• Journal of the Ergonomics Society of Korea
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• v.29 no.2
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• pp.241-248
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• 2010

In accident analysis, it is essential to understand the causal pathways of the accident. Although numerous accident models have been developed to help analysts understand how and why an accident occurs, most of them do not include all elements related to the accident in various fields. Thus analysis of human error accidents in railway operations using these existing models may be possible, but inevitably incomplete. For a more thorough analysis of the accidents in railway operations, a more exhaustive model of accident causation is needed. This paper briefly reviews four recent accident causation models, and proposes a new model that overcomes the limitations of the existing models for the analysis of human error accidents in railway operations. In addition, the usefulness and comprehensiveness of the proposed model is briefly tested by explaining 12 railway accident cases with the model. The proposed accident causation model is expected to improve understanding of how and why an accident/incident occurs, and help prevent analysts from missing any important aspect of human error accidents in railway operations

• Journal of the Ergonomics Society of Korea
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• v.11 no.2
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• pp.35-45
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• 1992

This study is to define a congitive paradigm including a new model of common cause human behavior error domain and to analyze their causal factors and their properties of common cause human error characteristics in software engineering. A laboratory study was performed to analyze the common causes of human behavior domain error in software development and to identify software design factors contributing to the common cause effects in common cause failure redundancy. The results and analytical paradigm developed in this research can be applied to reliabbility improvement and cost reduction in software development for many applications. Results are also expected to provide training guidelines for software engineers and for more effective design of ultra-high reliable software packages.

• Korean Journal of Computational Design and Engineering
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• v.22 no.2
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• pp.181-189
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• 2017

In this paper, we develop a human error-free wire connection guide system. The only related work is Japanese patent by Hitachi. The patent is guiding the wire connection using PC server. And no implementation details have been reported publicly. We propose a new method based on smart mobile devices. The proposed methods are registered as two Korean patents. We implement a prototype wire connection guide system to verify the patents. Through human experiments, we verify the system can reduce the human error more than 90% and speed up the connection process more than twice faster than working without the system. To be used in the industrial fields, the prototype system needs more product packaging works.

• Nuclear Engineering and Technology
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• v.54 no.6
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• pp.2037-2047
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• 2022

The contribution of degraded human performance (e.g., human errors) is significant for the safety of diverse social-technical systems. Therefore, it is crucial to understand when and why the performance of human operators could be degraded. In this study, the occurrence probability of human errors was empirically estimated based on the complexity of proceduralized tasks. To this end, Logistic regression analysis was conducted to correlate TACOM (Task Complexity) scores with human errors collected from the full-scope training simulator of nuclear power plants equipped with analog devices (analog environment). As a result, it was observed that the occurrence probability of both errors of commission and errors of omission can be soundly estimated by TACOM scores. Since the effect of diverse performance influencing factors on the occurrence probabilities of human errors could be soundly distinguished by TACOM scores, it is also expected that TACOM scores can be used as a tool to explain when and why the performance of human operators starts to be degraded.

• Journal of the Korean Society of Safety
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• v.33 no.1
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• pp.66-72
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• 2018

This study analyses the types, related operations, facilities, and causes of chemical accidents in Korea based on the RISCAD classification taxonomy. In addition, human error analysis was carried out employing different human error classification criteria. Explosion and fire were major accident types, and nearly half of the accidents occurred during maintenance operation. In terms of related facility, storage devices and separators were the two most frequently involved ones. Results of the human error-based analysis showed that latent human errors in management level are involved in many accidents as well as active errors in the field level. Action errors related to unsafe behavior leads to accidents more often compared with the checking behavior. In particular, actions missed and inappropriate actions were major problems among the unsafe behaviors, which implicates that the compliance with the work procedure should be emphasized through education/training for the workers and the establishment of safety culture. According to the analysis of the causes of the human error, the frequency of skill-based mistakes leading to accidents were significantly lower than that of rule-based and knowledge based mistakes. However, there was limitation in the analysis of the root causes due to limited information in the accident investigation report. To solve this, it is suggested to adopt advanced accident investigation system including the establishment of independent organization and improvement in regulation.

• Journal of the Korean Society of Marine Environment & Safety
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• v.21 no.5
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• pp.515-523
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• 2015

This study reviewed 612 DP LOP(Loss of Position) incident reports which submitted to IMCA from 2001~2010 and identified 103 human error caused incidents and classified it through HFACS. And, this study analysis of conditional probability of human error on DP LOP incidents through application of bayesian network. As a result, all 103 human error related DP LOP incidents were caused by unsafe acts, and among unsafe acts 70 incidents(68.0 %) were related to skill based error which are the largest proportion of human error causes. Among skill based error, 60(58.3%) incidents were involved inadvertent use of controls and 8(7.8%) incidents were involved omitted step in procedure. Also, 21(20.8%) incidents were involved improper maneuver because of decision error. Also this study identified that unsafe supervision(68%) is effected as the largest latent causes of unsafe acts through application to bayesian network. As a results, it is identified that combined analysis of HFACS and bayesian network are useful tool for human error analysis. Based on these results, this study suggest 9 recommendations such as polices, interpersonal interaction, training etc. to prevent and mitigate human errors during DP operations.

• Journal of the Ergonomics Society of Korea
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• v.16 no.2
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• pp.1-14
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• 1997

In conventional probability-based human reliability analysis, the basic human error rates are modified by experts to consider the influences of many factors that affect human reliability. However, these influences are not easily represented quantitatively, because the relation between human reliability and each of these factors in not clear. In this paper, the relation is expressed quantitatively. Furthermore, human reliability is represented by error possibilities proposed by Onisawa, which is a fuzzy set on the interval [0,1]. Fuzzy reasoning is used in this method in order to obtain error possibilities. And, it is supposed that many basic events affected by the above factors are connected to the top event through Fault Tree structure, and an estimate of the top event expressed by a member- ship function is obtained by using the fuzzy measure and fuzzy integral. Finally, a numerical example of human reliability analysis obtained by this method is given.

• Journal of the Ergonomics Society of Korea
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• v.26 no.4
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• pp.121-125
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• 2007

The objective of this study is to develop short-term prevention measures for minimizing possible human error in nuclear power facilities. To accomplish this objective, a group of subject matter experts (SMEs) were formed, which is consisting of those from regulatory bodies, academia, industries and research institutes. Prevention measures were established for urgent execution in nuclear power facilities on a short-term basis. This study suggests short-term measures for reducing human error on three different areas; (1) strengthening worker management, (2) enhancing workplace environments and working methods, and (3) improving the technologies regulating human factors. Under the leadership of the Ministry of Science and Technology, these short-term measures will be pursued and implemented systematically by utility and regulatory agencies. The details of prevention measures are presented and discussed.

• Journal of the Korea Safety Management & Science
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• v.16 no.3
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• pp.195-200
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• 2014

Occupational fatal injury rate per 10,000 population of Korea is still higher among the OECD member countries. To prevent fatal injuries, the causes of accidents including human error should be analyzed and then appropriate countermeasures should be established. There was an severe converter furnace accident resulting in five people death by chocking in 2013. Although the accident type of the furnace accident was suffocation, many safety problems were included before reaching the death of suffocation. If the safety problems are reviewed throughly, the alternative measures based on the review would be very useful in preventing similar accidents. In this study, we investigated the converter furnace accident by using human error analysis and accident scenario analysis. As a result, it was found that the accident was caused by some human errors, inappropriate task sequence and lack of control in coordinating work by several subordinating companies. From the review of this case, the followings are suggested: First, systematic human error analysis should be included in the investigation of fatal injury accidents. Second, multi man-machine accident scenario analyis is useful in most of coordinating work. Third, the more provision of information on system state will lessen human errors. Fourth, the coordinating control in safety should be performed in the work conducting by several different companies.

• Journal of the Korean Society of Safety
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• v.29 no.3
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• pp.91-97
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• 2014

This study aims to suggest a measure to reduce industrial accident and secure adaptation to the industrial safety regulation policies by empirically establishing the effects of stress from adaptation to the industrial safety regulation on the human error, one of direct causes of industrial accident to the target groups of the industrial safety regulation policies. This study as for content range examines the stress from adaptation to the industrial safety regulation, job satisfaction, human error, and as for spatial range, this study performed an empirical research on the workers of 24 companies located within Chungcheong region centers district among 153 companies nationwide that uses 7 chemicals by introducing PSM (process safety management) system of the Ministry of Employment & Labor as of January 2012. Based on these results and suggestions there are five(5) necessities to reduce industrial safety regulations adaptation stress and human error generation, first(1st) is the necessity of understanding influential factors to stress, second(2nd) is the necessity to customized vocational training, third(3rd) is improving enhance system of job satisfaction, forth(4th) is preparing stress-reduction program, and fifth(5th) is introducing on-site restrictive action of advanced country as politics items.