ABSTRACT

The principal sources of latent conditions in the 10 case studies described in Chapter 5 are summarized in Table 3.1. Before considering these in more detail (see Chapter 4), it is important to note that all of the case study accidents involved active failures both at the sharp end and through various levels of the system – this is not always the case (e.g., the King’s Cross Underground fire). Latent conditions alone can sometimes be sufficient to breach the defences.