Development of National profile for occupational safety and health services in Iran (IRANOSH): a mixed-method study focusing on input and process indicators

BACKGROUND

This study introduces a protocol for developing anational profile for occupational safety and health services (NPOSH), tailored for Iran (IRANOSH). Itfocuses on basic information, structure, programs, and human resources, highlighting challenges and practicesin the context of OSH services.

METHODS

Forty-six NPOSH indicators were identified through content analysis of literature and categorized into ten domains and six types. The NPOSH framework was customized for Iran (IRANOSH) following an initial focus group discussion. Quantitative data were collected by 2,317 occupational health inspectors from820,846 workplaces across Iran, including3,734,249 workers. The quantitative and qualitative indicators were further discussed in a second focus group.

RESULTS

Quantitative findings show the target population for occupational safety and health (OSH) services was estimated to be 34% of the country's population. Small workplaces comprised 98% of all workplaces including 40% of workers. Access to OSH structures indicates one OSH center per 154 workers and 33 workplaces, one OSH engineeringcompany per 12,447 workers and 2,736 workplaces, and one OSH medical examination center per 3,404 workers and 748 workplaces. Access to OSH human resources involves one OSH inspector for every 354 workplaces and 1,612 workers and one occupational medicine specialist for every 3,270 workplaces and 14,877 workers.Qualitative findings show that thekey OSH programs in Iran include targeted inspections, occupational medical examinations, and monitoring of occupational exposures focusing on difficult and hazardous occupations in medium to large workplaces. Small workplaces present the most significant challenge and priority. A pronounced shortage of human resources hampers service provision, making developing OSH services for these settings a top priority.

CONCLUSIONS

Implementing an OSH self-assessment system through trade unions is proposed to bridge OSH service gaps. Additionally, expanding the PHC system to incorporate OSH structures within public organizations is essential for improving service delivery. Customizing the NPOSH framework for other countries with various health system contexts is recommended. Updating this study and comparing current findings with other data sources will help validate the current findings.

Occupational respiratory disorders in Iran: a review of prevalence and inducers

The link between occupational respiratory diseases (ORD) and exposure to harmful factors that are present in the workplace has been well shown. Factors such as physical activity, age and duration of occupational exposure playing important roles in ORD severity, should be identified in the workplace, their effects on workers health should be studied, and ultimately, exposure to them must be minimized. We carried out a literature review by searching PubMed, Scopus, and Web of Science databases to retrieve studies published from 1999 until the end of April 2023 reporting the prevalence and inducers of ORD in Iran. In Iranian workers, several ORD such as interstitial lung disease, silicosis, occupational asthma, pulmonary inflammatory diseases, chronic obstructive pulmonary diseases, and lung cancers have been reported. It was indicated that ORD mainly occur due to repeated and prolonged exposure to noxious agents in the workplace. We also extracted the prevalence of ORD in different regions of Iran from the retrieved reports. Based on our literature review, the prevalence of ORD among Iranian workers highlights the importance of regular assessment of the risk of exposure to noxious agents in the workplace to develop measures for preventing potential adverse effects.

National, subnational and risk attributed burden of chronic respiratory diseases in Iran from 1990 to 2019

INTRODUCTION

Data on the distribution of the burden of diseases is vital for policymakers for the appropriate allocation of resources. In this study, we report the geographical and time trends of chronic respiratory diseases (CRDs) in Iran from 1990 to 2019 based on the Global burden of the Disease (GBD) study 2019.

METHODS

Data were extracted from the GBD 2019 study to report the burden of CRDs through disability-adjusted life years (DALYs), mortality, incidence, prevalence, Years of Life lost (YLL), and Years Lost to Disability (YLD). Moreover, we reported the burden attributed to the risk factors with evidence of causation at national and subnational levels. We also performed a decomposition analysis to determine the roots of incidence changes. All data were measured as counts and age-standardized rates (ASR) divided by sex and age group.

RESULTS

In 2019, the ASR of deaths, incidence, prevalence, and DALYs attributed to CRDs in Iran were 26.9 (23.2 to 29.1), 932.1 (799.7 to 1091.5), 5155.4 (4567.2 to 5859.6) and 587,911 (521,418 to 661,392) respectively. All burden measures were higher in males than females, but in older age groups, CRDs were more incident in females than males. While all crude numbers increased, all ASRs except for YLDs decreased over the studied period. Population growth was the main contributor to the changes in incidence at a national and subnational levels. The ASR of mortality in the province (Kerman) with the highest death rate (58.54 (29.42 to 68.73) was four times more than the province (Tehran) with the lowest death rate (14.52 (11.94 to 17.64)). The risk factors which imposed the most DALYs were smoking (216 (189.9 to 240.8)), ambient particulate matter pollution (117.9 (88.1 to 149.4)), and high body mass index (BMI) (57 (36.3 to 81.8)). Smoking was also the main risk factor in all provinces.

CONCLUSION

Despite the overall decrease in ASR of burden measures, the crude counts are rising. Moreover, the ASIR of all CRDs except asthma is increasing. This suggests that the overall incidence of CRDs will continue to grow in the future, which calls for immediate action to reduce exposure to the known risk factors. Therefore, expanded national plans by policymakers are essential to prevent the economic and human burden of CRDs.

Evaluation of pulmonary function among detergent powder factory workers- a cross sectional study in Semnan, Iran

Occupational respiratory diseases are the most prevalent occurring work-related diseases that contribute to global health concerns. The present study aimed to assess pulmonary function among detergent powder factory workers.In a cross-sectional study, 305 employees working at a detergent powder company in Semnan, Iran were enrolled. Demographic characteristics, health- and job-related information were recorded using a checklist. Subsequently, spirometer was used at baseline, before and after shift-working for recording respiratory ailments and pulmonary function tests (PFT).According to the results, the mean percentage of all spirometric indices significantly reduced after shift-work including forced vital capacity (FVC) (P < 0.01), forced expiratory volume in one second (FEV1) (P < 0.01), FEV1/FVC ratio (P = 0.038), peak expiratory flow (PEF) (P = 0.13) and forced expiratory flow at 25 and 75% of the pulmonary volume (FEF (25-75)) (P < 0.01). Although the mean percentage of FEV1 significantly improved upon wearing the protective mask (P = 0.014). Moreover, FVC and FEV1 indices were significantly less in smoking workers than in non-smoking participants (P = 0.005 and P = 0.003, respectively).This study revealed that using effective preventive measures should be tightly performed to promote health conditions. However, despite the occupational health programs for preventing and reducing work-related respiratory diseases, these can be considered as a serious threat for detergent powder factory workers that need to apply more control strategies and health assessment.