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Background and aim: The coronavirus disease 209 (COVID-19) pandemic has been affecting various strata of society including different guilds. Each of these segments has its role to play in controlling epidemics. Accordingly, this study aimed to explore trade unions’ roles and responsibilities in the prevention and emergency response to epidemic, including the COVID-19 pandemic.Materials and methods: The present qualitative research was conducted using directed content analysis. Participants were selected by a purposeful sampling method. Data were collected through semi-structured interviews and field notes and validated through Lincoln and Guba’s (1985) evaluative criteria. Data were analyzed by MAXQDA software.Results: Data analysis, constant comparison, and class integration provided a total of seven main themes, which were extracted into four domains of Plan, Implementation, Review, and Action. The main themes were categorized into the dimensions of each domain, so that the Plan domain included three dimensions of union/guild contexts, leadership and staff participation, and planning. The Implementation domain included two dimensions of support and operations. The Assessment domain had a performance evaluation dimension, and the Action domain was made up of an improvement dimension.Conclusion: Relying on their organizational and social capacities, trade unions can facilitate the leadership and participation of employees and communities for appropriate policies and making resilient decisions to control epidemics and other roles and responsibilities related to health.

Background and Purpose: The workplace is one of the priorities for health promotion in the 21st century by extending as the adult population extends. Also, the work environment has a significant impact on people's health. Therefore, the aim of this study was to determine the characteristics of a healthy environment promoting the health of women working in the hospital. Materials & Methods: This study was conducted using a qualitative method and content analysis. The participants were selected using the purposive sampling total of 48 working women, hospital managers, and health promotion specialists participated in the study. In this study, we tried to select participants with maximum diversity in terms of age, work experience, and the sector they are working in. The data were collected using a semi-structured interview. The texts of the interviews were extracted and divided into the meaningful units. The criterion of credibility or acceptability of the data (Credibility) was used to ensure the accuracy of the study results. Results: In the process of data analysis, 31 basic concepts that had the same characteristics were grouped into 12 subcategories, and based on the common characteristics at a more abstract level: they were transformed into 3 main categories, including organizational management and commitment to the health of working women. The psychological environment supports women's health, and also the social environment promotes women's health in the hospital by providing services. Discussion and conclusion: Hospital managers play an important role in creating healthy workplaces for women, and to achieve this goal, they should try to improve their health from the aspects of mental and social health and provide special services to working women.

Background In recent years, the Coronavirus disease 2019 (COVID-19) have greatly affected the safety of life and the economy. Taking rapid measures to reduce these problems requires effective and efficient decisions by various departments and headquarters in a country. The purpose of this study was to investigate the role and responsibilities of the National Anti-Corona Headquarters (NACH) in the workplace during the pandemic. Methods This study was a qualitative study conducted using a triangulation approach. Data were obtained through semi-structured interviews with 18 participants with a purposive sampling technique as well as the review of related documents and records in response to the COVID-19 pandemic. The inductive and deductive approach was used for the content analysis of data in the Plan-Do-Check-Act (PDCA) model of the ISO45001 management system. Results Based on the results, four themes (plan, do, check, and act) were considered as the main domains. Subthemes include understanding the needs and expectations of interested parties; specific policy-making for organizations/workplaces; leadership and organizational commitment; addressing risks and opportunities; providing resources; competence of individuals and organizations; awareness; communication; information documentation; emergency response; monitoring, analyze, and evaluate performance; management review; non-compliance and corrective action; and improvement in pandemic control. Conclusion To ensure the effectiveness and efficiency of organizations to deal with pandemics, the NACH must implement these responsibilities and play a pivotal role in responding to pandemics and using the participation of other government agencies and society. The findings of this study can be useful from national to local levels.

Background: Different factors affect the success of standard operational procedures (SOPs). This study was conducted to explore the viewpoints of employees of Tehran Oil Refining Company about factors affecting the usability of SOPs. Methods: This qualitative study was a conventional content analysis research conducted on the oil refining company employers 2020, using the semi-structured interviews. The data were analyzed by content analysis method using MAXQDA software. Results: The results showed that the employees had a positive perception toward the standard operating procedures and most of them used these procedures to improve work performance and reduce accidents. Also, from the viewpoint of the employees, organizational factors (desirable organizational culture, continuous supervision and evaluation and assurance of accurate implementation of instructions, and continuous personnel training), individual factors (positive perception of the personnel about the organization goals, rules obedience of the personnel, positive experiences of personnel from the implementation of instructions in the past), and environmental factors (environmental dynamics and their related SOP dynamics, desirable but formal relationships of managers and supervisors with personnel as well as optimal and standard work schedule) had a positive effect on the applicability of these procedures. Conclusion: The findings of this study showed that the employees, consider standard operating procedures of organizational, individual, and environmental factors effective in using standard operating instructions. Therefore, to increase the applicability of these procedures, the employees should consider their opinions.

Background: Socializing the health system is a new approach to participatory governance that aims to promote community health and enhance sustainable health equity in the community. This approach is a part of health system reform in the Islamic Republic of Iran. Aims: This study aimed to develop a conceptual framework for socializing the health system in the Islamic Republic of Iran as a theoretical basis for this reform. Methods: Data were gathered through a review of the literature, in-depth interviews, focus group discussions, and panel discussions. Participants were experts in the field of health systems within the health ministry and medical universities. Content analysis was used to analyse the data and identify core values, principles, and approaches for socializing the health system. Results: The core values identified included human dignity, equity, ethics, and trust. The principles were participation, empowerment, human rights, and responsiveness. The approaches identified were good governance, a health-oriented focus, capacity-building, a process-oriented method, and improvement in the social determinants of health. A strong political will was considered essential for socializing the health system. Conclusions: The conceptual framework outlines requirements for socializing the Iranian health system. As this is a new approach in health system governance, however, it needs to be refined and redefined through implementation and evaluation.

The outbreak of SARS-CoV-2 (COVID-19) has attracted much attention to study its possible presence and airborne transmission. The possibility of COVID-19 airborne transmission in indoor environments is debatable. The present study examined the concentration of viral RNA-containing particles produced directly or indirectly by breathing or coughing of confirmed COVID-19 patients or by carriers without symptoms. Some studies do not accept this method of transmission (COVID-19 airborne transmission). The present study aimed to measure the possible exposure of health care personnel to SARS-CoV-2 particles that may have been suspended in the air to respond to the hypothesis of COVID-19 airborne transmission. Airborne particle sampling was performed using impingement method based on NIOSH (chapter BA) and ASHRAE. Selection of sampling sections was in line with the WHO guidelines. The samples were analyzed using RT-PCR technique. Based on the given results, airborne particles of COVID-19 may present in the air and affect the health of hospital personnel. In fact, the analysis of gene expression in ambient conditions and thereby aerosol transmission of SARS-CoV-2 through air is possible and may lead to occupational exposure of health care personnel. Furthermore, it was found that airborne emission of COVID-19 through the breathing zone of patients, particularly in ICU wards with confirmed cases of COVID-19, may be higher than in other ICU wards. Also, the demonstrated results showed that there is a possibility of reaerosolization (reintroduction) of previously airborne SARS-CoV-2 particles into the atmosphere due to health care personnel frequently walking between different wards and stations of ICU.

Due to significant energy/exergy losses in expansion part of the cascade vapor compression cooling (C-VCC) systems in process engineering, the use of ejector expanders has been widely recommended. Although such an idea improves the energy and exergy performance indicators along with the unit cost of the process, safety aspect of the plant degrades considerably. In order to quantitatively investigate the role of ejector expander in safety of the C-VCC systems, quantitative risk assessment (QRA) along with 4E (energy, exergy, economic, and environment) analysis of the basic C-VCC (BC-VCC) system and ejector expander C-VCC (EEC-VCC) system are carried out and the results are compared with each other around the optimal and base points. In the base mode, the contribution of the expansion process to the overall risk of the BC-VCC system increases from 4.33 $/year to 50.56 $/year (for NH3) and from 116 $/year to 1393 $/year (for Propane) due to the employment of ejector expander instead of the expansion valve. Also, that means using NH3 instead of Propane in the EEC-VCC system substantially improves safety aspect of the whole unit. Although the maximum number of death is obtained due to release of Propane from the condenser of the system during the Flash Fire accident, the compressor of the high-temperature circuit (HTC) highly contributes to the overall risk due to its high release frequency. The results of multi-objective optimization for the NH3/CO2–based BC-VCC system showed that the COP (coefficient of performance), exergy efficiency, total cost, and risk can be improved by 56.66 %, 24.6 %, 26.14 %, and 1.78 %, respectively. Considering Propane/CO2 as a refrigerant pair used in the BC-VCC system, the COP, exergy efficiency, total cost, and risk were improved by 59.47 %, 26.77 %, 19.94 %, and 16.22 %, respectively. As an important conclusion, although employing ejector expander in the NH3/CO2 or Propane/CO2 BC-VCC system improves thermodynamic and cost metrics, such consideration significantly degrades the risk of the plant.

Aim and Background: Today, with the growth of different dimensions of sustainable development, managers at the organizational and governmental levels have become more and more interested in the components of sustainable development. A healthy and productive human being is at the core of sustainable development. Many factors are contributing to sustainable development, including human, economic, social, industrial, cultural, as well as health, safety, environmental and energy (HSEE) factors. In this regard, the existence of several processing indicators is important in promoting the program and organizational goals at the micro and macro levels. Since continuous evaluation and monitoring of all indicators is not feasible, developing a set of principles to facilitate managerial decision-making processes and monitoring continuous improvement of systems is an important issue in system performance management. Due to the vital role of correct selection of principles in the sustainability of the integrated management system, it is important to consider the key components involved in this choice. The present study aimed to prioritize the HSEE processing indexes in the integrated management system (HSEE IMS) of the Ministry of Industry, Mining and Trade. Methodology: The statistical population of this study is professionals and experts with occupational health, safety, environment, and energy orientation and work experience. In this study, to obtain process, safety, health, environmental and energy processing indicators, firstly, a list of environmental, safety, health, and energy indicators was prepared and evaluated, by using a set of indicators presented in scientific and credible research and articles, the Iranian Environmental Agency, HSE Ministry of Oil, HSEE Ministry of Industry, Mine and Trade, including mining and industrial organizations, including Industrial Development and Renovation Organization of Iran (IDERO), Iranian Mines and Mining Industries Development and Renovation Organization (IMIDRO) and other sources. In the present study, being SMART is the main selection criterion for indices, which are weighted as the five main affecting criteria by the AHP method. Weighted criteria were used to prioritize the eight principles of HSEE management including policy, continuous improvement, do, check, monitoring, and measurement of the system, commitment and leadership, planning and corrective action using the fuzzy TOPSIS technique. Results: The results show that the executive strategic index with a closeness coefficient of 0.937 was selected as the first priority. Continuous improvement and corrective action with the coefficient of closeness of 0.133 and 0.108 were selected from the weaker priorities of the Eight HSEE indices, respectively. Conclusion: Appropriate selection of indicators to facilitate managerial decision-making processes, optimal monitoring of these indicators with maximum efficiency and minimum cost is possible by using multi-criteria decision-making models. Based on the results, sustainable development can be achievable by ranking and prioritizing the HSEE processing indicators to facilitate managerial decision-making processes and monitor continuous improvement of systems to protect individuals, property and reduce accidents and pollution. Keywords: Prioritization, HSEE, Sustainable Development, Fuzzy TOPSIS, Index, Weighting, AHP. Introduction Preventing health, safety, the environment, and energy injuries and accidents by taking into account the health, safety of employees, customers, contractors and others requires a unified management system structure. This system tries to create a healthy, pleasant and joyful environment free from accident, damage and waste by integration and synergy of human resources and facilities. The present study aims to key and prioritize strategic principles in the HSEE integrated management system of the Ministry of Industry, Mine and Trade to evaluate the performance based on specific processes in subsidiary industrial-productive units. Methodology In this study, to obtain safety, health, environmental, and energy processing indexes, firstly, a list of environmental, safety, health, and energy indicators was prepared and evaluated, by using a set of indicators presented in scientific and credible research and articles, the Iranian Environmental Agency, HSE Ministry of Oil, HSEE Ministry of Industry, Mine and Trade, including mining and industrial organizations, including Industrial Development and Renovation Organization of Iran (IDERO), Iranian Mines and Mining Industries Development and Renovation Organization (IMIDRO) and other sources. Then, the SMART metrics including specificity, measurability, achievability, realism and being timely have weighted as five effective criteria by the AHP. After keying the HSEE strategic indicators of the Ministry of Industry, Mining and Trade, including: policy, continuous improvement, do, check, system monitoring, commitment and leadership, planning and corrective action were selected. Initial questionnaire was prepared based on the fuzzy TOPSIS method and key indicators and research criteria. Then, the reliability (internal consistency) and validity of the questionnaire were assessed and finalized. After completing the questionnaires and receiving the information, the expertschr('39') answers in the form of verbal statements were transformed into triangular fuzzy numbers with the capability of analysis. In the present study, to obtain effective indicators for identification and evaluation of key indicators, the five SMART criteria were weighted based on the AHP method. After weighting the research criteria using the AHP method, this ratio is used for weighting the key indexes by the fuzzy TOPSIS method to rank and prioritize. Results The results show that the face validity and content validity of the questionnaire were determined by FVR = 78.08% and CVR = 88%, respectively which have acceptable validity based on Lawshe’s model. The reliability of the research questionnaire was estimated by the appropriate Cronbachchr('39')s alpha equivalent in 0.935, illustrating the intrinsic homogeneity of the evaluated indices. Regarding weighting results, research criteria, weighting criteria and indices are presented in Tables 1-2. Table1. Final weight of criteria by the AHP method Realism Achievability Timely Specificity Measurability Criterion 0.300 0.203 0.135 0.231 0.341 Final Weight Table 2. Closeness coefficient and rank of HSEE processing indicators of Ministry of Industry, Mine and Trade Ranking CCi Criterion Commitment and Leadership 0.491 3 Policy 0.403 4 Planning 0.226 5 Do 0.937 1 Monitoring 0.699 2 Check 0.193 6 Corrective Action 0.108 8 Continuous Improvment 0.133 7 Conclusion Appropriate selection of indicators to facilitate managerial decision-making processes, optimal monitoring of these indicators with maximum efficiency and minimum cost is possible using multi-criteria decision-making models. This study aimed to weight, key and prioritize HSEE process indicators for the first time in Iran at the level of the largest executive-economic system. According to the results of the study, due to the high speed and efficiency of HSEE units in subsidiary organizations, do index (CCi = 0.937) was first priority and continuous improvement (CCi = 0.133) and corrective actions (CCi = 0.108) were found as the weakest priorities of the HSEE eight indicators because of weaknesses in the regular and systematic follow-up of regulatory units or lack of appropriate tools to evaluate these indicators. The results of this study showed an interesting convergence between the weight and prioritization of SMART criteria of strategic indicators of Ministry of Industry, Mine and Trade. This conclusion can help managers select key performance indicators based on SMART criteria and help them choose sustainability indicators that prevent wasting time and cost.

Background and aims: The diversity of health, safety and environmental issues (HSE) and limitations of the resources hinders response to all the research needs in the field of HSE. HSE promotion and policy making require research based on the real needs and problems of the society. Although, the budget allocated to the research is limited, this budget is not optimally utilized in present situation of Iran. Therefore, setting research priority in HSE is important to direct the flow of resources to the real needs of the society. This study aims to define research priorities in the field of HSE with the use of experts’ and other stakeholders’ opinions. Methods: The qualitative research method was used in this study. The proposed model of Council on Health Research for Development (COHRED) was applied in five stages including stakeholder analysis, situation analysis, identifying research topics, scoring research priority using defined criteria and prioritizing researches based on maximum agreement. The first stage was stakeholder analysis, the centers, institutions, organizations and universities related to HSE field were identified through review of literature, investigating Iranian scientific journals and by asking the experts. Also, the contact information of 70 experts, professionals, and stakeholders who were members of health centers, institutions or universities in the field of HSE were collected. In the second stage, an extensive search was done on the literature and published scientific articles from 2014 to 2019 in google scholar. The articles were selected through investigating the title and abstract of the articles and then studying deeper into the texts. Also, the official websites of Ministry of Health and Medical Education, Ministry of Cooperatives, Labor and Social Welfare, Ministry of Industry, Mine and Commerce were examined. The third stage was to identify the research topics and occupational areas, which was done by using the classification of International Labor Organization and also through brain storming of the experts. The fourth stage was scoring the priority of researches in each occupational area and research topic based on criteria such as necessity of research, appropriateness of the research to the target population, feasibility of researches based on the available resources and the research outcome. Scoring was done in a panel discussion based on a Likert scale of 1 to 9 by experts; one represented the lowest and represented the highest priorities. The fifth step was to prioritize the researches based on mean score given by the experts. Results: Situation analysis of studies in the field of HSE from 2014 to 2019 in Iran showed that most studies have been conducted in industries. According to experts, in the field of health and environment, the highest research priority was given to agriculture, fisheries, and livestock, and the highest priority to safety was given to workers in industry and mines, construction and driving. Also, workers in medium and small scale constructions and workers in small and medium industries and mines had the highest priority in the ten research areas in health and safety. Agriculture, fisheries, husbandry and poultry had the highest priority in most of the ten research areas in environment. Among the three HSE domains, in the managerial and sales jobs, the research priority was given to occupational health research. Priority research in health care, industries and mines and construction, service, armed forces and driving related jobs were given to safety related researches. In agriculture, fisheries and husbandry, the priority of research was given to environmental issues and then to occupational health. In the area of occupational health, the highest priority in managerial occupations was given to the researches that assess impact of different program. In sales jobs, the highest priority was given to the research area of developing new interventions or solutions. In large scale industries and mines, the highest priority was given to the researches that are related to developing interventions or solutions, but in medium and small industries and mines, the highest priority was given to the researches that assess the impact of a program or intervention. In the field of medium and small-scale construction workers, the highest priority was given to the research area of qualitative or quantitative situation analysis and assessing the causes of a problem. In the service occupations, the highest priority was given to the research area of qualitative or quantitative situation analysis. In the military occupations, the highest priority was assigned to the research area of developing new interventions or solutions. In large scale agriculture, fisheries, husbandry and poultry industries, the highest priority was given to the research area of determining the trends of a situation or problem. In agriculture, fisheries, husbandry and poultry industries of medium and small industries, the highest priority was assigned to the field of evaluation of the impact of programs. In the driving jobs, higher priority was given to the research area of developing new interventions or solutions. In the area of occupational safety research, the highest priority in managerial occupations was given to the research domain of cost effectiveness or cost benefit analysis. In the health care occupations, the highest priority was given to Evaluation of the interventions. In sales jobs, the highest priority was given to the research area of developing new interventions or solutions. In the field of large-scale mining and industrial workers, the highest priority was given to research in developing new interventions or solutions. In the field of medium and small-scale industrial and mining workers, the highest priority was given to evaluation of the interventions. In the field of large industrial construction, the highest priority was given to determining the trends of a situation or problems and developing new interventions or solutions. In the service occupations, the highest priority was given to the research area of developing new interventions or solutions. In the military occupations, the highest priority was devoted to the research of developing new interventions or solutions and evaluation of the interventions. In agriculture, fisheries, poultry, and small and medium-sized industries, the highest priority was given to evaluation of the impact of programs. In the driving jobs, the highest priority was given to the research area of developing new interventions or solutions. In the area of environmental research, the highest priority in managerial occupations was given to determining the trends of a situation or problems and developing plans or strategies. In the health care jobs, the highest priority was given to the evaluation of the interventions. In sales jobs, the highest priority was given to the qualitative or quantitative situation analysis. The highest priority was given to developing new interventions or solutions for workers in large-scale industries and mines. For workers in the field of medium and small industries and mines, the highest priority was given to developing plans or strategies. The highest priority was given to developing plans or strategies for workers in the field of medium and small scale construction. In service jobs, the highest priority was given to qualitative or quantitative situation analysis. In military jobs, the highest priority was given to determining the trends of a situation or problems and evaluation of the interventions. In agriculture, fisheries, husbandry and poultry industries, the highest priority was given to qualitative or quantitative situation analysis and determining the trends of a situation of problems. In agriculture, fisheries, poultry, and small and medium-sized industries, the highest priority was given to evaluation of the interventions and evaluation of the impact of programs. In the driving jobs, the highest priority was given to the determining the trends of a situation or problem. Conclusion: Most studies in the field of HSE have been conducted in industry. It is required to expand the HSE research based on the priorities set out in this study.

Falling from height known as one of the most important factors that leads to fatal accidents in the construction industry. The purpose of this study was to investigate and identify the effective factors in the occurrence of falling from height accidents in the construction projects and determine the causal relationships between organizational, individual and environmental factors. In this research, the surveyed population was the workers of five construction projects of a gas refinery in south of Iran from 2011 to 2015. Using the Integrated Management System (IMS) information, factors and sub-factors affecting the occurrence of falling from height accidents in the construction projects were determined. Then, a semi-comparative questionnaire based on the DEMATEL technique was designed and distributed among 10 experts at two different periods. Based on the expert's opinions, the identified factors and sub-factors were classified into three main factors and fourteen sub-factors, respectively. Then, the causal relationships between each the effective factor were identified, using DEMATEL technique. The results of DEMATEL technique revealed that the individual factors were considered to be the most important criteria, as it has acquired the maximum (D+R) value, i.e., 36.689 whereas, organizational factors had scored the least, i.e., 35.180. Accordingly, organizational factors and their sub-factors had a substantial effect on the falling from height accidents and were considered as causal variables (D-R>0), while, the indices of individual and environmental factors were the effect variables (D-R

Background and aims: All construction projects carry some levels of risk. The construction projects involve numerous uncertainties, multiple intricacies, varies techniques, and divergent environments. So that, workers in the construction industry are at greater risk because of the dynamic nature of the activities and momentous changes in working conditions in comparison with other industries. The construction projects involve many factors, interdependencies, and correlations, which makes determination of exact cause and effect very difficult. Therefore, these factors play a significant role in decision making and may affect performance of a project. The construction process frequently requires workers to work at height. The risks associated with working at height are often increased by adding accessibility and mobility restrictions. Falling from height is one of the most important causes of workerschr('39') fatality in the construction industries and constitutes a paramount part of the safety plans in the construction projects. Identifying the effective factors and sub-factors in the occurrence of this accident will be helpful in setting priorities for preventing and providing solutions in reducing their severity. The purpose of this study was to investigate and identify the factors and sub-factors affecting falling from height accidents and to determine the cause and effect relationships among them in the construction projects, using the fuzzy-DEMATEL technique. Methods: In order to carry out this descriptive-analytical study, information of the Occupational Health and Safety (OHS) department of five construction projects have been used. The statistical society of the present study was the workers of five construction projects of a gas refinery in the south of Iran, which 4000 people, on average, were involved in these projects from 2011 to 2015. After reviewing the scientific literature, project reports, and guidelines, factors and sub-factors affecting the occurrence of falling from height accidents in the construction projects were determined based on the experts opinions. Snowball method was used to identify experts and determine the statistical society. Fuzzy-DEMATEL technique, as one of the methods of decision making based on paired comparisons, was used to identify the cause and effect relationships among factors and sub-factors. Based on this technique, the pairwise comparison matrices of the factors and sub-factors were formed and sent to 10 health and safety experts. Next, the views of experts were aggregated via the mean fuzzy method, and then the cause and effect relationships were determined based on them. The step-by-step process of the research is as follows: Step 1: Identifying research factors and sub-factors All of the reported events were investigated between 2011 and 2015 and 74 out of 377 occupational accidents were considered as falling from height accidents. Considering the information of OHS department and literature review of effective factors in the occurrence of construction accidents, 70 factors and sub-factors were identified as effective factors in falling from height accidents. According to the objectives of the study and status of the projects, the identified factors and sub-factors divided to 3 main factors (organizational, individual, and environmental factors) and 14 sub-factors (management commitment, safety culture, mutual understanding, supervision/inspection, and size organization/project as an organizational factors; education, training hours, personal protective equipment (PPE), age/experience, and psychological/occupational stresses as an individual factors; thermal stress, interference, level smoothness, work platform height as an environmental factors). Step 2: Data analysis and use of DEMATEL technique In this research, Fuzzy-DEMATEL technique was used to construct a sequence of extracted data. This technique is one of the decision making methods based on pair comparisons with the benefit of expert’s judgment. The concept of this approach is based on the assumption that a system consists of a set of criteria and the pairwise comparisons of relationships between these criteria can be modeled by mathematical equations. DEMATEL technique is an approach to identify the cause and effect relationships among multiple factors in order to properly understand the problem. In general, it is very difficult to determine the opinion of experts with precise numerical values, especially in terms of uncertainty since the results of the decision depend heavily on unclear and subjective arbitrary judgments. These uncertainty conditions have led to the introduction of a fuzzy logic in the metamaterial technique. Therefore, in the Fuzzy-DEMATEL technique, fuzzy language is used which facilitates decision making in uncertainty conditions [37]. All calculations were performed in Excel (version 2013). The steps to implement this technique have been presented step-by-step based on the study of Li et al. I) Calculation the direct relation matrix: After gathering the expertschr('39') view, a fuzzy direct relationship matrix ( ) was formed and the fuzzy mean method was used to aggregate the views of experts. Assuming that n experts have expressed their idea about the relationship between the indices and each component of the fuzzy direct matrix is displayed by then by can be calculated from Eq. (1) as follows: II) Normalizing the direct relation matrix: To normalize the values of the direct contact matrix, of each row must be calculated. Then, the fuzzy normal matrix ( ) can be calculated from Eq. (2) by dividing each component of by the maximum attained : III) Calculation of the total-relation matrix To calculate the total-relation matrix, the fuzzy normalized matrix is divided to three definite matrices as follows: Then, the identify matrix is formed and the following operations are performed: Then, the fuzzy total-relation matrix is computed by using Eq. (4). Results: The results of this research showed that among the main factors, organizational and individual factors were known as causal factors, which indicates importance of these factors and their impact on other effective factors in falling from height accidents. On the other hand, among various sub-factors, the management commitment, safety culture, monitoring and inspection, organization/project size, education, and work platform height had the highest effects on the falling from height accidents and were considered as causal variables. In the present study, management commitment, as one of the organizational sub-factors, had the highest impact and was considered as a causal variable. According to the findings of this study, it can be concluded that four organizational sub-factors of mutual understanding, management commitment, safety culture and organization/project size, one individual sub-factor of education, and work platform height as an environmental sub-factor had the significant impact and were among the causal variables, while the rest of sub-factors were the effect variables. Also, the monitoring/inspection sub-factor has the highest interaction with and impact on other sub-factors. Conclusion: Falling from height is considered as one of the most important accidents, leading to death and physical injuries in construction projects. The findings of this study showed that a greater attention to organizational factors and their dimensions (as hidden and effective causes to prevent falling from height incidents) is necessary since an organization plays an important role in the design of work processes, design and implementation of safety management systems, commitment to safety and employee participation, and choosing the best people according to the requirements for the health and safety programs of the projects. The results of this study also showed that it is necessary to pay more attention to the management commitment and awareness of the workforce by training them in the construction projects. Hence, a greater attention to organizational factors and their sub-factors in the construction industry is essential for preventing falling from height incidents. Therefore, more attention to the organizational factor and its sub-factors in the construction industry is required to prevent falling from height accidents. Keywords: Falling from height, Fuzzy-DEMATEL technique, Construction projects, Workers.

Exposure to Whole Body Vibration (WBV) is one of the most important risk factors for musculoskeletal disorders (MSDs), which drivers are likely to report non-specific health complaints. The purpose of this study was to investigate the association between whole body vibrations with musculoskeletal disorders among intercity mini-buses drivers. 80 intercity mini-bus drivers were participated in this study. The values of the frequency-weighted Root Mean Square (RMS), Vibration Dose Values (VDV) and Crest Factor (CF) was measured using the SVAN-958 and the SV39A/L accelerometer, in accordance with ISO 2631-1. ANOVA, Post-hoc analysis, and correlation tests were used to analyze the obtained data using SPSS 23. This study show that the overall equivalent acceleration A_eq (T) difference in various studied models of minibuses was significant (P

Health governance challenges can make or break universal health coverage (UHC) reforms. One of the biggest health governance challenges is ensuring meaningful participation and adequately reflecting people’s voice in health policies and implementation. Recognizing this, Iran’s Health Transformation Plan (HTP) lays out the country’s blueprint for UHC with an explicit emphasis on the ‘socialization of health.’ ‘Socialization’ is seen as a key means to contribute to HTP objectives, meaning the systematic and targeted engagement of the population, communities, and civil society in health sector activities. Given its specific cultural and historical context, we sought to discern what notions such as ‘civil society,’ ‘non-governmental organization,’ etc mean in practice in Iran, with the aim of offering policy options for strengthening and institutionalizing public participation in health within the context of the HTP. For this, we reviewed the literature and analysed primary qualitative data. We found that it may be more useful to understand Iranian civil society through its actions, ie, defined by its motivation and activities rather than the prevailing international development understanding of civil society as a structure which is completely independent of the state. We highlight the blurry boundaries between the different types of civil society organizations (CSOs) and government institutions and initiatives, as well as high levels of overlaps and fragmentation. Reducing fragmentation as a policy goal could help channel resources more efficiently towards common HTP objectives. The National Health Assembly (NHA) model which was first launched in 2017 offers a unique platform for this coordination role, and could be leveraged accordingly.

Purpose 1,25-dihydroxyvitamin D3 may regulate adipogenesis in adipocytes in-vitro, but little is known about possible molecular mechanisms related to the inhibitory effect of 1,25-dihydroxyvitamin D3 on adipogenesis in humans҆ adipose tissue. Methodology In this study, human adipose-derived mesenchymal stem cells (hASCs) were cultured for 14 days in adipogenic differentiation media containing concentrations of 1,25-dihydroxyvitamin D3 (10−10–10−8 M). The extent of adipogenic differentiation in ASCs was assessed by Oil Red O staining and quantitative polymerase chain reaction (PCR) to determine expression levels of key adipogenic markers. Results Our results showed that vitamin D receptor (VDR), as a mediator of most actions of 1,25-dihydroxyvitamin D3, glucose trasporter-4 (GLUT4),and fatty acid binding protein-4 (FABP4) was expressed in vitamin D-treated hASCs. However, the protein level of these markers was lower than the control group. Treatment of human preadipocytes with 1,25-dihydroxyvitamin D3 significantly altered expression of adipogenic markers and triglyceride accumulation in a dose-dependent manner. 1,25-dihydroxyvitamin D3 at concentration of 10−8 M enhanced expression of sterol regulatory element-binding protein-1c (SREBP1c), CCAAT-enhancer-binding protein-β (C/EBPβ), a mitotic clonal expansion, peroxisome proliferator-activated receptor-gamma (PPARγ), fatty acid synthase (FASN), a marker of de novo lipogenesis,and lipoprotein lipase (LPL). Conclusion Our findings revealed that 1,25-dihydroxyvitamin D3 may provoke adipocyte development in critical periods of adipogenesis at concentration of 10−8 M, thereby leading to a greater risk of obesity in adulthood and an augmented risk of obesity-related diseases including diabetes, cardiovascular diseases, and some cancers.

Background: Musculoskeletal disorder (MSD) is one of the important problems concerning the staffs' health and productivity in the workplace. Nutritional status and consumption of some foods are also among the determining factors of MSD. So, this study aimed to evaluate the correlation of diet and consumed food groups with MSD. Methods: This cross-sectional study was conducted on 100 office workers. The participants' anthropometric parameters and their dietary information were collected using a semi-quantitative food frequency questionnaire. The findings were categorized into nine levels. The total scores were calculated for all the items per food group and per person. Nordic musculoskeletal questionnaire was also administered to evaluate the MSD symptoms in nine parts of body. Results: The score of consumed food groups was compared between individuals “with pain” and “without pain” in nine parts of the body. The scores of fruit intake in individuals “with pain” and “without pain” were 2.94 ± 1.27 vs. 3.29 ± 1.16 and 2.81 ± 1.10 vs. 3.49 ± 1.38 in terms of neck and wrists, respectively. The difference between the two groups were significant (P < 0.05). Furthermore, the participants with pain in the neck consumed significantly lower amounts of cereals and nuts (P = 0.03, 0.04). In the case of the shoulder pain, consuming legumes and nuts in the “without pain” group was higher than the group of participants who had pain (P = 0.01, P = 0.03). Fat intake was higher in the patients who had pain in their hips (P = 0.02). Conclusion: Less pain was reported in the musculoskeletal system by higher consumption of fruits, nuts, and legumes. It seems that plant-based dietary pattern is more effective in musculoskeletal health.

Background The purpose of this study was to examine the influence of hand-forearm anthropometric dimensions on handgrip and pinch strengths among 7–18 years children and adolescents and to investigate the extent to which these variables can be used to predict hand strength. Methods Four types of hand strengths including handgrip, tip to tip, key, and three-jaw chuck pinches were measured in 2637 healthy children and adolescents (1391 boys and 1246 girls) aged 7–18 years using standard adjustable Jamar hydraulic hand dynamometer and pinch gauge. A set of 17 hand-forearm anthropometric dimensions were also measured with an accurate digital caliper and tape measure. Results No significant differences were found between the hand strengths of boys and girls up to the age of 10 years. Gender related differences in handgrip and pinches were observed from the age of 11 years onwards, with boys always being stronger. The dominant hand was stronger than the non-dominant hand (8% for handgrip and by about 10% for all three types of pinches). The strongest correlations were found between the hand length and hand strengths (r > 0.83 for handgrip and three all pinches; p Conclusions These results may be used by health professionals in clinical settings as well as by designers to create ergonomic hand tools.

Background Obesity is considered a major health concern and mounting evidence suggests that the exposure to environmental endocrine disruptors, including Bisphenol-A (BPA), may enhance the risk to develop the disease. Moreover, growing documents propose that the vitamin D may contribute to adipogenic signaling and lipid accumulation during adipocyte differentiation. We focused on the molecular mechanism of vitamin D and BPA in human adipose-derived mesenchymal stem cells (hADMSCs) which vitamin D and BPA may influence adipose tissue development and function. Methods Human adipose-derived mesenchymal stem cells were cultured for 14 days in lipogenic differentiation media containing continuous concentrations of vitamin D plus BPA (0.1 nM or 10 nM). The expression of adipogenic markers including the peroxisome proliferator-activated receptor γ (PPARγ), CCAAT-enhancer-binding protein α (C/EBP α) CCAAT-enhancer-binding protein β (C/EBP β), fatty acid synthase (FASN), lipoprotein lipase (LPL), sterol regulatory element-binding protein-1c (SREBP1c), insulin-induced gene-2 (INSIG2), vitamin D receptor (VDR), estrogen receptor-beta (ER-β), fatty acid-binding protein-4 (FABP4), and glucose transporter-4 (GLUT4) was measured using Quantitative polymerase chain reaction (qPCR) and enzyme-linked immunosorbent assay (ELISA). Lipid accumulation was visualized with staining with Oil Red O. Results In the morphological assessment of mesenchymal stem cells treated with a concentration of 10 nM vitamin D plus BPA, more lipid accumulations were observed in comparison with the group with 0.1 nM concentration. Treatment of hADMSCs with vitamin D plus BPA (0.1 nM) significantly inhibited the induction of PPARγ, C/EBP β, C/EBP α, and FASN related to adipocyte differentiation and development. However, the exposure of cells to the concentration of 10 nM vitamin D plus BPA induced the expression of these genes associated to the adipogenesis. The remarkable increase in the level of SREBP1c was associated to the suppression of INSIG2 in treated preadipocytes with 10 nM vitamin D plus BPA. Our findings showed that the expression of VDR, ERβ, GLUT4, and FABP4 were upregulated through differentiation with the highest concentrations in 0.1 nM vitamin D plus BPA group for VDR, ERβ, and GLUT4. Conclusions Vitamin D plus BPA at concentration of 10 nM boosted the adipogenesis during the critical stages of adipocytes development, whereas it seems to inhibit this process at concentration of 0.1 nM.

Background Based on the World Health Organization (WHO), workplace violence can affect events where employees are abused, attacked or threatened in their workplace, and it also has some consequences such as safety, welfare, and health. Like other types of violence, workplace violence and aggression are an increasing phenomenon. Moreover, workplace violence not only disrupts interpersonal and organizational relationships, but it also impairs the persons self-esteem and affects their physical and mental health and well-being. Thus, this study aimed to explain the components of workplace violence against nurses from the perspective of women working in a hospital in Tehran, which was conducted through the qualitative method and content analysis. Methods In this study Purposive sampling included 21 female nurses who were working in different wards of the hospital. Also, female nurses were selected with maximum diversity in terms of work experience, age, and the wards they were working in. in this study the semi-structured interview was the main method of data collection. The interview transcriptions were extracted and then divided into meaningful units. For strengthening and confirming the results and accuracy of the research, the author used the data acceptability, credibility, accuracy, validity, believability, verifiability, reliability, and transferability. Results During the data analysis process of this study, the first 15 classes with the same characteristics were put together and then divided into 6 classes. Afterwards, based on the common features at a more abstract level, they were converted into 2 themes. Based on the findings, violence against women in the workplace occurs at two levels, that namely interpersonal violence and organizational coercion. Conclusion Therefore, it is necessary for managers to commit to lay the groundwork for reducing violence in the hospital, as well as barriers to report these cases especially the hospital managers and officials should create awareness on workplace among the staff, patient and visitors and must ensure stringent actions to prevent it.

Background The endocrine disruptor Bisphenol-A (BPA), has been involved in dysregulating adipose tissue development and increasing the risk of obesity. The objective of this experiment was to investigate whether treatment of human mesenchymal stem cells with BPA could modulate adipogenesis and adipocyte differentiation. Methods In this experimental study, the human adipose-derived mesenchymal stem cells (hASCs) were cultured for 2 weeks with continuous exposure to 10− 10 M or 10− 8 M concentrations of BPA. The extent of triglyceride accumulation was visualized by Oil Red O staining. To evaluate BPA effect on the expression levels of key adipogenic trascripotion factors and proteins, we used Quantitative reverse transcriptase-polymerase chain reaction (qRT-PCR) and ELISA. Results The results presented a dose-dependent triglyceride accumulation in treated cells with BPA. Additionally, we observed that BPA induced transcription of the Peroxisome proliferator-activated receptor-gamma (PPARγ), CCAAT-enhancer-binding protein-alpha (C/EBPα), CCAAT-enhancer-binding protein-beta (C/EBPβ), sterol regulatory element-binding protein-1c (SREBP1c), Fatty acid synthase (FASN), and lipoprotein lipase (LPL); BPA suppressed the expression of Fatty acid binding protein-4 (FABP4) and Estrogen receptor-beta (ERβ). Conclusions Our findings supported the hypothesis that BPA enhances adipogenic differentiation thereby may play a role in development of obesity and dysregulation of metabolic homoeostasis.

Background and aims: One of the most common accidents that annoy many people in the world every year is road traffic accidents. Today, the largest share of accidents related to traffic accidents. Iran is one of the countries with the highest incidence and mortality due to road accidents and traffic. Survey of these events can identify the main factors, prioritization and preventive programs for them. Methods: In this research, the multi-criteria decision-making method based on FUZZY TOPSIS has been used to selection the main risk factors. Five criteria specific, measurable, achievable, realistic and timeable are used for prioritizing of traffic police risk factors. Results: In this research, fuzzy multi-criteria decision-making method has been used to selection the most important risk factors. Five criteria include: specific, measureable, Attainable, Realistic, and time frame were used for ranking risk factors in traffic police. According to the results, the humanchr('39')s behavior was identified as the most appropriate factors for road safety (coefficients = 0.204684). Safety equipment and vehiclechr('39')s usage were ranked in grade 3 and 4. Other indicators of risk in order of importance and influence were at lower levels. Conclusion: Identify and Priority of traffic risk factors would help to managers and policy makers for managing the factors affecting accidents. Humanchr('39')s behavior and humanchr('39')s decision were identified as main role in road accident control.

Background and aims: Accidents happened as a result of LPG leakage emphasizes the importance of the consequence analysis of fire and explosion in LPG storage tanks. The purpose of this study is to analysis the consequences of fire and explosion in a cylindrical LPG storage tank in an oil and gas industry. Method: In this analytical study, four possible failure scenarios including 1) rupture in the cylindrical LPG tank 2) leakage from the loading line 3) leakage from the tank manhole and 4) undesirable opening of the safety valve, and their fire and explosion consequences were simulated by PHAST software. Then the results were compared with existing standards Results: The scenario of tank rupture leads to a radiation flux 37.5 kw/m2 affect a radius of 290 m from tank location that can cause major life and property losses. As the result of a flash fire due to the tanker rupture, there is a possibility of life-threatening to a radius of 520 m. An explosion (resulting from the tank rupture) with blast wave of 0.2 bar affect a radius of 2092 m that can cause the life and property losses. The scenario of leakage from the tank manhole leads to jet fire, explosion and flash fire. Also, the jet fire and flash fire will follow by the scenarios of leakage from the loading and undesirable opening of the safety valve. Conclusion: With attention to severity the tank rupture and the likelihood of occurrence of the domino effect, it is recommended to substitute the horizontal cylindrical LPG tanks by the spherical ones. Also, an emergency response plan should be established based on the result of this study. Keywords: Consequence Analysis, Fire, Explosion, LPG Tank, PHAST

Background and aims: Usability is the extent to which a system, product or service can be used by specified users to achieve specified goals with effectiveness, efficiency and satisfaction in a specified context of use. Increased public awareness of the usability issues has caused that usability plays an important role in production. Brooke’s SUS is one of the most used tool for measuring usability. Yet, the Persian translation of this tool has not been available to Iranian researchers, and therefore this study has been conducted in order to provide the Persian translation of it and measure its psychometric validation in assessing usability of traffic signs. Methods: Modified version of SUS by Annie(2011) was translated using Backward-Forward method of translation. For measuring validity of the questionnaire the opinions of 10 experts in related field were used. Content Validity Ratio (CVR) was measured based on Lawshi method and Content Validity Index (CVI) was measured based on Waltz and Basel method. The questionnaire content validity index was also calculated.There is 10 items in SUS for assessing usability of each traffic sign, therefore for assessing usability of 20 selected traffic signs, a 200 items questionnaire was developed. Questionnaires were distributed among 50 staff of Iran University of Medical Sciences. Cronbach’s α was used was used to measure the reliability of the questionnaire. Stability of questionnaire was calculated by using test – retest and intra-cluster correlation index. Results: All the items in SUS showed a high level of CVR and all items were accepted. CVI of all items were above the acceptable level of 0.79 . Content validity index was equal to 0.927. Cronbach’s α was equal to 0.965, and inter-cluster correlation index was equal to 0.993. Conclusions: The Persian version of SUS is a reliable tool for measuring usability level and showed a high level of validity and reliability and can be used for future researches in the field of usability.

Introduction: Metro driving is one of the newest jobs in Iran. There are few studies in this field. Therefore, the physical workload and their influencing factors have not been identified in metro driving. The objective of this study was task and physical workload analysis of metro driving to recommend control measures. Material and Method: In this mixed method study, task analysis and Quick Exposure Check (QEC) were used to assessment of physical workload in metro driving. Different methods and techniques including field investigation, document reviews, individual and focus group interviews, and focus group discussions were used to analysis physical workload to recommend control measures. Result: Whole body exposure with physical workload was assessed unacceptable in metro driving. Although the exposures in back, shoulder/arm and hand/wrist were under threshold 70%, neck exposure lead to over physical workload in the whole body. Many themes include unsupported body; non-sufficient view on the track and on displays; awkward posture and unsuitable layout were extracted as significant factors influencing on physical workload. Conclusion: An intervention plan was recommended to a) support body by chair, platform and footplate; b) optimize a sufficient view on the track and on displays; c) maintain body postures in seating position with easy reaching distance and sufficient view; and d) design a suitable layout for driving panel regarding to controls, keys and displays.

Background: People participation in health affairs has been gaining more importance recently. Establishment of the first National Health Assembly (NHA) was done in Iran to shape dialogue among stakeholders and advocacy for health among all non-health sectors; decentralizing health decision making process, involving community and societies in health policy and planning, identification, appreciation, and development of health policies and measures in all economic, social, and cultural institutions of the country. Case report: In order to ensure participation of all people around the country, provincial Health Assemblies, district health assemblies and neighborhood health assemblies was formed throughout the country. The main theme selected for the 1st NHA was “Health for All, All for Health”. Conclusion: Final statement mentioned that health is a citizens’ right and all people and organizations are responsible for it; therefore, cultural activities and legal support are needed for the institutionalization of social accountability for health.

Background: For sustainable development and resolve complex public health problems intersectoral collaboration is a necessity. A MOU is one of the tools used to develop intersectoral interactions. In this study, the challenges in development and implementation of MOUs and propose strategies to overcome these challenges were studied through collecting the views of some stakeholders from other organizations . Method: For identifying challenges and solutions to improve the situation, group discussions were conducted with the presence of representatives from four ministries of Agriculture, Roads and Urban Development, Sports and Youth, and Education and the representatives of the MoHME, who were responsible for preparing MoUs. All sessions were transcript and analyzed by using content analysis method. Results: Some challenges were defined according to development and implementation of MOUs . For better implementation ,suggested strategies were: Strengthening the stewardship of intersectoral collaboration, Effective and powerful management in monitoring the implementation of MOUs, Determining the appropriate financing path, Strengthening individual and organizational capabilities in developing and implementing of MoUs, Improving the terms and conditions of the implementing the MoUs. Conclusion: Collaboration with other sectors has now become one of the main issues in health systems. For better achievement, strengthening the stewardship of intersectoral collaboration to effective coordination for drafting MoU, and facilitates and monitors the effective implementation of MoUs by identifying key people in each organization and empowering them is necessary.

Organisations can have a significant impact (positive or negative) on society through their actions and decisions. Given this reality, it is important that they are held responsible and accountable for the consequences of their actions. This concept is often referred to as ‘social responsibility’. However, ‘social responsibility’, as currently conceived in the literature, neglects a specific focus on health as a social goal. Additionally, there are no practical tools to capture this concept in a holistic way to facilitate implementation and monitoring of organisational improvement. This paper reports on the process of developing a more holistic conceptual framework and tool for assessing organisational social responsibility and accountability for health (OSRAH). We conducted a review of the published and grey literature and engaged in expert consultation and focus group discussions. The initial OSRAH framework and the self-assessment tool were finalised for implementation and used by 95 organisations at a national event in Iran in February 2017. The results of the assessment data collected at the event showed organisations scored lowest in the domain of community health and highest in the domain of employee health. The OSRAH framework and assessment tool represents a new understanding of health and its determinants in organisations outside the health sector. It integrates health within the existing Corporate Social Responsibility (CSR) culture of organisations. The process of creating the tool and implementing it at the national festival of OSRAH in Iran created momentum for intersectoral action. This experience can inspire researchers and practitioners in other countries, especially in developing countries, to develop their own local definition and practical assessment framework for responsibility and accountability.

An amendment to this paper has been published and can be accessed via the original article.

Introduction: In recent years, a growing attention has been paid to assess the physical characteristics of rich and poor urban districts to understand social health differences. Urban districts environment play a major role in health of the residents. Previous few studies have considered some aspects of limited neighborhood environment. The current study was designed to investigate the reliability of the Neighborhood Health, Safety and Environment (NHSE) tool in one of Tehran city neighborhoods. Material and Method: Dimensions and related items of the NHSE were extracted based on the previous studies and interviews with city experts. Five observers completed the NHSE in a selected neighborhood in order to test inter and intra-rater reliability of the tool. Data analysis was done using the Cronbach’s alpha, Interclass Correlation Coefficient (ICC) and kappa coefficient. Result: The ICC and Cronbach’s alpha were estimated 0.86 for all dimensions of the NHSE. The calculated kappa values were in the range of 57%-66% for inter-rater reliability and 0.47-0.62 for intra-rater reliability. Conclusion: The NHSE tool was shown to have a desirable inter and intra-rater reliability and a good level of internal consistency for assessing the health, safety, and environment (HSE) of the neighborhoods.

The present study was explored whether emotional intelligence and social cognitive variables were related to risky driving behavior (speed and lane deviation). Driving behavior was considered as a key predictive factor in road traffic accidents. In this study, the sample were comprised 75 adults between 20- 30 years old (M = 26.80, SD = 3.175) who currently held a valid driver’s license. Emotional Intelligence was assessed via self-report using the EQ-i - Bar-on Emotional Quotient Inventory (EQ-i), and driving behavior was measured using a driving simulator. Different driving behaviors were recorded including speed and lane deviation. The objective data obtained from the simulator were compared to scores result from the emotional Intelligence. Spearman correlations were revealed that age, driving experience and accident cases were related to driving behavior. There was a significant negative relationship among the average speed on roads with subscales of EI except in assertiveness (r=.448). The average speed was correlated positively with assertiveness. The lane deviation score showed significant negative relationship with subscales of EI except in assertiveness (r=.873). This study proposed that programs should be developed to change the attitude of drivers to engage in risky behavior and encourage safe and responsible. It may lead to safer behavior in traffic and a reduction in the number of accidents.

Traffic violations and aggression are often regarded as social issues with important social and economic consequences. The present study investigated the potential contribution of demographic variables, driving anger, and aggression on the prediction of aggressive driving behaviors. The sample population consisted of 168 male drivers with an age range of 19–30 years old and the average driving experience of 9 years. All participants filled out the self-reported scales that assess driving anger, aggression dimension, and driving behaviors. Based on the participants' responses to the trait-anger dimensions in Spielberger State-Trait Anxiety Inventory, they were re-categorized in three driving anger categories of high-trait-anger, medium-trait-anger, and low-trait-anger. All of the participants had a driving certificate. The results of this research indicate that: (1) for almost all variables, the effect of anger was significant, (2) anger situation had a contribution in the prediction of lapse, errors, and violations, (3) demographic variables, driving anger, and aggression were all involved in a complementary manner in predicting the driving behavior, and (4) aggression was the best predictor of the violations. Future research is recommended to continue to investigate the effect of various environmental, social, psychological, and personality factors on risky driving behaviors in order to identify appropriate treatment and prevention strategies for this societal concern.

Work-related musculoskeletal disorders (WMSDs) are the main causes of pain, suffering, absenteeism, disability and reduction in productivity. This research aims to determine the role of training intervention based on protection motivation theory in reducing WMSDs and promoting productivity.The conducted study was based on a quasi-experimental design (control) that was carried out on 158 employees of the Kabl Khodro factory which were divided into two groups of 79 people. After splitting the 158 workers, an experimental and control group was formed. The data collection instruments were made up of two questionnaires and were analysed using a quick exposure check (QEC) method.Before intervention in both the experimental and control groups, there were no significant differences among the average protection motivation theory constructs, productivity and QEC scores (p 0.05). However, following training intervention there was a significant increase in these factors within the investigated group apart from the perceived response costs and efficacy.The conducted study shows that ergonomic training based on the protection motivation theory is effective in reducing musculoskeletal risk factors and that increased knowledge of the subject can lead to an increase in productivity.

Background: Little information is available on the trend in cardiovascular risk factors and hepatic enzymes in Iranian seafarers. Thepresent study aimed at assessing the pattern of obesity, hypertension, diabetes, elevated serum glutamic oxaloacetate transaminase(SGOT), and serum glutamate pyruvate transaminase (SGPT) in Iranian seafarers during 2010 to 2014.Methods: Data on cardiovascular risk factors and hepatic enzymes were extracted from seafarers’ annual health examination of NationalIranian Tanker Company (NITC) of 2010, 2012, and 2014. The repeated measure ANOVA was used to compare continuousvariables across 3 years. Categorical data were analyzed using Chi-square test. Over weight was defined as BMI (Body Mass Index)>25 kg/m2; obesity was defined as BMI>=30 kg/m2; hypertension was defined as systolic blood pressure (SBP)> 140 mmHg, and diastolicblood pressure (DBP)> 90 mmHg, or a history of antihypertensive drug use. Diabetes (DM) was defined as fasting blood sugar(FBS) > 110 mg/dl, or having a history of oral hypoglycemic agents; and elevated SGOT and SGPT were defined as SGOT > 40 U/Land SGPT > 40 U/L, respectively.Results: The BMI mean±SD values of Iranian seafarers were 24.81±3.07 kg/m2, 25.51±2.96 kg/m2, and 25.96 ± 3.02 kg/m2 in 2010,2012, and 2014, respectively. A significant difference was observed in BMI over the study period. The mean of systolic and diastolicblood pressure did not significantly increase over time. The SGOT and SGPT means were not significantly different from 2010 to2014. The prevalence of overweight increased significantly from 46.7% to 60.9% over the study period; however, the prevalence ofobesity, hypertension, elevated SGOT, and elevated SGPT did not change significantly.Conclusion: The current survey showed that the obesity problem has increased among Iranian seafarers working on tankers, which isa concerning problem because obesity has negative effects on seafarers’ health.

Urbanization is growing rapidly in recent centuries. This phenomenon can cause many changes in various aspects of human life including the economy, education and public health This study was conducted to assess the Health, Safety and Environment (HSE) problems in Tehran neighborhoods. A new instrument was developed based on the results of a literature review and formulated during a pilot study. Through cluster sampling, 10 neighborhoods were selected based from 374 neighborhoods of Tehran. Six observers completed observational items during the field studies. Secondary data were used to obtain non-observation characteristics. Standard descriptive statistics were used to compare the HSE characteristics in sampled neighborhoods. Furthermore, control chart was used to as a decision rule to identify specific variation among sampled neighborhoods. Niavaran neighborhood had the best HSE status (52.80%±25.03) whereas Khak Sefid neighborhood had the worst one (20.09%±27.51). Standard deviations of HSE characteristics were high in different parts of a neighborhood. Statistical analysis indicated that significant differences in HSE characteristics exist among sampled neighborhoods. HSE status was in warning situation in both rich and poor neighborhoods. Community-based interventions were suggested as health promotion programs to involve and empower people in neighborhoods.

The safe management of hospital waste is a challenge in many developing countries.The aim of this study was to compare volatile organic compounds (VOCs) emissions and the microbial disinfectant safety in non-incineration waste disposal devices.VOC emissions and microbial infections were measured in four non-incineration waste disposal devices including: autoclave with and without a shredder, dry heat system, and hydroclave. Using NIOSH and US EPA-TO14 guidelines, the concentration and potential risk of VOCs in emitted gases from four devices were assessed. ProSpore2 biological indicators were used to assess the microbial analysis of waste residue.There was a significant difference in the type and concentration of VOCs and microbial infection of residues in the four devices. Emissions from the autoclave with a shredder had the highest concentration of benzene, ethyl benzene, xylene, and BTEX, and emissions from the hydroclave had the highest concentration of toluene. The highest level of microbial infection was observed in the residues of the autoclave without a shredder.There is an increased need for proper regulation and control of non-incinerator devices and for monitoring and proper handling of these devices in developing countries.

OBJECTIVEs. The aim of this study was to assess the relationship between occupational cognitive failures (OCFs) and unsafe behaviors, accidents and driving offences among municipal bus drivers in Tehran, Iran. METHODS. Systematic random sampling was used to select 190 drivers from 3 transport and traffic Tehran districts. Data were collected with the occupational cognitive failure questionnaire (OCFQ), the driver behavior questionnaire and a data collection form. RESULTS. The mean (SD) numbers of driving-related offences and road traffic accidents were 1.5 (2.6) and 0.37 (1.0), respectively. The mean (SD) numbers of deliberate driving violations, unintended violations, driving slips and mistakes were 6.97 (5.5), 1.61 (1.5), 13.6 (9.0) and 4.53 (3.28), respectively. The mean (SD) number of the OCFs was 28.9 (20.5). A significant correlation was found between occupational cognitive error and unsafe driving behavior subscales. The stepwise logistic regression results showed that, while controlling the effects of confounding factors, the OCF predicts 6%, 9%, 15% and 9% of deliberate violations, unintended violations, driving slips and driving mistakes, respectively. CONCLUSION. The results of this study show that the score of the OCFQ is a predictor of unsafe driving behaviors and its subscales. Language: en

Background and aims: Street sweepers, due to exposure to medical waste, are a high risk group for infections such as HIV and Hepatitis. Regarding to importance of behavior role to decreasing morbidity in this category of disease and recognizing effective factors of performing safe behavior in this group, the present study aimed to predict the occupational behavior lead to prevention of infection based on the framework of the health belief model constructs in street sweepers who are working in district ninth, Tehran municipality in 2011. Methods: In this descriptive-analytical study, a convenience sample included 162 sweepers were surveyed and filled out designed questionnaires (based on health belief model constructs and occupational behavior lead to prevention of infection). Statistical analysis of data was performed with SPSS software, Chi-square, Pearson correlation, One-Way ANOVA and Regression analysis tests. Results: The findings showed that perceived barriers and perceived severity can predict 55% of the variations in occupational behavior lead to prevention of infection of street sweepers. Conclusion: In designing interventions (education) based on the health belief model, should be more emphasis on perceived severity and barriers constructs.

Background and Aims : Many systems and processes can cause the introduction of radioactivity into the environment. Human activities in nuclear industry such as nuclear fuel cycle and reactor operation, lead to a significant production and release of radioactivity to the environment. Understanding the physical and chemical nature, including size, chemical composition and radioactivity of aerosol particles in the safety chamber of Tehran research reactor is indispensable for evaluation of exposure level and methods of prevention. The aim of this study was to measure the size distribution of aerosols and their activities, which was determined using an Anderson cascade Impactor (ACI) ACFM model and liquid scintillation respectively. The measurements were performed in three workstations in the safety chamber of Tehran research reactor. Methods: The identification of existing radio nuclides on suspended particles were carried out in the safety chamber by means of environmental sampler and mass size distribution of particles was measured using an Anderson cascade Impactor (ACI). To determine the type and amount of radio nuclides in the aerosol particles the γ-ray spectrometry with a high –purity germanium (HPGe) detector and ultra-low level liquid scintillation spectrometer were used respectively. Results : The results showed that the activities median aerodynamic diameter (AMAD) value for three selected workstations were 2.4, 3.1 and 3µm with geometric standard deviation of 2.3, 2.12 and 2 respectively. Furthermore, the results of particle activity size distribution showed that the most fraction of activity was related to nucleation and accumulation mode, especially particles with the aerodynamic diameter less than 0.4µm. Conclusion: The most activity was related to the number of particles in the accumulation and nucleation mode (fine particles). The origin of these particles can be the coagulation of particles in the nucleation mode. The accumulation mode also contains droplets formed by the chemical conversion of gases to vapors that condense.

Background: Seafaring is a risky occupation that is associated with a high incidence of lifestyle-related diseases. The present study was carried out to examine health promotion behaviour and its associated factors in seafarers of the National Iranian Tanker Company. Materials and methods: A cross-sectional study was performed on 200 Iranian male seafarers in 2015. A self-administered socio-demographic and Health Promotion Lifestyle Profile II (HPLP-II) questionnaire was completed. One-way analysis of variance was used to identify significant differences among the various departments. The t-test was utilised to compare the HPLP-II scores according to the demographic variables. Multiple linear regression analysis was performed to assess the association between demographic variables and the overall HPLP-II score, in addition to the six health-promoting lifestyle subscale scores. Results: The mean age of the participants was 35.93 ± 9.51 years. Most of the seafarers were categorised as having a moderate (32%) or good lifestyle (61.5%). The mean lifestyle score was 136.14 ± 19.90, with the subscale spiritual growth showing the highest score (26.16 ± 5.03) and the subscale exercise behaviour showing the lowest score (19.95 ± 4.23). The lowest score for nutrition was found among the seafarers working in the engine department (engine: 20.41 ± 4.50, deck: 23.52 ± 4.97, and galley: 24.83 ± 4.64) (p

Background: Antimicrobial resistance (AMR) adversely impacts the prevention and treatment of a wide range of infections and is considered as a serious threat to global public health. Occupational-related AMR is a neglected area of research.Objective: To assess exposure to penicillin dust, penicillin active materials, and to report the frequency of penicillin resistance among pharmaceutical workers in Tehran, Iran.Methods: A quasi-experimental study was conducted among workers on a penicillin production line in a pharmaceutical company (n = 60) and workers in a food producing company (n = 60). Data were collected via survey, air sampling, and throat swab.Results: The mean overall concentrations of penicillin dust and penicillin active material were 6.6 and 4.3 mg/m3, respectively, in the pharmaceutical industry. Streptococcus pneumoniae (S. pneumoniae) was detected in 45% (27) individuals in the exposed group, 92.6% of which showed penicillin resistance. Resistance was significantly higher among workers in...

BACKGROUND: Since Iran's economy is based on the sale of petroleum products, seafaring is considered a crucial job. Little research has been done on issues related to seafarers' health in Iranian maritime industry. The present study investigated the prevalence and associated factors of cardio-metabolic risk factors in seafarers of National Iranian Tanker Company (NITC).MATERIALS AND METHODS: A cross-sectional study was performed on 234 Iranian male seafarers of NITC in 2015. Metabolic syndrome (MetS) was diagnosed according to the reports of National Committee of Obesity. Three main blood parameters (of elevated total cholesterol, elevated low-density lipoprotein cholesterol, and elevated very low-density lipoprotein cholesterol) and general obesity were included as additional cardio-metabolic risk factors.RESULTS: The mean age of the participants was 36.0 ± 10.3 years. The prevalence of MetS was 14.9%. The common cardio-metabolic risk factors were excess weight (51.1%), abdominal obesity (38.5%), and smoking (27.8%) among Iranian seafarers. In multivariate analysis, age (OR: 1.05, 95% CI: 1.01-1.09) and body mass index (OR: 1.14, 95% CI: 1.01-1.27) were associated with the increase in hypertension risk.CONCLUSIONS: Our finding showed that the current prevalence of MetS among Iranian male seafarers working on tankers can affect negatively their health and career at sea.

The purpose of this study was to assess living and workplace safety conditions of construction workers in Tehran, Iran.This cross-sectional study was conducted among 410 construction sites in a municipal area of Tehran whose municipal building permits were issued in 2011. Data on ventilation, workplace safety and hygiene were collected by direct observation and interviews with site foremen. Noise levels were estimated from 10 sound-level-meter stations in the municipality area.Lack of ventilation in the workers' rooms was abundant. Bathrooms were unhygienic and minimum requirements such as lighting and ventilation did not exist in 80% of the cases. In nearly 50% of large construction sites, sewage and garbage disposal were inappropriate. Elevator safety was poor at all sites and no measures for fall prevention were present in over 88% of active construction sites. This study showed that the mean 24-h equivalent continuous sound level Leq was over 70 dB in 80% of the sites during weekdays.The results of this study revealed poor health and safety living and working conditions of construction workers in Tehran.

Study design A prospective cohort study with 1-year follow-up. Objectives To assess incidence and recurrence of disabling low back (LBP) and neck-shoulder pain (NSP) in an industrial population, and to investigate the association with sex and job title during follow-up. Summary of background data Epidemiologic data of LBP and NSP are sparse from developing countries. Methods All employees (18,031) in an Iranian industry were invited to participate in a baseline survey and followed for 1 year regarding new episodes of sickness absence due to LBP or NSP (disabling pain). Results The 1-year incidence of disabling LBP was 2.1% and of NSP 0.1%. Although the prevalence of LBP in females was higher than in males, the incidence disabling LBP were higher in males. Both prevalence and incidence of disabling LBP were high in unskilled workers. For NSP, managers had the highest reported prevalence, but incident cases happened only among office workers and unskilled workers. Conclusions The incidence, especially for NSP, is much lower than from developed countries. To study prevalence, incidence and recurrence of LBP and NSP simultaneously leads to a better understanding of the natural pattern and distribution of LBP and NSP in a working population.

The Bam earthquake on 26 December 2003 was one of the worst natural disasters in Iran in the last century. The Iranian health system responded immediately to the devastating earthquake in various ways including diagnosis and treatment management, providing environmental health services, setting up health facilities and field hospitals with international aid, providing health professionals and medical assistants, and establishing mental and family health services. Ten months after the disaster, temporary housing for survivors was almost completed; mental health, reproductive health, environmental and oral health services were established; offering services of quality comparable or better than what was provided prior to the earthquake. A disease notification system was established within the Primary Health Care network (PHC) to prevent contagious and non-communicable diseases. This paper evaluates the responsiveness of the health sector to the disaster and reviews the strategies employed by national disasters and health managers following the earthquake.

Background Current evidence consistently confirm inequalities in health status among socioeconomic none, gender,ethnicity, geographical area and other social determinants of health (SDH), which adversely influence health ofthe population. SDH refer to a wide range of factors not limited to social component, but also involve economic, cultural,educational, political or environmental problems. Measuring inequalities, improving daily living conditions, andtackling inequitable distribution of resources are highly recommended by international SDH commissioners in recentyears to ‘close the gaps within a generation’. To measure inequalities in socio-economic determinants and core healthindicators in Tehran, the second round of Urban Health Equity Assessment and Response Tool (Urban HEART-2)was conducted in November 2011, within the main framework of WHO Centre for Health Development (Kobe Centre). Method For ‘assessment’ part of the project, 65 indicators in six policy domains namely ‘physical and infrastructure’,‘human and social’, ‘economic’, ‘governance’, ‘health and nutrition’, and also ‘cultural’ domain were targetedeither through a population based survey or using routine system. Survey was conducted in a multistage random sampling,disaggregated to 22 districts and 368 neighborhoods of Tehran, where data of almost 35000 households(118000 individuals) were collected. For ‘response’ part of the project, widespread community based development(CBD) projects were organized in all 368 neighborhoods, which are being undertaken throughout 2013. Conclusion Following the first round of Urban HEART project in 2008, the second round was conducted to trackchanges over time, to institutionalize inequality assessment within the local government, to build up community participationin ‘assessment’ and ‘response’ parts of the project, and to implement appropriate and evidence-based actionsto reduce health inequalities within all neighborhoods of Tehran.

Objectives: The study objective was to assess hydration status by measuring USG among construction workers in Iran. Materials and Methods: The study design was comparative and experimental. Sixty participants were randomly selected from the construction workers from a construction campus with a similar type of work, climate and diet and formed 2 groups (individuals exposed to the sun and non-exposed individuals). TWL and USG were measured in both groups on 2 consequent days, at the beginning, mid and end of the work shift. Results: USG test showed that mean USG was 1.0213±0.0054 in the control group and in the exposed group, where it was significantly higher, it amounted to 1.026±0.005. In the exposed group, 38% of workers had a USG level between 1.026-1.030, representing a higher risk of heat illness and impaired performance and 12.72% had a USG level above 1.030 representing a clinically dehydrated status, while this proportion in the control group was 15.2% and 0.58%, respectively. The mean TWL index measure was 215.8±5.2 W/m2 for the control group and 144±9.8 W/m2 for the exposed group, where, again, it was significantly higher. The Pearson correlation measure showed a significant correlation between USG and TWL. Conclusions: Strong correlation between TWL, as an indicator of thermal stress and USG shows that USG can be considered as a predictor of thermal stress. The difference between USG among the exposed and non-exposed workers and the increase in USG during midday work show the sensitivity of this measure in different thermal and climatic conditions, whereas, the high level of dehydration among workers despite acceptable TWL level, shows that heat stress management without considering the real hydration status of workers, is insufficient.

Background and Aims: Traffic noise is one of the most important urban noise pollution, which causes various physical and mental effects, impairment in daily activities, sleep disturbances, hearing loss and the impact on job performance. Thus it can reduce concentration significantly and increase the rate of traffic accidents. Some individual differences such as personality types in noise effects, affect. Methods : Traffic noise has been measured and recorded in 10 arterial streets in Tehran, and the average sound pressure level measured was72/9 dB during two hours played for participants in the acousticroom . The sample size consisted of 80 patients (40 cases and 40 controls) who were students of Tehran University of Medical Sciences. Personality type was determined by using Eysenc’s Personality Inventory (EPI)questionnaire. The error time movement anticipation before and after exposure to traffic noisewas measured by ZBA computerize test. Results: The results revealed that error time movement anticipation before exposure to traffic noise have significant difference for introverts and extraverts Introverts have less errortime movement anticipation than extroversion ,whereas extroverts have less error time movement anticipation that introversion after exposure to traffic noise. Conclusion: According to the obtained results, noise created different effects on the performance of personality type. Extroverts may be expected to adapt better to noise during mental performance, compared to people with opposite personality traits.

Background and Aims: Hot and humid conditions are common in many parts of the world; these conditions can influence both the health and performance of individuals. Therefore to describe the environmental conditions appropriately, the amount of reliability of heat stress indices should be measured. The aim of this study was evaluating the reliability of WBGT and P4SR by comparison to core body temperature in an OilTerminal. Methods: The participants (94 persons) were two groups of acclimatized and not acclimatized employees of different units of the Oil Terminal. After identifying the units and their activities, air and wet temperatures, WBGT, and core body temperature (oral and tympanic) were measured in three situations including outdoor, indoor, and rest activities. Results: The statistically significant correlation was found between above mentioned heat stress indices with oraland tympanictemperatures (P