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Activity-based accident analysis: from blame attribution to organizational learning
Raoni Rocha Simões1, Francisco de Paula Antunes Lima2, Francisco Jose de Castro Moura Duarte3
1Department of Production Engineering, Administration and Economics, Federal University of Ouro Preto (UFOP), Ouro Preto, MG, Brazil.
Abstract:
This paper proposes Activity-Based Accident Analysis (ABAA) as a methodological framework that integrates organisational accident analysis with the reconstruction of situated work activity. While systemic approaches have advanced the understanding of organisational accidents, they often provide limited methodological guidance for analysing activity in context. The study draws on an in-depth retrospective case of a process industry accident, combining documentary analysis, interviews, field observations, and technical process data. The analysis illustrates how ABAA can contribute to a more detailed understanding of accident dynamics by reconstructing the temporal sequence of events and identifying organisational and design-related conditions that were not highlighted in the official investigation. The findings suggest that integrating activity-based analysis with organisational perspectives may offer a promising avenue for enhancing accident investigation practices and supporting organisational learning.
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