Journal of Health and Safety at Work

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Introduction: Iran has the most extensive maritime transport fleet in the Middle East, with 2700 km of water border with other countries in the region. However, the complex and hazardous marine environment has turned this advantage into a disadvantage. On the other hand, technological advancement has added to the complexity. Thus, new accident analysis tools should be developed to bring unity to marine casualty analysis and improve the analyst’s power of discovery from incident information. The current project aims to develop a specialized AcciMap-based marine accident investigation method.
Material and Methods: The primary stages of this applied descriptive study include data collection, method development, and validation. The necessary information about the factors leading to marine accidents was initially gathered through a review of previous studies, expert interviews, and analysis of actual cases. The AcciMap technique was then partially developed, and marine experts approved the designed model.
Results: This study’s results included an AcciMap model established on three levels: external influences (national and international), intra-organizational factors, and environmental/individual conditions and individual activities. Whereas external factors (international and national) are categorized into three main layers, two sublayers, and 13 secondary sublayers, intra-organizational factors are categorized into two main layers, 11 sublayers, and 35 secondary sublayers, and environmental/individual conditions and individual activities are organized in one main layer, three sublayers, and 11 secondary sublayers.
Conclusion: The developed approach can identify flawed levels and determine who is responsible for implementing corrective action. Because it includes emerging components that are effective in accidents, the method used in this study can better examine data from marine accidents.

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Introduction: Medical centers, as complex technical-social systems, are exposed to the risk of fire incidents. This study analyzes the causes and contributing factors of the fire accident at Sina Mehr Clinic to prevent similar accidents, resulting in 19 deaths and 14 injuries.
Material and Methods: The causes and contributing factors for accidents in medical centers are found through studies related to laws and regulations, official accident reports, expert reports of regulatory bodies, interviews with experts, and review of past studies, extraction, and categorization. Accident analysis methods included AcciMap and STAMP. Finally, experts’ opinions were used to confirm and strengthen the findings.
Results: The most critical root and hierarchical causes of the weakness of medical center management in the field of safety, dangerous conditions, fire accidents, and emergency response are the issuance of a legal building completion permit for a building that violates national building regulations and the issuance of a legal permit for a medical institution for a building with residential use, as well as the insufficiency of supervision by government and public institutions with horizontal relationships with each other and vertical relationships with universities of medical sciences, labor offices, and firefighting organizations, as the direct supervisors of medical centers.
Conclusion: The AcciMap and STAMP findings indicate that the priority is to amend the regulations for the establishment, operation, and activity of medical centers with an emphasis on safety regulations, as well as the frequency and shortening of feedback loops such as inquiring about the building completion permit from the municipality, announcing the establishment of a medical center to other governmental and public supervisory authorities, and the reporting of unsafe cases directly by supervisors to the Ministry of Health. Legal authorities are the most crucial cycle in the resilience of fire incidents and their consequences in medical centers.