Ebook: Major Incidents

Ebook: Major Incidents in the Process and Energy Industries



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Ebook: Inherent Safety

Overview

This ebook describes some of the major incidents that have occurred in the process and energy industries during the last 150 years. The incidents were selected because "they changed everything". The following quotation to do with the sinking of the Titanic, could be made about any of the events listed here. 

The Titanic disaster suddenly ripped away the blindfolds and changed dozens of attitudes, practices, and standards almost literally overnight.

Two of the events referenced - The Great Eastern and Blackbeard - are actually non-events in that nothing actually happened. But the reasons for the absence of an incident provide valuable learnings.

The discussion for most of the incidents is divided into three sections: 

  1. The Event itself - a brief description as to what happened;

  2. Incident Analysis; and
  3. A review of the incident in the context of a Safety Management System (see next section).

There are, of course, many other incidents that could have been selected - unfortunately there is no shortage of instructive events, large and small. For example, the following did not make the cut:

  • Mumbai High North (but we do provide a Safety Moment to do with that event);
  • Three Mile Island;
  • and
  • Deepwater Horizon/Macondo

The specific industry in which the event occurred is not generally all that important. The causes of these incidents and the development of management systems to address them do not vary all that much from industry to industry. For example those working in the process industries can learn a good deal from the incidents to do with the largest ships of their time, the Great Eastern (1862) and Titanic (1912). Both ships were "unsinkable". One of them stayed afloat in spite of suffering major damage; the other sank even though the damage that she sustained was much, much less. Similarly, many of the risk analysis and management techniques that are now in use were first developed in the military and the nuclear power industry.

Ebook: Inherent Safety Ebook: Inherent Safety
Great Eastern - 1866 Titanic Sinking - 1912

Contents

Introduction
Elements of a Safety Management System
Great Eastern (1862) - The Unsinkable Ship
Spindletop (1901)
  The Event
  Incident Analysis
Titanic (1912) - The Unsinkable Ship
  The Event
  Incident Analysis
    Commercial Pressures
    Regulations
    Emergency Response
    Design Standards
    Complacency
  Safety Management System
    Management of Change
    Mechanical Integrity
    Emergency Response
Santa Barbara (1969)
  Long-Term Impact
  The Event
  Incident Analysis
    Follow the Rules
    Public Response
    Economic Loss
Bhopal (1984)
  The Event
  Incident Analysis
    Minimize
    Systems out of Service
    Sabotage
  Safety Management System
    Hazards Analysis
    Mechanical Integrity
    Emergency Response
Piper Alpha (1988)
  The Event
  Long-Term Impact
  Incident Analysis
    Performance-Based Standards
    Leadership
  Safety Management System
    Safe Work Practices
    Pre-Startup Review
    Records and Documentation
Valdez (1989)
  The Event
  Long-Term Impact
  Incident Analysis
    Captain’s Responsibility
  Safety Management Systems
    Mechanical Integrity
    Ultimate Work Authority
    Reporting Unsafe Work Conditions
Blackbeard
  The (Non) Event
  Incident Analysis

Other Materials

We provide a video to go wth this ebook.

At our Process Risk and Reliability Management blog site and at our Safety Moments site (here is an example) we often discuss the lessons to be learned from major incidents. Feel free to join in the discussion.

Purchasing Information

This ebook comes as part of a package; it includes:

  • The video
  • The ebook
  • The storyboard to go with the video
  • A test

About the Author

Ebook: Inherent Safety

Ian Sutton is a chemical engineer with over 40 years experience in the process industries. He has worked on the design and operation of offshore platforms, refineries, chemical plants, pipelines and minerals processing facilities.

 


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