bp texas explosion
DESCRIPTION
The explosion at BP Texas refinery taught the oil & gas industry an invaluable lesson. Process safety performance cannot be measured using LTIs!! This case study could be used to trigger some useful, practical discussions with your offshore employees.TRANSCRIPT
The USA's third-largest refinery, with a processing capacity of 470,000 barrels per day of oil
Source courtesy: Internet
The explosion on Wednesday 23-03-2005, afternoon at the BP (Research) plant in Texas City, Texas, outside Houston, killed more than 14 people.
BP Texas City Fire & Explosion
• 14 fatalities and 170 injured;
• Biggest BP refinery covers 1200 acres and produces11 million gallons of petrol a day;
• Third largest refinery in US;
• Fire and explosion occurred in the isomerization unit of the refinery.
The Isomerization Process
• BP Isomerization unit:– Isomerization process increases the Octane rating of
Gasoline by which straight chain HCs are converted to branched chain HCs;
– Raffinate splitter tower separates light & heavy gasoline components;
– Raffinate: the portion of the original liquid that remains after the other components have been dissolved by a solvent
– Raffanate consists of BTX, Hexane & Cycloheptane and are highly flammable
Source courtesy: CSB Video animation
What happened?• Raffinate splitter tower was overfilled with liquid
due to errors in instrumentation & flaws in start-up procedures;
• The tower was over heated, pressurized and pressure relief operated;
• HC flowed into the BD drum & stack;• HC overflowed through top of BD stack forming
a pool below; and• The vapour cloud formed resulted in a VCE.
The animated sequence of events
CSB Animation Video6m15s
You can get this great video and animation from CSB ‘free of charge’ if you write to them
Raffinate Splitter Blowdown Drum and ISOM Unit after explosion
BP Texas City ExplosionBefore and After
Source courtesy: Internet
Source courtesy: Internet
Source courtesy: Internet
The devastating power of explosions!! It can virtually level anything. Only blast walls can mitigate the effects. Source courtesy: Internet
Source courtesy: Internet
Firefighers and rescue personnel search the rubble for victims following an explosion at the BP-Amoco plant in Texas City.
BP Texas City ExplosionBP Fatal Accident Investigation
• Loss of Containment• Raffinate splitter start-up
procedure and applicaton of knowledge and skills
• Control of work and trailer siting
• Desgn and engineering of the blowdown stack
The report identified four critical areas:
BP Texas City ExplosionBaker Report
The report identified numerous failings in equipment, risk management, staff management, working culture at the site, maintenance & inspection & general health & safety assessments.
• BP management had not distinguished between “occupational safety” & “process safety”
• Their metrics, incentives, and management systems focused on measuring & managing occupational safety & confused improving trends in occupational safety statistics for a general improvement in all types of safety.
• An employee survey showed that managers & white collar workers had a rosier view of process safety culture than blue collar operators and maintenance techs.
BP Texas City ExplosionUS Chemical Safety Board Report
• The effectiveness of the safety management system at BP Texas refinery
• The effectiveness of BP North America’s corporate safety oversight of it’s refining facilities
• A corporate safety culture that may have tolerated serious longstanding deviations from good safety practice
An interim report cited serious concerns about:
• Cost cutting and a ‘cheque book’ mentality
• Failure of all levels of BP management including the board
The final report headlines two major issues:
What went wrong?
• BP Management over-looked warning signs of a possible catastrophic accident;
• BP Management had a typical ‘Cheque-Book mentality’;
• Antiquated equipment design;
• Siting of occupied trailers near ISOM unit; and
• Human errors.
Source courtesy: CSB Video animation
Source courtesy: CSB Video animation
Fines & Warnings ignored!!
• The Occupational Safety and Health Administration fined the refinery nearly $110,000 after two employees were burned to death by superheated water in September 2004.
• Another explosion forced the evacuation of the plant for several hours last March. Afterward, OSHA fined the refinery $63,000 for 14 safety violations, including problems with its emergency shutdown system and employee training.
Key Lessons Learnt…
• Learn from organization memory;• If no accident has occurred till today, that
does not mean that no accident is going to happen!
• Monitor process safety performance using appropriate indicators;
• Invest sufficient resources to correct problems; and
• Maintain an open & trusting safety culture.
Key lessons learnt
• Ensure that non-essential personnel & work trailers are located away from hazardous process areas;
• Ensure equipment & procedures are maintained up to date; and
• Carefully manage organizational changes and budget decisions to ensure safety is not compromised.