Document Type : Original Articles
Authors
Abstract
AbstractBackground: Human errors play a crucial role in the incidence of industrial accidents. Hence, human reliability assessment (HRA) is essential as the most significant element of the system. The present study was conducted aiming at assessing human reliability in steering a blast furnace in an iron melting industry.Methods: The study comprised all HRA stages, namely data collection (through questionnaire), determination of the scope of the study (using interviews and questionnaires), task analysis (through hierarchical task analysis (HTA), determination and identification of errors (SHERPA ), screening, error quantification (HEART), and analysis and effect assessment of human error reduction.Results: A number of 169 errors were identified among 140 Bottom-Level Tasks obtained from HTA diagrams. Among the 38 error producing factors, 22 were identified as effective factors, among which low workforce spirit (19%), excess team members (15.7%), operator inexperience (12.4%), and the poor quality of data transmission through instructions and through person-to-person interaction (11.75%) accounted for the highest effect on the whole operation.Discussion: Human errors in operations for steering blast furnace occur due to a variety of factors, often rooted in various management levels, instructions for steering operations and repair, operators-panels interaction levels, and some factors affecting performance. As a single approach, the techniques used in this study yielded fruitful results. These techniques enjoy high validity though there were signs of technical immaturity, which led to failure in providing consistent control methods.Conclusion: Despite the technical weaknesses in the HRA techniques, currently the HRA is a useful method to enhance the reliability of crucial operations, such as the steering operation of blast furnace.
Keywords
- Lyons M, Adams S, Woloshynowych M, Vincent C. Human reliability analysis in healthcare: A review of techniques. International Journal of Risk and Safety in Medicine; 2004, 16: 223-237
- Hollnagel E. Human Reliability Assessment in Context. Nuclear Engineering and Technology; April 2005, 37 (2)
- Jo yong-do, Park Kyo-shik. Dynamic Management of Human Error to reduce total risk. Journal of loss prevention in process industries; 2003, 16: 313-321
- Reason J. Human error. New York: Cambridge University Press, 1990
- Stanton NA. Hierarchical task analysis: developments, applications and extensions. Applied Ergonomics; 2006, 37: 55â79.
- Mills S. Contextualizing design: Aspects of using usability context analysis and hierarchical task analysis for software design. Behavior & Information Technology; 2007: 1 â 8, First article
- Doytchev. D E, Szwillus. G. Combining task analysis and fault tree analysis for accident and incident analysis: A case study from Bulgaria. Accident Analysis and Prevention; 2009, 41( 6): Pages 1172-1179
- Kirwan B. The validation of three Human Reliability Quantification techniquesâ THERP, HEART and JHEDI: Part 1â technique descriptions and validation issues. Applied Ergonomics; 1996, 27(6): 359 â373
- Shepherd. .A, HTA as a framework for task analysis. Ergonomics; 1998, 41(11): 1537â 1552
- Ainsworth L K, Kirwan B. A guide to task analysis, New York; Taylor and Francis; 1992
- Kirwan B. a guide to practical human reliability assessment. New York. Taylor and Francis. 1994
- Kirwan B. Human error identification techniques for risk assessment of high risk systems â Part 1: review and evaluation of techniques. Applied Ergonomics; 1998, 29 (3): 157-177.
- Kirwan B, Scannali S. Robinson L. A case study of a human reliability assessment for an existing nuclear power plant. Applied ergonomics;1996, 27(5): 289-302
- Williams JC. A data-based method for assessing and reducing human error to improve operational performance. 4th IEEE conference on Human factors in Nuclear Power plants; Monterey, California, 6-9 june, 1988: 436-450
- Rhonda L, Neville S, David H. Applying hierarchical task analysis to medication administration errors. Applied Ergonomics; 2006, 37, 669â679
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