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Normal Accidents analyzes the social side of technological risk. Charles Perrow argues that the conventional engineering approach to ensuring safety--building in more warnings and safeguards--fails because systems complexity makes failures inevitable. He asserts that typical precautions, by adding to complexity, may help create new categories of accidents. (At Chernobyl, tests of a new safety system helped produce the meltdown and subsequent fire.) By recognizing two dimensions of risk--complex versus linear interactions, and tight versus loose coupling--this book provides a powerful framework for analyzing risks and the organizations that insist we run them. The first edition fulfilled one reviewer's prediction that it "may mark the beginning of accident research." In the new afterword to this edition Perrow reviews the extensive work on the major accidents of the last fifteen years, including Bhopal, Chernobyl, and the Challenger disaster. The new postscript probes what the author considers to be the "quintessential 'Normal Accident'" of our time: the Y2K computer problem.
Environmental tragedies such as Chernobyl and the Exxon Valdez remind us that catastrophic accidents are always possible in a world full of hazardous technologies. Yet, the apparently excellent safety record with nuclear weapons has led scholars, policy-makers, and the public alike to believe that nuclear arsenals can serve as a secure deterrent for the foreseeable future. In this provocative book, Scott Sagan challenges such optimism. Sagan's research into formerly classified archives penetrates the veil of safety that has surrounded U.S. nuclear weapons and reveals a hidden history of frightening "close calls" to disaster.
Having always prided herself on blending in with "normal" people despite her cerebral palsy, seventeen-year-old Jean begins to question her role in the world while attending a summer camp for children with disabilities.
On April 14, 1994, two U.S. Air Force F-15 fighters accidentally shot down two U.S. Army Black Hawk Helicopters over Northern Iraq, killing all twenty-six peacekeepers onboard. In response to this disaster the complete array of military and civilian investigative and judicial procedures ran their course. After almost two years of investigation with virtually unlimited resources, no culprit emerged, no bad guy showed himself, no smoking gun was found. This book attempts to make sense of this tragedy--a tragedy that on its surface makes no sense at all. With almost twenty years in uniform and a Ph.D. in organizational behavior, Lieutenant Colonel Snook writes from a unique perspective. A victim of friendly fire himself, he develops individual, group, organizational, and cross-level accounts of the accident and applies a rigorous analysis based on behavioral science theory to account for critical links in the causal chain of events. By explaining separate pieces of the puzzle, and analyzing each at a different level, the author removes much of the mystery surrounding the shootdown. Based on a grounded theory analysis, Snook offers a dynamic, cross-level mechanism he calls "practical drift"--the slow, steady uncoupling of practice from written procedure--to complete his explanation. His conclusion is disturbing. This accident happened because, or perhaps in spite of everyone behaving just the way we would expect them to behave, just the way theory would predict. The shootdown was a normal accident in a highly reliable organization.
A “delightfully astute” and “entertaining” history of the mishaps and meltdowns that have marked the path of scientific progress (Kirkus Reviews, starred review). Radiation: What could go wrong? In short, plenty. From Marie Curie carrying around a vial of radium salt because she liked the pretty blue glow to the large-scale disasters at Chernobyl and Fukushima, dating back to the late nineteenth century, nuclear science has had a rich history of innovative exploration and discovery, coupled with mistakes, accidents, and downright disasters. In this lively book, long-time advocate of continued nuclear research and nuclear energy James Mahaffey looks at each incident in turn and analyzes what happened and why, often discovering where scientists went wrong when analyzing past meltdowns. Every incident, while taking its toll, has led to new understanding of the mighty atom—and the fascinating frontier of science that still holds both incredible risk and great promise.
A journalist recounts the surprising history of accidents and reveals how they’ve come to define all that’s wrong with America. We hear it all the time: “Sorry, it was just an accident.” And we’ve been deeply conditioned to just accept that explanation and move on. But as Jessie Singer argues convincingly: There are no such things as accidents. The vast majority of mishaps are not random but predictable and preventable. Singer uncovers just how the term “accident” itself protects those in power and leaves the most vulnerable in harm’s way, preventing investigations, pushing off debts, blaming the victims, diluting anger, and even sparking empathy for the perpetrators. As the rate of accidental death skyrockets in America, the poor and people of color end up bearing the brunt of the violence and blame, while the powerful use the excuse of the “accident” to avoid consequences for their actions. Born of the death of her best friend, and the killer who insisted it was an accident, this book is a moving investigation of the sort of tragedies that are all too common, and all too commonly ignored. In this revelatory book, Singer tracks accidental death in America from turn of the century factories and coal mines to today’s urban highways, rural hospitals, and Superfund sites. Drawing connections between traffic accidents, accidental opioid overdoses, and accidental oil spills, Singer proves that what we call accidents are hardly random. Rather, who lives and dies by an accident in America is defined by money and power. She also presents a variety of actions we can take as individuals and as a society to stem the tide of “accidents”—saving lives and holding the guilty to account.
'Move over King, Chuck Wendig is the new voice of modern American horror' Adam Christopher 'A rich, rewarding tale' The Guardian ____________________________________________________________________________ A family returns to their hometown - and to the dark past that haunts them still - in this masterpiece of literary horror by the New York Times bestselling author of Wanderers When Nate's father dies, he leaves behind a final gift for his son: his childhood home. Married now, Nate decides to move in with his wife, Maddie, and their son, Oliver, seeking peace from the chaos of the city. But it doesn't take long before things get strange in the night and even stranger by day. Because Nate was a child being abused by his father, and has never told his family. Because Maddie was a little girl who saw something she shouldn't have. Because something sinister, something hungry, walks in the tunnels and the mountains and the coal mines of this town in rural Pennsylvania... And now, what happened all those years ago is happening again, and this time, it is happening to Oliver. When he meets a strange boy with secrets of his own and a taste for dark magic, he has no idea that what comes next will put his family at the heart of a battle of good versus evil. ____________________________________________________________________________ 'The dread, the scope, the pacing, the turns-I haven't felt all this so intensely since The Shining' - Stephen Graham Jones 'Universally horrifying and viscerally intimate, Wendig brilliantly uses The Book of Accidents to explore a painful truth: in the end, we all haunt ourselves' - Kiersten White
As part of the national effort to improve aviation safety, the Federal Aviation Administration (FAA) chartered the National Research Council to examine and recommend improvements in the aircraft certification process currently used by the FAA, manufacturers, and operators.
Many organisations live with hazards that have the potential to cause disaster. This was the case at Moura underground coal mine in Central Queensland, where 11 men died in an explosion in 1994. Andrew Hopkins shows that the explosion was the result of organisational failure, and uses it to draw lessons about managing major hazards. He argues that there are always tell-tale signs of impending disaster, and that organisations need to find ways of gathering this information and reacting to it appropriately. The Moura story also demonstrates the need to move responsibility for risk management up the corporate hierarchy to ensure that it is not overshadowed by production pressures. Otherwise disasters will repeat themselves in horrifyingly similar ways. Managing Major Hazards is a gripping story and essential reading for occupational health and safety professionals, executives working in hazardous industries, policy makers, and readers interested in risk management and disaster studies.
Experts estimate that as many as 98,000 people die in any given year from medical errors that occur in hospitals. That's more than die from motor vehicle accidents, breast cancer, or AIDSâ€"three causes that receive far more public attention. Indeed, more people die annually from medication errors than from workplace injuries. Add the financial cost to the human tragedy, and medical error easily rises to the top ranks of urgent, widespread public problems. To Err Is Human breaks the silence that has surrounded medical errors and their consequenceâ€"but not by pointing fingers at caring health care professionals who make honest mistakes. After all, to err is human. Instead, this book sets forth a national agendaâ€"with state and local implicationsâ€"for reducing medical errors and improving patient safety through the design of a safer health system. This volume reveals the often startling statistics of medical error and the disparity between the incidence of error and public perception of it, given many patients' expectations that the medical profession always performs perfectly. A careful examination is made of how the surrounding forces of legislation, regulation, and market activity influence the quality of care provided by health care organizations and then looks at their handling of medical mistakes. Using a detailed case study, the book reviews the current understanding of why these mistakes happen. A key theme is that legitimate liability concerns discourage reporting of errorsâ€"which begs the question, "How can we learn from our mistakes?" Balancing regulatory versus market-based initiatives and public versus private efforts, the Institute of Medicine presents wide-ranging recommendations for improving patient safety, in the areas of leadership, improved data collection and analysis, and development of effective systems at the level of direct patient care. To Err Is Human asserts that the problem is not bad people in health careâ€"it is that good people are working in bad systems that need to be made safer. Comprehensive and straightforward, this book offers a clear prescription for raising the level of patient safety in American health care. It also explains how patients themselves can influence the quality of care that they receive once they check into the hospital. This book will be vitally important to federal, state, and local health policy makers and regulators, health professional licensing officials, hospital administrators, medical educators and students, health caregivers, health journalists, patient advocatesâ€"as well as patients themselves. First in a series of publications from the Quality of Health Care in America, a project initiated by the Institute of Medicine