Engineering Safety:
Going Lower - Reducing Risk, Enhancing Projects
Howard Thompson – February 2013AMEC Brownfield Projects & Operations Management - Technical Safety Manager
AMEC Europe – Head of Engineering Assurance & Governance
1
Outline of Presentation
Explore some of the trends that influence Engineering Safety
Explore some of the limitations of Hazard & Risk Management as an approach to Engineering Safety
Outline the principles of an Inherently Safer approach
Consider the organisational implications in developing an Inherently Safer approach to Engineering Safety
2
More Recently ...
4
The Hoover Dam:
112 people died
during construction
Attitudes to Hazards
and Risks are
constantly evolving
Trends in Occupational Safety
0
1
2
3
4
5
1993
1995
1997
1999
2001
2003
2005
Inc
ide
nts
pe
r 2
00
,00
0 w
ork
ho
urs
API
Bayer
BP
Chevron Texaco
Concawe
ConocoPhillips
Dow
DuPont
ExxonMobil
OMV
Shell
Trend Line
5
6
Unrevealed Safety Issues
• Despite improving HSE Performance indicators, the Texas City refinery suffered a major event in May 2005 … and a second event two months later …
OSHA Recordable Incident Frequency (RIF)
Texas City refinery: From 1.73 (1999) to 0.64 (2004)
API US refining average: 0.84 (2004)
BP Global: 0.53 (2004)
• Occupational safety data can give misleading indications of ‘design’ or ‘process’ safety performance
• ‘Process’ or ‘Design’ Safety was not widely measured in 2005, however, indicators of hardware safety issues are more widely recorded and assessed now … although there are many more Lagging indicators in use than Leading ones!
Trends in Refinery Damages
8
Incident costs - $ per 1000bbls refinery capacity corrected to 2000 prices
0.00
5.00
10.00
15.00
20.00
25.00
30.00
1964
1966
1968
1970
1972
1974
1976
1978
1980
1982
1984
1986
1988
1990
1992
1994
1996
1998
2000
Dam
age
$/10
00 b
bl r
efin
ery
pro
du
ctio
n a
t 20
00 p
rice
s
Raw data
5-year average
Linear (5-yearaverage)
Trends
Increased and increasing public risk aversion
Reducing regulatory tolerance
Increased damages where legal action ensues
Increased focus on occupational safety and statistics
Increasing focus on ‘technical’ safety and statistics
Increased Management of Change (MoC) challenges– Through the life of modern engineered facilities and products
– Due to evolution in stakeholder organisations
– Changing operational requirements
9
An Increasing Complex world … Nimrod 2006
After an Air-to-Air Refuelling (AAR), the plane caught fire
Experienced crew acted with calmness, bravery and professionalism, and in accordance with training, but could not control the fire
Aircraft exploded
All 14 on board died
Why Did it Happen?
Cross-Feed –
Supplementary Cooling Pack
Duct (HOT)
No 7 Fuel tank
Fuel vent pipes and couplings
↓
→
Airframe anti-icing
pipe←
Fuel pipes – refuel
and feed←──────
Uninsulated Bellows
Why Did it Happen?
Probable cause was fuel coming into contact with extremely hot surfaces; an overflow due to the Air to Air Refuelling, ignited by the cross-feed / Supplementary Cooling Pack (SCP) duct,
which could be at up to 400ºC,
and was not properly insulated
Major design flaws:
Original fitting of cross-feed duct
Addition of SCP
AAR modification
Why Did it Happen?
Fuel pipe / vent coupling seals sourced from new supplier
Couplings not to original specification
– Although thought to be by the procurement function
Fuel pipe / vent couplings known to be unreliable by maintenance teams
–This information never fed back to the design or safety case teams
Why Did it Happen?
A number of previous incidents and warning signs ignored
Safety case existed but contained significant errors
Widespread assumption that Nimrod was “safe anyway” after 30 years of successful flights
Safety case became a “tick-box” exercise
Missed key dangers, should have been the best opportunity to prevent the accident
Financial pressures and cuts led to there being distraction from safety as an overriding priority
Hazard and Risk Management Paradigm
What could happen?
What could happen?
So what?So what?
What do I do?What
do I do?
How often?How often? How bad?How bad?
16
Hazard and Risk Management
RiskRisk Management
RiskAnalysis
RiskAssessment
HazardIdentification
HazardIdentification
Evaluation ofHazard & RiskEvaluation of
Hazard & Risk
ManageResidual Risk
ManageResidual Risk
FrequencyAnalysis
FrequencyAnalysis
Consequence Analysis
Consequence Analysis
17
Event Sequences
18
A corner stone of the Hazard & Risk Management Paradigm is the concept of Event Sequence
The idea is that all event sequences are identified in the analysis, or covered within some more general event sequence
A key limitation is the issue of foresee-ability What is foreseeable? Is it really possible to foresee all categories of event
The case law is demanding engineers and experts are expected to foresee relatively remote events
The O&G industry regulator is not as demanding as for example the Nuclear industry regulator in these matters
Underlying techniques of Hazard and Risk Management Process
REQUIRED – The Hierarchical use of controls and barriers
REQUIRED – The Demonstration of ALARP
ALARP - As Low As Reasonably Practicable
19
We identified the Hazards and ensured there were adequate Safeguards, consistent with the ALARP principle“
“
Safe?
N.b. ... The cost emphasis of ALARP ... an encouragement to add safeguards until increased benefits through risk reduction can not be justified
21
Some North Sea Events
The SEA GEM 27th December 1965 – 13 Lost Mineral Workings (Offshore Installations) Act 1971
The ALEXANDER KEILLAND 27th March 1980 – 123 Lost Norway – Created a clear source of Authority for Abandonment The sister rig the Henrik Ibsen also got into difficulty a few months later
The PIPER ALPHA July 1988 – 167 Lost Mineral Workings (Offshore Installations) Act 1971
26
Ocean Ranger with Draupner Wave shown for comparison
1 – The Draupner wave 59 ft / 18 m2 – Location of unprotected portlight 28 ft / 8.5 m
3 – Location of the ballast control room
The Ocean Ranger – Capsized off Newfoundland February 1982 – 84 lost
Metocean Conditions - Foreseeable ?
28
Inherently Safer Design
The concept supports the view that the achievement of safe operations requires that HAZARDS are addressed during concept development and all subsequent phases of System, Structure, or Equipment design AND IMPLEMENTATION
The intent of Inherently Safer Design is to eliminate a hazard completely or reduce its magnitude significantly
Thereby eliminating / reducing the need for safety systems and procedures
Furthermore, this hazard elimination or reduction should be accomplished by means that are inherent in the design and process and thus permanent and inseparable from them
Examples - Minimise
Minimise storage of hazardous gases, liquids and solids
Minimise inventory by phase change (liquid instead of gas)
Eliminate raw materials, process intermediates or by-products
Just-in-time deliveries of hazardous materials
Hazardous materials removed or properly disposed of when no longer needed
Hazardous tasks (e.g. working at height or above water, lifting operations) combined to minimise the number of trips
Need for awkward postures and repetitive motions
minimised
30
Examples - Substitute
Substitute a less toxic, less flammable or less reactive substance
–Raw materials, process intermediates, by-products, utilities etc.
–Use of water-based product in place of solvent- or oil-based product
Alternative way of moving product or equipment in order to eliminate human strain
Allergenic materials, products and equipment replaced with non-allergenic alternatives
31
Gas Hot Oil
GasHot Water
Examples - Moderate
Reduce potential releases by lower operating conditions (P, T)
–Process system operating conditions
–New / replacement equipment that operate at lower Speed, P or T
Dilute hazardous substances to reduce hazard potential
Storage of hazardous gases, liquids and solids as far as way as possible in order to eliminate risk to people, environment and asset
Segregation of hazardous equipment / units to prevent escalation
Relocate facility to limit transportation of hazardous substances
New / replacement equipment that produces -
less noise or vibration
32
Examples - Simplify
Simplify and / or reduce - connections, elbows, bends, joints, small bore fittings
Separate single complex multipurpose vessel with several simpler processing steps and vessels
Equipment designed to minimize the possibility of an operating or maintenance error
Minimise number of process trains
Reactors designed / modified to eliminate auxiliary equipment (e.g. blender)
Eliminate or arrange equipment to simplify material handling
Ergonomically designed workplace
33
34
• Replace flammable hydraulic fluids with water-based equivalents
• Replace oil-filled switchgear with vacuum-insulated equivalent
• Replace Ex instrumentation with intrinsically safe equivalents
• Use low toxicity oils to replace PCBs in transformers
• Use low smoke, zero halogen, cable insulation
• Use PFP coatings that resist water ingress so avoid Corrosion Under Insulation
Examples of Equipment Level ISD in Brownfield & Operations Development 1
35
• Arrange equipment layout to minimise restrictions on explosion venting
• Arrange “Deluge on Gas” where advantageous to minimise explosion overpressures
• Arrange beam detection to replace or supplement point F&G detectors
• Position acoustic leak detectors to supplement gas detection for high pressure gas systems
• Position hand rails at all locations where there would be unguarded height, if equipment was removed for service
• Position pipe work, including flanges and rodding points, so that service leaks will be caught, and not by operators!
Examples of Equipment Level ISD in Brownfield & Operations Development 2
36
Inherently Safer Design – Why Bother?
Helps us to achieve safer operations, both in terms of day to day safety, and importantly ...
–In avoiding low likelihood high consequence events
–Through the elimination and reduction of hazards and unrevealed system vulnerabilities
Reduced number of Engineered Safeguards
Reduced Complexity
Reduced component and vessel sizes
Reduced energy consumption
Inherently Safer Designs have reduced CAPEX and OPEX and
are easier to operate and maintain!
37
An Example of how Design without the application of ISD results in unrevealed vulnerabilities
Mumbai High
How the cook cut his finger ... and the platform fell into the sea ...
A Case Study ...
39
Mumbai High North – Background
Mumbai High Field was discovered in 1974 and is located in the Arabian Sea 160 km west of the Mumbai coast
The field is divided into the north and south blocks, operated by the state-owned Oil & Natural Gas Corporation (ONGC)
Four platforms linked by bridges:–NA small wellhead platform (1976)
–MHF residential platform (1978)
–MHN processing platform (1981)
–MHW additional processing platform
Complex imported fluids from 11 other satellite WHPs and exported oil to shore via pipelines, as well as processing gas for gas lift operations
The seven-storey high MHN platform had 5 gas export risers and 10 fluid import risers situated outside the platform jacket
40
Mumbai High North – Sequence of Events (1)
Noble Charlie Yester jack-up was undertaking drilling operations in the field
The Samudra Suraksha was working in the field supporting diving operations
A cook onboard the Samudra cut off the tips of two fingers
Monsoon conditions onshore had grounded helicopters
The cook was transferred from the Samudra to the Mumbai High platform complex by crane lift for medical treatment
41
Mumbai High North – Sequence of Events (2)
While approaching the platform the Samudra experienced problems with its computer-assisted azimuth thrusters and was brought in stern-first under manual control
Strong swells pushed the Samudra towards the platform, causing the helideck at the rear of vessel to strike and damage one or more gas export risers – the resultant leak ignited
The close proximity of other risers and lack of fire protection caused further riser failure - the fire engulfed the Samudra and heat radiation caused severe damage to the Noble Charlie Yester jack-up
Emergency shutdown valves were in place at the end of the risers which were up to 12 km long - riser failure caused large amounts of gas to be uncontrollably released
44
Mumbai High North – Aftermath
The seven-storey high processing Platform collapsed after around two hours, leaving only the stump of its jacket above sea level
The Sumadra suffered extensive fire damage and was towed away from scene but later sank on 01 Aug 2005, about 18 km off the Mumbai coast
A total of 384 personnel were on board the platform and jack-up at the time of the accident … 22 reported dead (only)
Significant problems were reported with the abandonment of all the installations involved, only 2 of 8 lifeboats and 1 of 10 life rafts were launched
45
How could a better design
have avoided this disaster or reduce its impact?
• Position risers inside jacket structure• Location of boat landing on lee side of
platform• Larger separation distance between
platforms• Subsea Isolation Valves to reduce
hydrocarbon inventory during release• Relocation and fire proofing of risers to
prevent escalation• Improved availability of evacuation means
Would it be possible to eliminate the
hazard altogether?
46
Inherently Safer Design – How do we do it?
Establish an ISD Culture
Develop processes that support specific structured ISD events
47
Inherently Safer Design – How do we do it?
Establish an ISD culture within the organisation
–Driven from the top
–Involvement of all technical and project personnel
–Roll-out progressively – presentations, posters, pilot events
–Establish processes and guidance for their use
Ensure every project has planned ISD events in every phase
–Including each phase of Implementation
–Measure ISD uptake performance across all projects
–Sustain awareness and interest ensure all new starts involved and encourage champions
48
Success or Failure of ISD – Some Factors
All engineers and project personnel provided with ISD Awareness training as part of Induction
Ownership - ISD is not owned by HSSE or Technical / Process Safety personnel but by All engineering and project personnel
Operations personnel should be involved in all ISD workshop / study events
The language of ISD should be sustained in each project, ISD features should be captured and presented in appropriate media
Often “ISD design features” do not receive the credit and attention they should, or are only known amongst a few
–ISD design features should be acknowledged and shared with a wider audience
AMEC Several Years On – A Summary of Findings
To have, and to communicate, a clear systematic process
Definitions and Terms of Reference shared in advance with all workshop participants and stakeholders
Create an ISD Register at the earliest time and maintain through all phases
Expect to identify some possibilities that will not be actionable until a future phase, register needs to keep track of these
Develop and maintain an ISD culture, make ISD wins visible to the team as a whole
51
Encourage Each Project ...
An ISD Workshop Process
52
SET ISD GOALS
IDENTIFY HAZARDS
BRAINSTORM OPTIONS
IDENTIFY AND UNDERSTAND THE SPECIFIC HAZARDS AND RISKS OF REMAINING OPTIONS
DEVELOP EACH REMAINING OPTION FOR SELECTION•Eliminate hazards•Confirm that it will be practical to manage the residual hazards
SELECT / REJECT OPTION•Meets goals?•Meets economic criteria?•Possible to manage residual risks with defined protection layers and an aim of continuous risk reduction?
DEVELOP SELECTED OPTION•Meets goals•Minimise risks from residual hazards•Define minimum design standards/limits•Conduct risk management activities
RECOMMEND DISCONTINUING DEVELOPMENT
Final NoNo
Yes
INITIAL REDUCTION OF OPTIONSReject options that clearly cannot meet the goals
If multiple iterations fail to deliver a suitable outcome
ISD Goals - Examples of High Level Goals
53
LAYOUT EXAMPLES Minimise explosion overpressure potential Minimise frequency of occurrence of explosion overpressures Minimise escalation potential from fire and explosion events Minimise vulnerability of Emergency Escape and Rescue systems to fire and explosion; including Temporary Refuge
PROCESS EXAMPLES Maximise simplicity of plant Minimise hydrocarbon inventories and pressures Minimise leak potential Maximise integrity of containment envelope from internal and external loadings and hazards
High level goals require to be pursued through the development of low level goals with the involvement of each and every technical discipline contributing to the project
An ISD Output
55
Bridge length set to optimise separation between Process and Well Bay areas and the Temporary Refuge
Minimal inventory fuel gas for GTs
Both jackets designed for a minimum Reserve Strength (RSR) of 2.5
Diverse Fire Pump locations
Designed so as to minimise HP / LP interfaces
56
AdditionalEngineeringControls
InherentlySafer Design (ISD)
Strategy for Hazard Management - UK HSE (OTH 96 521)
Identify Hazards
Understand /Assess Hazards
Avoid Hazards
Reduce Severity
Reduce Likelihood
Segregate / Reduce Impact
Apply Passive Safeguards
Apply Active Safeguards
Apply Procedural Safeguards
Risks ALARPNo
OKYes
In Summary
Attitudes to safety continue to evolve and pose engineering project stakeholders ever greater safety challenges
The ‘traditional’ Hazard and Risk Management’ paradigm is imperfect and further steps are now required to meet modern challenges
Inherently Safer Design (ISD) consists of straightforward principals that can be widely applied
ISD when integrated with Hazard and Risk Management changes the emphasis on how safety is driven within design and planning processes
This change of emphasis is not only beneficial to safety but to other project and operational parameters including cost and maintenance burden
57