Citation

Backstrom T, Doos M. Int. J. Ind. Ergonomics 1997; 19(5): 361-376.

Copyright

(Copyright © 1997, Elsevier Publishing)

DOI

unavailable

PMID

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Abstract

This paper is concerned with machine failures that occur in automated installations that lead to occupational accidents. It is based on investigations of 76 cases of automation accidents. A conceptual apparatus has been developed which has the aim of describing the technical genesis of machine failures. Its external validity has been confirmed in large parts through its correspondence with concepts developed by other researchers. The apparatus has been applied to the automation accidents investigated. The factors, 'manifestation of fault', 'machine failure', and 'human intervention' have been utilized to describe 64 automation accidents involving machine failures. In nearly a third of the cases, the courses of events resulting in injury were similar: a work piece became stuck, or crookedly or incorrectly positioned; this led the machine to stop; the injury occurred while a person attempted to correct the position of the work piece. Four factors, 'origin of technical fault', 'history of fault', 'type of fault' and 'location of fault', have been employed in the investigation of 28 accidents. A majority of the technical faults were known to persons at the work site before the accident occurred, which suggests that opportunities are available for improving the handling of machine failures. Relevance to industryThe aspiration of the conceptual apparatus is to help industry: first to categorize machine failures accurately, to improve short-run remedy; second, to develop explanatory concepts, that will aid management of production problems. Further, advice is offered on measures aiming at reduction of accident risks at computer-controlled installations.