ABSTRACT
INTRODUCTION One of the factors in fatal accidents detailed in Chapter 1 was failure of the interaction between
individuals, between individuals and equipment, and between individuals and their environment. This
interaction often was directed through procedures, written or unwritten, followed, not followed, or
partly followed. Research presented in Chapter 1 indicated that some victims interacted with energy
sources and materials containing energy when equipment and systems were live. This interaction
sometimes occurred by choice, and sometimes through procedure. A deficiency in the interaction led
to the fatal contact with the energy source.
