By Trevor Kletz

ISBN-10: 1560329106

ISBN-13: 9781560329107

This identify appears at how humans, in place of know-how and pcs, are arguably the main unreliable issue inside of crops, resulting in harmful events.

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Extra info for An Engineer’s View of Human Error, Third Edition

Example text

5 (page 213) describes two medical errors involving computers. 9 Railways By considering accidentsdue to humanerror in other industries we can check the validityofour conclusion —thatoccasionalslips and lapsesofattention are inevitable andthat we musteitheracceptthemorchangethework sttuation, but that it is little use exhorting people to take more care. Because we are not involved, anddo not haveto rethinkour designs or modify our plants,we may see the conclusion more clearly. Railways have been in existence for a long time, railway accidents are well documentedin the officialreports by the Railway Inspectorate and in a numberofbool58'1820' 3, andtheyprovide examples illustrating all the principles of accident investigation, not just those concerned with human error.

It is thereforeworth studyingthe factors that influence the probability of error and ways ofreducingit. TEA i TEA÷SUGAR h BLACKTEA+ SUGAR 1 BLACKCOFFEE 1 - WFIITECOFFEE÷SUGAR WH1TECOFFEE- 1 I BLACKCOFFEE+ SUGAR HOT CHOCOLATE I! The errors were not due (I hope) to lack of training or instructions, or to lack of physicalor mental ability. They were certainly not due to lack of motivation becausewhen I got the wrong drink I had to drink it (beingtoo meanor shortofchange to throw it away and try again).

Pressingthe wrong button might result in a runawayor unwanted reaction or a customer complaint. It is thereforeworth studyingthe factors that influence the probability of error and ways ofreducingit. TEA i TEA÷SUGAR h BLACKTEA+ SUGAR 1 BLACKCOFFEE 1 - WFIITECOFFEE÷SUGAR WH1TECOFFEE- 1 I BLACKCOFFEE+ SUGAR HOT CHOCOLATE I! The errors were not due (I hope) to lack of training or instructions, or to lack of physicalor mental ability. They were certainly not due to lack of motivation becausewhen I got the wrong drink I had to drink it (beingtoo meanor shortofchange to throw it away and try again).

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