Journal of Loss Prevention in the Process Industries 34 (2015) 39e48

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Journal of Loss Prevention in the Process Industries

journal homepage: www.elsevier.com/locate/jlp

Application of CREAM human reliability model to cargo loading

process of LPG tankers
Emre Akyuz a, *, Metin Celik b
a
b

Department of Maritime Transportation and Management Engineering, Piri Reis University, Tuzla 34940, Istanbul, Turkey
Department of Marine Engineering, Istanbul Technical University, Tuzla 34940, Istanbul, Turkey

a r t i c l e i n f o

a b s t r a c t

Article history:
Received 21 August 2014
Received in revised form
25 November 2014
Accepted 10 January 2015
Available online 19 January 2015

The storage and handling processes of liqueed petroleum gas (LPG) constitutes a complex operational
environment in the maritime mode of transportation. The LPG cargo is carried by specially designed
ships called LPG tankers. The LPG cargo loading and discharging operations have always potential
hazards. Thus, the crew on-board LPG tankers should be fully aware of operational risks during the cargo
handling process, which includes various critical tasks such as drying, inerting, gassing-up, cooling, and
reliquefaction. During these stages, human reliability (operation without failure) plays a crucial role in
sustainable transportation of cargo. Human reliability analysis (HRA), related to various parameters such
as the human factor, technology, and ergonomics, is always a critical consideration as regards maritime
safety and environment. The main focus of the research is to systematically predict human error potentials for designated tasks and to determine the required safety control levels on-board LPG ships. The
paper adopted CREAM (Cognitive reliability and error analysis method) basic and extended versions in
order to assess human reliability along with the cargo loading process on-board LPG tanker ships.
Specically, the model is demonstrated with an operational case study. Consequently, the research
provides should contribute to maritime safety at sea and prevention of human injury and loss of life onboard LPG ship.
2015 Elsevier Ltd. All rights reserved.

Keywords:
Human reliability
Marine safety engineering
LPG ships
Human error
CREAM
Loss prevention

1. Introduction
Safety is an essential subject in maritime transportation. It
directly affects human life, the environment and the transported
commodities. Maritime operational safety requires following a set
of rules and activities on-board ships supported by shore based
organisations and the relevant maritime authorities. Maritime
safety at sea can be improved if internationally recognized applicable regulations are adopted and monitored continuously. In this
context, the International Maritime Organisation (IMO) was
established to govern maritime regulations and activities to
enhance maritime safety standards. Although numerous regulations and codes have been adopted by maritime authorities,
maritime safety has not been raised to the desired level. This is
especially true in the case of substandard ships, which reduce
safety standards, threaten human life and the maritime environment. In order to prevent this, maritime authorities have put strict

* Corresponding author.
E-mail addresses: emreakyuz82@gmail.com, eakyuz@pirireis.edu.tr (E. Akyuz).
http://dx.doi.org/10.1016/j.jlp.2015.01.019
0950-4230/ 2015 Elsevier Ltd. All rights reserved.

rules in places in order to control substandard ship. The authorities

especially focus on the LPG tankers owing to the particularly
dangerous cargo being carried on-board.
Since the human factor is an essential issue for safety, reliability
assessment has always been a critical issue for risk researchers,
decision makers, safety engineers and practitioners. The human
reliability assessment method is subjective and the data concerning
the human factor is imprecise. The human reliability can be dened
as human performance; which shows how reliable the person/
operator can perform a given action correctly or how long the
person/operator can perform an action without failure (Pyy, 2000).
In addition, the aim of HRA is to calculate probability of human
error for a specic type of task.
The HRA used as a tool in research into other disciplines is
relatively new. The rst probabilistic human reliability analysis was
performed after the Second World War for weapon system feasibility (Swain, 1990). Thereafter, the method has been applied to the
different elds, such as man machine systems, power plant,
healthcare, transportation, aviation, etc. Moreover, numerous HRA
techniques have been developed to determine the human factor

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E. Akyuz, M. Celik / Journal of Loss Prevention in the Process Industries 34 (2015) 39e48

and reliability. Most of techniques are applied in the nuclear energy

industry where the human risk factor is taken into consideration
comprehensively. One of the rst methods developed for the HRA is
the technique for human error rate prediction (THERP) (Swain and
Guttmann, 1983). It is considered as a rst generation method. The
technique is recognised as a hybrid model and basically utilises
both probability trees and model of dependency in order to model
human error. Furthermore, success likelihood index methodology
(SLIM) was proposed by Embrey et al. (1984) in order to assess
failure in task or action sequences. The method has been applied for
maintenance or operational cases and is mainly based on an expert's judgement to assess human performance. Another HRA
method is a technique for human error analysis (ATHEANA) which
has been developed in recent years by the US Nuclear Regulatory
Commission (Cooper et al., 1996). The ATHEANA is a new technique
and provides a detailed search process for identifying human actions. The aim of it is to provide a powerful psychological framework to assess and diagnose performance shaping factors (PSF).
Williams (1988) originates another technique named human
error assessment and reduction technique (HEART). The practitioners utilise HEART in order to quantify error probability occurring throughout the completion of a particular task by applying
weighting factors. The applications show that there are some
fundamental limitations of the rst generation of HRA methods. For
example, the classication system is not properly dened. In
addition to this issue, there are some discrepancies in practice by
evaluating different analyse assessment. The most common
method used for HRA is cognitive reliability and error analysis
method (CREAM) which is considered as second generation technique (Hollnagel, 1998). There are two versions of the CREAM
method; the basic and the extended. The basic method provides an
overall evaluation of the performance reliability that might be expected for tasks while the extended version uses the results of the
basic version to check or investigate actions of task more deeply.
Bayesian network (Almond, 1992) method has been proposed in
recent years as the latest generation of the HRA (Jensen and
Nielsen, 2007). The method is based on a compact representation
of a multivariate distribution function and is applied in various
disciplines. Whilst various HRA techniques have been offered, there
have been numerous article utilising the HRA application such as
manufacturing (Bertolini et al., 2010), healthcare (Wu et al., 2009),
medicine (Chadwick and Fallon, 2012), transportation (Guo et al.,
2012; Calhoun et al., 2014), power plant (Zubair and Zhijian,
2013; Groth and Mosleh, 2012), off-shore platforms (Turan and
El-Laden, 2012), etc. Yet, studies upon nuclear energy have still
been prominent topic for the HRA since the human error risk
involvement is comparatively high. For instance, a simplied
CREAM was introduced by He et al. (2008) including the basic and
extended method in order to assess human reliability in a nuclear
power plant. Likewise, Lee et al. (2011) introduced a qualitative and
a quantitative method to analyse communication errors for nuclear
power plant operators' communication by utilising CREAM. A
different approach has been proposed by Konstandinidou et al.
(2006). This paper combined the CREAM into a fuzzy logic in order to determine the error actions probability.
Nevertheless, the HRA researches upon maritime transportation
industry are quite limited. For instance, Yang et al. (2013) have
proposed a modied CREAM method by incorporating the Bayesian
reasoning model. The proposed method was shown through the
illustrative example of analysing an oil tanker cargo oil pump shut
down scenario. Likewise, another study conducted for the HRA in
the marine industry has recently been done by Martins and
Maturana (2013). In this paper, the authors introduce Bayesian
belief networks method in order to analyse human reliability during operation of a crude oil tanker while focussing on collision

accidents. Another study has been presented by Musharraf et al.

(2013) in order to do a quantitative approach to the HRA during
emergency condition in an off-shore environment. Bayesian
Network method is another approach to represent the dependency
among the human factors and their associated actions. Furthermore, Vanem et al. (2008) introduced a generic high level risk
assessment for LNG tanker ships. The paper was produced from the
Safedor European Commission project and it provides a generic
formal safety risk assessment studies on LNG tanker ships.
Considering the lack of maritime related studies towards critical
topics, this paper aims to extend the HRA analysis to critical shipboard operations.
In broad sense, LPG tanker operations are always very sensitive
and hazardous; hence, the control measures are required to be
effectively implemented on-board ships. There is no doubt that if
there would be any operational failure during critical processes (i.e.
cargo loading), it might lead to a catastrophic accident such as a
massive explosion. Therefore, relevant maritime authorities such as
port state control organisations to target LPG ships and their cargo
operations for special inspection at terminal. In addition, the crew
employed in LPG ships must be fully aware of potential danger
during loading and discharging operation. Moreover, the IMO has
adopted a series of practice and training standards for crew who
work in gas carrier ships to avoid serious risks to human life,
environment and ship. Therefore, this paper is proposed to provide
practical contribution for cargo loading operations in LPG tanker. In
this context, CREAM technique is used to control and monitor potential human errors on-board ships. The paper is focused on predicting human error potentials for designated tasks on-board LPG
ships in order to determine safety control levels. Therefore, the next
section presents CREAM methodology.
1.1. CREAM
The CREAM, introduced by Hollnagel (1998), is a frequently used
second generation HRA technique in the safety science literature. It
consists of a basic and an extended version. The aim of basic
method is to demonstrate initial screening of human interaction
where the tasks and its major segments are classied under control
mode. The extended method utilises the outcome of the basic
method in order to get more detailed analysis for human interaction. The method is based on three primary areas of task; task
analysis, error reduce opportunity and human performance. The
CREAM technique has been derived from Contextual Control Model
(COCOM). The aim of the COCOM was to provide conceptual and
practical basis in order to enhance operator performance
(Hollnagel, 1993). Thus, COCOM principles clarify and anticipate the
dynamic balance among the human action and system response.
The essential point is that situation determines the human performance in the system operation. Therefore, control modes in four
different characteristics are dened in accordance with the human
cognition and action content. The classication method introduced
by COCOM has been enhanced and named CREAM to conduct bidirectional HRA inference to achieve retrospective/prospective
analysis (Hollnagel, 1998).
Investigating the human reliability studies towards the maritime industry, it seemed that the CREAM methodology has been
rarely utilised. For instance, Sun et al. (2012) has proposed a
modied basic CREAM to provide the point estimation for the human error probability (HEP). This paper discusses the outcomes by
validating THERP and HEART methodology to illustrate a simple
example about starting up the submarine engine and calculating
the error probability. Furthermore, a modied CREAM to quantify
human reliability has been introduced to analyse human reliability
in marine engineering (Yang et al., 2013). The paper incorporates

E. Akyuz, M. Celik / Journal of Loss Prevention in the Process Industries 34 (2015) 39e48

the fuzzy evidential reasoning and Bayesian inference logic into the
CREAM to analyse human reliability. An illustrative example is
demonstrated upon cargo oil pump operation in a crude oil tanker.
It is obvious that CREAM has been applied to a few marine industry cases, particularly to the gas carriers whose popularity have
been increasing over the last years. The carriage of liqueed gases
can be performed by the LNG and LPG vessels. Since demand for
LPG, one of the cleanest and safest energy sources, has been
increasing over the last decades, the transportation and service
requirements have also grown considerably to meet increased demand in process industry.
1.2. Carriage of liqueed petroleum gas
Due to its cargo which is carried under high pressure or a
cooling system, the LPG carriers are often considered to be one of
the most dangerous vessels from a maritime safety point of view.
Despite this, statistics shows that the LPG tankers have the best
safety records (UK P&I Club, 2013). Statistic shows that the LPG
tanker eet is expected to grow by 5% and 1.3 million cubic metres
are scheduled for delivery in 2014. Furthermore, the LPG eet is
expected to increase by 7% in 2015, before allowing for deferrals,
cancellations, and demolition. Presently the abundance of the gas
commodity from the Middle East and the Caspian Sea, and strong
demand kept the market aoat (Danish Ship Finance, 2014).
The LPG, composed of propane or butane, is a ammable
mixture of hydrocarbon gases used as a fuel in heating appliances,
vehicles and power plants. Furthermore, it can also form a feedstock at chemical plants. At ambient temperature and atmospheric
pressure LPG forms a gas. However, it is never transported in gas
form. Transportation of this type of cargo is provided in liqueed
form because more cargo can be tted in a given volume. The
carriage of liqueed petroleum gas can be done in various forms
such as pressurised, refrigerated or semi-pressurised by LPG tanker
ships. When the carrier is fully refrigerated, butane is carried
at
5  C, with propane at
42  C (IGC Code, 1993). The LPG tankers
are designed to carry mainly butane, butadiene, vinyl chloride
monomer (VCM), propane, propylene and are also able to transport
anhydrous ammonia. Their cargo tank capacity varies up to 100
thousand cubic metres. The LPG tankers transport a large selection
of gas and petrochemical products. Some of the LPG vessels are also
capable of transporting clean petroleum products, which are
normally carried by chemical product tankers.
The LPG tanker design is slightly different than other type of gas
carriers or chemical tankers. The liqueed petroleum gas carriage
can be provided by tanker ships under three different conditions;
fully pressurised, semi pressurised and fully refrigerated (IGC Code,
1993).
1.2.1. Fully-pressurised LPG tankers
In fully-pressurised LPG ships, the cargo are transported fully
pressurised at ambient temperature. These types of vessels are the
most common LPG carriers in the marine industry and mostly
designed with type-C tanks (IGC Code, 1993).

41

thousand cubic metres (IGC Code, 1993).

Despite the need for larger global LPG tanker eet, to date there
are not enough experienced and qualied crew with which to man
additional ships. In this context, a catastrophic problem can arise at
the operational level of the LPG tankers. This is especially true in
the cargo handling process where crew awareness and reliability
are critical.
1.3. Problem description
The liqueed petroleum gas carriers are often regarded as a
potential oating bomb in the transportation industry. Thankfully,
their accident statistics to date do not bear this out. However, it
shows the criticality of potential risks for the environment, ship and
crew members due to the large amounts of highly concentrate
combustible hydrocarbon cargo being carried. It is inherently
hazardous if the operators do not take the required precautions.
Furthermore, there is a potential threat owing to liqueed petroleum gas cargo being transported under refrigerated or high pressurised condition. Here, the implementation of operational
procedures and continuous monitoring are also crucial. Therefore,
it is imperative that all precautionary steps are taken to avoid any
leakage and limit all sources of ignition. Moreover, liqueed petroleum gas cargo carriage and handling (loading or discharging
process) operation also poses a considerable potential hazard,
including threats to environment, injury or death risk to crew onboard ship and terminal. In this context, each crew member
working on-board the LPG tanker should have an ability to perform
required operational functions without any conict under different
conditions. At this stage, human reliability plays a signicant role in
sustainable maritime transportation with the highest level of safety
and loss prevention sensitiveness. Thus, crew reliability shall be
assessed in order to minimize probable operational human failure
while performing cargo loading or discharging operations on-board
LPG tankers. Accordingly, it might be minimised risk of the LPG
transportation as far as practicable. Therefore, the paper is focused
on developing an approach towards the problem of continuous
monitoring of crew reliability along with the critical operations onboard LPG tanker ships in different environmental conditions.
In the light of above, this paper utilises a model based approach
to evaluate human reliability in cargo operation process on-board
LPG tankers. The model used is CREAM, including basic and
extended versions. The purpose of the method is to produce specic action assessment for the HRA upon the LPG cargo loading
process. Within this scope, the paper is organised into four sections.
This section gives the motivation behind the research as well as
literature review. The following section deals with the research
methodology. The demonstration covering cargo loading process
on-board LPG tanker is provided in section three. Consequently, the
nal sections give the discussion, original contribution and
conclusion of the study to enhance maritime safety, prevention of
human injury and loss of life.
2. Research methodology

1.2.2. Semi-pressurised LPG tankers

These types of ships are similar to fully-pressurised, but design
pressure is limited to 7 bars. Semi-pressurised LPG ships have a
larger size than the fully-pressurised types, but their numbers are
limited in the marine industry (IGC Code, 1993).

This paper introduces an approach on the HRA on-board LPG

tanker ships based on CREAM method. The method covers both
basic and extended versions. The aim is to assess human reliability
in cargo loading operation on-board LPG carriers in the maritime
transportation industry.

1.2.3. Fully refrigerated LPG tankers

These ships are designed to carry their cargoes at approximately
atmospheric pressure and lower temperatures. They are apparently
the largest LPG tankers, with cargo capacities reaching up to 100

2.1. Introducing control modes and common performance

conditions (CPCs)
The CREAM methodology has four control modes to determine

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E. Akyuz, M. Celik / Journal of Loss Prevention in the Process Industries 34 (2015) 39e48

failure probabilities of different actions. The fundamental theory of

control modes is established based on COCOM. Furthermore, personal experiences, knowledge of dependencies between events,
expectations about the condition can inuence the level of control.
Each mode can be introduced as follows.
2.1.1. Scrambled control mode
The choice of next action is random or unpredictable. This
modes indicates that the operator have minimum control over the
system.
2.1.2. Opportunistic control mode
The choice of next action is ascertained by careless characteristics of the situation which is due to lack of time, operator inexperience, etc.
2.1.3. Tactical control mode
Performance more or less follows planned procedures, but some
variation is still possible.
2.1.4. Strategic control mode
Time is widely available and operator can consider action at
higher level. This mode enables an operator to perform better and
more efcient than the other modes.
The control modes are linked with different failure probability
intervals representing human action failure probabilities. Fig. 1 illustrates the basic operator control modes while Table 1 provides
control modes and human error probability intervals (Hollnagel,
1998). The HEP intervals are frequently used as an initial
screening of human failure events.
The human cognition and action context are determined in
accordance with CPCs (Common Performance Conditions) which
provide a well-structured and comprehensive basis for characterizing the circumstances where performances are expected to cover.
In addition, the CPCs have been utilised by the CREAM technique in
order to dene sets of possible error modes and error causes. The
CPCs and related performance reliability is shown in Table 2
(Hollnagel, 1998).
The CPCs scores can be derived by counting the number of times
that is expected to reduce performance reliability, increase performance reliability and not having any signicant effect on performance reliability. After having total CPCs scores, basic operator
control modes are dened to assess human performance reliability.
P
P
The combined scores, reduced and improved will give the correct
coordinate in control modes axis. The CPCs combined scores for
P
not signicant have no impact upon human performance reliability.
Therefore, it can be ignored. One of the four control modes will be
selected in accordance with CPCs combined score which indicate
the point upon coordinate axis in basic operator control modes.

Table 1
Control modes and HEP intervals.
Control mode

HEP interval

Strategic
Tactical
Opportunistic
Scrambled

0.5
1.0
1.0
1.0

E
5
E
3
E
2
E
1

<
<
<
<

P
P
P
P

<
<
<
<

1.0
1.0
0.5
1.0

E
2
E
1
E
0
E
0

Table 2
CPCs and performance reliability.
CPC

CPC level/description

Effects

Adequacy of organisation

Very efcient
Efcient
Inefcient
Decient

Improved
Not signicant
Reduced
Reduced

Working conditions

Advantageous
Compatible
Incompatible

Improved
Not signicant
Reduced

Adequacy of MMI and

operational support

Supportive
Adequate
Tolerable
Inappropriate

Improved
Not signicant
Not signicant
Reduced

Availability of procedures/plans Appropriate

Acceptable
Inappropriate

Improved
Not signicant
Reduced

Number of simultaneous
Goals

Fewer than capacity

Matching current capacity
More than capacity

Not signicant
Not signicant
Reduced

Available time

Adequate
Temporarily inadequate
Continuously inadequate

Improved
Not signicant
Reduced

Time of day

Day-time (adjusted)
Night-time (unadjusted)

Not signicant
Reduced

Adequacy of training and

Experience

Adequate, high experience

Improved
Adequate, limited experience Not signicant
Inadequate
Reduced

Crew collaboration quality

Very efcient
Efcient
Inefcient
Decient

Improved
Not signicant
Not signicant
Reduced

Thereafter, corresponding HEP intervals are chosen for corresponding control modes. Since the goal of the basic CREAM technique is to nd out the probability of general action failure, the
control modes and the HEP intervals are considered too wide to get
realistic results. Hence, the extended version of the CREAM has
been introduced to obtain more detailed and precise results for
human performance in a specic action. Meanwhile, the basic
method provides important sources for extended version in order
to get more accurate results.
2.2. Identifying context inuence index (CII)
In order to simplify and quantify the basic version of the CREAM,
CII (context inuence index) has been proposed (He et al., 2008).
This index provides the numerical value for CPCs. The CII value can
be found by deducting the number of reduced CPCs from number of
improved CPCs. The CII can be calculated with following Equation
(1) (He et al., 2008);

CII X
Y

X
reduced

Fig. 1. Operator control modes.

(1)

improved

In equation, X states the number of reduced CPCs and Y states

E. Akyuz, M. Celik / Journal of Loss Prevention in the Process Industries 34 (2015) 39e48

the number of improved CPCs. In Fig. 2, the CII and control modes
are illustrated in accordance with CPCs scores where the control
modes are divided into region to calculate the CII value more accurate. However, there would be three limitations where the each
mode is neighbouring. Nevertheless, the neighbouring region
changes step by step from one to other modes and overlaps will
occur. In this context, Table 3 illustrates the control modes and CII
values instead of control modes and HEP intervals.
P
Since the CPCs combined scores for
not signicant have no
impact upon human performance reliability, the value of CII is
considered as 0.
2.3. Obtaining performance inuence index (PII)
P

CII

9
X

Table 3
Control modes and CII values.
Control mode

CII values

Strategic
Tactical
Opportunistic
Scrambled

7 to
3

3 to 1
2 to 5
6 to 9

Table 4
PII for CPCs.
CPC

CPC level

PII

Adequacy of organisation

Very efcent
Efcent
Inefcient
Decient

0.6
0
0.6
1.0

Working conditions

Advantageous
Compatible
Incompatible

0.6
0
1.0

Adequacy of MMI and

operational support

Supportive
Adequate
Tolerable
Inappropriate

1.2

0.4
0
1.4

Availability of procedures/
plans

Appropriate
Acceptable
Inappropriate

1.2
0
1.4

Number of simultaneous
goals

Fewer than capacity

Matching current capacity
More than capacity
Adaquate
Temporarily inadequate
Continuously inadequate

0
0
1.2

1.4
1.0
2.4

When the number of reduced and improved performance reliability score are equal which means that CII 0, the inuence of the
different CPCs upon the performance reliability will be almost
similar (CFP CFP0 CFP: Cognitive Failure Probability). This situation is undesirable and it is for screening stage only. Therefore,
the extended version of the CREAM can be utilised in order to
perform detailed reliability analysis. Thus, the substantial effect of
the CPCs into the performance reliability can be provided. In this
context, the PII has been used to calculate for the specic quantitative effects of the CPCs rather than linguistic cluster (reduced or
improved) of the CPCs effect upon performance reliability. Hence,
the CII can be found with Equation (2) in the extended version (He
et al., 2008).

Available time

PII

(2)

i1

The PII value is derived from He et al. (2008) since the

mentioned values can be applicable in different cases. The database
has been derived in order to specify proper weighting factors for all
cognitive functions (observation, interpretation, planning and
execution). The main idea behind this step is to weight and categorize the CPC concepts in order to determine related CFPs in
practical applications. Table 4 shows the PII values for each CPC.

43

Time of day

Day-time (adjusted)
Night-time (unadjusted)

0
0.6

Adequacy of training and

experience

Adaquate, high experience

Adaquate, low experience
Inadequate

1.4
0
1.8

Crew collaboration quality

Very efcent
Efcent
Inefcient
Decient

1.4
0
0.4
1.4

2.4. Calculating CFP

The CFP indicates probability of failure for each cognitive failure
type. In order to get nal HEP, the CFP values can be inserted into
system operation action. Moreover, characteristics of the CPCs are
used to adapt the nominal CFP. There are totally 13 generic failure
types on which Table 5 shows the nominal failure probability

Table 5
Nominal cognitive failure probability.
Cognitive function

Generic failure type

Basic value

Observation

O1. Wrong object observed

O2. Wrong identication
O3. Observation not made

1.0 E
3
7.0 E
2
7.0 E
2

Interpretation

I1. Faulty diagnosis

I2. Decision error
I3. Delayed interpretation

2.0 E
1
1.0 E
2
1.0 E
2

Planning

P1.Priority error
P2.Inadequate plan

1.0 E
2
1.0 E
2

Execution

E1.
E2.
E3.
E4.
E5.

3.0
3.0
5.0
3.0
3.0

Action of wrong type

Action at wrong time
Action on wrong object
Action out of sequence
Missed action

E
3
E
3
E
4
E
3
E
2

according to four cognitive functions (observation, interpretation,

planning and execution) and their basic values (Hollnagel, 1998).
The relation between the CFP and CII can be revealed with
following Equation (3) (He et al., 2008);
Fig. 2. CII and control modes.

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E. Akyuz, M. Celik / Journal of Loss Prevention in the Process Industries 34 (2015) 39e48

CFP CFP0 x 100:25

CII

(3)

In equation, CFP0 indicates nominal cognitive failure probability

provided in Table 5 while the CFP is adjusted nal cognitive function probability.
2.5. Determining human error probability (HEP)
To calculate total HEP value for specic action, related tasks shall
be divided into sub-tasks in order to perform human reliability
assessment properly. In this context, the HEP value for each subtask can be calculated in accordance with Equation (3). In this
stage, probability values can be combined into a single value by
using PSA (Probabilistic Safety Assessment) HTS (Hierarchical Task
Analysis). The substantial point taken into consideration is the
determination of sub-task dependency. The two simplest ways of
these are known as series and parallel system. The following rules
can be utilised to decide whether the system is parallel or serial.
If failure of a sub-task leads to the combination becoming
inoperable, the two sub-tasks are considered to be serial.
If failure of a sub-task leads to the other part taking over the
operations of the failed part, the two sub-tasks are considered to
be parallel.
The minimum HEP value is preferred if parallel sub-tasks have
high dependency in the system. It means that the related tasks
could be operable if any of sub-tasks succeed. The HEP values will
be multiplied if the sub-tasks have low or no dependency in a
parallel system. On the other hand, the maximum HEP value is
preferred if serial sub-tasks have high dependency in the system. It
means that the related tasks could not be operable if any of the subtasks fail. Likewise, the HEP values will be summed if the sub-tasks
have low or no dependency in a serial system. Table 6 shows notations in line with the rules (He et al. (2008).
3. Demonstration
In this section, the CREAM will be utilised to conduct human
reliability assessment for cargo loading process on-board the LPG
tankers.
3.1. The LPG cargo loading process
Carriage of liqueed petroleum gases can be broken down into
three stages; loading process, storage/transportation process, and
discharging process. In order to illustrate the application of methodology, the loading operation process in a terminal is used as a
case study. The loading operation process of the LPG cargo is more
critical when it is compared to transportation and discharging
processes. For example; before loading process, inerting gas (IG) of
cargo tanks has an important safety role since IG keeps the oxygen
content of the cargo tank ambient below 8%. If the IG procedure is
not conducted, there could be an explosion in the cargo tanks. In

Table 6
Notation in line of the rules.
System description System sub-task dependency Notation for task HEP
Parallel system

High dependency
Low or no dependency

HEPTask MinfHEPSub
task i g
Q
HEPTask HEPSub
task i

Serial system

High dependency
Low or no dependency

HEPTask MaxfHEPSub
task i g
P
HEPTask HEPSub
task i

addition, the reliquefaction system has a critical role since it compensates the overpressure during the loading operation. Otherwise,
overpressure may exceed the safety limit and it might cause an
unexpected explosion. Therefore, operator (crew on-board ship)
performance reliability has a signicant role conducting those
processes without any system failure, near miss, accident, and
catastrophes.
The cargo loading operation process has mainly four steps for
the LPG tankers; i) Drying and inerting of cargo tanks, ii) Gassingup and cooling down of cargo tanks, iii) Controlling cargo loading
plan, ship stability and stress calculation, iv) Loading full cargo
without vapour return and using ship reliquefaction system. Table 7
illustrates the loading operation process (LOP) of the LPG cargo into
tankers (IMO, 2007).

Table 7
Loading process of LPG cargo into tanker ship.
LOP1. Drying and inerting of cargo tanks
LOP1.1. Check the composition of tank atmosphere
LOP1.2. Determine which cargo tanks to start drying and inerting
LOP1.3. Control the line from IG blower to the manifold through the cooler
and drier
* Start IG fan
* Start up on-board drier
LOP1.4. Monitor the dry air ow and dew point temperature after drying in
the cargo tanks
LOP1.5. Verify whether drying operation continuous until the required dew
point temperature is attained
LOP1.6.Start up IC/N2 plant and monitor of IG/N2 ow, O2 content and dew
point temperature in the cargo tanks
LOP1.7.Check if the IG operation continue until the required O2 content and
dew point temperature in the cargo tanks is attained
LOP2. Gassing-up and cooling down of cargo tanks
LOP2.1. Adjust the gas pipeline route from deck storage tank using cargo
vaporizer where available to the cargo tanks
LOP2.2. Start up intake operation small quantity LPG cargo for gassed up
LOP2.3. Check if the cooling down of the cargo tanks is started with the use of
reliquefaction system on-board LPG tanker
LOP2.4. Control whether the overpressure is compensated by the
reliquefaction system
LOP2.5. Monitor if the cooling down continuous until liquid starts to form in
the cargo tanks
LOP2.6. Monitor if the cargo loading commenced simultaneously
* Continuous monitoring of gas ow
* Continuous control of cargo tank pressure and temperature
LOP2.7. Check percentage volume of liqueed gas and dew point temperature
in the cargo tanks
LOP3. Controlling loading plan, ship stability and stress calculation
LOP3.1. Verify cargo loading sequence to be set up regarding space and weight
available
LOP3.2. Control ship trim, stress and stability by taking into account the free
surface effect
LOP3.3. Monitor whether cargo loading plan to be followed and cargo tanks to
be loaded up to certain tank limits
LOP4. Loading full cargo without vapour return and using ship reliquefaction
LOP4.1. Check the stress of vessel by loadmaster
LOP4.2. Ensure that the shore manifold is connected to ship's liquid line and
cargo tanks lling commenced simultaneously by running reliquefaction
system
LOP4.3. Prepare the gas pipeline route from the liquid manifold to the cargo
tanks and vapour from cargo tanks to ship's reliquefaction system
*Control if overpressure is compensated by the reliquefaction system
LOP4.4. Adjust liquid loading quantity until the cargo tanks level is reached
90%
* Start up topping off
* Monitor liqueed gas ow and operation of reliquefaction system
LOP4.5. Check cargo tanks level during lling
* Monitor topping off
* Control the operation of high level alarm
* Check cargo tanks pressure and temperature (if tank pressure exceed 70%
of MARVS, stop loading)
LOP4.6. Verify cargo tanks are loaded up to the calculated maximum loading
limit

E. Akyuz, M. Celik / Journal of Loss Prevention in the Process Industries 34 (2015) 39e48

45

Table 8
Descriptor of CPCs assessment.
CPC

Drying and inerting

of cargo tanks (LOP1)

Gassing-up and
cooling down of
cargo tanks (LOP2)

Controlling loading plan,

ship stability and stress
calculation (LOP3)

Loading full cargo without

vapour return and using ship
reliquefaction (LOP4)

Adequacy of organisation
Working conditions
Adequacy of MMI and operational support
Availability of procedures/plans
Number of simultaneous goals
Available time
Time of day
Adequacy of training and experience
Crew collaboration quality

Very effective
Compatible
Adequate
Appropriate
Matching current capacity
Adequate
Not signicant
Adequate, high experiences
Decient

Efcient
Compatible
Tolerable
Appropriate
Fewer than capacity
Adequate
Not signicant
Inadequate
Inefcient

Very efcient
Compatible
Supportive
Appropriate
Matching current capacity
Temporary inadequate
Night-time (unadjusted)
Adequate, high experience
Efcient

Efcient
Compatible
Tolerable
Appropriate
Matching current capacity
Adequate
Not signicant
Adequate, high experience
Efcient

Before the loading process of liqueed petroleum gas into the

LPG tanker, all cargo tanks should be dried and inerted. This process
mainly includes the step LOP1.1 to LOP1.7. Thereafter, the tanks
should be gassed-up and consequently cooled for loading of the
LPG cargo. This basically includes the steps LOP2.1 to 2.7. Then,
loading plan, ship stability and stress calculations are controlled in
accordance with steps LOP3.1 to LOP3.3. The nal process is to load
full cargo without vapour return and topped off by using ship's
reliquefaction system. This process contains steps LOP4.1 to LOP4.6.
3.2. Analysis of respondents
To demonstrate the model, prestigious shipping companies
which have liqueed petroleum gas tanker eets was contacted.
The eet age varies between 4 and 18 years old and ship size varies
from 3200 to 11,000 cubic metres cargo capacity. The eet is
comprised of four semi-pressurised LPG tanker ships which are
commonly tted with type-A cargo tanks. They are mainly transporting their cargo in coastal waters.
The CREAM mainly utilises nine CPCs level evaluation results.
However, this is not enough to get utmost accurate outcomes for
human reliability assessment for the LPG tanker cargo loading
operations. Therefore, each CPC question is asked to marine experts
and ship crew member working on-board LPG tankers in accordance with loading process steps of the LPG cargo. The marine
expert prole includes professional managers (marine superintendent, HSEQ manager and DPA) who have seagoing background
and professional execution experiences on-board liqueed petroleum gas carriers as well as master and chief ofcer. They have also
adequate seagoing experience on handling of the LPG cargo onboard ship. Thereafter, the subjective CPC questions level is
reduced to one CPC level by getting geometric means of results.
3.3. Reliability analysis based on basic version
Since the loading operation process of the LPG cargo needs extra
attention from the crew, maritime human reliability analysis is
essential. Therefore, reliability analysis can be initially performed
based on basic version of the CREAM, which depends on identication of nine CPCs level. In this context, the subjective CPC questions are asked to marine experts (marine superintendent, HSEQ
manager and DPA) and ship crew (Master and chief ofcer) to get
the CPC levels for four main steps of cargo loading process. The
result is reduced to one CPC level by getting geometric means of all
results. Table 8 shows the descriptor of CPCs assessment conducted
by selected respondents upon cargo loading process.
Considering the organizational structure, quality, health, safety
and environmental management policy, operational procedures,
existing personnel competencies, and previous experiences of the
company, the required evaluations in accordance with the

proposed approach are executed as follows; before commencement

of cargo loading operation for the LPG tankers, all cargo tanks are
purged with dry air/inert gases (LOP1). In order to perform this
process, the shipping companies provide quite good crew organisation and all cargo handling processes are executed as per procedure/plans (check lists). The adequacy of organisation is
considered to be as very effective and availability of procedures/
plans is considered to be appropriate for drying and inerting of
cargo tanks process. Likewise, crew on-board ship has sufcient
skill and experience in drying and inerting process. Therefore, the
adequacy of training and experience is considered as adequate,
high experiences. Since there is enough time for this process,
available time is considered as adequate. Furthermore; working
condition, adequacy of MMI (manemachine interface) and operational support, number of simultaneous goals, time of day have not
signicant effect upon performance reliability for drying and
inerting of cargo tanks process. Therefore, these CPCs are regarded
as not signicant. On the other hand, cooperation and assistance of
crew with each other is quite limited. Thus, the crew collaboration
quality is considered decient.
During gassing-up and cooling down of cargo tank process
(LOP2), availability of procedures/plans is considered appropriate
since it is executed as per check lists. Similarly, there is no time
limitation for this process, available time is considered as
adequate. On the contrary, the crew does not have enough skill
and experience for this job, therefore adequacy of training and
experience is considered inadequate. On the other hand, the
remaining CPCs do not considerably affect the performance reliability during gassing-up and cooling down of the cargo tanks
process. Therefore, the effects of them are regarded as not

Table 9
Expected effect upon performance reliability.
CPC

LOP1

LOP2

LOP3

Adequacy of organisation

Improved

Not
signicant
Not
signicant
Not
signicant
Improved
Not
signicant
Improved

Improved

Working conditions

Not
signicant
Adequacy of MMI and
Not
operational support
signicant
Availability of procedures/plans Improved
Number of simultaneous goals Not
signicant
Available time
Improved
Time of day
Adequacy of training and
experience
Crew collaboration quality

LOP4

Not
signicant
Not
Not
signicant signicant
Improved Not
signicant
Improved Improved
Not
Not
signicant signicant
Not
Improved
signicant
Not
Reduced
Not
signicant
signicant
Reduced
Improved Improved

Not
signicant
Not
signicant
Reduced
Not
Not
Not
signicant signicant signicant

46

E. Akyuz, M. Celik / Journal of Loss Prevention in the Process Industries 34 (2015) 39e48

signicant.
The process of controlling loading plan, ship stability and stress
calculation (LOP3) and loading full cargo without vapour return and
using ship reliquefaction (LOP4) are shown in Table 8 respectively.
Since the loading operation of the LPG cargo in most of terminals
can be performed considerably fast, there could be a time limitation. Therefore, controlling loading plan, ship trim, stability calculation, sheering and bending force by loadmaster will take a long
time. Thus, available time is considered temporarily inadequate.
Likewise, due to the loss of concentration and serious fatigue at
night time, time of day is regarded as night-time (unadjusted)
which induces reduced performance reliability. Table 9 illustrates
the expected effect on performance reliability.
According to the Equation (1), CII - 3 for step LOP1; CII - 1 for
step LOP2; CII
3 for step LOP3 and CII - 3 for step LOP4. Thus,
control mode for step LOP1, step LOP2, step LOP3 and step LOP4 can
be found in tactical mode. It means that the performance reliability
of crew during cargo loading process is adequate and typically
follows planned procedures, but some temporal deviation is still
possible. In addition, human error probability interval varies between 1.0 E
3 to 1.0 E
1 as shown in Table 1. On the other hand,
initial screening of human interaction with control mode in basic
version of the CREAM is not satisfying. Therefore, extended version
is needed to give more detailed analysis of specic tasks.

3.4. Reliability analysis based on extended version

CIILOP1

CIILOP2

CIILOP4

Pii
4:0

Step 2: Calculating cognitive failure probability (CFP): Since each

CII value has been obtained for each loading process step, Equation
(3) will be used to calculate adjusted CFP.

CFPLOP1 CFP0 x 100:25

CII

CFP0 x 10
0:9

CFPLOP2 CFP0 x 100:25

CII

CFP0 x 10
0:05

CFPLOP3 CFP0 x 100:25

CII

CFP0 x 10
0:55

CFPLOP4 CFP0 x 100:25

CII

CFP0 x 10
1

Reliability analysis based on an extended version for each

loading process is illustrated in Table 11 which includes cognitive
activity, cognitive function, generic failure type, nominal cognitive

Sub- Cognitive Cognitive

Loading
steps activity
function
operation
process (LOP)

Generic
failure
type

Nominal CFPAdjusted
CFP
(CFP0)

LOP1

I3

1.0E
02 1.3E
03

I2
E2
O3

1.0E
02 1.3E
03
3.0E
03 3.8E
04
7.0E
02 8.8E
03

O1

1.0E
03 1.3E
04

E3
I1

5.0E
04 6.3E
05
2.0E
01 2.5E
02

E2

3.0E
03 2.7E
03

E3
I2

5.0E
04 4.5E
04
1.0E
02 8.9E
03

O3

7.0E
02 6.2E
02

O3

7.0E
02 6.2E
02

O3

7.0E
02 6.2E
02

I2

1.0E
02 8.9E
03

O2

7.0E
02 2.0E
02

O3
O3

7.0E
02 2.0E
02
7.0E
02 2.0E
02

I3

1.0E
02 1.0E
03

O3

7.0E
02 7.0E
03

I3

1.0E
02 1.0E
03

E2

3.0E
03 3.0E
04

I2

1.0E
02 1.0E
03

O2

7.0E
02 7.0E
03

LOP2

Pii
0:2

i1

LOP3
Table 10
PII value for CPCs upon LOP.

Adequacy of organisation
Working conditions
Adequacy of MMI and operational support
Availability of procedures/plans
Number of simultaneous goals
Available time
Time of day
Adequacy of training and experience
Crew collaboration quality

9
X
i1

Pii
3:6

CPC

Pii
2:2

i1

i1
9
X

9
X

Table 11
Reliability analysis based on extended version.

The extended version of the CREAM is needed for more specic

work. Instead of general performance reliability, detailed analysis
will be conducted. Therefore, each loading operation process step
should be divided into sub-steps for dening cognitive functions.
Thereafter, likely cognitive failure type should be identied and
calculated in accordance with Equations (2) and (3) for each
cognitive activity by utilising normal cognitive failure probability
value and CPCs.
Step 1: Calculating PII values for each loading operation process
(LOP): In accordance with Equation (2), PII values of the CPCs upon
LOP1, LOP2, LOP3 and LOP4 are provided in Table 10 depending on
the outcomes derived from the basic version. With this, the context
inuence index (CII) results for each loading process can be found
as;
9
X

CIILOP3

PII value

LOP4

LOP1

LOP2

LOP3

LOP4

0.6
0

0.4

1.2
0

1.4
0

1.4
1.4

0
0
0

1.2
0

1.4
0
1.8
0.4

0.6
0

0.6

1.2
0
1.0
0.6

1.4
0

0
0
0

1.2
0

1.4
0

1.4
0

LP1.1 Evaluate

Interpretation/
Planning
LP1.2 Compare Interpretation
LP1.3 Execute
Execution
LP1.4 Monitor Observation/
Interpretation
LP1.5 Verify
Observation/
Interpretation
LP1.6 Execute
Execution
LP1.7 Evaluate Interpretation/
Planning
LP2.1 Regulate Observation/
Execution
LP2.2 Execute
Execution
LP2.3 Evaluate Interpretation/
Planning
LP2.4 Monitor Observation/
Interpretation
LP2.5 Monitor Observation/
Interpretation
LP2.6 Monitor Observation/
Interpretation
LP2.7 Evaluate Interpretation/
Planning
LP3.1 Verify
Observation/
Interpretation
LP3.2 Observe Observation
LP3.3 Monitor Observation/
Interpretation
LP4.1 Evaluate Interpretation/
Planning
LP4.2 Verify
Observation/
Interpretation
LP4.3 Monitor Observation/
Interpretation
LP4.4 Regulate Observation/
Execution
LP4.5 Evaluate Interpretation/
Planning
LP4.6 Verify
Observation/
Interpretation

E. Akyuz, M. Celik / Journal of Loss Prevention in the Process Industries 34 (2015) 39e48

failure probability and adjusted cognitive failure probability result.

In order to build up a cognitive demands prole, which show the
specic demands to cognition associated with a task, cognitive
activities should be dened (Rouse, 1981). Each of these activities
corresponds to an elementary action of a human. Thereafter, each
cognitive activity is correlated with one or more cognitive functions
(observation, planning, interpretation and execution) and
described by a corresponding combination (Hollnagel and
Cacciabue, 1991). Then, generic failure type is identied based on
knowledge of the experts (Hollnagel, 1998). Consequently, adjusted
CFP can be calculated in accordance with Equation (3).
Step 3: Determining human error probability (HEP): The nal step
is to incorporate the adjusted CFPs into HTA in order to derive
single failure probability value for overall assessment. Fig. 3 shows
the HTA for the LPG cargo loading process.
According to Fig. 3, the LOP1 consists of seven sub-tasks which
shall be conducted correctly in order to complete the drying and
inerting of the cargo tanks process. It means that if any of seven
sub-task operations fails, the LOP1 will fail (serial system). Since
seven sub-tasks have high dependency, overall HEP value for the
LOP1 is assigned as the maximum value of the seven sub-tasks
which is 2.5E
02. Likewise, the LOP2 will fail if any of seven subtask operations fails (serial system). Hence, the overall HEP of the
LOP2 is assigned as the maximum value which is 6.2E
02 since the
seven sub-tasks have a high dependency. Furthermore, the LOP3
will fail if any of three sub-task operations fails (serial system). As
three sub-tasks have low dependency, the total HEP value is
assigned as the sum of three sub-task values which is 6.0E
02.
Similarly, the LOP4 will fail if any of six sub-task operations fails
(serial system). Since there is high dependency among six sub-task
operations, the overall HEP value is found to be 7.0E
03. Apparently, controlling whether the overpressure is compensated by the
reliquefaction system, monitoring if the cooling down continuous
until liquid starts to form in the cargo tanks and monitoring if the
cargo loading commenced simultaneously are the most importance
sub-step processes contributing human error during the LPG
loading process based on the effectiveness value.
In order to determine nal HEP value for cargo loading process
into the LPG tanker, four main loading processes (steps) should
succeed individually. This means that loading process will not be
performed properly if any of the four main steps fails. Thus, as four
main steps (LOP1, LOP2, LOP3 and LOP4) have high dependency,

Fig. 3. HTA for cargo loading process into LPG tanker.

47

nal HEP can be found by taking the maximum value of the four
main steps. Therefore, the nal HEP value is 6.2E
02.
3.5. Extended discussions on ndings
The ndings show that outcome of basic and extended version
compromise properly. The HEP value obtained from basic version
varies between 1.0 E
3 to 1.0 E
1 whereas value obtained from
extended version is found to be 6.2E
2 which conrms that the
result is inside the probability interval. The extended version value
gives specic results compared to the basic version. Since it provides results in a more sensitive interval; the value provided by the
extended CREAM apparently decreases the uncertainty.
To validate the model with the real data, the research was
extended to review the available operational records of the company. While focussing on events or errors during loading operation
process in the LPG tanker ship eet in previous two years, the data
provided by shore-based management executives show that there
are 47 recorded minor errors occurred practically during the
loading processes (LOP1, LOP2, LOP3 and LOP4) entire ship eet.
The average LPG shipments to be completed with tanker eet in the
last two years were about 900 in total. The loading process error
(minor or major operational crew failure) frequency is about 0.052
(5.2 E
2) which is very close to the 6.2E
2. The statistical data of
the tanker eet shows that the derived results from the model is
recognised as a consistent value. As advised, reliability is the
probability of a part of equipment or service operating without
failure. Basically, R(t) 1- F(t) formula represents the relation between reliability and failure/error. Therefore, the nal HEP value
proves that performance reliability (practically, this means operation without failure) of crew during cargo loading process is
satisfactory and typically following planned procedures as some
provisional deviation is still possible.
It is quite difcult to attain error data for most of HRA methods.
Therefore, cognition method is an alternative solution to overcome
scarcity of data. The CREAM extended version apparently gives
satisfactory result since the methodology based on cause and effect
classication scheme. Thus, the method should be utilised as
guidance for data collection and assessment.
4. Conclusion
The crew performance reliability will be utmost level for safety
and loss prevention in marine industry. This paper provides a
quantied human reliability assessment towards cargo operation
on-board LPG tanker ship by utilising the cognitive reliability and
error analysis (CREAM) approach. The result shows that the total
HEP value during the cargo loading operation process in the LPG
tanker ship is 6.2E
2. This means that the performance reliability
of LPG tanker ship crew is reliable and performance typically follows planned procedures but some temporal deviations are
possible.
In order to demonstrate the model, the LPG cargo loading process has been adopted and analysed since it has relatively high
complexity compared to other processes. The result of research has
shown that the human performance reliability is at the desired
level during the LPG cargo loading process. The available statistical
data has also conrmed that the results are consistent and
reasonable. The research is expected to yield original contribution
to the ship management companies, ship operators and safety
engineers for evaluation of crew performance reliability on-board
ship, since it is focused on performing quantied data analysis to
prove the applicability of CREAM approach on the cargo loading
operation of the LPG tankers. Furthermore, the paper is expected to
contribute to activities of international maritime authorities (i.e.

48

E. Akyuz, M. Celik / Journal of Loss Prevention in the Process Industries 34 (2015) 39e48

IMO, EMSA, etc.) and cargo owners (i.e. vetting inspections, TMSA,
etc.) into enhancement of the critical processes of safety and loss
prevention on-board LPG and LNG tanker platforms. The following
aspects within the research are highlighted;
i) The model can utilise both qualitative and quantitative data
to enhance safety parameters in the LPG cargo transportation
at sea.
ii) The research provides benets to ship operators and safety
engineers for crew performance reliability assessment and
crew loss prevention on-board ship.
iii) The quantied outcomes of the research such as adjusted CFP
will be utilised to avoid human/crew error in maritime safety
and to ensure safety at sea, prevention of human injury and
loss of life.
iv) The shortcomings of the CPCs for loading process can be
utilised to prevent human/crew error in advance.
In conclusion, this research developed a human reliability
assessment approach applicable to monitoring of the crew cognitive actions or attitudes during cargo operations on-board LPG
tankers. The model can be applied to any other critical operational
processes such as cargo discharging, ballasting, bunkering, maintenance, manoeuvring, emergency response actions, etc. where
crew reliability have high level of importance on-board ships. The
further investigations might be concerned with deriving specic PII
for maritime transportation in order to enhance consistency in the
CREAM.
References
Almond, R.G., 1992. An Extended Example for Testing Graphical Belief. Technical
Report 6. Statistical Sciences Inc.
Bertolini, M., Bevilacqua, M., Cooper, S.E., 2010. Fuzzy Cognitive Maps for Human
Reliability Analysis in Production Systems. In: Production Engineering and
Management under Fuzziness Studies in Fuzziness and Soft Computing, vol.
252, pp. 381e415.
Calhoun, J., Savoie, C., Randolph-Gips, M., Bozkurt, I., 2014. Human reliability
analysis in spaceight applications Part 2: modified CREAM for spaceight.
Qual. Reliab. Eng. Int. 30, 3e12.
Chadwick, L., Fallon, E.F., 2012. Human reliability assessment of a critical nursing
task in a radiotherapy treatment process. Appl. Ergon. 43, 89e97.
Cooper, S.E., Ramey-Smith, A.M., Wreathall, J., 1996. A Technique for Human Error
Analysis (ATHEANA). USNRC. Nureg/CR-6350.
Danish Ship Finance, April, 2014. LPG Tanker, Shipping Market Review.
Embrey, D.E., Humphreys, P.C., Rosa, E.A., Kirwan, B., Rea, K., 1984. SLIM-MAUD: An
Approach to Assessing Human Error Probabilities Using Structured Expert
Judgement. NUREG/CR-3518. US Nuclear Regulatory Commission, Washington
DC.
Groth, K.M., Mosleh, A., 2012. A data-informed PIF hierarchy for model-based

human reliability analysis. Reliab. Eng. Syst. Saf. 108, 154e174.

Guo, H., Wang, W., Gou, W., Jiang, X., Hubb, H., 2012. Reliability analysis of pedestrian safety crossing in urban traffic environment. Saf. Sci. 50, 968e973.
He, X., Wang, Y., Shen, Z., Huang, X., 2008. A simplied CREAM prospective quantication process and its application. Reliab. Eng. Syst. Saf. 93, 298e306.
Hollnagel, E., 1998. Cognitive Reliability and Error Analysis Method. Elsevier,
Amsterdam.
Hollnagel, E., 1993. Human Reliability Analysis: Context and Control. Academic
Press, London, UK.
Hollnagel, E., Cacciabue, P.C., 1991. Cognitive modelling in system simulation. In:
Proceeding of Third European Conferance on Cognitive Science Approaches to
Process Control, Cardiff, 1991.
IGC, 1993. International Code for the Construction and Equipment of Ships Carrying
Liqueed Gases in Bulk. IMO.
IMO, 2007. Liqued Petrolium Gas (LPG) Tanker Cargo and Ballast Handling
Simulator. London, UK.
Jensen, F.V., Nielsen, T.D., 2007. Bayesian Networks and Decision Graphs. SpringerVerlag, Berlin, Germany.
Konstandinidoua, M., Nivolianitoub, Z., Kiranoudisa, C., Markatos, N., 2006. A fuzzy
modeling application of CREAM methodology for human reliability analysis.
Reliab. Eng. Syst. Saf. 91, 706e716.
Lee, M.S., Ha, S.J., Seong, H.P., 2011. CREAM-based communication error analysis
method (CEAM) for nuclear power plant operators' communication. J. Loss Prev.
Process Ind. 24, 90e97.
Martins, M.R., Matuna, M.C., 2013. Application of Bayesian belief networks to the
human reliability analysis of an oil tanker operation focusing on collision accidents. Reliab. Eng. Syst. Saf. 110, 89e109.
Musharraf, M., Hassan, J., Khan, F., Veitch, B., MacKinnon, S., Imtiaz, S., 2013. Human
reliability assessment during offshore emergency conditions. Saf. Sci. 59, 19e27.
Pyy, P., 2000. An approach for assessing human decision reliability. Reliab. Eng. Syst.
Saf. 68 (1), 17e28.
Rouse, W.B., 1981. Systems Engineering Models of Human Machine Interaction.
Elsevier North-Holland, Amsterdam.
Sun, Z., Li, Z., Gong, E., Xie, H., 2012. Estimating human error probability using a
modied CREAM. Reliab. Eng. Syst. Saf. 100, 28e32.
Swain, A.D., 1990. Human reliability analysis: need, status, trends and limitations.
Reliab. Eng. Syst. Saf. 29, 301e313.
Swain, A.D., Guttmann, H.E., 1983. Handbook of Human Reliability Analysis with
Emphasis on Nuclear Power Plant Applications. Nuclear Regulatory Commission, Washington, DC.
Turan, O., El-Laden, S.B., 2012. Human reliability analysisdTaxonomy and praxes of
human entropy boundary conditions for marine and offshore applications.
Reliab. Eng. Syst. Saf. 98, 43e54.
UK P&I Club, 2013. Circular: The Carriage of Liqueed Gases.
Vanem, E., Antao, P., Ostvik, I., Comas, F.D.C., 2008. Analysing the risk of LNG carrier
operations. Reliab. Eng. Syst. Saf. 93, 1328e1344.
Williams, J.C., 1988. A data-based method for assessing and reducing human error
to improve operational performance. In: Proceedings of IEEE 4th Conference on
Human Factor and Power Plants. Monterey, California, pp. 436e453.
Wu, S., Hrudey, A., French, S., Bedford, T., Soane, E., Pollard, S., 2009. A role for
human reliability analysis (HRA) in preventing drinking water incidents and
securing safe drinking water. Water Res. 43, 3227e3238.
Yang, Z.L., Bonsall, S., Wall, A., Wang, J., Usman, M., 2013. A modied CREAM to
human reliability quantication in marine engineering. Ocean Eng. 58,
293e303.
Zubair, M., Zhijian, Z., 2013. Reliability Data Update Method (RDUM) based on living
PSA for emergency diesel generator of Daya Bay nuclear power plant. Saf. Sci.
59, 72e77.