Hygienic performance evaluation and effect of training in order to confronting with the Covid-19 virus in the metal industries staff

Background and aims: Recently, the respiratory acute syndrome or Covid-19 disease has been become as one of the most important concerns in the national and global level. Covid-19 disease is caused by the virus SARS-CoV-2 or Covid-19. Covid-19 virus is spreading through saliva drops or nasal discharge when coughing or sneezing. Covid-19 disease not only has significantly negative affect on the general health of the society but also on job activities of the people like business, economy and industries activities so that outlook of this disease create stress and concern for the workers and employees about the affecting this disease in the workplace and this stress can be transferred to other workers, family and customers.  Occupational Health and Safety Administration (OSHA) has classified the workplaces into 4 categories in terms of potential of disease: very high risk, high risk, intermediate risk and low risk. Jobs classification include: 1. Very high exposure risk jobs are those with very high potential to meet the discovered cases or suspected of Covid-19 disease during medical cares, after death or during clinical experiments like healthcare stuff and laboratories stuff. 2- High exposure risk jobs: jobs with high potential and lower than previous class jobs to meet the discovered cases or suspected of Covid-19 disease like healthcare and support services employees, medical transportation and funeral workers. 3. Medium exposure risk jobs: jobs where workers are in repeated contact with other workers, public or in close contact with people those possibly with Covid-19 disease but are not diagnosed as suspected ill. These jobs include schools, some crowded retails and activities with high population density. 4. Low exposure risk jobs:  jobs where workers are not in close and continuous contact with other works, public or people suspected of Covid-19 disease. The work international organization announced people who are affected to Covid-19 in the workplace must have access  to healthcare and treatment services including usual medical cares, specialized cares( inside and outside of the hospital) pharmaceutical , hospital and medical rehabilitation services. On the other hand, since no vaccine or certain treatment is known for this disease till now, the best way to prevent and decrease this disease is to raise the awareness and information about this virus, how this disease is created and how it spreads.so, the present study was conducted with the aim of determining the hygienic performance and effect of training in order to confronting with the Covid-19 virus in the metal industries staff Methods: This analytical-descriptive study is cross-sectional in terms of time. 5 metal industries were studied by the census method in Isfahan province (3 industries) and Chaharmahal and Bakhtiari province (2 industries). The studied units include employers and directors, administrative, production, Facilities (Technical) and services stuff. To collect data, researcher-made checklist was used to evaluate the personal hygienic of stuff and to evaluate the industry environment and building, environment checklist was used. Totally 569 stuff and 11 checklists were studied to consider environmental health status in the studied industries buildings. Research team was composed of 2 experts. One expert was required to study the personal health of stuff and buildings environments hygiene and the other was responsible to teach stuff. The education subjects included properties of Covid-19 virus, symptoms of affecting to disease, disease transmission methods, methods of preventing the spread of the disease and importance to observe the personal health and the correct method to use the mask and gloves. After studying the personal health by the checklist, stuff specially who did not observed the personal health were trained for 10-15 minutes. Training was performed face to face while observing the hygienic protocols and standard physical distance. In order to study the effect of training in the personal health observance, the studied industries were referred after 3 weeks and personal health checklist was completed for all workers participating in the research. Data analysis was performed by the    SPSS 21 software and paired-samples T-test. Results: The total studied stuff was 569 persons, 7.38% were women and 92.62% were men. The age average of stuff was 36.7± 8.31 years and 81.27% were married. Before training, 23.73% of stuff used mask and gloves and 30.93% just used mask. Also 78.21% observed the appropriate distance with others and 76.8% observed using personal devices or common surfaces disinfectant solution and 31.46% had hand disinfectant solution. But after training, the personal health observance was raised significantly so that the significant relation (PValue<0.001) was obtained between before and after training personal health observance. Table 1 shows the results of studying stuff personal health after and before of training. Table 1. Results of studying stuff personal health after and before of training variable         amount Using the personal protection devices (n=569)   Observance of physical distance (n=569) Personal devices (pencil, pen, etc.) (n=569) Hand disinfectant solution (n=569) Only mask Only gloves Mask and gloves None Distance observance Lack of observance use Lack of use Having personal solution No having personal solution Frequency percentage (frequency) before the training 30.93 (176) 28.64 (163) 23.73 (135) 16.7 (95) 78.21 (445) 21.79 (124) 76.8 (437) 23.2 (132) 31.46 (179) 68.54 (390) Frequency percentage (frequency) After the training 47.62 (271) 4.38 (25) 37.1 (211) 10.9 (62) 81.9 (466) 18.1 (103) 87.7 (499) 12.3 (70) 59.23 (337) 40.77 (232) PValue <0.001 0.003 <0.001 0.002 <0.001 <0.001 <0.001   Results of the environmental health study suggested that cases like 1. Personnel fever test when coming factory, 2. Installment of Covid-19 dealing with disease training poster and stand, 3. Training personnel about this disease, 4. Instruction installation of washing hands in WC, 5. Preparation of enough detergents, disinfectants and cleaning equipment, 6. Existence of ventilation system in WC, 7. Preventing presence of workers suspected of Covid-19, 8. Use of special personnel as responsible for cleaning and disinfection, 9. Using mask, gloves, and work cloth of personnel when cleaning and disinfecting, 10. Observance of method of cleaning and disinfecting instruction, 11. Separation of napkin bucket and cleaning and disinfecting supplies from other devices and parts, 12. Discharge of buckets at the end of work shift, 13. Using of personal items for prayer, 14. Existence of liquid soap piping system with contained having hand washing liquid, 15. Keep doors and windows open, 16. Deactivating finger presence and absence system in more than half of studied saloons were observed. While other cases of observing environmental health including 1. workerschr(chr('39')39chr('39')) blood oxygen test when entering the factory (9.1%), 2. Installment of dealing with Covid-19 environmental control guide (18.2%), 3. Daily Cleaning and disinfecting (45.45%), 4. Collecting rubbishes in the pedal bucket with lid (45.45%), 5. Availability of first aid box (27.27%), 6. Removing water coolers (0), 7. Placing hand disinfecting solution in the entrance of buildings and next to elevators (36.36%), 8. Existence of smart toilet or foot pedal faucet (9.1%) was less observed. Conclusion: More than half of workers observed the personal health but increasing their information about these diseases, methods of transmission and preventing outlook of it caused workers to pay more attention to preventive actions and follow personal health instructions seriously. Also environmental health actions in the studied industries buildings were observed but were not observed in some cases due to lack of awareness or economic problems of industrial factory. So, to achieve the best performance in control and decreasing the Covid-19 disease, 3 essential actions are required: 1. Preparation of health supplies (like: mask, gloves, disinfectant solution) and delivering the health supplies to the workers daily 2.  Training workers about the correct method of using the health supplies 3. Supervising use of the health supplies and implementation of health protocols. It should be noted that since Covid-19 disease is a new and unknown disease, training about this disease should be continuously performed and according to updated information.