Occupational Medicine Quarterly Journal
فصلنامه علمی تخصصی طب کار
tkj
Medical Sciences
http://tkj.ssu.ac.ir
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2021
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شناسایی و ارزیابی خطاهای انسانی اپراتورهای اتاق کنترل اپوکسی یک شرکت لوله سازی با استفاده از تکنیک HEC
Identification and evaluation of human errors of Epoxy control room operators of a pipe Mill company using HEC technique
ایمنی و حوادث ناشی از کار
Safety and occupational accidents
پژوهشي
Research
<strong><span style="color:black;"><span style="font-family:B Nazanin;"><span style="font-size:10.0pt;">مقدمه:</span></span></span></strong> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">امروزه</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">در</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">بسیاری</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">از</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">محیطهای</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">شغلی،</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">بروز</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">یک</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">خطای</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">انسانی</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">میتواند</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">به</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">حادثهای</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">فاجعهبار منتهی</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">شود</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">که</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">خطاهای</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">انسانی</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">عامل</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">اصلی</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">حوادث</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">محسوب</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">میشوند. با توجه به نقش حیاتی اتاق کنترل در هدایت و کنترل سایتهای مختلف صنعت لولهسازی بهخصوص بخش پوشش خارجی، رخداد هرگونه خطایی میتواند منجر به حوادث انسانی، آسیب به ماشینآلات، وقفه در تولیدات شود. هدف</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">ا</span></span><span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">ز</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">پژوهش</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">حاضر</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">شناسایی</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">و</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">ارزیابی</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">خطای</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">انسانی</span></span><span style="font-family:B Nazanin;"><span style="font-size:12.0pt;"> به روش</span></span> <span dir="LTR"><span style="font-family:Times New Roman,serif;">Human Error Calculator </span></span><span style="font-family:B Nazanin;"><span style="font-size:12.0pt;"> (</span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:12.0pt;">HEC</span></span></span><span style="font-family:Times New Roman,serif;"><span style="font-size:12.0pt;">)</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;"> در اتاق کنترل اپوکسی یک شرکت لولهسازی است</span></span><span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">.</span></span><strong><span style="color:black;"><span style="font-family:B Nazanin;"><span style="font-size:12.0pt;"></span></span></span></strong><br>
<strong><span style="color:black;"><span style="font-family:B Nazanin;"><span style="font-size:10.0pt;">روش بررسی:</span></span></span></strong> <span style="color:black;"><span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">در </span></span></span><span style="color:black;"><span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">پژوهش</span></span></span> <span style="color:black;"><span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">توصیفی</span></span></span><span dir="LTR"><span style="color:black;"><span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">-</span></span></span></span><span style="color:black;"><span style="font-family:B Nazanin;"><span style="font-size:12.0pt;"> مقطعی</span></span></span> <span style="color:black;"><span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">حاضر </span></span></span><span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">از</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">رو</span></span><span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">ش</span></span> <span dir="LTR"><span style="font-family:Times New Roman,serif;">HEC</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">جهت</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">شناسایی</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">و</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">ارزیابی</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">خطاهای</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">انسانی</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">استفاده گردید. تکنیک </span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;">HEC</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">توسط شرکت </span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;">Risk Map</span></span><span style="font-family:B Nazanin;"><span style="font-size:12.0pt;"> ارائهشده است و در آن احتمال خطای انسانی بر اساس پنج فاکتور مؤثر بر رخداد خطای انسانی شامل درجهی فوریت، پیچیدگی، اهمیت، درجهی مهارت فردی و تکرار وظیفه و با استفاده از یک ابزار دیسکی شکل تحت عنوان </span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;">Risk Disk</span></span><span style="font-family:B Nazanin;"><span style="font-size:12.0pt;"> و از طریق مشاهده مستقیم، دستورالعملهای موجود و مصاحبه با سرپرست واحد مذکور تعیین میشود.</span></span><strong><span style="color:black;"><span style="font-family:B Nazanin;"><span style="font-size:12.0pt;"></span></span></span></strong><br>
<strong><span style="color:black;"><span style="font-family:B Nazanin;"><span style="font-size:10.0pt;">نتایج:</span></span></span></strong><span style="font-family:B Nazanin;"><span style="font-size:12.0pt;"> با</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">توجه</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">به</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">نتایج</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">بهدستآمده</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">از</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">این</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">پژوهش</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">مشخص گردید که از 11 وظیفه شناساییشده، 5 وظیفه شغلی </span></span><span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">با عدد ریسک 70 درصد دارای احتمال خطای انسانی زیاد، 4 وظیفه شغلی با عدد ریسک 50 درصد و یک وظیفه شغلی با عدد ریسک 40 درصد دارای احتمال خطای انسانی متوسط است و یک وظیفه شغلی با عدد ریسک 20 درصد دارای احتمال خطای انسانی در حال افزایش است.</span></span><br>
<strong><span style="color:black;"><span style="font-family:B Nazanin;"><span style="font-size:10.0pt;">نتیجهگیری:</span></span></span></strong> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">نتایج حاصل از مطالعه حاضر نشان داد که روش </span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;">HEC</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">کاربری</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">آسانی</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">داشته</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">و</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">یک</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">ابزار</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">ساده</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">و</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">مفید</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">برای</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">متخصصان</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">بهمنظور</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">محاسبه</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">احتمال</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">بروز</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">خطای</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">انسانی میباشد. علاوه</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">براین، </span></span> <span dir="LTR"><span style="font-family:Times New Roman,serif;">HEC</span></span><span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">یک</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">روش</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">کاربردی، مؤثر و سودمند</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">برای</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">مدیران</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">بهمنظور</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">کاهش</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">خطای انسانی</span></span><span style="font-family:B Nazanin;"><span style="font-size:12.0pt;"> است.</span></span><strong><span style="color:black;"><span style="font-family:B Nazanin;"><span style="font-size:12.0pt;"></span></span></span></strong><br>
<strong><span style="color:black;"><span style="font-family:B Nazanin;"><span style="font-size:12.0pt;"></span></span></span></strong><br>
<em><strong>Introduction:</strong></em> In many workplaces today, the incidence of human error can lead to catastrophic accidents in which human error is the main cause of accidents. Due to the vital role of the control room in guiding and controlling various sites of the pipe industry, especially the outer coating sector, the incidence of any error can lead to human accidents, damage to machinery, and interruption in production. This study aimed to identify and evaluate human error by Human Error Calculator (HEC) method in the epoxy control room of a pipe mill company. <br>
<em><strong>Materials</strong></em><em> <strong>and</strong> <strong>Methods:</strong></em> In the present descriptive cross-sectional study, the HEC method was used to identify and evaluate human errors. The HEC technique is provided by Risk Map Company, in which the probability of human error is based on five factors affecting the occurrence of human error, including a degree of urgency, complexity, importance, degree of individual skill, and task repetition, using a disk-shaped tool called Risk Disk is determined through direct observation, available instructions and interview with the head of the mentioned unit.<br>
<em><strong>Results:</strong></em> According to the results of this study, out of 11 identified tasks, five job tasks with a risk number of 70% have a high probability of human error, four job tasks with a risk number of 50%, and one job task with a number There is a 40% risk of moderate human error, And a job task with a 20% risk number has an increased chance of human error.<br>
<em><strong>Conclusion:</strong></em> The results of the present study showed that the HEC method is easy to use and is a simple and useful tool for professionals to calculate the probability of human error. In addition, HEC is a practical, effective and beneficial method for managers to reduce human error.
خطای انسانی, اتاق کنترل, اپوکسی, لولهسازی, HEC
Human error, Control room, Epoxy, Pipe mill, HEC
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http://tkj.ssu.ac.ir/browse.php?a_code=A-10-1115-1&slc_lang=fa&sid=1
Gholamabbas
Shirali
غلامعباس
شیرالی
gshirali52@gmail.com