Abnormal Situation Management


Since the early 1970’s process Industries were faced with an alarming number of incidents causing undesired effects ranging from reduced profits to loss of lives. Industry began doing studies into the causes of these incidents and found that human factors had a significant impact. From the alertness level of operators, to poorly designed alarm systems and operator interface, to inappropriate staffing levels, to poorly designed work environments, human factor issues were a significant contributor to major and minor incidents. Incidents such as Three Mile Island and Texaco Pembroke were caused as a direct result of “human error.”

Abnormal Situations

Abnormal situations encompass a range of events outside the “normal” plant operating modes, e.g. trips, fires, explosions, toxic releases, human error, or just not reaching planned targets.

Abnormal Situation Management

Abnormal Situation Management is a comprehensive process or system for improving performance which addresses the entire plant population. It promotes effective utilization of all available resources—i.e. hardware, software, and people, to achieve safe and efficient operations.

Abnormal Situation Management Consortium®

The Abnormal Situation Management Joint Research and Development Consortium conducts research and shares experiences on factors contributing to the successful reduction of abnormal situations in petrochemical processes, and develops, evaluates and proves new solutions to reduce risks even further. The ASM Consortium was informally established in 1992 as an outgrowth of an effort to define improvements to current DCS alarm system technologies. Realizing that the alarm system was but a part of the larger issue of the management of unexpected process upsets, a number of companies teamed with Honeywell to develop a problem statement and a vision for the solution.

The ASM team has conducted many additional formal site studies, and other, less-formal, on-site analyses, to further develop our understanding of ASM best practices and deliver benefits to our Consortium member companies.

The Best Practices Guidelines currently contain criteria in seven areas of interest.

  • Understanding of Abnormal Situation
  • Management Structure and Policy
  • Training and Skill Development
  • Communications
  • Procedures
  • Control Building Environment
  • Process Monitoring and Control Applications

The ASM Consortium has agreed to share these best practices through paid site assessment studies to consortium and non-consortium members.

The current members of the Consortium are BAW Architecture, Celanese, ChevronTexaco, ConocoPhillips, ExxonMobil, Honeywell, Shell, TTS Performance Systems, UCLA.

Ian Nimmo, President of User Centered Design Services, INC, was the ASM Program Director from it’s inception until December 1999.

User Centered Design Services was an Associate member from 2000 to 2005

The ASM Consortium operates a website that contains a large collection of public documents on the research program and solution elements. http://www.asmconsortium.com


Early work of the Abnormal Situation Management Consortium® included a survey of the US petrochemical industry. The consortium estimated that there were losses of approximately $20,000,000,000 per year from abnormal situations (approximately the total overall annual profits)

Evidence leading to this estimate

  • Plant surveys showed that incidents were frequent with typical costs ranging from $100,000 to well in excess of $1,000,000 per year. For example, one plant surveyed, had 240 shutdowns per year at a total cost of $8,000,000. Many of these shutdowns were preventable
  • It was found that refineries, on average, suffer a major incident once every three years costing on average $80,000,000
  • One insurance company’s statistics showed that the industry was claiming on average over $2.2 billion per year due to equipment damage. It is likely that actual total losses to the companies would be significantly higher than what was claimable.


These studies by Abnormal Situation Management Consortium® indicated that companies who achieved Best Practice in operations improve their productivity by 5 – 12%.

© 2013 User Centered Design Services


UCDS has in-depth experience in designing control rooms and modifying existing field shelters. Our process is compliant with the ISO 11064 Ergonomic Design Standard for Control Buildings. We interview management, supervision and a significant group of the operators to understand functional requirements, what works well in the existing environment, and identification and correction of problems with the existing design. To learn more Click Here


Situation Awareness

Abnormal situations encompass a range of events outside the “normal” plant operating modes, e.g. trips, fires, explosions, toxic releases or just not reaching planned targets. In the past incidents such as Piper Alpha, Milford Haven, Flixborough, Texas City and the 2003 northeast electrical blackout have all been attributed, at least in part, to a fundamental lack of good situational awareness. Early work of the Abnormal Situation Management Consortium® included a survey of the US petrochemical industry. Based on their research the consortium estimates industry losses of around $20 billion per year from abnormal situations, approximately equal to the total annual profits of that industry. Furthermore these studies indicate that companies achieving Best Practices in operations can improve productivity by 5-12%. To learn more Click Here


Fatigue Alertness Management

We have many customers looking to enhance their shift handover procedures and follow some of the Recommended Practices identified in the API documents; others are focusing attention on fatigue and fatigue countermeasures. We have great solutions for both these topics. For more details please contact Steve Maddox. To learn more Click Here



User Centered Design Services promotes Behavior – Based Safety which is a process that helps employees identify and choose safe behavior over an unsafe one. Safety in the workplace is a combination of three measurable components – the person their environment, and their behavior. To learn more Click Here

About the Control Room Operator Performance Group

The purpose of this group is to share ideas and solutions that contribute to improving the performance of the control room operator. Abnormal situations can be managed safely and effectively if we provide our operators with the right training, workload, environment, and interfaces.