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H2 and O2 explosion learnings (UH explosion resultings in amputation)
Since gas use was integral to the UH accident and since compressed gas cylinders present serious safety issues, several specific examples of improper gas and gas cylinder usage are detailed here. 1. Cylinders in the laboratories adjacent to POST 30 as well as in several laboratories located in different buildings, contained Teflon tape on the CGA connection threads to the cylinder valve Membership Content
Employee injured in Wisconsin stadium explosion settles suit for $22M
He was working for a subcontractor on April 13, 2022, when a GC foreman used a flame torch to dry an area of the floor of an enclosed mechanical room beneath the football stadium as he and another worker were applying a flammable material to the floor. The torch sparked an explosion, and he was burned over 70% of his body when he tried to run from the room but stumbled, spilling primer on himself, according to court documents. He has since undergone surgeries and required extensive medical care. Utilizing an SMS needs to a CORE VALUE, not a government mandate
Image Souce: Flight Guardian Combustible Dusts and entry into Permit-Required Confined Spaces (PRCS)
Both OSHA PRCS standards define and quantify a Hazardous Atmosphere in terms of combustible dust...
The "note" seems to exempt us from having to actually measure the atmosphere, which is a good thing as I am not sure most facilities have the ability to measure dust concentrations. But that 5' distance is a heck of a lot of dust! Does your program permit this quantity of combustible dust to be suspended in the atmosphere of space? We always used "any visible dust" as our measure, as we had quite a few different combustible dusts with widely varying LELs. For example: VW Plant votes 73% to 27% for a union - Is this a measure of "culture"?
VW chose Tennessee for its new assembly plant because it is a "right to work" state. The union campaigns lost in 2014 and 2019, but last week, it won big (2,628 for and 985 opposed), at least based on the NLRB count so far. A few votes are being challenged, but nothing near the number needed to change the overall outcome.
Could this be viewed as a cultural indicator? We are told we can't measure culture; I'm afraid I have to disagree, but that is my opinion.
Do we read anything into the large gap between those FOR and those AGAINST? 73% to 27%
Safety Thought of the Week... Operating situations are richly varied
Some raw materials are sensitive to humidity; this valve sticks and is more demanding than its supposedly similar neighbor; that pump has broken down; this operation sometimes occurs at night and sometimes during the day, sometimes when it’s hot, other times when it’s cold, sometimes our co-worker is tall, sometimes he is short, we may be under pressure time-wise, etc. Thanks to their experience and abilities, operators will recognize these variations and try to adapt their way of working accordingly. Sometimes, they will detect that the situation is very far from normal and will seek help from their co-workers or their managers. Production occurs only because each person manages many sources of variation while executing his tasks, with expertise acquired through experience.
Source: The ICSI “Safety Culture” working group (2017). Safety Culture: from Understanding to Action. Issue 2018-01 of the Cahiers de la Sécurité Industrielle collection, Institut pour une Culture de Sécurité Industrielle (ICSI), Toulouse, France. Making Human Factors matter by REDUCING the opportunity for error
The story behind this picture is said to be a 19-year-old granddaughter's attempt at designing for her grandfather's dementia. Human Factors Engineering (HFE)!!! Making human factors matter by REDUCING the opportunity for error. It really can be this simple! Pic Credit: Amy Dalton Safety Management System (SMS) was stolen from the QMS/ISO era of Quality
If you have ever attended one of my SMS presentations or training courses, you know I am a huge Edward Demming fan. I started my career during the ISO 9001 era, which many call the "Quality Era." Do you remember Ford's slogan in the 1990s? "Quality is #1," and the ISO quality movement was considerably driven by automobile manufacturers such as Ford, GM, etc. But I was lucky, as my first plant manager believed in the ISO management system and decided that was exactly what "safety" needed as well. So we began to transform our "safety programs" into a "management system," adopting the very same principles of ISO quality management in the way we managed Safety, Health, and Process Safety. It did not hurt that this was 1993, one year after OSHA's Process Safety Management standard came out. We were also getting further in our commitment to becoming an OSHA VPP STAR workplace. All these "management systems" approach to managing safety collided; it was a lot to digest as a recent OSH graduate. So Westvaco sent me off to QA/QC training to understand the QMS; believe it or not, there were NOT any SMS training courses at the time. Although PSM was a hot topic, even those courses did NOT teach process safety management as a "management system" approach to managing process hazards. Yes, the name is in the title of the standard, but the SMS philosophies were just not part of these training courses. However, after my ISO training courses, I began to recognize the 14 elements of PSM (1910.119) were indeed an SMS for managing chemical processing risks and that the same approach was needed for Occupational Safety & Health (OSH) as well, and that is where our VPP journey was a game changer for me. But here is Deming’s 14 Points on Quality Management. We coverted these to our 14 points of SMS, as well as the 14 elements of our PSMS. I think you will see the similarities of how these 14 bullet statements play a dramatic role in building an SMS." Line Break gone bad (Hydrate)
The following incident is a precautionary example of the potential hazards of improperly depressurizing piping to remove a hydrate. During production operations, a control room operator observed a decrease in gas lift pressure supplied through a pipeline to a remote well location. The control room operator notified the onboard platform operators of the pressure drop and the possibility of a hydrate forming inside the 3-inch gas lift piping. The control room operator and platform operators planned to isolate and bleed the pressure to remove the possible hydrate. The control room operator from his station closed the pipeline shutdown valve (SDV) upstream of the manual flow control valve. Additionally, the platform operators physically closed the manual isolation valve upstream of the SDV, assumed the hydrate location, and departed the pipeline. The platform operators then started to relieve the pressure downstream of the hydrate location to atmospheric pressure without properly isolating the pipeline from the bleed point through a ball valve assembly attached to the 3-inch gas lift piping. The ball valve assembly consisted of a threadolet, threaded steel pipe nipples, two 1-inch ball valves inline, and a 90-degree elbow that pointed upward. With approximately 900 psi trapped behind the valve, the assembly separated from the threadless, striking one of the platform operators under the left armpit area, and causing bruising and swelling. The injured offshore worker was sent for medical treatment and was later released to full duty. The valve assembly could not be found and is suspected to have fallen overboard after striking the worker. Ever wonder how we can measure "management's leadership in safety"?
One of the finest men I ever worked for, Jim Krumholz, taught me this trick in 1999! Manager MUST attend the "safety training" their employees attend! Even if this manager would never participate in an entry into PRCS, perform HW, or even participate in a lockout, they need to understand the expectations of their team members and how safety integrates with their team's daily activities. They need to understand the REQUIREMENTS of these safety programs so that when they are out and about their Unit/Department and they come across these safety activities, they can IDENTIFY any deviations and INTERVENE at that moment (as this is their EXPECTATION). Imagine a manager walking by unsafe act(s) and never recognizing the deviation; they just validated that hazardous act/condition and may have never intended to. So, if your management team does not participate in safety training, they cannot "own the safety process/SMS." |
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