Abstract
BACKGROUND: Effective Reporting, Registration, and Investigation of Occupational Incidents (RRIOI) are essential for monitoring incident frequency, identifying root causes, and implementing control measures to improve workplace safety. While RRIOI systems have been successfully adopted in many countries, challenges persist, particularly in developing countries such as Iran. This study investigates the culture and practices of RRIOI process within industrial workplaces in West Azerbaijan province, Iran. METHODS: A mixed-methods approach was used, involving 631 participants from diverse companies to assess the culture of RRIOI. Additionally, in-depth interviews were conducted with 20 Occupational Health and Safety (OHS) experts to explore internal and external factors affecting the RRIOI process. Quantitative data were analyzed using t-tests, Spearman correlations. Hierarchical linear regression applied to investigate the predictive capacity of independent variables on RRIOI culture. The content analysis was employed to analyze the qualitative data. RESULTS: The overall RRIOI culture score averaged 3.09 (± 0.35). Among the sub-factors, corrective actions scored highest (3.27 ± 0.64), whereas barriers for under-reporting scored lowest (2.90 ± 0.54). A t-test revealed that OHS training and prior experience with occupational accidents were positively associated with RRIOI culture scores. Hierarchical regression indicated that management role positively influenced RRIOI culture, while industry type had a negative effect. Telephone communication was the most common method for reporting incidents. Notably, reporting of low-severity incidents and near-misses was markedly deficient across organizations. Participants also highlighted a lack of feedback from OHS authorities. Furthermore, this study identified key factors contributing to reluctance in incident reporting. CONCLUSIONS: This is the first study in Iran to systematically examine RRIOI culture across multiple industries using a mixed-methods approach. The integration of stakeholders' perspectives provides a comprehensive understanding of the systemic and cultural challenges hindering effective incident reporting. The findings highlight the need for national policies to foster a non-punitive reporting culture, implement integrated electronic incident reporting systems, enhance workforce training, and ensure adequate resource allocation. These insights offer actionable guidance for strengthening RRIOI frameworks in Iran.