Factors Associated with the Return to Work after Carpal Tunnel Release Surgery: A Cross-Sectional Study of the Worker Population.

Background: There is controversy regarding the factors influencing the duration of sickness absence and return to work (RTW) after surgical treatment of carpal tunnel syndrome (CTS). This study aimed to determine factors related to RTW in these patients. Methods: This descriptive-analytical study was performed on all patients with CTS who underwent surgery in a main orthopaedic centre from December 2020 to April 2021. Patients were followed for 90 days after surgery for the RTW. The patients were classified into two groups based on the time of RTW, early (<21 days) and late (>21 days). These two groups were compared in terms of occupational, individual and disease-related factors and the type of surgery. Results: The mean time to RTW in patients was 23.2 ± 7.1 days, with a range of 7-60 days. There was a statistically significant relationship between early RTW and gender (female) (p = 0.005 OR = 6.5), non-manual work (p = 0.002 OR = 1.2), the total score of the Boston carpal tunnel questionnaire before surgery and job satisfaction (p = 0.04). The mean time to RTW in patients who underwent open surgery was less than in endoscopic surgery (22.89 ± 6.29 vs. 24.58 ± 4.7), but this difference was not statistically significant (p > 0.05). Conclusions: Based on the findings of our study, the type of surgery does not affect the RTW of patients with CTS. Considering the effect of job type and job satisfaction on RTW, it is recommended to pay attention to the type of occupation in addition to the type of surgery so that this workforce can RTW with good performance. Level of Evidence: Level IV (Therapeutic).

Effect of Lipid Profile Parameters on Noise Induced Hearing Loss.

Background: Noise induced hearing loss (NIHL) is an irreversible occupational disease among industrial workers. Recent studies have reported that changes in some metabolic factors such as the serum level of sugar and lipids might have a role in suffering from NIHL among workers exposed to noise. We designed this study to assess the association between lipid profile changes and NIHL occurrence among noise-exposed workers. Methods: This case-control study has been conducted according to noise-exposed workers registry data in one of the Iranian automobile factories between 2007 and 2017. We classified study workers into the NIHL and control groups. We assessed the impact of lipid profile parameters across the study groups using the independent samples t-test, chi-square, and regression. Results: The mean serum level of cholesterol was significantly higher in the NIHL group than in workers of the control group (215.27 ± 60.30 vs 204.49 ± 63.69 mg/dL; P = 0.041). Moreover, the serum level of HDL was significantly lower in workers in the NIHL group compared with the control group (35.21 ± 6.87 vs 37.43 ± 7.28 mg/dL; P < 0.001). Although other lipid profile parameters (LDL, TG, LDL/HDL ratio) were higher among workers of the NIHL group, their differences were not significant. Conclusion: A cholesterol level lower than 200 mg/dL is known as a protective factor and an HDL level lower than 40 mg/dL is an NIHL risk factor. More attention should be paid to controlling serum levels of cholesterol and HDL.

The Effect of Active and Passive Smoking on Hearing Loss in Noise-Exposed Metal Workers.

Background: Many people are exposed to cigarette smoke actively or passively. We aimed to determine the effect of active and passive smoking on hearing thresholds and hearing loss noise-exposed workers. Methods: This cross-sectional study was conducted on 929 metal workers. We divided the workers into 3 groups according to smoking status-current smokers, nonsmokers, and passive smokers. Audiometric testing was recorded for both ears. Hearing loss was defined by 3 models. The SPSS software Version 24 was used to analyze the collected data. We used an independent t test, chi-square, Fisher exact, and analysis of variance tests and logistic regression, and the significance level was set at P ˂0.05 to interpret the relationships between variables. Results: The hearing threshold levels at 4000 Hz, high frequencies, and low frequencies were significantly higher in smokers than nonsmokers (P < 0.05). Also, and hearing loss at the 4000 Hz (P = 0.002; odds ratio [OR] = 1.96; 95% CI = 1.27-3.03) and high frequencies (P = 0.001; OR = 2.15; 95% CI = 1.36-3.4) had a significant correlation with smoking. Hearing loss was significantly correlated with passive smoking at 4000 Hz (P < 0.001; OR = 5.87; 95% CI = 3.29-10.47), high frequencies (P < 0.001; OR = 7.16; 95% CI = 3.97-12.89) and low frequencies (P = 0.021; OR = 4.16; 95% CI = 1.12-15.43). Conclusion: The findings show that active and passive smokers who work in noisy environments are at higher risk for noise-induced hearing loss. Therefore, smoking cessation in smoker workers and reduction of environmental exposure to cigarette smoke is necessary to reduce the exacerbation of hearing loss. Moreover, more attention should be paid to passive smokers and they should be given priority in the same programs.

Predictor Factors of Return to Work in Workers with Kidney Transplantation in Iran: A Retrospective Cohort Study.

INTRODUCTION: Return to work after a kidney transplantation in a previously functioning person is determined by a number of medical and non-medical factors. In this regard, this study was to investigate the factors that influence return to work in kidney transplant recipients. METHODS: This retrospective cohort study was conducted in patients with kidney transplant in the main nephrology center in Tehran (December to April 2022). The primary outcome was the cumulative rate of return to work at 3, 6, and 12 months after transplantation. The secondary outcome was to compare the occupational, individual, and disease-related factors between patients who had returned to work and those who had not. RESULTS: Among 214 kidney transplant recipients, the overall cumulative rate of return to work after kidney transplantation at 3, 6 months, and 12 months were 44.4%, 63.1% and 69.6%; respectively. According to the univariate analysis, male sex, age less than 40 years, nonphysical jobs, job satisfaction, employer support, partner support, and absence of diabetes mellitus significantly affected the time of return to work (P < .05). According to the multivariate analysis, absence of diabetes mellitus, nonphysical jobs and job satisfaction had greater impact on the time of return to work (P < .05). CONCLUSION: The results showed that older age, female gender, having a physical job, the presence of diabetes mellitus, lack of job satisfaction, and employer and partner support are associated with not returning to work in these patients and adjusting factors linked to the work environment and support of colleagues and supervisors might play an important role in improving the general condition of these patients.  DOI: 10.52547/ijkd.7210.

Work-related Hazards Among Pathologists and Residents of Pathology:Results of a Cross-sectional Study in Iran.

BACKGROUND & OBJECTIVE: Pathologists as medical professionals involved in the diagnosis and planning of therapies in many diseases are exposed to occupational hazards in workplaces. Hence, we aimed to determine the occupational health problems among Iranian pathologists in this cross-sectional study. METHODS: This cross-sectional study was conducted among the Iranian pathologists. The data required for this study was collected through a self-reported questionnaire containing 48 questions about major occupational health problems, including musculoskeletal problems, visual disorders, workplace characteristics, health behavior, and other medical conditions. RESULTS: Among the study participants (N=350), 87.4% presented with musculoskeletal disorders in the past year, with the neck as the most common location of pain (71%). Musculoskeletal pain was significantly higher in those working with the computer for more than 5 hours per day (P=0.007). Furthermore, 273 (78%) participants reported visual refractive errors, and myopia was the most common error (53%). Acute injuries were reported in 263 (75%) participants, and the cutting injury had the highest frequency (56.6%). Depression was reported in 54 (15.4%) of the participants, followed by burnout (10.3%) and hypertension (4%). Intolerance reactions to formalin were reported by 222 (63.6%) and were significantly more frequent among the residents (P<0.001). The residents were more prone to musculoskeletal pain (P=0.002) and injury (P=0.026). CONCLUSION: We observed a noticeable prevalence of health risks, including musculoskeletal problems, visual disturbances, injuries, and ergonomic problems among the Iranian pathologists. Solving these problems demands thorough prevention and personal protection, as well as educational programs with more attention toward optimization of ergonomics in the workplace and awareness about chemical and biological hazards.

Impact of two ergonomics training on prevalence of upper and lower extremity complaints among nurses.

BACKGROUND: Musculoskeletal disorders (MSDs) were known as one of the main occupational problems among health-care workers. However, we had some limitations and difficulties for transferring ergonomic concepts to the health-care workers, especially nurses due to heavy work task and insufficient time for that. This study compares the impacts of two ergonomic training methods (lecture and pamphlet) in nurses of an Iranian tertiary hospital on prevalence of their upper and lower extremity complaints. MATERIALS AND METHODS: In the present randomized clinical trial with parallel groups, 1140 nurses were randomly selected and allocated to the control and two interventional groups. In the interventional groups, nurses revived a training program and pamphlet as ergonomic training methods about work-related MSDs and related ergonomic concept to MSDs prevention and nurses in the control group, did not receive any ergonomic training methods. Upper and lower extremity complaints measure among study nurses with Nordic MSDs before 6 months and 1 year after trial intervention. Statistical analysis including the Kolmogorov-Smirnov goodness-of-fit, Chi-square test, and independent sample t-test was performed using SPSS version 22. A two-tailed P ≤ 0.05 was considered statistically significant. RESULTS: At the first and second parts of the study follow-up, the prevalence of upper and lower extremities significantly improved in the interventional groups in comparison with the control group. Moreover, between the two trial groups, the frequency of MSDs in upper and lower extremities significantly improved among nurses of the pamphlet group in comparison with the lecture group. CONCLUSION: Findings of the study showed that we can use pamphlet as a suitable tool for describing ergonomic concepts in comparison with lecture among nurses.

Ergonomic intervention to reduce musculoskeletal disorders among flour factory workers.

BACKGROUND: Work-related musculoskeletal disorders are the most common occupational health hazards. In the flour production industry, the fast pace of work, high frequency of repetitive movements, manual handling of loads, and awkward postures put a lot of pressure on the worker's body. OBJECTIVE: Given the high exposure of the workers of the flour production industry to ergonomic risk factors, this study aimed to reduce the rate of musculoskeletal disorders among a group of flour factory workers through ergonomic interventions. MATERIALS AND METHODS: This interventional study was performed using the census method on the eligible workers of a flour factory. An ergonomic intervention program was planned and implemented with the goal of reducing musculoskeletal disorders. The effectiveness of the program was evaluated by measuring the prevalence of musculoskeletal disorders before and six months after the interventions. RESULTS: Before the intervention, musculoskeletal disorders were most prevalent in the lower back, arms, shoulders, legs, thighs, knees, neck and wrists, respectively. Evaluation of the prevalence of musculoskeletal disorders after the intervention showed the positive effect of the ergonomic intervention program on musculoskeletal disorders in the neck, shoulders, lower back, thighs, knees, and legs (P < 0.05). CONCLUSION: Engineering and management interventions implemented in this study led to a significant reduction in the level of ergonomic risk factors and a reduced rate of musculoskeletal disorders among workers of different units in the flour factory.

Assessment of Pulmonary Function Parameters and Respiratory Symptoms in Shipyard Workers of Asaluyeh City, Iran.

BACKGROUND: Workers in shipyard companies are exposed to different respiratory hazards. The present case-control study was designed to evaluate pulmonary function tests and respiratory symptoms among shipyard workers in Asaluyeh city in Southwest Iran. MATERIAL AND METHOD: Between March and October 2015 we recruited participants from two separate populations: shipyard workers as cases and office workers from the same shipyard company, who are not exposed to the same respiratory hazards, as controls. History was obtained from all participants and they all underwent physical examination and spirometry. RESULTS: Respiratory signs and symptoms were present in a significantly higher number of shipyard workers compared to the unexposed office workers. Similarly, there were significant spirometric differences between cases and controls. CONCLUSION: It seems that workplace hazards play a more significant role than other factors such as air pollution in development of respiratory diseases, and future studies for investigating respiratory symptoms, pulmonary function parameters, biological monitoring and measurement of respiratory hazard need to be performed.

Factors associated with the severity of fatal accidents in construction workers.

Background: Construction work (building houses, roads, workplaces, and repairing and maintaining infrastructures) is a dangerous land-based job. This includes many hazardous tasks and conditions such as working at the following conditions: Height, excavation, noise, dust, power tools and equipment. Construction work has been increased in developed and underdeveloped countries over the past few years. Occupational fatalities have increased with an increase in this type of work. Occupational fatalities refer to individuals who pass way while on the job or performing work related tasks. In the present study, to identify the factors, personal characteristics and work-related factors associated with fatal occupational mortality were assessed using data for Tehran, Iran, 2014-2016. Methods: We conducted a retrospective study, using 967 postmortem reports from fatal occupational injuries collected through postmortem investigations during 2014-2016. A sampling frame of 967 postmortem reports from fatal occupational injuries was used to draw a total sample of 714 fatal construction accidents for this cross-sectional study. Pearson χ2 test and Kruskal-Wallis tests were used for statistical analysis. Results: Based on the results of this study, male gender (n=714; 100%), age range of 30-39 years (n=183; 25.6%), secondary educational level (n=273; 38.2%), being married (317; 44.4%), causal employee (n=389; 54.5%), unskilled performance (389; 54.5%), no insurance coverage (472; 66.1%), and daytime duty work (287; 40.2%) were identified as risk factors for fatality in the event of construction fatal injury. A significant relationship was found between the type of injury and sociodemographic and work related variables. Conclusion: Workers' characteristics such as age, gender, experience, and educational background, and work related variables such as skill training, safety measurement, and close monitoring could be used to discriminate among different severity levels of occupational fatal accidents.

Work-related stress and quality of life among Iranian blue-collar workers with self-reported low back pain.

Background: Impairment in quality of life and mental health had been reported in the previous studies as the results of musculoskeletal disorders among workers. Mental health has a wide concept and contains different disorders including anxiety, depression or even decreased quality of life, all of which having challengeable impacts on work- related characters such as work productivity and absensism. The present study aimed at evaluating work- related stress and quality of life among Iranian blue-collar workers of Fars ABFA Company with selfreported low back pain. Methods: In the present study, we focused on the low back pain among 451 blue-collar workers and assessed their work- related stress and quality of life status using DASS-21 and short form questionnaire (SF-36), respectively. Independent sample t-test was used to compare the qualitative variables, and chi-square test was utilized for statistical analysis of the qualitative variables. Results: Mean of the total score of quality of life among workers with low back pain was significantly lower than in those workers without low back pain. The mean of work- related stress score was significantly higher in workers with low back pain than in workers without low back pain. The mean quality of life subdomains in patients with low back pain was significantly lower than in workers without low back pain. Conclusion: Findings of the present study revealed that workers with low back pain had lower quality of life score and higher work- related stress score. These findings should be considered in designing preventive programs rather than controlling the pain.

The effect of magnification lenses on reducing musculoskeletal discomfort among dentists.

Background: Work-related musculoskeletal disorders are the most important problems in the health workforce. These discomforts cause many working days losses, increase absenteeism from work, and impose annual economic costs. Awkward posture is the most important factor among the risk factors for work-related musculoskeletal disorders. This study aimed at implementing an interventional ergonomic program to minimize musculoskeletal disorder among dentists. Methods: This semi- experimental study was conducted on 75 dentists of Milad hospital using a census method. The Nordic Questionnaire was used to determine the prevalence of musculoskeletal disorders. In this study, the intervention was to apply optical magnification lens whose impact on reducing musculoskeletal disorder had been previously investigated. Corlett and Bishop Scale was used to evaluate musculoskeletal disorders before and after the intervention. Paired t-test was conducted to compare the discomfort intensity before and after the intervention. Results: The results revealed that the prevalence of musculoskeletal disorders in neck, back, shoulder, and arm were higher than other areas of the body in dentists. There was a significant difference in discomfort intensity of the neck, shoulder, arm, back, elbow, forearm, and the whole body after the ergonomic intervention (p<0.05). Surveys on improving working conditions using the magnification lens revealed that more than 89% of the individuals expressed that the use of the lens increased the ease while working. Conclusion: The present study revealed that the use of optical magnification loupes, because of providing a suitable posture while working, could reduce musculoskeletal disorders in different areas of the body. Thus, we can predict that the prevalence of musculoskeletal disorders will be reduced in dentists in a long run if they use optical magnification loupes.