• 대한안전경영과학회:학술대회논문집
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• 대한안전경영과학회 2007년도 춘계학술대회
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• pp.113-123
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• 2007

Through so that accident of semiconductor industry deduces unsafe factor of the person center on unsafe behaviour that incident history and questionnaire and I made starting point that extract very important factor. It served as a momentum that make up base that analyzes factors that happen based on factor that extract factor cause classification for the first factor, the second factor and the third factor and presents model of human error. Factor for whole defines factor component for human factor and to cause analysis 1 stage in human factor and step that wish to do access of problem and it do analysis cause of data of 1 step. Also, see significant difference that analyzes interrelation between leading persons about human mistake in semiconductor industry and connect interrelation of mistake by this. Continuously, dictionary road map to human error theoretical background to basis traditional accidental cause model and modern accident cause model and leading persons. I wish to present model and new model in semiconductor industry by backbone that leading persons of existing scholars who present model of existent human error deduce relation. Finally, I wish to deduce backbone of model of pre-suppression about accident leading person of the person center.

• 산업경영시스템학회지
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• 제39권2호
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• pp.129-137
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• 2016

To identify the cause of the error and maintain the health of system, an administrator usually analyzes event log data since it contains useful information to infer the cause of the error. However, because today's systems are huge and complex, it is almost impossible for administrators to manually analyze event log files to identify the cause of an error. In particular, as OpenStack, which is being widely used as cloud management system, operates with various service modules being linked to multiple servers, it is hard to access each node and analyze event log messages for each service module in the case of an error. For this, in this paper, we propose a novel message-based log analysis method that enables the administrator to find the cause of an error quickly. Specifically, the proposed method 1) consolidates event log data generated from system level and application service level, 2) clusters the consolidated data based on messages, and 3) analyzes interrelations among message groups in order to promptly identify the cause of a system error. This study has great significance in the following three aspects. First, the root cause of the error can be identified by collecting event logs of both system level and application service level and analyzing interrelations among the logs. Second, administrators do not need to classify messages for training since unsupervised learning of event log messages is applied. Third, using Dynamic Time Warping, an algorithm for measuring similarity of dynamic patterns over time increases accuracy of analysis on patterns generated from distributed system in which time synchronization is not exactly consistent.

• Nuclear Engineering and Technology
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• 제51권3호
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• pp.709-718
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• 2019

The international nuclear industry has undergone a lot of changes since the Fukushima, Chernobyl and TMI nuclear power plant accidents. However, there are still large and small component deficiencies at nuclear power plants in the world. There are many causes of electrical equipment defects. There are also factors that cause component failures due to human errors. This paper analyzed the root causes of failure and types of human error in 300 cases of electrical component failures. We analyzed the operating experience of electrical components by methods of root causes in K-HPES (Korean-version of Human Performance Enhancement System) and by methods of human error types in HuRAM+ (Human error-Related event root cause Analysis Method Plus). As a result of analysis, the most electrical component failures appeared as circuit breakers and emergency generators. The major causes of failure showed deterioration and contact failure of electrical components by human error of operations management. The causes of direct failure were due to aged components. Types of human error affecting the causes of electrical equipment failure are as follows. The human error type group I showed that errors of commission (EOC) were 97%, the human error type group II showed that slip/lapse errors were 74%, and the human error type group III showed that latent errors were 95%. This paper is meaningful in that we have approached the causes of electrical equipment failures from a comprehensive human error perspective and found a countermeasure against the root cause. This study will help human performance enhancement in nuclear power plants. However, this paper has done a lot of research on improving human performance in the maintenance field rather than in the design and construction stages. In the future, continuous research on types of human error and prevention measures in the design and construction sector will be required.

• International Journal of Reliability and Applications
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• 제11권2호
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• pp.123-138
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• 2010

This paper investigates a mathematical model of a system composed of two non-identical unit parallel system with common-cause failure, critical human error, non-critical human error, preventive maintenance and two type of repair, i.e. cheaper and costlier. This system goes for preventive maintenance at random epochs. We assume that the failure, repair and maintenance times are independent random variables. The failure rates, repair rates and preventive maintenance rate are constant for each unit. The system is analyzed by using the graphical evaluation and review technique (GERT) to obtain various related measures and we study the effect of the preventive maintenance preventive maintenance on the system performance. Certain important results have been derived as special cases. The plots for the mean time to system failure and the steady-state availability A(${\infty}$) of the system are drawn for different parametric values.

• 대한인간공학회지
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• 제34권2호
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• pp.103-113
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• 2015

Objective: This study proposes a systematic process to present the analysis methods and solutions of organizational root causes to human errors on the railroad. Background: In fact, organizational root cause such as organizational culture is an important factor in the safety concerns on human errors in the nuclear power plant, railroad and aircraft. Method: The proposed process is as follows: 1) define analysis boundary 2) select human error taxonomy 3) perform accident analysis 4) draw root causes with FGI 5) review root causes analysis with survey 6) chart analysis of root causes, and 7) propose alternatives and solutions. Results: As a result, root causes of the organizations like railroad and nuclear power plant came from the educational problems, violations, payoff system, safety culture and so forth. Conclusion: The proposed process does predict potential railroad accident through retrospect error analysis by building new human error taxonomies and problem solution. Application: This study would contribute to examination of the relationship between human error-based accidents and organizational root causes.

• 대한인간공학회지
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• 제27권3호
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• pp.43-52
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• 2008

Human errors are now considered as the most significant source of accidents or incidents in large-scale systems such as aircraft, vessels, railway, and nuclear power plants. As 61% of the train accidents in Korea railway involving collisions, derailments and fires were caused by human errors, there is a strong need for a systematic research that can help to prevent human errors. Although domestic railway operating companies use a variety of methods for analyzing human errors, there is much room for improvement. Especially, because most of them are based on written papers, there is a definite need for a well-developed computerized system supporting human error analyzing tasks. The purpose of this study is to propose a framework for a computerized human error analysis system focused on the railway industry on the basis of human error analysis mechanism. The proposed framework consists of human error analysis (HEA) module, similar accident tracking (SAT) module, cause factor recommendation (CFR) module, cause factor management (CFM) module, and statistics (ST) module.

• 한국항해항만학회:학술대회논문집
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• 한국항해항만학회 2005년도 춘계학술대회 논문집
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• pp.95-100
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• 2005

지금까지 수년 동안 선박승무원의 피로는 해양사고의 잠재적인 원인(potential cause) 또는, 인간과실(human error)에 기여하는 것으로써 그 개념이 무시되거나 고려되지 않았다. 그러나 최근 해양사고 자료나 조사에 의하면 피로가 임무수행에 밀접하게 영향을 미쳐서 인간과실을 유발하게 하고 결국 각종 해양사고가 발생한다는 사실을 밝혀내게 되었고, 여기에 대한 많은 관심과 연구가 집중되고 있다. 본 연구에서는 선박승무원의 피로에 대한 개념을 정립하고, 항해사의 업무수행능력에 영향을 미치는 피로유발원인에 관한 설문조사를 실시하고 그 결과를 분석하였다.

• 제어로봇시스템학회:학술대회논문집
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• 제어로봇시스템학회 2000년도 제15차 학술회의논문집
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• pp.378-378
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• 2000

The permissible positioning error of the transducer used in reactor inspection must be within 10 mm. To implement the required precision it is necessary to manufacture all components affecting the positioning mechanism correctly and precisely. In addition, it is also necessary to handle error factors accurately. This paper describes the activities of the findings and corrections of the errors which were occurred in experiments. Those activities are; i) Categorization of error factors, ii) Cause analysis of errors, iii) Correction of errors founded in experiments by the analysis of laser induction type and by the validation of real measurement of horizontal, vertical baselines.

• 한국항공운항학회지
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• 제28권4호
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• pp.21-31
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• 2020

There are two to three helicopter accidents every year in Korea, representing 5.7 deaths per 100,000 flights. In this study, an analysis was conducted on helicopter accidents that occurred in Korea from 2005 to 2017. The accident analysis was based on the aircraft accident and incident report published by the Aircraft and Railway Accident Investigation Board. This Research analyzed the characteristics of accidents occurring in Korea caused by human error by pilots. Accident analysis was done by classifying the organization, flight mission, aircraft class, flight stage, accident cause, etc. Pilot's huan error was classified as Skill-based error, decision error and perceptual error in accordance with the HFACS taxonomy. The accidents caused by pilot's human error were classified into five categories: powerlines collision, loss of control, fuel exhaustion, unstable approach to reservoir, and elimination of tail rotor.

• 웰빙융합연구
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• 제7권1호
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• pp.27-33
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• 2024

Purpose: This study investigates human error accidents in the Korean railway sector, emphasizing the need for systematic management to prevent such incidents, which can have fatal consequences, especially in driving-related jobs. Research design, data and methodology: This paper analyzed data from the Aviation and Railway Accident Investigation Board and the Korea Transportation Safety Authority, examining 240 human error accidents that occurred over the last five years (2018-2022). The analysis focused on accidents in the driving, facility, electric, and control fields. Results: The findings indicate that the majority of human error accidents stem from negligence in confirmation checks, issues with work methods, and oversight in facility maintenance. In the driving field, errors such as signal check neglect and braking failures are prevalent, while in the facility and electric fields, the main issues are maintenance delays and neglect of safety measures. Conclusions: The paper concludes that human error accidents are complex and multifaceted, often resulting from a high workload on engineers and systemic issues within the railway system. Future research should delve into the causal relationships of these accidents and develop targeted prevention strategies through improved work processes, education, and training.