نشریه طب کار
سال دوازدهم شماره 3 (پیاپی 40، پاییز 1399)

Despite widespread efforts to reduce human error in different occupations, unsafe practices and behaviors are still the main cause of many accidents. The occurrence of medical errors in health care systems as one of the most important factors in decreasing the quality of services in this field has received much attention in recent years. Therefore, this study aimed to identify and evaluate all kinds of human error among nurses of Yazd Mother hospital.

This cross-sectional and descriptive-analytical study was conducted at Yazd Mother hospital in 2019. All nursing duties in gynecology, infertility, emergency, neonatal intensive care, and in vitro fertilization were identified and subdivided using hierarchical task analysis (HTA) and then analyzed using SHERPA method.

The highest number of errors was in a gynecology (83), infertility (73), emergency (54), neonatal intensive care (31) and in vitro fertilization, respectively. The highest percentage of errors was related to performance in all sectors. The least frequent error was selection error.

The results of this study showed that functional errors account for a large proportion of errors, which should be the priority of control strategies in each segment for these types of errors in order to prevent such errors. The magnitude of the errors identified after the proposed control solutions in all sections indicated the fact that acceptable solutions can be achieved by applying these strategies.

 Firefighters are at high risk of developing post-traumatic stress disorder (PTSD), and that Quality of Life (QoL) is seriously compromised in individuals who have PTSD. This study was designed to assess the relationship between post-traumatic stress disorders and quality of life among firefighters.

 In this analytical and cross-sectional study, all firefighters in Birjand city were selected by census method (N = 96) in 2018. PTSD and QoL status was assessed by the Persian version of the Mississippi (Eshel) and WHOQOL-BREF questionnaires, respectively. Using Cronbachchr('39')s α, the Iranian version of these two scaleschr('39') internal reliability has been reported to be 0.92 and more than 0.7, respectively. Data analysis using SPSS software version 21 and independent T-test, ANOVA, Tukeychr('39')s test, and Pearson correlation coefficient were used for statistical analysis.

 The results showed that most firefighters (70.5%) were suffered from moderate PTSD symptoms (79.2± 11.7). Based on the self-report scale, 53.7% of the firefighters rated their quality of life as Good, and 43.2% of the firefighters were satisfied with their health. Statistical analysis showed that there is a statistically significant inverse relationship between PTSD score and areas of mental health (P = 0.03), social relations (P = 0.002), and environmental health (P = 0.004). Between PTSD score and physical health, no statistically significant relationship was found (P = 0.08).

 This study has proven a high rate of PTSD among firefighters and its negative correlation with the quality of their life. However, most firefighters rated their health and quality of life as good. Implementing strategies to combat mental disorders among firefighters improves the quality of their life and increases their job productivity.

 Exposure to dust is an essential factor in the brick production industry. Determining the mortality rate from silicosis and lung cancer is very important in exposure to crystalline silica dust. Therefore, this study was conducted to risk assessment of workers in machine factories and traditional brick production workshops.

 This cross-sectional study was conducted in 2016 in a machine factory and five traditional active brick production workshops located in the southeast of Tehran. All employees of a brick-making machine factory (40 people) and five traditional brick-making workshops (30 people) were selected by census sampling. Their exposure to total respiratory dust and respirable crystalline silica was evaluated by the NIOSH0600 method and NIOSH7602 optimal method. Mortality risk assessment from silicosis and lung cancer was performed based on Mannetej and Rice models. Data were analyzed by t-test after entering SPSS19 software.

 The average concentrations of crystalline silica and total respiratory dust in traditional workshops are 0.651 ±0.69 and 28.27 ± 23.05, and in a machine factory are 0.297± 0.27 and 17.6 ±8.6 mg / m3. The T-test showed a significant difference between the traditional and mechanical brick factory in occupational exposure to total respiratory dust (P=0.001). However, no significant difference was observed in exposure to crystalline silica (P=0.107). In both traditional and machine brick factory, the risk of death from silicosis and lung cancer is unacceptable.

 The results showed that the industrychr('39')s mechanization has reduced exposure to total respiratory dust and crystalline silica and reduces the risk of death from lung cancer. But the risk of death from lung cancer and silicosis is still high in both traditional and mechanical factories

noise is one of the most important harmful factors in the workplace. The physiological effects of noise on humans are gradual in the long run. Despite industrial advances, exposure to excessive noise is one of the health problems of workers in the worldchr('39')s steel industry. This study aimed to investigate the effect of noise on hearing loss in steel industry workers.

This descriptive cross-sectional study was designed and conducted. The study population was 121 workers in a steel rolling industry whose 5-year audiometry was studied from 1391 to 1395. An audiometer performed the audiometric test of these workers in 5 years. Their audiometric results were extracted from their medical records and examined under ethical principles. Data were analyzed using SPSS software version 21, and T-Test and Wilcoxon Signed Ranks Test was used for statistical analysis.

The mean age of participants was 38.88 ± 4.92 years and the mean work experience was 10.94 ± 3.57 years. In this study, a gradual increase in the average hearing threshold at different frequencies in both ears was seen from 2012 to 2016.

noise as a detrimental factor in the steel industry causes a gradual increase in exposed workerschr('39') hearing threshold.

Spirometry is used as a screening method for occupational lung diseases. Dental laboratory workers are exposed to solvent vapors, toxic gases, and dust from metal alloys, acrylics, and gypsum. This study aimed to investigate the spirometric function of lung function in dental staff in Yazd.

This descriptive cross-sectional study was performed on 37 technicians of dental laboratories in Yazd in the three months of spring 2017. To evaluate respiratory problems and their pulmonary function, standard respiratory and spirometry questionnaires according to ATS / ESR guidelines were used, respectively. Data were analyzed by SPSS software version 18 using Mann-Whitney U, Chi-square, and Studentchr('39')s T-test.

Mean age of participants was 35.59±1.13. 54% of participants had no respiratory symptoms. The most common respiratory complain were dry and exudative cough. The work field was the only influential factor in FVC%. Age and work experience, and exercise no significant effect on respiratory parameters. Overall spirometry parameters were in the normal pattern range, and only 5% of participants showed a mild restrictive pattern.

Spirometric pulmonary function of Yazdchr('39')dental laboratory technicians was in the normal range, and possibly working in the dental laboratory did not have a significant effect on the pulmonary Function of technicians based on spirometric indices.

 Due to the importance and necessity of accident analysis, it is necessary to use the proper technique for precise accident analysis and provide corrective and preventive measures to prevent an accidentchr('39')s recurrence.
 In this descriptive-analytical paper, the most important criteria for investigating and selecting accident investigation and analysis techniques and selecting the best accident analysis method were identified in critical industrial accidents in the construction phase, were identified and analyzed. In this study, the most important criteria for selecting an accident analysis method were identified using previous research and gathering expert opinions. Then, two critical power plant accidents were analyzed using TRIPOD BETA and FTA accident analysis methods. Then the pairwise comparisons matrix was formed based on the strengths and weaknesses of the models. Finally, the prioritization of these two methods was done using the hierarchical analysis decision-making method. 
 In this paper, seven key factors, model realism, model descriptive, systematic modeling, run time, required training courses, ability to quantify, and visibility of events, were identified as the most important criteria for selecting an incident analysis method.
 The TRIPOD BETA method has been introduced as an optimal method for investigating specific events due to its capabilities.

 Stroke is considered a relatively common disease in developing societies. This disease is one of the most important causes of sudden non-cardiac incapacity. On the other hand, the disease can naturally occur in working-age and drivers. Therefore evaluation of the fitness for work in a driver with a history of stroke can be a significant challenge for the occupational health physician and road safety. 

 In this study, to identify the main indicators and evaluate job fitness in a driver with stroke history, research has been conducted in valid databases such as Embase, UpToDate, PubMed, Medline (Ovid), Scopus, and web of science. Indicators that should be considered in this evaluation include the type and severity of the stroke, the probability of recurrence of the stroke attack, the degree and type of limb defect in the driver following the stroke, etc. Also in this study has been paid to some guidelines for help in deciding how to continue driving.

Stroke is the most common acute neurological disease among working-age adults. About a quarter of strokes occur at working age. Cerebrovascular disease can lead to sudden disability. Approximately 50% of people with stroke in developed countries want to continue driving.

 Things such as the probability of occurrence of stroke and sudden incapacity in the future and comparing this amount with acceptable risk and the amount of limb defect caused by stroke and its interference with driving should be considered. Also, consumption medications and their side effects and other comorbidities should be considered in this job fitness evaluation.