Sleep quality in long haul truck drivers: A study on Iranian national data / 中华创伤杂志(英文版)

<p><b>PURPOSE</b>Iran has a high rate of road traffic accidents. Poor quality of sleep brings about loss of attention, which is an important cause of road traffic accidents particularly in monotonous roads. The causes of poor quality of sleep in occupational drivers are multifactorial. The objective of the present study was to assess the prevalence of poor sleep quality among occupational drivers with rotating work schedules and analyze its different risk factors.</p><p><b>METHODS</b>2200 professional long-haul truck drivers who had been referred to the Occupational Health Clinic for routine education course were invited. We obtained data from eight provinces from various parts of Iran during 2012-2013. Data were collected using a questionnaire including questions about demographic and job characteristics. Pittsburg Sleep Quality Index (PSQI) was used to assess drivers' sleep quality.</p><p><b>RESULTS</b>Mean working (driving) time was (9.3±2.5) hours daily and (55.5 ± 18.29) hours weekly. About 23.5% of the drivers reported history of smoking, 14.5% had low job satisfaction and 60% had irregular work schedule. 16.4% of drivers had an accidents leading to injury during the past five years. The mean PSQI score was 4.2 ± 2.7; 54% had a PSQI>5 (poor quality of sleep). Multivariate logistic regression showed that smoking, job satisfaction, history of accidents, shift work and work hours per day were the most important risk factors for poor sleep quality.</p><p><b>CONCLUSION</b>Results obtained from the current study showed a high prevalence of poor quality of sleep among professional drivers. It warrants more attention to this significant problem using some measures to improve working conditions in professional drivers, as well as health promotion interventions.</p>

Traffic crash accidents in Tehran, Iran: Its relation with circadian rhythm of sleepiness / 中华创伤杂志(英文版)

<p><b>PURPOSE</b>Road traffic accidents are one of main problems in Iran. Multiple factors cause traffic accidents and the most important one is sleepiness. This factor, however, is given less attention in our country. Road traffic accidents relevant to sleepiness are studied.</p><p><b>METHODS</b>In this cross-sectional study, all road traffic accidents relevant to sleepiness, which were reported by police, were studied in Tehran province in 2009.</p><p><b>RESULTS</b>The risk of road traffic accidents due to sleepiness was increased by more than sevenfold (odds ratio = 7.33) in low alertness hours (0:00-6:00) compared to other time of day. The risk of road traffic accidents due to sleepiness was decreased by 0.15-fold (odds ratio = 0.15) in hours with maximum of alertness (18:00-22:00) of circadian rhythm compared to other time of day.</p><p><b>CONCLUSION</b>The occurrence of road traffic accidents due to sleepiness has significant statistical relations with driving during lowest point of alertness of circadian rhythm.</p>

Respiratory symptoms and pulmonary function tests among Galvanized workers exposed to zinc oxide

Background: Galvanization is the process of coating steel or cast iron pieces with a thin layer of zinc allowing protection against corrosion. One of the important hazards in this industry is exposure to zinc compounds specially zinc oxide fumes and dusts. In this study we evaluated chronic effects of zinc oxide on the respiratory tract of galvanizers

Method: 188 workers were selected from a galvanization plant, 71 galvanizers as exposed group and 117 workers from other departments of plants as control group. Information was collected using American Thoracic Society [ATS] standard questionnaire, physical examination and demographic data sheet. Pulmonary function tests were measured for all subjects. Exposure assessment was done with NIOSH 7030 method

Results: The Personal Breathing Zone [PBZ] air sampling results for zinc ranged from 6.61 to 8.25 mg/m[3]] above the permissible levels [Time weighted average; TWA: 2 mg/m[3]]. Results showed that the prevalence of the respiratory symptoms such as dyspnea, throat and nose irritation in the exposed group was significantly more than the control group. Decreasing in average percent in all spirometric parameters were seen in the galvanizers who exposed to zinc oxide fumes and dusts. The prevalence of obstructive respiratory disease was significantly higher in the exposed group

Conclusions: Results suggest that high workplace zinc levels are associated with an increase in respiratory morbidity in galvanizers

Cross-shift study of acute respiratory effects in cement production workers

Cement dust exposure is associated with increased respiratory impairment. As the major occupational hazard in the cement production industry is cement particles, our aim was to more thoroughly examine the acute effects of occupational exposure to cement dust on the respiratory system. A cross-shift study was conducted in a cement factory in Iran. 100 high exposed workers from production and packing sections and 100 low exposed from office workers were included. Environmental total dust was measured in each section. Assessment of lung function was done by pre and post shift spirometry. At the end of the day shift, acute respiratory symptoms were recorded. The means of total dust among high and low exposed workers were 16.55 mg/m3 and 0.9 mg/m3, respectively. The most common acute respiratory symptoms in high exposed workers were stuffy nose [52%] and shortness of breath [49%]. A statistically significant post shift reduction in PEF, FEV1, FEF 25-75, FVC and FEV1/ FVC was demonstrated in high exposed group. Multivariate linear regression showed a significant relationship between the percentage of the cross-shift decrease in spirometric indices and exposure to cement dust. We detected significant relationship between exposure to cement dust and acute respiratory symptoms and pulmonary function indices. Effective dust-control measures and preparing a suitable strategy for respiratory protection are highly recommended

Epigastric and umbilical hernia; work relatedness and return to work

Abdominal wall hernia is common but reliable scientific data about its work relatedness is very limited and inconsistent. In this paper, a less common type of abdominal wall hernia in a 30 year old male worker is presented with recurrence after first surgery when he returned to work. In contrast with almost all kinds of hernia, a lifelong limitation for heavy lifting was recommended. It seems that contrary to popular belief, work relatedness of abdominal wall hernia is seriously doubtful, although conclusive evidences are not enough. It is preferable to make decisions cautiously for return to heavy duties of work after surgery of large umbilical, umbilical and epigastric or incisional hernia, while avoiding recommendations for long days off work after surgery of any hernia

Sleep quality of professional firefighters

Firefighting is a unique job with contradictious demands that expose firefighters to many well documented causal factors of sleep debt, but no studies in Iran and only a few worldwide studies have investigated their sleep quality while sleep problems may lead to catastrophes especially in critical service workers. The aim of this study is to evaluate sleep quality and its related factors among a sample of professional Iranian firefighters. Using simple random sampling method in a cross-sectional study, 427 personnel of fire and rescue service were invited. They completed the Persian version of Pittsburgh Sleep Quality Index [PSQI] and a data collection sheet about their demographic and occupational features during an individual face to face interview in central office and firehouses throughout Tehran. Response rate was 88.7%. The mean +/- SD global PSQI score was 7.97 +/- 3.77. Sleep latency was the component of PSQI with the greatest degree of abnormality. 69.9% of participants were poor sleepers. Interestingly, we found no significant differences between sleep quality of shift workers and non shift workers. Using multiple logistic regression analysis, only having another job, smoking and years of job experience were predictors of poor sleep. In comparison with adult population of Tehran, sleep quality deterioration is notably more common in Tehran firefighters which require health promotion interventions to prevent its serious adverse outcomes

Asthma symptoms and specific IgE levels among toluene diisocyanate [TDI] exposed workers in Tehran, Iran

Toluene diisocyanate [TDI] is an imperative chemical substance used in the production of polyurethane foams, elastomers, paints and coatings that cause a variety of health problems in workers who are exposed in work places. This study aimed to determine the asthma symptoms and serum specific IgE levels in TDI exposed workers and comparing the results with healthy control group. All the plants that use TDI in the manufacturing of paint and glue in the west of Tehran Province entered to the study and all the workers [550] completed modified initial questionnaire of the NIOSH, the questions were consisted of asthma symptoms. For each symptomatic exposed worker one healthy, sex and age matched control selected. Total IgE and Specific TDI IgE tests were done for each case and control groups. Among 550 TDI exposed workers, 26[4.7%] had asthma symptoms. Nine [34.6%] of symptomatic workers who were exposed to TDI were active cigarette consumer versus 3[11.5%] unexposed workers, P=0.049[CI= 0.953-17.29] OR=4.059. Nine [34.6%] workers had positive family history of atopy versus 1[3.8%] unexposed workers, P=0.0138 [CI= 1.45-305.41] OR=13.24. TDI specific IgE was found in 2 TDI exposed workers and 1 unexposed worker [P=0.5]. Mean of total IgE was 339.05 in exposed workers [P=0.201]. This study provides clinical and paraclinical data of workers exposed to TDI and points to a relation between atopy and smoking habit with asthma symptoms that offer preventing recommendations for TDI exposed workers and their heath administrators

[Comparative assessment of low back pain and its determinants among Iranian male general dentists and pharmacists]

Regarding the diversity of reported low- back pain among dentists in different countries and lack of control group in most of the previous studies, the purpose of this study was to compare low- back pain and related risk factors between male general dentists and pharmacists to determine the relation between dentistry and development of low back pain. In this cross-sectional study, 261 male dentists were compared with 193 male pharmacists as a control group with Standardized Nordic Questionnaire [low back section]. Subjects were at least one year in clinical practice after becoming qualified and did not suffer from connective tissue diseases and history of a traumatic event causing fracture in spinal column. The data were analyzed by Chi- square, T-test and logistic regression analyses. The prevalence of low back pain in the past 12 months was 54.8% in male dentists and 36.3% in male pharmacists [P=0.001]. Logistic regression analyses, adjustmenting for occupation, age, body mass index [BMI], smoking, working years and working hours per week, revealed that there was a significant association between being a dentist and having low- back pain [OR=2.54, P=0.001]. Dentistry as a profession in male gender is associated with low back pain, independent of age, body mass index [BMI], smoking, working years and working hours per week.

Validity and Reliability of the Iranian Version of the Insomnia Severity Index

Background: The Insomnia Severity Index (ISI) is a short subjective questionnaire which helps physicians in making decisions about patients suffering from insomnia. The present study was an attempt to test the reliability and validity of the Iranian version of the ISI and to measure the correlation between ISI items and polysomnography results in chronic insomnia patients. Methods: Two groups responded to the Persian translation of four questionnaires; ISI, Pittsburg Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), and General Health Questionnaire (GHQ). The first group consisted of 135 patients diagnosed with chronic insomnia, and the second group was comprised of 55 normal people. After completing the questionnaires, the insomniac patients underwent standard overnight polysomnography. Results: The internal consistency demonstrated by Cronbach’s alpha coefficient was above 0.8 for both groups. The Intra-class correlation coefficient was above 0.7 after two weeks for both groups. The correlations between ISI, PSQI, ESS, and GHQ were high. In addition, close correlations were found between scores obtained from the ISI questionnaire items in insomniac patients with corresponding polysomnographic variables. Conclusion: The Iranian version of the ISI is a reliable and valid instrument. It is a valuable short and first-line questionnaire for insomnia research and clinical work.

[Effect of exercise on quality of sleep in post-partum women]

Rapid changes experienced after child birth expose mothers to unpleasant experiences such as disturbances in sleep pattern. These experiences threaten health of mothers and infants. Some studies have shown that exercise can be an effective and nonpharmacologic method in improving sleep quality. The purpose of this study was to examine the effect of exercise on sleep quality among postpartum mothers. This was a randomized clinical trial. Eighty primiparous women aged 18-35 years were recruited from health centers in Rafsanjan in 2009. The inclusion criteria were singleton pregnancy, lack of any acute and chronic physical and mental illnesses, having healthy and term babies, and having vaginal deliveries. Participants were randomly allocated to the intervention [n=40] and control [n=40] groups. Women in the intervention group received five 30-minutes sessions of Pilates weekly for eight weeks. The PSQI instrument was used to measure the related variables at baseline, forth and eighth weeks after the deliveries. Data were analyzed using the repeated measures ANOVA. Significant improvement was seen in the intervention group within eight weeks follow-up; the interaction within time and group was significant [P=0.02]. Comparison of mean sleep quality between the two groups has shown that the intervention was effective [P<0.001]. The Pilates exercise was effective in improving quality of sleep in postpartum period

Musculoskeletal disorders in female dentists and pharmacists: a cross-sectional study

Musculoskeletal disorders are an important occupational health problem in dentistry. Few studies have compared these disorders in dentists with other occupational groups. We assessed musculoskeletal disorders in female dentists in comparison with female pharmacists. A cross-sectional study by means of Musculoskeletal Nordic Questionnaire was performed among 191 female general dentists and 211 female general pharmacists who were at least one year in clinical practice and selected using the random sampling method. Those with a history of a traumatic event causing fracture in spinal column or extremities and connective tissue diseases excluded. The data were analyzed by univariate and multivariate logistic regression analyses. 91.6% of the female dentists and 87.7% of the female pharmacists reported having at least one musculoskeletal symptom in the previous 12 months. 12-month period prevalence symptoms of neck [OR=3.17], upper back [OR=2.19] and upper extremity [OR=1.99] had the most ORs in comparison of dentists to pharmacists. In summary, female dentists are at risk of developing musculoskeletal disorders particularly in the neck, upper back and upper extremities.

Urinary beta 2 microglobulin in workers exposed to arc welding fumes

Welding is a process in which two or more metals are attached by the use of heat and, in some cases, pressure. Direct exposure and inhalation of welding fumes causes acute and chronic side effects in humans. Kidney damage is one of these important side effects. beta 2 microglobulin is an 11.8 kilodalton protein and levels increase in the case of some inflammatory and viral diseases, or kidney malfunction and autoimmune diseases. In this study measurements of beta 2 microglobulin were used as a criterion for assessing effects on the kidneys of workers exposed to welding fumes. The study population were electric arc welders in an industrial plant in Tehran, Iran. For control we selected workers who did not have any exposure to welding fumes. Both groups were selected on the basis of a questionnaire and the consideration of criteria for inclusion and exclusion. In the end 50 cases and 50 controls were chosen. A urine sample was collected from all participants and urinary pH was set to between 6-8 using NaOH [1M]. Sample transportation to the laboratory complied with the related standards. The samples were assessed using the ORG 5BM kit. For quantitative assessment of beta 2 microglobulin we used the Enzyme-linked Immunosorbent Assay [ELISA] method. The ages of the welders ranged from 21 to 48 years [mean=30.5 +/- 5.9 yrs] and of controls from 23 to 56 years [mean=31.8 +/- 5.9 yrs]. Mean employment duration was 7.86 +/- 5.01years [range 2 to 27 years] for welders. Mean beta 2 microglobulin level was 0.10 +/- 0.096 ?g/ml in welders and 0.11 +/- 0.06 in controls. This difference was not statistically significant [P=0.381]. In conclusion we don't find that exposure to electric arc welding fumes cause a significant change in urinary beta 2 microglobulin compared to the control group