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www.jrc.ec.europa.eu

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Stimulating innovation

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eMARS Reporting and Analysis, and Prospective Improvements

Maureen Heraty WoodEC-JRC-IPSC Major Accident Hazards Bureau

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Presentation Outline

• General updates to the JRC-MAHB work programme• eMARS and Lessons Learned Activity Outlook• AIDA (Accident Information and Data Analysis) management

system• Prospective improvements to eMARS

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General updates to the MAHB work programme

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JRC-MAHB Milestones for 2015 and beyond

Accident Analysis and Lessons Learned

Risk Assessment Training and Good Practice Exchange

•Lessons Learned Bulletin and special studies •Enhanced accident analysis tools•New improved eMARS•Accident analysis benchmarking project•AIDA – Accident analysis tool•Lessons learned exchange internationally•ER lessons learned study

•ADAM consequence analysis model

•GIS-ARA/ADAM online tool•Land-use planning scenarios

handbook•Chemical hazard identification

and mapping•eSPIRS establishments

database

•Seveso inspections exchange and tools•Seveso training in Neighbourhood countries (DG-ECHO collaboration)•Collaborations with partners – (OECD, UNEP, UN ECE, UNEP-OCHA)

Knowledge management portal “MINERVA”Horizontal

Projects launched or in developmentRisk Assessment

•ADAM consequence analysis model

•GIS-ARA/ADAM online tool•Land-use planning scenarios

handbook•Chemical hazard identification

and mapping•eSPIRS establishments

database

Training and Good Practice Exchange

•Seveso inspections exchange and tools•Seveso training in Neighbourhood countries (DG-ECHO collaboration)•Collaborations with partners – (OECD, UNEP, UN ECE, UNEP-OCHA)

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eMARS and Lessons Learned Activity Outlook

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Current eMARS status (published reports) - 2015

https://emars.jrc.ec.europa.eu

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Current eMARS reports online and in process - 2015

• 850 reports published online, 979 in the system (129 in process)

• Delays mostly due to translation and confirmation process following translation

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eMARS – General Update - 2015

• What’s New in eMARS• A number of accidents involving explosives are in translation including two

investigation reports• Buncefield and Toulouse confirmed in 2014• Several important Dutch accidents to be reported soon (Chemie-Pak, Oldfeld,..)

• Several countries have invested time in updates and completing reports

• Bulgaria has notified Gorni Lom (2014) but investigation is ongoing.

• New database links to add on eMARS Home Page • DECHEMA (Germany) http://www.dechema.com/process_net/en/incident_db.html

• High Pressure Gas Institute (Japan)

https://www.khk.or.jp/english/accident_reports.html#top

• Lessons learned analysis continues to be limited in some reports.

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Recent and future publications

Lessons Learned Bulletins – 2014/2015

Natech accidents Accidents related to ageing

http://ipsc.jrc.ec.europa.eu/index.php/Information-material/503/0/ (Temporary)

Lessons Learned Bulletin

2nd Semester 2015

Accidents involvingExplosives

Published December 2015

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Special projects underway 2015/2016

• Expert Collaboration on Accident Analysis Benchmarking Study –5-6 November 2015

More information at: https://minerva.jrc.ec.europa.eu/en/shorturl/minerva/accident_analysis_benchmarking_project

• AIDA – Accident data management and analysis programmeCompletion of Phase 1 development

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AIDA - Accident data management and analysis programme

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AIDA project

Programme in development for managing and analysingaccident data from any source

Supported by funding from DG-ECHO and JRC

AIDA will give added options for MAHB chemical accident work1.The option of giving a country/organisation an accident data collection system

- AIDA basic (aka “eMARS Light”)-a basic reporting form on the eMARS model

- Designed for countries who need an accident data collection system

2. The ability to beta test new reporting features for eMARS without touching eMARS

3. The ability to collect and manage non-eMARS accident data for analysis

4. The possibility to apply different analytical models to data analysis

5. The ability to save (in one location) all models, data conversions, fields, tablesand results of JRC accident analyses

As it is developed, parts of the AIDA programme will be made available onlinefor individual use by EU/OECD Member States/other partners.

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2015-2016

Phase 1 - AIDA basic (“eMARS

light”) completed

2016-2017

Phase 2 – Implementation in AIDA of

proposed eMARS restructuring for

beta-testing

2017-2019????

Implementation of proposed eMARS field

changes in AIDA and beta-testing

Other potential work (variable time frame)

- Implementation of selected analytical models in AIDA

-Accident analysis support tools (Excel worksheets for extracting and manipulating data), etc.

AIDA Development plan

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eMARS Prospective Improvements

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eMARS Re-Design – Past developments

Modification and potential restructuring and redesign of eMARShas been in the planning process for the past several years.

2009Online eMARS

established

2012 - 2013 External study of potential eMARS

changes (DG-ENV funded)

2013 EU - OECDSummary of new vision for eMARS

presented

JRC launches Lessons Learned Bulletin

JRC Enlargement workshop on

accident/risk analysis

2014 –Development of

conceptual design (MAHB)

2000 Concerns expressed by MS/OECD about lessons learned reporting in eMARS

OECD requests JRC to produce lessons learned

summaries

2011EU - OECD

New eMARSstrategy

presented

2012Expert Workshop

on MAHB Accident

Analysis & Lessons Learned

Initiatives

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Establishment of online eMARS - 2009

Several problems in the front and backend of the new eMARS

Limitations in functionality identified by MAHB and MS since 2010. • Lacking basic administrative tools, e.g., ability to download into Excel

• Tracking of modification history

• Alphanumeric consequence fields (deaths, injuries no longer quantifiable)

• Mandatory fields made optional (consequences again)

• Etc.

Design of form fields maintains and adds to (in many cases) weakness in the original MARS reporting form

• Too many checkboxes, mismatched/inappropriate field options

• Discontinuity of accident description

• Form does not follow lessons learned reporting logic

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2012-2013 eMARS Improvement Activities

2012 Expert workshop on MAHB Accident Analysis & Lessons Learned Initiatives to obtain feedback on AIDA initiative

External study of eMARS re-design options (DG-ENV funded) –outcomes (completed 2013)

• Recommendations to make reporting process more practical and user-friendly for reporters

• Recommendations to encourage better lessons learned analysis and reporting

• Recommendations to improve multiple choice field options to correspond with typical accident events and search needs

• Recommendations to make the accident report easier to read and follow

• Recommendation for XML data import - export tool

Not published externally. Intended to stimulate internal discussions on potential changes.

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Current eMARS improvements underway2016

Phase 1 (2016) – Re-programming into new IT platform

• Re-programming of eMARS into the new MINERVA platform• EMARS has the highest security programming possible now.

• Re-programming required to adapt to new servers (who are the only ones with JRC security certificates)

• Improve accident administration functionality (MS/MAHB)

• No or very few changes to the form itself

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Future improvement timeline 2016-2017

Phase 2 (2016 – 2017 ) – eMARS Form Re-organisation

• Re-organisation of form in AIDA for EU/OECD beta-testing

• No changes in eMARS itself yet …

• New emphasis on telling the story • Encourage one continuous free text description of the accident• Make free text the prominent feature in input and output views• Re-order tabs to reflect a logical accident sequence• Provide advice in tool tips for completing the form• Multiple choice options still available but less prominent• Accident reporting handbook with models for eMARS reporting• New and consistent search options for both PUBLIC and ADMIN• Improved list view for Admin and Public

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Example: Improved Status Options for List View

NEW STATUS OPTIONS*NEW CREATEDNEW REVISION

UNDER INVESTIGATION

IN TRANSLATION

ONLINE/PUBLISHED

New status options (in bold)

likely to be proposed for the

PUBLIC view.

Additional options for ADMIN

review similar to eSPIRS.

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Example Re-organisation: Free Text Entry

Existing free text entry points in eMARS – Total of 8 free text entry options – Creates a serious discontinuity in the accident story

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Example: New emphasis on Free Text

“Please give relevant background information about the site and unit(s) where the accident occurred, and what was happening when the accident occurred. Then give the sequence of events starting with the initiating event until consequences. If you find it easier to include a description of the emergency response and all consequences here, please do so. Alternatively you may provide this information in TAB 5: EMERGENCY RESPONSE and TAB 6: CONSEQUENCES.

<Click here to keep ACCIDENT BACKGROUND AND SEQUENCE OF EVENTS OPEN as a side bar>

• Reporters are encouraged to tell the story “in one go”, i.e., in the Accident Description free text space in the Accident Description Tab.

• Accident description (“the story”) can be continually visible and scrollable as a

reference while working with different tabs

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Example: Scrollable side bar containing accident “story”

Accident Description:On August 22nd, just after shift handover one of our operators detected a spill of n-heptane into the sewer. The total amount was 20 mton and was caused by a wrong connection of a hose. One of our distillation-columns was in start-up mode. The bottom stream was recirculated over the tank farm back to the feed. The morning of August 22nd, the panel operator instructed one of the operators to change the hose connection to a different line in order to run off to a tank. The operator isolated the circulation, blew the hose empty and disconnected it. He then moved the hose under the manifold and picked it up on the other side to connect it to a different line. From what we now know, he must have picked up. another hose and connected the …

Disclaimer: This is a visualisation of the concept. Actual implementation may be different.

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Example: Emphasize free text in the public view

The Current View

Where is the rest of the story???

The check boxes go on and on and on …

Page down about 7 pages and you start getting the rest of the story(but only in bits).

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Example: Public view – what we would like to see

+ Major Occurrences

ReleaseFluid release to groundFluid release to waterGas/vapour/mist/etc. release to airSolid release to airSolid release to groundSolid release to waterNot known/not applicable

X FireX Conflagration (a general engulfment …)

Fireball (burning mass rising in air …)Flash fire (burning vapour cloud …)Jet flame (burning jet of fluid …)Pool fire (burning pool of liquid …)Not known/not applicable

- Major Occurrences

Disclaimer: This is a visualisation of the concept. Actual implementation may be different.

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Future eMARS improvement 2017-2018

• MS/EC will also need to make a choice• Implement re-organisation of form into eMARS (i.e., changes that do not

require a formal EU Implementing Decision)?• Hold changes until form field changes are also agreed and implement all

changes at once with EU Implementing Decision?• Do Nothing – Leave everything in AIDA only?

At the same time Phase 3 development is planned to continue in AIDA

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Phase 3 – Development of modifications to eMARS input fields• If all goes well with Phase 2 …• Introduce field changes in AIDA for EU/OECD beta-testing and feedback

Changes under considerationAdd Seveso III, facilitate administration, clarify and clean-up Change of approach to describing “Initiating Event” and “Major Occurrences” fieldsMultiple choice for “Unit Involved”; more logical choices for “Equipment Involved” fieldsMore precise fields for “Emergency Response” TabMore appropriate fields for “Consequences” TabDifferent organisation and more logical choices for “Causes” TabNew “Corrective Measures” Tab“Lessons Learned” topics organised under headings “Technical” and “SMS” (multiple choice, possible to choose which SMS element)Some additions could be mandatory, some could be optional

Future eMARS improvement 2017-2018

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Example 1: Description of Event

• Different definition of initiating event asthe start of the sequence of events (e.g., start-up, overfill, wrong substance, etc.)

• The possibility of identifying the Loss of containment event

• “Major occurrences” replaced by “dangerous phenomena”.

INITIATING EVENT (Describe)Free text box

LOC EVENT (Describe)Free text box

DANGEROUS PHENOMENA (Dropdown list)

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Should the Environmental Consequence section be reviewed? (from JRC study 2013 – presented to EU/OECD)

• Currently no reference to environmental mediums, …• Air pollution• Water pollution• Soil contamination

• Rather eMARS lists conservation areas(e.g., 4 different kinds of shore/beach terrain!)

• Does not have categories to capture anything other than spatial impacts, e.g.,• Fishkills• Drinking water/ground water contamination• Clean-up costs, etc.• The “other” field is the second most used category

• No report uses the “quantity” field (what to put??)29

Example 2: Environmental Consequences

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Example 2: Environmental Consequences

The Current View

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TYPE OF ENVIRONMENTAL IMPACT MAGNITUDE(How much?)

UNIT OF MEASURE

EXPLANATION OR COMMENT

RIVER/STREAM/TRIBUTARYPORT/HARBOUR/DOCKSIDE/JETTYPOND/LAKE/RESERVOIRBEACH OR SHORELANDMARSH OR SWAMPLANDOFFSHOREGROUNDWATER*DRINKING WATER*SOIL*DRAINAGE OR SEWAGE SYSTEM*NATURA 2000 SITE (EU)*CONSERVATION AREA (OTHER THAN NATURA 2000)*RECREATION AREA*MARINE OR TERRESTRIAL WILDLIFE KILLED*MARINE OR TERRESTRIAL WILDLIFE INJURED*OTHER

Countries often have other criteria not captured by the current eMARS form

• Fish kills (tonnes of fish)• Elevated contamination levels

• Groundwater/drinking water contamination

• Soil contamination

(Results of MAHB Study, 2013, as reported to

EU/OECD)

*POTENTIAL NEW CATEGORIES

Example 2: Environmental Consequences

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Considerations in implementation

Change have disadvantages as well as advantages:

• Few challenges to EC or reporters in Phase 1. • Changing IT platform brings a lower security risk/enhanced functionality

• Challenges in Phase 2. • Few big challenges foreseen - EU beta test feedback will guide how much &

direction of change.

• Whatever changes are decided, data fields remain the same.

• Change of location and public view of information can be automated but could be some unforeseen issues

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Considerations in implementation

Advantages and challenges in Phase 3 -• Important challenges in Phase 3

• Field changes require an EU Implementing Decision (Legal change)

• Agreement with countries on changes to specific fields

• Alignment of agreed changes with country databases (if similar to eMARS)

• Transfer of old data into new structure (admin and public view)

The beta test process will ask countries to give their feedback on these challenges.

Decisions will be based on consensus of EU Member States• Final results almost certainly will be a compromise.

• Some decisions could require EC to find individual solutions for individual Member States.

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eMARS Re-Design – Past and Future Estimated time frames

2009 Online eMARS

established

2011 – CCA - OECDNew accident

reporting strategypresented

2012 - 2013 JRC report (DG-ENV funded) on potential

eMARS changes

2013 – CCA - OECDSummary of new vision for eMARS

presented

2014 – Development of conceptual design

(MAHB)

2016-2017-Launch Phase 1.

Transfer of eMARSto MINERVA portal

-Development of AIDA application

-Launch Phase 2. Reorganisation of eMARS fields in AIDA for beta testing

2017-2018MS beta testing and feedback of eMARS

modifications in AIDA

2018-2019Implementation of

agreed Phase 2 changes in eMARS

Launch Phase 3. modifications in

AIDA for beta test?

2019 - ?implementation

decision??

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Thank you for your kind attention!

351/11/2016

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Thank you for your kind attention!

361/11/2016