Almost all the major accident investigations–Texas City, Piper Alpha, the Phillips 66 explosion, Feyzin, Mexico City–show human error as the principal cause, either in design, operations, maintenance, or the management of safety. This book provides practical advice that can substantially reduce human error at all levels. In eight chapters–packed with case studies and examples of simple and advanced techniques for new and existing systems–the book challenges the assumption that human error is «unavoidable.» Instead, it suggests a systems perspective. This view sees error as a consequence of a mismatch between human capabilities and demands and inappropriate organizational culture. This makes error a manageable factor and, therefore, avoidable.
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