The workers adjust work execution under constant goals, rules, and norms. Whereas, organizational activities are induced to change them by external forces and internal conflicts. However, conventional safety analysis methods did not deal with the interaction between the organization and the work practice. In this study, we propose a safety analysis method by integrating the Activity Theory which regards human behavior as mediated by artifacts such as rules and norms of the organization and Functional Resonance Analysis Method which traces partial alteration of work procedures and predicts how that propagates over the entire work. We apply our method into an actual railway accident case, and then we show how the alteration of organizational norms and the alteration of work procedures interact with each other leading to the occurrence of accidents. Our proposal is useful in grasping how the work procedure alters when a new tool is delivered into practice, and how the organization acknowledges such alteration.
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