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A colleague described a very unusual situation in his project. A facility was undergoing an upgrade on the inlet of the facility. Nothing unusual about that, but what was unusual was as a result of the upgrade, 100% of the feed would flow through the new upgrade. And … while that statement by itself is not unusual, what was unusual was the transition. There would be a time when 100% of the feed HAD to flow through the new system, while it was being commissioned and before it had been handed over to operations.

Let me say that differently … an entire complex was forced to rely on an “incomplete” system to continue to operate. And I am not talking about partial capacity; I am talking about 100% of the feed having to go through an incomplete system before entering the rest of the complex. If the new system was not available, the rest of the complex would get no feed.

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Just as a point of clarification, I recently mentioned that one airline did not stock life rafts on their aircraft. I just got off a flight with that airline, and the flight crew informed me that their new aircraft are CURRENTLY not fitted with life rafts, but WILL be fitted in the next 12 months.

Therefore, this airline did not permanently compromise on extra safety, but temporarily compromised on extra safety.

Again, just a point of clarification

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The aviation industry here in Australia has been in the headlines recently, for all the wrong reasons. One airline was forced to ground its fleet because of safety violations. The other airlines were quick to say something like “we will never compromise on safety”.

Then there was a volcano in Chile that erupted, sending ash into the atmosphere at the height airplanes fly. It circled the globe twice, and twice disrupted air travel in Australia and New Zealand. How did the airlines respond? Well, one grounded its fleet when the ash cloud was present, and another flew under and around the cloud. For two companies that “will never compromise on safety” the response could not have been more different.

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One of the most enjoyable parts of my job is visiting sites. I get to see many, and the differences between the processes, the way local problems are solved, etc are interesting and sometimes a source of inspiration.
But whenever I look at a facility, I make one conclusion based purely on visual information … is this a SAFE facility? First impressions apply to facilities as well as people, and this is my first impression.

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I recently saw a map of the Nord Stream Project pipeline, linking Russia and Germany. It runs under the Baltic Sea, following very close to the seabed boundaries between Russia and Finland and Estonia and Finland before entering Swedish water. It then enters German waters near the German-Polish subsea boundary.

Why is this being done? Surely land based construction is more economical (both in capital and operating costs) than a sea based pipeline?

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Recently I was delivering a guest lecture at one of the Australian universities, and I had to stop my lecture because I had lost the audience. I was able to get them back, but only by abandoning my prepared talk and instead speaking “off the top of my head”.

The reason I had lost my audience … I assumed they understood the three components of the triple bottom line. They did not fully grasp the original member … the financial bottom line.

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I recently read a news article out of the USA regarding electric cars. It seems the US government receives revenue from transportation fuel taxes, which is used cross-country highway maintenance. This government revenue stream would be lost if all cars became electric cars. Naturally, a road “does not know” if the cars are fossil fuel or electric (or bio-diesel, for that matter), they just “know” they need to be maintained. The government needs to not only satisfy the general public’s desire to transform to a lower carbon economy, but also to maintain the existing income streams. The current budget situation in Washington DC just adds to the complexity of the issue. One possible solution being proposed is a one-off or annual fee.

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I am continually fascinated by how inconsistently people and organisations treat technical skills that should be “portable” across industries. By “portable” I mean skills that can be used immediately in a variety of industries. Let us consider two extreme examples … facility layout and photocopy machines. A person that has spent a career doing layout of small package water treatment units that will fit in containers or on the back of a small flatbed truck is inherently not qualified to provide layout design skills for an entire mineral processing facility (no experience in mineral processing). But a person that has serviced photocopy machines in high rise offices is qualified to service a photocopy machine at a remote mineral processing facility. By the way … you can replace mineral processing with oil and gas, power generation, hydrometallurgy, food processing, pulp and paper, or any number of specific industries.

And I must ask … why? Both people have spent years learning their skill, and have been faced with unique situations before. Why is one suitable for work immediately and the other not?

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An elite athlete retired from his sport (a team sport).

This elite athlete is recognised as not one of the greatest ever, but in the next tier below the greatest ever. He was an integral member of the “unofficial world championship team” as his sport had no official world championship. His retirement had an immediate detrimental effect on the team (they missed him).

He wanted to stay active in the sport, and offered to be a specialist coach for his local side.

It is a sign of the times that he was turned down because he did not have a “coaching certificate”. His 14 years of experience at international level were apparently worthless without a piece of paper saying he had completed a “training course on how to be a coach”.

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Recently I was involved in a rather serious two-car automobile accident. His car was a write-off, and my car was very close to being a write-off. There was also collateral damage – a street light and a residential brick wall were damaged.

The good news is that there were no injuries. At all. The paramedics released the driver of the other car and me without sending either of us to hospital. No neck braces, no bandages, nothing. Based on my limited understanding of the definitions of injuries, I think this would be considered to be a “near miss”. This is because there was no injury and no time was lost from work. I was fit for work, and he was also fit for work. I cannot comment on the other driver, but, unfortunately for me, insurance duties prevented me from doing productive work. So when I say no time was lost from work, I mean I could have spent the day doing actual work … if I had someone else to do the insurance work that was required. Forgive me, I am starting to babble … car accidents can do that.

However, it did get me thinking about the concept of near misses and process safety. Why does the concept of a near miss only apply to occupational health and safety? And what actually constitutes a near miss? Let’s consider some examples.

Recently I was participating in HAZOP. We found a scenario where the pressure relief valve was undersized. We made a recommendation to rectify the situation. Should this be classified as “near miss”? Or are we satisfied with the current “classification” of people doing their job adequately.

Here is another example. I was checking a calculation about sizing a relief device. One relief scenario was not calculated correctly, and it became the governing scenario. In fact, it caused a change in the relief valve size, the size of the inlet piping, and the size of the flare piping lateral. Again, was this a “near miss”, or was this merely the process of checking a calculation.

I am impressed at the way many organisations managed near misses (or in the terminology of some of the organisations, “near hits”) for managing Occupational Health and Safety. They have used these near miss statistics to systematically reduce occupational risk. But occupational incidents are less severe and more frequent than process safety incidents. Would it be possible for the inclusion of near miss into a process safety statistics to be used constructively to further enhance process safety?

I think organisations that do a good job of managing occupational health and safety could use this concept in some way to improve process safety. For example, these organisations have a culture where a documented near miss is not cause from punishment but a reason to investigate (and manage) the root cause of the problem. The same should be able to be applied to process safety.

It is obviously beyond the scope of this newsletter to develop criteria for improving process safety based on the statistical anomalies of calculations, HAZOP findings, risk assessment and other methods of evaluating process safety. Instead it is the intention of this newsletter to try to highlight potential shortcomings. If you have any suggestions or examples of how your organisation is measuring near misses of past process safety incidents we would love to hear from you.