Fundamentals in Industrial SafetyLecture 6 - Occupational Safety & HealthManagement System
ProductionProtectionBankruptcyCatastropheProduction–ProtectionNeglecting safety could lead to serious consequence10 September 20162
Accident Causation Theory10 September 20163
Heinrich’s Domino Theory•In 1931, W.H. Heinrich developed the domino theory•98% of all accidents are caused by unsafe acts and actions and 2%by “acts of God”•A 5-step accident sequence occurred in which each factor wouldactuate the next step just like a row of falling dominoes•Removing a single domino in the row, the sequence would beinterrupted, thus preventing the accident•The key domino to be removed from the sequence is unsafe Act &Unsafe condition10 September 20164
Heinrich’s Domino Theory5-step Accident SequenceSocial EnvironmentFault ofPersonsAccidentUnsafe Act &Unsafe ConditionInjury10 September 20165
The removal of the Central Factor(Unsafe Act & Condition) makesthe action of preceding factors ineffective10 September 2016Heinrich’s Domino TheoryUnsafe Act &UnsafeConditionInjuryAccidentSocialEnvironmentFault ofPersons6
Contactwith energyorsubstanceIncident•Personalfactors•JobfactorsBasicCausesSub-standard acts&conditionsImmediateCauses•Inadequateprogrammes•Inadequateprogrammestandards•Inadequatecompliance tostandardsSystem FailureLoss•People•Property•ProcessSurface causesRoot causes10 September 20167Multiple Causation Theory
Multiple Causation Theory•In any single accident, there may be many contributingsurface and root causes•This theory brings out the fact that rarely, if ever, is anaccident the result of a single cause or act10 September 20168
10 September 20169A majority of accidents involve both sub-standard practices and sub-standard conditions. All these are only symptoms.Behind the symptoms are the basic causes, the personal factors andjobfactors whichledtothe substandardactsandsubstandardconditions.One should determine what deficiencies in the management system,such as lack of training, inadequate maintenance, poor hiring andplacement, permitted or caused those personal and job factorsMultiple Causation Theory
HazardsLossesDefences / BarriersRelationship between Hazards, Defences and Losses10 September 201610
Swiss Cheese Model10 September 201611
•James Reason (1990, 1997) made a key distinction between theactive,operationalerrors(“unsafeacts”)andthelatent(organisational) conditions•Reason stated that“systemsaccidents have their primary origins inthe fallible decisions made by designers and high-level (corporate orplant) managerial decisionmakers”•Active errors were therefore seen as symptoms or tokens of adefective systemSwiss Cheese Model10 September 201612
PEOPLEENVIRONMENTSYSTEM10 September 201613
Occupational Safety & Health ManagementSystem (OSHMS)10 September 201614
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