Assessment of the relationship between the return to work and the severity of work-related upper limb injuries using the whole person impairment / 中华创伤杂志(英文版)

PURPOSE@#Upper limb disorders are one of the most common and important types of occupational injuries. Besides, identifying the factors influencing return to work following these injuries is essential to reduce the dimensions of the problem. In this study, we investigated the return to work and associated factors following occupational injuries leading to upper limb impairment.@*METHODS@#In this retrospective cohort study, the rate of return to work and associated factors were assessed in 256 workers with work-related upper limb injury referred to a teaching hospital from March 2011 to December 2018. The inclusion criterion was a history of occupational injury resulting in upper limb impairment, and exclusion criteria included the presence of simultaneous impairment in other organs, congenital or non-occupational limb defects as well as patients with incomplete information in their medical records. Individuals' records, including age at the time of injury, gender, date of injury, marital status, education, level of amputation and injury, whole person impairment (WPI) and physiotherapy (prescribed by the physician) were reviewed. The WPI was calculated to assess the extent of the injury. All analyzes were performed by SPSS version 25.0.@*RESULT@#The rate of return to work was 54.3%, in which 51.8% for the same job and 48.2% for a new job. The main factors associated with non-return to work were more days off work (p = 0.001), higher injury severity (p = 0.001), and dominant hand injury (p = 0.034).@*CONCLUSION@#The number of days off work, the WPI, and dominant hand injury are the most important determinant in returning to work. In addition, increased job satisfaction and support from co-workers and employers are work-related factors that can lead to an increased return to work.

Knowledge and practice assessment of workers in a pharmaceutical company about prevention of coronary artery disease

Coronary artery disease is one of the most common reasons of death around the world. Also, according to previous studies, the incidence of coronary artery disease is rapidly increasing in developing countries such as Iran. The aim of this study was to evaluate the knowledge and practice of pharmaceutical company workers towards the prevention of cardiovascular disease. In this cross sectional study that was conducted in Tehran, 1223 workers of a pharmaceutical company were enrolled. Data was collected using a questionnaire that assessed the level of knowledge and practice of the participants towards coronary artery disease. Regression analysis was used to evaluate the relationship between study variables and the workers knowledge level. The results of this study showed that 49% of the workers were in a good level of knowledge and according to the regression analysis, the female gender, age above 28, education level higher than high school diploma, body mass index above 25 kilograms per square meters, history of hyperlipidemia, history of diabetes, history of hypertension, history of myocardial infarction, daily activity and exercise, were significantly related to a good knowledge towards coronary artery disease. In addition, the mean score of the participants' performance in preventing coronary artery disease was 4.66 out of 9. The results of this study showed that increasing level of knowledge of labors in order to prevent missing specialized work force, leads to imposition of health costs to the industry and the labor society

[Occupational stress and influencing factors, in medical residents of one of the educational hospitals of Tehran University of Medical Sciences]

Occupational stress is one of the most common hazards in workplaces and leads to different physical, mental, and behavioral outcomes and complications. Medical residents, due to the nature and characteristics of their job, confront various stressors. This study has been designed in order to identify the frequency of occupational stress in medical residents and factors influencing it. This cross-sectional study was conducted on 305 residents with various specialties in Rasoul-e-Akram Hospital on spring 1389. For measuring the degree of stress, we used Osipow occupational stress inventory. T-test, Chi-Square, ANOVA and Logistic regression were used to evaluate associations. Response rate was 87%. Most of the residents had moderate stress. Average score of total stress was 147.06 from 250. The most frequent stressor was work overload [31.05 from 50] and responsibility [29.55 from 50]. Stress significantly increased with shift work [OR=4.591, CI=1.31-16.13, p=0.017], surgery [OR=3.769, CI=2.10-6.76, p=0.001] and also correlated with lower rest time [OR=1.962, CI=1.12-4.08, p=0.048] and higher weekly work hours [OR=1.242, CI=1.10-2.34, p=0.050]. The most frequent stressors were work overload and responsibility, so it is recommended that in order to reduce stress, work hours must be limited and the residents must be strongly supported. In addition, some education and consultation for specialty choice must be given to the physicians

[Effects of cigarette smoking and contemporary noise exposure on hearing loss]

Both cigarette smoking and noise exposure have a common pathway to produce hearing loss. In this study, effects of cigarette smoking on hearing loss, in assembly line employees of one of the automobile plants in Iran, who were exposed to noise with more than permissible level, were examined. A case-control study was conducted in an automobile plant in order to assess the effects of contemporary exposure to excessive noise and smoking. Male workers of the assembly part were divided to cases [smokers] and controls [nonsmokers] groups. All workers were exposed to excessive noise. Hearing loss was defined in two models and effects of smoking on hearing loss were evaluated with statistical analysis. According to model 2, severity of hearing loss was higher in smokers group than nonsmokers group [odds ratio: 6.94 95%CI: 4.54-10.64]. Both models of hearing loss, even after adjusting for other variables, were significantly higher in smokers group [p<0.001]. Smokers who are working in areas with excessive noise are more susceptible to noise induced hearing loss. So, their hearing system must specially be assessed in periodic exams

Hearing impairment due to cigarette smoking and simultaneous exposure to occupational noise

Noise is the most common hazard in the workplace and noise induced hearing loss considered to be the most common occupational disease as well. Cigarette smoking, in some studies, has been known to induce hearing loss. The purpose of this study was to evaluate the effect of contemporary exposure to occupational noise and cigarette smoking on hearing. 478 assembly workers of an automobile plant which were exposed to the noise more than TLV [threshold limit value] level included in this study. After considering the exclusion criteria, all participants according to the smoking status were divided in smoker and nonsmoker groups and compared for hearing impairment. Hearing impairment in this study was assessed with the offered method of American Academy of Otolaryngology [AAO]. Of 478 assembly workers, 225 persons were smokers and others non smokers. Prevalence of hearing impairment in smokers was significantly higher [p<0.001]. Hearing impairment had a significant relation with smoking status even after adjusting for cofounders like age and duration of work [OR=8.23, 95% CI=3.63-18.66]. The results of this study suggested that cigarette smokers had more hearing impairment than non smokers. According to these results we concluded that in working environments, especially in noisy ones, workers must be encouraged to quit smoking and regular audiometric tests, especially for smokers, must be applied. We must consider not only the noise, but indeed all effective elements of hearing impairment in working environment that could compromise the hearing

Respiratory complaints and spirometric parameters in tile and ceramic factory workers

Respiratory disorders are among the most common occupational diseases. Tile and ceramic industry is quite popular in Iran and workers in this industry are exposed to harmful dust particles affecting their respiratory system. This study was conducted in a tile and ceramic factory. The study group consisted of factory workers of the production units; whereas, the control group included the executive employees of the factory. A questionnaire was designed covering all the required data. There were a total of 411 workers. After considering the exclusion criteria, 243 workers in the study group were compared with 168 controls in terms of their respiratory status. Respiratory complaints were significantly higher in the study group compared to controls [p=0.023]. Frequency of abnormal spirometric findings was significantly higher in the study group [p<0.001]. A significant correlation was found between the occupational exposure to tile and ceramic dust and abnormal spirometric findings after adjusting for age, duration of employment and smoking habits [p<0.05]. Our study results demonstrated that occupational exposure to ceramic and tile dust can harm workers' respiratory system. Therefore, it is recommended to diminish workers' exposure to tile dust by proper implementation of respiratory protection programs. Also, filling out the standard respiratory questionnaire and performing the pulmonary function tests are advised for workers in their periodic examination programs

Cardiovascular diseases impairment [Coronary Artery Diseases, Hypertension, Arrhythmia]

Cardiovascular diseases are the most common cause of mortality and morbidity in developed and several of developing countries and estimates for 40 - 45% of that. In Iran statistics shows high prevalence of cardiovascular diseases and cardiovascular diseases with accidents are the most important causes of mortality. Health deputy of Ministry of Health reported 70000 deaths from cardiovascular diseases in 2007. Also cardiovascular diseases are one of the most causes of impairment. Cardiovascular impairment is high in Iran because of high rate of cardiovascular diseases, but unfortunately, it has not been paied attention yet and there is no known functional way for impairment assessment. Impairment and disability assessment is a complex and difficult method and physicians should assess impairment based on patients' history, physical and Paraclinical findings, but a team work is necessary for determination of disability based on multiple aspects such as impairment, psychosocial and job of patients