Journal of Health and Safety at Work

---

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.
 

---

Introduction: Exposure to noise is one of the most common harmful factors in the dental profession that can have significant consequences. Unfavorable acoustic conditions of the environment can also worsen the conditions and lead to reduced speech clarity, auditory fatigue, and reduced quality of communication between the doctor and the patient. In this regard, designing effective acoustic interventions can play an important role in improving sound.
Material and Methods: This study was conducted in an academic dental clinic. After measuring the sound pressure level, reverberation time, and speech transmission index, the amount of rock wool absorber required was determined using the Sabin formula. The panels were structurally installed on the clinic walls, and after 24 hours, the sound pressure level, RT60, and STI were measured again, and appropriate statistical tests were used to determine the effect of the intervention.
Results: The results showed that the sound pressure level before and after the panel installation was significantly different and decreased after the intervention (p-value <0.05). The reverberation time at the dominant frequency of 2000 was 0.992 seconds before the intervention and reached 0.599 seconds after the intervention (p=0.027, z= 2.207). The speech transmission index in the center of the room improved from 0.64 and the “average” level to 0.85 and the “excellent” level, indicating an increase in speech clarity.
Conclusion: The acoustic intervention was able to bring the clinic’s acoustic indices closer to the recommended ranges. The significant reduction in reverberation time and sound pressure level along with the increase in the speech clarity index indicates the high efficiency of this intervention. Utilizing sound absorbers can be a low-cost and feasible solution to improve acoustic conditions and improve speech communication in dental treatment and educational environments.