The Risk Assessment of Patient Handling in Hospitals of Northeast of Iran.

The study aim was to determine the risk of Manual patient handling (MPH) in Shahroud public hospitals, Iran. A cross-sectional study was performed in Imam Hossein (IHospital) and Bahar (BHospital) with 21 wards. MPH risk assessment was performed using MAPO (Movement and Assistance of Hospital Patient) index. The ratio of operator to disabled patient (NC/Op and PC/Op), lifting, minor aid, wheelchair, environmental, and training factor are evaluated to calculate MAPO index. Among studied wards 57%, 33.3%, and 9.5%, respectively, were in the high, moderate, and low risk exposure level. The maximum MAPO score were 16.7 in CCU of IHospital. Emergency ward of BHospital had the highest score of 9.8 and PC/OP ratio 17.5. The most risk factors were minor aid (90.5%), lifting factor (71.4%), and PC/OP (66.7%). Immediate ergonomic action is recommended.

Investigating the relationship between job stress, workload and oxidative stress in nurses.

Objectives. Occupational stress and workload are common risk factors among nurses that increase absenteeism, reduce the quality and quantity of patient care, increase care costs and increase the patient safety risk. The relation between these risk factors and oxidative stress levels has not been clearly defined. Methods. This study was conducted with 258 participants (126 nurses as the case group and 132 healthy adults as the control group). Information was collected using a demographic questionnaire, the nurses' occupational stress scale and the NASA task load index workload questionnaire. Blood samples were taken from the participants and then the levels of malondialdehyde (MDA), superoxide dismutase (SOD), catalase and total antioxidant capacity (TAC) were measured in the serum samples. Independent t tests and one-way analysis of variance were used for statistical analysis. Results. SOD and TAC were significantly higher and MDA was significantly lower among the case group compared to the control group. TAC levels significantly decreased with increased stress. MDA levels showed negative associations with stress and workload. Nurses experience high levels of occupational stress and workload. Conclusion. Biomarkers such as SOD, TAC and MDA are the most important predictors of work stress and overwork in this study.

Musculoskeletal disorders and selecting an appropriate tool for ergonomic risk assessment in the dental profession.

BACKGROUND: Work-related Musculoskeletal Disorders (WMSDs) are major challenges in the occupational health services industry. Dental practitioners are regularly subjected to ergonomic risks, which can cause Musculoskeletal Disorders (MSDs) in various body regions. OBJECTIVE: This comparative cross-sectional study aimed to investigate MSDs and select a proper ergonomic risk assessment method in dental practice. METHODS: This study was conducted on 70 dentists and 70 administrative staff of dental offices (comparison group) from Shahroud, Iran. The Cornell Musculoskeletal Discomfort Questionnaire (CMDQ) and two observational ergonomic risk assessment methods, including Quick Exposure Check (QEC) and Rapid Entire Body Assessment (REBA), were utilized. RESULTS: The results suggested that the mean score of musculoskeletal discomforts was significantly higher in dentists than in the administrative personnel. Additionally, the results of multiple regression analysis technique inferred that job tenure, working hours, and age had a significant impact on total MSDs. Regular exercise was found to significantly reduce neck discomfort complaints. It was also found that QEC was more effective in predicting musculoskeletal discomforts compared to REBA. CONCLUSION: Considering the high incidence of WMSDs in dentists, various interventional measures revolving around ergonomically redesigned workstations, enhanced physical working conditions, and ergonomic training courses are suggested.

The role of circadian rhythm stability and amplitude in musculoskeletal disorder prevalence and work-family conflict.

AIM: This study aimed to investigate the effect of circadian rhythm stability and amplitude on musculoskeletal disorder prevalence and work-family conflict among nurses. DESIGN: This cross-sectional study was conducted on 386 nurses working in three hospitals, in Shahroud, Iran. METHOD: The data were collected using the Circadian Rhythm Inventory, Nordic Musculoskeletal Disorders, and Carlson Work-Family Conflict questionnaires. RESULTS: The highest prevalence of musculoskeletal disorders was reported in the lower back (68.4%), upper back (65.5%) and shoulders (53.6%), respectively. No significant relation was found between circadian rhythm stability and amplitude, and musculoskeletal disorders prevalence. The nurses who could not overcome drowsiness reported more Work Interference with Family (WIF), Family Interference with Work (FIW) (time-based) and FIW (strain-based) compared to the nurses who overcame drowsiness. In addition, the appropriate nurses for shift work experienced less WIF, FIW (behavioural-based) and WIF (strain-based) compared to the nurses who could not work overtime or at night.

The effect of chronic exposure to flour dust on pulmonary functions.

Purpose. This study aimed to examine the effect of chronic exposure to flour dust on the pulmonary symptoms and pulmonary indices of mill workers. Methods. The cohort study was conducted on 67 mill workers and 53 controls from 2014 to 2016. Demographic information was collected through interviews and pulmonary indices; flour dust exposure was measured by spirometry, and NIOSH 0500 and NIOSH 0600 methods. Results. The incidences of pulmonary symptoms, including cough, sputum, dyspnea, wheezing and bronchitis, were significantly more in the case group than the control group. At the beginning of the study, there was no significant difference between the case and control groups regarding the pulmonary indices of forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), peak expiratory flow and FEV1/FVC; however, after 2 years of exposure to flour dust, the pulmonary indices significantly decreased in the case group and showed a restrictive pattern. Based on the linear regression model, the most important predictor variables of FVC and FEV1 were age, body mass index, smoking and level of exposure to respirable flour dust. Conclusions: There is a strong correlation between chronic exposure to flour dust and the incidence of pulmonary complications and reduced pulmonary functions.

Oxidative stress associated with long term occupational exposure to extremely low frequency electric and magnetic fields.

BACKGROUND: Occupational exposure to extremely low frequency electromagnetic fields (ELF-EMFs) may have harmful effects on biologic systems and has raised many concerns in the last decades. OBJECTIVE: The aim of this study was to determine the effects of exposure to extremely low frequency electric and magnetic fields on lipid peroxidation and antioxidant enzyme activities. METHODS: This study was conducted on 115 power plant workers as the exposed group and 145 office workers as the non-exposed group. The levels of Malondialdehyde (MDA), superoxide dismutase (SOD), Catalase (Cat), and total antioxidant capacity (TAC) were measured in the serum of all subjects. Exposure to ELF-EMFs was measured based on spot measurements and the IEEE Std C95.3.1 standard. RESULTS: The levels of MDA, SOD, and Cat in the exposed group were significantly higher than in the non-exposed group. However, the level of TAC was not significantly different between the exposed (2.45±1.02) and non-exposed (2.21±1.07) groups. The levels of MDA and SOD were higher among workers with higher exposure to electric fields than workers with low exposure. All oxidative stress indicators increased with increased exposure to magnetic fields, except TAC. CONCLUSIONS: The antioxidant system imbalance among power plant workers may be related to long term occupational exposure to electromagnetic fields.

The Effects of Antioxidant Vitamins on Proinflammatory Cytokines and Some Biochemical Parameters of Power Plant Workers: A Double-Blind Randomized Controlled Clinical Trial.

Some epidemiological studies have suggested that exposure to extremely low-frequency magnetic fields (ELF-MFs) can affect the immune system. This study aimed to investigate the effects of antioxidant vitamin consumption on proinflammatory cytokines and biochemical parameters changes. In this randomized, controlled double-blinded trial study, power plant workers exposed to ELF-MFs were enrolled based on inclusion criteria. Ninety-one eligible subjects were randomly divided into four groups: the first group (400 units of vitamin E/day), second group (1,000 mg of vitamin C/day), third group (400 units of vitamin E and 1,000 mg of vitamin C/day), and control group. The intervention was conducted for 3 months. Proinflammatory cytokines interleukin-1ß (IL-1ß), IL-6, and tumor necrosis factor-α (TNF-α), and biochemical parameters (fasting blood sugar, total cholesterol, triglyceride, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol [HDL-c], total protein, and albumin) were measured among the participants' serums, before and after the intervention. The mean level of IL-6 in all vitamin-receiving groups, the mean level of IL-1ß in vitamin C and E&C groups, and the mean level of TNF-α in the vitamin C group, decreased significantly after intervention. The arithmetic means of the effect sizes for IL-1ß, IL-6, and TNF-α were 0.71, 0.57, and 0.2, respectively. The level of HDL-c in the vitamin E and vitamin E&C groups and the level of triglyceride in the vitamin C group significantly increased after the intervention. Taking antioxidant vitamins can prevent an increase of proinflammatory cytokines induced by prolonged exposure to ELF-MFs. Bioelectromagnetics. 2021;42:18-26. © 2020 Bioelectromagnetics Society.

ESTIMATION OF THERMAL POWER PLANT WORKERS EXPOSURE TO MAGNETIC FIELDS AND SIMULATION OF HAZARD ZONES.

Extremely low-frequency magnetic fields (ELF-MFs) have raised some concerns due to their possible effects on workers' health. In this study ELF-MFs were measured in different units of the thermal power plant based on gridding the indoor space. The exposure level was measured by spot measurement based on the IEEE Std C95.3.1 and then simulated in units with the highest magnetic field intensity by using ArcGIS software. The operators and balance of plant (BOP) technicians (12.64 ± 9.74 µT) and office workers (2.41 ± 1.22 µT) had the highest and lowest levels of both measured and estimated ELF-MFs exposure. The highest measured ELF-MFs were in the vicinity of the power transmission lines in the transformers' building (48.2 µT). Our simulation showed the high and low exposure areas and ranked exposure well; but, the actual measurements of ELF-MFs exposure were in all cases higher than the estimated values, which means we still need to improve our estimations.

Neuropsychological effects of long-term occupational exposure to mercury among chloralkali workers.

BACKGROUND: Mercury is one of the most well-known toxic metals for humans. Chloralkali workers are exposed to mercury vapours extensively, which may be associated with neurotoxicity. OBJECTIVE: The aim of this study was to determine the associations between mercury concentration in blood and air samples, and mercury's neuropsychological effects among chloralkali workers. METHODS: This study was conducted on 50 chloralkali workers as the exposed group and 50 non-industrial office workers as the unexposed group. All subjects were assessed using the Hamilton Depression Rating Scale, Piper Chronic Fatigue Scale and Essential Tremor Rating Scale. Mercury concentration was measured in blood and air samples using cold vapour atomic absorption spectrometry. RESULTS: There was significantly more severe fatigue, depression and tremor in the exposed group compared with the unexposed group. The mean concentration of blood mercury in the exposed group was 22.59±12.5µgL-1 which was significantly higher than the unexposed group (1.28±1.05µg L-1). Based on multiple linear regression, shift work, smoking, fatigue, depression and tremor were predictor variables for blood mercury concentration. CONCLUSIONS: This study indicated that this sample of chloralkali workers suffered from neuropsychological problems such as fatigue, depression and tremor, which is probably related to mercury exposure.

Investigating the effects of exposure to extremely low frequency electromagnetic fields on job burnout syndrome and the severity of depression; the role of oxidative stress.

OBJECTIVES: This study was designed to investigate the possible effect of exposure to extremely low frequency electromagnetic fields (ELF-EMFs) on occupational burnout syndrome and the severity of depression experienced among thermal power plant workers and the role of oxidative stress. METHODS: In this cross-sectional study, 115 power plant workers and 124 administrative personnel of a hospital were enrolled as exposed and unexposed groups, respectively, based on inclusion and exclusion criteria. Levels of oxidative stress biomarkers, including malondialdehyde (MDA), superoxide dismutase (SOD), catalase (Cat), and total antioxidant capacity were measured in serum samples. Exposure to electric and magnetic fields was measured using the IEEE Std C95.3.1 standard at each workstation. The burnout syndrome and the severity of depression were assessed using the Maslach Burnout and Beck Depression Inventory. RESULTS: The levels of MDA and SOD were significantly lower in the exposed group than the unexposed group. The exposed group reported a higher prevalence of burnout syndrome and higher depression severity. Multiple linear regression showed that work experience, MDA level, and levels of exposure to magnetic fields are the most important predictor variables for burnout syndrome and severity of depression. In addition, a decrease in the level of Cat was significantly associated with increased burnout syndrome. CONCLUSION: The thermal power plant workers exposed to ELF-EMFs are at risk of burnout syndrome and depression. These effects may be caused directly by exposure to magnetic fields or indirectly due to increased oxidative stress indices.

Environmental aircraft noise aggravates oxidative DNA damage, granulocyte oxidative burst and nitrate resistance in Ogg1-/- mice.

Background: Large epidemiological studies point towards a link between the incidence of arterial hypertension, ischaemic heart disease, metabolic disease and exposure to traffic noise, supporting the role of noise exposure as an independent cardiovascular risk factor. We characterised the underlying molecular mechanisms leading to noise-dependent adverse effects on the vasculature and myocardium in an animal model of aircraft noise exposure and identified oxidative stress and inflammation as central players in mediating vascular and cardiac dysfunction. Here, we studied the impact of noise-induced oxidative DNA damage on vascular function in DNA-repair deficient 8-oxoguanine glycosylase knockout (Ogg1-/-) mice.Methods and results: Noise exposure (peak sound levels of 85 and mean sound level of 72 dB(A) applied for 4d) caused oxidative DNA damage (8-oxoguanine) and enhanced NOX-2 expression in C57BL/6 mice with synergistic increases in Ogg1-/- mice (shown by immunohistochemistry). A similar pattern was found for oxidative burst of blood leukocytes and other markers of oxidative stress (4-hydroxynonenal, 3-nitrotyrosine) and inflammation (cyclooxygenase-2). We observed additive impairment of noise exposure and genetic Ogg1 deficiency on endothelium-independent relaxation (nitroglycerine), which may be due to exacerbated oxidative DNA damage leading to leukocyte activation and oxidative aldehyde dehydrogenase inhibition.Conclusions: The finding that chronic noise exposure causes oxidative DNA damage in mice is worrisome since these potential mutagenic lesions could contribute to cancer progression. Human field studies have to demonstrate whether oxidative DNA damage is also found in urban populations with high levels of noise exposure as recently shown for workers with high occupational noise exposure.

The effect of vitamin E and C on comet assay indices and apoptosis in power plant workers: A double blind randomized controlled clinical trial.

Extremely low frequency electromagnetic fields have been classified as a possible human carcinogen by the International Agency for Research on Cancer and this has raised some concern about its health effects on employees extensively exposed to these fields at thermal power plants. In this study, the effect of using vitamin E and C supplements have been examined on employees working at a thermal power plant. In this randomized controlled, double-blind clinical trial, 81 employees from different parts of the thermal power plant were enrolled between July and November 2017, and divided into four groups: Group 1 received vitamin E (400 units/day), Group 2: vitamin C (1000 mg/day), Group 3: vitamin E + C and Group 4: no intervention. DNA damage was measured in peripheral blood lymphocytes using comet assay and apoptosis, using flow cytometry. Based on the results, tail intensity and tail length in the vitamin E group, and all comet assay indices in the vitamin E + C and vitamin C groups (except DNA damage index) significantly decreased after the intervention, while the comet assay indices did not change significantly in the control group. None of the flow cytometry indices including early apoptosis, late apoptosis and necrosis changed after intervention in either group. The use of antioxidant vitamins such as E and C, can increase the activity of the non-enzymatic antioxidant defense system, and protect DNA from damage caused by exposure to extremely low frequency magnetic fields. But, taking these vitamins has no effect on apoptosis. It seems that consumption of vitamin E affected all investigated comet assay indices and can be probably considered as the best intervention.

DNA damage from long-term occupational exposure to extremely low frequency electromagnetic fields among power plant workers.

Extremely low frequency electromagnetic fields (ELF-EMFs) are not known as definite occupational carcinogens, but some studies have reported the genotoxic effects of these fields on cell lines. The present study aimed to evaluate the effects of long-term occupational exposure to these fields on DNA damage. In this cross-sectional study, blood samples were taken from 102 thermal power plant workers as the exposure group and 136 subjects as the unexposed group. DNA damage was evaluated using alkaline comet assay and flow cytometry. Exposure to ELF-EMFs was measured based on spot measurements and the IEEE Std C95.3.1 standard. The indices of comet assay, tail DNA percent, tail factor (%), and damage index were significantly higher in the exposed group compared to the unexposed group. Increased exposure to magnetic fields enhanced comet assay indices, except tail length; while exposure to electric fields had no significant effect on such indices. The percentage of cells at early apoptosis and late apoptosis phases caused by exposure to magnetic fields, respectively, decreased and increased significantly. Long-term occupational exposure to ELF-EMFs can probably cause genotoxic effects.

The effects of industrial noise exposure on lipid peroxidation and antioxidant enzymes among workers.

PURPOSE: The aim of this study was to measure individual exposure to noise and its effect on the levels of lipid peroxidation and enzymatic antioxidant defense. METHODS: In this cross-sectional study, 94 male workers working in a food factory in Shahroud, Iran, were selected as the case group and 112 people were also included as the control group. The level of exposure to noise was measured using a dosimeter and the equivalent level was calculated. The levels of malondialdehyde (MDA), catalase (Cat), superoxide dismutase (SOD), and Total Antioxidant Capacity (TAC) were measured in the serum samples of all participants. Independent t test, one-way ANOVA, and multivariate linear regression were used to analyze the data. RESULTS: The levels of MDA, Cat, and TAC were significantly higher in staff exposed to noise than in the controls. The starch and warehouse units' staff were exposed to the highest (99.3 ± 3.23 dB) and lowest (77.1 ± 9.68 dB) mean levels of sound pressure. Based on the linear regression model, noise exposure level was the most important predictor variable for levels of MDA (ß = 0.48, CI 95% = 0.04-0.93), Cat (ß = 0.43, CI 95% = 0.05-0.83), and TAC (ß = 0.11, CI 95% = 0.06-0.16). CONCLUSIONS: Noise exposure increases the production of free radicals. As exposure rate increases, the levels of MDA, Cat, and TAC enzymes increase as well.

Chronic occupational noise exposure: Effects on DNA damage, blood pressure, and serum biochemistry.

Noise levels experienced by industrial workers may cause both auditory and non-auditory harmful effects. We have studied the effects of chronic industrial noise exposure on DNA damage, blood pressure, and serum biochemistry in factory workers. Male workers (109 individuals) in three parts of a food factory in Shahroud, Iran were enrolled as the exposed group and male office workers (123 individuals) were the unexposed control group. Noise exposure was measured (dosimetry) and the comet assay was used to evaluate DNA damage in peripheral blood mononuclear cells. Glutathione peroxidase (GPx) and ceruloplasmin (Cp) levels were measured in serum samples. GPx levels, systolic and diastolic blood pressure, and DNA damage were significantly higher in the exposed group than in the control group. However, ceruloplasmin levels were not significantly different. Based on multivariate linear regression analysis, noise exposure was the most important predictor of GPx levels, systolic and diastolic blood pressure, and DNA damage.

The effects of amplitude and stability of circadian rhythm and occupational stress on burnout syndrome and job dissatisfaction among irregular shift working nurses.

AIM: To investigate the relation between the circadian rhythm amplitude and stability, and occupational stress with burnout syndrome and job dissatisfaction among shift working nurses. BACKGROUND: Irregular shift working nurses are prone to burnout syndrome (BS) and job dissatisfaction (JD). circadian rhythm difference and occupational stress might be effective in causing burnout syndrome and dissatisfaction. DESIGN: In total, 684 nurses who worked in four teaching hospitals were selected by stratified random sampling in a cross-sectional design based on STROBE guidelines. METHODS: The data were collected by the Circadian Type Inventory, Job Content Questionnaire, Minnesota Satisfaction Questionnaire and the Maslach Burnout Inventory. Multiple linear regression, one-way ANOVA and independent t test were used for statistical analysis by SPSS v24. RESULTS: About 15% of the nurses suffered from high levels of burnout syndrome. Psychological demand (ß = 0.022, CI 95% = 0.003-0.047 and ß = 0.016, CI 95% = 0.001-0.032) and workplace support (ß = -0.043, CI 95% = -0.097-0.003 and ß = -0.025, CI 95% = -0.046-0.006) were significant predictors of BS and JD. Male nurses reported lower BS and higher JD compared to female nurses. Irregular shift working schedule was also related to a significantly higher odd of BS (p = 0.009) and JD (p = 0.011). Nurses classified as languid experienced significantly more BS and JD than vigorous nurses. CONCLUSION: This study shows that BS and JD were strongly associated with psychological demand and workplace support; and vigorous nurses were less prone to BS and JD, and were more suitable for irregular shift work. RELEVANCE TO CLINICAL PRACTICE: In order to reduce burnout syndrome and job dissatisfaction among irregular shift working nurses, we need to identify the effect of risk factors such as individual differences on the circadian rhythm and job demand which can affect nurses who work in irregular schedules.

The associations of workload, individual and organisational factors on nurses' occupational injuries.

AIMS AND OBJECTIVES: To determine the prevalence and type of occupational injuries in nurses and their associations with workload, working shift, and nurses' individual and organisational factors. BACKGROUND: Nurses are vulnerable to occupational injuries due to the nature of their job. DESIGN: A cross-sectional correlational design (based on STROBE Statement) was conducted. METHODS: This study was conducted among 616 nurses of four public hospitals located in four different provinces in Iran. Data were collected using three questionnaires including an organisational and demographic questionnaire, an occupational injuries checklist and the NASA-TLX questionnaire (about mental workload). Chi-square test, one-way ANOVA and multivariate logistic regression were used in SPSS version 23.0 for statistical analysis. RESULTS: Blood and body fluid exposures had the highest prevalence (47.4%) among all injuries. Needlestick injuries showed a significant relation with gender, age, number of shifts in a month and work experience. With increase in mental workload, needlestick injuries increase by 35%. Also, injuries reported by nurses working in rotating shifts were 15%-53% more than nurses working in fixed shifts. CONCLUSION: Working in rotating shifts and work overload was significantly related to all injuries. Decreasing nurses' mental workload, introducing guidelines and efficient training in shift work schedules can help decrease occupational injuries among nurses. RELEVANCE TO CLINICAL PRACTICE: In order to reduce occupational injuries among nurses, in addition to incorporating advanced management and technology, it is necessary to pay attention to psychosocial, individual and organisational risk factors related to occupational injuries and their frequency in nurses. Also, reducing personnel's mental and occupational pressure should be considered.

The effect of chronic exposure to extremely low-frequency electromagnetic fields on sleep quality, stress, depression and anxiety.

Exposure to extremely low-frequency electromagnetic fields (ELF-EMF) is inevitable in some industries. There are concerns about the possible effects of this exposure. The present study aimed to investigate the effect of chronic exposure to extremely low-frequency electromagnetic fields on sleep quality, stress, depression and anxiety among power plant workers. In this cross-sectional study, 132 power plant workers were included as the exposed group and 143 other workers were included as the unexposed group. The intensity of ELF-EMF at work stations was measured by using the IEEE Std C95.3.1 standard and then the time weighted average was calculated. Sleep quality, stress, depression and anxiety were measured by using the Pittsburgh Sleep Quality Index Questionnaire; and the Depression, Anxiety and Stress Scale. The workers in the exposed group experienced significantly poorer sleep quality than the unexposed group. Depression was also more severe in the exposed group than the unexposed group (P = 0.039). Increased exposure to ELF-EMF had a direct and significant relation with increased stress, depression, and anxiety. Sleep quality in technicians with the highest exposure was significantly lower than the other groups. This study suggests that long-term occupational exposure to ELF-EMF may lead to depression, stress, anxiety and poor sleep quality.

Evaluating the relationship between job stress and job satisfaction among female hospital nurses in Babol: An application of structural equation modeling.

Background: This study was designed to investigate job satisfaction and its relation to perceived job stress among hospital nurses in Babol County, Iran. Methods: This cross-sectional study was conducted on 406 female nurses in 6 Babol hospitals. Respondents completed the Minnesota Satisfaction Questionnaire (MSQ), the health and safety executive (HSE) indicator tool and a demographic questionnaire. Descriptive, analytical and structural equation modeling (SEM) analyses were carried out applying SPSS v. 22 and AMOS v. 22. Results: The Normed Fit Index (NFI), Non-normed Fit Index (NNFI), Incremental Fit Index (IFI)and Comparative Fit Index (CFI) were greater than 0.9. Also, goodness of fit index (GFI=0.99)and adjusted goodness of fit index (AGFI) were greater than 0.8, and root mean square error of approximation (RMSEA) were 0.04, The model was found to be with an appropriate fit. The R-squared was 0.42 for job satisfaction, and all its dimensions were related to job stress. The dimensions of job stress explained 42% of changes in the variance of job satisfaction. There was a significant relationship between the dimensions of job stress such as demand (ß =0.173,CI =0.095 - 0.365, P≤0.001), control (ß =0.135, CI =0.062 - 0.404, P =0.008), relationships(ß =-0.208, CI =-0.637- -0.209; P≤0.001) and changes (ß =0.247, CI =0.360 - 1.026, P≤0.001)with job satisfaction. Conclusion: One of the important interventions to increase job satisfaction among nurses maybe improvement in the workplace. Reducing the level of workload in order to improve job demand and minimizing role conflict through reducing conflicting demands are recommended.