Evaluating the importance of this cascade of events, Lagadec published a book in 1987 entitled “Le risque technologique majeur” [LAG 83]2. At the same time, Kervern, with the help of a team of researchers, set out to understand the reasons for this chain of failures. They studied a series of accidents, whether technological, natural or domestic, and deduced that the causes were not only due to technical failures, but also to those of the human operator. These feedback studies revealed strange similarities with the notion of immune “deficiency” in living organisms. By analogy, they concluded that an accident occurs when pathogenic elements (such as gaps, vagueness or ambiguities) are created within organizations and do not encounter “appropriate defense systems”. This discovery reinforced the primacy of the concept of danger over that of risk, and the name deficit was given to these pathogenic elements. This is how the science of danger or cindynics (name taken from the Greek kindunos) was born, bringing to light, at system level, the notion of systemic cindynogenic deficit. And, these pioneers, from all of the “small islands” explored, were thus able to identify the archipelago of danger [KER 91]. The resulting book, “L’archipel du danger”, has a postface by Laborit, a medical surgeon and neurobiologist, who was one of the pioneers of complexity theory and the initiator of complex thinking.
The small islands of the archipelago (probability calculations, data processing, actuarial calculations, financial mathematics, psychology, sociology, phenomenology, ontology, etc.) were already sufficient in number to justify the plural displayed in the term cindynics.
Here, the necessary awareness of the danger was regained.
After 1990
New types of accidents and disasters were calling into question the organization of work.
This period saw new disasters causing real damage to the environment (pesticide factory 91, Mede 92, oil tanker wrecks 92-93-96-99). These events reinforced the need to complete the list of technical and human factors with that of organizational factors.
However, despite all of these advances leading to spectacular progress in risk management, the downward curve in the number of accidents seemed to have reached an asymptotic limit which, for the time, remained a brick wall. Figure P.1. illustrates this asymptotic limit3.
One reason may explain this limitation.
A close look at the characteristics of current risk management studies shows that they are based on five pillars: the primacy of analytics, the notion of risk, the dreaded random event, quantitative aspects and finally, those related to the senses. These five fundamentals resemble axioms that will generate certain biases (see Appendix 1).
Figure P.1. Changes in annual passenger fatality and death rates in scheduled services since 1987, Source: Ministère de la Transition Écologique et Solidaire (Aviation Safety Report, 2016). For a color version of this figure, see www.iste.co.uk/planchette/cindynics.zip
Consequently, based on these characteristics, the description of the potentiality of the events generating risk is based only on a space limited to the two dimensions noted (p,g), characterizing the probability of occurrence p of a dreaded event and the severity g of the consequences generated.
Not giving up on pushing back this limiting wall, Kervern and his team found that human beings are at the heart of organisms and fulfill diverse and varied roles. Their goals are both complementary and antagonistic. Moreover, the existence of these actors intervening within different organizations (see Glossary) generates interactions (see Appendix 2) through the exchange of data, information and so on, leading to the emergence of verbal and non-verbal influence relationships (conflicts of interest, rivalries, cooperation and competition).
Indeed, according to its sociological definition, an organization generates a double problem: it is at the same time a place of creation of social links and a place of actions turned towards the achievement of concrete results. This bivalence can generate tensions, considering for example:
– dissatisfaction, to a greater or lesser extent, with the choices made in terms of the distribution of activities;
– individual recognition needs.
An organization is therefore a place where both ambiguity (source of uncertainty) and the search for a minimum of coherence necessary to achieve the desired goals coexist.
In the book “Comportements humains et management” [ALE 09], Alexandre-Bailly et al. suggest that organizations are complex systems structured according to three parts: the organizational devices, the culture and the games of the individuals composing the organization.
Therefore, we are faced with a second reason for the limit mentioned above. Because of the presence of these interactions, we do not live in a world where cause and effect relationships are linear. Indeed, the integration of human and social interactions leads us into the universe of complexity, which can in no way be translated by a two-dimensional space.
As a result, any actor or group of actors (see Glossary) with their own characteristics may cause other types of pathogenic elements, such as ambiguities, blurred, divergent points of view, conflicts and rivalries.
Thus, in addition to deficits acting as gaps, dissonance is also a source of tension between actors. Other forms of danger (and therefore dangerous situations) than those identified up until now also appear. It is therefore necessary to better define the danger, that is, “to identify it, in order to be able to hope to reduce its negative consequences” [KER 91].
Faced with this awareness, it became crucial for Kervern to find another mode of description capable of identifying the potentiality of these new types of dangers, a mode that could no longer only be expressed by the dimensions mentioned above.
Fortunately, even though dangerous situations defy human perception, humans have a certain capacity to undertake the description. It was the art of establishing a cindynics epistemology which, based on the work of Simon, Le Moigne, Morin and Mugur Schächter, made it possible to proceed, by describing dangerous situations through a process of genesis of danger (see Chapter 1, section 1.2 and Chapter 2).
These sciences of danger thus widen their fields of investigation by seeking in priority, all of the deficits and dissonances that can generate vulnerability in the organization. Because of this vulnerability and under the effect of pathogenic elements, the dangerous situation thus created tends to evolve, either progressively or abruptly towards accident, catastrophe or crisis.
These cindynics concepts have been transferred from the industrial sphere to the civil society sphere, with applications to the family [FOU 97], the city and public health. After September 2001, these concepts explored the transition from industrial and psychological risk to threat. And other perspectives are being developed to deal with other aspects of conflict (see Chapter 6).
These developments show the relevance of the use of the risk analysis approach and its adaptability to any complex situation dealing with hazards and risks.
The birth of a new science: cindynics