International Journal of Occupational Safety and Health
IJOSH is the official journal of the Occupational Health and Safety Society of Nepal (OHSSN). International Journal of Occupational Safety and Health (IJOSH) is an international peer-reviewed, open-access journal covering occupational health and safety-related disciplines (occupational health, safety, and workers' health, including homemakers and students). IJOSH is published quarterly. It provides occupational health physicians, doctors, nurses, engineers, ergonomists, and a wide range of occupational hygiene, health, and safety professionals with a dependable single source of proficiently written legal, practical, and management occupational health information. This journal provides immediate open access to its content on the principle that making research freely available to the public supports a greater global exchange of knowledge. IJOSH is a member of the Committee on Publication Ethics (COPE). IJOSH is indexed in the Directory of Open Access Journals (DOAJ), EBSCO, EMBASE (Excerpta Medica database), SCI Journal, SCImago, and Scopus. IJOSH does not collaborate with any international conferences and publication houses, and please do not contact us for the same.
Occupational Health and Safety Society of Nepal
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A pilot study approach on occupational disorders among metal craftsmen of Lalitpur, Nepal
Introduction: Metalcraft is a centuries-old tradition in Lalitpur, Nepal. Workers are exposed to various ergonomic and respiratory risks due to prolonged exposure to metal dust, fumes, and repetitive physical tasks. The present study aims to assess the pulmonary function and musculoskeletal complaints among metal craftsmen, particularly involved in making sculptors . Methods: A pilot cross-sectional study was conducted among 30 metal craftsmen purposively selected in Lalitpur Metropolitan City ward no. 6 and 17. Pulmonary Function Tests (PFT) were performed using a digital spirometer. Musculoskeletal discomfort was assessed using the standardized Nordic Musculoskeletal Questionnaire. Results: 46.6% of metal craftsmen showed signs of respiratory disorders. Significant differences were found in % Predicted FEV1 and FEV1/FVC ratios (p < 0.05) between the different types of work in which metal craftsmen were involved. Lower back discomfort was the most common musculoskeletal complaint, but differences across work types and hours were not statistically significant. Conclusion: Occupational exposure among metal craftsmen may contribute to respiratory impairment. Musculoskeletal issues, although reported, were not significantly associated with work type or duration in this pilot sample. Further research with a larger sample is warranted.
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Bronchoalveolar lavage as a tool for assessing potential occupational exposure: a retrospective study
Introduction: Bronchoalveolar lavage (BAL) is a fundamental diagnostic procedure for evaluating diffuse parenchymal lung diseases (DPLDs). However, its diagnostic precision is critically dependent on the integration of a detailed occupational history. Occupational exposures are frequently overlooked in clinical practice, leading to potential misdiagnosis. Methods: We conducted a retrospective analysis of 210 BAL samples from 207 patients over one calendar year at a tertiary referral hospital in Attica, Greece. Data regarding demographics, smoking status, and occupational history (classified via ISCO-08) were correlated with BAL cytology using descriptive statistics, χ² tests, t-tests, and one-way ANOVA with post-hoc comparisons. Missing data were supplemented through extensive record review and patient interviews. Results: Occupational history was absent in 79.5% of initial clinician referrals. Upon data completion, 23.3% of patients were identified as active workers. Workers in the agricultural and forestry sector (ISCO-08 Group 6) showed significantly higher total BAL cell counts (P = 0.025) and specific cytological patterns, including increased macrophages and mast cells. While smoking significantly altered differential counts, it did not influence the total cell count. Conclusion: Specific BAL profiles are associated with certain occupational groups, yet a significant gap in history-taking persists. Systematic occupational assessment is mandatory to improve the diagnostic utility of BAL in respiratory medicine. These findings suggest that BAL can serve as a valuable 'sentinel tool' for occupational surveillance in respiratory medicine.
Burnout syndrome and (self-)dehumanization among nurses in intensive care units [ICUs]: a cross-sectional study
Introduction: Burnout and dehumanization are frequent psychological phenomena in healthcare environments, particularly among nurses. While dehumanization may serve as an adaptive mechanism to manage emotional strain and enhance clinical efficiency, excessive or prolonged exposure can lead to self-dehumanization and disrupt nurse–patient relationships, ultimately impairing the quality of care. Methods: A cross-sectional study was conducted among 78 volunteer nurses employed in intensive care units [ICUs] of Evangelismos General Hospital in Athens, Greece. Data were collected using three validated questionnaires based on the Oldenburg Burnout Inventory and the Dehumanization and Mechanistic Self-Dehumanization scales developed by Katerina Roupa. Statistical analyses included Mann–Whitney, Kruskal–Wallis, and Spearman’s rho tests, with the significance level set at 0.05. Results: Most participants were female (67.9%) and over 40 years old (55.2%). Low burnout levels were found in 76.9% of participants, moderate in 15.4%, and high in 7.7%. Higher burnout levels were observed among nurses with lower educational backgrounds, permanent contracts, one or two children, and fewer working hours. Male nurses demonstrated higher dehumanization and self-dehumanization scores than females. Work exhaustion was associated with males having 3–10 years of experience. A significant negative correlation was found between self-dehumanization and burnout. Additionally, nurses who tended to dehumanize their patients were more likely to self-dehumanize. Conclusion: Although dehumanization and self-dehumanization may function as emotional regulation strategies against burnout, they have detrimental implications for nursing care and therapeutic relationships. Preventive interventions should aim to balance emotional resilience with patient-centered care. Keywords: Burnout, Dehumanization, Nurses, Occupational Stress, Self-Dehumanization
Development of an attitude scale for occupational health and safety
Introduction: The concept of occupational health and safety has become one of the most fundamental issues in today's working life. This concept, which has extremely important implications in human, economic, legal and social dimensions, has created an important field of research in the scientific arena. The aim of this study is to develop an attitude scale towards occupational health and safety, which is one of the most current issues in working life. Methods: In this study, scale design technique, one of the quantitative research methods, was used. The study was conducted on 554 blue-collar workers employed at two factories operating in the ceramics and forest products sectors in the Çanakkale Çan Organised Industrial Zone. Results: A draft scale consisting of 50 items was developed. Exploratory factor analysis was performed with data collected from 277 participants, and the scale completed the EFA analysis with 34 items and 4 sub-factors. Conclusion: As a result of the study, the Attitude Scale Towards Occupational Health and Safety was developed, consisting of four sub-factors (personal, management, education, and work environment) and 32 items.
Factors affecting risk level of work postures of durian farmers during pesticide spraying in southern peninsular Thailand: A cross-sectional study
Introduction: Work-related musculoskeletal disorders (WMSDs) are a major occupational health problem among farmers in Thailand. The purpose of this study was to evaluate the risk level and risk factors in work posture of durian farmers during pesticide spraying. Methods: This cross-sectional study was carried out among 82 durian farmers (n = 82) in southern peninsular Thailand. A questionnaire was used to collect data on socio-demographics and work characteristics. The posture analysis during pesticide spraying was done using Rapid Entire Body Assessment (REBA). The Chi-squared test was applied to find associations between socio-demographics or work characteristics with the risk level according to REBA assessments, with statistical significance requiring p<0.05. Results: REBA assessments indicated that most work postures during pesticide spraying by durian farmers had a high risk. Ergonomic risk factors for durian farmers involved prolonged work while standing in awkward postures, including bending the neck with more than 20° extension, bending the trunk with 0°-20° extension, raising and abducting the shoulder, both hands holding spray handles all the time, or carrying backpack pesticide sprayers with weights from 8 to 22 kg. Season, age, monthly income, pesticide spraying experience, pesticide spraying on other plants, pesticide spraying method, frequency of spraying pesticide, and durian tree height were statistically significantly associated with risk levels of work postures during pesticide spraying by durian farmers. Conclusion: Therefore, regular ergonomic training accompanied by modifications to the workstations and to tools for pesticide spraying are essential in improving work postures during pesticide spraying by durian farmers.
Improving occupational safety through the implementation of a management system based on ISO 45001 in a primary forest processing plant – Puno, Peru
Introduction: This study assessed the impact of implementing an Occupational Health and Safety Management System (OHSMS) based on ISO 45001:2018 at Corporación Caliz S.A.C.'s primary forest processing facility in Puno, Peru— an industrial site with high occupational risks. The objective was to evaluate whether the structured implementation of this international standard could significantly enhance workplace safety culture and operational risk management. Methods: A quasi-experimental design with pre-test and post-test measurements was applied to a cohort of 37 employees. Data collection involved a 22-item structured survey mapped to the seven core clauses of ISO 45001, the IPERC matrix for risk assessment, and direct on-site observations. The Shapiro–Wilk and Wilcoxon signed-rank tests were used for statistical analysis. Results: Post-intervention results showed significant improvements (p < 0.001) across all ISO 45001 clauses. Safety perception increased by 45%, leadership and worker participation by 41%, and proper use of personal protective equipment by 52%. The significant progress was observed in Clause 7 (Support, Z = 4.99), Clause 6 (Planning, Z = 4.47), and Clause 9 (Performance Evaluation, Z = 4.55), confirming the strengthening of the preventive culture and the improvement of risk control mechanisms. Conclusion: Implementing ISO 45001:2018 can produce measurable advancements. It led to significant improvements in preventive culture, risk mitigation, and regulatory compliance in hazardous industrial settings. It led to significant improvements in preventive culture, risk mitigation, and regulatory compliance in hazardous industrial settings within high-risk industries. These findings provide empirical support for adopting the standard and highlight the importance of sustained corrective action and continuous monitoring. Future longitudinal and cross-sectoral studies are recommended to evaluate the long-term impact and integration with other management systems.
Longitudinal trajectories of noise-induced hearing loss in a municipal workforce: a pilot study of diagnostic migration (2023–2025)
Introduction: Noise-Induced Hearing Loss (NIHL) remains a prevalent occupational health issue in industrial sectors. This study aimed to evaluate the longitudinal progression of hearing thresholds in municipal workers exposed to noise levels exceeding 85 dB(A) and to determine the impact of specific risk stratification on auditory health. Methods: A Retrospective Longitudinal Cohort Study was conducted on 23 male municipal workers over a two-year surveillance period (2023–2025). Participants were stratified into Group A (Gardeners, n=5) and Group B (Drivers, n=18) categories based on job profiles. Pure-tone audiometry was analyzed according to Health and Safety Executive (HSE 2021) guidelines. Statistical analysis included Wilcoxon signed-rank test and Mann–Whitney U tests for group comparisons. Results: The cohort exhibited a statistically significant deterioration in mean hearing thresholds over the study period. Wilcoxon signed-rank test comparing mean high-frequency thresholds (3–4–6 kHz) between 2023 and 2025 yielded p < 0.001. By 2025, 47.8% (n=11) of the workforce met the criteria for clinical referral (Category 3). A distinct disparity was observed between exposure groups: 100% (n=5) of Group A workers progressed to Category 3, compared to only 33.3% (n=6) of Group B workers (p = 0.042). Conclusion: Group A demonstrated significantly accelerated hearing loss compared to drivers (B), validating the need for stratified risk management. The findings support the implementation of a shortened 6-month audiometric review cycle for high-risk groups.
Lower-back discomfort and ergonomic hazards among artisanal fishermen in Tamil Nadu, India: a cross-sectional study
Introduction: Lower back discomfort is a prevalent occupational health issue among fishermen, substantially contributing to disability adjusted life years and reduced work performance. The primary aim of the study is to examine the lower back discomfort, occupational profile, ergonomic hazard exposure and overall health and wellbeing among artisanal fishermen. Methods: : The present study has been conducted among 400 randomly selected artisanal fishermen from coastal villages of Ramanathapuram District, Tamil Nadu, India between February 2024 and April 2025. Data has been collected using a pretested interview schedule, the standardized Nordic Musculoskeletal Questionnaire (2007), Perceive Stress Scale – 10 and adapted Workplace health and safety survey. Descriptive statistics, Spearmen correlation and regression have also been performed. Results: Among the selected 400 artisanal fishermen, 269(64%) reported lower back discomfort in the past 12 months with 68(22%) have experienced interference in daily activities. Ergonomic hazards including lifting of heavy weights 172(64%), repetitive movements 252 (91%), improper working postures 78 (29%) and prolonged standing (>2 hours) 105(39%) have been significantly associated with Lower Back Discomfort. With frequent lifting showing adjusted odds ratios of 7.7 (always) and 6.4 (often), psychosocial factors such as poor sleep quality (aOR = 3.6), moderate perceived stress (aOR = 2) and alcohol consumption (22%, p<0.05) have also showed significant associations with Lower Back Discomfort. No significant relationships have been observed with demographics, body mass index and comorbidities. The coping strategies have included medication use (70%) and medical consultation (20%). Conclusion: The study highlights that ergonomic hazards and psychosocial stressors are key determinants of lower back discomfort among artisanal fishermen. Tailored ergonomic interventions, occupational health education and stress management strategies are essential to mitigate musculoskeletal strain to improve their Quality of Life.
Prevalence of work-related musculoskeletal disorders and vision problems among electronics industry employees in Chennai, India
Introduction: Employees of the electronics industry are exposed to ergonomic hazards due to repetitive tasks, prolonged standing, awkward posture and sustained near work activities resulting in work related musculoskeletal disorders (WMSD) and vision problems. The presence of these hazards could affect the productivity and well-being of the individual. The study was conducted to estimate the prevalence of WMSDs and vision problems among the employees and to assess factors associated with these occupational health outcomes. Methods: A cross-sectional study was done during December 2024 – January 2025 among 259 employees of an electronics company in Chennai using simple random sampling. A semi-structured questionnaire containing demographic details and work profile, Nordic musculoskeletal questionnaire to assess the prevalence of work-related musculoskeletal disorders and a questionnaire to assess the prevalence of vision problems were used for collecting data. Data was entered in MS excel and analyzed using SPSS version 16. Descriptive statistics were used, and associations were tested using the Chi-square test with odds ratios and 95% confidence intervals. Results: The mean age of the participants was 24.16 ± 4.03 years and 76.1% were women. The prevalence of WMSDs was 61.4% and vision problems were reported by40.2%. The shoulder (52.1%) and neck (49%) were the most commonly affected body regions. Eye strain (49%) was the most frequent visual complaint. WMSDs and vision problems showed significant associations with gender, job process, work shift, work experience, and health-related leave taken (p < 0.05). Conclusion: The study showed a high prevalence of WMSD and vision problems in the electronics workforce. These findings highlight the need for ergonomics risk assessment as well as routine health screening to enable early identification and prevention of these occupational health problems.
Safety culture maturity and related risk factors among automotive workers in Malaysia
Introduction: The automotive industry in Malaysia has a high rate of workplace accidents, highlighting concerns about the effectiveness of safety culture. Safety culture reflects workers’ attitudes and behaviors toward safety and can influence accident outcomes. Therefore, this study aims to assess the safety culture maturity level and its associated sociodemographic and occupational factors among automotive workers in Malaysia. Methods: This cross-sectional study was conducted at one of the largest automotive factories in Malaysia. Survey data were collected for over one month, from early August to September 2022, from 387 workers in the manufacturing division using a non-probability sampling method. A standardized 28-item SASTO questionnaire was administered. Results: Most respondents were between eighteen and thirty years old (32.3%), male (63.3%), with an education level of Sijil Pelajaran Malaysia (49.1%), working as operators (76.0%), with one to ten years of work tenure (52.7%), and no history of occupational accidents (79.3%). The results indicated that the average level of safety culture maturity among the respondents was 3.46 (SD = 0.94), indicating a proactive stage. Among the aspects of safety culture, the organizational aspect had the highest mean level (M = 3.48, SD = 1.05), followed by the psychological aspect (M = 3.46, SD = 0.82), and the behavioral aspect (M = 3.42, SD = 0.98)In multivariate analysis, significant associations were found between gender (β = 0.145), educational level (β = 0.156), had history of occupational accidents (β = 0.346), and departments (β = 0.171) with the level of safety culture maturity. The most dominant factor was the history of occupational accidents. Conclusion: The safety culture among workers exhibits a generally positive level, even with areas identified for potential improvement. This safety culture is influenced by their sociodemographic and working backgrounds, as well as their history of occupational accidents. Therefore, it is recommended that future intervention strategies for preventing occupational accidents consider these factors to ensure their effectiveness.
Sleep specialist – defined phenotypes in healthcare staff: a cross-sectional study
Introduction: Healthcare professionals face irregular work schedules and sleep disruption. Identifying sleep–function phenotypes may support early prevention and occupational performance. Methods: Exploratory, cross-sectional study aimed to characterize sleep parameters and work-related conditions through certified sleep-specialist interviews, defining clinically meaningful sleep phenotypes in healthcare workers. This single-center cross-sectional study was conducted between December 2021 and February 2022 in a tertiary hospital. Interviews captured occupational and sleep-related parameters by a sleep specialist. Validated Greek versions of the Pittsburgh Sleep Quality Index (PSQI), Athens Insomnia Scale (AIS), and Epworth Sleepiness Scale (ESS) were administered. Data collection involved structured questionnaires and statistical analysis using STATA/IC software. Results: Among 38 healthcare professionals, most were medical/nursing staff (71%), one-quarter worked rotating shifts (26%), and the majority reported short sleep duration (74% <7 h). Unadjusted analyses indicated that poorer sleep was associated with younger age, reduced job performance, cognitive strain, morning headaches, and being overweight, whereas evening-type individuals reported fewer sleep complaints; in adjusted models, however, chronotype remained the only independent predictor of sleep disturbance, while reduced job performance independently predicted excessive daytime sleepiness. Medical/nursing personnel also reported higher rates of weight gain and greater daytime sleepiness compared with non-medical staff. Conclusion: This study demonstrates that clinician-led sleep interviews can effectively identify key sleep phenotypes in healthcare professionals, revealing that evening-type individuals consistently exhibit a more favorable sleep profile. Targeted screening of resilient sleep phenotypes, such as the evening type identified in this study, can help support safer and more sustainable working conditions for healthcare professionals.
Study of the correlation between indoor air quality in school buildings and children’s health problems in Greece
Introduction: In the last years, air quality studies are focused on the indoor environments of the school buildings, since children spend much of their daily time in the classrooms. There is proof that indoor air pollutants can cause health problems to the vulnerable school population. The purpose of this study was to examine the correlation between air quality in school classrooms and students’ health. Methods: The study was conducted in sixty-one (61) classrooms of thirty-three (33) school buildings located in the Central Athens within the Attica Region and in the Argolida Sector of the Peloponnese Region in Greece. Students’ health who attended the selected school classrooms was evaluated by anonymous questionnaires completed by the students’ parents. Indoor concentrations of chemical air pollutants in the selected classrooms such as carbon dioxide (CO2), carbon monoxide (CO), volatile organic compounds (VOCs), nitrogen dioxide (NO2), particulate matters (PM10, PM2.5), along with temperature (T) and relative humidity (RH), were monitored using the series 500 Portable Air Quality Monitor and used for the statistical correlations. Results: Study showed that there was a statistically significant correlation between indoor CO2 (p=0.007) and students’ performance, indoor VOCs (p=0.023), PM2.5 (p=0.008) and bronchitis, indoor PM2.5 (p=0.002) and asthma, indoor PM10 (p=0.002), PM2.5 (p=0.012) and migraines in students. Conclusion: Indoor air pollutants were related with students’ health problems. Indoor air quality in school buildings is a very serious environmental issue and authorities must enforce health policy strategies in order to minimize air pollutant concentrations in classrooms and protect student health.
Breaking Ground, Breaching Safety: A Case Study of Construction Health Hazards
Introduction: India's construction industry constitutes 16.4% of worldwide occupational dangers, although employing just 7.5% of the labor force, indicating significant safety shortcomings. Contributing elements encompass ineffective communication, absence of protective equipment, hazardous work practices, insufficient training, psychological strain, deficient safety culture, and restricted legal adherence. Notwithstanding the sector's multidisciplinary characteristics necessitating robust safety planning, insufficient protections persistently result in significant accidents and productivity declines. Methods: This study investigates methods to improve safety performance utilizing Building Information Modeling (BIM) for proactive risk detection and real-time monitoring, alongside Blockchain for transparent and tamper-proof compliance administration. Results: Blockchain guarantees secure compliance records, while BIM facilitates early hazard detection, improved risk visualization, and coordination. Together, these features improve accountability, lower accident rates, and increase overall construction safety. Conclusion: By enabling proactive risk management and transparent compliance, lowering accidents, increasing productivity, and directing stakeholders toward successful digital adoption, the integration of BIM and Blockchain enhances construction safety.
Analysis of maritime accident dynamics and risk factors: A focus on vessel age, human element, and safety trends in the Greek Merchant Fleet (2019–2023)
Introduction: Maritime safety has evolved from reactive measures to proactive risk management. Despite the implementation of frameworks like the Formal Safety Assessment (FSA), maritime accidents continue to pose significant risks to occupational health and the environment. Recent global empirical studies, spanning from the South China Sea to North Atlantic shipping lanes, corroborate that these risks are not regionally isolated but represent a systemic challenge in modern seafaring. Unlike standard institutional reports (e.g., EMSA, ELSTAT) which primarily provide descriptive statistics, this study introduces an integrative analytical framework that correlates vessel age with specific human-machine interaction failures. Methods: By identifying a distinct 'risk threshold' at 20 years and proposing the 'reliability paradox' in automated systems, this research offers a methodological breakthrough in understanding how structural decay and technological dependency converge to influence maritime risk. The research employed a mixed-methods approach to correlate accident categories—such as collisions and hull failures—with vessel age and human-related causal factors. Results: The findings indicate that while incident frequency has risen, severity in terms of total ship losses has significantly decreased. The "human element" remains the primary catalyst, involved in approximately 75% of global incidents and 59.1% of the refined national study sample. A critical structural risk threshold was identified at 20 years of vessel age, beyond which the probability of hull failure and serious casualties indicates a sharp upward trend. Furthermore, a significant divergence in safety trends was observed, as the vast majority of recorded maritime fatalities occurred in coastal areas and were non-occupational, whereas occupational fatalities on commercial cargo ships and tankers remained remarkably low. The study proposes the emergence of a 'reliability paradox in mid-aged vessels (5–25 years), where increased reliance on advanced bridge automation is linked to higher collision risks due to diminished situational awareness. Conclusion: Enhancing maritime occupational safety requires a transition toward predictive analytics and AI-driven monitoring. Policy interventions should address the safety disparity between the commercial and fishing sectors and prioritize the optimization of human-machine interaction. This study underscores the need for targeted training to mitigate cognitive load and ensure the safety of the maritime profession in the digital age.
Microplastics in groundwater and their effects
This paper is a narrative review on microplastics (MPs). The properties and behavior of MPs in the environment are emphasized, noting that they are groundwater pollutants, are harmful to biotic and abiotic environments, exhibit stable and unique chemical properties, and persist in the environment for prolonged periods. They are resistant to biodegradation, precipitate and accumulate in the bodies of microorganisms. The routes of exposure to MPs in work environments are highlighted, noting that deposition is the main route of human exposure to MPs. The risk assessment for MPs is implemented with the polymer hazard index ecological hazard index, the hazard quotient, and the ecological hazard quotient. The pollution load index, which is related to the microplastic concentration coefficient, and the MPs pollution risk index are utilized. The effects of MPs on humans are highlighted, the main ones being thyroid disorders, headaches, cardiovascular problems and obesity. The prevention and control of MPs pollution is mentioned through the Operation Clean Sweep program, which includes containment measures and employee awareness training. The new contributions of my narrative review are mentioned, which lie in strengthening research on the mechanisms of interactions of MPs with human health and the complete clarification of the organs in which inhaled particles are deposited. Another contribution is the elimination of biochar limitations such as the quantification of the dynamic accumulation of MPs in the environment.
Occupational hazards among food delivery workers: a systematic review of empirical studies
Introduction: The rapid growth of e-commerce has driven the global expansion of food delivery services. Delivery riders are exposed to multiple occupational hazards due to time pressure, long working hours, and physically demanding tasks. Despite their essential role, research on their health and safety remains fragmented. Methods: This review followed the PRISMA 2020 guidelines. A systematic search was conducted in the MEDLINE and Scopus databases. Only cross-sectional studies involving adult food delivery workers were included. Studies focusing on any type of accident or work-related health problem were considered. Other study designs, such as systematic reviews, were excluded. Studies involving non-food delivery workers or participants under 18 years of age were also excluded. The search was conducted only in English. Keywords and phrases such as “work,” “accidents,” and “delivery rider” were used with Boolean operators. The methodological quality of the included studies was assessed using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Prevalence Studies. Results: Occupational hazards were grouped into four categories. Traffic risks included speeding, running red lights, and mobile phone use while driving, with younger and less experienced riders showing a higher risk of accidents. Ergonomic risks were associated with prolonged sitting, vibration exposure, and repetitive movements, contributing to musculoskeletal disorders, particularly in the lower back, neck, and shoulders. Psychosocial risks included stress, burnout, verbal or physical abuse, and job insecurity. Socioeconomic factors, such as dependence on delivery income and lower educational levels, further increased vulnerability and limited access to preventive measures. Conclusion: Food delivery workers face multidimensional risks that affect physical health, mental well-being, and road safety. Addressing these challenges requires comprehensive interventions, including road safety training, ergonomic improvements, psychosocial support, protective equipment, and improved working conditions to reduce accidents and protect worker health.
Occupational noise and vibration hazards: A narrative review of characteristics, health effects, assessment methods, and prevention strategies
Introduction: Occupational noise and vibration are common physical hazards across many industries and are associated with substantial auditory, musculoskeletal, vascular, neurological, and other non‑auditory health effects. This narrative review integrates current evidence to support recognition, assessment, and prevention of these hazards in workplace settings. Methods: A narrative review approach was adopted, consistent with established narrative‑review guidelines and SANRA criteria. Literature searches in major databases focused on occupational noise, hand‑arm and whole‑body vibration, health outcomes, exposure assessment, and prevention. Peer‑reviewed studies, reviews, and authoritative guidelines were included if they addressed exposure characterization, auditory or non‑auditory and musculoskeletal or neurovascular health effects, assessment methods or standards, or engineering, administrative, and personal protective controls. Evidence was synthesized thematically without formal risk‑of‑bias assessment or meta‑analysis. Results: The review indicates that hazardous noise and vibration exposures remain widespread and contribute to noise‑induced hearing loss, cardiovascular and psychological disorders, hand‑arm vibration syndrome, low back pain, and other musculoskeletal and neurovascular conditions. Assessment commonly uses time‑weighted or equivalent continuous sound levels for noise and frequency‑weighted acceleration metrics for vibration, in accordance with international standards and regulations. Multiple engineering, administrative, and personal protective measures are available, but fully integrated workplace programs are still limited. Conclusion: This review provides an occupationally focused framework to strengthen systematic management of combined noise and vibration hazards.
Post-mortem artifacts mimicking blunt force trauma: a systematic review for forensic differential diagnosis
Introduction: The accurate differentiation between genuine blunt force trauma and various post-mortem artefacts is a critical challenge in forensic death investigation, directly impacting the determination of the manner of death. Post-mortem changes, ranging from decomposition processes to animal activity, often produce lesions that closely mimic antemortem injuries. The primary objective of this study is to systematically identify and evaluate the diagnostic criteria used to differentiate genuine blunt force trauma from post-mortem artefacts. Methods: A comprehensive search was conducted across five major databases (PubMed, Scopus, Web of Science, Embase, and Cochrane Library) covering literature from their inception until December 2025. Unlike previous narrative reviews, this study employs a systematic methodology adhering to PRISMA 2020 standards. Data collection involved independent screening and extraction by two reviewers, focusing on morphological, histological, and analytical differentiation criteria. Methodological quality was appraised using JBI tools, and evidence certainty was assessed using the GRADE approach. Results: The findings emphasize that the presence of a vital reaction, primarily manifested through hemorrhage and inflammation, remains the most essential diagnostic indicator. Specific indicators such as fracture edge characteristics, skeletal surface coloration, and anatomical distribution of lesions are also identified as key discriminators. Following the primary filter, the algorithm diverges into two main evaluation pathways: one focusing on verifying trauma characteristics (e.g., injury patterns consistent with BFT) and the other on validating artefact characteristics (e.g., consistency with taphonomic processes). Additionally, the framework incorporates a distinct, parallel evaluation for animal activity, necessitating a specific analysis of marks and patterns (e.g., gnawing or punctures) to distinguish scavenger damage from mechanical trauma. Conclusion: This review provides a standardized diagnostic hierarchy and a decision tree to minimize subjective assessment in medico-legal investigations. By integrating advanced imaging and microanalytical approaches with traditional morphological observation, forensic practitioners can improve diagnostic reliability and ensure the integrity of the judicial process.
Reframing occupational safety culture through dharma: lessons from the Ramayana
Introduction: Occupational safety culture is conventionally understood through technical systems, regulations, and management structures. However, ethical values hold a key role in shaping human behavior, responsibility, and risk- related decision-making in workplaces. The Ramayana, a classical epic of the East, foregrounds the concept of dharma-moral duty, righteousness and responsibility, offering a rich moral framework that can inform contemporary approaches to occupational safety. This conceptual paper examines how the principles of workplace ethics and duty (dharma), as articulated in the Ramayana, can contribute to a deeper understanding of contemporary occupational safety culture. It aims to develop an integrative conceptual model that connects ancient moral philosophy with contemporary safety paradigms. Methods: The study employs qualitative textual analysis of the epic's major episodes and characters. It focuses on duty, leadership, protection of the weak, worker responsibility, and ethical decision-making. These themes are then linked to modern occupational safety culture constructs, such as leadership commitment, worker participation and protection of vulnerable groups, using a narrative synthesis approach. Results: The Ramayana illustrates multiple ethical responsibilities. Rama, the protagonist, as the perfect ruler, promotes collective welfare. Lakshmana, Hanuman, and the Vanara Sena, as devoted workers, accept responsibility. Sita’s trials focus on the importance of systems that protect vulnerable individuals. Vibhishana’s moral dissent exemplifies the courage to stand against unethical practices. From these narratives, a Dharma-based safety culture framework is derived, highlighting (1) ethical leadership that protects workers, (2) worker duty and solidarity, (3) institutional protection of vulnerable groups, and (4) moral decision-making under risk. Conclusion: Integrating dharma principles into occupational safety culture provides a complementary ethical foundation for technical and regulatory systems. Future empirical studies can validate and operationalize this framework in workplace settings.