• 한국안전학회지
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• 제25권2호
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• pp.18-23
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• 2010

This paper describes a cause of fire accidents on power system fire DC electric traction vehicles. We investigated fire scene of power line for DC electric traction vehicles. From analysis results, the cause of fire on power line turned out line to ground fault between a feeder of electric power services(pantagraph) and DC electric traction vehicle roof. Fire accident of DC electric traction vehicles be assumed that electric sparks had been produced between the pantagraph and the power line conductor by repetitively making contact and separation, maybe if some material like branches get in between connecting rod it makes progress line to ground fault. ZnO arresters are widely used to protect DC electric traction vehicles against overvoltages caused by lightning or switching surges. However, the arresters are deteriorated by commercial overvoltages and/or lightning one. The deteriorated arresters could lead power failures, such as line to ground fault by a thermal runaway resulting from the increases in leakage current even in a nominal power system voltage. Finally, the power failures would be causative of the fire accident.

• 한국항행학회논문지
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• 제25권3호
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• pp.256-266
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• 2021

국내외 연구들은 무인항공기 사고의 주원인으로 인적요인을 지목하고 있고, 이러한 인적요인을 효과적으로 분석하는 기법으로 HFACS를 소개하고 있다. 현재까지는 HFACS를 이용해 무인항공기 사고의 인적요인을 분석했던 국내외 사례는 주로 군용 무인항공기가 대상이었는데, 항공사고를 유발하는 인적요인 정보를 분석하여 객관적 원인 규명과 유사 사고 예방 도구로 사용할 수 있는 HFACS가 국내 민간 무인항공기 분야에서도 활용이 필요한 시점이다. 특히, 국내 민간 무인항공기의 성능과 운용 여건을 고려한 HFACS 적용중점을 식별한다면 사고 발생 시 원인 규명과 재발 방지에 큰 도움이 될 것으로 예상된다. 본 연구는 HFACS version 7.0을 근간으로 우리나라 항공철도사고조사위원회가 수행했던 사고조사 결과보고서 자료를 분석하여 국내 민간 무인항공기 사고조사에 활용할 수 있는 HFACS 적용중점을 식별하였다.

• 해양환경안전학회:학술대회논문집
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• 해양환경안전학회 2017년도 추계학술발표회
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• pp.80-80
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• 2017

• 한국항해항만학회지
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• 제41권5호
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• pp.303-318
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• 2017

In the shipping industry, it is well known that around 80 % or more of all marine accidents are caused fully or at least in part by human error. In this regard, the International Maritime Organization (IMO) stated that the study of human factors would be important for improving maritime safety. Consequently, the IMO adopted the Casualty Investigation Code, including guidelines to assist investigators in the implementation of the Code, to prevent similar accidents occurring again in the future. In this paper, a process of the human factors investigation is proposed to provide investigators with a guide for determining the occurrence sequence of marine accidents, to identify and classify human error-inducing underlying factors, and to develop safety actions that can manage the risk of marine accidents. Also, an application of these investigation procedures to a collision accident is provided as a case study This is done to verify the applicability of the proposed human factors investigation procedures. The proposed human factors investigation process provides a systematic approach and consists of 3 steps: 'Step 1: collect data & determine occurrence sequence' using the SHEL model and the cognitive process model; 'Step 2: identify and classify underlying human factors' using the Maritime-Human Factor Analysis and Classification System (M-HFACS) model; and 'Step 3: develop safety actions,' using the causal chains. The case study shows that the proposed human factors investigation process is capable of identifying the underlying factors and indeveloping safety actions to prevent similar accidents from occurring.

• 한국재난정보학회 논문집
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• 제19권1호
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• pp.146-160
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• 2023

연구목적: 건설업은 복합공정이 동시에 진행되는 복잡한 메커니즘으로 사고 발생 빈도 와 강도가 다른 산업보다 높은 비중을 차지하고 있으며, 사고 사망만인율 또한 전 산업의 50% 이상 차지하고 있다. 이런 사고 감소를 위해 정부의 재해조사 방법에 대해 시스템 안전 관점에서 한계를 분석하여 개선방안을 제시하고자 한다. 연구방법: 정부의 중대 재해조사에 대한 주요 내용을 파악하고, 시스템 안전 관점에서 효과성/타당성을 분석하였다. 연구결과: 법규 위반 및 준수에 맞춰진 재해조사 및 분석기법은 근원적인 해결방안을 제시하기에 한계가 있었으며, 안전 제약, 제어, 계층별 상호작용을 접목할 때 시스템 전체의 구성 요소별로 사고 예방을 위한 대안 제시가 가능했다. 결론:현재의 사고분석 방법에서 시스템 안전 관점의 재해조사 및 분석 방법을 접목할 때 계층별 상호작용의 문제점과 의사소통 과정의 문제점을 확인할 수 있어 통합적 관점에서 사고 예방을 위한 대안 제시가 가능하다.

• 대한인간공학회지
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• 제30권1호
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• pp.137-150
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• 2011

Nationally and internationally reported statistics on marine accidents show that 80% or more of all marine accidents are caused fully or in part by human error. According to the statistics of marine accident causes from Korean Maritime Safety Tribunal(KMST), operating errors are implicated in 78.7% of all marine accidents that occurred from 2002 to 2006. In the case of the collision accidents, about 95% of all collision accidents are caused by operating errors, and those human error related collision accidents are mostly caused by failure of maintaining proper lookout and breach of the regulations for preventing collision. One way of reducing the probability of occurrence of the human error related marine accidents effectively is by investigating and understanding the role of the human elements in accident causation. In this paper, causal factors/root causes classification systems for marine accident investigation were reviewed and some typical human error analysis methods used in shipping industry were described in detail. This paper also proposed a human error analysis method that contains a cognitive process model, a human error analysis technique(Maritime HFACS) and a marine accident causal chains, and then its application to the actual marine accident was provided as a case study in order to demonstrate the framework of the method.

• Nuclear Engineering and Technology
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• 제44권3호
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• pp.311-322
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• 2012

Since the crisis at the Fukushima plants, severe accident progression during a station blackout accident in nuclear power plants is recognized as a very important area for accident management and emergency planning. The purpose of this study is to investigate the comparative characteristics of anticipated severe accident progression among the three typical types of nuclear reactors. A station blackout scenario, where all off-site power is lost and the diesel generators fail, is simulated as an initiating event of a severe accident sequence. In this study a comparative analysis was performed for typical pressurized water reactor (PWR), boiling water reactor (BWR), and pressurized heavy water reactor (PHWR). The study includes the summarization of design differences that would impact severe accident progressions, thermal hydraulic/severe accident phenomenological analysis during a station blackout initiated-severe accident; and an investigation of the core damage process, both within the reactor vessel before it fails and in the containment afterwards, and the resultant impact on the containment.

• 한국환경보건학회지
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• 제37권5호
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• pp.335-341
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• 2011

The Goseong abandoned mine accident was a typical case of long-term sequela resulting from environmental disruption during the rapid economic development of Korea. While the final conclusion of epidemiologic investigation was that residents surrounding the abandoned mine were simply exposed to cadmium from the abandoned mine without any patient contracting 'itai-itai' disease, not only did residents around the abandoned mine suffer enormous psychological and economic damage, but people in neighbouring communities did as well when the entire area was stigmatized as an contaminated area. Environmental civic groups and the government worked together to solve the problem by forming a joint committee which held the right of decision in any matter to be determined. By inviting all the stakeholders to participate in the joint committee, a transparent investigation was guaranteed and the results of investigation and recommendations to solve the problem were accepted by all involved. Even though the environmental health division in Ministry of Environment has developed considerably and built up a capacity to deal with environmental accidents, the process which was adopted to solving the Goseong abandoned mine accident can be useful to settle environmental health issues with severe conflicts among stakeholders.

• Safety and Health at Work
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• 제8권3호
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• pp.306-314
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• 2017

Background: In order to obtain a deeper understanding of an incident, it needs to be investigated to "peel back the layers" and examine both immediate and underlying failures that contributed to the event itself. One of the key elements of an effective accident investigation is recording the scene for future reference. In recent years, however, there have been major advances in survey technology, which have provided the ability to capture scenes in three dimension to an unprecedented level of detail, using laser scanners. Methods: A case study involving a fatal incident was surveyed using three-dimensional laser scanning, and subsequently recreated through virtual and physical models. The created models were then utilized in both accident investigation and legal process, to explore the technologies used in this setting. Results: Benefits include explanation of the event and environment, incident reconstruction, preservation of evidence, reducing the need for site visits, and testing of theories. Drawbacks include limited technology within courtrooms, confusion caused by models, cost, and personal interpretation and acceptance in the data. Conclusion: Laser scanning surveys can be of considerable use in jury trials, for example, in case the location supports the use of a high-definition survey, or an object has to be altered after the accident and it has a specific influence on the case and needs to be recorded. However, consideration has to be made in its application and to ensure a fair trial, with emphasis being placed on the facts of the case and personal interpretation controlled.

• 해양환경안전학회:학술대회논문집
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• 해양환경안전학회 2018년도 공동국제학술발표회
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• pp.120-120
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• 2018