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Record W2085430918 · doi:10.1080/14639220500078153

The Walkerton<b><i>E. coli</i></b>outbreak: a test of Rasmussen's framework for risk management in a dynamic society

2006· article· en· W2085430918 on OpenAlex

Why this work is in the frame

A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.

affAt least one author lists a Canadian institution in the pinned OpenAlex snapshot.
fundA Canadian funder is recorded on the work.
aboutThe title or abstract carries a Canadian signal from the geographic lexicon.

Bibliographic record

VenueTheoretical Issues in Ergonomics Science · 2006
Typearticle
Languageen
FieldHealth Professions
TopicOccupational Health and Safety Research
Canadian institutionsUniversity of Toronto
FundersNatural Sciences and Engineering Research Council of CanadaMinistry of Education, IndiaMinistry of Earth Sciences
KeywordsSociotechnical systemAgency (philosophy)EnforcementGovernment (linguistics)Risk managementTest (biology)Law enforcementBusinessPublic relationsRisk analysis (engineering)Political scienceEngineeringKnowledge managementSociologyComputer scienceLaw

Abstract

fetched live from OpenAlex

In May 2000, the water transportation system in Walkerton, Ontario (a small town with 4800 residents) became contaminated with E. coli bacteria, eventually causing seven people to die and 2300 to become sick. The 700-page report from a comprehensive public inquiry into this tragedy provided a rich source of data about the outbreak itself and the factors leading up to it. That report was used to test the explanatory adequacy of Rasmussen's framework for risk management in a dynamic society. Close agreement was observed between the predictions of the framework and the causes contributing to the Walkerton outbreak. The sequence of events reveals a complex interaction between all of the levels in a complex sociotechnical system spanning strictly physical factors, the unsafe practices of individual workers, inadequate oversight and enforcement by local government and a provincial regulatory agency and budget reductions imposed by the provincial government. Furthermore, the dynamic forces that led to the accident had been in place for some time—some going back 20 years—yet the feedback to reveal the safety implications of these forces was largely unavailable to the various actors in the system. Rasmussen's framework provides a theoretical basis for abstracting from the details of this particular incident, thereby highlighting generalizable lessons that might be used to ensure the safety of other complex sociotechnical systems.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.006
metaresearch head score (Gemma)0.002
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Theoretical or conceptual · Consensus signal: Theoretical or conceptual
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.186
Threshold uncertainty score0.874

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0060.002
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.000
Bibliometrics0.0000.001
Science and technology studies0.0010.002
Scholarly communication0.0000.000
Open science0.0010.000
Research integrity0.0000.001
Insufficient payload (model declined to judge)0.0000.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.016
GPT teacher head0.421
Teacher spread0.405 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it