نشان داد بروز اختلالات اسکلتی عضلانی در بین کارکنان چندعاملی است؛ به‌گونه‌ای که در بین عوامل روانی اجتماعی؛ نیازهای شغلی، تعاملات اجتماعی و استرس اهمیت مؤثری در ایجاد اختلالات اسکلتی عضلانی داشته‌اند. در بین عوامل فردی جنسیت و شاخص توده بدنی(BMI) و در بین عوامل ایستگاه کاری صندلی نقش بارزی در ایجاد اختلالات اسکلتی-عضلانی داشته‌اند.   2 Introduction: Musculoskeletal disorders are one of the main problems of industries and administrative jobs, which are caused by various factors. The study aimed to determine the role of each individual, physical, psychosocial, and environmental factors in causing musculoskeletal disorders; Identifying and controlling risk factors, is an important step in reducing and preventing these disorders. Materials and methods: The present study is a cross-sectional study of 342 employees working in different government offices in Saveh city in 2021. In this study, the Nordic summary questionnaire and ROSA checklist were used to investigate the prevalence of musculoskeletal disorders. Also, to investigate individual and psychosocial factors of the work environment, a personal information questionnaire and a general Nordic questionnaire were used. In addition, the evaluation of conditions of work environment was done by Hagner model E1 lux meter devices, TIS10 model thermal stress measuring device, and TES1358 sound meter. Finally, all the resulting data were entered into SPSS software and tested after coding. Results: The results showed that body mass index and gender have a significant effect on suffering from musculoskeletal disorders (p-value<0.05). The results of the Pearson correlation test indicated that there is a significant relationship between the report of pain or discomfort in the neck area with the screen-phone risk score, wrist/hand with the keyboard-mouse risk score, as well as shoulder, upper back, elbow and lower back with the chair risk score. p-value <0.05). In addition, there is a significant relationship between the report of pain or discomfort in the neck, shoulder, and wrist/hand areas with the overall ROSA score. Also, there is a significant difference between the prevalence of musculoskeletal disorders and levels of job demands, levels of job control, levels of social interactions, levels of leadership, levels of the organizational atmosphere, levels of job satisfaction, and levels of stress (p-value<0.05). Conclusion: The results of this study showed that several factors play a role in musculoskeletal disorders, such as job requirements, social interactions, and stress in the group of psychosocial factors that had considerable importance in causing musculoskeletal disorders. Among the individual factors, gender and body mass index (BMI) is important, and among the workstation factors, the chair has played a significant role in causing musculoskeletal disorders.   26 41 2022/11/82022/09/42022/07/72022/11/1 1401/8/10 2022/11/122022/11/172022/08/252022/11/24 1401/9/3 محسن فلاحتی mohsen falahati دانشکده علوم پزشکی ساوه ایران falahatimohsen64@gmail.com اعظم بیابانی azam biabani دانشگاه علوم پزشکی تهران ایران A.BIABANI.67@GMAIL.COM مجتبی ذکایی mojtaba zokaei دانشکده علوم پزشکی ساوه ایران mzokaei2011@gmail.com Musculoskeletal disorders Environmental ergonomic risk factors demographic psycho social اختلالات اسکلتی عضلانی فاکتورهای محیطی ریسک فاکتورهای ارگونومی دموگرافیک فاکتورهای روانی اجتماعی 1-Malik KM, Beckerly R, Imani F. Musculoskeletal disorders a universal source of pain and disability misunderstood and mismanaged: A critical analysis based on the US model of care. Anesthesiology and pain medicine. 2018;8(6): e85532.##2-Blackwell DL, Lucas JW, Clarke TC. 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Association Between Psychosocial Factors With Upper Extremity Musculoskeletal Disorders: An Academic Review. Malaysian Journal of Public Health Medicine. 2017;17(1):1-7.##8-Punnett L, Wegman DH. Work-related musculoskeletal disorders: the epidemiologic evidence and the debate. Journal of electromyography and kinesiology. 2004;14(1):13-23.##9-Noroozi MV, Hajibabaei M, Saki A, Memari Z. Prevalence of musculoskeletal disorders among office workers. Jundishapur journal of health sciences. 2015;7(1):e27157.##10-Jaffar NAT, Rahman MNA, editors. Review on risk factors related to lower back disorders at workplace. IOP Conference Series: Materials Science and Engineering; 2017: IOP Publishing.##11-Piranveyseh P, Motamedzade M, Osatuke K, Mohammadfam I, Moghimbeigi A, Soltanzadeh A, et al. Association between psychosocial, organizational and personal factors and prevalence of musculoskeletal disorders in office workers. International Journal of Occupational Safety and Ergonomics. 2016;22(2):267-73.##12-Aalamolhodaei M. Ergonomic survey of librarian's work place and injuries caused by computer working: [MSc Thesis] Tehran: Iran University of Medical Sciences; 2001.##13-Choobineh A, Rahimi Fard H, Jahangiri M, Mahmood Khani S. Musculoskeletal injuries and their associated risk factors. Iran Occup Health. 2012;8(4):70-81.##14-Dayani F, Sadeghei-Naeenei H, Bahrami M, Choopankareh V. Assessment of body work condition by RULA method in a motor vehicle industry in order to design an effective exoskeleton system. Iran Occup Health. 2012;8(4):36-47[persian].##15-Kotejoshyer R, Punnett L, Dybel G, Buchholz B. Claim Costs, Musculoskeletal Health, and Work Exposure in Physical Therapists, Occupational Therapists, Physical Therapist Assistants, and Occupational Therapist Assistants: A Comparison Among Long-Term Care Jobs. Physical Therapy. 2019;99(2):183-93.##16-Osama M, Ali S, Malik RJ. 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بررسی اثر مواجهه با صدا بر روی بار کار ذهنی، حساسیت به صدا و سلامت عمومی و روانی اپراتورهای جرثقیل های سقفی در یکی از صنایع فولاد جنوب ایران Investigating the effect of noise exposure on mental workload, noise sensitivity and general and mental health of overhead crane operators in one of the Steel Industries in south of Iran 1 1 مقدمه: جرثقیل‌های سقفی در هدایت و راهبری صنایع فولاد و نگه‌داشتن وضعیت نرمال آن نقش حیاتی بر عهده دارند. این ماشین‌آلات توسط انسان اداره می‌شوند و خطر بزرگی از تصادفات را ایجاد می‌کنند که ممکن است به دلیل اشتباهات انجام‌شده توسط اپراتورها رخ دهد. با توجه به مطالب مذکور، عوارض غیرقابل‌اغماض صدا بر سلامت جسمی و روانی افراد در محیط‌های کاری، پیچیدگی و حساسیت اپراتورهای جرثقیل‌های سقفی و همچنین صدمات جدی ناشی از خطای این وظیفه، این مطالعه با هدف اثر مواجهه با صدا بر بارکار ذهنی، حساسیت به صدا و سلامت عمومی و روانی اپراتورهای جرثقیل‌های سقفی در یکی از صنایع فولاد جنوب ایران صورت گرفت. روش بررسی: این مطالعه در دو فاز، انجام شد. در فاز اول مواجهه کارگر با تراز صدا مورد ارزیابی دقیق قرار گرفت. بدین‌صورت که تراز فشار صوت، حین انجام‌وظیفه‌ی اپراتور و در کابین جرثقیل مطابق توصیه ISO 9612 انجام  شد. در فاز دوم تحقیق و پس از تعیین میزان مواجهه اپراتورهای جرثقیل‌های سقفی موردبررسی با صدا، پرسشنامه‌های حساسیت به صدا، ارزیابی ذهنی مواجهه با شرایط صوتی و پرسشنامه سلامت عمومی توزیع و مورد تجزیه‌وتحلیل آماری قرار گرفتند. تجزیه‌وتحلیل آماری داده‌ها با استفاده از نرم‌افزار  SPSS نسخه 22 انجام گردید. با استفاده از آزمون آنالیز واریانس یک‌طرفه، تی تست مستقل و ضریب همبستگی پیرسن به بررسی چگونگی ارتباط بین عوامل مختلف پرداخته شد. در این مطالعه سطح معناداری 5 درصد در نظر گرفته شد. نتایج: میانگین تراز معادل مواجهه اپراتورهای جرثقیل‌های سقفی برای یک دوره زمانی 8 ساعته  76.4 دسی‌بل و حداکثر و حداقل تراز معادل مواجهه 8 ساعته به ترتیب؛ 84  و 68.2 دسی‌بل به دست آمد. نتایج این مطالعه نشان داد بین متغیرهای جنسیت، وضعیت تأهل و ساعت کاری با حساسیت به صدا و متغیرهای  جنسیت، تحصیلات، بحران روحی در یک ماه اخیر و شغل دوم با بار ذهنی و متغیر بحران روحی در یک ماه اخیر با سلامت عمومی ارتباط معناداری وجود دارد (P<0/05). جهت بررسی ارتباط بین مقادیر حساسیت به صدا، بار ذهنی و سلامت عمومی با صدا از ضریب همبستگی پیرسون استفاده شد، نتایج نشان داد که بین هیچ یک از مقادیر حساسیت به صدا، بار ذهنی و سلامت عمومی با صدا ارتباط معناداری وجود ندارد (P>0/05). ارتباط منفی یا معکوس بین حساسیت به صدا و سلامت عمومی با صدا وجود دارد. بدین معنی که با افزایش میزان صدا، حساسیت به صدا و سلامت عمومی کمتر می‌شود و بلعکس. نتیجه‌گیری: نتایج این تحقیـق می‌تواند بسـتر لازم جهت بهبود شرایط کاری اپراتورهای جرثقیل‌های سقفی را فراهم آورد تا بدین ترتیب از به وجـود آمدن ناراحتی‌ها و مشکلات اثرات غیر شنیداری صدا، در مقادیری کمتر از 85 دسی‌بل جلوگیری شود.   2 Introduction: Overhead cranes play a vital role in guiding steel industries and maintaining their normal condition. These machines are operated by humans and pose a great risk of accidents that may occur due to mistakes made by operators. According to the mentioned contents, the non-negligible effects of noise on the physical and mental health of people in the work environment, the complexity and sensitivity of overhead crane operators, as well as the serious injuries caused by the error of this task, this study aimed at the effect of exposure to noise on mental workload, noise sensitivity and general and mental health of overhead crane operators in one of the steel industries in southern Iran. Materials and Methods: This study was conducted in two phases. In the first phase, the worker's exposure to the sound level was carefully evaluated. In this way, the sound pressure leveling was done during the operator's duty and in the crane cabin according to the recommendation of ISO 9612. In the second phase of the research, after determining the level of exposure of overhead crane operators to noise, noise sensitivity questionnaires, mental assessment of exposure to noise conditions, and general health questionnaires were distributed and subjected to statistical analysis. Statistical analysis of data was done using SPSS version 22 software. Using a one-way analysis of variance, independent t-test, and Pearson's correlation coefficient, the relationship between different factors was investigated. In this study, a significance level of 5% was considered. Results: The average equivalent level of exposure of overhead crane operators for 8 hours is 76.4 dB and the maximum and minimum equivalent levels of 8-hour exposure, respectively; 84 and 68.2 dB were obtained. The results of this study showed that there is a significant relationship between the variables of gender, marital status, and working hours with noise sensitivity and the variables of gender, education, a mental crisis in the last month and second job with mental load, and the variable of mental crisis in the last month with general health (P<0.05). Pearson's correlation coefficient was used to investigate the relationship between noise sensitivity, mental load, and general health with sound. The results showed, there is no significant relationship between noise sensitivity, mental load, and general health with sound (P> 0.05). There is a negative or inverse relationship between noise sensitivity and general sound health. This means that with the increase in volume, sensitivity to sound and general health will decrease and vice versa. Conclusion: The results of this research can provide the necessary platform to improve the working conditions of overhead crane operators to prevent the occurrence of inconveniences and problems of inaudible noise in values ​​less than 85 dB.   42 51 2022/11/82022/09/42022/07/72022/11/12022/09/12 1401/6/21 2022/11/122022/11/172022/08/252022/11/242022/12/6 1401/9/15 زینب السادات نظالم الدینی zeinabsadat nezamodini دانشگاه علوم پزشکی جندی شاپور اهواز ایران z.nezam@yaahoo.com بهنوش جعفری Behnoush Jafari دانشگاه علوم پزشکی جندی شاپور اهواز ایران behnoosh.jafari@yahoo.com پیام امینی Payam Amini ، دانشگاه علوم پزشکی تهران ایران payam.amini87@gmail.com زهرا هاشمی Zahra Hashemi دانشگاه علوم پزشکی بهبهان ایران z.hashemi2012@gmail.com Noise public health mental workload overhead crane operators steel industry صدا سلامت عمومی بار کار ذهنی اپراتورهای جرثقیل های سقفی صنعت فولاد 1. Gagnon JF, Gagnon O, Lafond D, Parent M, Tremblay S. 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نقش فعالیت بدنی و جایگاه شغلی بر فاکتورهای خونی ،پروفایل چربی و آنزیم‌های کبدی کارگران The role of physical activity and job status on blood factors, fat profile and liver enzymes of workers 1 1 زمینه و هدف: اطلاعات سازمان بهداشت جهانی ، نشان می‌دهد شیوه زندگی بدون تحرک یکی از ده دلیل عمده مرگ و ناتوانی است ازاین‌رو هدف از این تحقیق نقش فعالیت بدنی و جایگاه شغلی بر فاکتورهای خونی،پروفایل چربی و آنزیم‌های کبدی کارگران بود. روش تحقیق: 94 نفر از کارگران پست‌های عملیاتی و غیرعملیاتی کارخانه‌های کاشی که شرایط حضور در مطالعه را داشتند بر اساس روش نمونه­گیری در دسترس و به‌صورت کاملاً داوطلبانه در مطالعه انتخاب شدند. با بررسی پرسشنامه بک ،شرکت‌کننده‌ها  به دو گروه فعال و غیرفعال تقسیم شدند. که از بین شرکت‌کننده‌ها، گروه فعال 44(عملیاتی20 و غیرعملیاتی 24 نفر) و گروه غیرفعال50(عملیاتی 27و غیرعملیاتی 23)تشکیل دادند. بعد از گذشت 12 ساعت ناشتا از کارگران مقدار ده میلی­لیتر خون سیاهرگی برای بررسی متغیرهای بیوشیمیایی فاکتورهای خونی،پروفایل چربی و آنزیم‌های کبدی در آزمایشگاه طب کار شهرستان میبد انجام شد.در این تحقیق برای تجزیه‌وتحلیل داده‌ها از تحلیل واریانس یک‌طرفه و آزمون تعقیبی توکی استفاده و از طریق نرم‌افزار SPSS23 مورد تجزیه تحلیل قرار گرفت. نتایج: نتایج تحقیق حاضر نشان داد، اختلاف میانگین کلسترول ، تری گلیسرید، هماتوکریت و ALP در بین گروه‌های فعال،غیرفعال، عملیاتی و غیرعملیاتی معنی‌دار بود.نتایج نشان داد، کاهش در گروه فعال نسبت به غیرفعال، عملیاتی و غیرعملیاتی در کلسترول ،تری گلیسرید، هماتوکریت و ALP رخ‌داده که این تغییرات معنی‌دار بود. نتیجه‌گیری: با توجه به نتایج تحقیق، فعالیت بدنی می‌تواند تأثیرات مثبت بروی متغیرها داشته و جایگاه شغلی (عملیاتی و غیرعملیاتی) نمی‌تواند تأثیری بر نیمرخ چربی ، فاکتورهای خونی  و آنزیم‌های کبدی داشته باشد.   2 Introduction: World Health Organization information shows that a sedentary lifestyle is one of the ten major causes of death and disability. Therefore this study aimed research the role of physical activity and occupational status on blood factors, fat profile, and liver enzymes Materials and Methods: This study was of a causal-comparative type. Ninety four workers of operational and non-operational positions of tile factories who had the conditions to participate in the study were selected based on the available sampling method and voluntarily. By examining Beck's questionnaires, the participants were divided into active and inactive groups. Among the participants, 44 people formed as active group (20 operational and 24 non-operational) and 50 as inactive group (27 operational and 23 non-operational). After 12 hours of fasting, ten milliliters of venous blood were collected from the workers to investigate the biochemical variables of blood factors, fat profile, and liver enzymes performed in the medical laboratory of Meibod city. In this research, a one-way analysis of the variance model and Tukey's post hoc test were used to analyze the data and analyzed through SPSS23 software. Results: The current research showed that the difference in mean cholesterol, triglyceride, hematocrit, and ALP was significant among the active, inactive, operative, and non-operative groups. The results showed that there was a decrease in cholesterol, triglyceride, hematocrit, and ALP in the active group compared to the inactive, operative, and non-operative groups, and these changes were significant. Conclusion: According to the research results, physical activity can affect variables, and job position (operational and non-operational) cannot affect fat profile, blood factors, and liver enzymes.   52 64 2022/11/82022/09/42022/07/72022/11/12022/09/122022/08/9 1401/5/18 2022/11/122022/11/172022/08/252022/11/242022/12/62022/10/20 1401/7/28 محمد حسن دشتی خویدکی mohammad hassaan Dashty khavidaki دانشکده علوم تربیتی و روانشناسی، دانشگاه پیام نور ایران Dashty54@gmail.com Physical activity Operational Non-operational Blood lipid profile Liver enzymes. فعالیت بدنی عملیاتی غیرعملیاتی پروفایل چربی خون آنزیم کبدی 1.Askarishahi M, shayegh M, Mostaghasi M, Zare Sakhvidi M. Interval censoring Analysis of Factors affecting the time of development of pulmonary restrictive disorder in yazd tile workers. OCCUPATIONAL MEDICINE Quarterly Journal. 2018;10(2):22-31. [Persian]##2.Kowalski C, Ommen O, Driller E, Ernstmann N, Wirtz MA, Kohler T, et al. 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بررسی خستگی شغلی، کیفیت زندگی و خواب پرسنل نوبت‌کار شاغل در شرکت توزیع نیروی برق استان ایلام Investigation of job fatigue, quality of life and sleep of shift staff working in the electric distribution company of Ilam Province 1 1 مقدمه: نوبت‌کاری ازجمله پدیده‌های اجتماعی است که ریشه در تاریخ پیدایش انسان دارد و امروزه نیز به دلایل اقتصادی و تکنولوژیک وجود دارد. با توجه به عوارض نوبت‌کاری، مطالعه حاضر باهدف بررسی خستگی شغلی، کیفیت زندگی و خواب کارکنان نوبت‌کار شاغل در شرکت توزیع نیروی برق ایلام انجام گرفت. مواد و روش‌ها: در این مطالعه توصیفی-تحلیلی کلیه کارکنان نوبت‌کار شرکت توزیع نیروی برق استان ایلام، انتخاب شدند. ابزار جمع‌آوری اطلاعات شامل پرسشنامه خستگی شغلی سوئدی، کیفیت زندگی (۳۶-SF)، پرسشنامه ارزیابی بی‌خوابی و پرسشنامه بررسی کارکنان نوبت‌کار (SOS) بود. برای تجزیه‌وتحلیل داده‌های جمع‌آوری‌شده از نرم‌افزارSPSS  نسخه۲۶ استفاده شد و داده‌ها با استفاده از آزمون‌های آماری T-Test، One-way و کای دو تجزیه‌وتحلیل شدند. نتایج: آزمون همبستگی پیرسون نشان داد که بین سن و عملکرد جسمانی (r = 0.439; p = 0.022)، مصرف سیگار و مشکلات خواب (r = 0.528 ; p = 0.006) و تحصیلات و محدودیت ایفای نقش مشکلات هیجانی (r = 0.382 ; p = 0.049) رابطه معنی‌دار مستقیمی وجود دارد، همچنین بین سن و محدودیت ایفای نقش جسمانی (r = - 0.501 ; p = 0.008) رابطه معنی‌داری معکوسی وجود داشت. بین نوبت‌کاری و رضایت از زندگی فردی (p<0.045)، زندگی اجتماعی (p<0.038)، زندگی خانوادگی (p<0.023) و عدم رضایت خانواده نوبت‌کاران رابطه معنادار معکوسی وجود داشت. نتیجه‌گیری: نوبت‌کاری تأثیرات نامطلوبی بر رضایت خانواده‌ها، ریتم‌های سیرکادین، عملکرد گوارشی و سلامت روان دارد. پیشنهاد می‌شود مدیران کاری دقت بیشتری را در رابطه با ساعات کاری، شیفت کاری، زمان‌های استراحت شاغلین داشته باشند.   2 Introduction: Shift work is one of the social phenomena that has its roots in the history of human origin and still exists today for economic and technological reasons. Due to the complications of shift work, the present study was conducted to investigate job fatigue, quality of life, and sleep of shift staff working in Ilam Electric Distribution Company. Materials and Methods: In this descriptive-analytical study, all shift workers of Ilam Electric Distribution Company were selected. Data collection tools included the Swedish Job Exhaustion Questionnaire, Quality of Life (SF-36), the Insomnia Assessment Questionnaire, and the Survey of shift workers (SOS). SPSS software version 26 was used to analyze data using independent sample T-Test, One-way ANOVA, and Chi-square tests.  Results: Pearson correlation test showed that there was a direct and positive correlation between age and physical function (r = 0.439; p = 0.022), smoking and sleep problems (r = 0.528; p = 0.006), and education and limitation of the role of emotional problems (r = 0.382; p = 0.049). Also, the was a significant indirect correlation was found between age and physical role limitation (r = - 0.501; p = 0.008), shift work with satisfaction with individual life (p <0.045), social life (p <0.038), family life (p <0.023) and family dissatisfaction. Conclusion: shift working has adverse effects on family satisfaction, circadian rhythms, digestive performance, and mental health. It is suggested that managers be more careful about working hours, work shifts, and rest times.   65 73 2022/11/82022/09/42022/07/72022/11/12022/09/122022/08/92021/12/9 1400/9/18 2022/11/122022/11/172022/08/252022/11/242022/12/62022/10/202022/10/19 1401/7/27 عاطفه عزیزی Atefeh Azizi دانشگاه علوم پزشکی ایلام ایران azizi.atefeh22@gmail.com محسن جلیلیان Mohsen Jalilian دانشگاه علوم پزشکی ایلام ایران jalilian91@yahoo.com زهرا بهرامی Zahra Bahrami دانشگاه علوم پزشکی ایلام ایران zahraa.bahrami1998k@gmail.com حجت الله کاکایی Hojatollah Kakaei دانشگاه علوم پزشکی ایلام ایران hojatkakaei@gmail.com مائده کمالوندی Maedeh Kamalvandi شرکت توزیع نیروی برق استان ایلام ایران m.k9016@yahoo.com Insomnia Job Fatigue Quality of Life Shift Work Job Stress Electric Distribution Company. بی‌خوابی خستگی شغلی کیفیت زندگی نوبت‌کار استرس شغلی شرکت توزیع نیروی برق 1. Nezamodini Z, Hoseyni P, Behzadi E, Latifi SM. Relationship between shift works with sleep disorders and public health in a pipe company. Safety promotion and injury prevention (Tehran). 2014; 2(3): 189-196.##2. Moonk T, Folkard S. Shift work, problems and solutions. Translation by: Choobineh AR (3rd Ed), Shiraz: Publishers of Shiraz University of Medical Sciences. 2005:2-3.##3. Skipper Jr JK, Jung FD, Coffey LC. Nurses and shiftwork: effects on physical health and mental depression. Journal of Advanced Nursing. 1990;15(7):835-42. ##4. Bolghanabadi S, Pour M, Dehghan H. The relation between shift work, fatigue and sleepiness and accidents among workers in sugar factory. Journal of Occupational Hygiene Engineering. 2014;1(3):45-52.##5. Mousavi SM, Sharifiniya S, Yazdani Rad S, Esmaeilzadeh A, Hajizadeh R, MoradiRad R. The Relationship between shift work and its effects on the health of the operational staff in Abadan Oil Refining Company. Journal of Preventive Medicine. 2017;4(2):19-25.##6. Pati AK, Chandrawanshi A, Reinberg A. Shift work: consequences and management. Current science. 2001;81(1):32-52.##7. Asghari M, Ahmadnezhad I, Rahmani A, Sadeghi A, Abbassinia M, Rezaie E, et al. Investigation of disorders and problems caused by shift work in an automotive industry. 2013;5(1):7-14.##8. Fischer FM. What do petrochemical workers, healthcare workers, and truck drivers have in common? Evaluation of sleep and alertness in Brazilian shiftworkers. Cadernos de Saúde Pública. 2004;20(6):1732-8.##9. Yadollahi S, Salehi H, Ansari F, Solaimanian M. Shift Work-induced Disorders in Selected Nurses of Educational Hospital of Sharekord University of Medical Sciences, In 2018. Paramedical Sciences and Military Health. 2019;14(1):10-7.##10. Choobineh A, Soltanzadeh A, Tabatabaee S, Jahangiri M, Khavaji S. Shift work-related health problems in" 12-hour shift" schedule in petrochemical industries. Iran Occupational Health. 2011;3(1):38-42.##11. Akerstedt T, Knutsson A, Westerholm P, Theorell T, Alfredsson L, Kecklund G. Sleep disturbances, work stress and work hours: a cross-sectional study. Journal of psychosomatic research. 2002;53(3):741-8.##12. Habibi E, Dadkhah Tehrani S, Ghareh Baei S , Mahaki B. A survey of the relationship between shift work and job burnout in nurse staff of Alzahra hospital application maslach’s burnout questionnaire. J Health Syst Res 2015; 11(1):77-87##13. Knutsson A. Health disorders of shift workers. Occupational medicine. 2003;53(2):103-8.##14. Javadpour F, Keshavarzi S, Choobineh A, Aghabaigi M. Validity and reliability of the Swedish Occupational Fatigue Inventory (SOFI-20) among Iranian working population. Iranian Journal of Ergonomics. 2015;3(1):50-8.##15. Sasaki T, Iwasaki K, Mori I, Hisanaga N, Shibata E. Overtime, job stressors, sleep/rest, and fatigue of Japanese workers in a company. Industrial health. 2007;45(2):237-46.##16. Gaffari F, Zeighami Mohammadi S. Frequency of daytime sleepiness in hypertensive women. Scientific Journal Of Hamadan Nursing And Midwifery Faculty. 2011;19(1):5-15.##17. Choobineh A, Rajaeefard A, Neghab M. Problems related to shiftwork for health care workers at Shiraz University of Medical Sciences. EMHJ-Eastern Mediterranean Health Journal,2006;12 (3-4): 340-346.##18. Wilson MG, PolzerDebruyne A, Chen S, Fernandes S. Shift work interventions for reduced work‐family conflict. Employee Relations. 2007.##19. Beutell NJ. Work schedule, work schedule control and satisfaction in relation to workfamily conflict, workfamily synergy, and domain satisfaction. Career Development International. 2010.##20. Costa G. Shift work and occupational medicine: an overview. Occupational medicine. 2003;53(2):83-8.## ##

ارزیابی ریسک سطح مهندسی تاب‌آوری و مهندسی تاب‌آوری تلفیقی با ایمنی، بهداشت و محیط‌زیست بیمارستان‌ها ( مطالعه موردی : دو بیمارستان منتخب فراجا در سال 1400 ) Risk assessment of resilience engineering level and integrated resilience engineering with safety, health and environment of hospitals (case study: two selected hospitals of Faraja in 1400) 1 1 زمینه و هدف: با ارزیابی سطح مهندسی تاب‌آوری و مهندسی تاب‌آوری تلفیقی با ایمنی، بهداشت و محیط‌زیست، اولویت‌های مراکز درمانی برای مواجهه با بحران‌ها مشخص می‌شود. لذا هدف این مطالعه، پیاده‌سازی یک مدل ارزیابی ریسک با یک چک‌لیست طراحی‌شده در محیط فازی بود. روش بررسی: این مطالعه به‌صورت مقطعی، در سال 1400، در دو بیمارستان فراجا در ایران با استفاده از دو فرم ارزیابی ریسک شامل 7 شاخص تاب‌آوری (24 زیر شاخص) و 3 شاخص تاب‌آوری تلفیقی با ایمنی، بهداشت و محیط‌زیست (8 زیر شاخص) انجام شد که سطح ریسک نهایی در هر شاخص، با اعداد فازی ذوزنقه‌ای در محیط فازی، محاسبه شدند و در وزن هر خبره ضرب شدند. بر این اساس، اولویت‌های هر بیمارستان تعیین شد. یافته‌ها: در نتایج ارزیابی، مشخص شد که در بیمارستان نخست، تعهد مدیریت و شفافیت و در بیمارستان دوم، انعطاف‌پذیری اولویت‌های اصلی هستند. در هر دو بیمارستان نیز، به ترتیب تعهد مدیریت در HSE، آگاهی در HSE و فرهنگ یادگیری در HSE اولویت‌های RE-HSE بودند. نتیجه‌گیری: بر اساس این نتایج پیشنهاد می‌شود در ارتقای سطح تاب‌آوری بر همه‌ی پارامترها به‌ویژه پارامترهای مرتبط با شاخص‌های تعهد مدیریت، شفافیت و انعطاف‌پذیری در RE و تعهد مدیریت در HSE، متمرکز شود.   2 Introduction: By evaluating the level of resilience engineering and resilience engineering combined with safety, health, and environment, the priorities of medical centers to face crises are determined. Therefore, this study aimed to implement a risk assessment model with a checklist designed in a fuzzy environment. Materials and Methods: This cross-sectional study, in 2014, in two Faraja hospitals in Iran, using two risk assessment forms including seven resilience indicators (24 sub-indices) and three integrated resilience indicators with safety, health, and environment (8 sub-index) was done that the final risk level in each index was calculated with trapezoidal fuzzy numbers in the fuzzy environment and multiplied by the weight of each expert. Based on this, the priorities of each hospital were determined. Results: In the evaluation results, it was found that in the first hospital, management commitment and transparency, and in the second hospital, flexibility are the main priorities. In both hospitals, management commitment in HSE, knowledge in HSE, and learning culture in HSE were RE-HSE priorities, respectively. Conclusion: Based on these results, it is suggested to focus on all the parameters, especially the parameters related to management commitment indicators, transparency and flexibility in RE, and management commitment in HSE.   74 85 2022/11/82022/09/42022/07/72022/11/12022/09/122022/08/92021/12/92021/12/19 1400/9/28 2022/11/122022/11/172022/08/252022/11/242022/12/62022/10/202022/10/192022/11/17 1401/8/26 رسول جنتی rasoul jannaty مرکز تحقیقات تروما در پلیس، معاونت بهداشت، امداد و درمان، نیروی انتظامی،تهران ایران rasouljannaty@gmail.com سعید حقی saeed haghi مرکز تحقیقات تروما در پلیس، معاونت بهداشت، امداد و درمان، نیروی انتظامی،تهران ایران saeedhaghi@gmail.com هلاله جنتی halaleh jannaty دانشکده بهداشت، دانشگاه علوم پزشکی ارومیه ایران halalehjannaty@gmail.com لیمو جنتی limo jannaty دانشگاه تبریز ایران limojannaty@gmail.com فریده پرگر farideh pargar دانشگااه علوم پزشکی جندی شاپور اهواز ایران faridpargar@gmail.com مهرداد علی دوست mehrdad alidoust دانشگاه علوم پزشکی تبریز ایران mehralidoust@gmail.com Resilience Safety Health and Environment Crisis management Risk assessment تاب‌آوری ایمنی بهداشت و محیط‌زیست مدیریت بحران ارزیابی ریسک 1-Davoud Mahmoudi, Seyed Shamsaddin Alizadeh, Yahya Rasoulzadeh, Mohammad Asghari Jafarabadi. Prioritizing the thirteenth dimensions of Organizational Resilience in dealing with crises and major accidents. Iran Occupational Health. 2020 (27 Dec);17:62[Persian].##2-Blanchet, K., Nam, S., Ramalingam, B., Pozo-Martin, F. Governance and Capacity to Manage Resilience of Health Systems: Towards a New Conceptual Framework. International Journal of Health Policy and Management, 2017; 6(8): 431-435. ##3-Rangachari P, L Woods J. Preserving Organizational Resilience, Patient Safety, and Staff Retention during COVID-19 Requires a Holistic Consideration of the Psychological Safety of Healthcare Workers. Int J Environ Res Public Health. 2020 Jun 15;17(12):4267. ##4-Nuzzo, J.B., Meyer, D., Snyder, M. et al. What makes health systems resilient against infectious disease outbreaks and natural hazards? Results from a scoping review. BMC Public Health 19, 1310 (2019). https://doi.org/10.1186/s12889-019-7707-z##5-Meyer D, Bishai D, Ravi SJ, et al. A checklist to improve health system resilience to infectious disease outbreaks and natural hazards. BMJ Global Health 2020; 5: e002429. ##6-Ranasinghe U, Jefferies M, Davis P, Pillay M. Resilience Engineering Indicators and Safety Management: A Systematic Review. Saf Health Work. 2020;11(2):127-135. ##7-Fridell M, Edwin S, von Schreeb J, Saulnier DD. Health system resilience: what are we talking about? A scoping review mapping characteristics and keywords. Int J Health Policy Manag. 2020;9(1):6–16. ##8-Hanefeld J, Mayhew S, Legido-Quigley H, Martineau F, Karanikolos M, Blanchet K, Liverani M, Yei Mokuwa E, McKay G, Balabanova D. Towards an understanding of resilience: responding to health systems shocks. Health Policy Plan. 2018;33(3):355-367. ##9-Rubio-Romero JC, Molinillo S, López-Arquillos A, Arjona-Jiménez R, De La Varga-Salto JM. Comparative study of resilience engineering in solid waste treatment plants: A case study in two European cities. Work. 2018;60(4):613-622. ##10-Ahmadvand A, Arjmandi R, Mohammadi A, Mazloumi A, Mirzahosseini S A. A Systematic Review of Factors Affecting HSE Management on Performance Assessment Evaluation Based on Resilience Engineering (A Case Study in an Automobile Manufacturing Company). JHSW. 2020; 10 (4) :460-476.##11-Hamed Mohammedi, Hossein Teymouri. The Assessment of Health, Safety and Environment Management System in Zanjan Zinc Industrial Plants from the Resilience Engineering Perspective in 2018. Iran Occupational Health. 2020; 17:65[Persian].##12- Abedi K, Jannaty R, Jannaty L. Assessment of the Risk of Individual and Occupational Factors Affecting the Causes of Occupational Accidents in the Construction Industry Using the Fuzzy Hierarchical Analysis Approach: A Case Study in Kurdistan Province, Iran. sjsph. 2020; 18 (3) :333-342[Persian].##13-Azadian S, Shirali G, Saki A. Evaluation Reliability and Validity a Questionnaire to Assess Crisis Management Based on Seven Principles of Resilience Engineering Approach in Hospitals. Iran Occupational Health . 2016; 13 (1) :15-26[Persian].## ##