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Background: Mental workload (MW) and occupational fatigue (OF) are among the harmful factors in the working environment of the emergency nursing profession, which can be related to the quality of care provided and job stress (JS) in emergency nurses. Accordingly, this study investigates the relationship between MW, MF and JS in emergency nurses in 2023 in Ardabil, Iran. Materials and Methods: This cross-sectional study was conducted by measuring OF, JS and MW of emergency nurses in hospitals of Ardabil Province, Iran. Information was collected through a checklist that recorded the demographic information in addition to the NASA task load index, JS by Orly and Giordano and the Swedish OF inventory questionnaires. The statistical analysis was conducted by the SPSS software, version 22. Results: The mean mental state of the participants was 16.7±3.6. Meanwhile, 40% of nurses had a high mental load. The mean condition of the OF was high (49.02±4.2; 23.2%). Regarding JS, 45.5%, 25.9% and 28.6% were the high, medium, and low levels, respectively. A direct and significant relationship was detected between MW, JS and OF (P

Background: Critical risks are one of the most important problems in industries, which have high costs for the industry. This study aimed to assess critical safety and health risks through job safety analysis and analytic hierarchy process in industrial printing. Materials and Methods: The present study was conducted as a descriptive and analytical in one of the printing industries in Iran, in 2020. Critical risks were collected by visiting and observing the job safety analysis checklist. Then, critical risk prioritization was performed by an analytic hierarchy process using Expert Choice software, version 11. Results: A total of 23 hazards were identified. Mechanical hazards (61%) and chemical hazards (9%) had the highest and lowest frequencies, respectively. The identified safety and health hazards included musculoskeletal disorders (MSDs) in the upper and lower back, respiratory and skin exposure to chemicals, the risk of electric shock, and mechanical hazards (hand entrapment, hand amputation, and falling objects). Conclusion: The highest priority of critical risk was related to MSDs of the upper and lower back. The next priority of critical risk was related to chemical agents, respiratory exposure to organic solvents, and dermal exposure to organic solvents.

Abstract Background Musculoskeletal disorders (MSDs) are known as one of the main problems affecting the health of industrial workers and can lead to lost working days, functional disability of workers and wasting the financial resources of an organization. Therefore, the present study aimed to evaluating the effect of ergonomic interventions on reducing MSDs and improving working posture in the in a foundry industry workers. Methods A field multicomponent cross-interventional study was conducted on workers working in a foundry industry. In this study, 117 male workers were divided into 4 groups, including a control group, a group with specialized ergonomics training, a group with workstation intervention, and a group simultaneously undergoing training and workstation intervention. All 4 groups were evaluated during a period of baseline, 6 and 12-months follow- up. The Cornell Musculoskeletal Discomfort Questionnaire (CMDQ) and direct observations of working postures by using the Quick Exposure Check (QEC) method were used. Results The results showed that the implemented interventions in the shoulder/arm, back and stress level were effective and the difference in the final score was significant among different groups (P-value > 0.05). In addition, the interventions led to a significant decrease in the QEC scores and musculoskeletal symptom scores in the neck, shoulder, lower back, knee, and lower leg regions among different groups (P-value > 0.05). Conclusion The results showed that workstation modification and training and workstation intervention simultaneously had a greater effect on MSDs and improving working posture compared to training alone.

Background: People’s participation in more efficient control of the disease and public awareness about the risk of COVID-19 affect their preventive behavior. This study examines the level of fear of COVID-19 infection in Iranian society after returning to social activities and business reopening. Methods: This Cross-Sectional study consisted of urban dwellers in Iran, and the data gathering tool was a researcher-designed questionnaire. To design the instrument, the authors interviewed experts and ordinary people to determine the key questions . Then, the questions were modified and finalized based on the experts’ feedback and a reexamination by the experts after two weeks. An online version of the questionnaire was disseminated using social networks. 168 people were included in the study by the available sampling method. Data were analyzed through descriptive statistics methods. Quantitative data as mean and standard deviation were reported, and the qualitative data were reported as numbers. Chi-square test and Spearman correlation coefficient were used to examine the relationship between questions related to COVID-19 infection fear and demographic variables. Data analyses were done in SPSS 20. Results: The study was carried out on 168 participants, and 78 of them were employees of different offices. The participants believed that among the ways of spreading the disease, kissing and hugging (n=142, 84.5%), shaking hands (n=127, 75.6%), contact with the saliva of an infected person (n=116, 69.0%), and spread through the air (n=60, 35.7%) had the highest frequencies. Conclusion: Fear of COVID-19 infection in the participants was at moderate and above moderate levels. The participants also hoped that the vaccine would be found and made available to the public. Policy-makers in the health sector can use the results.

Abstract Occupational accidents (OA) are among the main causes of disabilities and death in developing and developed countries. The aims of this study were to identify the subgroups of OA and assess the independent role of demographic characteristics on the membership of participants in each latent class. This cross-sectional study was performed on 290 workers between 2011 and 2017. Data gathering was done using the reports of accidents recorded in filed lawsuits. Descriptive statistical analysis was done using SPSS 16 and LCA was done using PROC LCA in SAS9.2. For latent classes were identified; namely “critical due to distractions and lack of supervision” (40.1%), “critical due to lack of safety knowledge” (27.9%), “critical due to fatigue and lack of supervision” (13.1%), and “catastrophic” (18.8%). After adjusting for other studied covariates, being illiterate significantly increased the odds of membership in “critical due to fatigue and lack of supervision” (OR = 4.05) and “catastrophic” (OR = 18.99) classes compared to “critical due to distractions and lack of supervision” class. Results of this study showed that the majority of workers fell under the latent class of critical due to distractions and lack of supervision. In addition, it should be noted that although a relatively small percentage of the workers are in the catastrophic class, the probability of occurring death is quite high in this class. Focusing on the education of workers and enhancing manager’s supervision and employing educated workers could help in reducing severe and catastrophic OA.

Background: The outbreak of coronavirus is a global crisis, which has caused many deaths and injuries around the world. Observing preventive behaviors of the general public is one of the main ways to break the chain of transmission, and get rid of this crisis. The aim of this study is to determine the extent of preventive measures regarding Coronavirus disease in the lifestyle and home-based jobs of Iranian society. Methods: In this validation, methodological study, after reviewing the opinions of experts, the authors collected questions to evaluate the extent of preventive behaviors against coronavirus (PBAC). Questions with a face validity index greater than 1.5, a Content Validity Index (CVI) index greater than 0.79, and a Content Validity Ratio (CVR) index greater than 0.62 were considered appropriate. If Cronbach's alpha coefficient was greater than 0.7, the internal reliability of the instrument was established. Results: The face validity of all questions was more than 1.5, and the face validity of all questions was confirmed. In the 5 questions, the CVI index was less than 0.79, and the CVR index was less than 0.62. After removing those 5 questions, the final questionnaire of 16 questions was introduced as a tool. Also, the internal reliability of the instrument was (α = 0.71). Conclusion: Results of this study demonstrated that the proposed questionnaire is suitable for measuring the level of preventive PBAC regarding the lifestyle and home-based businesses, and has good validity and reliability as a useable tool.

Background: Coronavirus is a viral disease with a fast-spreading rate. It has become a pandemic. For preventing the covid-19 infection, respect for health protocols is necessary. The level of adherence to the protocols depends on one’s risk perception. To measure the level of risk perception, a valid and reliable measurement tool is needed. The present study is an attempt to evaluate the psychometric properties of the coronavirus infection risk perception (CIRP) questionnaire, with a working life approach. Methods: The article concentrated on the generation, translation, cross-cultural adaptation, and psychometric properties of the CIRP questionnaire. In this cross-sectional study, authors generated an item pool, extracted from the literature relating to risk perception in COVID-19 disease. 228 people participated in the study. The initial scale, consisting of 41 Items, was produced from literature. A scale, containing 26 Items, appeared as a result of Exploratory Factor Analysis (EFA). Cronbach’s alpha was used to measure the internal consistency. Data analysis was conducted at a 95% confidence level. Data were analyzed using the SPSS statistical version (V. 21). Results: Exploratory factor analysis of the scale, explained 45.3% of the variance observed. In addition to the analyses indicated, satisfactory results for internal consistency (Cronbach's alpha ranging from 0.72 to 0.87) and intra-class correlation (ranging from 0.79 to 0.94) were obtained. Conclusion: This study generated the Persian-language version of the CIRP, for Iranian individuals through psychometric testing, to measure risk perception. This questionnaire is reliable for measuring people's CIRP.

Abstract Background Crimean-Congo hemorrhagic fever (CCHF) is an acute, feverous disease that is caused by tick bites or humans’ direct contact with the blood and tissues of infected livestock and humans. The transmission of the disease is also possible via human-to-human contacts and nosocomial transmission is well described. The majority of patients suffering from this disease are slaughterhouse workers (including butchers), farmers, veterinarians and hospital staff. Thus, this study aimed to investigate the health behaviors of butchers regarding CCHF and study factors affecting such behaviors based on the health belief model. Methods This is a descriptive cross-sectional study conducted on 500 butchers in Ardabil Province in 2020 by a multistage sampling method. The participants of the study completed the researcher-made questionnaire of health belief model and health behaviors model relevant to CCHF. The collected data were then analyzed by descriptive statistical tests and linear regression analysis. Results The mean (SD) age of the participants was 44.4 (10.5) years, and 96% were males. Only 11.1% of the participants displayed acceptable disease-preventive behaviors. The validity and reliability of the developed questionnaire were confirmed. The results of the exploratory factor analysis showed that the constructs of the model explained 84% of the total variance. The results of the study revealed that among the variables of the health belief model, perceived susceptibility (p-value = 0.006, β = 0.152) and perceived barriers (p-value = 0.023, β = 0.14) were the strongest factors predicting disease-preventive behaviors regarding CCHF. Conclusion The results of the study showed that the health belief model can predict preventive behaviors for CCHF. Therefore, designing and executing interventions based on the results of this study may encourage such preventive behaviors in butchers.

Introduction: Labor is one of the most important wards of hospital, where human error is high. Midwifery errors in the maternity ward and in the delivery can be a serious threat to the health of the mother and the infant, resulting in increased treatment costs. Factors affecting human error are diversity in work, high workload, and fatigue. Therefore, this study aimed to evaluate the midwifery errors in the maternity ward using the systematic human error reduction and prediction approach (SHERPA) technique. Material and Methods: This cross-sectional study was conducted in 2019, during which different midwifery tasks were determined in four stages of admitting, pre-labor, delivery, and postpartum. Tasks and sub-tasks were identified using the hierarchical task analysis (HTA) technique and human error was evaluated using the SHERPA technique. Results: The results of the HTA technique identified 19 main tasks, 52 sub-tasks, and 114 activities. After assessing human error risk with the SHERPA technique, the performance was the most frequent type of error and the highest frequency was related to the undesirable risk level. Conclusion: The errors of the midwifery profession in the hospital’s labor are high-risk and largely critical. Factors such as high workload, time pressure, and fatigue influence the incidence of human error. In order to reduce human error in this area, strategies such as reducing staff workload, developing standard checklists and guidelines are essential to reduce human error in this ward.

Background: Work-related accidents are one of the most important factors in the loss of human lives. With technology and industrial progress, the consequences of accidents due to hazards become more severe and may even stop the work of power plants. This study aimed to identify and assess the risk of hazards in a combined cycle power plant. Methods: The descriptive cross-sectional study was conducted to assess the risk of a combined cycle power plant using the FMEA method. Having studied various documentation and records, holding different meetings, and brainstorming, the risk priority number was calculated and corrective suggestions have been presented. Results: Out of a total of 74 identified risks, 34 (45.94%) were at high risk, and 40 (54.05%) were of medium risk. 85% of the risks had the highest severity levels that could cause explosions and fires, injuries, and burns. Conclusion: It can be mentioned that the risks associated with industries such as power plants were high and preventive measures in such places are very important. Identifying hazards and risk assessments with a standard method such as FMEA was a useful way to prevent accidents and human and financial losses.

BackgroundNurses in intensive care units (ICU) are under a lot of stress because of special conditions caused by the work environment and the high level of knowledge and skills required to work in these units, which can lead to cognitive failures. This study aimed to investigate the relationship between occupational cognitive failures (OCF) and job content (JC) in nurses in the ICU of Ardabil hospitals in 2020.MethodsThe present study was a descriptive-analytical cross-sectional study that was conducted in 2020. The study population included nurses working in the ICU of hospitals in Ardabil, from which 267 people who were eligible to enter the study were selected. OCF and JC questionnaires were used to collect data. Data were analyzed using SPSS software 23.ResultsOCF with work records in the ICU, total work records, and work records in the COVID-19 and non-COVID-19 units are significantly associated. OCF was inversely related to the JC subscales of skill discretion and decision authority. And directly related to other subscales of JC.ConclusionsDevelop job ability, reduce repetitive tasks, create diversity in work, create opportunities for creativity, have the authority and freedom to make decisions, facilitate work with new technologies, have enough time to do work, have a friendly work environment with colleagues, support by the supervisor, improving posture, especially for the upper body, feeling job security can help to reduce the cognitive failure of nurses.

Background and aims: Work-related musculoskeletal disorders usually engage the lower back, cervical spine and upper extremities (shoulder, elbow, wrists, hands and fingers). According to reports from around the world, work- related musculoskeletal disorders are the most common occupational disorders and diseases. There is no accurate estimate of the prevalence of these disorders in Iran, but studies have reported a high prevalence. These disorders are the most important cause of absenteeism among workers. They also play a significant role in the premature disablement of workers. Disorders also induce economic losses in human societies due to the loss of working days, the cost of treatment and rehabilitation, reduction of quality of life of affected people and their families. These disorders affect the individual, organization, and society. Studies have shown that musculoskeletal disorders are very costly, in such a way that they induce the highest suffering for the patient and among them, back pain has the highest rank. Many of these disorders are due to the failure to observe the ergonomic principles and the unfavorable and non-standard conditions governing the work environment and how to perform the job. It can be clearly stated that the range of ergonomic problems in work environments is not limited to musculoskeletal injuries, but also include loss of productivity and efficiency, increased errors, fatigue, discomfort and environmental stress. The risk factors for these disorders are multifactorial, and they are still not fully understood in some respects. The most important factors include occupational ones such as unfavorable work environment, manual work, heavy lifting, repetitive and heavy work. Agriculture, like mining and construction, is recognized as one of the three highly hazardous and high-risk industries in terms of health. National and international studies show that the physical needs of farming occupation can be a cause of work-related musculoskeletal disorders. Dairy plants is one of the subsectors of the agriculture and food. Dairy plants, and especially milking the cows, affects the musculoskeletal system of the workers in the industry due to physical needs, poor working posture and repetitive movements and tasks. Musculoskeletal disorders in the areas of waist, shoulders, hands, wrists and knees are one of the common problems in this industry. Cow-milking is one of the most hazardous sectors in terms of ergonomic risk factors in the livestock industry. According to studies, about one-third of workers in the milking sector often experience symptoms of pain in the shoulders and necks. Increased work time, milking more cows per hour, high physical activity and repetitive tasks are among the potential risk factors for work-related musculoskeletal disorders in this industry. This study aims at investigating the effects of ergonomic engineering interventions and management decisions on reducing the frequency of musculoskeletal disorders and improving work postures among milking workers in dairy plants. Methods: This is an interventional study performed in a dairy plants with 240 personnel working in different parts of Isfahan. In the primary health and safety investigations in this industry, the hazardous milking sector was selected as the research environment because it produces the highest number of physical complaints by personnel, the highest number of occupational accidents and back injuries. All 48 workers of the milking sector were investigated. The purpose of the study and the methodology was fully explained to the participants in the study. They were assured that, firstly, their information would be completely confidential to the researchers. Secondly, participation in this study was entirely voluntary and if they were not willing to participate in the study, there were no consequences for them. After explaining the study, in case they were willing, the consent form was completed by the participants and the presence of the individual was confirmed. The procedure was carried out in 4 steps as follows. 1. Evaluation of the occupation of milking and determining the frequency of disorders among the workers. 2. Implementing intervention programs. 3. Re-evaluation of the occupation of milking and determining the frequency of disorders after completing the intervention program. 4. Comparing the results before and after the interventions. In order to evaluate musculoskeletal disorders, the Persian version of Cornell Musculoskeletal Discomfort Questionnaire (CMDQ) was completed by the participants. The questionnaire analyzes the frequency of discomfort, severity of discomfort and its impact on work power in the last week in twelve parts of the body. The CMDQ is a suitable tool for the evaluation of work-related musculoskeletal disorders. The ergonomic evaluation uses a quick exposure check (QEC) posture analysis method. This methodology allows assessing worker exposure to a wide range of risk factors for musculoskeletal disorders. In this method, part of the work is completed by the observer and the other part by the operator. The QEC methodology is used to assess a range of occupations including: manual handling, repetitive tasks, dynamic tasks, tasks involving sitting and standing. In the QEC posture analysis, psychosocial risk factors are considered in addition to physical risk factors. This method is also an appropriate method for evaluating interventional operations, because immediately and after intervention programs, the impact of interventions can be assessed by re-evaluating the work environment. After the analysis, the results were discussed with the top management of the organization and officials from other sectors to determine intervention measures. At the end of the meeting, decisions were made to improve the ergonomic situation of the milking personnel, which include the engineering interventions, management interventions and implementation of educational programs. The time required for the implementation of the interventions and the authority responsible for their implementation was determined. After completing the intervention, the frequency of musculoskeletal discomfort among the participants and the ergonomic status of the milking occupation were re-evaluated using the CMDQ and QEC posture analysis. In the end, in order to investigate the effect of these interventions on decreasing musculoskeletal discomfort and improving personnel postures, the scores before and after the evaluation compared by use of paired t-test and their significance was examined. Results: All participants in this study were men. 56.26% of the research population was under 30 years old and 66.66% had a work experience of under 4 years of age, indicating the low age and low experience of the population studied. The highest score of the CMDQ in terms of the frequency of discomfort was related to the lower back (364.5 before and 187.5 after intervention), shoulder (190.25 before intervention and 114 after intervention) and neck (164.5% before and 85.5 after intervention), respectively. Paired t-test showed that the scores of the CMDQ were significantly decreased after intervention in the three parts of frequency of discomfort, severity of discomfort, and its impact on work (p-value 0.05) but in other areas (neck, shoulder, upper back, lower back , forearm, wrist, thigh, knee and leg) (p-value

Background and aims: Cement production processes are associated with different hazards, such as health and safety hazards and environmental pollution. The current study was conducted to evaluate and determine the safety, health, and environmental risks of using FMEA and AHP techniques in the cement factories while providing certain suggestions for controlling them. Methods: The study was conducted as a case in one cement factory in 2019. The checklists for FMEA and AHP techniques were filled out by the evaluation team. The risks were identified and prioritized. Controlled approaches were suggested for the identified risks. Results: In this study, 101 risk cases were evaluated and categorized in various units of the factory, such as manufacturing and service units. The results of FMEA technique showed that crushing, crushing monitoring, milling, filtration, and pre-heater sections had the highest degree of health and safety risks. The results of AHP technique also showed that the environmental pollution caused by the removal of electro filter from the circuit, electro fan burning caused by over current, the failure of the equipment and process, and the defect in the filtration system were all prioritized. Conclusion: Through taking technical-engineering measures, adopting comprehensive HSE management solutions, such as changes in the work process, making replacements in parts and used machinery, installing recyclable systems, repairing and maintaining the system of air pollution protection, installing a warning and responsive system, mechanizing activities, shielding, implementing instructions and regular curriculum can greatly reduce the risk level.

Objective: The aim of this study was to investigate the moderating role of job control in relation to mental workload and job satisfaction of healthcare workers.Methods: This cross-sectional study was carried out on 480 nurses, midwives, and administrative workers in four educational hospitals of Ardabil, Iran. Research tools were included demographic information questionnaire, NASA-TLX questionnaire, job description index (JDI) questionnaire and job control inquiry.Results: Compared with administrative workers, mental workload of nurses and midwives was significantly higher and likewise mental workload of nurses was significantly difference compared to midwives (P < 0.001). Nurses and midwives had substantially higher job satisfaction than administrative workers (P < 0.001). Also, nurses and midwives had higher job control than administrative workers (P < 0.001 and P = 0.002, respectively). Based on the designed model, the correlation between mental workload and job satisfaction was negative and significant (r = −0.22); which in the presence of job control, the relationship between the two variables of workload and job satisfaction slightly increased (r = −0.19, P < 0.001). These conditions were the same in the three job groups separately.Conclusion: Mental workload is inversely related to job satisfaction and job control. Job control plays an important role in improving working conditions in healthcare workers.

Ergonomics of schools and school furniture is one of the main issues in students' education. The proportion of school furniture to the anthropometric dimensions of students is one of the main ergonomic challenges in schools that affect students' health. This systematic review study aimed to examine the match between anthropometric measures and school furniture dimensions among Iranian students. A systematic review was carried out using databases to Google Scholar, SID, IRANDOC, PubMed, MEDLINE, and ScienceDirect and specific keywords to find papers published before March 2020. The references of seminal studies were also used to extend the search scope. Totally, 11 studies entered the review. The results showed that there was no proportion between classroom furniture and students in schools under study. This lack of proportion was evident at different grades in both boys' and girls' schools. The results showed a lack of proportion between classroom furniture and Iranian students. There is a need to design and procure furniture based on the anthropometric dimensions of the society that will help to health promotion of students. An updated national anthropometric databank of Iranian students can be a step to solve the problem.

BACKGROUND: The quality of life (QOL) is essential in all different stages of life; however, It is more important for older people as it can be effective in promoting their health. Therefore, the present study aimed to review the literature on the QOL in the Iranian elderly population. MATERIALS AND METHODS: The study was carried out as a systematic review. For this purpose, all databases were searched in March 2021. The keywords used for the search were “quality of life, elderly, older adults, aging, seniors, and Iran” along with the Persian equivalents. PRISMA protocol was used to screen articles. After removing duplicate and irrelevant items, two evaluators appraised the articles separately based on a researcher-made checklist derived from the SBEM and STROBE Statement standard checklists. RESULTS: The initial search yielded 3734 studies on the QOL in the Iranian elderly population. After screening and assessing the studies based on inclusion and exclusion criteria, 22 articles remained in the study. Most of the studies (cross-sectional) were conducted in Tehran using a 36-item Short-Form Health Survey to assess the QOL. The studies investigated sociodemographic determinants, physical and health-related behaviors, and spirituality and psychological determinants of the QOL. The sociodemographic determinants were the most common factors under study. The results showed that the role of gender and socioeconomic status was the strongest among the sociodemographic characteristics. A significant association was found between the QOL in the Iranian elderly population and factors such as depression and religious confrontation. CONCLUSION: In addition to chronic diseases, diseases of the oral and dental, as well as an unhealthy diet, should be considered in the elderly. Therefore, attention should be paid to all social, physical, and psychological variables that affect the QOL of older people.

Background: Critical risks are one of the most important problems in industries, which have high costs for the industry. This study aimed to assess critical safety and health risks through job safety analysis and analytic hierarchy process in industrial printing. Materials and Methods: The present study was conducted as a descriptive and analytical in one of the printing industries in Iran, in 2020. Critical risks were collected by visiting and observing the job safety analysis checklist. Then, critical risk prioritization was performed by an analytic hierarchy process using Expert Choice software, version 11. Results: A total of 23 hazards were identified. Mechanical hazards (61%) and chemical hazards (9%) had the highest and lowest frequencies, respectively. The identified safety and health hazards included musculoskeletal disorders (MSDs) in the upper and lower back, respiratory and skin exposure to chemicals, the risk of electric shock, and mechanical hazards (hand entrapment, hand amputation, and falling objects). Conclusion: The highest priority of critical risk was related to MSDs of the upper and lower back. The next priority of critical risk was related to chemical agents, respiratory exposure to organic solvents, and dermal exposure to organic solvents. [ABSTRACT FROM AUTHOR]

Aims: The present study aimed to evaluate the assessment methods of human errors and compare the results of these techniques in order to introduce the precise method of human error assessment, and recognize the factors affecting the occurrence of these errors. Materials and Methods: This case study was done at three workstation control room of a cement industry in 2014. After determining the responsibilities and critical jobs by hierarchical task analysis, cognitive reliability and error analysis method (CREAM) and human error assessment and reduction technique (HEART) were used in order to analyze the human errors. Results: The results showed that in the CREAM method, the highest probability of error occurrence is related to monitoring and control (operator) with a probability of 0.207, and that of in the HEART method, is related to control signs (operator) with a probability of 0.416. The number of errors detected by CREAM and HEART method were 85 and 80, respectively. Time and cost of applying the CREAM methods were 235 h and 1175($), while those in the HEART techniques were 215 h and 1075($). Conclusion: We concluded that the highest probability of calculated errors relates to "monitoring and control (operator)," "controlling warning signs (operators)," and "cooperation in solving the problem (supervisor)" for both techniques. By considering the time and cost factors, HEART has superiority, while CREAM is better due to its extensive evaluation and the number of detected errors.