From Latent Failure to Active Failure: The Investigation of Human Errors in Aviation Operation

2007 ◽  
Vol 51 (20) ◽  
pp. 1425-1429
Author(s):  
Wen-Chin Li ◽  
Don Harris
Keyword(s):  
Human Factors ◽  
Human Error ◽  
Analytical Framework ◽  
Civil Aviation ◽  
Human Errors ◽  
Aviation Accidents ◽  
Republic Of China ◽  
Long Time ◽  
The Republic ◽  
Supervisory Practices

The Human Factors Analysis and Classification System (HFACS, Wiegmann & Shappell, 2003) was developed as an analytical framework for the investigation of the role of human factors in aviation accidents. HFACS is based upon Reason's model (1990) of human error in which active failures are associated with the performance of front -line operators in complex systems and latent failures are characterized as inadequacies which lie dormant within a system for a long time, and are only trigge red when combined with other factors to breach the system's defenses. In this research HFACS was used to analyze accidents occurring in civil aviation aircraft in the Republic of China (ROC). Forty-one accident reports from the Aviation Safety Council (A SC) were analyzed. Relationships in the HFACS framework were identified linking fallible decisions at higher (organizational) levels with supervisory practices, thereby creating the preconditions for unsafe acts and hence indirectly impairing the performance of pilots.

Applying Determination Models for Human Errors in Sequential Analysis of Maritime Accidents

2013 ◽  
Vol 837 ◽  
pp. 780-785
Author(s):  
Ramona Tromiadis ◽  
Radu Hanzu-Pazara
Keyword(s):  
Human Factors ◽  
Human Error ◽  
Sequential Analysis ◽  
Standard Procedure ◽  
Human Operator ◽  
Human Errors ◽  
Management Plans ◽  
Long Time ◽  
High Level ◽  
Marine Accidents

Human part in the socio-technical system in which they operate in order to achieve the object of work is essential. This system, because of the technological progress is characterized by a high level of technicality, continuing growth in complexity and danger. In this context, the human operator is required to make a substantial effort, which includes besides standard procedure and operations also emergency resolution calling for the ability to make judgments and assumptions based on the knowledge one holds.The main cause of the growing number of accidents has been attributed specifically to "human error". It is generally considered the fact that human factors contribute to accidents. But there are different opinions on the importance of this factor. Suggestions regarding the proportion of marine accidents caused by human errors vary from 50 to 90% of the total number of accidents. Some research considered that 60% of the total number is due to human error as a direct cause and the remaining of 30% human error is from indirect contributory cause. Effects of active cause are usually noticed almost immediately, while consequences of indirect cause may remain invisible in the system for a long time, until in combination with other factors compromise the system and lead to an accident.Different methodologies are developed, adopted from the investigations on risk analysis to performe the models that will determine the human errors in sequential analysis of maritime accidents.According to IMO resolution, human factors which contribute to marine casualties and incidents may be broadly defined as the acts or omissions, intentional or otherwise, which adversely affect the proper functioning of a particular system, or the successful performance of a particular task. Understanding human factors thus requires a study and analysis of the design of the equipment, the interaction of the human operator with the equipment, and the procedures followed by crew and management.Since human factors are triggered by human errors, which are the main source of risk in maritime activities, it seems important to develop different methodologies that allow a quantitative and qualitative analysis of the real incidence of several human factors over maritime accidents with the aim of taking human factors into account in properly developed risk management plans.

scholarly journals Improved HFACS on Human Factors of Construction Accidents: A China Perspective

2018 ◽  
Vol 2018 ◽  
pp. 1-15 ◽  
Author(s):  
Gui Ye ◽  
Qin Tan ◽  
Xiaoli Gong ◽  
Qingting Xiang ◽  
Yuhe Wang ◽  
...  
Keyword(s):  
Human Factors ◽  
Construction Industry ◽  
Classification System ◽  
Analytical Framework ◽  
Safety Performance ◽  
Human Errors ◽  
Aviation Accidents ◽  
Factors Analysis ◽  
Critical Paths ◽  
Human Factors Analysis

Human errors are one of the major contributors of accidents. In order to improve the safety performance, human errors have to be addressed. Human Factors Analysis and Classification System (HFACS) has been developed as an analytical framework for the investigation of the role of human errors in aviation accidents. However, the HFACS framework did not reveal the relationships describing the effect among diverse factors at different levels. Similarly, its interior structure was not exposed. As a result, it is difficult to identify critical paths and key factors. Therefore, an improved Human Factors Analysis and Classification System in the construction industry (I-HFACS) was developed in this study. An analytical I-HFACS mechanism was designed to interpret how activities and decisions made by upper management lead to operator errors and subsequent accidents. Critical paths were highlighted. Similarly, key human factors were identified, that is, “regulatory factors,” “organizational process,” “supervisory violations,” “adverse spiritual state,” “skill underutilization,” “skill-based errors,” and “violations.” Findings provided useful references for the construction industry to improve the safety performance.

scholarly journals A systems approach to training aeronautical decision making: from identifying training needs to verifying training solutions

2007 ◽  
Vol 111 (1118) ◽  
pp. 267-279 ◽  
Author(s):  
W.-C. Li ◽  
D. Harris
Keyword(s):  
Decision Making ◽  
Human Error ◽  
Systems Approach ◽  
Training Programme ◽  
Analytical Framework ◽  
Republic Of China ◽  
Training Course ◽  
Emergency Situations ◽  
The Republic Of China ◽  
The Republic

The human factors analysis and classification system (HFACS) was developed as an analytical framework for the investigation of the role of human error in aviation accidents. A total of 523 accidents in the Republic of China (ROC) Air Force between 1978 and 2002 were analysed using this framework. The results showed that in a great many cases, poor pilot decision making was implicated. Following a survey of flight instructors’ opinions, two of most promising mnemonic-based methods currently available to guide the decision making of pilots were identified (SHOR and DESIDE). These methods were developed into a short (four hour) aeronautical decision making training course. A total of 41 pilots from the Republic of China Tactical Training Wing then participated in a study to evaluate the effectiveness of this training course. Half of the participants received the short ADM training programme and half did not. Their decision making skill was evaluated in a series of emergency situations presented in a full-flight simulator. Furthermore, their decision making processes were examined in a series of pencil-and-paper based tests. The results clearly showed significant improvements in the quality of pilots’ situation assessment and risk management (underpinning processes in pilot decision making) although this was usually at the expense of speed of response. Pilots used the quicker to apply SHOR mnemonic in situations that which required a fast decision and the more comprehensive but slower to perform DESIDE method when there were fewer time pressures. The results do strongly suggest that ADM is trainable and the short programme devised was effective.

CIVIL AVIATION ACCIDENTS AND INCIDENTS CLASSIFIED ACCORDING TO GROUPS OF AVIATION SPECIALISTS

Aviation ◽  
2013 ◽  
Vol 17 (2) ◽  
pp. 76-79 ◽  
Author(s):  
Peter Trifonov-Bogdanov ◽  
Leonid Vinogradov ◽  
Vladimir Shestakov
Keyword(s):  
Human Error ◽  
Human Factor ◽  
Negative Influence ◽  
Civil Aviation ◽  
Flight Safety ◽  
Complex Action ◽  
Primary Parameter ◽  
Aviation Accidents ◽  
Operational Process ◽  
Operational Activities

During an operational process, activity is implemented through an ordered sequence of certain actions united by a common motive. Actions can be simple or complex. Simple actions cannot be split into elements having independent objectives. Complex actions can be presented in the form of a set of simple actions. If the logical organisation of this set is open, a complex action can be described as an algorithm consisting of simple actions. That means various kinds of operational activities develop from the same simple and typical actions, but in various sequences. Therefore, human error is always generated by a more elementary error of action. Thus, errors of action are the primary parameter that is universal for any kind of activity of an aviation specialist and can serve as a measure for estimating the negative influence of the human factor (HF) on flight safety. Aviation personnel are various groups of experts having various specialisations and working in various areas of civil aviation. It is obvious that their influence on conditions is also unequal and is defined by their degree of interaction with the performance of flights. In this article, the results of an analysis of air incidents will be presented.

scholarly journals Practice of Running Dyeing & Weaving Weekly in the Republic of China and Dissemination of Science and Technology

2021 ◽  
Vol 17 (6) ◽  
pp. 13
Author(s):  
Bochong Zhao ◽  
Kehui Deng
Keyword(s):  
Textile Industry ◽  
Positive Impact ◽  
Science And Technology ◽  
Modern Science ◽  
Modern China ◽  
Republic Of China ◽  
Long Time ◽  
Technology Dissemination ◽  
History Of ◽  
The Republic

Dyeing & Weaving Weekly (1935-1941) is a scientific and technological periodical which has been published for a long time and has never been interrupted in the field of textile in modern China. The journal publishes a large number of the latest achievements in textile science and technology, and is an important historical material and typical case for the study of modern science and technology dissemination. Rich in content, Dyeing & Weaving Weekly focuses on solving practical problems in the textile industry and guiding the direction of scientific research, which not only promotes the dissemination of textile science and technology but also contributes to the development of the textile industry. Therefore, from the perspective of science and technology communication and the history of newspapers and periodicals, this paper examines the practice and communication strategies of Dyeing & Textile Weekly, in order to prove that Dyeing & Textile Weekly has a positive impact on science and technology communication in modern China, and also provides experience reference for the development of contemporary science and technology periodicals in China, which has certain reference significance.

Assessing Human Reliability Behaviour from Use of Technology for Ships Navigating within Coastal Water

2015 ◽  
pp. 1141-1153
Author(s):  
Oladokun Sulaiman Olanrewaju
Keyword(s):  
Human Factors ◽  
Coastal Water ◽  
Human Error ◽  
Qualitative Assessment ◽  
Human Reliability ◽  
Human Errors ◽  
Performance Shaping Factors ◽  
Use Of Technology ◽  
Quasi Experimental ◽  
Guidelines And Standards

The traditional approach to the study of human factors in the maritime field involves the analysis of accidents without considering human factor reliability analysis. The main approaches being used to analyze human errors are statistical approach and probability theory approach. Another suitable approach to the study of human factors in the maritime industry is the quasi-experimental field study where variations in performance (for example attention) can be observed as a function of natural variations in performance shaping factors. This chapter analyzes result of modelling for human error and human reliability emanating from the use of technology on board ship navigation in coastal water areas by using qualitative and quantitative tools. Accident reports from marine department are used as empirical material for quantitative analysis. The literature on safety is based on common themes of accidents, the influence of human error resulting from technology usage design, accident reports from MAIB, and interventions information are used for qualitative assessment. Human reliability assessment involves analysis of accidents in waterways emanating from human-technology factors. The chapter reports enhancement requirement of the methodological issues with previous research study, monitoring, and deduces recommendations for technology modification of the human factors necessary to improve maritime safety performance. The result presented can contribute to rule making and safety management leading to the development of guidelines and standards for human reliability risk management for ships navigating within inland and coastal waters.

scholarly journals A Study of the Differences about Chinese Qixi Festival Custom——Taking Shanxi’s Old Local Chronicles as an Example

2021 ◽  
Vol 8 (1) ◽  
pp. 1
Author(s):  
Bei Zhang
Keyword(s):  
Qing Dynasty ◽  
Production Model ◽  
Shanxi Province ◽  
Cultural Elements ◽  
Republic Of China ◽  
The Qing Dynasty ◽  
Gender And Age ◽  
Long Time ◽  
The Republic ◽  
The Impact

The Qixi Festival is a traditional festival in China, which inherits the production model of men's farming and women's weaving for thousands of years. It is considered as a symbol of Chinese farming culture and widely propagated in many provinces in China since a long time ago. However, people in different areas celebrate this festival in different ways during different periods. This can be found in the documents that recorded in local chronicles. This research takes Shanxi Province as an example. Through sorting out 72 types of local chronicles that recorded the contents of the Qixi Festival which compiled during the Qing Dynasty and the Republic of China, we found that the differences mainly manifested in four aspects: the gender and age of the participants, the objects of sacrifice, the sacrificial offering, and the behavior of begging dexterousness. Through analyzing, it can be seen that these differences are caused by the impact of the environment and also related to the integration of multiple cultural elements in the festival itself.

scholarly journals Application of Integrated Human Error Management in Human Factors Engineering Process to Nuclear Power Plant Design

2021 ◽  
Vol 6 (4) ◽  
pp. 1186-1198
Author(s):  
Kenji Mashio ◽  
Kodo Ito
Keyword(s):  
Power Plant ◽  
Nuclear Power Plant ◽  
Human Factors ◽  
Nuclear Power ◽  
Human Error ◽  
Error Management ◽  
Human Factors Engineering ◽  
Plant Design ◽  
Integrated Process ◽  
Human Errors

Integrated process of human error management in human factors engineering (HFE) process provides a systematic direction for the design countermeasures development to prevent potential human errors. The process analyzes performance influence factors (PIFs) for crew failure modes (CFMs) and human failure events (HFEvs) in human reliability analysis (HRA). This paper provides applications of the process to the event evaluation for nuclear power plant design, especially PWR. In this application, the HRA/HFE integrated process had specified further detail for PIF attributes which had not been obtained in HRA, and showed further investigations to treat how operators induced their human errors through their cognitive task process in their work environment. This application showed effectiveness of the process in order to provide design countermeasures for preventing potential human errors occurrence based on the extensive PIFs and their error forcing context in HRA.

Human Error and Commercial Aviation Accidents: An Analysis Using the Human Factors Analysis and Classification System

2017 ◽  
pp. 73-88 ◽  
Author(s):  
Scott Shappell ◽  
Cristy Detwiler ◽  
Kali Holcomb ◽  
Carla Hackworth ◽  
Albert Boquet ◽  
...  
Keyword(s):  
Human Factors ◽  
Classification System ◽  
Human Error ◽  
Commercial Aviation ◽  
Aviation Accidents ◽  
Factors Analysis ◽  
Human Factors Analysis
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