A fire in a furnace in a crude unit in a refinery in the USA has critically injured a worker. He apparently inhaled superheated air. I can imagine the terrible internal burns he must have received. The cause is being investigated.Read about the accident in this link.
OSHA has a good technical description of refinery processes and their safety hazards. Read it in this link.
June 9, 2011
June 8, 2011
Learning lessons
The investigation of the refinery tank explosion that killed 4 persons is underway. A BBC news item mentions the following:
"Maintenance work had been carried out on a 730 cubic metre storage tank which exploded on Thursday evening, damaging an adjacent vessel.Dr Ivan Vince, a safety, health and environmental specialist at ASK Consultants told BBC Radio Wales that the investigators will look at two types of causes.
"The first part of the investigation is narrowing it down to exactly what happened and what were the immediate causes," he said. It could be some time before the cause of the explosion is known."Then the route cause investigation looks at the bigger picture like the safety management systems, the adequacy of the training and procedures in general or deeper, the status of the safety culture, the working environment in general."I have never come across a situation where there have not been lessons to be learnt. The problem is lessons are learnt but then forgotten when personnel change."
The last statement is highly significant. Organisations should implement and sustain a process safety knowledge management system.Otherwise, as people change, their knowledge goes with them.
Read the article in this link
"Maintenance work had been carried out on a 730 cubic metre storage tank which exploded on Thursday evening, damaging an adjacent vessel.Dr Ivan Vince, a safety, health and environmental specialist at ASK Consultants told BBC Radio Wales that the investigators will look at two types of causes.
"The first part of the investigation is narrowing it down to exactly what happened and what were the immediate causes," he said. It could be some time before the cause of the explosion is known."Then the route cause investigation looks at the bigger picture like the safety management systems, the adequacy of the training and procedures in general or deeper, the status of the safety culture, the working environment in general."I have never come across a situation where there have not been lessons to be learnt. The problem is lessons are learnt but then forgotten when personnel change."
The last statement is highly significant. Organisations should implement and sustain a process safety knowledge management system.Otherwise, as people change, their knowledge goes with them.
Read the article in this link
June 5, 2011
A piece of cloth causes chlorine release!
An interesting incident is mentioned by Stephen P. Andrew, T. Kim Parnell, Robert Caligiuri, Lawrence Eiselstein of Parnell Engineering and consulting:
"A process upset at a chlorine production facility resulted in a release that forced the partial evacuation of a nearby town. Investigations revealed that the events commenced with the failure of a shell and tube heat exchanger used to condense chlorine gas. Post-incident inspections revealed a cloth at the liquefier coolant inlet that accelerated the flow in that region, causing certain tubes to be breached. As a result, the water-based brine liquefier coolant was entrained in the chlorine process stream, forming a highly acidic oxidizing mixture. This corrosive mixture then flowed to the chlorine storage tanks destroying an elbow in the tank inlet piping and rendering the tank shut-off tank valve ineffective, thus allowing chlorine to vent into the atmosphere".
Read the detailed report in this link.
"A process upset at a chlorine production facility resulted in a release that forced the partial evacuation of a nearby town. Investigations revealed that the events commenced with the failure of a shell and tube heat exchanger used to condense chlorine gas. Post-incident inspections revealed a cloth at the liquefier coolant inlet that accelerated the flow in that region, causing certain tubes to be breached. As a result, the water-based brine liquefier coolant was entrained in the chlorine process stream, forming a highly acidic oxidizing mixture. This corrosive mixture then flowed to the chlorine storage tanks destroying an elbow in the tank inlet piping and rendering the tank shut-off tank valve ineffective, thus allowing chlorine to vent into the atmosphere".
Read the detailed report in this link.
June 3, 2011
Tank explosion in refinery
An incident in a refinery in the UK has reportedly killed 4 persons. The Telegraph reports the following:
"Four people were killed yesterday evening when a 730 cubic metre storage tank exploded in what appears to have been a tragic industrial accident.This is the first serious accident at the plant. Previous incidents include a small fire caused by a hydrogen leak in 2001 and two fires in 2003 in which no one was seriously injured.John Davies, leader of Pembrokeshire Council, praised the refinery's safety record saying: “I have known it all my life and this is first time as far as I am aware that a life has been lost in similar circumstances. It has an exceptional (safety) record.”
The refinery is one of the largest in western Europe, employing 1,400 people".
Read the article and see the video of the tank and spokespersons comments in this link We have to wait for the investigation to see why this happened.
See some photos of the explosion in this link.
Read the article and see the video of the tank and spokespersons comments in this link We have to wait for the investigation to see why this happened.
See some photos of the explosion in this link.
Understand the basics of chemical safety while managing change
The International Program on chemical safety has a good basic write up on chemical safety - corrosive materials, incompatibilities, materials of constructions, storage and effects of chemicals on concrete. Many times, we tend to forget the basics when managing change, that later results in an incident.
Read the article in this link.
Read the article in this link.
June 1, 2011
Welder killed in accident
A regulator of a gas cylinder apparently malfunctioned and came out, killing a welder on the spot at an accident in a factory in Odisha. Times of India reports the following:
"In the accident, Rawat`s leg flew 50 m away from the spot, while the palm of his left hand is still missing, Ponda sub-divisional fire officer Parab said. Quoting the factory officials, Parab said that the blast was the result of a broken knob of a gas cylinder with which Rawat was cutting metal sheets at the Kundaim-based iron plant. "As the cylinder's knob was broken, the force of the gas centered around the knob and moved out with a tremendous force that caused the blast," Parab said."
Treat your gas cylinders and their fittings with respect. I keep observing scant disregard for the handling and safe usage of gas cylinders at many sites. Read the article in this link.
"In the accident, Rawat`s leg flew 50 m away from the spot, while the palm of his left hand is still missing, Ponda sub-divisional fire officer Parab said. Quoting the factory officials, Parab said that the blast was the result of a broken knob of a gas cylinder with which Rawat was cutting metal sheets at the Kundaim-based iron plant. "As the cylinder's knob was broken, the force of the gas centered around the knob and moved out with a tremendous force that caused the blast," Parab said."
Treat your gas cylinders and their fittings with respect. I keep observing scant disregard for the handling and safe usage of gas cylinders at many sites. Read the article in this link.
Process safety and metrics - don't get lulled into a false sense of security!
There has been a lot of discussion on how to make process safety management work and new initiatives like risk based PSM and others have been suggested. These include metrics for tracking of process safety performance. The old adage " what cannot be measured cannot be managed" is true for process safety, too. However, I observe a stark difference between metrics for measuring PSM performance and UNDERSTANDING that measurement. In many of today's chemical companies, the board of directors often do not have a person competent to analyze the PSM metric that is being displayed. With the net result that the number being displayed is just that - a number. For example, if a metric that is being displayed to the board is the pending items from a process safety audit, the actual number may be less but its severity may be very high. What is the solution? There is only one answer - the board of directors of chemical manufacturing companies should ensure that there is someone competent to analyse the PSM metrics for them.
May 29, 2011
Air and cyanide - a potent combination!!
An incident that occured in a gold treatment plant in Australia has lessons to be learnt for all of us in the chemical industry. In this incident, a cyanide line was being cleared of a choke using plant air. The hose was left connected to the system after the choke was cleared. As the blockage was not totally cleared, cyanide pressure went up more than the air pressure and cyanide entered the air system. Two employees were treated for cyanide poisoning.
Read about the incident in this link. .
Read about the incident in this link. .
May 27, 2011
Transportation of hazardous cargo - How ready are you?
As India's highways develop rapidly, more and more transportation of hazardous chemicals take place on our highways. Many of you will agree that there is still a lot more to do to improve the safety while transporting hazardous cargo. 35 years ago, in the US, there was an accident involving a road tanker carrying liquid ammonia, which reportedly killed 7 persons. The cause of the accident was reported to be speeding, sloshing of the partially filled tanker, and inadequately designed guard rails. The lessons learnt from that accident are still valid today. A blog post mentions the following about the reasons for the accident:
- "The truck was driving at or near 53.6 mph when it took the curve taking it from the Loop to the Southwest Freeway. We’ll probably never know why Schmidt was speeding when he exited the Loop.
- Back then, barrier systems on routes that carry hazardous materials were not capable of redirecting vehicles that transport dangerous materials. The bridge rail at that stretch of road was more equipped to contain automobiles than trucks carrying hazardous cargo.
- The ramp where the crash occurred opened in 1963.
- Schmidt, who had been employed by Transportation Co. of Texas since 1975, had driven commercial vehicles since 1969. He had left Corpus Christi between 5 and 5:30 a.m. for the Tenneco plant and had made at least 10 trips to Houston carrying liquid loads.
- It’s said that this crash led to restrictions on the transportation of hazardous cargo through Houston, but that’s not necessarily the case. According to the NTSB report, the city had been using Loop 610 as a hazardous materials route since 1970."
May 24, 2011
Blast in storage of raw materials for explosives
Times of India has reported a blast in a stores containing raw material for manufacturing explosives, in Nagpur. The reason is being investigated.. According to the article, "The blast that obliterated at AMA Industries' store in Bazargaon on Thursday morning and caused a tremor in the city, also left those in this business confused. The structure housed raw materials for making commercial explosives and did not have finished products. Experts say the thumb rule is raw materials usually would not explode unless bound into a single explosive even in case of a fire. They can burn resulting in a massive fire but not cause a blast, said industry players on condition of anonymity. "Various chemicals like ammonium nitrate, aluminium powder, sulphur when mixed in specific proportions make an explosive. However, all such chemicals stored at different places even in a single premises do not explode under normal fire. A safe distance has to be maintained for storing each of them," said an explosive maker. Aluminium powder is known to catch fire if water is sprayed on it but still a blast is not heard of, he added".
Read the article in this link
Read another article on the effect of the blast wave in this link.
Read the article in this link
Read another article on the effect of the blast wave in this link.
May 22, 2011
Mechanical seals and flushing/cooling systems
(Diagram Courtesy Flowserve) Mechanical seals need to be understood by plant operators for their proper operation. Many times, the operations and maintenance personnel are at loggerheads because many of the operation personnel do not fully understand the principles of seal flushing/cooling systems. Flowserve has a very good mechanical seal piping plan document in this link which clearly explains the functioning for various types.
Aviation safety and Chemical Process Safety- Different approaches!
I was reading a press release by the Press Information Bureau about the improvements made by the civil aviation minsitry one year after the fatal Mangalore air crash. The report mentions the following:
"A Civil Aviation Safety Advisory Council (CASAC) was formed on May 28, 2010 with the mandate to strengthen aviation safety environment through synergisation of available expertise in areas of airlines, airworthiness, operations, air navigation, aerodromes, aircraft engineering, human performance. Special invitees to the Council include FAA, ICAO Experts, IATA, Airbus, Boeing, Bombardier etc. This is an ongoing initiative under the Chairmanship of Secretary (Civil Aviation). The Council gets its technical inputs from working groups covering Operations (Fixed wing and helicopter sub-Groups), Aerodromes, Air Navigation Services, Airworthiness General Aviation and Helicopters. Based on the reassurance drive several issues in the three areas of aerodromes, operations and airworthiness came up. Immediate actions to address the deficiencies have been taken up during the past one year. Several safety related circulars have been issued and implementation ensured. These include presence of Cabin crew in cockpit in case of one pilot leaving the cockpit, Cabin Crew to interact with pilots on intercom during period of lean cockpit activity, in the event of incapacitation of PIC, copilot to take over control and in the event of PIC not responding to calls of copilot regarding ‘go around’, assertiveness by copilot to be encouraged. Regulatory provision for penal action for reporting for duty with alcohol consumption has been made. Pilots are being subjected to Breath Analyser test prior to flights. License are being suspended for three months in case of first BA positive and on second BA positive instance, the licence is cancelled.
In a move to step up the quality of training Captains, the period of Instructorship/ Examiner-ship has been restricted to 5 years with proficiency check every 2 years. Increased oversight for selection of trainers, quality of training imparted by trainers, integrity of simulator training have been introduced. Breath Analyser Test has been mandated for approval of Training Captains and Pilots with BA ‘positive’ report have been debarred from becoming Training Captains. Existing Training Captains if found BA ‘positive’ are debarred from training Captain list for three years.The process for approval of foreign pilots has been made stringent wherein background checks are being done to ensure that these pilots have accident free record. The experience requirements for the foreign pilots have been enhanced and the pilots are subjected to Proficiency Checks before approval is granted by DGCA. These pilots are being subjected to same medical standards as the Indian pilots." Read the press release in this link
While appreciating the efforts taken by the Government in improving air safety, I could not help comparing the status of process safety management in India after the Bhopal disaster, when compared to developed nations. The PSM rule which is mandatory in USA since 1992 is still not mandatory in India......
"A Civil Aviation Safety Advisory Council (CASAC) was formed on May 28, 2010 with the mandate to strengthen aviation safety environment through synergisation of available expertise in areas of airlines, airworthiness, operations, air navigation, aerodromes, aircraft engineering, human performance. Special invitees to the Council include FAA, ICAO Experts, IATA, Airbus, Boeing, Bombardier etc. This is an ongoing initiative under the Chairmanship of Secretary (Civil Aviation). The Council gets its technical inputs from working groups covering Operations (Fixed wing and helicopter sub-Groups), Aerodromes, Air Navigation Services, Airworthiness General Aviation and Helicopters. Based on the reassurance drive several issues in the three areas of aerodromes, operations and airworthiness came up. Immediate actions to address the deficiencies have been taken up during the past one year. Several safety related circulars have been issued and implementation ensured. These include presence of Cabin crew in cockpit in case of one pilot leaving the cockpit, Cabin Crew to interact with pilots on intercom during period of lean cockpit activity, in the event of incapacitation of PIC, copilot to take over control and in the event of PIC not responding to calls of copilot regarding ‘go around’, assertiveness by copilot to be encouraged. Regulatory provision for penal action for reporting for duty with alcohol consumption has been made. Pilots are being subjected to Breath Analyser test prior to flights. License are being suspended for three months in case of first BA positive and on second BA positive instance, the licence is cancelled.
In a move to step up the quality of training Captains, the period of Instructorship/ Examiner-ship has been restricted to 5 years with proficiency check every 2 years. Increased oversight for selection of trainers, quality of training imparted by trainers, integrity of simulator training have been introduced. Breath Analyser Test has been mandated for approval of Training Captains and Pilots with BA ‘positive’ report have been debarred from becoming Training Captains. Existing Training Captains if found BA ‘positive’ are debarred from training Captain list for three years.The process for approval of foreign pilots has been made stringent wherein background checks are being done to ensure that these pilots have accident free record. The experience requirements for the foreign pilots have been enhanced and the pilots are subjected to Proficiency Checks before approval is granted by DGCA. These pilots are being subjected to same medical standards as the Indian pilots." Read the press release in this link
While appreciating the efforts taken by the Government in improving air safety, I could not help comparing the status of process safety management in India after the Bhopal disaster, when compared to developed nations. The PSM rule which is mandatory in USA since 1992 is still not mandatory in India......
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