ESReDA_GLSIA_Final_June_2009_For_Download.pdfVIP专享VIP免费原创优质

ESReDA-EuropeanSafetyReliabilityandDataAssociationESReDAWorkingGrouponAccidentInvestigationSafetyInvestigationsofAccidentsGuidelinesforJune2009ESReDA-EuropeanSafetyReliabilityandDataAssociationSafetyInvestigationsofAccidentsJune2008ESReDA-EuropeanSafetyReliabilityandDataAssociationEuropeanSafetyReliabilityandDataAssociation(ESReDA)ISBN978-82-51-50309-9©ESReDA2009.Thisworkiscopyright.Intheinterestofenhancingthevalueofinformationcontainedinthispublicationyoumaycopy,download,display,print,reproduceanddistributethismaterialinunalteredform(retainingthisnotice).Incaseofuseof(partof)theGuidelinesyouarerequestedtorefertothisPublication.TheseGuidelinesarealsoavailablefordownloadingfromtheESReDAwebsite:www.esreda.orgESReDA-EuropeanSafetyReliabilityandDataAssociationESReDA-EuropeanSafetyReliabilityandDataAssociationiPREFACEbythePresidentofESReDAOperatingfeedbackorlearningfromexperienceisrecognisedtobeoneofthepillarsofsafetymanagement.Intheory,ithelpstoreveal―failures‖inthesocio-technicalsystem,whichcanberemediedsothat-accordingtothestandardphrase–suchevents"canneverhappenagain".Thisiswhyinvestigationsareseenasimportantsourcesofsafetyinformation,astheydemonstratehowthingscangowrong.Safetyinvestigationofaccidentsisafieldwhichisimprovingandexpanding.Theambitionoftheseguidelinesistoreflectthestateofartaswelltoaddressfuturechallengesinaccidentinvestigation.Byformulatingtheseconsiderations,theintentionistosupportalearningprocessacrosssectors,andtoimprovethequalityofinvestigations.TheseguidelineshavebeenwrittenbyaprojectgroupwithintheEuropeanSafety,ReliabilityandDataAssociation(ESReDA).ESReDAisanon-profitmakingassociationofEuropeanindustrialandacademicorganisationsconcernedwithadvancesinthesafetyandreliabilityfield.Theassociationalwayswelcomescommentsandcontributionsconcerningtheirpublicationsandinvitesalltosubmitideasforfurtherdevelopmentsinthefieldofreliabilitydataaswell.TheseguidelineswouldnothavebeenpossiblewithoutsubstantialindividualeffortoftheESReDAprojectgroupmemberswhocomefromdifferentcompanies,researchinstitutes,universitiesandauthorities.Theyhaveproduceditscontentswithoutanyfinancialsupportandhavedevotedconsiderablefreetimetothetask.Thispublicationcollectsconsiderableexperiencesfromseveralindustrialsectors(transportation,energy,chemical,…)andcountriesinEurope.ESReDAisproudtopresenttheresultsoftheirworkandhopesitwillbenefitthemanyorganisationsandindividualsworldwideconcernedwithsafetyinvestigationofaccidentsandlearningfromexperience.ESReDAwouldliketothanktheauthorsfortheircontributionandalsothememberorganisationsforfundingtravelexpensesforitsmembers.Inparticularspecialthanksareduetothoseorganisationsthathaveallowedworkinggroupmemberstoparticipateinthisworkincludinggivingfreeaccesstotheirextensivein-houseexpertiseandexperience.Werecordourappreciationandgratefulthanksto:InstitutNationaldel‘EnvironnementIndustrieletdesRisques,(INERIS),France;ÉlectricitédeFrance,EDFR&D,France;EDP–GestãodaProduçãodeEnergia,S.A.,Portugal;DetNorskeVeritasAS,Norway;N.V.NederlandseGasunie,theNetherlands;WorkResearchInstitute,Norway;KindunosSafetyConsultancyLtd,theNetherlands;KarlstadUniversity-PublicHealthSciences/RiskResearch,Sweden;RailSafetyandStandardsBoard,UnitedKingdom;Tukes-SafetyTechnologyAuthority,Finland;EuropeanCommission,DG-JointResearchCentre,InstituteforEnergy,theNetherlands;We...