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- 2009 Spring Meeting & 5th Global Congress on Process Safety
- 43rd Loss Prevention Symposium
- Poster Session
- (78k) Do We Really Learn from Loss Incidents?
We want to assure our readers that there are definitely some organizations and individuals who take this learning from incidents very seriously. We can draw very useful lessons from not only major incidents that have caught the public and media eye, but also from smaller incidents that occur in one's industry. When an incident is reported in the media everyone is naturally curious as to what happened. But if we want to learn from the incident we have to go beyond simple curiosity. There are some known hurdles in our ability to learn from other people's incidents. In order to learn lessons, we need to review the incident in depth. In analyzing these incidents for the purpose of learning lessons for the future, there is no point in trying to blame specific person or persons. ?Culpability? is applicable in cases of sabotage or other deliberate actions with malice aforethought. In accidents and incidents, it is better to concentrate on systemic or procedural failures or design deficiencies so that viable, effective and long-term remedial measures can be proposed and implemented.
The learning process is not easy. You need to have the will and the ability to pay attention to detail.
?... Safety management is not rocket science. Rocket science is trivial pursuit compared to the management of safety. There are only a limited number of fuel types capable of lifting a payload into space: but the variety of ways in which harm can come to people is legion? ? Trevor Kletz (from his book entitled: Still Going Wrong!).