Applicazione della Metodologia RAMCOP – ORAT – Runway Incursion

Italo OddoneCarlo Cacciabue

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Risk management

Risk assessment

Qualitative Analyses

Quantitative Analyses

Bow tie

RAMCOP ORAT

ET FT……TESEO HEART THERP …….

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ADREP taxonomy

Occurrence classOccurrence categories

Events

Event phase

Descriptive factors Explanatory factors

Modifier

Organization and persons

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Cacciabue, P. C., Cassani, M., Licata, V., Oddone, I., and Ottomaniello, A. (2015). Int. Journal of Cognition Technology and Work (CTW), 17 (2), pp. 249–267.

Risk Assessment Methodologyfor Company Operational Processes

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RAMCOPRAMCOPQuantitative Analysis

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RAMCOPRAMCOP

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2. Available methods and reference Risk Matrix

Reliability assessment (probabilities evaluation)

Deterministic assessment Risk Matrix

Quantify severity and valuesIf Severityocc = Negligible then disregard occur. from RA

Define reference probabilitiesif pocc.≤ pmin then disregard occurrence from RA

2A

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2B Systems , processes and procedures involved

Identify: Existing Causal Barriers Consequential Barriers Initiating Events (IE)

Select methods to calculate probabilities of

success/failure

Identify existing data, information etc for fail. of

componetns/tech. the selected methods

Identify existing data, information etc for HRA

selected methods

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RA

MC

OP –

OR

AT O

vera

ll R

isk

Ass

essm

ent

Tab

le

RA

MC

OP –

OR

AT O

vera

ll R

isk

Ass

essm

ent

Tab

le1. Selection of Hazards to be assessed2. Definition of Initiating Events & Threats 3. Evaluation of data, probabilities & uncertainties4. Identification potential Consequences

PHASE 1

List of Hazards & Consequences to assess

Hazards to be further contained

For each Hazard:1. Definition of all incident sequences2. Identification of existing control measures & barriers3. Evaluation of Consequences & associated Severities 4. Assessment of Risk and acceptabilty vs Risk Matrix

PHASE 2

For each Hazard to be further contained:1. Consider additional safeguards & barriers2. Evaluation of data, probabilities & uncertainties 3. Re-evaluation of Consequences 4. Re-assessment of Risk acceptability post mitigation

PHASE 3

All hazards contained

Case Study

Risk Assessment of Airport Runway Change

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Mov/Y: 200.000 - Primary Runway 8R/26L

Risk Assessment of Airport Runway Change

Mov Day Mov Week Mov Month Mov Year

RISK MATRIX 5.479E+02 3.846E+03 1.667E+04 2.000E+05

S1 S2 S3 S4 S5

Negligeable Minor Major Hazerdous Catastrophic

p > 2.600E-04

6.000E-05 < p ≤ 2.600E-04

5.000E-06 < p ≤ 6.000E-05

5.000E-08 < p ≤ 5.000E-06

p < 5.000E-08

min≈1/1000 y;

max=1/100 yExtremely Improbable

P1

4 4 4 3 2

min=1 /100 y;

max= 1/y Extremely Remote

P2

4 3 3 2 1

min= 1/y; max=

1/monthRemote

P3

4 3 2 2 1

1min= 1/month;

max=1/week

Frequent

P4

3 2 2 1Reasonably probable

1min1/week;

max= always

Severity Level

Probability

Level

P5

3 2 1 1

Hazard 1. Runway Incursion A/C;Hazard 2. Veer-off;Hazard 3. Runway Incursion ground means/vehicles;Hazard 4. FOD.

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Hazard 3. Runway Incursion ground means/vehicles

Bow - Tie

Human Error

runway incursion non aer. means

Bad weather

ATC comm.

Aircraft collision with object/obstacle on ground - ADREP Event 2050400

Crew ability

Near collision with object on groundADREP Event 2180400

Inadequate managemnt of ground means

Inadequate funct.

of ground

technology

Workload

High

High

Guided routes

Inadeq. knowl. of

procedures

High

Training Airport staff

High

High

Follow me check and intervention

High

Training workers & engineers

Check by airport staff

High

S

S

SP

S

SP

Legenda

Escalation

Factor

CONSEQUENCETHREAT

HAZARD

Undesired

Operational State

HighMedLow

Barriers:P: Physical;

F: Functional

S: Symboblic;

I: Immaterial

P F I

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RAMCOP – ORAT HEART for HF World data ….

Hazard

UOS

Actions &

owners

Monitoring &

Review req.

Description Prob.Description and

probabilityConsequences

Prob. without

controlBarriers

Prob.

reductionSeverity Probab. Risk

Type of

Barriers

Type of barr.

ReductionSeverity Probab. Risk

ATC comm. 0.3

2.57E-03

Pilot

teamwork

0.3

Ground

marking

0.1

Checks of

Airport staff

0.01

Training of

workers and

engineers 0.05

The Safety Manager of

the Airport is the

person responsible for

monitoring the proper

implementation of

procedures and specific

safety measures.

Catast.

“Runway incursion” 08R/26L non-aeronautical means

Aircraft collision

with

object/obstacle on

ground

ADREP Event

2050400

The current level of

barriers and safeguards

for ...... airport does

not strictly requires the

implementation of

extra barriers.

However, the overall

risk evaluated for the

consequences of a

possible runway

incursion is very close

to the limit of

acceptability.

Consequently it is

strongly advised to

implement a further

barrier based on the use

of Follow-me to guide

and support the

movement on the

ground of means and

technologies.

Hazard 3. “Runway

incursion” 08R/26L non-

aeronautical means

pUOS = 2.57E-3

Outcome

(Post-Mitigation)

Phase 1 Phase 2 Phase 3

Threats Incident sequence

description

Existing control Outcome

(Pre-Mitigation)

2.57E-03

Th1 =

• Exces. workers workload

HF Method adopted: HEART

GTU Error 1 = 9E-2 (0.06 - 0.13)

EPC : 13, 15, 20, 21

Effect: 0.05, 0.3, 0.3, 0.05

HEP - 1: 2.17 E-01 (0.145 - 0.314)

GTU Error 2 = 3E-3 (0.0008 - 0.007)

EPC : 4, 15, 21, 31

Effect: 0.2, 0.05, 0.3, 0.3

HEP - 2: 1.18 E-02 (3.15E-3 - 2.76E-2)

21.16E-08 Follow-me 0.01 Catast. 1.16E-102

Add. Mitigation

required

Hazard

UOS

Description Prob.Description and

probabilityConsequences

Prob. without

control

2.57E-03

2.57E-03

Th1 =

• Exces. workers workload

HF Method adopted: HEART

GTU Error 1 = 9E-2 (0.06 - 0.13)

EPC : 13, 15, 20, 21

Effect: 0.05, 0.3, 0.3, 0.05

HEP - 1: 2.17 E-01 (0.145 - 0.314)

GTU Error 2 = 3E-3 (0.0008 - 0.007)

EPC : 4, 15, 21, 31

Effect: 0.2, 0.05, 0.3, 0.3

HEP - 2: 1.18 E-02 (3.15E-3 - 2.76E-2)

Aircraft collision

with

object/obstacle on

ground

ADREP Event

2050400

Hazard 3. “Runway

incursion” 08R/26L non-

aeronautical means

pUOS = 2.57E-3

Threats Incident sequence

descriptionBarriersProb.

reductionSeverity Probab. Risk

ATC comm. 0.3

Pilot

teamwork

0.3

Ground

marking

0.1

Checks of

Airport staff

0.01

Training of

workers and

engineers 0.05

Outcome

(Pre-Mitigation)

1.16E-08 2Catast.

Existing control

Actions &

owners

Monitoring &

Review req.Type of

Barriers

Type of barr.

ReductionSeverity Probab. Risk

2 Follow-me 0.01 Catast. 1.16E-10

Add. Mitigation

required

The Safety Manager of

the Airport is the

person responsible for

monitoring the proper

implementation of

procedures and specific

safety measures.

The current level of

barriers and safeguards

for Venice airport does

not strictly requires the

implementation of

extra barriers.

However, the overall

risk evaluated for the

consequences of a

possible runway

incursion is very close

to the limit of

acceptability.

Consequently it is

strongly advised to

implement a further

barrier based on the use

of Follow-me to guide

and support the

movement on the

ground of means and

technologies.

Outcome

(Post-Mitigation)

Phase 3

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GTU EPC MultiplierAssessed prop.

of Effect

Assessed

EffectHEP GTU EPC Multiplier

Assessed

prop. of

Effect

Assessed

EffectHEP

9.00E-02 13 4 0.05 1.15 2.17E-01 3.00E-03 15 3 0.05 1.1 1.18E-02

0.06 - 0.13 15 3 0.3 1.6 0.0008 - 0.007 31 1.2 0.3 1.06

0.06 20 2 0.3 1.3 1.45E-01 0.0008 21 2 0.3 1.3 3.15E-03

0.13 31 1.2 0.05 1.01 3.14E-01 0.007 4 9 0.2 2.6 2.76E-02

PHE = p1 * p25th perc.

boundary

95th perc.

boundary

PHE = 2.57E-03 4.57E-04 8.66E-03

p 1 = Probability of positioning non-aeronautical

material / technologies on sensible areas

p 2 = Probability of failing to detect non-aeronautical

material / technologies on sensible areas

HEART HE Probability of runway incursion

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Risk Informed Decision Making - RIDM

Hazard Severity Barrier Like. Risk level Barrier Severity Lakelihood Risk levelCost

K$

H1 High - 4/5 Existing Barriers pH1 RED B2 High pH1,B2 RED 10

B3 High pH1,B3 YELLOW 30

B2, B3 High pH1,B2,B3 YELLOW 40

B4 High pH1,B4 YELLOW 50

B2, B3, B4 High pH1,B2,B3,B4 GREEN 90

B3, B4 High pH1,B3,B4 YELLOW 80

…. ….. ….. …. …

H2 Catastr. - 5/5 Existing Barriers pH2 RED B5 Catastr. pH2,B6 YELLOW 100

B6 Catastr. pH2,B6 YELLOW 70

B4 Catastr. pH2,B4 YELLOW 50

B6, B4 Very High pH2,B4,B6 GREEN 120

…. ….. ….. …. …..

H3 Major Existing Barriers pH3 YELLOW B5 Major pH3,B5 GREEN 100

B3, B2 Major pH3,B3 YELLOW 40

B6, B4 Major pH3,B4,B6 GREEN 120

…. ….. ….. ….

Pre-mitigation Post-mitigation

Barrires Cost Barrier N. of app. CostCost/

Benefit

B2, B3, B4 90 YELLOW YELLOW YELLOW B2 4 10 2.50

B2, B3, B6 110 YELLOW YELLOW YELLOW B3 5 30 6.00

B5, B3 130 YELLOW YELLOW GREEN B4 6 50 8.33

B4, B6 150 YELLOW GREEN GREEN B5 2 100 50.00

B2, B3, B4, B6 160 GREEN GREEN GREEN B6 3 70 23.33

ϕ of barriers K$Means to reduce all Hazards

H1 H2 H3

Barriers efficiency for RIDM

Generic format of RIDM table

Thank you for your attention

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