Food safety is a very high-level concern for ordinary consumers. This is true because the food we eat can poison us or ruin our health, and yet consumers have little ability to evaluate the safety of the foods available in the marketplace. Therefore government regulation of food safety appears to be mandatory in any complex …
Fire safety in urban China
A rapidly rising percentage of the Chinese population is living in high-rise apartment buildings in hundreds of cities around the country. There is concern, however, about the quality and effectiveness of fire-safety regulation and enforcement for these buildings (as well as factories, warehouses, ports, and other structures). This means that high-rise fires represent a growing …
High reliability organizations
Charles Perrow takes a particularly negative view of the possibility of safe management of high-risk technologies in Normal Accidents: Living with High-Risk Technologies. His summary of the Three Mile Island accident is illustrative: “The system caused the accident, not the operators” (12). Perrow’s account of TMI is chiefly an account of complex and tightly-coupled system processes, …
Electronic Health Records and medical mistakes
Electronic Health Record systems (EHRs) have been broadly implemented by hospitals and health systems around the country as a way of increasing the accuracy, availability, and timeliness of patient health status and treatment information. (These systems are also sometimes called "Digital Medical Records" (DMRs).) They are generally regarded as an important forward step in improving …
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O-rings and production pressure
Allan McDonald's Truth, Lies, and O-Rings: Inside the Space Shuttle Challenger Disaster (2009) has given me a somewhat different understanding of the Challenger launch disaster than I've gained from other sources, including Diane Vaughan's excellent book The Challenger Launch Decision: Risky Technology, Culture, and Deviance at NASA. McDonald is a Morton Thiokol (MTI) insider who was present through …
Organizational culture
It is of both intellectual and practical interest to understand how organizations function and how the actors within them choose the actions that they pursue. A common answer to these questions is to refer to the rules and incentives of the organization, and then to attempt to understand the actor's choices through the lens of …
The US Chemical Safety Board
The Federal agency responsible for investigating chemical and petrochemical accidents in the United States is the Chemical Safety Board (link). The mission of the Board is described in these terms: The CSB is an independent federal agency charged with investigating industrial chemical accidents. Headquartered in Washington, DC, the agency’s board members are appointed by the …
Pervasive organizational and regulatory failures
It is intriguing to observe how pervasive organizational and regulatory failures are in our collective lives. Once you are sensitized to these factors, you see them everywhere. A good example is in the business section of today's print version of the New York Times, August 1, 2019. There are at least five stories in this …
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Soviet nuclear disasters: Kyshtym
The 1986 meltdown of reactor number 4 at the Chernobyl Nuclear Power Plant was the greatest nuclear disaster the world has yet seen. Less well known is the Kyshtym disaster in 1957, which resulted in a massive release of radioactive material in the Eastern Ural region of the Soviet Union. This was a catastrophic underground …
Nuclear power plant siting decisions
Readers may be skeptical about the practical importance of the topic of nuclear power plant siting decisions, since very few new nuclear plants have been proposed or approved in the United States for decades. However, the topic is one for which there is an extensive historical record, and it is a process that illuminates the …
Understanding Society 