#Incident investigation
Comprehensive incident management and accident investigation at industrial enterprises. Moving from mere blame-seeking to deep root-cause analysis (5W principle) and building a proactive culture. Transforming routines for 'Target Zero'.
Understanding the Human Factor as the Primary Source of Accidents and Injuries in Mining Enterprises
The article considers the human factor as the main source of accidents and injuries at mining enterprises, pointing out that a repressive policy toward workers does not increase production safety. The author shows that most violations of safety rules are caused by deficiencies in process organization on the part of management, rather than by worker discipline. Using examples of real management practices, it is demonstrated how responsible risk control and systematic production preparation make i...
From Dry Bulletins to Real Stories: How the "Matter of Chance" Video Series Shapes a Conscious Safety Culture
Instead of dry newsletters, the company launched a video series titled "Matter of Chance", in which employees share personal experiences of injuries and safety rule violations. Real stories and candid emotions from colleagues make risks tangible and force one to think about consequences before taking risky actions. This approach helps bridge the gap between formal informing and the formation of a conscious attitude toward safety.
"Safety Contact": A Targeted Strike on Risks
The article discusses the operational “Safety Contact” — a concise tool for the rapid analysis of specific production incidents and risks. The material details the format structure, which includes analyzing the causes of the incident and formulating practical recommendations for employees. Such a tool helps to promptly inform the team, prevent repeated errors, and increase overall safety.
Regular Incident Analysis: From Blaming Individuals to Systemic Solutions
Traditional blame-seeking in occupational health and safety incidents is ineffective and is giving way to a systemic approach, where every incident is viewed as a symptom of deep organizational problems. Regular analysis of even minor incidents allows identifying up to 80% of potentially dangerous situations before they escalate into severe accidents. Such an approach transforms industrial safety from a formal procedure into a living system that reliably protects the lives and health of workers.
Not By Oil Alone
Although public attention to environmental accidents is focused mainly on the oil and gas sector, virtually any human economic activity carries potential danger. This article presents the author's ranking of the largest non-oil-related disasters of the past century — from chemical spills and radiation accidents to dam failures and large-scale fires. The publication reminds us that preventing incidents is much more important and cheaper than eliminating their consequences, which often prove to be...
Incident Investigation: Not About Blame, But Hunting for Root Causes
The article explains why a punitive "find and punish" approach when investigating an industrial incident is dangerous, and how failures due to the "human factor" hide systemic flaws. The author shows how switching to a "search for causes" helps discover weak links in occupational health and safety and work organization. Using the "5 Whys" method as an example, it examines a way to find the root cause of an accident and eliminate a real threat in production.
Safety Compass: How AI is Changing the DNA of HSE
Using generative neural networks and low-code platforms (Replit, Bolt) to automate routine tasks for HSE specialists. The "Health Compass" system was developed to monitor epidemiological risks for traveling employees, along with dashboard prototypes for incident forecasting and categorization.
Exercise for Practicing the Identification of Accident Causes: Immediate, Underlying, and Root
The publication presents a practical exercise for determining the immediate, underlying, and root causes of an accident using a case study as an example. Based on a story about a female employee being injured on stairs, it is proposed to analyze the combination of factors that led to the incident. At the end of the material, the author provides their own version of the analysis for checking and comparing the results obtained.
Hazard Observation Cards Methodology as a Near Miss Management Tool
Implementation of a system for collecting and analyzing hazard observation cards (HOC) for near miss management. The practice includes a four-step HOC algorithm, accounting automation based on an internal IT solution, application of the "Five Whys" and "Bowtie" methods for investigation, and financial motivation of personnel for active risk identification.
Immediate, Underlying, and Root Causes of an Accident?
The article explains the three-level classification of workplace accident causes — immediate, basic, and root — and explains why incident investigations should not be limited to recording obvious facts. The author shows how identifying deep systemic violations in occupational health and safety management helps eliminate the root causes of incidents instead of a formal search for culprits. Understanding the difference between these levels allows implementing sustainable corrective actions, improv...
Why Use a Structured Approach in Accident Investigation?
The effectiveness of workplace accident investigations directly depends on a methodology that allows moving from superficial analysis to true root causes. The article examines a structured approach that eliminates subjectivity and replaces finding fault with the systematic improvement of the occupational health and safety system. You will learn how applying established methods helps identify systemic flaws, implement effective preventive measures, and strengthen safety culture.
The "5 Whys" Method: A Simple Tool for Finding the Root Causes of Incidents
The "5 Whys" technique, developed by Sakichi Toyoda, allows during workplace incidents to move away from superficial factors and determine the true cause of a failure in a system or process. By sequentially asking the question "Why?", it is possible to reach the root of the problem, not to look for culprits, but to prevent a recurrence of the situation. The article demonstrates the algorithm for applying this tool using a practical example and explains its role in forming a systematic approach t...