The accidents described in this chapter are not due to a fifth type of error. They are due to the failure of senior managers to realize that they could do more to prevent accidents. They are thus mainly due to lack of training, but some may be due to lack of ability and a few […]
A point has been reached in the development of technology where the greatest dangers stem not so much from the breakdown of a major component or from isolated operator errors, as from the insidious accumulation of delayed-action human failures occurring primarily within the organizational and managerial sectors. These residual problems do not belong exclusively to
Human factors, as we know it today, got its inspiration from these basic ideas about human error. It then showed something different: an alternative way of looking at human error. As a result, there are basically two ways of looking at human error today. We can see human error as a cause of failure, or
Since we are in a snow apocalypse here in the Midwest, I thought I would lose my mind hearing all the “weather professionals” declaring that with wind chills below zero, the roads will freeze as the salt won’t work below 15F. And I thought these were “science-based” professionals. TIP: Wind chill is how the temperature
The environment, organization, economics, capabilities, technology, and regulatory context all change over time. This backdrop of continuous systemic change ensures that hazards and how they are managed are constantly changing. Progress on safety concerns anticipating how these kinds of changes will create new vulnerabilities and paths to failure even as they provide benefits on other
Now, I’m 100% certain that Mr. Gogh did not have the safety profession in mind when he said the following, but it could not be more true in the context of our profession. Few professions need passion like that of the safety profession. Find me a world-class safety pro, and we will have one who
Please remember, these principles were proposed over 100 years ago! Mr. Heinrich may not have been 100% correct in all his beliefs, but I would go as far as to say that if a business today were to embrace his principles from the 1920s, it would see significant improvements in both culture and performance. Industrial
When it comes to safety and health, internal consequences to support the right behavior are terribly important. Remember, external and intrinsic (natural) consequences for safe behaviors are not readily available, and we cannot expect to receive sufficient support (extra consequences) from others to sustain our proactive, safe, and healthy choices. So, we need to talk
Post-accident remedies for “human error” are usually predicated on obstructing activities that can “cause” accidents. These end-of-the-chain measures do little to reduce the likelihood of further accidents. In fact, the likelihood of an identical accident is already extraordinarily low because the pattern of latent failures changes constantly. Instead of increasing safety, post-accident remedies usually increase
Growing up in the Process Safety world with OHSA’s PSM and EPA’s RMP standards, I thought everyone had a “Safety Management System.” In school, we learned about OSH Management Systems and all they could do for a business. However, when I started consulting in 2005, I realized that SMSs were elusive in industrial facilities. Even
As an accident investigator this has to be one of my favorite books. Of course, I am a massive fan of Dekker’s books and videos. He has a newer book on this topic that is also a MUST-READ for safety professionals and accident investigators. After nearly 16 years as a safety professional in the chemical
James Reason’s Human Failure Model: Active and Latent [Organizational] Failures As safety professionals, we need to understand that we ALL make errors, mistakes, and violations. When we are asked to facilitate a causal analysis, it is incumbent upon us to keep the team aware of this fact and educate them on the differences between Active
