Learning from an experience, challenges and approaches in the workplace during COVID-19 pandemic: a content analysis of international documents.

BACKGROUND: This study aims to investigate international measures for pandemic control in the workplace based on guidelines from international organizations to learn from their experiences. METHODS: We conducted a qualitative study using content analysis. The search method involved reviewing published guidelines on preventing and responding to the COVID-19 pandemic in workplaces. After the screening process, ten guidelines were included in the content analysis. During the analysis, 200 meaning codes, 49 subcategories, and eleven categories were identified. Trustworthiness criteria were utilized to ensure the accuracy and strength of the findings. RESULTS: Eleven categories of international content during the COVID-19 pandemic were legal requirements and duties of employees and employers, structural and program changes, risk assessment, risk communication, information and training, internal and external consultation and cooperation, provision of facilities and tools for workplace hygiene, special conditions, special groups, closing and reopening workplaces, reducing contact and exposure and mental health. CONCLUSIONS: Protecting employees during a pandemic requires a multifaceted approach and strong advocacy. The operational plan for pandemic control should be developed based on the level of risk, with support tailored to employees' conditions and needs. Cooperation among international organizations is essential to develop a standardized plan and issue comprehensive guidelines in response to health emergencies with a global perspective and local implementation, drawing from the lessons learned during the COVID-19 pandemic.

Executive and hierarchical models for participatory response to health emergencies in the workplace: Lessons from COVID-19.

Introduction: Workplaces are high-risk environments for epidemic transmission, and the COVID-19 pandemic has highlighted the significant impacts that health emergencies can have on both the healthcare system and the economy. This study presents executive and hierarchical models for participatory response to health emergencies in the workplace, with a focus on COVID-19. Methods: The study was conducted in three phases. Content analysis of interviews with 101 stakeholders and national documents was used to identify key themes and dimensions for an executive model. A focus group discussion and review of international documents were then used to refine and expand the executive and hierarchical models. The alignment and trustworthiness of the final models, as well as feedback, were gathered from 117 informants working in various workplaces. Results: The executive model highlighted that context understanding, management commitment, and participation play critical roles in developing tailored prevention and response plans, and adequate support is necessary for successful plan implementation. Monitoring and review processes should be established to ensure proper functioning. The hierarchical model emphasizes the need for collaborative efforts from various stakeholders to effectively implement pandemic prevention and participatory response plans. Conclusion: Overall, the executive and hierarchical participatory models presented in this study provide a framework for effectively controlling pandemics and other health emergencies in the workplace, enhancing both health resilience and the sustainability of economic activities.

Exploration roles and responsibilities of trade unions in preventing and responding to emergencies against epidemics: The case of COVID-19.

BACKGROUND AND AIM: The coronavirus disease 209 (COVID-19) pandemic has been affecting various strata of society including different guilds. Each of these segments has its role to play in controlling epidemics. Accordingly, this study aimed to explore trade unions' roles and responsibilities in the prevention and emergency response to epidemic, including the COVID-19 pandemic. MATERIALS AND METHODS: The present qualitative research was conducted using directed content analysis. Participants were selected by a purposeful sampling method. Data were collected through semistructured interviews and field notes and validated through Lincoln and Guba's (1985) evaluative criteria. Data were analyzed by MAXQDA software. RESULTS: Data analysis, constant comparison, and class integration provided a total of seven main themes, which were extracted into four domains of Plan, Implementation, Review, and Action. The main themes were categorized into the dimensions of each domain, so that the Plan domain included three dimensions of union/guild contexts, leadership and staff participation, and planning. The Implementation domain included two dimensions of support and operations. The Assessment domain had a performance evaluation dimension, and the Action domain was made up of an improvement dimension. CONCLUSION: Relying on their organizational and social capacities, trade unions can facilitate the leadership and participation of employees and communities for appropriate policies and making resilient decisions to control epidemics and other roles and responsibilities related to health.

Explaining the role and responsibilities of the National Anti-Coronavirus Headquarters in prevention and emergency response to pandemics in the workplace: a qualitative study on COVID-19 experience in Iran.

BACKGROUND: In recent years, the Coronavirus disease 2019 (COVID-19) have greatly affected the safety of life and the economy. Taking rapid measures to reduce these problems requires effective and efficient decisions by various departments and headquarters in a country. The purpose of this study was to investigate the role and responsibilities of the National Anti-Corona Headquarters (NACH) in the workplace during the pandemic. METHODS: This study was a qualitative study conducted using a triangulation approach. Data were obtained through semi-structured interviews with 18 participants with a purposive sampling technique as well as the review of related documents and records in response to the COVID-19 pandemic. The inductive and deductive approach was used for the content analysis of data in the Plan-Do-Check-Act (PDCA) model of the ISO45001 management system. RESULTS: Based on the results, four themes (plan, do, check, and act) were considered as the main domains. Subthemes include understanding the needs and expectations of interested parties; specific policy-making for organizations/workplaces; leadership and organizational commitment; addressing risks and opportunities; providing resources; competence of individuals and organizations; awareness; communication; information documentation; emergency response; monitoring, analyze, and evaluate performance; management review; non-compliance and corrective action; and improvement in pandemic control. CONCLUSION: To ensure the effectiveness and efficiency of organizations to deal with pandemics, the NACH must implement these responsibilities and play a pivotal role in responding to pandemics and using the participation of other government agencies and society. The findings of this study can be useful from national to local levels.

Correlation of Work Fatigue and Mental Workload in Train Drivers: A Cross-sectional Study.

BACKGROUND: Evidence suggests that train drivers experience a high level of fatigue and mental workload. The present study aimed to assess overall, physical, and mental fatigue levels and their correlations with the mental workload in the metro train operation. Study Design: A cross-sectional study. METHODS: This study was conducted on all 1194 train drivers in the Tehran Metro. The train drivers completed the Samn-Perelli Fatigue Scale and the Fatigue Assessment Scales at the beginning and end of the shift. In addition, they completed the National Aeronautics and Space Administration Task Load Index in the middle and at the end of the shift. Correlation and regression analyses were performed on the data to test the study hypothesis. RESULTS: Overall, physical, and mental fatigue levels increased significantly at the end of the shift compared to the onset of the shift (P<0.001). The mental workload and related dimensions were significantly increased at the end of the shift compared to the middle of the shift (P<0.001). Mental demand was the most important workload problem among the train drivers. The highest correlation was found between overall workload and time pressure (R=0.68, P<0.001). CONCLUSION: The mental workload had a significant correlation with work fatigue in the train drivers. Control measures should be focused on the mental workload and related dimensions, especially mental demand and time pressure.

People's Voice and Civil Society Participation as a Core Element of Universal Health Coverage Reforms: Review of Experiences in Iran.

Health governance challenges can make or break universal health coverage (UHC) reforms. One of the biggest health governance challenges is ensuring meaningful participation and adequately reflecting people's voice in health policies and implementation. Recognizing this, Iran's Health Transformation Plan (HTP) lays out the country's blueprint for UHC with an explicit emphasis on the 'socialization of health.' 'Socialization' is seen as a key means to contribute to HTP objectives, meaning the systematic and targeted engagement of the population, communities, and civil society in health sector activities. Given its specific cultural and historical context, we sought to discern what notions such as 'civil society,' 'non-governmental organization,' etc mean in practice in Iran, with the aim of offering policy options for strengthening and institutionalizing public participation in health within the context of the HTP. For this, we reviewed the literature and analysed primary qualitative data. We found that it may be more useful to understand Iranian civil society through its actions, ie, defined by its motivation and activities rather than the prevailing international development understanding of civil society as a structure which is completely independent of the state. We highlight the blurry boundaries between the different types of civil society organizations (CSOs) and government institutions and initiatives, as well as high levels of overlaps and fragmentation. Reducing fragmentation as a policy goal could help channel resources more efficiently towards common HTP objectives. The National Health Assembly (NHA) model which was first launched in 2017 offers a unique platform for this coordination role, and could be leveraged accordingly.

Molecular mechanisms of vitamin D plus Bisphenol A effects on adipogenesis in human adipose-derived mesenchymal stem cells.

BACKGROUND: Obesity is considered a major health concern and mounting evidence suggests that the exposure to environmental endocrine disruptors, including Bisphenol-A (BPA), may enhance the risk to develop the disease. Moreover, growing documents propose that the vitamin D may contribute to adipogenic signaling and lipid accumulation during adipocyte differentiation. We focused on the molecular mechanism of vitamin D and BPA in human adipose-derived mesenchymal stem cells (hADMSCs) which vitamin D and BPA may influence adipose tissue development and function. METHODS: Human adipose-derived mesenchymal stem cells were cultured for 14 days in lipogenic differentiation media containing continuous concentrations of vitamin D plus BPA (0.1 nM or 10 nM). The expression of adipogenic markers including the peroxisome proliferator-activated receptor γ (PPARγ), CCAAT-enhancer-binding protein α (C/EBP α) CCAAT-enhancer-binding protein ß (C/EBP ß), fatty acid synthase (FASN), lipoprotein lipase (LPL), sterol regulatory element-binding protein-1c (SREBP1c), insulin-induced gene-2 (INSIG2), vitamin D receptor (VDR), estrogen receptor-beta (ER-ß), fatty acid-binding protein-4 (FABP4), and glucose transporter-4 (GLUT4) was measured using Quantitative polymerase chain reaction (qPCR) and enzyme-linked immunosorbent assay (ELISA). Lipid accumulation was visualized with staining with Oil Red O. RESULTS: In the morphological assessment of mesenchymal stem cells treated with a concentration of 10 nM vitamin D plus BPA, more lipid accumulations were observed in comparison with the group with 0.1 nM concentration. Treatment of hADMSCs with vitamin D plus BPA (0.1 nM) significantly inhibited the induction of PPARγ, C/EBP ß, C/EBP α, and FASN related to adipocyte differentiation and development. However, the exposure of cells to the concentration of 10 nM vitamin D plus BPA induced the expression of these genes associated to the adipogenesis. The remarkable increase in the level of SREBP1c was associated to the suppression of INSIG2 in treated preadipocytes with 10 nM vitamin D plus BPA. Our findings showed that the expression of VDR, ERß, GLUT4, and FABP4 were upregulated through differentiation with the highest concentrations in 0.1 nM vitamin D plus BPA group for VDR, ERß, and GLUT4. CONCLUSIONS: Vitamin D plus BPA at concentration of 10 nM boosted the adipogenesis during the critical stages of adipocytes development, whereas it seems to inhibit this process at concentration of 0.1 nM.

1,25-Dihydroxyvitamin D3 modulates adipogenesis of human adipose-derived mesenchymal stem cells dose-dependently.

PURPOSE: 1,25-dihydroxyvitamin D3 may regulate adipogenesis in adipocytes in-vitro, but little is known about possible molecular mechanisms related to the inhibitory effect of 1,25-dihydroxyvitamin D3 on adipogenesis in humans҆ adipose tissue. METHODOLOGY: In this study, human adipose-derived mesenchymal stem cells (hASCs) were cultured for 14 days in adipogenic differentiation media containing concentrations of 1,25-dihydroxyvitamin D3 (10-10-10-8 M). The extent of adipogenic differentiation in ASCs was assessed by Oil Red O staining and quantitative polymerase chain reaction (PCR) to determine expression levels of key adipogenic markers. RESULTS: Our results showed that vitamin D receptor (VDR), as a mediator of most actions of 1,25-dihydroxyvitamin D3, glucose trasporter-4 (GLUT4),and fatty acid binding protein-4 (FABP4) was expressed in vitamin D-treated hASCs. However, the protein level of these markers was lower than the control group. Treatment of human preadipocytes with 1,25-dihydroxyvitamin D3 significantly altered expression of adipogenic markers and triglyceride accumulation in a dose-dependent manner. 1,25-dihydroxyvitamin D3 at concentration of 10-8 M enhanced expression of sterol regulatory element-binding protein-1c (SREBP1c), CCAAT-enhancer-binding protein-ß (C/EBPß), a mitotic clonal expansion, peroxisome proliferator-activated receptor-gamma (PPARγ), fatty acid synthase (FASN), a marker of de novo lipogenesis,and lipoprotein lipase (LPL). CONCLUSION: Our findings revealed that 1,25-dihydroxyvitamin D3 may provoke adipocyte development in critical periods of adipogenesis at concentration of 10-8 M, thereby leading to a greater risk of obesity in adulthood and an augmented risk of obesity-related diseases including diabetes, cardiovascular diseases, and some cancers.

Analysis of hand-forearm anthropometric components in assessing handgrip and pinch strengths of school-aged children and adolescents: a partial least squares (PLS) approach.

BACKGROUND: The purpose of this study was to examine the influence of hand-forearm anthropometric dimensions on handgrip and pinch strengths among 7-18 years children and adolescents and to investigate the extent to which these variables can be used to predict hand strength. METHODS: Four types of hand strengths including handgrip, tip to tip, key, and three-jaw chuck pinches were measured in 2637 healthy children and adolescents (1391 boys and 1246 girls) aged 7-18 years using standard adjustable Jamar hydraulic hand dynamometer and pinch gauge. A set of 17 hand-forearm anthropometric dimensions were also measured with an accurate digital caliper and tape measure. RESULTS: No significant differences were found between the hand strengths of boys and girls up to the age of 10 years. Gender related differences in handgrip and pinches were observed from the age of 11 years onwards, with boys always being stronger. The dominant hand was stronger than the non-dominant hand (8% for handgrip and by about 10% for all three types of pinches). The strongest correlations were found between the hand length and hand strengths (r > 0.83 for handgrip and three all pinches; p < 0.001, 2-tailed). Based on the partial least squares (PLS) analysis, 8 out of 17 anthropometric indices including hand length, hand circumference, thumb length, index finger length, middle finger length, and forearm length had considerable loadings in the PLS analysis, which together accounted for 46% of the total variance. CONCLUSIONS: These results may be used by health professionals in clinical settings as well as by designers to create ergonomic hand tools.

Bisphenol A enhances adipogenic signaling pathways in human mesenchymal stem cells.

BACKGROUND: The endocrine disruptor Bisphenol-A (BPA), has been involved in dysregulating adipose tissue development and increasing the risk of obesity. The objective of this experiment was to investigate whether treatment of human mesenchymal stem cells with BPA could modulate adipogenesis and adipocyte differentiation. METHODS: In this experimental study, the human adipose-derived mesenchymal stem cells (hASCs) were cultured for 2 weeks with continuous exposure to 10- 10 M or 10- 8 M concentrations of BPA. The extent of triglyceride accumulation was visualized by Oil Red O staining. To evaluate BPA effect on the expression levels of key adipogenic trascripotion factors and proteins, we used Quantitative reverse transcriptase-polymerase chain reaction (qRT-PCR) and ELISA. RESULTS: The results presented a dose-dependent triglyceride accumulation in treated cells with BPA. Additionally, we observed that BPA induced transcription of the Peroxisome proliferator-activated receptor-gamma (PPARγ), CCAAT-enhancer-binding protein-alpha (C/EBPα), CCAAT-enhancer-binding protein-beta (C/EBPß), sterol regulatory element-binding protein-1c (SREBP1c), Fatty acid synthase (FASN), and lipoprotein lipase (LPL); BPA suppressed the expression of Fatty acid binding protein-4 (FABP4) and Estrogen receptor-beta (ERß). CONCLUSIONS: Our findings supported the hypothesis that BPA enhances adipogenic differentiation thereby may play a role in development of obesity and dysregulation of metabolic homoeostasis.

Development of a national conceptual framework and measuring tool for Organisational Social Responsibility and Accountability for Health (OSRAH).

Organisations can have a significant impact (positive or negative) on society through their actions and decisions. Given this reality, it is important that they are held responsible and accountable for the consequences of their actions. This concept is often referred to as 'social responsibility'. However, 'social responsibility', as currently conceived in the literature, neglects a specific focus on health as a social goal. Additionally, there are no practical tools to capture this concept in a holistic way to facilitate implementation and monitoring of organisational improvement. This paper reports on the process of developing a more holistic conceptual framework and tool for assessing organisational social responsibility and accountability for health (OSRAH). We conducted a review of the published and grey literature and engaged in expert consultation and focus group discussions. The initial OSRAH framework and the self-assessment tool were finalised for implementation and used by 95 organisations at a national event in Iran in February 2017. The results of the assessment data collected at the event showed organisations scored lowest in the domain of community health and highest in the domain of employee health. The OSRAH framework and assessment tool represents a new understanding of health and its determinants in organisations outside the health sector. It integrates health within the existing Corporate Social Responsibility (CSR) culture of organisations. The process of creating the tool and implementing it at the national festival of OSRAH in Iran created momentum for intersectoral action. This experience can inspire researchers and practitioners in other countries, especially in developing countries, to develop their own local definition and practical assessment framework for responsibility and accountability.

Health needs assessment of workers in Kaveh industrial city.

Background: Health needs assessment (HNA) is essential for allocation of limited resources to the most prioritized problems. HNA in work places has gained increasing importance. Kaveh industrial city is the largest and oldest industrial city in Iran, with a wide range of different industries, making it an exemplary industrial city in Iran. This study was done to conduct health needs assessment of workers in Kaveh industrial city. Methods: In this study, intensive HNA approach and qualitative method were used. In-depth interviews and Focus Group Discussions (FGDs) were conducted to collect information related to health risk factors, and Delphi method was used to prioritize these risk factors. A total of 74 key informants participated in this study, which constituted more than 80% of the total related experts of Kaveh industrial city. Results: The main identified health challenge was inefficiency of the existing Health, Safety and Environment (HSE) control and monitoring system. The most important physical health risk factors were smoking and obesity and the most prioritized psychosocial risk factors were stress and lack of appropriate management and organizational culture. Ergonomic issues and noise pollution were the prioritized work environmental factors and inappropriate placement of pollutant industries in the industrial city was the most prioritized bioenvironmental risk factor. Unsafe road to industrial zone and poor safety devices used by workers were the most prioritized occupational injuries risk factors. Conclusion: Addressing the identified health needs of workers in Kaveh industrial city is of high importance. Also, redefining the HSE control and monitoring system should be prioritized.

A qualitative study on physical health threatening factors of Iranian seafarers working on ocean going tankers.

BACKGROUND: Seafaring is a highly physically demanding profession in a risky environment due to exposure to unique job health related risk factors. The purpose of the study is to describe physical health threatening factors of Iranian seafarers working on tankers. MATERIALS AND METHODS: A qualitative content analysis with inductive approach was performed on 17 Iranian male seafarers in 2016. Subjects were selected by purposive sampling, which continued until data saturation. Data were gathered using semi-structural questionnaire via in-depth-interviews. All interviews were transformed into computer files. Analysis was done based on conventional content analysis approach. RESULTS: Mean job history and age of the participants was 11.9 ± 7.2 and 35.8 ± 9.3 years, respectively. Two main themes emerged during analysis of data and categories were created. The themes are (1) physical health threatening factors at the ship; (2) high risk ranks at the ship. CONCLUSIONS: The need for addressing nutrition at sea was acknowledged by seafarers. Also, it seems that revision of some regulations regarding seafarers' medical examination, oral health and heart diseases is necessary.

Penicillin dust exposure and penicillin resistance among pharmaceutical workers in Tehran, Iran.

BACKGROUND: Antimicrobial resistance (AMR) adversely impacts the prevention and treatment of a wide range of infections and is considered as a serious threat to global public health. Occupational-related AMR is a neglected area of research. OBJECTIVE: To assess exposure to penicillin dust, penicillin active materials, and to report the frequency of penicillin resistance among pharmaceutical workers in Tehran, Iran. METHODS: A quasi-experimental study was conducted among workers on a penicillin production line in a pharmaceutical company (n = 60) and workers in a food producing company (n = 60). Data were collected via survey, air sampling, and throat swab. RESULTS: The mean overall concentrations of penicillin dust and penicillin active material were 6.6 and 4.3 mg/m3, respectively, in the pharmaceutical industry. Streptococcus pneumoniae (S. pneumoniae) was detected in 45% (27) individuals in the exposed group, 92.6% of which showed penicillin resistance. Resistance was significantly higher among workers in penicillin production line (p = 0.014). CONCLUSIONS: High level of AMR among workers in penicillin production line is a health risk for the workers as well as society as a whole through the spread of drug resistant micro-organisms.

Educational intervention for reducing work-related musculoskeletal disorders and promoting productivity.

BACKGROUND AND OBJECTIVES: Work-related musculoskeletal disorders (WMSDs) are the main causes of pain, suffering, absenteeism, disability and reduction in productivity. This research aims to determine the role of training intervention based on protection motivation theory in reducing WMSDs and promoting productivity. METHODOLOGY: The conducted study was based on a quasi-experimental design (control) that was carried out on 158 employees of the Kabl Khodro factory which were divided into two groups of 79 people. After splitting the 158 workers, an experimental and control group was formed. The data collection instruments were made up of two questionnaires and were analysed using a quick exposure check (QEC) method. RESULT: Before intervention in both the experimental and control groups, there were no significant differences among the average protection motivation theory constructs, productivity and QEC scores (p < 0.05). However, following training intervention there was a significant increase in these factors within the investigated group apart from the perceived response costs and efficacy. CONCLUSION: The conducted study shows that ergonomic training based on the protection motivation theory is effective in reducing musculoskeletal risk factors and that increased knowledge of the subject can lead to an increase in productivity.

Assessment of the living and workplace health and safety conditions of site-resident construction workers in Tehran, Iran.

OBJECTIVES: The purpose of this study was to assess living and workplace safety conditions of construction workers in Tehran, Iran. METHODS: This cross-sectional study was conducted among 410 construction sites in a municipal area of Tehran whose municipal building permits were issued in 2011. Data on ventilation, workplace safety and hygiene were collected by direct observation and interviews with site foremen. Noise levels were estimated from 10 sound-level-meter stations in the municipality area. RESULTS: Lack of ventilation in the workers' rooms was abundant. Bathrooms were unhygienic and minimum requirements such as lighting and ventilation did not exist in 80% of the cases. In nearly 50% of large construction sites, sewage and garbage disposal were inappropriate. Elevator safety was poor at all sites and no measures for fall prevention were present in over 88% of active construction sites. This study showed that the mean 24-h equivalent continuous sound level Leq was over 70 dB in 80% of the sites during weekdays. CONCLUSIONS: The results of this study revealed poor health and safety living and working conditions of construction workers in Tehran.

Women's Awareness and Attitude Toward Breast Self-Examination in Dezful City, Iran, 2013.

BACKGROUND: Over one million new cases of breast cancer (BC) are diagnosed each year with a mortality rate of more than 600 thousand women per year. Breast self-examination (BSE) is a patient-centered, inexpensive, and noninvasive diagnostic test. We focused on the role of screening in BC in early diagnosis. OBJECTIVES: The purpose of this study was to evaluate awareness and attitude of women toward BSE in Dezful City, Iran, in 2013. PATIENTS AND METHODS: This descriptive cross-sectional study included 1020 women over 15 years of age in Dezful City, in 2013. Simple random clustering was used to enroll accessible women. We have applied the available pieces of software for statistical analysis. RESULTS: The mean age of recruited women was 37.1 ± 1.3 and 23.6% of participants had a history of BC in themselves or in their relatives (mother, sister, aunt, and grandmother). In addition, 70.1% of participants benefited from early diagnosis of BC, 83.3% of participants considered BSE necessary and useful for early diagnosis of BC, and 51% of them performed BSE. There was a statistically significant correlation between being married and doing BSE (P = 0.034) and between women's level of education and awareness to perform BSE (P = 0.009). CONCLUSIONS: With regard to high prevalence of BC in Iran, this study showed a positive attitude of women in Dezful City toward BSE. Health policymakers in Dezful City can establish training programs to increase women's awareness of BSE and to instruct them to perform it properly.

Peutz-Jeghers Syndrome With Diffuse Gastrointestinal Polyposis: Three Cases in a Family With Different Manifestations and No Evidence of Malignancy During 14 Years Follow Up.

INTRODUCTION: Peutz-Jeghers syndrome (PJS) is a rare disorder characterized by mucocutaneous perioral pigmentation, gastrointestinal hamartomatous polyposis, and an increased risk of malignancy. Families with PJS may show a variable spectrum of manifestations in spite of their consecutive generations. A probable explanation is novel mutations in contributing genes. CASE PRESENTATION: This report describes 3 cases of a family. Two daughters presented the classic PJS, while their father only manifested mucocutaneous perioral pigmentation. The junior daughter was underwent 3 and the eldest daughter 2 laparotomies for intussusception. The patients were visited annually and their medical findings were recorded during a follow-up period of 14 years. They were periodically examined in our hospital and despite conveying diffuse polyposis from the esophagus throughout the rectum in these three cases, even a simple hyperplasia was not found in obtained specimens. CONCLUSIONS: The patients with diffuse PJS may be asymptomatic and without gastrointestinal or extragastrointestinal malignancies.

Occupational cognitive failure and its relationship with unsafe behaviors and accidents.

OBJECTIVES: The aim of this study was to assess the relationship between occupational cognitive failures (OCFs) and unsafe behaviors, accidents and driving offences among municipal bus drivers in Tehran, Iran. METHODS: Systematic random sampling was used to select 190 drivers from 3 transport and traffic Tehran districts. Data were collected with the occupational cognitive failure questionnaire (OCFQ), the driver behavior questionnaire and a data collection form. RESULTS: The mean (SD) numbers of driving-related offences and road traffic accidents were 1.5 (2.6) and 0.37 (1.0), respectively. The mean (SD) numbers of deliberate driving violations, unintended violations, driving slips and mistakes were 6.97 (5.5), 1.61 (1.5), 13.6 (9.0) and 4.53 (3.28), respectively. The mean (SD) number of the OCFs was 28.9 (20.5). A significant correlation was found between occupational cognitive error and unsafe driving behavior subscales. The stepwise logistic regression results showed that, while controlling the effects of confounding factors, the OCF predicts 6%, 9%, 15% and 9% of deliberate violations, unintended violations, driving slips and driving mistakes, respectively. CONCLUSION: The results of this study show that the score of the OCFQ is a predictor of unsafe driving behaviors and its subscales.