Human Error
In many incident investigations, the conclusion often points to human error as the culprit. Declaring an incident as the result of human error can provide a convenient explanation, suggesting that the fault lies solely with the individual involved and absolving management and legislative oversight. However, it’s crucial to recognize that the focus should be on reducing the likelihood of human error through various measures.
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Mitigating Human Error Through Comprehensive Measures
Engineering Measures – Technical Controls
Technical or engineering controls are essential for directly addressing hazards and minimizing the chance of inappropriate actions. In process safety, this involves implementing automatic systems such as temperature, pressure, or level trips that operate without human intervention. While these measures are common, they can lead to overreliance on instrument readings, as seen in the Texas City Refinery incident. The inaccurate readings led to overfilling a tower, emphasizing the need for personnel to fully understand the process and think critically about potential issues.
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Operational Measures – Procedural Controls
Procedural controls encompass the standards and guidelines set by an organization to ensure safety. These procedures are developed based on identified best practices and approved codes within the organization. It’s vital to periodically update these procedures with input from those directly affected to maintain their relevance and effectiveness.
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Management Supervision – Behavioral Controls
Behavioral controls focus on influencing how individuals act, making safety a core value rather than just a target. While this approach can be challenging, it ultimately promotes a culture where safety is ingrained in everyday behavior. Encouraging individuals to view safety as an integral part of life, rather than a mere number, is key to effective behavioral control.
By implementing a combination of technical, procedural, and behavioral measures, organizations can significantly reduce the occurrence of human error and enhance overall safety.
