Assessment of the prevalence of occupational accidents and their influential actors in an electricity distribution company during a five-year period

BACKGROUND: Occupational accidents have been considered as one of the most important crippling factors contributing to disabilities and life-threatening situations in many countries. This study was conducted to survey the prevalence of occupational accidents and the factors of that lead to injuries in an Electricity Distribution Company during a five-year period. METHODS: In this descriptive study, the accident report form included items asking about the season of the year when the accident occurred, the ages and the average age of those injured, the type of employment, work experience, nature of the injuries that occurred, parts of the body affected, treatments that were applied, average number of days lost per accident, the levels of education of those involved, and their marital status. Data was analyzed using SPSS. RESULTS: A total of 66 Electricity Distribution Company workers were determined to be suffering from injuries due to accidents. The accidents mostly occurred in the summer (33). Most of the injured workers (16.7) belonged to the age groups of 25 to 29 and 40 to 44; there were no accidents reported for workers who were less than 20. About 48 of the accident victims had to be hospitalized. Furthermore, 35 of the accident victims were treated in outpatient clinics, and 7.4 of the accident victims died. We demonstrated that there were significant relationships between: 1) marital status and accidental injuries (P0.05) or work experience and the distribution of the accidents (P>0.05). CONCLUSION: This study indicated that most of the injuries in these accidents were related to the nature of employment, marital status, and level of education. The results showed the necessity for providing appropriate safety training for the workers

What Do Patients Expect from Their Physicians?

Background: To identify the most important expectations that patients have from their physicians. Methods: We collected data from 199 hospitalized and 201 ambulatory patients (response rates 88% and 93% respectively). We used random sampling for selection of hospitalized patients and systematic sampling for the ambulatory ones. The questionnaire consisted of 18 different expectation items categorized in 5 domains. The participants scored each item from 1 to 9 using a VAS scale and ranked domains based on their importance. We analyzed the data using univariate and regression analyses. Results: Among the ambulatory patients, the mean±standard error of the most important expectations was as follows: com­petency (8.9±0.01), courteousness (8.8±0.04), consultation in case of need (8.8±0.4), clear explanation of the disease (8.8± 0.05) and attentiveness (8.8±0.04). In hospitalized patients, the following items were the most important: competency (8.4± 0.08), courteousness (8.4±0.09), availability of physician (8.4±0.09), consultation in case of need (8.2±0.11), setting follow­ing appointments (8.2±0.1), and disease follow-up (8.2±0.09). In both groups, the most important domain of expecta­tions was "competency and quality of care" followed by "availability" in hospitalized and "giving information and patient auton­omy" among ambulatory patients. Conclusions: Our findings are similar to what reported in the literature from other countries and cultures. In addition to physician expertise and knowledge, patients value giving information and efficient doctor-patient relationship

Presentation of a method for consequence modeling and quantitative risk assessment of fire and explosion in process industry (Case study: Hydrogen Production Process)

Introduction: Process industries, often work with hazardous and operational chemical units with high temperature and pressure conditions, such as reactors and storage tanks. Thus, probabilities of incidence such as explosions, and fire are extremely high, The purpose of this study was to present a comprehensive and efficient method for the quantitative risk assessment of fire and explosion in the process units. .Material and Method: The proposed method in this study is known as the QRA and includes seven steps. After determination of study objectives and perfect identification of study process, first, qualitative methods are used to screen and identify hazard points and the possible scenarios appropriate are identified and prioritized. Then, estimation of frequency rate are done using past records and statistics or Fault Tree Analysis along whit Event Tree. PAHST professional software and probit equations are used in order to consequence modeling and consequence evaluation, respectively. In the last step by combination of consequence and frequency of each scenario, individual and social risk and overall risk of process or under study unit was calculated.  .Result: Applying the proposed method showed that the jet fire, flash fire and explosion are most dangerous consequence of hydrogen generation unit. Results showed that social risk of the both fire and explosion caused by full bore rupture in Desulphrizing reactor (Scenari3), Reformer (scenario 9) and Hydrogen purification absorbers are unacceptable. All of the hydrogen generation unit fall in ARARP zone of fire individual risk (FIR) and FIR up to 160 m of boundary limit unit is unacceptable. This distance is not only beyond of hydrogen generation unit boundary limit, but also beyond of complex boundary limit. Desulphurization Reactor (75%) and Reformer (34%) had the highest role in explosion individual risk in the control room and their risks are unacceptable.  .Conclusion: Since the proposed method is applicable in all phases of process or system design, and estimates the risk of fire and explosion by a quantitative, comprehensive and mathematical-based equations approach. It can be used as an alternative method instead of qualitative and semi quantitative methods

Assessment of the prevalence of occupational accidents and their influential actors in an electricity distribution company during a five-year period

BACKGROUND: Occupational accidents have been considered as one of the most important crippling factors contributing to disabilities and life-threatening situations in many countries. This study was conducted to survey the prevalence of occupational accidents and the factors of that lead to injuries in an Electricity Distribution Company during a five-year period. METHODS: In this descriptive study, the accident report form included items asking about the season of the year when the accident occurred, the ages and the average age of those injured, the type of employment, work experience, nature of the injuries that occurred, parts of the body affected, treatments that were applied, average number of days lost per accident, the levels of education of those involved, and their marital status. Data was analyzed using SPSS. RESULTS: A total of 66 Electricity Distribution Company workers were determined to be suffering from injuries due to accidents. The accidents mostly occurred in the summer (33). Most of the injured workers (16.7) belonged to the age groups of 25 to 29 and 40 to 44; there were no accidents reported for workers who were less than 20. About 48 of the accident victims had to be hospitalized. Furthermore, 35 of the accident victims were treated in outpatient clinics, and 7.4 of the accident victims died. We demonstrated that there were significant relationships between: 1) marital status and accidental injuries (P0.05) or work experience and the distribution of the accidents (P>0.05). CONCLUSION: This study indicated that most of the injuries in these accidents were related to the nature of employment, marital status, and level of education. The results showed the necessity for providing appropriate safety training for the workers

The role of modeling and consequence evaluation in improving safety level of industrial hazardous installations: A case study: Hydrogen production unit

Background and aims: One of the most essential and important steps for improving safety level in existing or designing units is consequence evaluation of hazards such as fire, explosion and dispersion of hazardous chemical substances. Due to severe operational conditions, high explosive and flammable gases such as methane and hydrogen, hydrogen production process is causing major industrial accidents of the view life and financial losses. Therefore safety is main concern of hydrogen producers. Methods: First, all hazards and potential scenarios of hydrogen production were identified by applying HAZID Technique, and after collecting the required data, consequence modeling was done by means of professional software PHAST6.54. Death probability of people by means of valid equations of probit was calculated and ultimately, the severity of the consequences was estimated using conventional criteria. Results: The results revealed that, jet fire caused by a full bore rupture in Desulphurization reactor has the highest fatality (26person). The harm effect distance, maximum radiations of this incident were 250 m, 370 kW/m2 respectively. A full bore rupture in Reformer can lead to the most dangerous flash fire. So that people at distance up 130 m from placing leakage and affected area 1505m 2 were exposed to concentration of 61120 ppm and all people would be killed. The most dangerous vapor cloud explosion caused by hydrogen purification absorbers, so that distances up to 60m from absorbers location all people would be killed and all process equipments and buildings will be completely destroyed. The safe distance of hydrogen production unit equals to 746 m from its boundary limit. Conclusion: Consequence evaluation is a quantitative and comprehensive method for estimation and evaluation of potential incidents severity of industrial hazardous units. The occurrence of incidents such as fires and explosions has the great life and financial losses in the hydrogen production process, Thus safety of industries nearby hydrogen production and consume must be specifically considered

Medical student training and patient satisfaction in the internal medicine clinics of Imam Khomeini Hospital

Introduction: The aim of this study was to investigate the effect of Medical Student Training on patients satisfaction referred to the internal medicine clinics. Methods: This is a cross sectional descriptive study. 200 outpatients referred to the internal medicine clinic Imam Khomeini Hospital were selected by convenient sampling. The participants were divided into two groups. The group which firstly visited by a specialist and the group which firstly visited by intern and then a specialist. In this study, researcher made questionnaire was used for measuring the patient satisfaction. Data were analyzed by using one-sample t-test, independent t-test and pair-t test. Results: The finding showed that patients are satisfied of the presence and performance of medical interns in clinics and they preferred to be visited by intern and a specialist rather than only by a specialist (p<0.001, t=13.55). The satisfaction scores of the patients in the areas of description of personal issues, a doctor knowledge, involvement in treatment decisions, feeling of visitor comfort and understand the patient's feeling visited by an intern were higher than those who were visited by only a doctor. Also, the mean scores of the patient satisfaction in the dimensions of asking questions, understandable given information, complete treatment, compliance of respectable and understand competence of given information in patients who were visited by only a doctor were more than the patients who were visited by an intern (p<0.05, t= 1.99). Conclusion: It can be concluded that the training medical students in internal medicine clinic of hospitals can be an effective strategy for the rate of satisfaction level of patients from their treatment