Cause and Prevention

PAUL RANDALL AND ASSOCIATES
Health and safety Training
CAUSES AND PREVENTION OF

ACCIDENTS
NEBOSH Certificate: 6.3.1, 6.3.2, 6.3.3
Causes and prevention of accidents

1 Immediate and underlying accident causes ...................................... 5
2 Accident triangle / pyramid / iceberg ................................................. 7
2.1 Heinrichs and Birds accident pyramids ................................... 7
3 Domino theory (single-causal) ........................................................ 10
3.1 Heinrichs domino theory ........................................................ 10
3.2 Bird and Loftus domino model ............................................... 12
4 Multiple-causal accident models ..................................................... 13
5 Unsafe acts and unsafe conditions ................................................. 15
6 Classification of accidents ............................................................... 17
7 (Pro)active and reactive monitoring of h and s performance ......... 18
8 Safe person and safe place strategies ............................................ 19
9 Five steps to a safe system of work ................................................ 21
Syllabus coverage
6.3.1 The principles of accident prevention and the main causes of

accidents
6.3.2 The differences between immediate and root (underlying)

causes of accidents
6.3.3 The concepts of safe place (for example: safe workplace,

equipment, environment); and safe person (personal protective
equipment, information, instruction, training, safe behaviour)
24 Stirling Road, Chichester, PO19 2ES

01243 776394 paulrandallandassociates.com
Immediate and underlying accident causes

In the part of the examination dealing with the management of
safety, NEBOSH will often ask questions such as ...
Question X ... describe the immediate and underlying (root) causes
of an accident in which an operators clothing is caught ...
Question Y ... with reference to an accident of your own choosing,
describe the immediate and underlying (root) causes.
Two typical NEBOSH Certificate accident causes questions
If, as with Question X, a specific accident is provided, NEBOSH
will ensure that the situation in question is straightforward and
understandable to all students.
Very often, the question will be of the second type above (... your
own choosing ...) and you should ensure that you are wellprepared to provide an answer; clearly you will be able to choose
between a major accident which you have seen on television or
read about in the journals or a much less dramatic accident from
your own experience.
Dont feel that more marks are available for a discussion of (say)
the Chernobyl catastrophe rather than a minor accident of your
own experience - NEBOSH encourage you to relate your studies
to your own work experience and here is a good opportunity.
Accordingly, we urge you to prepare an appropriate from your
own experiences answer and submit it to the Chichester centre
for discussion.

In general terms, the NEBOSH examiners will be looking for the

following distinctions between immediate and underlying causes:
Immediate cause
Root cause
inadequacies in the system that

substandard acts or conditions
which lead directly to the accident : allow the immediate causes to
arise and lead to an accident :
removal of, or damage to, a guard
inadequate training and instrucoperator error
tion in the use of equipment
not wearing ppe (helmet, gloves,
poor maintenance
boots, rpe)
unsatisfactory systems of work
lack of concentration
failure to conduct appropriate risk
stress / fatigue / drugs
assessments and inspections
poor housekeeping (build-up of
inadequate staff selection
litter, spillages)
unrealistic demands and expectations placed on the staff leading
to stress and corner-cutting
You can probably add items to the table above. At times you may
find it difficult to know whether to classify a particular cause as
being immediate or root; for example the stress experienced by a
worker suffering in silence which led to an accident may be said
to be immediate and personal in the sense that it arose from, say,
a bereavement. Alternatively the stress in question might be best
described as institutional with just about everyone in the workplace overstressed.
Clearly, a sympathetic and well-organised workplace should be
able to cope with the bereaved worker, supporting him or her,
whilst ensuring that no-one is put at risk.
In their quarterly reports, the NEBOSH examiners have sometimes noted that, when answering accident causes questions,
few students support their answers with basic accident causation
theory. Accident theory is a natural extension of what we have
looked at so far, and accordingly, this is where we will now turn
(sections 2, 3 and 4).

Accident triangle / pyramid / iceberg

Shortly after the Piper Alpha disaster, there was another oil rig
fire which resulted in the death of the radio operator. As the
shocked survivors were brought to shore, a reporter asked one
man when did you realise that something was wrong?. I clearly
remember his embittered response: about six months ago. This
chilling claim brought vividly to mind the feeling of a whole weight
of factors pushing inexorably towards an accident, with one final
capricious throw of fates dice determining the if, the when, and
the what of the outcome.
Starting in the early years of the last century, various models have
been developed to explain the factors behind, and the build-up to,
an accident. Some models were developed by industrial organisations, keen to maximise their efficiency, some as part of the
growing interest in the (then) new subjects of psychology / human
behaviour.
One of the models that established itself most strongly was that of
Heinrich who claimed that:
... for every mishap resulting in an injury, there are many accidents
that cause no injuries at all.
Heinrich 1931
2.1 Heinrichs and Birds accident pyramids
Heinrich estimated that, in a group of 330 accidents, 300 result in
no-injury, 29 in minor injuries, and 1 in major lost-time injury. In a
subsequent analysis of nearly 100,000 actual incidents over a
seven year period, Bird discovered that for every 1 disabling
injury there were 100 minor injuries and over 500 property damage accidents.
More important than the differences between these tip of the
iceberg models of Bird and Heinrich (in any case, their methodologies differ in several details) are the overall principles which
they encompass.
You should note that these iceberg models are sometimes also
called accident pyramids or accident triangles - not to be confused with the fire triangle.
disabling
(major lost-time injury)
29
300
minor injury
no injury
accident
Heinrich (1931)
1
100
500
disabling injury
minor injury
property damage
accident
Bird (1966)
As an aside, here is another example of the accident iceberg or

triangle ...
The following was taken from a recent issue of the useful Croner
Health and Safety Briefing. (For your interest, we have also
included a little more of the article, about levels of fines etc.)
Local authority report
The Health and Safety Executive (HSE) has published the latest
HSE/Local Authority Enforcement Liaison Committee (HELA)
annual report, giving health and safety statistics for work activities
where the local authority is the enforcement agency.
The provisional figures for injuries reported in the year 1999/2000
include:
* 11 work-related fatal injuries to employees (12 last year)
* 6,845 work-related non-fatal injuries to members of the public
(4,202 last year)
* 27,932 work-related non-fatal injuries to employees (30,882 last
year).

The report states that the total time spent on health and safety by
local authority inspectors has gone down, although higher risk
workplaces are being targeted and the rate of visits per inspector is
being maintained.
The report also identifies an increase in the level of fines for health
and safety offences. In the year 1999/2000, the average fine per
conviction was 4,098, which is an increase of 84% from last year.
In order to help local authorities to improve standards of health and
safety in the sectors that they enforce, the Health and Safety Commission (HSC) is planning to help HELA in drawing up an indicator
against which local authorities can measure their enforcement and
promotional activity.
Copies of HELA Annual Report 2000 and HELA National Picture
are available free from:
HSE Books, PO Box 1999, Sudbury, Suffolk CO10 2WA
telephone: 01787 881165 website: www.hsebooks.co.uk
Croner Health and Safety Briefing 198, 12 September 2000
Whichever model you favour (and there are plenty of variations
on this iceberg / pyramid / triangle theme), the same conclusions
follow ...
... if, through appropriate management of risk, you reduce the noinjury accidents / the property damage accidents (ie the base of
the iceberg), you will reduce the numbers of the more serious
accidents occurring higher up.
On first reading you may think that the previous sentence is not
very ambitious in its aims - shouldnt the aim be total safety, no
accidents ever; our answer is that in life it is more sensible to
develop a practical approach that works rather than aim for an
ideal system that doesnt.
In section 3 and 4 of this book, we will look further at various
accident causation theories.

Domino theory (single-causal)

We will look at two so called single-causal models, that of
Heinrich (section 3.1) and that of Bird and Loftus (section 3.2).
3.1 Heinrichs domino theory
According to Heinrich, a preventable accident is one of five
factors in a sequence that results in an injury. The injury is
invariably caused by an accident and the accident in turn is
always the result of the factor that immediately preceded it.
This approach leads to the row of dominoes model of accident
causation: if you knock over the first domino it knocks the second
and so on. This knock-on effect is easy to imagine and
offers a simple answer to accident causation, namely
that if we remove one of the five dominoes, then
the sequence is broken and the injury cannot
occur. The following shows the domino
sequence:
ino
dom
s
h
c
inri
He
Ancestry and social environment

Character traits can be passed through inheritance and reinforced
by the social environment. Both factors can lead to faults of the
person.
Fault of the person
Can lead to unsafe acts and allow unsafe conditions to exist and
to continue.
10
Unsafe acts and conditions

Horseplay and reckless behaviour. Working without guards or in
insufficient light.
Accident
Events such as falls, trips, being hit by flying objects etc resulting
in injury.
Injury
Fractures, lacerations, disablement and death resulting directly
from accidents.
Which domino do you think it best to remove?
Heinrich believed that the first two dominoes can only be removed
through a lengthy period of education which aims at changing
attitudes. This may take place alongside the accident prevention
programme, but will not produce immediate results. Dominoes 4
and 5 occur too far along the accident sequence. Therefore, the
best candidate for the accident prevention programme to focus
upon is domino 3 - unsafe acts and conditions.
Personal view
I must admit that ever since I first read about Heinrichs
model, I have felt a sense of irritation; firstly because the
language seems so dated with its overtones of accidents
resulting from moral degeneracy on the part of the worker(s).
My second concern was that the domino model wasnt very
good anyway: I never felt happy with the idea of stopping the
accident by removing (say) the second domino - surely, it is
reasonable to ask, why cant a new domino-tumbling sequence start with the third domino?
In any case, life is too complicated to be encompassed by five
dominos. Harbouring a suspicion that probably no-one had
actually read Heinrichs original work for many decades, I
went back to the original and was pleased to find that it was
not as outdated and objectionable as I had suspected, but
nevertheless, I still felt uneasy with the model

11
Bird and Loftus showed similar concerns regarding Heinrichs

emphasis on the fault of the individual and they adapted the
domino sequence to produce what is generally seen to be a more
satisfactory domino model ...
3.2 Bird and Loftus domino model
The Bird and Loftus domino sequence - shown here certainly overcomes some of the objections to
the original Heinrich model but it still has
the problem of over-simplification: in
the real world several, or indeed
many, accident causes may
occur at the same
time.
ino
nd
rd a
om
s d
tu
Lof
Bi
Lack of management control
Basic causes (personal and job factors)
Immediate causes
Accident
Loss
12
Multiple-causal accident models

In an attempt to develop a more sophisticated accident model - in
particular in response to the over-simplification problem which we
just mentioned - Bird and Loftus and other authorities developed
a multi-causal model of accident causation.
Immediately, to me at least, this multi-causal model feels much
more satisfactory - it reflects the fact that many factors will be
involved in the build-up to an accident, you do not have to choose
just one unsafe action or condition domino, rejecting all other
possibilities, and so on.
Another advantage of the multiple-causal model is that you can
extend and modify the tree as additional factors come to light.
The multiple-causation approach also changes the emphasis from

the fault of the person, often the victim, to encompass other
causes such as lack of training. The multiple-causation approach
results in a tree diagram rather than the domino sequence. A
typical tree is shown below:
sub-causes
cause a
cause b
unsafe acts
cause c
accident
cause d
cause e
injury damage
or near miss
unsafe
conditions
cause f
You will see a relationship between this multi-causation tree
model and the single-causation domino model - dominoes 5 and
4 are immediately identifiable on the tree model, domino 3 is split
into two, and so on.
This multiple-causation tree model allows us to investigate the
causes of unsafe acts and conditions in a more sophisticated
way.
13
As we said earlier in this book, the NEBOSH examiners have

frequently commented that: when answering accident causes
questions, few students support their answers with basic accident
causation theory. Accordingly ...
Q Choose a few accidents of your own experience and see if

you can present them in accident tree form. We strongly
encourage you to submit your answers to the Chichester
centre for comment.
By way of another example, consider a worker who was
injured in the eye by a fragment of drill-bit which shattered
when drilling into concrete.
sub-causes
cause
is this the workers
regular task?
was there adequate
supervision and
instruction?
was the worker aware
of the availabilty of
eye protection?
is routine equipment
maintenance
undertaken?
poor training
was full range of bits
available?
was eye protection
made available?
are the bits inspected
as part of a
maintenance
programme?
unsafe act of wrong

selection of
equipment
unsafe condition of
poor/wrong bit and
lack of protection
accident, bit
splinters
eye injury
Working backwards through the tree, the unsafe act would be

the selection of an ordinary bit instead of a masonary bit. The
unsafe condition would be the unsuitability of the bit - perhaps
it was in poor condition as well; another component of unsafe
condition is that no eye protection was being worn.
(In a single-causation model, these unsafe acts and conditions
would be combined in domino 3. It has to be admitted that
lumping acts and conditions together in one domino can be
14

quite handy as it side-steps categorisation problems - is it an
act? is it a condition?)
Continuing to work backwards through the tree ... amongst the
causes we would include the workers fault in selecting the
wrong bit and his failure to wear eye protection. Thus, in
moving a step back, we are now highlighting the responsibility
of the individual employee involved in the accident. In moving
backwards in this way we will also draw back the veils on
management involvement.
To emphasise that, with the multiple causation approach, the tree
can always be extended as new factors come to light - there is no
artificial cutting-off point as with the single-causation theories.
Tree analysis can be a great help in developing recommendations
to prevent recurrence of accidents.
We have already hinted that the distinction between unsafe acts
and unsafe conditions may not always be clear; it might now be
appropriate to say a little more on this subject (not that we will
claim to make it any clearer!).
Unsafe acts and unsafe conditions

Unsafe acts are often associated with inappropriate attitudes, lack
of knowledge or skill and/or physical unsuitability; unsafe acts
may be sub-divided into:
active unsafe acts where employees actively engage in

activities such as the removal of guarding
passive unsafe acts where the action is one of habit rather

than conscious thought; clearly this may be difficult to tackle does management dramatise the dangers involved in order to
raise awareness or not - we are all aware of the problems
associated with such an approach
Unsafe conditions can be sub-divided into the following two

categories:
unsafe mechanical conditions: machine design, guarding,

ergonomic matching of the machine to the employees, safe
systems of work (including permits to work), effective means of

15

stopping the machinery in the event of an emergency, and so
on
unsafe physical conditions which include environmental

factors such as noise, temperature, build-up of rubbish etc
You will not need telling that if both unsafe acts and unsafe
conditions are present, the likelihood of an accident is that much
greater; an effective way of demonstrating this idea is as follows:
unsafe acts
unsafe conditions
accident potential
The remainder of this book firstly pulls together ideas to which

you will have been introduced elsewhere in our study material (we
assume that the present book comes late in your study) and
secondly, for completion, we introduce some ideas which are
pursued in more detail at Diploma level.

16
Classification of accidents
This is a subject which definitely falls into the category of pursued
in more detail at Diploma level but is we feel well worth a mention
in the present context. The prime purpose of classifying accidents is of course to ensure that they can thereby be effectively
recorded - a subject we have covered elsewhere in our study
material (notably syllabus sections 5.3.3 and 6.3.4 and 6.3.5).
The International Labour Office system of accident classification
encompasses the following main headings:
machinery
transport equipment
explosion or fire
poisonous, hot or corrosive substances
electricity
falls of persons
stepping on or striking against objects
falling objects
handling without machinery
hand tools
animals
other causes
ILO system of accident classification
Accidents may also be classified according to:
the nature of the act giving rise to the accident
the physical or material cause
age, sex and experience of the victim
time and nature of the accident
the part of the body injured
Obviously the method(s) selected will be determined by the use to

which the information is to be put and by the circumstances
involved.
17
(Pro)active and reactive monitoring of

health and safety performance
Already covered to the depth you require at Certificate level
(syllabus sections 4.3.14.3.3), this subject area may also be
seen as a spring-board to the Diploma where it, rightly, occupies
a key position in the syllabus.
As an aside, at this point we should mention the HSE publication HSG 65 Successful health and safety management. As
we have said elsewhere, this is not in our view an easy book
to digest but it is undoubtedly very important - more than any
other HSE document it encompasses their philosophy on
health and safety management:
policy
organisation
planning
measuring performance
auditing and reviewing performance
HSG 65 might be said to be the set text at Diploma level and

we suspect that in years to come it will probably be co-opted
to assume that role at Certificate level also.
Returning to your Certificate studies, let us remind you of what we
covered in syllabus sections 4.3.14.3.3 concerning proactive and
reactive health and safety monitoring.
Proactive monitoring (increasing called active monitoring)

Systems should be measured and checked before things go
wrong. This is best achieved by regular safety inspections,
sampling and so on, involving the workforce by constantly
asking questions and encouraging them to report potential
hazards. (Syllabus section 4.3.2 is largely concerned with
proactive monitoring.)
Reactive monitoring
Information relating to failures in health and safety (ie accidents and near misses) should be collected and analysed - the
organisation learning from its mistakes. (Several syllabus
18

sections touch on reactive monitoring, including: 5.3.3, 6.3.4,
6.3.5 and 4.3.2.)
The information gained from both the proactive and reactive
monitoring systems can be used to highlight areas of the highest
potential risks and enable management to concentrate on control
systems that are effective.
Safe person and safe place strategies

As always in health and safety, the correct balance needs to be
struck ... laboriously protecting each individual worker at the
expense of providing a satisfactory working environment for all
strikes the wrong balance and runs counter to the legal requirement to consider all other means of control before resorting to
personal protective equipment.
Of course, there are certain categories of worker who cannot be
provided with a safe place of work; take for example ...
... a fireman or other emergency worker; every time (s)he goes
into a fire or has to deal with a chemical spillage, (s)he is at risk.
In such situations, the only way that the risk can be reduced is to
concentrate on a safe person strategy, taking into account:
personal protective equipment
information, instruction and training
safe behaviour of the individual
In addition of course to these emergency workers, there will be

times when a worker who normally works in what we might
describe as a well-organised safe place environment, becomes
someone who needs to be given the safe person treatment - at
times of accidental spillage, clean-up operations, maintenance
and so on.
Striking the appropriate safe place / safe person balance in
different work environments is the responsibility of all who manage and it has formed the subject of several Certificate questions
over the years. On that point, let us repeat the requirements of
the syllabus, see over ...
19
The concepts of safe place (for example: safe workplace, equipment, environment); and safe person (personal protective equipment, information, instruction, training, safe behaviour)
NEBOSH Certificate syllabus section 6.3.3
Editors note. This syllabus section is such an important subject
area but we are aware that if we say more we will end up repeating what we have said elsewhere; accordingly we leave you to
provide more cross references to 6.3.3 ...
safe place
requirements of section 2 HASAWA
safe workplace
equipment
environment
safe person
personal protective equipment
hearing (3.3.16)
COSHH (3.3.10)
ionising radiation (3.3.12)
PPE Regs (3.3.18)
information, instruction, training
safe behaviour

20

You may think we have left quite a lot of space for the syllabus
cross references, but we think that once you get started, you will
soon find that you may need even more space.
As always, we encourage you to contact the Chichester centre if
you wish to discuss these matters further.
Five steps to a safe system of work

Again, this section of our book really acts as a reprise of what we
have already covered (and a preview of a more detailed look at
the requirements of HASAWA and the Management Regulations,
syllabus section 7).
The five steps recommended by the HSE to enable a safe system
of work to be devised and implemented are as listed below. We
will then discuss them in turn:
Step 1 Assess the task
Step 2 Identify the hazards
Step 3 Define safe methods
Step 4 Implement the system
Step 5 Monitor the system
Step 1 Assess the task

All aspects of the task and the risks which it presents must be
assessed. Hazards to health as well as to safety should be
considered. There are six key words which will prompt the
questions to be asked in the course of this assessment:
what is used, for example:

plant and substances
potential failures of machinery
toxic hazards
electrical hazards
design limitations
risk of inadvertently operating automatic controls

21
who does what, for example:

delegation
training
foreseeable human errors
ability to cope in an emergency
how the tasks are carried out, for example:

procedures
potential failures in work methods
short cuts
lack of foresight of infrequent events
why the tasks are done this way, for example:

particular problems with the process
alternative methods (possibly safer)
where and when the various tasks are carried out, for
example:
how they interact with one another
how they affect others in the vicinity
Step 2 Identify the hazards

When a task has been assessed, its hazards should be clearly
identified and the risks weighed up. As we said earlier, wherever
possible the aim should be to eliminate the hazards and reduce
the risks before you rely upon a safe system of work - if the
hazards can be eliminated altogether there is no need for the safe
system of work.
Step 3 Define safe methods

Your safe system of work may be defined orally, or by a simple
written procedure or in exceptional cases by a formal permit to
work scheme:
consider the preparation and authorisation needed at the start

of the job
ensure clear planning of job sequences

22
specify safe work methods
include means of access and escape, if relevant
consider the tasks of dismantling, disposal etc at the end of

the job
Involve the people who will be doing the work; their practical
knowledge of problems can help avoid unusual risks and prevent
false assumptions being made at this stage.
In those special cases where a permit to work system is needed,
there should be a properly documented procedure. It is important
that everyone understands which jobs need a formal permit to
work. Permits to work should:
define the work to be done
say how to make the work area safe
indentify any remaining hazards and the precautions to be

taken
describe checks to be carried out before normal work can be

resumed
name the person responsible for controlling the job
Jobs likely to need a permit to work system include:
working in confined spaces
hot work on plant containing flammable dusts, liquids, gases

or residues of these
cutting into pipework containing hazardous substances
work on electrical equipment
Step 4 Implement the system

Your safe system of work must be communicated properly,
understood by employees and applied correctly. Employees
should be aware of your commitment to reduce accidents by
using safe systems of work.
Ensure that supervisors know that they should implement and
maintain those systems of work and that employees, supervisors
and managers are all trained in the necessary skills and and are
23

fully aware of potential risks and the precautions they need to
adopt.
Stress the need to avoid short cuts. It should be part of a system
of work to stop work when faced with an unexpected problem until
a safe solution can be found.
Step 5 Monitor the system

Monitoring means periodically checking :
that employees continue to find the system workable
that the procedures laid down in the system of work are
being carried out and are effective
that any changes in circumstances which require alterations to the system of work are taken into account

24

Cause and Prevention

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PAUL RANDALL AND ASSOCIATES

Health and safety Training

CAUSES AND PREVENTION OF

NEBOSH Certificate: 6.3.1, 6.3.2, 6.3.3

Causes and prevention of accidents

6.3.1 The principles of accident prevention and the main causes of

6.3.2 The differences between immediate and root (underlying)

6.3.3 The concepts of safe place (for example: safe workplace,

Causes and prevention of accidents

24 Stirling Road, Chichester, PO19 2ES

Causes and prevention of accidents

Immediate and underlying accident causes

24 Stirling Road, Chichester, PO19 2ES

Causes and prevention of accidents

In general terms, the NEBOSH examiners will be looking for the

inadequacies in the system that

24 Stirling Road, Chichester, PO19 2ES

Causes and prevention of accidents

Accident triangle / pyramid / iceberg

Causes and prevention of accidents

As an aside, here is another example of the accident iceberg or

24 Stirling Road, Chichester, PO19 2ES

Causes and prevention of accidents

24 Stirling Road, Chichester, PO19 2ES

Causes and prevention of accidents

Domino theory (single-causal)

Ancestry and social environment

Causes and prevention of accidents

Unsafe acts and conditions

24 Stirling Road, Chichester, PO19 2ES

Causes and prevention of accidents

Bird and Loftus showed similar concerns regarding Heinrichs

Lack of management control

Basic causes (personal and job factors)

Causes and prevention of accidents

Multiple-causal accident models

The multiple-causation approach also changes the emphasis from

Causes and prevention of accidents

As we said earlier in this book, the NEBOSH examiners have

Q Choose a few accidents of your own experience and see if

unsafe act of wrong

Working backwards through the tree, the unsafe act would be

Causes and prevention of accidents

Unsafe acts and unsafe conditions

active unsafe acts where employees actively engage in

passive unsafe acts where the action is one of habit rather

Unsafe conditions can be sub-divided into the following two

unsafe mechanical conditions: machine design, guarding,

24 Stirling Road, Chichester, PO19 2ES

Causes and prevention of accidents

unsafe physical conditions which include environmental

The remainder of this book firstly pulls together ideas to which

24 Stirling Road, Chichester, PO19 2ES

Causes and prevention of accidents

the nature of the act giving rise to the accident

the physical or material cause

age, sex and experience of the victim

time and nature of the accident

the part of the body injured

Obviously the method(s) selected will be determined by the use to

Causes and prevention of accidents

(Pro)active and reactive monitoring of

auditing and reviewing performance

HSG 65 might be said to be the set text at Diploma level and