CCPS International Conference and Workshop

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- 5, 2001
Toronto, ON, CANADA

Atwood & Fennell Oct 2001 Cost Effective Human Factors Techniques for Process Safety 1 

### Cost

- effective Human Factors Techniques for Process Safety

By

Dennis Attwood

Human Factors Consultant ExxonMobil Biomedical Sciences, Inc.

Baytown, TX

and

David Fennell Senior Safety Advisor Imperial Oil Resources Limited Calgary, AL



### ABSTRACT
This p aper illustrates how the structured application of Human Factors can be cost

effective. It proposes a model for the analysis and implementation of Human Factors in existing plants and presents a case study that describes the results of a series of human

Fa ctors analyses that were conducted in several process plants. The case study summarizes the recommendations made, itemizes the follow

- up that resulted and estimates the costs of the analyses and follow

- up and the subsequent savings based on

the interventi ons. Recommendations provide prospective users of Human Factors services with a set of processes to assist them to conduct similar analyses.



### 1. INTRODUCTION
Human Factors is defined as the systematic process of designing for human use. It is a discipline that improves the interface between humans and the systems they operate to reduce the occurrence human errors and their consequences. Since its formal introduction as a scientific discipline in the early 1940's, Human Factors has had a far reaching effect on the usability of workplaces and equipment world wide. Not surprisingly, Human Factors design techniques have also been introduced into the design of the facilities and operating systems of process plants

It is estimated that within the process industry , Human Error accounts for 70

- 80% of all operating incidents resulting in billions of dollars of loss each year (Essex, 1992) and countless deaths and injuries. So, improving the human

- system interface should increase profitability and

reduce the number an d severity of injuries resulting from operating incidents.

The safety and industrial literature contains many examples of the cost

- benefits of human factors. Hendrick (1997) recounts case studies from the forestry, steel and the petroleum industry

where human factors interventions were cost effective. Little (1998) and Springer (1992) provide several examples from the office environment where changes to the workspace had beneficial effects on office workers. Well known examples of catastrophic accidents t hat haveCCPS International Conference and Workshop

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Atwood & Fennell Oct 2001 Cost Effective Human Factors Techniques for Process Safety 2 occurred in the process industry include Three Mile Island, Bhopal and Chernobyl. Less well known incidents such as the Piper Alpha explosion and the Ocean Ranger sinking are also examples of disasters that have extracted a large toll in loss of l ife and property. In each case, poor human Factors design of the man

- machine interface either contributed to or was the root

cause of the disaster. Incident analyses suggest that each disaster could have been prevented by the proper human factors design of the interfaces. In some cases, the plants or rigs were built before the benefits of Human Factors were as well known as they are today. The question facing the process industry is whether the cost of conducting a Human Factors assessment and improvement p rogram in each of these plants and rigs after they were put into service would

have been cost

- beneficial?CCPS International Conference and Workshop

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Atwood & Fennell Oct 2001 Cost Effective Human Factors Techniques for Process Safety 3 Figure 1 illustrates one version of the systematic process of designing for human use. The model begins with the integration of Human Factors into the Safety Management Systems of the company. This initiative underscores the importance that management places on the use of Human Factors in the design of facilities, equipment and work processes such as shift schedules and procedures and permitting syst ems. Once Human Factors is established in the management systems, it then becomes a legitimate (sponsored) part of the management process. Next, plant personnel are trained in Human Factors techniques. Training is attended by not only the plant workers an d first line supervisors, but also by the plant management. The content and length of training is tailored to the requirements of the attendees. Design staff, for example, needs more information on the use of Human Factors in the design of equipment and fa cilities. Management requires an overview and familiarization and Operations Staff needs to know how to analyze existing units and affect change. A process is built into each of the training programs to identify tasks with critical HF issues for

follow

- up.

The plant's risk analysis systems can also be used to identify those tasks that pose the highest risk of error or musculoskeletal stress. An analysis of the selected tasks can then be conducted to identify the Human

Factors issues. The issues are evaluat ed and analyzed using a battery of tools specifically designed for this purpose, interventions are identified and action plans are developed and implemented. Finally, the results of

the interventions are mea sured to ensure that they were

effective at resol ving the issues. If an issue has not been satisfactorily resolved, follow

- up is initiated and the process repeated.

For new projects, the model for analysis and implementation consists of applying unique Human Factors tools at each stage of project

-- pl anning, design and execution.

2. CASE STUDY: Analysis of control systems at process plants During the 1995

- 96 period, a series of Human Factors analyses was conducted of the process control spaces and systems in several Gas plants. The Human Factors surv eys were undertaken

for several reasons:

 To evaluate specific issues that were identified as a problem for the process control

operators

 To evaluate the effects of consolidating process control rooms or systems

 To evaluate the effects of introducing new eq uipment Fig. 1: The HF analysis and implementation ModelCCPS International Conference and Workshop

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Atwood & Fennell Oct 2001 Cost Effective Human Factors Techniques for Process Safety 4  To proactively evaluate the process control spaces and equipment design for improved efficiency The evaluation included all aspects of Human Factors interface design to determine what, if anything, could be done to improve the layout, the ergonomi c design of the control consoles and panels and the design of the operator interface with the process control system. This case study describes the results of a series of Human Factors analyses, summarizes the recommendations made, itemizes the follow

- up t hat resulted and estimates the costs of the analyses and follow

- up and the subsequent savings based on the interventions.

2.1 Methodology The methods used in the analysis of the sites included a wide range of human factors tools that sought to assess the ergonomics design of the process control space and furnishings, the noise, lighting and temperature environment that the operators worked in and the design of the interface of the process control system. This latter analysis was conducted using several to ols as follows:

1. Alarm function analysis

2. Communications analysis

3. Training analysis

4. Critical task analysis Each of the surveys were completed on

- site within 2

- 3 days and the report was completed within

2

- 4 days. The interventions that were completed as a re sult of the recommendations from the analyses were usually accomplished within days or weeks and generally consisted of minor facilities improvements or modifications to the design of existing process control screens or changes in work processes.

2.2 Resu lts The costs and benefits of Human Factors improvements are best determined by viewing the improvement as the elimination or minimizing of waste. Although some of the benefits are easily measured and tracked, most are ambiguous and more difficult to peg down. The following examples from three control room assessments have quantifiable benefits that will demonstrate the cost effectiveness of Human Factors improvements.

2.2.1 Ring Back feature on alarms: The control system in one plant was fitted with a nu mber of alarms and shut downs for high level, gas detection, low level, high and low pressures etc. Each alarm would provide an audible and visual signal when a set point and/or shut down level were reached. The plant could not be

restarted until the al arms had cleared, however, many of the alarms required that the operator look at the alarm level or pull up a new screen on the control system to determine that the alarms had actually cleared. This would result in delays of approximately 15 minutes in th e start up process and up to 30 minutes during very busy periods. The Human Factors consultant recommended installing a ring back feature when the alarms had cleared. This allows the operator to acknowledge the cleared alarm and begin his start up proces s without searching for alarms that may have already cleared. For the plant in question, shut down or diversion of product costs about $1.5 k per 15 minutes and there were about 50 such diversions or shutdowns per year for a total annual cost of $75k. Th e reprogramming to eliminate this longer than necessary down time was completed with 8 hours of instrument technicians time at approximately $0.4 k.CCPS International Conference and Workshop

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Atwood & Fennell Oct 2001 Cost Effective Human Factors Techniques for Process Safety 5 2.2.2 Reduction of Emissions: Emissions from another gas plant are strictly regulated and violations o f the emissions standards can result in fines of $5 k per violation. Although no fines had been levied against the plant, approximately 26 exceedances of the standards per year did occur. Basic human factors control items, mostly programming of warning a larms, providing consistency of read outs, and providing alarms on inlet streams that caused sulphur plant upsets that lead to emissions, were applied based on the consultants recommendations. The human factors initiatives, along with other improvements r esulted in the annual emissions being reduced to 8. This meant that a total of 18 potential fines had been avoided. This case demonstrates that once again simple programming changes that took less than 2 person days ($0.8 k) to implement had a potential saving of $90 k in penalties.

2.2.3 Consolidation of Control rooms made possible: The consolidation of the control rooms in two separate plants was made possible through the

Human Factors recommendations of a 1995 review. This reduction from two to one control rooms had a direct saving of $400k through the elimination of one shift position. Although there were costs associated with a number of hardware changes required to control both plants from the one control room, the key issue in this strategy was to ensure that the one operator could work efficiently with both control systems and that there would be no confusion, no duplicate systems and no contradicting control systems. The human factors study identified numerous simple changes, mostly programmin g, that would make this possible. The solutions involved identifying and implementing common screen design, consistent protocols for alarms, run switches, ESD’s and consistent patterns and terminology for screen layout. This ensured that

one operator cou ld effectively monitor both plants. Programming time for these changes took approximately 45 days of instrument tech time (approx. $45 k) and it made it possible to achieve the $400k savings.

2.2.4 Nominations Screens: The deliveries of natural gas to a Government

- owned utility were based on daily contracts or

"nominations" If the plant delivered on the nomination (up to 5% over) there was no penalty. If they under

- delivered by any amount at all then the penalty was applied. The penalty would depend on th e amount of the nomination, so an average value of $5K per under delivery was used on any one day. The analysis showed that the operators did not have the information that they required to meet

the NOMINATION. History had shown that there was a potential f or an under

- delivery, because of the human factors issues about 5 times per month, giving a total average of $25K per month. This would happen throughout the year with a higher potential in the winter months. So, the potential was to under

- deliver 5 times a month for about 8 months a year for a total of about 8 x $25K = $200K.

The changes to the process control system as a result of the analysis virtually eliminated under

deliveries resulting in savings of $200K per year. The cost of the process control sy stem
modifications was 2

- person weeks of programming ($4K).

2.2.5 Control system consolidation:CCPS International Conference and Workshop

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Atwood & Fennell Oct 2001 Cost Effective Human Factors Techniques for Process Safety 6 The control system for a production field was moved into the control room of an associated production plant. The plant night shift operator could monitor the f ield control system for shut down wells and facilities and call out operators to correct problems. The plant control systems all had alarm screens that scrolled in from the top of the screen and new alarms showed as bold until acknowledged. The field sys tem had alarms that scrolled in from the bottom with no distinction in print. Approximately 60 field alarms per year were missed by the plant operators resulting in a lost production of $1.6 k per alarm. Three days of programming ($1.2 k) was able

to ali gn the alarm screens and resulted in no missed alarms in the next year for a savings of $100k.

In summary, the above interventions resulted in an estimated savings of about $865K. To achieve this result, the sites involved invested about $30K for analysis from outside consultants and another $52K internally for follow

- up work. The benefit to cost ratio is about 10.5.

2.3 Discussion As a result of the above Case Study the following cost

- effective strategies for implementing Human Factors analyses of contr ol rooms and process control systems are proposed.

2.3.1 Leave the Operation with the skills to implement the solutions

. The benefits of a human factors review can be multiplied when some basic skills, tools and techniques are left with the key people i n an organization after the assessor or consultant has left. Every assessment should include a planned training session for those who will be implementing the solutions. This provides them with an understand of what is to be achieved, the most cost effec tive way of achieving it, and skills for identifying and correcting future problems independently.

2.3.2 Programming changes can be cheaper than hardware : Many of the changes recommended in the control room assessments required absolutely

no new hardwar e or equipment. The improvements were achieved simply through programming changes to sequences, displays, enunciations, alarms and using the full strength of the control system for calculations, nominations and reminders.

2.3.3 Evaluate the cost

- effect iveness of recommended interventions during the survey : In most cases, the resultant savings from an intervention can be estimated by the plant staff while the evaluation is proceeding. For example, most gas plant personnel can "ball

park" the hourly or da ily cost of a plant shutdown and hence the potential savings if a shutdown is avoided. At the same time, most operations personnel can estimate the cost of installing sensors and equipment and applications technicians can estimate the time required to repr ogram the process control system.

2.3.4 Negotiation can achieve the same purpose as hardware: The intent of a Human Factors recommendation may be achieved cost effectively through means other than the purchase and installation of expensive monitoring equi pment. The intent of a sensor and alarm on a pipeline is to provide early warning of an off spec product so a facility can prepare for its arrival and adjust their processes to minimize itsCCPS International Conference and Workshop

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Atwood & Fennell Oct 2001 Cost Effective Human Factors Techniques for Process Safety 7 impact. The cost of this equipment may not be necessary if an ag reement can be reached with the supplier that they will provide the advanced warning for the plant.

2.4 Recommendations The results of this investigation demonstrate that retrospective Human Factors analyses of Process Control Rooms and Process Control Sy stems can provide interventions that save much more in productivity than they cost to develop or implement. However, in many cases the interventions have not been implemented and the benefits of the intervention have not been

determined. With this in mind the following processes are recommended for on

- site evaluation of

cost effectiveness:

2.4.1 Establish operations and instrumentation contacts to be part of the evaluation team. This provides training for the instrument technician, an understanding of the issues by the instrument technician and operator and leaves them with the ability to provide quick effective implementation of the simpler programming recommendations.

2.4.2 Pre

- establish costs of Business Interruptions and down time.

This allows the a ssessors to instantly connect the value of recommendations to real dollars at the facility. For example if a particular recommendation will eliminate 20 instances of diverting an off spec product and the value of those diversions has already

been recorded through tracking of business interruptions, then the benefit of the recommendation can be instantly quantified.

2.4.3 Establish approximate costs of programming. Many of the recommendations on control room human factors improvements involve programming changes within the system. Knowing the costs of that programming time will allow the assessment team to attach a cost for implementing those recommendations.

2.4.4 Estimate the rough cost for hardware that is usually associated with HF improvements. ( i.e. costs of ergo chair, adding a monitor, installation of an additional end point sensor)

2.4.5 Allocate a small amount of money and time for low cost, quick hit benefits. (recommend an amount of money equal to the cost of the assessment plus 5 days of instrument tech time for programming)

2.4.6 Allocate a small amount of money for comfort/annoyance issues. There is great value in addressing these type issues immediately after an assessment as it helps maintain the momentum of the implementation of t he HF recommendations.

3. DISCUSSION The results of the Case Study, presented above, demonstrate that Human Factors interventions in existing plants can be extremely cost

- effective. The results also point out that the value of the

benefit

- to

- cost ratio depends, to a large degree, on five items:

1. The willingness of site management to undertake the Human Factors analysis and implementation process and provide funding and resources.CCPS International Conference and Workshop

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Atwood & Fennell Oct 2001 Cost Effective Human Factors Techniques for Process Safety 8 2. The preparation of the site personnel.

3. The participation of site personnel i n the process and their willingness to own (follow

- up)

the results

4. The quality of the analysis and the proposed interventions

5. How well the site is prepared to estimate the costs and benefits of the proposed

interventions.

4. REFERENCES Essex Corporation ( 1992) Containing error in the workplace. Internal publication.

Hendrick, H. (1997), Good ergonomics is good economics. Ergonomics in Design, April 1997

Little, R. (1998), Ergonomics an exercise in economics. Office Life, April, 11

- 13.

Springer, T.J. (19 92), Does ergonomics make good business sense? Facilities Design and Management, July 1992.