نشریه طب کار
پیاپی 1 (پاییز 1388)

Periodic examinations for employees serve as one of the main parts of health surveillance in these persons, and there is a legal obligation to perform it. Although there isnt any quality control criteria and standards for its monitoring. So quality of the examinations may decline, and the main objective of the examinations, maintaining and improving employee's health, may not be achieved. This research has been accomplished to assess the quality of occupational medical examinations.

A questionnaire was designed to evaluate the quality of the examinations according to scientific and legal measures. To fulfill the questionnaire, we used medical files of the employees in each plant. The study is cross-sectional and descriptive, and 333 employees were selected by cluster sampling.

Recording the specifications of the employees and their medical histories was appropriate in 98.6% and 94.6%, respectively. The interval between examinations was inappropriate in 62.5% of cases. Recording of occupational history, recording of the specifications of the occupational exposures, performing and recording physical examinations, spirometry, audiometry, chest X ray, specific occupational and general health paraclinic tests was appropriate in 69%, 36% 26.3%, 30%, 29%, 0%, 15.9%, and 19%, respectively. The final comment of the industrial hygienist was acceptable in 23% of cases. 40% of surveyed files required referring or intervention, but final comment of the examining physician was incorrect in 100% of cases.

In present time, occupational medicine examinations has not an appropriate quality. In order to correct this condition, there is a need for proper training and enacting obvious guidelines and laws in the connection of performing and auditing occupational health examinations.

Decreasing demand for drugs through raising awareness of the population regarding the harms and dangers of drug abuse is deemed as one of the important methods of substance abuse prevention. The present study has been conducted in order to evaluate the effect of education on knowledge and attitude of petrochemical companies’ staff members in south Pars region regarding substance abuse in summer 2006. The study was designed as an experimental research with a sample size of 224 individuals. Sampling was performed in a multi-stage manner. The material of the study was a researcher-designed questionnaire, including 21 items. Face validity of the questionnaire was appropriate and its reliability was acceptable through test- retest (r= 0.8). Analysis of the data included descriptive statistics (frequency, percentage, mean, and standard deviation) and analytical statistics (t-test, one way and two way ANOVA). The research revealed the fact that education has a significant effect on knowledge and attitude of the staff members regarding substance abuse. This effect is more obvious on the staff members with high school diploma. On the other hand, the results show that the effect of education on knowledge and attitude of the staff members regarding substance abuse is significantly different among staff members with day shift workers comparing with the offshore workers. Decreasing demand is one of the major strategies in substance abuse prevention. Thus raising awareness among different population subgroups regarding the harms and dangers of substance abuse and their awareness regarding the noxious effects of substance on their physical and mental health, occupational, social and familial function can be considered as an effective means in different levels of substance abuse prevention. If case individuals receive this information and trust it, the probability of substance abuse will decline.

There are many risk factors that predispose nurses to sleep disorders. In one hand, sleep disorder affects health and safety of nurses and patients and on the other hand, risk factors of this occupations raise the prevalance of sleep disorders and their complications. this study was done cross-sectionally on 190 nurses of Imam Khomeini hospital in Tehran, Iran. We used sleep impairment index for insomnia, Epworth sleepiness scale for excessive daytime sleepiness, Martinez method for obstructive sleep apnea syndrome, and sleep disorder was defined as insomnia or hypersomnolance. prevalence of sleep disorders, insomnia, excessive daytime sleepiness, obstructive sleep apnea syndrome, and narcolepsy was, 83.8%, 81.5%, 33.1%, 12.1%, 3.7%, respectively. Using multivariable model, just shift work was significantly effective on prevalence of sleep disorders. We determined the prevalence of important subtypes of sleep disorders in nurses by standard self-report questionnaires and physical exam. Many risk factors that other studies in western countries have shown their importance, cant affect the prevalence of sleep disorders in Iranian nurses. To find the true reason for this issue, we suggest that a study must be done to compare occupation definition, Job, and task of Iranian nurses with western nurses.

Many workers in different jobs work in shift schedules. Health care workers, especially nurses are a working group which according to the job nature always have shift work. Shift work causes different physical and mental diseases, including depression. In a cross-sectional study, 110 nurses working in SSU hospitals were surveyed in two groups: shift worker and non-shift worker. The frequency of depression was measured by means of Beck questionnaire. Frequency of depression was compared in two groups. Mean Beck point for non-shift-workers and shift-workers was 10.09  6.56 and 12.67  5.86, respectively and the difference was statistically significant. shift work is regarded as a risk factor for inducing depression. This study showed the higher frequency of depression in shift workers comparing to non-shift-workers which most of the previous studies had shown.

Foundry is an industry with a great exposure to silica. exposure to silica may cause COPD. This study was conducted in order to evaluate the frequency of silicosis and spirometric dysfunction in this industry. In a cross-sectional descriptive- analytic study, in order to identify the frequency of silicosis and spirometric dysfunction, 143 foundry workers with employment history of at least 15 years and exposure to silica were evaluated with questionnaire, chest X- ray, and spirometry. Sampling method was census. 9 persons (6.3%) fulfilled criteria of silicosis, 2 of them had advanced disease. There was a statistically significant relationship between the frequency of silicosis and employment in a job with hight concentration of silica (p=0.003). There wasnt any statistically significant association between the frequency of silicosis, and age, employment history, and smoking (p> 0.05).Among all workers 70% had normal, 18% restrictive, 4.9% obstructive, and 7% mixed spirometric pattern. There wasnt any statistically significant association between the pattern of spirometry and the frequency of silicosis. Foundry working exposes the worker to silica dust and may cause COPD or silicosis. Although dignosis of silicosis is based on history of exposure and chest X- ray, spirometry can help to diagnose other diseases due to silica exposure.

Noise, as the most common industrial hazard, besides hearing loss may have adverse effects on other body systems. Many studies have demonstrated the adverse effects of noise on the cardiovascular system. Using personal protective devices is one of the methods for reducing noise exposure. Controlling noise exposure by means of personal protective devices theoretically reduces condiovascular effects of noise, but there isnt any study about this effect. We decided to examine the effects of using personal hearing protective devices in a noisy environment on the systolic & diastolic blood pressure and heart rate. In an interventional study, 30 workers exposed to 85dB sound or more for 8 hours per workday were assessed. First, after sitting at workplace for 5 minutes, their blood pressure and heart rate was measured three times between 10 and 11 AM, observing the standard conditions. Then, after recommending to wear the earplugs and giving the necessary relevant instructions, all of the workers supervised for wearing the ear-plugs. During 2 weeks of using earplugs, the blood pressures and heart rates were measured again. The mean systolic blood pressure decreased 5.70 mmHg after using the ear-plugs (P=0.004); the mean diastolic blood pressure decreased 2.13 mmHg after using the ear-plugs (P=0.05); and the difference between the heart rate before and after wearing the ear-plugs was not statistically significant (0.635). The abserved difference in blood pressure before and after wearing earplugs, though may not be important clinically, is statistically significant. Thus recommending the workers to use personal protective devices in noisy environment, besides decreasing the effects of noise on hearing, can also reduce the effects of noise on cardiovascular system and can be significant clinically.

Occupational exposure to styrene can lead to various psychological and somatic complaints including color vision disorder that can occur even in low concentrations. Color vision disease is an early clue for effect of styrene on human, which can be used as an appropriate screening method in workers exposed to styrene.

Working in waxy foundry is a job with exposure to styrene. This study has been performed to evaluate color vision of workers who work in this factory. When considering inclusion and exclusion criteria, 35 waxy foundry workers and 62 workers unexposed to styrene were assessed. To determine color confusion Index we used Launtony D15 d test to discover yellow-blue color vision disorder. Urinary mandelic acid in end shift of the first workday was measured as biologic exposure monitoring.

There was no difference in age between cases and controls (P=0.2). Color confusion index in cases was significantly higher than control group (P=0.017). Urinary mandelic acid of cases was in the range of 1000-1400 mg/l that indicate daily exposure to more than 50 ppm (OSHA PEL) of styrene. There was no significant correlation between uric mandelic acid and color vision disorders (P=0.93). There was no correlation between age and color vision disorders too (CC=-0.01).

Exposure to styrene in a concentration above permissible limit can cause color vision disorders.

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