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Mattias Holmgren
Mattias Holmgren

Mattias Holmgren

Senior Lecturer
Luleå University of Technology
Operation and Maintenance
Operation, Maintenance and Acoustics
Department of Civil, Environmental and Natural Resources Engineering
+46 (0)920 492433
T2047 Luleå


My research aims to understand how risks in technical systems can be reduced by taking into account human error. I have studied railway accidents in Sweden with a focus on collisions and derailments related to improper maintenance. The study shows that inadequate infrastructure maintenance is a significant cause of collisions and derailments. Three significant sources of risk are identified: communication deficiencies, deficiencies in receiving information and omitted work steps.

I have also studied risks in connection with maintenance stoppages at Swedish paper mills, then with a focus on the performers, ie the maintenance staff and their collaboration. Here, too, it was found that inadequate information and communication cause risks in connection with maintenance. One conclusion is that incidents that are made visible in connection with the performance of maintenance may have been caused by sources of risk in other maintenance-related activities in the maintenance process. Therefore, it is important to not only focus the analysis on the actual execution of maintenance, as problems are built in latently through errors in, for example, planning and control of the maintenance process.

In order to achieve continuous improvements and risk reduction, it is helpful to consider maintenance through a process approach. When planning and managing the maintenance process, it should be vertically integrated with the organization's overall goals in order to be efficient, that is, to do the right things. In addition, the maintenance process should also be horizontally integrated with the ongoing operational and modification processes to be efficient, that is, to do things correctly.


My interest in education was aroused when I trained parachutists. That training was about getting the students to survive their first parachute shop by being able to escape from the plane and then steer home and land the parachute safely. The idea with the training is that they should be able to perform certain steps under high stress without having to think, ie performed instinctively. To achieve this, they had to practice the same thing over and over again. Special part that deals with the travel tug procedure, ie how a faulty parachute should be disconnected and then pull out the spare parachute. This may seem far from academic education where we expect reflective students, but what I learned is that education must be situational. What would save lives in a stressful situation with small time margins worked for that purpose. Later in the education, the students' stress had decreased, the degree of difficulty increased and the pedagogy changed in step with it. When it came to teaching students a correct fall position, a higher degree of reflection was required. Here we went through the steps and the students got to practice on the lawn before they tested in the air. We alternated theory, exercise and flexible flight and gave feedback on the implementation. Where, as in other education, feedback is important. In order for the feedback to be as effective as possible, it was important that it came directly in connection with the completed steps.


Supervision of Doctoral students



Conference paper

Process Analysis of Human Failures in Railway Maintenance (2016)

Holmgren. M, Söderholm. P
Part of: Current Trends in Reliability, Availability, Maintainability and Safety, An Industry Perspective, s. 381-393, Encyclopedia of Global Archaeology/Springer Verlag, 2016
Article in journal

A process approach to maintenance-related hazard identification (2008)

Holmgren. M, Söderholm. P
International Journal of COMADEM, Vol. 11, nr. 1, s. 36-46
Article in journal

A process view of maintenance and its stakeholders (2007)

Söderholm. P, Holmgren. M, Klefsjö. B
Journal of Quality in Maintenance Engineering, Vol. 13, nr. 1, s. 19-32
Article in journal

Maintenance-related losses at the Swedish rail (2005)

Holmgren. M
Journal of Quality in Maintenance Engineering, Vol. 11, nr. 1, s. 5-18