When Deviation Becomes the Norm

In contractor safety management, a key question concerns me: what happens after a risk is identified? A safety finding can be registered, discussed, and closed out. But will conditions actually change before the next shift?

Two international investigations demonstrate how an unsafe practice can persist within an active control system.

On August 11, 2025, at U.S. SteelClairtonCokeWorks an explosion occurred: two people were killed and 11 injured. In its final report dated August 10, 2026, the CSB described high-pressure water flushing of a gate valve involving a contractor. This method had been used for at least three years, despite lacking a written procedure. The pressure destroyed the valve, causing a gas release and explosion.

At NorwoodJunction station on July 1, 2025, a train departed with a boarding ramp still attached. No one was injured. The RAIB established that an unsuitable type of ramp was used; a suitable one had been missing since September 2021, and inspections had failed to identify this. The report was published on June 22, 2026. But do we really believe that no one knew or noticed?

These cases differ in their causes and consequences. For me, their shared management lesson is that the repetition of an operation and the regularity of inspections do not yet confirm the reliability of protection.

For contractors, this is especially critical at the interface of responsibility. The client knows the equipment, the contractor owns the work methodology, and the supervisor organizes the shift. Who verifies the safety of their joint solution?

Prequalification helps assess a company's readiness. Before starting a specific job, it is necessary to verify the applicability of the method and critical barriers. The ICMM, in its 2026 guidance, also links critical control management with verifying their actual operational performance and taking action based on findings.

I propose connecting this verification to a conversation about actual work on site with the workers. You can start like this: "Tell me how you performed this task last time. Where did you have to depart from the plan agreed during the shift briefing?" The response must be listened to without any predefined assumptions. Full impunity cannot be promised; protection from pressure for good-faith reporting must be ensured.

Next, a management decision is required: if a critical barrier is compromised, stop the affected work, protect personnel, assign responsibility for restoration, and verify conditions before resuming. The supervisor needs authority, time, and client support. Importantly, feedback must be provided to the person who reported the issue.

In contractor evaluation, I would include the recurrence of barrier failures and the proportion of actions whose results are verified on site. The number of reports itself is ambiguous: an increase may indicate greater openness. Likewise, a reduction in work stoppages cannot automatically be considered a success.

During your next site walk, suggest that the supervisor review one routine operation that has to be performed differently than planned. What management decision will allow the next shift to execute it safely?