risk evaluation
Hossein Ghasemi; Ida Tayebian
Abstract
Purpose: The purpose of this study was to identify and analysis the human errors of control room operators of the second refinery of South Pars using the « hierarchical task analysis», «systematic human error reduction and prediction.Methodology: This study was conducted in the central ...
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Purpose: The purpose of this study was to identify and analysis the human errors of control room operators of the second refinery of South Pars using the « hierarchical task analysis», «systematic human error reduction and prediction.Methodology: This study was conducted in the central control room of the second refinery in South Pars, the necessary data was collected using SHERPA and HTA methods. A Hierarchical Task Analysis (HTA) was used in the first phase, and then, in the next step in order to the identification and assessment of the human errors, SHERPA method was performed.Findings: Of all the errors identified in the refinery (143 errors) from the analysis of SHERPA worksheets, 102 errors (71.33%) are related to functional errors, 35 errors (24.47%) are related to visit errors, 3 errors (2.1%) are related to Regarding communication errors, 3 errors (2.1%) related to retrieval errors and 0 errors (0%) related to selection errors were reported. Also, according to this study, 14% of the types of consequences caused by errors were very severe consequences. The most obvious errors were related to performance and visit errors. With regard to preventing and reducing the occurrence of each of the identified errors and limiting their consequences, suitable control measures were provided in the form of changes in equipment design, type of training, changes in work methods, revision, formulation and updating of work instructions.Originality/Value: in this regard, the present study investigates identify and analysis the human errors of control room operators of the second refinery of South Pars using the hierarchical task analysis, systematic human error reduction and prediction.
