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.