Recent studies have shown that the rate of needlestick and sharps injuries (NSIs) is unacceptably high in Iranian hospitals. The aim of the present study was to use a systematic approach to predict and reduce these injuries. This cross-sectional study was conducted in 5 hospitals in Tehran, Iran. Eleven variables thought to affect NSIs were categorized based on the Human Factors Analysis and Classification System (HFACS) framework and modeled using a Bayesian network. A self-administered validated questionnaire was used to collect the required data. In total, 343 cases were used to train the model and 50 cases were used to test the model. Model performance was assessed using various indices. Finally, using predictive reasoning, several intervention strategies for reducing NSIs were recommended. The Bayesian network HFACS model was able to predict 86% of new cases correctly. The analyses showed that safety motivation and fatigue were the most important contributors to NSIs. Supervisors' attitude toward safety and working hours per week were the most important factors in the unsafe supervision category. Management commitment and staffing were the most important organizational-level factors affecting NSIs. Finally, promising intervention strategies for reducing NSIs were identified and discussed. To reduce NSIs, both management commitment and sufficient staffing are necessary. Supervisors should encourage nurses to engage in safe behavior. Excessive working hours result in fatigue and increase the risk of NSIs.

Nurses, as the largest forces in the health system, are always challenged with various work responsibilities such as long working hours, lack of manpower and death of patients. This study aimed at providing a model of the relationship between workload and physical and mental health, sleep disorders, and individual and family problems by the mediation role of job stress. The present study is a cross-sectional study that was conducted on 300 nurses in a specialty and sub-specialty hospital in Tehran. For this reason, various questionnaires including demographic, survey of shift workers (SOS) and job stress questionnaires were used to collect the desired data. The proposed model was presented using structural equation modeling method based on Smart-PLS and SPSS-20 software. The results show that workload has an effect on job stress (β=0.747), mental health (β=-0.291), Physical health (β=-0.253), sleep quality (β=-0.234) and personal and family problems (β=-0.206). Also the results of this study show that job stress has an effect on mental health (β=-0.295), Physical health (β=-0.349), sleep quality (β=-0.295) and Personal and family problems (β=-0.441). In conclusion, results showed that the data fitted well with the model and that workload is associated with physical and mental problems, sleep disorders and individual and family problems both directly and indirectly through job stress mediation.

Background: Working outside daylight hours (7 am to 7 pm) is called shift work. Shift work is a common practice in many industries and factories such as steel industries, petroleum industries, power plants, and in some services such as medicine and nursing and police forces, in which professionals provide services during day and night. Objectives: Considering the contradictory reports of different studies, we decided to evaluate the effect of shift work on cholesterol and triglyceride (TG) levels through a historical cohort on steel industry workers. Patients and Methods: This retrospective cohort study was performed on all the staff of Isfahan’s Mobarakeh Steel Company between years 2002 and 2011. There were 5773 participants in this study. Data were collected from the medical records of the staff using the census method. For analysis of data, generalized estimating equation (GEE) regression was used. Results: The results showed a significant difference in cholesterol levels between shift workers and day workers on the first observation (P < 0.001), yet no such difference was observed for TG (P = 0.853). Moreover, the results showed that the variables of age, work experience and BMI were not similar between shift workers and day workers. Therefore, to remove the effect of such variables, we used GEE regression. Despite the borderline difference of cholesterol between regular shift workers and day workers, this correlation was not statistically significant (P = 0.051). The results for TG also showed no correlation with shift work. Conclusions: According to the findings of this study, there is no relationship between shift work and changes in serum TG and cholesterol. The lack of relationship can be due to shift plans for shift workers, nutrition, or the “Healthy Heart project” at Isfahan Mobarakeh Steel Company. Keywords: Shift Work; Cholesterol; Triglycerides; Cohort Studies; GEE

Objective: Malnutrition, overweight and obesity are major health concerns in modern societies and especially among children. Overweight and obesity affect children's current and future health. It is known that the prevalence of overweight differs by race, sex, and geographic location. Methods: In a cross-sectional study 30092 Iranian children aged 7-18 years in six ethnic groups were selected by a cluster sampling. Prevalence of obesity and overweight and distribution of body mass index (BMI) by gender, age, and ethnicity were measured. Cutoff points of BMI for defining obesity and overweight were based on the Iranian, and IOTF standard values. Findings: This study showed a significant ethnic difference in BMI. Prevalence of overweight and obesity among Iranian children was 9.27% and 3.22% respectively comparing international standards. The frequency of overweight and obesity was higher in boys. Conclusion: This study showed a significant difference in BMI among different ethnic groups.

Background It has been suggested that shift work (SW) is associated with changes in blood pressure (BP). However, studies have reported contradictory results. Aims To prospectively examine the association between SW and BP among male workers. Methods A historical cohort study, involving workers of Esfahan's Mobarakeh Steel Company, in Iran, was conducted over 14 years. The association between SW, systolic BP (SBP) and diastolic BP (DBP) was investigated after adjusting for body mass index, age, work experience, marriage, smoking and education based on the Bayesian multilevel modelling approach. Results The study sample included 5331 male workers. The mean age (standard deviation, SD) was 34.8 (6.6) years and mean work (SD) experience was 9.4 (6.1) years. Among these subjects, 2348 (44%), 340 (6%) and 2643 (50%) were day workers, weekly rotating shift workers and routinely rotating shift workers, respectively. The mean SBP (SD) and DBP (SD) of these workers were 118.7 (8.1) and 73.1 (6.7) mmHg, respectively. After controlling for several confounding variables, there was no significant relationship between SBP and DBP and SW. Conclusions No significant association between SW and BP was observed among these three groups (day workers, weekly rotating shift workers and routinely rotating shift workers). Prospective studies, which control for confounding factors, such as the healthy worker effect, occupational history, family history and psychological factors (e.g. occupational stress and job satisfaction), are required to evaluate this further.