"The clock at Gate 1 stopped at 3:43 p.m. The explosion that shook
the BASF site in Ludwigshafen at this time on July 28, 1948 wrought
unthinkable destruction in a place that was still being rebuilt
following the Second World War and which was still under French
occupation three years after the end of the war. The disaster created a
widespread stir as a result of extensive international press coverage.
Similarly, aid also came from virtually all over the world after the
explosion, and soldiers from both the French and the adjacent American
occupation zones immediately made their way to the site to assist."
PROCESS SAFETY MANAGEMENT (PSM) INDIA
RISK BASED PSM PROCESS SAFETY MANAGEMENT INDIA CONSULTANT INCIDENT INVESTIGATION HAZOP TRAINING ROOT CAUSE ANALYSIS AND LESSONS FROM INCIDENTS
October 10, 2024
The explosion of 1948
October 6, 2024
Are you controlling and venting reactors safely?
An employee was cleaning the chemical reactor with a flammable mixture of solvents when the reactor burst its rupture disc and the mixture was expelled into the plant. The solvent ignited and the vapor cloud explosion resulted in the plant's 43 employees being injured by flying debris and/or being thrown by the force of the explosion. The employee and two others died from the explosion. Many were injured.
It appeared that the reactor was not vented to a safe location and had primitive temperature controls, and the company did not enforce the mandatory attendance of operators at the reactors during operation. All of these factors, including minimal operating procedures (none specifically for cleaning), led to the explosion and the resulting extensive injuries and property damage.
Source: Osha.gov
October 2, 2024
Employee dies of cardiac arrest after spalsh of chemical from an open drain
Employee #1 was placing the #6 water condenser back on line, leaving the drain valve open while he opened a valve under the condenser. Hydrofluoric acid suddenly drained into the catch basin/drain system, and splashed the employee. He suffered first- and second-degree burns and later died of cardiac arrest.
Siurce: OSHA.gov
September 27, 2024
UNDERSTAND CHEMICAL INCOMPATIBILTY
On November 17, 2005, Employee #1 and other employees noticed a plugged drain. The employee poured an undetermined amount of Red Devil Lye Drain Cleaner into the drain. A violent splash back deposited sodium hydroxide onto Employee #1 and the nearby surroundings. The employee was wearing his personal protective eyeglasses. Employee #1 suffered chemical burns on his head. The employee was hospitalized.
Source: OSHA.gov
September 23, 2024
Employee Is Burned While Sampling Waste Drums
On August 1, 2007, Employee #1 was working as a Sampler in East Palo Alto. He was opening sealed 55-gallon metal drums containing flammable liquid which had been received in a batch of 12 metal drums on July 26, 2007. The drums had to be sampled to verify whether the waste received was consistent with information on the manifest and the waste profile the facility kept on its records.
The Drum Sampling Area was located adjacent to the North Drum Storage Area, which was designated for storage of waste solvents and organic wastes. An air hose was available to be used with an impact wrench .The pneumatic impact wrench (air gun) was equipped with an attachment to open the bung on the drum and weighed approximately 7 pounds.
At approximately 8:30 a.m., Employee #1 had lined up all the 12 drums and put sampling jars on top of each drum, while the Production Manager and several other workers were standing nearby, chatting. Employee #1 was wearing his full-facepiece respirator, gloves, rubber apron and Tyvek over his long sleeve uniform and long sleeve T-shirt. After opening four or five drums using the air gun, he attempted to open the next drum, which did not show any indication of bulging or deformity. As soon as the air gun hit the bung, the drum burst open in flames. The accident was most likely caused by the mechanical sparks created from the impact of the air gun with the drum bung, which ignited the flammable vapors released from the drum. The exploding drum hit Employee #1 in the stomach area and engulfed him in flames. His clothes caught on fire. Employee #1 started running up the aisle, where he was spotted by the Production Manager, who rolled him down on the ground to put out the flames on his clothes. Another employee sprayed him with a Class D fire extinguisher. Employee #1 was taken to Stanford Medical Center Emergency Room by paramedics, where he was treated for first- and second-degree burns on his right ear.
Source: OSHA.gov
September 19, 2024
AI accident
"After a series of highly publicized operator errors at its Cleveland plant, a chemical manufacturer, installs a software based control system to prevent accidental releases of toxic substances. The system relies on a machine learning model trained on millions of hours of operating data from their facilities. Using sensor data from the plant, the model can identify when it is safe to open the plant’s exhaust vents. Thanks to its extensive “experience,” the model adapts seamlessly to process changes and physical modifications within the complex plant, which were blamed for confusing human operators in the past. The new
software system proves highly reliable and becomes a trusted tool within the company. Months later, a windstorm disrupts several of the plant’s sensors. Based on the flawed sensor input, the
control system continues to read “safe,” and the plant operators act accordingly, leaving the vents open, even as managers elsewhere in the plant begin an unscheduled production run in response to an urgent customer request. The run produces a cloud of lethal chlorine gas, which escapes through the open exhaust vents and drifts toward downtown."
Source: https://cset.georgetown.edu/publication/ai-accidents-an-emerging-threat/
September 15, 2024
AI IN PSM - A DOUBLE EDGED SWORD ARTICLE
Interesting article Ai in PSM- adouble edged sword for PSM
https://www.leancompliance.ca/post/ai-in-psm-a-double-edged-sword-for-process-safety-management
September 12, 2024
H2S is both flammable and toxic!
At 6:45 p.m. on October 28, 2021, an employee was circulating a tank of hydrogen sulfide when a burner box, which was 15 feet away, was turned on and the hydrogen sulfide that was in the atmosphere ignited. The employee was hospitalized to treat second and third-degree burns to his hands and face.
Source: OSHA.gov
September 8, 2024
Employee killed, another injured in storage tank explosion
"On or about January 28, 1993, Employee #1, a contract welder, was repairing and replacing flanges on storage tanks in order to install a closed ventilation system. The storage tanks contained sodium sulfide, which reacts with acid to generate hydrogen sulfide gas. This highly flammable gas accumulated in a vapor space. Prior to the accident, a tank flashed while being cut or welded into by the employee. When a lighted torch was brought in proximity, the tank ruptured. Employee #1 died. Employee #2 had gone up on a tank to tell Employee #1 not to cut into the tank when the tank exploded. Employee #2 was hospitalized."
Source: OSHA.gov
September 3, 2024
Employee Sustains Kidney Rupture And Multiple Fractures when H2S released from a safety valve
"At 10:30 a.m. on September 30, 2019, an employee was performing maintenance on a storage tank battery for oil and gas operations support. The employee was on a crew which was working on a line which was not pressurizing properly. As the employee was working on the line, the pop off valve relieved causing the employee to be struck by released hydrogen sulfide. The employee fell off the tank, rupturing his kidney and fracturing his left fibula and right hip. The employee was hospitalized".
Source: OSHA.gov
August 27, 2024
Employee is killed when overexposed to H2S during confined space entry
"At 12:30 p.m. on June 7, 2021, an employee entered a sewer manhole to estimate the amount of materials needed to perform a manhole repair when the employee was overcome by high levels of hydrogen sulfide at the base of the manhole shortly after entry. The employee did not perform atmospheric monitoring and had not donned his harness with rescue tripod before entry into the confined space. A four gas monitor and rescue equipment were located in the employee's work vehicle. Coworker #1 (attendant) and Coworker #2 (helper) were not trained or equipped for performing a confined space entry rescue. A volunteer fire department responded within 8 minutes and performed the confined space entry rescue shortly after arrival. The employee was killed by overexposure to hydrogen sulfide"
SOurce: OSHA.gov.
August 22, 2024
Four Employees Are Chemically Poisoned with Epichlorohydrin
On May 17, 2010 Employee #1, Employee #2, Employee #3 and Employee #4, were in the pipe rack planning to install a flanged spool piece on the Epi three transfer line. The line had been isolated at the west end and the east end. A one inch bleeder valve on both ends was yellow tagged open and returned to operations.
Employee #1, Employee #2, and Employee #3 had pulled their tools and bolts up. Employee #4, the rigger had gone up to the job site to figure out the best way to lift the pipe spool in place. As all this was going on, an employee of the host employer connected an eighty pound nitrogen hose to the one inch bleeder. That worker then charged the line with the eighty pounds of nitrogen.
Shortly after that, ten gallons of epichlorohydrin was released from the west end of the open pipe hitting Employee #1 directly in the chest and midsection. Employee #1 was admitted to the hospital immediately by life flight. Employee #2 was exposed on the neck, back and hands, and admitted to the hospital. Employee #3 had mild splotchy discoloration of several small areas on the hand and arms. Also a sore throat from inhalation. Employee #4 had splotchy superficial burns on the arms and back as well as a mild associated rash.
Source:OSHA.gov
August 18, 2024
Hydrotest fatility
"At 1:00 p.m. on September 27, 1993, a hydrostatic test crew operator and two helpers began testing 19 sections of 7 inch P-110 casing pipe at 9,500 psi.
The hydrostatic crew would roll the pipe onto the holding devices, check the drift (proper dimensions), apply thread dope, install the front header plug and rear "gun" plug, align the header plug bleed valve, fill the pipe with water, close the bleed valve, tighten the header plug, and assume their designated positions for pressure testing in accordance with pressure test specifications.
After conducting the pressure test, employees would drain the water, remove the plugs, roll the pipe down the line, grease the threads, and stencil the pipe.
Near 4:00 p.m. the crew was working on pipe section number 18. About 4:15 p.m., the pipe was filled with water and the crew began the pressure test. At 1,000 psi the header plug exploded blew out of the coupler on the pipe and struck Employee #1. Coworkers rushed to his aid and emergency medical services were notified. CPR was administered. Medical services arrived and transported Employee #1 to the hospital, where he died at about 5:00 p.m".
Source: OSHA.gov
August 13, 2024
CO2 pipeline incident due to landslide
"On February 22, 2020, a carbon dioxide (CO2) pipeline ruptured in proximity to the community of Satartia, Mississippi. The rupture followed heavy rains that resulted in a landslide, creating excessive axial strain on a pipeline weld.
• Carbon dioxide is considered minimally toxic by inhalation and is classified as an asphyxiant,
displacing the oxygen in air. Symptoms of CO2 exposure may include headache and drowsiness.
Individuals exposed to higher concentrations may experience rapid breathing, confusion,
increased cardiac output, elevated blood pressure, and increased arrhythmias. Extreme CO2
concentrations can lead to death by asphyxiation.
• When CO2 in a super-critical phase (which is common for CO2 pipelines) releases into open air, it
naturally vaporizes into a heavier than air gas and dissipates. During the February 22 event,
atmospheric conditions and unique topographical features of the accident site significantly
delayed dissipation of the heavier-than-air vapor cloud. Pipeline operators are required to
establish atmospheric models to prepare for emergencies
• Local emergency responders were not informed of the rupture and the nature of the
unique safety risks of the CO2 pipeline. As a result, responders had to guess the nature of the risk,
in part making assumptions based on reports of a “green gas” and “rotten egg smell” and had to
contemplate appropriate mitigative actions. Fortunately, responders decided to quickly isolate
the affected area by shutting down local highways and evacuating people in proximity to the
release. No fatalities were reported.
• This event demonstrated the need for:
o Pipeline company awareness and mitigation efforts directed at addressing integrity
threats due to changing climate, geohazards, and soil stability issues.
o Improved public engagement efforts to ensure public and emergency responder
awareness of nearby CO2 pipeline and pipeline facilities and what to do if a CO2 release
occurs. This is especially important for communities in low-lying areas, with certain
topographical features such as rivers and valleys".
August 8, 2024
Two employees killed when natural gas pipeline explodes
At approximately 3:30 p.m. on June 14, 2012, Employee #1 was performing hydro testing of two recently constructed and installed crude oil pipelines. The employee removed a pressure test manifold from a pressure test flange while the pipeline contained a pressure of 2000 psi. Employee #1 did not lock-out the pipe valves, nor bleed the pressure off of the line prior to removing the pressure test manifold. The employee was struck-by the pressure test manifold that was propelled by the stored pipeline pressure. Employee #1 was transported by the impact of the manifold for a distance of 40 feet. The steel pressure test manifold impacted the skull of the employee which resulted in injuries to the employee and subsequent death.
Source:OSHA.gov
August 4, 2024
PRESSURE TESTING FATALITY
At approximately 3:30 p.m. on June 14, 2012, Employee #1 was performing hydro testing of two recently constructed and installed crude oil pipelines. The employee removed a pressure test manifold from a pressure test flange while the pipeline contained a pressure of 2000 psi. Employee #1 did not lock-out the pipe valves, nor bleed the pressure off of the line prior to removing the pressure test manifold. The employee was struck-by the pressure test manifold that was propelled by the stored pipeline pressure. Employee #1 was transported by the impact of the manifold for a distance of 40 feet. The steel pressure test manifold impacted the skull of the employee which resulted in injuries to the employee and subsequent death.
Source: OSHA.gov
Note: Obviously the pipeline was not filled up complete;y with water and air was pressurized, resulting in the propelling of the pressure test manifold
July 30, 2024
Pipefitt er Struck by Pressurized Pipe and Killed
On March 6, 2018, a 49-year-old pipefitter was hit in the chest by a pressurized 12-inch diameter polyvinyl chloride (PVC) pipe during a hydrostatic pressure test of a fire suppression system. The sudden pipe movement was attributed to a pipe joint connection failure in a buried section of the pipeline. The failure was due to torque shear bolts at the joint connection that were not tightened, which was missed during the utility installation process and the work inspection prior to the incident.
Read the incident in this link
July 25, 2024
Employees Chemically Burned by Leaking Dimethyl Sulfate Pipe (leak caused by thermal expansion of pipeline)
At 11:30 a.m. on June 20, 2007, Employees #1, #2, #3, and #4, who worked for Scaffolding Company, and Employees #5, and #6, who worked for Plant Services Company, and Employees #7 and #8, who worked for a chemical manufacturer, were hospitalized after being exposed to dimethyl sulfate (DMS) in the ethoxylation area where it was used in reactors 4 and 5. Employee #7 was an operator who moved bags containing chemicals into the area in order to add it to reactor 4. Employee #8 was a mechanic that worked unplugging an auger at reactor 4.
Employees #7 and #8 started working at 7 a.m. at reactor 4. Employees #1, #2, #3, and #4 dismantled a scaffold at a platform at the reactors. Employees #5 and #6 removed and installed new insulation on piping at a platform at the reactors. The host employer did not become aware that employees were exposed to DMS until about 2 p.m., when workers were discovered having chemical burns. Employees worked on a raised platform around the two reactors. In order to enter and leave the area, they walked along a path between two the reactors that was only 30 inches wide, and a pipe that contained DMS which ran overhead between the reactors. The piping system normally operated at 5 psi, but thermal expansion of DMS caused pressures over 300 psi and caused a valve on the overhead pipe to leak this extremely hazardous compound down onto employees that worked beneath the pipe.
Source:OSHA.gov
July 21, 2024
FIRE AND EXPLOSION HAZARDS WITH THERMAL FLUID SYSTEMS
"Incidents relating to thermal fluid systems are unfortunately more common than we might realise,
and can be extremely serious. The fire and explosion hazards with thermal fluid systems have been
re-emphasised by recent incidents. These incidents have a direct bearing on the estimated 4,000 UK
companies that operate thermal fluid systems.
Water or steam can be used as heat transfer fluids, but when high temperatures are needed
organic fluids, which are capable of forming explosive atmospheres, are often used. Although
fire and explosion hazards of low flash point flammable liquids are generally recognised, similar
hazards with high flash point materials, such as thermal fluids, are often missed. These heat transfer
fluids are often handled at temperatures above their flash point.
However, many people are unaware that heat transfer fluids based on mineral oils
degrade over time. This degradation can cause the fluid’s flash point to decrease dramatically, so
that thermal fluids which were not flammable at the operating temperature when they were initially
installed may, over time, become flammable at the operating conditions. Also, high flash point
materials (such as thermal fluids), can form explosive mist atmospheres when handled under
pressure, even at temperatures below the flash point".
Read the article in this link.
July 16, 2024
EXPANSION BELLOW INCIDENT
"In this study, the explosion failure of a bellows expansion joint made of Type 304 stainless steel (UNS S30400) in a pipeline conducting methane (CH4) gas at 400 °C is analyzed. Using the simulation mechanical software, the behavior of the pipeline during the working condition was investigated.
Observations of the metallographic sections indicated that corrosion was involved in the cracking of the bellows that led to the explosion. After investigating the fracture surface, it was noted that the cracks occurred at dimples in the bellows. The presence of hydrogen sulfide (H2S) in the gas stream resulted in stress corrosion cracking".
Read the incident in this link