2026-09-16T03:41:24+03:30 http://tkj.ssu.ac.ir/browse.php?mag_id=66&slc_lang=fa&sid=1

66-1344 2026-09-16 10.1002

Occupational Medicine Quarterly Journal tkj 2251-7189 2251-8274 7 2025 17 1 Iraj Alimohammadi irajrastin1@gmail.com Mahdi Farrokhi farokhi1.ma@gmail.com Sevda Javadi sevdajavadi82@gmail.com Saideh Nasher saeideh.na82@gmail.com Abstract Introduction: Nowadays, noise pollution in the environment has become as a worldwide health concern. A  large share of this noise comes from vehicles, where mufflers in their exhaust systems are essential for lowering engine noise levels. Proper muffler design and modifications to its geometric parameters,  including adding holes in the baffle and changing their orientation, can significantly influence the acoustic performance of mufflers and contribute  effective in enhanced noise reduction. Materials and Methods: The finite element numerical method was utilized to examine the acoustic effectiveness of the analyzed mufflers.  At first, the mufflers were designed and modeled using COMSOL software. Subsequently, by modifying the desired geometric parameters, specifically by adding perforations to the baffle and changing the baffle orientations, their effect on sound transmission loss was examined. Results: The results of this study indicated that the sound transmission loss across the examined frequency range did not exhibit a consistent pattern with changes in geometric parameters. Specifically, at certain frequencies, the changes led to an increase in sound transmission loss, whereas at others, they resulted a decrease. However, in general, positioning the baffle's apex towards the muffler outlet increased the average transmission loss, while orienting the baffles’s peak towards the muffler outlet enhanced the average transmission loss, whereas adding  perforations to the baffle reduced the average transmission loss. Conclusion: Creating perforations on the baffle and changing its orientation in reactive mufflers can affect sound transmission loss and, more broadly, its acoustic performance. Comsol Reactive muffler Finite element analysis Baffle Acoustics 2025 3 01 1 11 http://tkj.ssu.ac.ir/article-1-1344-en.pdf 10.18502/tkj.v17i1.18372

66-1345 2026-09-16 10.1002

Occupational Medicine Quarterly Journal tkj 2251-7189 2251-8274 7 2025 17 1 Mohammad Bashir Hassan AlDabi mobasheer1986@gmail.com Hajar Torkan ht_17f@yahoo.com Abbas Ali Shallal abbass.edbs@uomustansiriyah.edu.iq Ali Mehdad alimahdad.am@gmail.com Introduction: Educators in exceptional schools represent a significant research focus explored by researchers across various disciplines, primarily owing to the intense demands of their jobs and their coping strategies for such circumstances. In light of this, the present research was conducted to explore the connection between job stress and organizational commitment, focusing on the mediating effects of job satisfaction and job burnout among exceptional education teachers in Baghdad, Iraq. Materials and Methods: The method of research employed was causal correlation research (structural equation modeling). The statistical population for the research consisted of all the exceptional education teachers from elementary schools in Baghdad, Iraq, during the spring and summer of 2024, totaling 524 individuals. Among them, 200 individuals (100 females and 100 male) were chosen as samples using the convenience sampling method. Data were collected using occupational stress questionnaires of the Health and Safety Institute of England (HSE), job burnout by Maslach, & Jackson (1996), organizational commitment by Allen and Meyer (1991), and job satisfaction evaluation by Smith et al. (1969). To analyze data, a structural equation model was used through SPSS 26 and AMOS 23 software. Results: The results of direct effects showed that job stress significantly impacted organizational commitment, job satisfaction, and burnout (p<0.01). Additionally, both job satisfaction and job burnout significantly influenced organizational commitment (p<0.01). Examining the indirect effects revealed that both job satisfaction and job burnout played a significant mediating role in  how work stress influences organizational commitment (p<0.01). Conclusion: According to the results of this study, it is recommended that managers and policymakers in the Iraqi education system focus significantly on decreasing job stress, due to its impact on enhancing job satisfaction, fostering organizational commitment, and lowering job burnout among special education teachers. In this regard, they can take advantage of the presence and advice of organizational psychologists to recognize and address the sources of job-related stress Job stress Job burnout Organizational commitment Job satisfaction Exceptional teachers Iraq 2025 3 01 12 26 http://tkj.ssu.ac.ir/article-1-1345-en.pdf 10.18502/tkj.v17i1.18373

66-1322 2026-09-16 10.1002

Occupational Medicine Quarterly Journal tkj 2251-7189 2251-8274 7 2025 17 1 Mina Behari Kia mina.kiabahari@gmail.com Bahman Hasanvand bahmanhasanvand@ut.ac.ir Introduction: Individuals with metabolic syndrome face a higher risk of developing cardiovascular disease compared to healthy individuals, attributed to endothelial dysfunction, increased blood lipids, and insulin resistance. Despite exercise being an effective prevention method for enhancing and preventing metabolic syndrome, fewer than 23% of adults perform the minimum recommended physical activity. Materials and Methods: In this semi-experimental research (applied, with pre-test, and post-test), 30 women diagnosed with metabolic syndrome and a body mass index ranging from 30.9 to 33 were selected and randomly divided into two groups (control and exercise). The participants underwent an 8-week training intervention, 3 sessions per week, with progressive intensity under the supervision of a trainer. Cardio metabolic markers and body composition were evaluated at the beginning and again after 8 weeks of training. Furthermore, the questionnaire on enjoyment and motivation to continue the activity was assessed following the exercise intervention. All statistical analyses were conducted at a significance level of 0.05 using SPSS software version 21. Results: The findings indicated that 8 weeks of HIFT training led to a significant decrease in systolic and diastolic blood pressure, triglycerides, LDL, HDL, and fasting blood sugar (P=0.05). Significant changes were observed in body composition and perceived enjoyment of physical activity (P=0.05). Conclusion: HIFT exercises lead to significant clinical improvements in the cardiovascular risk factors associated with metabolic syndrome and body composition while allowing participants to enjoy their activities and minimizing obstacles to  engaging in sports. Therefore, it is recommended that sports specialists and medical doctors utilized this type of exercise as a method for the prevention and treatment of metabolic syndrome. High-intensity functional training (HIFT) Metabolic syndrome Cardiovascular disease Exercise enjoyment 2025 3 01 27 37 http://tkj.ssu.ac.ir/article-1-1322-en.pdf 10.18502/tkj.v17i1.18374

66-1351 2026-09-16 10.1002

Occupational Medicine Quarterly Journal tkj 2251-7189 2251-8274 7 2025 17 1 Ali Alboghobeish fereydoonlaal@yahoo.com Abolfazl Komeili abkomeili1998@gmail.com Amir Masoud Ansari amiransaarii78@gmail.com Fereydoon Laal fereydoonlaal@gmail.com Introduction: Considering the  rising development of industries and technology and the  resulting rise in workplace accidents and injuries, this study aimed to investigate and analyze the epidemiological events in the steel industry in Iran. Materials and Methods: This study was a descriptive-analytical investigation conducted to investigate work-related accidents in a steel factory in Iran over a period of 7 years, from 2016 to 2022. In this study, data were collected via documentation and interviews with individuals  affected by the accident or those who witnessed it.  Subsequently, data analysis was performed  utilizing the demographic information of the victims (age, work experience, etc.), accident type, and cause of the accident using SPSS version 22 software.  Additionally, the victims’ educational background, work shifts, and the timing of the accident were  analyzed. Results: The results indicated that  among 7251 workers, 130 accidents occurred  over a span of7 years. The results showed that individuals with extensive work experience had the  fewest accidents. A significant relationship was observed between lost work days and unsafe practices and conditions (P<0.001), with unsafe conditions exerting a more considerable influence on lost work days due to accidents. Additionally, the greatest harm to individuals resulted from impact with objects.  Regarding the timing of the accidents, the highest number of accidents occurred in the fall and during the morning shift. Conclusion: In this study, the highest number of accidents was seen in individuals with under 5 years of work experience who had previously undergone safety training. The primary factors contributing to the accident were hazardous behavior and their interaction with unsafe conditions. Therefore, ongoing basic information and training for workers based on the changing environmental conditions, alongwith routine inspections, can improve safety and reduce unsafe practices in this industry. Epidemiological analysis Accident Steel industry Unsafe acts Unsafe conditions Time of the accident 2025 3 01 38 48 http://tkj.ssu.ac.ir/article-1-1351-en.pdf 10.18502/tkj.v17i1.18375

66-1337 2026-09-16 10.1002

Occupational Medicine Quarterly Journal tkj 2251-7189 2251-8274 7 2025 17 1 Haydar Abdulridha Hussein Shihmani haydar@khuisf.ac.ir Gholamreza Manshaee smanshaee@yahoo.com Adnan Marid Jabur Al-Magsoosi adnan@uowasit.edu.iq Ali Mehdad alimahdad.am@gmail.com Background: Current research was conducted with the aim of predicting extra-role behaviors through job commitment, organizational loyalty, stress perception, justice perception, conscientiousness and internal work motivation of faculty members of Wasit University in Iraq. Methods: Research method was Correlational and statistical population included all faculty members of Wasit University in summer of 2024. From mentioned statistical population 250 people were selected through convenience sampling and a set of questionnaires included extra-role behaviors (Lee and Allen, 2002), perception of organizational justice (Colquitt, 2001), internal job motivation (Gagne et al., 2015). ), conscientiousness (McCrae and Costa, 1992), Blau's (1993) job commitment, organizational loyalty (Kumar and Shekhar, 2012) and job stress (Cohen et al., 1964). Research data were analyzed using Pearson's correlation coefficient and multiple regression analysis by stepwise method using SPSS version 25 software. Results: The results showed that there is a significant positive relationship between job commitment, organizational loyalty, perception of justice, internal motivation, and conscientiousness with extra-role behaviors, and there is a significant negative relationship between the perception of job stress and extra-role behaviors (p<0.01). Moreover, results of multiple regression analysis by stepwise method revealed that, among all predictor variables during the three steps justice perception, internal motivation and organizational loyalty were able to explain 45% of the variance of extra-role behaviors. Conclusion: Based on the findings of the present study, for the development of extra-role behaviors in academy members, it is necessary to pay attention to the necessary platforms for improving and increasing job commitment, organizational loyalty, perception of justice, internal motivation, conscientiousness and stress reduction. This should be taken into consideration by the policymakers of Iraqi higher education system.                                           extra-role behavior intrinsic motivation organizational justice faculty Wasit Iraq 2025 3 01 49 61 http://tkj.ssu.ac.ir/article-1-1337-en.pdf 10.18502/tkj.v17i1.18376

66-1317 2026-09-16 10.1002

Occupational Medicine Quarterly Journal tkj 2251-7189 2251-8274 7 2025 17 1 Naser Sadra Abarghoei Nasersadra@yahoo.com Afarin Akhavan akhavan@sau.ac.ir miresmaeili@gmail.com Mahla Nazri mahlanazri66@gmail.com Introduction: Burnout refers to a decrease in an individual's ability to adapt to stressors and includes a syndrome consisting of emotional exhaustion and decreased personal success. A primary factor contributing to burnout is job stress. The job of train stewardess is one of the most stressful jobs due to the need to work in different work shifts, especially night shifts.  Consequently, this study aimed to investigate the relationship between job-related stress, insufficient sleep, and burnout among Yazd-Tehran train attendants. Materials and Methods: This study was a cross-sectional study. The research data were collected using the standard questionnaires for OSIPO job stress, burnout, and Petersburg sleep deprivation (PSQI). The Pearson and Spearman correlation method was applied using SPSS version 20 software to analyze the statistical data. The statistical population for this study comprised all the train crews of the Yazd-Tehran train. Based on the data supplied by the company’s hiring department, there were 123 individuals working on this line. Due to the small population, the sampling of this study was judgment, utilizing the Cochran formula, resulting in the selection of 90 individuals.  The Cronbach's alpha method was utilized to determine both the validity and reliability of the test. Smart Pls software was used to examine the research hypotheses, and a significance level of less than 0.05 was considered. Results: Male participants made up the majority of the sample at 68.9%. A considerable portion of the participants possessed a master's degree, making up 53.3%, whereas individuals holding a bachelor’s degree accounted for 34.5%. According to the model drawn, all paths had factor loadings greater than 0.4. The t-statistic value in this analysis was calculated for all confirmatory factor analysis relationships and greater than 1.96 for the structural model. The alpha value, Rho_A coefficient, and CR for every variables were all determined to be above 0.7, with the AVE value also evaluated to be greater than 0.5. To ensure the results, the bootstrapping test was also simulated in two cases of 500 and 800 samples, which did not change the results obtained and these paths were significant. First, descriptive results of the research variables were presented, and then the validity and reliability of the measurement tool were examined using convergent and divergent validity and structural equation modeling. Conclusion: The results indicated that job stress positively and significantly impacts job burnout and sleep deprivation. The effect of this independent variable on the dependent variable of sleep deprivation is relatively high. Sleep deprivation also has a positive and significant effect on job burnout. Hostess Job Stress Job Burnout Pittsburgh Questionnaire 2025 3 01 62 72 http://tkj.ssu.ac.ir/article-1-1317-en.pdf 10.18502/tkj.v17i1.18377

66-1328 2026-09-16 10.1002

Occupational Medicine Quarterly Journal tkj 2251-7189 2251-8274 7 2025 17 1 Fatemeh Jannesar FatemehJannesar1999@gmail.com Ahmad Zandvanian Naeini azand2000@yazd.ac.ir Hossain Hassani Hassani.hossain@yazd.ac.ir Introduction:  The imbalance between reward and effort, characterized by the disparity between effort put in and rewards received, can be greatly affected by personal abilities and feelings.  The present study aimed to investigate the relationship of resilience with Reward-Effort imbalance mediated by teaching emotions in elementary school teachers of Taft City. Materials and Methods: The methodology used in the research was correlational along with structural equation modeling. The statistical population included all elementary school teachers in Taft City during the academic year 2020-2023, totaling 679 individuals. A sample size of 250 participants was determined, and the sampling was conducted on a voluntarily basis. The research tools included the Connor and Davidson Resilience Questionnaire (2003), Reward-Effort Imbalance (Siegrist, 2010), and Teaching Emotions (Villavicencio, 2010). Finally, data from 234 participants were analyzed using structural equation modeling through SPSS26 and AMOS24 software. Results: The results showed that the direct effect of resilience on Reward-Effort imbalance was significant (β=0.180; P=0.029); moreover, the direct effect of resilience on teaching emotions was notable (β=0.396; P=0.001); And the direct effect of teaching emotions on Reward-Effort imbalance is also significant (p=0.211; P=0.018);  additionally, the results showed that the indirect effect of resilience on Reward-Effort imbalance through the mediating influence of teaching emotions was significant (β=0.083; P=0.011) and the total effect was also significant (βt =0.264, P=0.001). Conclusion: In conclusion, focusing on teaching emotions within resilience training programs for elementary school teachers may help reduce Reward-Effort imbalance by regulating emotions.   Resilience Elementary level Reward-Effort Imbalance Teachers Teaching Emotions 2025 3 01 73 87 http://tkj.ssu.ac.ir/article-1-1328-en.pdf 10.18502/tkj.v17i1.18378

66-1314 2026-09-16 10.1002

Occupational Medicine Quarterly Journal tkj 2251-7189 2251-8274 7 2025 17 1 Mehdi Asghari m.asghari2011@gmail.com Mohammad Javad Ghanadzadeh mghanadzadeh.7@gmail.com Razieh Soltani Gerdfaramarzi raziyeh_soltani@yahoo.com Nakicenovic N, Alcamo J, Davis G, Vries Bd, Fenhann J, Gaffin S, et al. Special report on emissions scenarios. 2000. Asghari M, Ghalhari GF, Ghanadzadeh M, Moradzadeh R, Tajik R, Samadi S, et al. Modeling of thermal discomfort based representative concentration pathways (RCP) scenarios in coming decades using temperature-humidity index (THI) and effective temperature (ET): a case study in a semi-arid climate of Iran. Air Quality, Atmosphere & Health. 2023;16(6):1195-205. Romm JJ. Climate change: What everyone needs to know: Oxford University Press; 2022. Koocheki A, Nassiri Mahallati M, Jafari L. Evaluation of climate change effect on agricultural production of Iran: I. Predicting the future agroclimatic conditions. Iranian Journal of Field Crops Research. 2016;13(4):651-64. Asghari M, Fallah Ghalhari G, Heidari H, Moradzadeh R, Samadi S, Tajik R, et al. Modeling and predicting trends of heat stress based on climate change phenomenon: A case study in a semi-arid climate. Environmental Health Engineering And Management Journal. 2022;9(4):399-407. Nassiri P, Monazzam MR, Golbabaei F, Farhang Dehghan S, Shamsipour A, Ghanadzadeh MJ, et al. Modeling heat stress changes based on wet-bulb globe temperature in respect to global warming. Journal of Environmental Health Science and Engineering. 2020;18:441-50. Luber G, Prudent N. Climate change and human health. Transactions of the American Clinical and Climatological Association. 2009;120:113. Moda HM, Filho WL, Minhas A. Impacts of climate change on outdoor workers and their safety: some research priorities. International journal of environmental research and public health. 2019;16(18):3458. Phuomg V, Few R, Winkels A. Heat stress and adaptive capacity of low-income outdoor workers and their families in the city of Da Nang, Vietnam. Da Nang (Vietnam): International Institute for Environment and Development; 2013. Heidari H, Golbabaei F, Arsang JS, Shamsipour AA. Validation of humidex in evaluating heat stress in the outdoor jobs in arid and semi-arid climates of Iran. 2016. Ghalhari GF, Dehghan SF, Shakeri F, Abbasinia M, Asghari M. Thermal comfort and heat stress indices for outdoor occupations over 15 years: a case study from Iran. Weather. 2019;74:S40-S5. Nassiri P, Reza Monazzam M, Golbabaei F, Abbasinia M, Chavoshi M, Taheri F, et al. Exposure to heat stress in the workplace: A systematic review. Iran Occupational Health. 2018;15(2):118-128. Monazzam MR, Asghari M, Farhang Dehghan S, Hajizadeh R, Beheshti MH, Monazzam M, et al. Presentation of an operational program to reduce vulnerability of outdoor workers to to heat stress and climate change. Iran Occupational Health Journal. 2019;16(3). Chirico F, Taino G. Climate change and occupational health of outdoor workers: an urgent call to action for European policymakers. Environmental Disease. 2018;3(4):77-9. Schulte PA, Chun H. Climate change and occupational safety and health: establishing a preliminary framework. Journal of occupational and environmental hygiene. 2009;6(9):542-54. Asghari M, Fallah Ghalhari GA, Heidari H. Investigation of thermal comfort changes using Summer Simmer Index (SSI): A case study in different climates of Iran. The Open Environmental Research Journal. 2021;14(1(:13-23. Lundgren K, Kuklane K, Gao C, Holmer I. Effects of heat stress on working populations when facing climate change. Industrial health. 2013;51(1):3-15. Bai L, Li Q, Wang J, Lavigne E, Gasparrini A, Copes R, et al. Increased coronary heart disease and stroke hospitalisations from ambient temperatures in Ontario. Heart. 2018;104(8):673-9. Marchand M, Gin K. The cardiovascular system in heat stroke. CJC open. 2022;4(2):158-63. Nassiri P, Monazzam MR, Golbabaei F, Shamsipour A, Arabalibeik H, Mortezapour AR, et al Applicability of Modified discomfort index (MDI) in Outdoor occupational environments: a case study of an open pit mines in Tehran Province. Iran Occupational Health. 2018;15(1):136-45. Asghari M, Ghalhari GF, Abbasinia M, Shakeri F, Tajik R, Ghannadzadeh MJ. Feasibility of relative strain index (RSI) for the assessment of heat stress in outdoor environments: Case study in three different climates of Iran. The Open Ecology Journal. 2020;13(1):11-18. Bonafede M, Marinaccio A, Asta F, Schifano P, Michelozzi P, Vecchi S. The association between extreme weather conditions and work-related injuries and diseases. A systematic review of epidemiological studies. Annali dell'Istituto superiore di sanita. 2016;52(3):357-67. Narocki C. Heatwaves as an Occupational Hazard: The Impact of Heat and Heatwaves on Workers’ Health, Safety and Wellbeing and on Social Inequalities. ETUI Research Paper-Report. 2021. Bourbonnais R, Zayed J, Lévesque M, Busque M-A, Duguay P, Truchon G. Identification of workers exposed concomitantly to heat stress and chemicals. Industrial health. 2013;51(1):25-33. Martinez GS, Kendrovski V, Salazar MA, de’Donato F, Boeckmann M. Heat-health action planning in the WHO European Region: Status and policy implications. Environmental Research. 2022;214:113709. Pogaèar T, Bogataj LK, Črepinšek Z. Preparing an occupational heat action plan in agriculture. 2021. Baraer A. The impact of climate events on French industrial facilities between 2010 and 2019. Loss Prev Bull. 2021;227:1:9-22. Urothody A, Larsen HO. Measuring climate change vulnerability: a comparison of two indexes. Banko Janakari. 2010;20(1):9-16. Organization WH. Climate change and health: Resolution of the 61st World Health Assembly. Geneva; 2008. Asghari M, Nassiri P, Monazzam M, Golbabaei F, Arabalibeik H, Shamsipour A. The development of an empirical model for estimation of the sensitivity to heat stress in the outdoor workers at risk. Annals of Medical and Health Sciences Research. 2017;7(2):77-84. Hahn MB, Riederer AM, Foster SO. The Livelihood Vulnerability Index: A pragmatic approach to assessing risks from climate variability and change—A case study in Mozambique. Global environmental change. 2009;19(1):74-88. Tawatsupa B, Lim LL, Kjellstrom T, Seubsman S-a, Sleigh A, Team TCS. Association between occupational heat stress and kidney disease among 37 816 workers in the Thai Cohort Study (TCS). Journal of epidemiology. 2012;22(3):251-60. Mathee A, Oba J, Rose A. Climate change impacts on working people (the HOTHAPS initiative): findings of the South African pilot study. Global health action. 2010;3(1):5612. Kiatkitroj K, Arphorn S, Tangtong C, Maruo SJ, Ishimaru T. Risk factors associated with heat-related illness among sugarcane farmers in Thailand. Industrial health. 2021;60(5):447-58. Xiang J, Bi P, Pisaniello D, Hansen A. The impact of heatwaves on workers׳ health and safety in Adelaide, South Australia. Environmental research. 2014;133:90-5. Pogačar T, Črepinšek Z, BOGATAJ LK, Lars N. Comprehension of climatic and occupational heat stress amongst agricultural advisers and workers in Slovenia. Acta Agriculturae Slovenica. 2017;109(3):545–54-–54. Mutic AD, Mix JM, Elon L, Mutic NJ, Economos J, Flocks J, et al. Classification of heat‐related illness symptoms among Florida farmworkers. Journal of nursing scholarship. 2018;50(1):74-82. Arcury TA, Quandt SA, Arnold TJ, Chen H, Daniel SS. Occupational Injuries of Latinx Child Farmworkers in North Carolina: associations with work safety culture. Journal of occupational and environmental medicine. 2020;62(10):853-8. Messeri A, Morabito M, Bonafede M, Bugani M, Levi M, Baldasseroni A, et al. Heat stress perception among native and migrant workers in Italian industries—case studies from the construction and agricultural sectors. International journal of environmental research and public health. 2019;16(7):1090. Amoadu M, Ansah EW, Sarfo JO, Hormenu T. Impact of Climate Change and Heat Stress on Workers’ Health and Productivity: A Scoping Review. The Journal of Climate Change and Health. 2023:100249. Boonruksa P, Maturachon T, Kongtip P, Woskie S. Heat stress, physiological response, and heat-related symptoms among Thai sugarcane workers. International journal of environmental research and public health. 2020;17(17):6363. Wesseling C, Aragón A, González M, Weiss I, Glaser J, Rivard CJ, et al. Heat stress, hydration and uric acid: a cross-sectional study in workers of three occupations in a hotspot of Mesoamerican nephropathy in Nicaragua. BMJ open. 2016;6(12):e011034. Lao J, Hansen A, Nitschke M, Hanson-Easey S, Pisaniello D. Working smart: An exploration of council workers’ experiences and perceptions of heat in Adelaide, South Australia. Safety science. 2016;228:35-82. Hansen AL, Williams S, Hanson-Easey S, Varghese BM, Bi P, Heyworth J, et al. Using a qualitative phenomenological approach to inform the etiology and prevention of occupational heat-related injuries in Australia. International journal of environmental research and public health. 2020;17(3):846. Lam M, Krenz J, Palmández P, Negrete M, Perla M, Murphy-Robinson H, et al. Identification of barriers to the prevention and treatment of heat-related illness in Latino farmworkers using activity-oriented, participatory rural appraisal focus group methods. BMC Public Health. 2013;13:1-12. Masuda YJ, Castro B, Aggraeni I, Wolff NH, Ebi K, Garg T, et al. How are healthy, working populations affected by increasing temperatures in the tropics? Implications for climate change adaptation policies. Global environmental change. 2019;56:29-40. Moyce S, Mitchell D, Armitage T, Tancredi D, Joseph J, Schenker M. Heat strain, volume depletion and kidney function in California agricultural workers. Occupational and environmental medicine. 2017;74(6):402-9. Foster J, Smallcombe JW, Hodder S, Jay O, Flouris AD, Nybo L, et al. An advanced empirical model for quantifying the impact of heat and climate change on human physical work capacity. International Journal of Biometeorology. 2021;65:1215-29. Butler-Dawson J, Krisher L, Asensio C, Cruz A, Tenney L, Weitzenkamp D, et al. Risk factors for declines in kidney function in sugarcane workers in Guatemala. Journal of occupational and environmental medicine. 2018;60(6):548-58. Spencer S, Samateh T, Wabnitz K, Mayhew S, Allen H, Bonell A. The challenges of working in the heat whilst pregnant: insights from Gambian women farmers in the face of climate change. Frontiers in Public Health. 2022;10: 785254. Wegman DH, Apelqvist J, Bottai M, Ekström U, García-Trabanino R, Glaser J, et al. Intervention to diminish dehydration and kidney damage among sugarcane workers. Scandinavian journal of work, environment & health. 2018:16-24. Hansson E, Glaser J, Jakobsson K, Weiss I, Wesseling C, Lucas RA, et al. Pathophysiological mechanisms by which heat stress potentially induces kidney inflammation and chronic kidney disease in sugarcane workers. Nutrients. 2020;12(6):1639. Li L, Liu H, Chen L, He J, editors. Investigation on heat stress of construction workers in summer in Chongqing, China. E3S Web of Conferences; 2019: EDP Sciences. Golbabaei F, Monazzam MR, Aval MY, Allahyari T, Taban E, Shendi MRA. Investigation of heat stress and heat strain in outdoor workers: a case study in Iran. Archives of Advances in Biosciences. 2016;7(4):30-8. Pundee R, Kongtip P, Nankongnab N, Anutrakulchai S, Robson MG, Woskie S. Cross-shift change of acute kidney injury biomarkers in sugarcane farmers and cutters. Human and Ecological Risk Assessment: An International Journal. 2020;27(5):1170-87. Nassiri P, Monazzam MR, Golbabaei F, Shamsipour A, Arabalibeik H, Abbasinia M, et al. Personal risk factors during heat stress exposure in workplace. Journal of Health & Safety at Work. 2017;7(2). Hunt AP, Parker AW, Stewart IB. Heat strain and hydration status of surface mine blast crew workers. Journal of occupational and environmental medicine. 2014;56(4):409-14. Phanprasit W, Rittaprom K, Dokkem S, Meeyai AC, Boonyayothin V, Jaakkola JJ, et al. Climate warming and occupational heat and hot environment standards in Thailand. Safety and Health at Work. 2021;12(1):119-26. Kearney GD, Hu H, Xu X, Hall MB, Balanay JAG. Estimating the prevalence of heat-related symptoms and sun safety–related behavior among Latino farmworkers in Eastern North Carolina. Journal of agromedicine. 2016;21(1):15-23. Alam MM, Siwar C, bin Toriman ME, Molla RI, Talib B. Climate change induced adaptation by paddy farmers in Malaysia. Mitigation and Adaptation Strategies for Global Change. 2012;17:173-86. Asghari M, Nassiri P, Monazzam MR, Golbabaei F, Shamsipour AA, Arabalibeik H. Provision of an empirical model to estimate the adaptive capacity of workers at risk of heat stress. Health Scope. 2018;7(1). Wolf J, Lorenzoni I, Few R, Abrahamson V, Raine R. Conceptual and practical barriers to adaptation: vulnerability and responses to heat waves in the UK. Adapting to climate change: Thresholds, values, governance. 2009:181-96. Tirgar A, Shirouye A, Hajiahmadi M, Hoseini S. Determination of susceptibility to heat-related disorders and prevention methods among agriculture workers. J Health Saf Work. 2012;1(1):39-46. Jackson LL, Rosenberg HR. Preventing heat-related illness among agricultural workers. Journal of agromedicine. 2010;15(3):200-15. Council CI. Guidelines on site safety measures for working in hot weather. Wanchai, Hong Kong. 2013. Ghalhari GF, Heidari H, Dehghan SF, Asghari M. Consistency assessment between summer simmer index and other heat stress indices (WBGT and Humidex) in Iran's climates. Urban Climate. 2022;43:101178. Asghari M, Teimori G, Abbasinia M, Shakeri F, Tajik R, Ghannadzadeh MJ, et al. Thermal discomfort analysis using UTCI and MEMI (PET and PMV) in outdoor environments: case study of two climates in Iran (Arak & Bandar Abbas). Weather. 2019;74:S57-S64. Teimori G, Monazzam MR, Nassiri P, Golbabaei F, Dehghan SF, Ghannadzadeh MJ, et al. Applicability of the model presented by Australian Bureau of Meteorology to determine WBGT in outdoor workplaces: A case study. Urban Climate. 2020;32:100609. Climate Change and Outdoor Workers: A Narrative Review Asghari M 1[1], Ghanadzadeh MJ 2, Soltani Gerdfaramarzi R 3 1 Associate Professor, Department of Occupational Health and Safety Engineering, School of Public Health, Arak University of Medical Sciences, Arak, Iran. 2 Assistant Professor, Department of Environmental Health Engineering, Faculty of Health, Arak University of Medical Sciences, Arak, Iran. 3 Industrial Diseases Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Abstract Introduction: Global warming and climate change have become one of the controversial topics that have a critical impact on human health and threaten human life. Workers, especially those working outdoors, are often the first ones exposed to the effects of climate change. The study aimed to analyze the impacts and dimensions of climate change on workers' health, investigate the factors contributing to workers' vulnerability to this phenomenon, and propose protective and control strategies. Materials and Methods: This narrative review highlights findings from global studies on climate change and its consequences (heat stress) in occupational environments. The articles published between 2005 and 2023 were analyzed using Scopus, PubMed, and Web of Science databases, focusing on keywords such as climate change, outdoor workers, vulnerability, and heat stress. Results: The review of various articles showed that climate change affects work settings and employees through rising ambient temperature and elevated heat stress, greater exposure to  ultraviolet radiation, increased air pollution, climate-related vector-borne diseases, and other related hazards. It also encompasses risks linked to industrial shifts and the rise of new green industries such as solar and wind energy production, mental health issues (including anxiety, stress, substance abuse) as well as reducing productivity and economic burden. To evaluate the vulnerability of workers' health to climate change, three key factors are  taken into account: sensitivity (the level of physical and inherent vulnerability to climate  change effects), exposure (the extent and intensity of climate change-relate interactions ), and adaptive capacity (the ability of the system to cope with and recover from the effects of climate change). Conclusion: Climate change, as a global challenge, significantly impacts various professions, particularly those in outdoor environments. The foremost consequence of climate change is global warming and the rising levels of heat stress. These changes can give rise to various health problems, from minor issues like Skin rashes to severe conditions like heatstroke. Additionally, they can impede workers' productivity, leading to decreased physical and mental performance and an increased risk of accidents. Outdoor workers must adjust to these climate changes and adopt modern, sustainable approaches to tackle upcoming challenges.     Climate change Heat stress Vulnerability Sensitivity Exposure Adaptive Capacity 2025 3 01 88 100 http://tkj.ssu.ac.ir/article-1-1314-en.pdf 10.18502/tkj.v17i1.18379