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At least 73 records · Page 4

All sources NASA NTRS DOE OSTI

NASA NTRS2018

A Risk Analysis Tool for Estimating the Risk of Electrical Failures Due to Human Induced Defects

Aerospace electrical systems are required to withstand and adequately operate in extremely harsh environments that include, for example, high radiation exposure, temperature extremes, intense vibrational stress and drastic temperature cycling. The nature of aerospace electronics also demands high reliability since, with very few exceptions, there is no chance for hardware servicing or repairs. Common risk mitigation techniques for this type of situation are to perform a Reliability Analysis of the system throughout the development cycle, and to use electrical components that are regarded as “high reliability” because of additional controls and requirements applied in their design, manufacturing and testing. Unfortunately, studies have shown that even though these techniques are used, many systems fail to meet mission requirements well before the predicted lifetimes. This paper presents the analysis of failures of electrical parts, experienced during various stages of system development, at NASA Goddard Space Flight Center, Greenbelt MD, between the years 2001 and 2013. These components were subjected to qualification, screening and testing in which the goal was to ensure that the components would survive the stresses of the mission. The analysis categorizes failures by part type and failure mechanisms. One of the results of the analysis was the realization that a surprising proportion of failures experienced during system integration and testing were caused by human error (i.e. human induced defect). Further analysis included the determination of root failure mechanisms and any influencing factors contributing to these failures. The major causes of these defects were attributed to electrostatic damage (ESD), electrical overstress (EOS), mechanical overstress (MOS), and thermal overstress (TOS). Finally, the study proposes a risk analysis tool which incorporates these major causes for the failures, termed error-producing conditions (EPCs), and a proportionality factor representing the number of each type of failure that has occurred at the facility under study. These factors are quantified and used to communicate the risk of human induced defects for the assembly, integration and testing of space hardware based on the system’s electrical parts list. The new risk identification can trigger risk-mitigating actions more effectively, based on the presence of component categories or other hazardous conditions that have a history of failure due to human error.

Majewicz, Peter J.↗

DOE OSTI2024

Effects of machine learning errors on human decision-making: manipulations of model accuracy, error types, and error importance

Abstract This study addressed the cognitive impacts of providing correct and incorrect machine learning (ML) outputs in support of an object detection task. The study consisted of five experiments that manipulated the accuracy and importance of mock ML outputs. In each of the experiments, participants were given the T and L task with T-shaped targets and L-shaped distractors. They were tasked with categorizing each image as target present or target absent. In Experiment 1, they performed this task without the aid of ML outputs. In Experiments 2–5, they were shown images with bounding boxes, representing the output of an ML model. The outputs could be correct (hits and correct rejections), or they could be erroneous (false alarms and misses). Experiment 2 manipulated the overall accuracy of these mock ML outputs. Experiment 3 manipulated the proportion of different types of errors. Experiments 4 and 5 manipulated the importance of specific types of stimuli or model errors, as well as the framing of the task in terms of human or model performance. These experiments showed that model misses were consistently harder for participants to detect than model false alarms. In general, as the model’s performance increased, human performance increased as well, but in many cases the participants were more likely to overlook model errors when the model had high accuracy overall. Warning participants to be on the lookout for specific types of model errors had very little impact on their performance. Overall, our results emphasize the importance of considering human cognition when determining what level of model performance and types of model errors are acceptable for a given task.

97 MATHEMATICS AND COMPUTING↗

NASA NTRSDate not supplied

On the Use of Resilience Models as Digital Twins for Operational Support and In time Decision Making

Human error is a major contributor to accidents and performance losses in complex engineered systems. If one examines these human error caused failures further, a specific cause, the lack of situation awareness, has dominated as a major cause of human errors that instigate latent or catastrophic failures in complex systems. Studies of aviation accidents involving major air carriers revealed that situation awareness was the root cause of around 90% of accidents involving pilot error. Another study explored offshore drilling accidents involving human error and found that 40% of accidents were directly attributed to the loss of situation awareness. Studies of human errors in other domains such as nuclear power, air traffic control, process industry, and advanced driving show that loss of SA was a root cause in a majority of the events. Situation awareness-related failures are not only common but also costly and fatal (e.g., Bhopal Gas Leak, Air France 447 Flight Crash). Thus, the concept of situation awareness has emerged as an important construct in human factors, resulting in numerous models and measurement methods to aid in promoting appropriate levels of situation awareness.

Lukman Irshad↗

NASA NTRS2014

Human Reliability and the Cost of Doing Business

Human error cannot be defined unambiguously in advance of it happening, it often becomes an error after the fact. The same action can result in a tragic accident for one situation or a heroic action given a more favorable outcome. People often forget that we employ humans in business and industry for the flexibility and capability to change when needed. In complex systems, operations are driven by their specifications of the system and the system structure. People provide the flexibility to make it work. Human error has been reported as being responsible for 60%‐80% of failures, accidents and incidents in high‐risk industries. We don't have to accept that all human errors are inevitable. Through the use of some basic techniques, many potential human error events can be addressed. There are actions that can be taken to reduce the risk of human error.

DeMott, D. L.↗

DOE OSTI2023

Simulation-Based Recovery Action Analysis Using the EMRALD Dynamic Risk Assessment Tool

A recovery action is defined as the action that prevents deviant conditions from producing unwanted effects. It generally indicates a kind of countermeasure performed in response to a failure of human action. The recovery actions especially play an important role in complex systems like nuclear power plants (NPPs), which consist of highly sophisticated controllers to ensure that desired performance and safety must be achieved and maintained. This is because a combination of human error and its recovery failure may be able to cause a catastrophic effect on a system. Analyzing recovery actions has been a critical part of HRA, which is a technique to evaluate human errors and provide human error probabilities (HEPs) for application in probabilistic safety assessment (PSA). If recovery actions are not adequately analyzed and applied to PSA models, the PSA results may be under-estimated or be not able to reasonably account for the failure of human actions in the context of PSA. For this reason, some regulatory documents such as ASME/ANS RA-Sb-2013 by the American Society for Mechanical Engineers and the American Nuclear Society and NUREG-1792 by U.S. Nuclear Regulatory Commission have emphasized the importance of recovery analysis within the HRA. A couple of existing HRA methods, such as the Technique for Human Error-Rate Prediction (THERP), the Cause-Based Decision Tree (CBDT), and the Korean Standard HRA (K-HRA), have respectively suggested their own approaches to the HRA recovery analysis. However, there are a couple of limitations to treating recovery actions using only the current HRA methods available. The biggest limitation is that the existing recovery analysis does not explicitly consider a variety of recovery action types and recovery sequences as they occur in actual NPPs. To handle the limitations of existing recovery analysis, this study proposes a simulation-based recovery analysis method using the Event Modeling Risk Assessment Using Linked Diagram (EMRALD) software. The EMRALD software is a dynamic simulation tool for PSA. It supports realistic and dynamic modeling of human actions as they would be performed at NPPs. It is also favorable to simultaneously model the specific moment at which an action is performed, the time it takes to perform the action, and the failure probability of that action. In this paper, a detailed methodology for modeling recovery actions in the simulation platform is proposed with a couple of examples. Then, outputs from the simulation are discussed as reviewing if this novel approach can complement the challenges of existing recovery analyses.

99 GENERAL AND MISCELLANEOUS↗

NASA NTRS1992

Modeling human response errors in synthetic flight simulator domain

This paper presents a control theoretic approach to modeling human response errors (HRE) in the flight simulation domain. The human pilot is modeled as a supervisor of a highly automated system. The synthesis uses the theory of optimal control pilot modeling for integrating the pilot's observation error and the error due to the simulation model (experimental error). Methods for solving the HRE problem are suggested. Experimental verification of the models will be tested in a flight quality handling simulation.

Ntuen, Celestine A.↗

NASA NTRS2010

The Importance of HRA in Human Space Flight: Understanding the Risks

Human performance is critical to crew safety during space missions. Humans interact with hardware and software during ground processing, normal flight, and in response to events. Human interactions with hardware and software can cause Loss of Crew and/or Vehicle (LOCV) through improper actions, or may prevent LOCV through recovery and control actions. Humans have the ability to deal with complex situations and system interactions beyond the capability of machines. Human Reliability Analysis (HRA) is a method used to qualitatively and quantitatively assess the occurrence of human failures that affect availability and reliability of complex systems. Modeling human actions with their corresponding failure probabilities in a Probabilistic Risk Assessment (PRA) provides a more complete picture of system risks and risk contributions. A high-quality HRA can provide valuable information on potential areas for improvement, including training, procedures, human interfaces design, and the need for automation. Modeling human error has always been a challenge in part because performance data is not always readily available. For spaceflight, the challenge is amplified not only because of the small number of participants and limited amount of performance data available, but also due to the lack of definition of the unique factors influencing human performance in space. These factors, called performance shaping factors in HRA terminology, are used in HRA techniques to modify basic human error probabilities in order to capture the context of an analyzed task. Many of the human error modeling techniques were developed within the context of nuclear power plants and therefore the methodologies do not address spaceflight factors such as the effects of microgravity and longer duration missions. This presentation will describe the types of human error risks which have shown up as risk drivers in the Shuttle PRA which may be applicable to commercial space flight. As with other large PRAs of complex machines, human error in the Shuttle PRA proved to be an important contributor (~12 percent) to LOCV. An existing HRA technique was adapted for use in the Shuttle PRA, but additional guidance and improvements are needed to make the HRA task in space-related PRAs easier and more accurate. Therefore, this presentation will also outline plans for expanding current HRA methodology to more explicitly cover spaceflight performance shaping factors.

Hamlin, Teri↗

DOE OSTI2022

Human reliability analysis studies from simulator experiments using Bayesian inference

Probabilistic Safety Assessment (PSA) of complex facilities is performed to arrive at the risk posed by them. PSA also accounts for the contribution of the human errors towards the overall risk through Human Reliability Analysis (HRA) in terms of Human Error Probability (HEP). Human operators are part of the system and do not work in isolation. Their performance is influenced by the context in which the actions are performed. As a result, quantification of HEP requires operator performance data under the given context. Some good sources of operator performance data are plant‘s operation data, simulator data and expert judgement. The plant operation data pertaining to HRA is generally sparse. In this situation, a full scope plant simulator provides a good alternative for operator performance data generation. Many of the currently practiced HRA methods have been developed by combining the empirical evidence with expert judgement and contain a lot of uncertainty in their estimates. Bayesian inference is suitable for updating the prior HRA estimates with the simulator evidence to obtain the posterior HEP. Here, posterior HEP has been calculated for postulated accident scenarios in advanced reactor (first of its kind) at design stage, using plant simulator.

97 MATHEMATICS AND COMPUTING↗

NASA NTRS2018

Human-Centered Operations

Efforts to improve operational safety often focus on preventing human error. But humans don't just make mistakes. They do, in fact, make a tremendous contribution to operational safety, and there is much to learn from what goes right. To support people in their role, the operation should be human-centered. To make the operation human-centered, the framework of the 4Ps can be used to create a clear, coherent, consistent and comprehensive guidance.

flight safety↗

DOE OSTI2023

An Investigation of Time Distributions for Task Primitives to Support the HUNTER Dynamic Human Reliability Analysis

As an effort to support data collection for dynamic human reliability analysis (HRA), this study investigates time distributions for task primitives defined in the Goals, Operators, Methods, and Selection rules (GOMS)–Human Reliability Analysis (HRA) method. GOMS-HRA was developed to provide cognition-based time and human error probability information for dynamic HRA calculation in the Human Unimodel for Nuclear Technology to Enhance Reliability (HUNTER) framework. HUNTER is a framework to support the dynamic modelling of human error in conjunction with other modelling tools. In this paper, we investigate time distributions using experimental data collected from the Simplified Human Error Experimental Program (SHEEP) study, which suggests an HRA data collection framework to complement full-scope simulator research as well as collect input data for dynamic HRA using simplified simulators such as the Rancor Microworld Simulator. In this study, time required for GOMS-HRA task primitives to satisfy thirteen statistical distributions is investigated. Then, the time distributions from student operators and professional operators are compared and discussed. As a result, this study identified several time distributions on five GOMS-HRA task primitives at a statistically significant level. According to analyses to date, a greater number of significant time distributions was found in abnormal or emergency operating procedures rather than standard operating procedures. In the future, it is expected that the result of this study can provide objective reference on elapsed time data for task primitives as well as help to realistically simulate scenarios within dynamic HRA.

99 GENERAL AND MISCELLANEOUS↗

NASA NTRS1981

Modeling human tracking error in several different anti-tank systems

An optimal control model for generating time histories of human tracking errors in antitank systems is outlined. Monte Carlo simulations of human operator responses for three Army antitank systems are compared. System/manipulator dependent data comparisons reflecting human operator limitations in perceiving displayed quantities and executing intended control motions are presented. Motor noise parameters are also discussed.

Kleinman, D. L.↗

DOE OSTI2024

Approach for Inferring Full-Scope Human Reliability Data Based on Simplified Simulator Data

This paper proposes a method for inferring full-scope human reliability data based on the Simplified Human Error Experimental Program (SHEEP) data. It mainly focuses on the human errors observed when using simulators with different complexity levels. In the proposed method, the manner in which human error probabilities (HEPs) change as a result of increasing simulator complexity and how simulator complexity levels are quantified represent key information for inferring full-scope data. In the present study, SHEEP error data pertaining to actual professional operators using Rancor Microworld (Rancor) (i.e., a more simplified simulator) and Compact Nuclear Simulator (CNS) (i.e., a less simplified simulator) were compared with the HuREX error data. An approach to quantifying simulator complexity levels was then proposed based on information theory and acquired eye-tracker data.

99 - GENERAL AND MISCELLANEOUS↗

NASA NTRS2013

A Satellite Mortality Study to Support Space Systems Lifetime Prediction

Estimating the operational lifetime of satellites and spacecraft is a complex process. Operational lifetime can differ from mission design lifetime for a variety of reasons. Unexpected mortality can occur due to human errors in design and fabrication, to human errors in launch and operations, to random anomalies of hardware and software or even satellite function degradation or technology change, leading to unrealized economic or mission return. This study focuses on data collection of public information using, for the first time, a large, publically available dataset, and preliminary analysis of satellite lifetimes, both operational lifetime and design lifetime. The objective of this study is the illustration of the relationship of design life to actual lifetime for some representative classes of satellites and spacecraft. First, a Weibull and Exponential lifetime analysis comparison is performed on the ratio of mission operating lifetime to design life, accounting for terminated and ongoing missions. Next a Kaplan-Meier survivor function, standard practice for clinical trials analysis, is estimated from operating lifetime. Bootstrap resampling is used to provide uncertainty estimates of selected survival probabilities. This study highlights the need for more detailed databases and engineering reliability models of satellite lifetime that include satellite systems and subsystems, operations procedures and environmental characteristics to support the design of complex, multi-generation, long-lived space systems in Earth orbit.

Fox, George↗

NASA NTRS1984

Report of the Panel on Human Factors

Human error in the operation of complex systems is the largest single cause of incidents, accidents, and the loss of lives and dollars. Therefore, it is understandable that the focus of human factors research and engineering is on increasing our understanding of the basic mechanisms of human error and on developing techniques for reducing or eliminating the various causes of human error.

Rouse, William B.↗

NASA NTRS1984

Human factors in aircraft incidents - Results of a 7-year study (Andre Allard Memorial Lecture)

It is pointed out that nearly all fatal aircraft accidents are preventable, and that most such accidents are due to human error. The present discussion is concerned with the results of a seven-year study of the data collected by the NASA Aviation Safety Reporting System (ASRS). The Aviation Safety Reporting System was designed to stimulate as large a flow as possible of information regarding errors and operational problems in the conduct of air operations. It was implemented in April, 1976. In the following 7.5 years, 35,000 reports have been received from pilots, controllers, and the armed forces. Human errors are found in more than 80 percent of these reports. Attention is given to the types of events reported, possible causal factors in incidents, the relationship of incidents and accidents, and sources of error in the data. ASRS reports include sufficient detail to permit authorities to institute changes in the national aviation system designed to minimize the likelihood of human error, and to insulate the system against the effects of errors.

Billings, C. E.↗

DOE OSTI2024

An Approach to Dynamic Human Reliability Analysis and Its Data Collection Framework

Human reliability analysis (HRA) is a method for evaluating human errors in a variety of complex systems such as nuclear power plants, military systems, aircraft, and chemical plants. Most HRA methods currently used by regulatory institutes or utilities are called static HRA and are carried out by simple worksheets or simple calculators. To date, there are many unsolved or intrinsic challenges in static HRA. For example, existing static HRA does not realistically model and evaluate human actions as they would be performed at actual systems. There is no method with HRA to objectively estimate the time required for human actions despite being essential to HRA processes. In addition, many HRA methods still rely on a dataset generated prior to the 1980s, from unrelated industry experience or simply from expert judgment. Accordingly, this study attempted to research how to overcome the challenges of existing HRA via dynamic risk assessment (a.k.a., simulation-based or computation-based risk assessment) techniques. First, this study developed a dynamic HRA method, named as PRocedure-based Investigation Method of EMRALD Risk Assessment – HRA (PRIMERA-HRA). The PRIMERA-HRA mainly concentrates on providing HRA analysts with specific guidelines on how to reasonably model human actions, assign human reliability data and evaluate output of simulation within a dynamic probabilistic risk assessment tool, called as Event Modeling Risk Assessment using Linked Diagrams (EMRALD). Second, this study also developed a module for performance shaping factors (i.e., the key concept in HRA quantification) applicable to dynamic HRA, then implemented it based on PRIMERA-HRA within the EMRALD tool. Third, this study developed an HRA data collection framework to support dynamic HRA, called as Simplified Human Error Experimental Program (SHEEP). Originally, the SHEEP study aimed to support static HRA and its data collection, but recently extended the scope to the new technologies such as dynamic HRA or HRA for advanced reactors. SHEEP focuses on the use of data collected from simplified simulators to complement—but not replace—data collection studies using full-scope simulators and actual operators. To date, many experiments were conducted under the SHEEP framework. Multiple analyses, such as human performance analysis, human error analysis, task complexity analysis, learning effect analysis and time distribution analysis, were also carried out using the collected data. Then, based on the major insights, an approach to inferring full-scope data based on simplified simulator data was proposed. The PRIMERA-HRA and SHEEP research are expected to evaluate human actions more realistically than existing static HRA, provide an opportunity to collect more HRA data with reasonable cost and labor, then contribute to enhance the quality of HRA.

99 - GENERAL AND MISCELLANEOUS↗

DOE OSTI2024

An Approach to Dynamic Human Reliability Analysis and Its Data Collection Framework

99 - GENERAL AND MISCELLANEOUS↗

NASA NTRS2016

Tailoring a Human Reliability Analysis to Your Industry Needs

Companies at risk of accidents caused by human error that result in catastrophic consequences include: airline industry mishaps, medical malpractice, medication mistakes, aerospace failures, major oil spills, transportation mishaps, power production failures and manufacturing facility incidents. Human Reliability Assessment (HRA) is used to analyze the inherent risk of human behavior or actions introducing errors into the operation of a system or process. These assessments can be used to identify where errors are most likely to arise and the potential risks involved if they do occur. Using the basic concepts of HRA, an evolving group of methodologies are used to meet various industry needs. Determining which methodology or combination of techniques will provide a quality human reliability assessment is a key element to developing effective strategies for understanding and dealing with risks caused by human errors. There are a number of concerns and difficulties in "tailoring" a Human Reliability Assessment (HRA) for different industries. Although a variety of HRA methodologies are available to analyze human error events, determining the most appropriate tools to provide the most useful results can depend on industry specific cultures and requirements. Methodology selection may be based on a variety of factors that include: 1) how people act and react in different industries, 2) expectations based on industry standards, 3) factors that influence how the human errors could occur such as tasks, tools, environment, workplace, support, training and procedure, 4) type and availability of data, 5) how the industry views risk & reliability, and 6) types of emergencies, contingencies and routine tasks. Other considerations for methodology selection should be based on what information is needed from the assessment. If the principal concern is determination of the primary risk factors contributing to the potential human error, a more detailed analysis method may be employed versus a requirement to provide a numerical value as part of a probabilistic risk assessment. Industries involved with humans operating large equipment or transport systems (ex. railroads or airlines) would have more need to address the man machine interface than medical workers administering medications. Human error occurs in every industry; in most cases the consequences are relatively benign and occasionally beneficial. In cases where the results can have disastrous consequences, the use of Human Reliability techniques to identify and classify the risk of human errors allows a company more opportunities to mitigate or eliminate these types of risks and prevent costly tragedies.

DeMott, D. L.↗