Abstract

The Human Factors Analysis and Classification System (HFACS), based upon Reason's model of human error in an organisational context, is currently the most widely used human factors accident analysis framework. However, it has been criticised for merely categorising accident data rather than analysing it. Previous research has established statistical associations between the levels and categories within HFACS but has not specified a mechanism by which one category influences subsequent behaviour. This paper extends the approach in two ways. Using the categories of control flaws derived from Leveson's Systems–Theoretical Accident Model and Processes (STAMP) approach, it describes the mechanisms by which categories within HFACS are associated with other categories lower in the organisational hierarchy. It also provides a mechanism by which active failures can promulgate across organisations. The revised methodology HFACS-STAMP is illustrated using the case study of the Uberlingen mid-air collision on 1 July 2002.

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