[SystemSafety] Fwd: Measurement + Control

Andrew Rae andrew.rae at york.ac.uk
Sun Dec 15 20:15:29 CET 2013


Absolutely. I think both supporters and opponents of safety cases can agree
that demonstrating that a system is safe is not the goal of safety
engineering.
Even going into a program with the _mindset_ that your job is to prove that
the system is safe is asking for trouble.

I do think that having an external body/person with a somewhat adversarial
mindset is important for good safety practices. It's the only real way to
distinguish between _thinking_ that you're managing safety well, and
actually managing it well. This necessarily means that some of the safety
activity is going to involve _demonstrating_ safety, rather than improving
it, but as Nancy says, this should be much more straightforward if you've
actually made a safe system. [Slight caveat - being safe and being
demonstrably safe are not always the same thing. It is worth thinking early
in the program about how you are going to demonstrate safety].

There are good reasons to believe that making your reasons for believing
that a system is safe explicit will help to combat the inevitable
confirmation bias that goes along with any demonstration of safety. That
applies whether your reasons are related to a particular set of practices,
or following a standard, or something particular to your program and system
architecture. I understand why Nancy disagrees with this, and I wish there
weren't so many cases of "retrospective" application of goal-based
standards to support her position. "But that's not proper use of safety
cases" becomes a weaker cry every time someone does it and calls it a
safety case.

As an aside, and picking two particular notations at random, I'd really
like to see someone not already involved with STPA or GSN produce and have
certified/accepted a system using both at once, just to make clear that
designing a safe system and demonstrating its safety are complementary
rather than competing ideas.

My system safety podcast: http://disastercast.co.uk
My phone number: +44 (0) 7783 446 814
University of York disclaimer:
http://www.york.ac.uk/docs/disclaimer/email.htm


On 15 December 2013 18:35, Nancy Leveson <leveson.nancy8 at gmail.com> wrote:

> I am getting increasingly frustrated by a prevalent attitude that the goal
> of safety engineering is to prove that a design is safe. I am not picking
> on Drew -- he is bringing up a good point. But it emphasizes the absurdity
> of the approach if safety is being "outsourced."
>
> The goal of safety engineering is to design safe systems. It is not to,
> after-the-fact or independently, try to show that a system is safe. At
> best, the latter goals are simply add-ons to the primary goal, i.e., a
> final step that is used simply to ensure that what was done before is
> approved). If safety engineering is done correctly, i.e., the hazard
> analysis and safety engineering steps have been accomplished by the
> engineers as they are designing the system and making design decisions,
> then the after-the-fact preparation of the case for the regulators is
> simple and consists of simply packaging up what was done during
> development.
>
> Engineering is not about making "arguments."
>
> Nancy
>
>
>
> On Thu, Dec 12, 2013 at 3:48 AM, Andrew Rae <andrew.rae at york.ac.uk> wrote:
>
>> Thanks for alerting to the availability of the article, Peter.
>>
>> One of the "outsourcing" issues which the paper alludes to but does not
>> elaborate on is outsourcing of the safety function itself.
>> I've found it hard to get exact figures, but anecdotal and advertising
>> indicators suggest that outsourcing major hazardous facilities safety
>> reports
>> (COMAH in the UK) to consultants seems to be a widespread practice.
>> Combine this with overworked and under-staffed regulators, and we have
>> safety analysis prepared by consultants and then never thoroughly
>> reviewed by either the customer or the regulator. The Buncefield safety
>> report
>> had been in the system for well over a year without the review being
>> completed at the time of the accident.
>>
>> I worry sometimes that safety expertise can be too intimidating, damaging
>> culture. Because the safety experts see themselves as the only ones
>> competent to do the analysis, everyone else sees safety as something to be
>> outsourced to internal or external expert groups. The result is that we
>> have a small group of people doing safety work (themselves too divorced
>> from the actual design and operation of the system to do the work
>> properly), and no one spare to review and check the work, or to improve the
>> way the work is done.
>>
>>
>> My system safety podcast: http://disastercast.co.uk
>> My phone number: +44 (0) 7783 446 814
>> University of York disclaimer:
>> http://www.york.ac.uk/docs/disclaimer/email.htm
>>
>>
>> On 11 December 2013 18:27, Peter Bernard Ladkin <
>> ladkin at rvs.uni-bielefeld.de> wrote:
>>
>>> I received this message from the publishing house Sage. They used to be
>>> known mostly for social-scince stuff, but recently took over PEP, who
>>> do/did the various parts of the Proceedings of the IMechE, and I suppose
>>> those for other engineering professional societies also.
>>>
>>> Sage offers free access to  certain articles until Sunday, somif you're
>>> quick you can download the Buncefield article by Colin Howard, as I did.
>>> The Secretary of the German functional safety standards committee, Ingo
>>> Rolle, is interested in issue concerning Buncefield, and I sent it to him.
>>> He is on this list, as I seem to remember is Carl Sandom, who is convening
>>> the IEC project on human factors in functional safety. Ingo's comment
>>> speaks directly to HF issues.
>>>
>>> [begin comment Ingo Rolle]
>>>
>>> Thanks for this article, one of the few I read in full recently. The
>>> switching device for the high level alarm was replaced in 2004, prior to
>>> the accident, at that tank which was overfilled in 2005. I draw the
>>> conclusion that the change of switching principle in that device was a
>>> major contribution to the ill-fated sequence of events, although I didn't
>>> find a more explicit statement of the author on this.
>>>
>>>
>>> [I agree with that conclusion. PBL]
>>>
>>>
>>>
>>> Nevertheless, the scenario described of actions and efforts to replace
>>> the switch and amend the situation reminded me of my own experience as an
>>> engineer associated with process facilities. In my view such a situation
>>> [as occurred here] is the clear consequence of outsourcing of maintenance
>>> personnel. It is strange to make large investments, establish facilities on
>>> green field sites, and then leave such assets without people assigned to
>>> operate them and look after them properly. I think we are the first
>>> civilization to engage in such foolishness ("outsourcing"). Only people who
>>> know and understand  the facilities, have a close relation to them, know
>>> their colleagues and environment and have some time for that will track
>>> weaknesses, address them and keep the whole thing safe and well running.
>>>
>>>
>>>
>>> One may outsource particular activities but the core management of
>>> maintenance must stay in the company or facility
>>>
>>>
>>>
>>> Ingo Rolle
>>>
>>>
>>>
>>> [end comment Ingo Rolle]
>>>
>>>
>>> PBL
>>>
>>> Prof. Peter Bernard Ladkin, University of Bielefeld and Causalis Limited
>>>
>>> Begin forwarded message:
>>>
>>> *From:* "SAGE Measurement and Control" <announcements at news.sagepub.co.uk
>>> >
>>> *Date:* 4 December 2013 14:21:13 CET
>>> *To:* <ladkin at rvs.uni-bielefeld.de>
>>> *Subject:* *Measurement + Control*
>>> *Reply-To:* "mailbox20825x12699" <mailbox20825x12699 at news.sagepub.co.uk>
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>
>
> --
> Prof. Nancy Leveson
> Aeronautics and Astronautics and Engineering Systems
> MIT, Room 33-334
> 77 Massachusetts Ave.
> Cambridge, MA 02142
>
> Telephone: 617-258-0505
> Email: leveson at mit.edu
> URL: http://sunnyday.mit.edu
>
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