Abstract
This paper compares all accident investigation reports covering railway accidents issued by the national investigation boards in Sweden, Norway and Denmark during a two-year period (2008-2009). By using content analysis, units of text describing attributed causes have been selected and categorized as belonging to one of three hierarchical levels; the micro level (technical malfunctioning and human actions), meso level (organizational actions and factors in the physical environment), and
macro level (inter-organizational and regulatory factors). In addition, attributed causes on each level have been further categorized as belonging to different ‘types’ of causes. In a similar manner the recommendations described in all studied reports have been divided into different classes. The results show that the majority of attributed causes in all three countries belong to the micro level, and about
half of all recommendations aim at human factors aspects. Furthermore, the diversity in different ‘types’ of causes differs between the countries. The analysis has been followed up by interviews with
the investigation boards. Based on these interviews, it can be concluded that the structure, mandate and traditions of the investigation boards influences the outcome of the investigations in such way that a broader mandate gives rise to a higher potential for accidents to be examined from multiple perspectives.
macro level (inter-organizational and regulatory factors). In addition, attributed causes on each level have been further categorized as belonging to different ‘types’ of causes. In a similar manner the recommendations described in all studied reports have been divided into different classes. The results show that the majority of attributed causes in all three countries belong to the micro level, and about
half of all recommendations aim at human factors aspects. Furthermore, the diversity in different ‘types’ of causes differs between the countries. The analysis has been followed up by interviews with
the investigation boards. Based on these interviews, it can be concluded that the structure, mandate and traditions of the investigation boards influences the outcome of the investigations in such way that a broader mandate gives rise to a higher potential for accidents to be examined from multiple perspectives.
Original language | English |
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Title of host publication | Proceedings 10th International Probabilistic Safety Assessment & Management Conference. |
Number of pages | 11 |
Publication status | Published - 2010 |
Event | The 10th International Probabilistic Safety Assessment & Management Conference (PSAM) - Seattle, United States Duration: 2010 Jun 7 → 2010 Jun 11 |
Conference
Conference | The 10th International Probabilistic Safety Assessment & Management Conference (PSAM) |
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Country/Territory | United States |
City | Seattle |
Period | 2010/06/07 → 2010/06/11 |
Subject classification (UKÄ)
- Social Sciences Interdisciplinary
- Other Civil Engineering
- Building Technologies
Free keywords
- Accident investigations
- Investigation boards
- Learning