Accident Causation

Learning Objectives
 To explain the philosophy behind
accident causation
 To understand the investigation process
 To undertake an investigation
 To prepare and present an investigation
report
Outline

 Model of accident causation

 Lack of control
 Basic causes : Personal
 Basic causes : Job
 Immediate causes
Outline contd
 Accident
 Loss
 Your role in Accident Investigation
 Which accidents
 Outcome of investigation
 Conclusion of Part 1
Model of accident causation
 H. W. Heinrich
1. Effects of Ancestry
2. Faults in a Person
3. Unsafe Act or Unsafe Condition
4. Accident
5. Loss
Model of accident causation
 Bird & Lofthus
1. Lack of management control
2. Basic Causes
3. Immediate causes
4. Accident
5. Loss
Lack of control

 Inadequate safety program

 Inadequate program standards

 Inadequate compliance with the

standards
 Basic causes : Personal
 Inadequate psychological capability
 Inadequate physical capability
 Physical stress or illness
 Improper motivation
 Lack of knowledge
 Lack of skill
Basic causes : Job
 Poor leadership or supervision
 Poor purchasing
 Poor engineering
 Poor maintenance
 Inadequate tools or equipment
 Poor working standards
 Abuse or misuse
Immediate causes
 Operating equipment without authority
 Operating at improper speed
 Making safety devices inoperable
 Using defective equipment
 Using equipment improperly
 Failure to follow procedures
Immediate causes
 Inadequate barriers or guards
 Defective tools or equipment
 Poor housekeeping
 Hazardous environment e.g. noise, gas,
fume, high temp, low temp
 Inadequate warning systems
 Inadequate ventilation
Accident
 Contact with energy or substance

 Death
 Near miss
 Minor injuries
 Major injuries
 Multiple deaths
Loss

 People
 Property

 Process

 Money
Model of accident causation
 Multi-Causal Theory
Emphasis on Heinrich’s 3rd Domino

Cause A

Cause B Effect

Cause C
Accident/Incident Ratios

Serious or disabling injuries

1
Minor Injuries

10
Damage Accidents

30
Incidents (i.e. no-injury
or damage accidents)
600
Costs of Accidents - Moral

 Loss of earnings
 Pain and suffering
 Physical and/or mental disability
 Incapacity for work
 Effect on families and dependants
 Effect on quality of life
 Loss of life !
Costs of Accidents - Legal

 Fines and Penalties

 Adverse publicity
 Personal convictions
 Criminal record
 Enforcement notices
Cost of Accidents - Economic
 Lost time of injured person
 Lost time of anyone else involved
 Lost time of those reporting and investigating
 Lost time in selection and training of replacement
 Lost time in attending court cases
 Cost of medical attention
 Cost of repair/replacement of plant and equipment
 Cost of lost production and possibly missed orders
 Cost of overtime/replacement person
 Cost of overheads - heat, light, rates, etc. continue
Summary of Losses Identified

Sector Total loss Ann. loss Representing

Construction £245075 £700,000 8.5% tender price

Creamery £243834 £975336 1.4% of op costs

Transport £48928 £195712 1.8% of op costs

37% profits

Oil Platform £940921 £3763684 14.2% of output

Hospital £99285 £397140 5% of run costs

Revised Cost of Accidents
 Construction

 18 week study, 120 employees, 0 >3 days, 56 minor,

3570 non injury accidents
 Total of 3626 accidents
 Accident ratio 1:56+:3570

 Injury : non injury Accident ratio 1:64

 Accidents per year per employee 87
 Insured to uninsured ratio costs 1:11
Revised Cost of Accidents
 Creamery

 13 week study, 338 employees, 6 >3 days, 31 minor,

889 non injury accidents
 Total of 926 accidents
 Accident ratio 1:5:148

 Injury : non injury Accident ratio 1:24

 Accidents per year per employee 11
 Insured to uninsured ratio costs 1:36
Revised Cost of Accidents
 Transport

 13 week study, 80 employees, 0 >3 days, 0 minor,

296 non injury accidents
 Total of 296 accidents
 Accident ratio n/a

 Injury : non injury Accident ratio n/a

 Accidents per year per employee 14
 Insured to uninsured ratio costs 1:8
Revised Cost of Accidents
 Oil Platform

 13 week study, 210 employees, 2 >3 days, 8 minor,

252 non injury accidents
 Total of 262 accidents
 Accident ratio 1:4:126

 Injury : non injury Accident ratio 1:25

 Accidents per year per employee 5
 Insured to uninsured ratio costs 1:11
Revised Cost of Accidents
 Hospital

 13 week study, 700 employees, 6 >3 days, 58 minor,

1168 non injury accidents
 Total of 1232 accidents
 Accident ratio 1:10:195

 Injury : non injury Accident ratio 1:18

 Accidents per year per employee 7
 Insured to uninsured ratio costs n/a
Revised Cost of Accidents
 All studies

 70 week study, 1448 employees, 14 >3 days, 153

minor, 6175 non injury accidents
 Total of 6342 accidents
 Accident ratio 1:11:441

 Injury : non injury Accident ratio 1:37

 Accidents per year per employee 17
 Insured to uninsured ratio costs n/a
Revised Cost of Accidents
 All studies except construction

 52 week study, 1328 employees, 14 >3 days, 97

minor, 2605 non injury accidents
 Total of 2716 accidents
 Accident ratio 1:7:189

 Injury : non injury Accident ratio 1:23

 Accidents per year per employee 8
 Insured to uninsured ratio costs n/a
So what about you
 Your role in Accident
Investigation

 To look into the accident

 To report what you find
 To identify why it happened
 To recommend improvements to
management
Which accidents
 Near misses

 Minor accidents

 Major accidents
 Outcome of investigation

 Clear and measurable

recommendations

 A timetable for implementation

 An estimation of resource implications,

i.e. time, money. space, etc.
Conclusion Part 1
 The model of accident causation is a
fundamental part of the investigation
approach.

 The application of this model is not

difficult.