Journal of Occupational

  Background: Health care workers occupationally are exposed to blood and other body fluids which might increase their risk of acquiring blood-borne pathogens and psychological stress . The aim of the present study was to determine the lifetime occupational exposure to needlestick injuries and body fluids among doctors and medical students in Rafsanjan University of Medical Sciences (2009).

  Materials and methods : In this descriptive study, 100 doctors and medical students were asked to complete a valid and reliable self-reporting questionnaire regarding their lifetime occupational exposure to needlestick and body fluids. Data were analysed using SPSS. T-test and Chi-square test were used to compare the groups.

  Results : The results highlighted that 57 (60%) of the respondents had at least one lifetime occupational exposure to needlestick and 45 persons (48.4%) had exposure to body fluids. However, only in 30 (31.5%) cases the event was reported to the appropriate authorities. The highest number of needlestick injuries occurred within the emergency departments (n=29, 51%), during nightshift (n=29, 51%), and with suture needle (n=37, 65%).

  Conclusion : Occupational exposures to needlestick and body fluids among doctors and medical students in our study have occurred with a relatively high lifetime incidence. Improving medical attentions might have positive effects on decreasing the incidence and prevalence of these constant occupational threats.

  Background: Suicide can be defined as an intentional act of self harm that leads to death. The aim of the present study was to determine the epidemiological characteristics of suicide cases which were recorded by Rafsanjan Legal Medical Organization from 2004 to 2009.

  Materials and Methods: This descriptive study was carried out in the year 2010 in Rafsanjan County of Kerman Province which is located in Southeast of Iran. Suicide data were gathered by applying a checklist in which gender, age, method of committing suicide as well as cause and the year of the event were recorded.

  Results: During the six years of our investigation, 20 cases of suicide were recorded. The mean age were 27.92±6.77 and 29.14±10.38 years for males and females, respectively. There were 13 (65%) males among the cases. Poison ingestion in 7 (35%) cases was the highest most frequent applied method of suicide. Family disputes in 16 (80%) cases and unemployment along with addiction in 4 (20%) cases were reported as the causes of suicide.

  Conclusion: Although it seems that suicide occurs less often in Rafsanjan, the possibility of under-enumeration and under-reporting of it must also be taken into account. In addition, a comprehensive prevention plan should be designed and implemented in order to tackle the root causes of suicide i.e. family disputes, unemployment and addiction. Meanwhile, easy access to the most prominent method of suicide i.e. organophosphate poison and similar substances should be restricted.

  Background : Malnutrition is still a major health problem in the developing countries. It is recognized that 60% of deaths among children under five year in these countries are associated with malnutrition. The aim of this study was to estimate the prevalence of malnutrition in children under 5 years old in Iranshahr in 2011.

  Materials and Methods : This is a cross-sectional descriptive study. The sample consisted of 700 children less than 5 years old who were randomly selected by cluster and quota method among health centers. Child growth was measured based on NCHS-WHO charts. A questionnaire was used for data collection. Data were analysed by SPSS Ver.18, using chi-square, and logistic Regression tests for comparing groups.

  Results : Prevalence of stunting (height for age) was 11.1%, (disorder of growth = 7.7%, severe malnutrition = 3.4%), underweight (weight for age) was 9.8% (disorder of growth = 7%). Malnutrition has significant association with birth grade, delivery type, hospitalization history, educational level of parents, parents' job, birth weight, vaccination and the regular consumption of supplementary vitamins (p<0/05).

  Conclusion: Although prevalence of malnutrition in this study was lower than WHO statistic report, (30%) but this is locally important and health staff and parents must be educated on nutritional values. Malnutrition is a major problem which is a reason for suppressed immune system, causing the increase of infectious diseases and infant mortality.

  Background: The most common method of collecting data in any area of human health research is to apply a questionnaire. However, if extreme cautiousness is not taking into account while designing a questionnaire, the gathered data might be ineffective. Therefore, the aim of the present article is to discuss some of the most important set of guidelines in designing a questionnaire.

  Materials and methods: To fulfil the aim of the study, it has been tried to search the relevant literature by looking at different search engines and also carry out hand searching. It has also been tried to elaborate any selected guidelines by examples relevant to occupational epidemiology .

  Results: The literature highlights that there are at the very least ten common-sense guidelines that one should take into account for designing a valid and reliable questionnaire.

  Conclusions: By following the proposed guidelines it is hoped that a deigned questionnaire is able to elicit the responses that one might need.

  Background: Composition of dust in the air due to contact with human via inhalation, ingestion and skin absorption will have a large impact on public health. In the learning environments such as universities, many people spend most of their day in contact with the dust. The purpose of this study was to evaluate the concentration of heavy metals lead, chromium and copper in the training space of the University of Birjand (Faculty of Agriculture and Natural Resources) and examining its ecological risks.

  Materials and Methods: This descriptive study evaluated a total of 16 samples where 4 samples pertained to the Faculty of Natural Resources and Environment and 12 samples were from the Faculty of Agriculture. For estimation of the heavy metals copper, chromium and lead, hydrochloric acid and nitric acid digestion were used. The concentration of heavy metals was measured using an atomic absorption instrument. T he regression coefficient was calculated by Ms Excle software.

  Results: The results showed that lead (3.414) and copper (14.884) degrees in the official room of the Faculty of Agriculture was more than the Faculty of Natural Resources and Environment while lead (2.575) and chromium (0.187) degrees were higher in the classrooms of the Faculty of Natural Resources. The regression correlation coefficient studies showed that the case study heavy metals had week correlation(R² 0.13 and 0.20) . The pollution index of the element chromium depicted the lowest pollution level and copper had the high pollution levels in some samples.

  Conclusions: However, the samples exhibited little ecological risks. Thus, the presence of these elements in dust does not lead to serious health hazards. Nevertheless, further studies at different time periods are worthwhile.

Background: Changes in global temperature and its health effects have recently been under much investigated. Consequently, these changes have affected mortality and morbidity rates which are important public health indices. The present study examines the effect of mean temperature on the frequency of hospitalization due to cardiovascular and respiratory diseases in Ali Ibn Abi Talib Hospital of Rafsanjan, Iran.

Materials and Methods: In this ecological study, data on hospitalization were gathered from electronic systems of hospitals and the data from the weather organizations were extracted from the weather station. All patients not living in Rafsanjan were excluded. Data were entered into SPSS and SAS software and the association between mean temperature and hospitalization frequency were analyzed using Poisson regression models.

Results: A negative significant association was found between mean temperature and mean number of hospitalizations due to cardiovascular and respiratory diseases. By each 1 °C decrease in mean temperature, the mean number of hospitalizations due to cardiovascular and respiratory diseases increased by 1% (95% CI 0.63-1.26%) and 4.33% (95% CI 4-4.64%), respectively. For cardiovascular diseases, there was no significant difference in mean number of admissions based on different age groups. However, in the 0-4-year age group, the mean number of hospitalizations due to respiratory diseases was significantly higher than the other age groups. For both cardiovascular and respiratory diseases, there was no significant difference between females and males in terms of the mean number of hospitalizations.

Conclusions: Reduction in mean temperature, in the present study, increased the mean number of hospitalizations due to cardiovascular and respiratory diseases and it was stronger for respiratory diseases. According to these findings, people who are at risk of cardiovascular and respiratory diseases should be forbidden from exposure to extremely cold temperatures.

 Background: We are living in an era in which different branches of science are growing very rapidly. Therefore, retrieving and summarizing all new valid findings on a specific subject is one of the most important priorities of scientists. The aim of the present article is to categorize different review studies within the health domain based on their approach to retrieving and summarizing original findings.

 Methods: The most relevant articles have been selected and summarized in order to accomplish the aim of the study.

 Results: Narrative reviews, systematic reviews, meta-analyses from published data, and individual participant data meta-analyses are different types of review studies. More recently, prospectively planned pooled analyses have also been introduced.

  Conclusions: Diverse types of review studies have been developed one by one over the course of time based on their approaches to retrieving and summarizing original findings. Therefore, they have their own especial applications and scientists of different disciplines need to know their advantages and disadvantages.

Background: Injuries and accidents are one of the main problems in the present century. The purpose of this study was the identification and analysis of the characteristics of pre-hospital emergency motor vehicle accidents (MVA) in Rafsanjan, Iran, in 2014.

Materials and Methods: This cross-sectional descriptive study was performed on all patients recorded by pre-hospital emergency during a period of one year (from 21 March 2013 to 20 March 2014). Our data were obtained from a crash record book kept at pre-hospital emergency dispatch. The crash database variables include age and gender of victims, vehicle type, type of collision, response time, location, and crash hotspots, and severity of injury. Accident data have been analyzed in SPSS software.

Results: In 2014, 1878 injured patients were transported to the general hospital by pre-hospital emergency dispatch. The mean age of victims was 29.10 ± 15.65 years, with the age range of 1-95 years. Among these cases, 85.8% were men and 14.2% were women. The majority of the patients (56.7%) were in the age range of 15-29 years, 30-44 years (20.6%), and 46-65 years (10.8%), respectively. Motorcycle accidents were the major cause of injuries (48.6%), and 4 patients (0.2% of all cases) died on the accident scene.

Conclusions: In the present study, motorcycle accidents constitute the majority of cases of MVAs. Therefore, safety training targeted at motorcyclists would be one of the best interventions for the prevention and controlling of trauma due to MVAs. This intervention could be the most efficient among younger drivers.

Background: One of the important aspects of the epidemiologic study of suicide and its related behaviors is the identification of suicide methods. This study aimed to investigate the geographical epidemiology of common methods of suicide and suicide attempts in Fars Province located in Southwestern Iran during the years 2010-2013.

Materials and Methods: The present study was conducted on 17,342 suicide and suicide attempt cases in Fars Province. To collect the data, the monthly suicide prevention program checklist was used. Data were analyzed using the SPSS software, R software, and ArcGIS software. Using Bayesian hierarchical models, the standardized mortality ratios (SMRs) were prepared and calculated according to the common suicide and suicide attempt methods.

Results: On average, the suicide rate in Fars Province was 3.85 in one hundred thousand people per year. The geographic pattern of suicide in the mentioned province showed that the highest rates of hanging were reported in the cities of Firuzabad, Farashband, and Larestan, Iran, and the highest rates of self-immolation were reported in cities of Mamasani, Shiraz, and Firuzabad, Iran.

Conclusions: Despite the low rate of suicide in the cities of Fars Province, the rate of suicide-related behaviors, including suicide attempt and suicide by violent and deadly methods, was high in some areas of the province. Therefore, restricting access to lethal means and methods of suicide and planning to identify areas with high risk for suicide in the province is necessary.

Background: Soil pollution and accumulation of heavy metals in crops in industrial areas is one of the most important environmental issues threatening the life of plants, animals, and humans. The aim of this study was to determine the concentration of Cr and Cd in the soil and barberry plants in farms surrounding the Qayen Cement Company, South Khorasan Province, Iran.

Materials and Methods: In this study, 8 soil samples were collected from a depth of 0-30 cm and 30-60 cm and 4 samples of barberry plant containing fruits and leaves in summer 2014. The concentrations of Cr and Cd in the samples were determined using atomic absorption spectrometry.

Results: The maximum concentration of Cr and Cd was observed in the soil sample collected from a depth of 0-30 cm (95.10 and 1.32 mg/kg of soil, respectively). The concentration of Cr and Cd was higher in the fruits of barberry than the leaves; 18.58 mg/kg and 59.45 µg/kg, respectively, which are higher than the standard values. Transfer factor was calculated as less than 1 for all stations.

Conclusions: According to obtained results, Qayen Cement Company has the greatest impact on plants in this region. The barberry fruit is the strategic product in Qayen; therefore, attention to and management of the impact of the cement factory on agricultural products is necessary.

Background: Health-promoting lifestyle is one of the determination criteria for health factors and the prevention of health-threatening factors. According to the available statistics, 53% of deaths are related to lifestyle. The aim of this study was to evaluate health-promoting lifestyles in medical students of Rafsanjan University of Medical Sciences (RUMS), Rafsanjan, Iran.

Materials and Methods: This was a descriptive study conducted in 2014 on 262 volunteer medical students. To collect data, a demographic information questionnaire and the Health-Promoting Lifestyle Profile II (HPLP-II) were used. Minimum and maximum scores of HPLP-II were 48 and 192, respectively. Data analysis was conducted using t-test, one-way ANOVA, Tukey's multiple comparison test, and non-parametric Kruskal-Wallis test.

Results: In this study, 58.8% of the participants were women. The mean age of the participants was 22.50 ± 2.16 years. The mean and standard deviation of the HPLP-II score of the medical students was 109.74 ± 18.65. There was a significant relationship between health-promoting lifestyle and variables of age (P = 0.007), university entrance year (P < 0.001), mother’s education level (P = 0.003), and father’s education level (P = 0.011). However, no relationship was observed between health-promoting lifestyle and parental occupation and place of residence (P > 0.050).

Conclusions: This study showed that the status of health-promoting lifestyles in medical students of RUMS was at a moderate level, but it is still at a great distance to the optimal level. Therefore, it is necessary to implement programs to promote a healthy lifestyle in order to maintain health in the youth until graduatio.

Background: Sleep and rest are basic physiological human needs. Nurses work irregularly in morning, afternoon, and evening shifts; therefore, they are at greater risk of sleep problems than others. The aim of this study was to identify the factors related to sleep quality of nurses at Rafsanjan University of Medical Sciences, Iran.

Materials and Methods: This cross-sectional study was conducted in 2013. The study subjects consisted of 366 nurses who were randomly selected from among nurses working at the medical university. Data collection tools included the occupational demographic questionnaire and Pittsburgh Sleep Quality Index (PSQI). Data analysis was performed using chi-square test and logistic regression model in SPSS software.

Results: It was found that 273 (74.7%) of the nurses had poor sleep quality. The overall mean score of nurses was 7.35 ± 2.86. The logistic regression model showed a statistically significant relationship between poor sleep quality and variables of age (P = 0.030) (95% CI: 1.09-1.010) (OR = 1.50), gender (P = 0.001) (95% CI: 0.23-0.70) (OR = 0.40), number of night shifts (P = 0.003), (95% CI: 1.138-1.11) (OR = 1.20), and having children of less than one year of age (P = 0.019) (95% CI: 3.8-1.12) (OR = 2.10). The chi-square test showed a significant relationship between poor sleep quality and the type of working shift (P = 0.001). About one-third of the nurses in this study used medicine for sleeping and had difficulty in falling asleep.

Conclusions: The results indicated that the sleep quality of the majority of the nurses was poor. It is suggested that a certain guideline be developed for planning nurses’ schedules using the results of this study and other studies in this area.

Background: Nosocomial infections are an important cause of hospital mortalities. Staphylococcus aureus (S. aureus) carriers among medical staff are an important source of nosocomial infections. The purpose of this study was to investigate the prevalence of the nasal carriers of S. aureus and antibiotic resistance in staff of Nikuee Hospital, Qom, Iran.

Materials and Methods: In this cross-sectional study, 152 health care workers (HCWs) were assessed to determine the frequency of nasal carriage of S. aureus, the rates of methicillin-resistant S. aureus (MRSA), and their antibiotic resistance profiles in Nikuee Hospital in 2012. Clinical samples were cultured and S. aureus was detected using conventional bacteriologic methods. Antimicrobial susceptibility patterns against penicillin, vancomycin, erythromycin, clindamycin, cefazolin, co-trimoxazole, and doxycycline were evaluated using the Kirby-Bauer disk diffusion technique. Methicillin resistance was confirmed by oxacillin disk diffusion test. Data were analyzed in SPSS software using chi-square test and independent two-sample t-test.

Results: Among the processed samples, 34.2% illustrated nasal carriage of S. aureus, and among them, 23.5% were carriers of MRSA. None of the isolates were resistant to vancomycin. However, 96.1%, 33.3%, 27.5%, 19.6%, 9.8%, and 15.7% resistance to penicillin, erythromycin, clindamycin, cefazolin, co-trimoxazole, and doxycycline were observed. There was no significant relationship between sex, age, and number of years of healthcare service and positive nasal carriage.

Conclusions: Data obtained in this study revealed high prevalence of nasal carriage of S. aureus (34.2%) in HCWs at Nikuee Hospital. Therefore, it can be concluded that the role of the hospital staff in Nikuee Hospital as a source of staphylococcal infections is prominent. Thus, to prevent nosocomial infections, we recommend the identification and treatment of the carriers among the staff of other hospitals.

Background: Iron deficiency anemia (IDA) during pregnancy is a common nutritional disorder with adverse effects for the baby, such as premature birth and low birth weight, and the mother, such as cardiovascular symptoms and reduced physical and mental strength. Therefore, identifying factors affective on IDA will assist the improvement of the health of the mother and fetus. This study aimed to determine the prevalence of IDA in the first and third trimester of pregnancy and some related factors in pregnant women referred to healthcare centers in Bandar Lengeh, Iran, in 2015.

Materials and Methods: In this cross-sectional study, 418 pregnant women, who were referred to health centers in the city and had completed their pregnancy, were assessed through systematic sampling. Data were collected using the researcher-made checklist and through a review of health records. Data were analyzed using chi-square, Fisher's exact, and McNemar's test.

Results: The mean age of the participants was 27.17 ± 5.62 and most participants were in the age group of 18-35, had high school education, were homemakers, and experienced their first pregnancy. The findings of the study showed that the prevalence of IDA was 22.5% (confidence interval: 18.4%–26.5%) and 45.9% (Confidence interval: 41.1%–50.6%) in first and third trimester of pregnancy, respectively. IDA in first and third trimester of pregnancy had significant correlation with pregnancy interval (P < 0.009 and P < 0.001, respectively); with increase in the pregnancy interval, the prevalence of IDA also increased.

Conclusions: According to the results, it seems that the prevalence of IDA was undesirable, especially in the third trimester. Since this eating disorder is a preventable complication and pregnant women are a group at risk of anemia, attention to the expansion of pre-pregnancy care, increased awareness of mothers regarding appropriate nutrition and maintenance of a diverse and balanced diet, regular consumption of supplements, contraception in older women, and maintenance of appropriate intervals between pregnancies seem essential.

Background: Every year, eating, exercise, work, and travel patterns change during the holidays and these behavioral changes at a larger scale may cause death due to cardiovascular disease (CVD). Considering the importance of CVD, the present study was conducted for the first time in Iran to determine the differences in the ratio of deaths due to CVD on holidays and working days.

Materials and Methods: This was a descriptive study. The study population consisted of all hospitalized cases of CVD in the city of Rafsanjan, Iran, during the years 2010-2014. Data on individuals were collected through electronic systems available at Ali-ibn Abi Talib Hospital, Rafsanjan. Holidays were specified using the official Iranian calendar and the number of deaths caused by CVD on holidays and working days were extracted. Finally, the collected data were entered into SPSS software and were analyzed using independent t-test, chi-square, and logistic regression model.

Results: Within 5 years, about 11124 cases of hospitalizations due to CVD were studied. Among the total hospitalized cases, 993 deaths were reported. Of these cases of death 3.5% occurred on Iranian New Year holidays, 4.5% on Islamic and National holidays, 11.5% on Fridays and 80.5% on the ordinary days of the year (P< 0.001). The results of logistic regression model have revealed that after considering the effects of other variables the odds ratio of death due to CVD was 1.913, 1.477 and 1.572 respectively in Iranian New Year holidays, Islamic and National holidays and Fridays compared with the ordinary days of the year.

Conclusions: The results of this study showed that the holidays in Iran may have an additive effect in relation to deaths from cardiovascular disease.

Background: Gastrointestinal cancers are among the most common cancers in different communities. Gastrointestinal tract cancer is the most common cancer among Iranian men and the second common cancer among Iranian women. Due to the impact of environmental factors on the risk of gastrointestinal cancer and the increasing use of agricultural pesticides, this study aimed to investigate the effects of exposure to pesticides on gastrointestinal cancer among  pistachio farmers, Rafsanjan, Iran

Materials and Methods: In this case-control study, 79 patients with gastrointestinal cancer (cases) and 143 healthy people (controls) were studied. For each case, two people were selected as controls for each case  from  their neighbors and relatives. Data were  collected  using the study checklist which included demographic  information and specific items related to their exposure. Data were  analyzed using independent t-test, chi-square test, Fisher’s exact test, and logistic regression. 

Results: The risk of gastrointestinal cancer after controlling some confounding factors among individuals who were exposed to  spraying pesticides  for less than 10 days per year was 1.38 (CI: 0.70-2.71), and in individuals who were exposed to it for between 10 to 20 days per year was 1.71 (CI: 0.79-3.7). The difference was not statistically significant . However, for individuals who had this exposure for more than 20 days per year, the risk was increased to 8.53 (CI: 2.1-34.7) which was statistically significant (P = 0.004). Unexpected exposure to agricultural pesticides and living close to pistachio gardens, both significantly (P < 0.05) increased the risk of gastrointestinal cancers by 8.67 (CI: 1-75.71) and 2.7 (CI: 1.43-5.1), respectively. Among subjects who used  protective equipment, the risk of gastrointestinal cancer was statistically lower (OR = 0.18, 95%CI: 0.042-0.85) than this risk among people who did not use this equipment (P = 0.03).

Conclusions: Our findings showed that exposure to pesticides, in particular for long time, increased the risk of gastrointestinal cancer among pistachio farmers. Further studies in this area are recommended.

Background: Acquired immune deficiency syndrome (AIDS) is a fatal viral disease which can affect the patient’s immune system and render the patient susceptible to opportunistic infections. In recent years, the number of women with HIV acquired through sexual transmission has increased. Therefore, due to the importance of quality of life (QOL) among these women and the impact of violence and social support on their QOL, this study can assist in the recognition of effective factors on QOL of these patients.

Materials and Methods: The study population of this descriptive study consisted of all patients with Human immunodeficiency virus infection/AIDS (HIV/AIDS) who had medical records at the Behavioral Disorders Counseling Center of Shiraz, Iran. To assess QOL, violence, and social support among these patients, the World Health Organization Quality of Life (WHOQOL) scale and the Domestic Violence Questionnaire (DVQ) plus Social Support Questionnaire (SSQ) were used. The collected data were analyzed using Independent two-sample t-test, ANOVA, and correlations.

Results: The QOL and SSQ scores of single individuals were higher compared to other groups and violence was lower in this group. The QOL and SSQ scores of residents of rural areas were lower compared to residents of urban areas. Moreover, the violence score of this group was higher. The QOL and SSQ scores of individuals with higher educational level and better economic status were higher than other groups, but their violence score was lower.

Conclusions: Total mean QOL, violence, and social support scores were assessed in the present study. Based on the correlation found between these variables, it can be concluded that women with HIV/AIDS require more social support so that their QOL, which is one of the main determinants of health, can be improved.

Background: A disease impacts patients’ participation level in their individual and social life through impacting their physical and mental performance. Due to the increasing prevalence of diabetes mellitus (DM), and the importance of patients’ participation and quality of life (QOL) and the determination of the most important aspects affected by the disease in the participation and Quality of Life of patients with type II DM in Rafsanjan, Iran, the present study was conducted.

Materials and Methods: In this cross-sectional study, 227 patients with type II DM were assessed. The data collection tool consisted of a 2-part questionnaire. The first part was a demographic characteristics checklist. The second part was the Persian version of the Impact on Participation and Autonomy (IPA-p) scale. The IPA-p scale was used to collect data on the subjects' participation in their own life. Then, a trained individual completed the demographic checklist through interviews. Subsequently, the subjects were asked to complete the IPA-p scale.The collected data were analyzed in SPSS software. Statistical tests such as t-test and ANOVA were used to compare the obtained means.

Results: The highest level of participation was observed in the age group of 30-49 years, and participation was higher in men, single individuals, and individuals with a good economic status.

Conclusions: The results of the present study suggested the presence of a statistically significant relationship between the participation of patients with type II DM and individual, social, economic factors. Thus, this disease causes a reduction in their participation in different life aspects, and therefore, causes a reduction in QOL. With the consideration of the long-term course of the disease, taking measures to improve individuals’ participation level seems necessary.