علیرضا صفاییان

In any country, the prevention and management of occupational injuries lead to the improvement of the health of the workers of that society. Recognizing occupational injuries is of special importance to achieve the above goal. In this regard, the present study was conducted to determine occupational injuries in the referrals to the Forensic Medical Occupational Compensation Commission of Isfahan during the years 2017 to 2022.

This descriptive, analytical and cross-sectional study was conducted in 1400 on all those who referred to forensic medicine with occupational compensation complaints. The sample size based on the number of patient visits in the last 5 years was equal to 120 people who were included in the study by the census. Data were collected by checklist and analyzed in SPSS version 22 software at a significance level of less than 0.05.

115 people (95.8%) were male, 48 people (40%) were between 40 and 50 years old, 93 people (77.5%) were married, and 58 people (48.3%)had a diploma. Most injuries were related to skeletal injuries in 66 (55%)of the patients. The work experience of 58 people (48.3%) was less than 10years, 27 people (22.5%) were from other industries and 119 people (99.2%)were from service jobs. The employment status of 88 people (73.3%) was contractual. There was a significant relationship between the organ involved and work history (P<0.05).

Considering that most injuries are related to musculoskeletal disorders, necessary measures, correct policies, appropriate training and protective equipment should be provided to reduce these injuries.

Hospital personnel are susceptible to sleep disorders due to their occupational nature, which has a negative impact on their behavioral and cognitive function and can decrease their ability to work. The aim of this study was to investigate the relationship between daytime sleepiness and its affecting factors and work ability index.

This cross-sectional study was performed on 384 personnel of different departments of Al-Zahra hospital in Isfahan who were selected by quota sampling based on the ratio of number of staff of each job title to the total number of hospital personnel. For participants a checklist of demographic and occupational variables and two questionnaires: ESS (Epworth sleepiness scale) and WAI (Work Ability Index) were completed. Scores 13 and more for ESS questionnaire were considered as daytime sleepiness, and scores 28 and less for the WAI questionnaire were considered as poor performance.

48% of participants were male and 52% were female. The mean age of the participants was 35.79±7.65 years and their mean working experience was 10.48±7.24 years. The results showed that there is a significant relationship between daytime sleepiness and demographic and occupational variables other than gender and educational level. Regarding the work ability index a significant relationship was seen with the above variables except gender, educational level and job title. A strong reverse and significant relationship was observed between daily drowsiness and the work ability index.

The relationship between WAI and ESS in hospital personnel indicates that the ability to work can be increased by improving sleep status and controlling the factors that lead to daytime sleepiness.

Regarding the increasing importance of influenza, especially in those at risk, this study aimed to explore the effectiveness and the effective factors of influenza vaccination acceptance among the staff of Alzahra hospital, Isfahan, Iran

This cohort study was performed in Alzahra hospital for 9 months from September 2018 to May 2019. The staffs of different occupations who received influenza vaccination considered as treatment (vaccinated) group, and equal numbers of staffs who did not receive vaccination were selected as the control (unvaccinated) group. In both groups, a questionnaire of knowledge and attitude to vaccination and a checklist of demographic and occupational variables, vaccination acceptance or rejection factors, and influenza infection rate were completed in the study.

During the study, one case in exposed group, and 3 cases in control group got the influenza, and there was no significant difference between two groups (P = 0.130). The relative risk of influenza was 0.33. There was a significant difference between the two groups based on vaccination in previous years (P = 0.001). Moreover, the knowledge and attitude in the vaccinated group was higher than the non-vaccinated group (P <0.050).

 Increasing awareness and attitude to influenza and its vaccination, as well as the availability of vaccination at the right time, can be effective in health care workers’ tendency for influenza vaccine.

The aim of this study was to investigate the sick leave and its causes among the health care workers in Alzahra hospital, Isfahan, Iran.

 The present study was a cross-sectional study conducted at Alzahra hospital in 2018. Subjects were staff of hospital that referred to trusted forensic physician for sickness certification confirmation by census method in one year. After obtaining informed consent, a checklist of demographic and occupational variables, causes of sick leave and confirmation or not was completed by forensic physician. The data were entered into SPSS software, and analyzed using chi-square and independent t tests.

 192 sickness certifications were enrolled the study. The most prevalent sick leave causes of hospital staff were respiratory (21.4%), musculoskeletal (18.8%), gynecology (16.1 %), gastrointestinal (15.1%), and accidents (cuts and fracture) (8.9%) causes, respectively. There was a significant relationship between gender and work experience with the reasons of sick leave (P < 0.05). There was no significant relationship between age, marital status, number of children, education, type of job, type of shift, department, and duration of sick leave with the causes of sick leave (P > 0.05).

The most prevalent sick leave causes among Alzahra hospital staff were respiratory and musculoskeletal disorders. The male staff suffered mainly from musculoskeletal and gastrointestinal problems, hence female staff often suffered from respiratory and gynecological disorders. The least prevalent sick leave causes were accidents (cuts and fracture), and ophthalmological and cardiovascular diseases.

The efficiency and effectiveness of human resources depends on many factors that job satisfaction is one of the most important of them. This study aimed to assess the job satisfaction among the staff of Alzahra health center in Isfahan, Iran, and the effective occupational and non-occupational factors.

In this cross-sectional study conducted in Alzahra hospital during the years 2017-2018, 603 personnel of this hospital were enrolled the study. Demographic checklist including general information such as age and gender, as well as occupational checklist including work experience and type of shiftwork, were completed for the participants. Then, Minnesota Satisfaction Questionnaire (MSQ) was completed for the health care workers. Finally, the results of the questionnaires were evaluated based on the demographic and occupational variables using SPSS software.

The nurse aides had the highest, and nurses had the lowest job satisfaction. There was a significant relationship between job satisfaction and shift-work in all subscales of job satisfaction. It was also observed that all subscales of job satisfaction, except job type and organizational situation, had significant relationship with type of the employment relationship.

Based on the results of this study, nurses had the lowest job satisfaction; regarding the subscales of job satisfaction, managers should plan for increasing job satisfaction.

Regarding the increasing importance of influenza, especially in those at risk, this study aimed to explore the effectiveness and the effective factors of influenza vaccination acceptance among the staff of Alzahra hospital, Isfahan, Iran

This cohort study was performed in Alzahra hospital for 9 months from September 2018 to May 2019. The staffs of different occupations who received influenza vaccination considered as treatment (vaccinated) group, and equal numbers of staffs who did not receive vaccination were selected as the control (unvaccinated) group. In both groups, a questionnaire of knowledge and attitude to vaccination and a checklist of demographic and occupational variables, vaccination acceptance or rejection factors, and influenza infection rate were completed in the study.

During the study, one case in exposed group, and 3 cases in control group got the influenza, and there was no significant difference between two groups (P = 0.130). The relative risk of influenza was 0.33. There was a significant difference between the two groups based on vaccination in previous years (P = 0.001). Moreover, the knowledge and attitude in the vaccinated group was higher than the non-vaccinated group (P <0.050).

Increasing awareness and attitude to influenza and its vaccination, as well as the availability of vaccination at the right time, can be effective in health care workers’ tendency for influenza vaccine.

The quality of working life of workforce is a factor in attracting qualified, tactful, and motivated people to health-care organizations. Job stress is one of the factors that affect quality of service delivery. The aim of this study was to investigate occupational stress of health-care staff working in Alzahra hospital, the largest healthcare center of Isfahan Province, Iran.

A cross sectional study was performed on 581 employees of Alzahra hospital. The subjects were sampled using quoto-random sampling method in 8 occupations including nurses (290 cases), care aides (88 cases), office workers (72 cases), operating room personnel (37 cases), anesthesia technicians (36 cases), midwives (21 cases), laboratory staff (20 cases), and radiology staff (17 cases). The Health and Safety Executive (HSE) Health Stress Questionnaire was completed by participants in self-administration. The checklist of the study, including demographic characteristics and occupational factors (job title, the place of service for employment, contract type, work history, and employee shift) was also completed and compared.

Total stress score according to HSE questionnaire was 118.1 ± 6.5, and the highest score was in demands and role subscale. The job title had a significant relationship with the total score of job stress and as well with control and role subscale (P < 0.050). The highest stress was seen among the operating room technicians, and the lowest among midwifery personnel. Overall, there was no significant difference in the overall job stress score in terms of service area of the employees, work experience, second job, and type of shift (P > 0.050); otherwise, there was a significant relationship between type of shift with role subscale (P < 0.050). There was a significant relationship between the type of contract with total stress score (P < 0.050).

The findings of this study indicate that job stress among employees of Alzahra hospital is significantly different among various job titles, which requires more attention to reduce stress in stressful jobs such as operating room technicians and nurses. Considering the relationship between shiftwork and contract type with some subscales of job stress, managers need to pay more attention to convert contracts from temporary to permanent, and preparation of staff shift schedules.

Stress in jobs such as medicine can cause physiological and psychological damage. Therefore, the aim of this study was to investigate and compare the stress among emergency physicians, identify strategies for managing stress, and ranking these strategies.

This cross-sectional study was conducted on 91 emergency physicians of Shahid Sadoughi, Shohadaye Kargar, Afshar, and Shahid Rahnemoon hospitals in Yazd City, Iran, in year 2017. The participants were selected using convenience sampling method. In this survey, we studied general physicians, emergency medicine specialists, and the residents of internal medicine, general surgery, cardiology, and emergency medicine. The questionnaire used in this article was obtained from Miguel research, and according to the opinion of the professors, its questions reduced from 192 to 125 questions, and after verification of validity and reliability, it was used.

Afshar hospital had the highest mean of stress (325.20 ± 57.30), and hospitals of Shahid Sadoughi (304.9 ± 52.8), Shahid Rahnemoon (288.02 ± 39.01), and Shohadaye Kargar (174.70 ± 21.60) were ranked next. Moreover, the dimensions of communication with the supervisor (17.40 ± 2.29) and communication with the staff had the lowest (20.24 ± 2.60) and medical care in general (18.20 ± 2.73) and family conditions (27.12 ± 2.98) had the highest mean of dimensional stress. The results of ranking stress management strategies also showed that emergency doctors showed negative reactions in stressful situations to reduce stress.

Emergency practitioners work in a high-profile environment, which reduces their work efficiency and burnout. Therefore, recognizing the dimensions of stress and its management solutions can improve working conditions.

Occupational exposure to body fluids, and consequently the blood-borne infections, is an important risk to healthcare workers. Needle-stick injury (NSI) causes occupational injuries, and imposes heavy health, as well as psychological and economic burdens on the individual, health system and community. In this study, we evaluated the risk factors of NSI in Alzahra hospital, the largest hospital of Isfahan City, Iran. This case-control study was carried out on 200 healthcare workers of Alzahra hospital affiliated to Isfahan University of Medical Sciences (100 cases and 100 controls). A total of 100 employees with NSIs were selected as cases and compared with 100 of those who had not NSIs as controls. Job content questionnaire (JCQ), job factors (job title, work experience, shift work, employment status, and department of activity), and NSIs characteristics (exposure severity, type of procedure, type and characteristics of tools) were asked and compared between the groups. There was a significant association between left dominant hand (P = 0.020), and history of participation in educational classes (P = 0.010) with NSIs. Highest rate of needle-stick was among nurses (72% in controls vs. 65% in cases), those with rotational shifts (80% in controls vs. 72% in cases), and those with less than 15 years of work experience (52% in controls vs. 46% in cases); but the differences were not statistically significance (P > 0.050 for all). Logistic regression analysis showed that social support [odds ratio (OR) = 0.85, P < 0.001)], psychosocial demand (OR = 1.07, P = 0.001), gender (OR = 0.44, P = 0.010), the dominant hand (OR = 0.52, P = 0.040), and participation in educational classes (OR = 0.24; P = 0.005) were risk factors of NSIs. Participating in training classes by healthcare worker can play a crucial role in preventing NSIs. Attitude to skill, decision-making power, physical activity, and social support have a significant relationship with NSIs, and should be planned comprehensively in health care centers.

Due to the high prevalence of diabetes and dyslipidemia, which are risk factors for diseases such as metabolic syndrome in today's modern society, especially in the working population, the aim of this study was to determine the effect of shift work on fasting blood glucose and lipid profiles in workers in Isfahan City, Iran, during the years 2014-2015.
In this cross-sectional study, 6983 employees referred to labor centers for periodic examinations were entered according to the inclusion and exclusion criteria. The patients were divided into three groups based on the type of work shift as day, fixed night, and rotate shift workers, and two groups based of type of work as official and non-official workers. The level of blood glucose and lipid profiles [cholesterol, triglyceride, low-density lipoprotein (LDL) and high-density lipoprotein (HDL)] were evaluated and compared between the groups.
Findings: There were no significant differences between three groups according to the levels of fasting blood glucose (FBS), triglyceride, and high-density lipoprotein (P > 0.050); but there was a significant difference between the three groups based on the cholesterol and low-density lipoprotein (P Based on the results of this study, cholesterol and low-density lipoprotein levels was higher in day shift worker than fixed night and rotate shift workers in high sample sizes of workers in Isfahan City.

High prevalence of musculoskeletal disorders is one of the serious problems of today's society, especially in the working class, and has a high prevalence in healthcare community staff, according to some studies. The purpose of this study was to evaluate the prevalence of musculoskeletal disorders in specialty residents of different fields and years in School of Medicine, Isfahan University of Medical Sciences, Iran, in 2016.
In this cross-sectional study, 400 residents from all specialty fields in Isfahan University of Medical Sciences were randomly selected. Musculoskeletal disorders of the auxiliaries were assessed using self-administered standard Nordic questionnaire. Data were analyzed using SPSS software.
Findings: There was a significant difference in presence of pain during the last week between the specialty residents of different fields (P 0.050).
The prevalence of musculoskeletal disorders among the specialty residents in different years is similar; but in some fields that have more shift works and physical activity, pain may be more prevalent than the other fields.

Regarding the high prevalence of obesity and cardiovascular diseases in people, especially worker population, and the problems caused by these diseases, this study aimed to evaluate the effect of work shift (day, night, and rotate shift workers) on blood pressure and body mass index (BMI).
In this cross-sectional study, 6983 employees who referred to the occupational centers of the city of Isfahan, Iran, in 2015, participated according to inclusion and exclusion criteria. They were divided into two groups based on type of work as official and non-official and three groups based on work shift: day, fixed night, and rotate shift working. Age, systolic and diastolic blood pressure, body mass index, and occupational type were compared between these groups.
Findings: 82.2%, 0.7%, and 17.1% of participants were day, fixed night, and rotate shift workers, respectively. There was a significant difference between the groups in age and type of occupation (P 0.050 for all).
The results of this study indicate that shift work has no effect on the level of blood pressure and body mass index.