Making sense of process safety
By all accounts it had been an accident; still others, the quiet majority perhaps, might have described it as having been an “accident waiting to happen.” It really didn’t matter. Not at the moment when there were 28 bodies, 28 funerals to arrange, 28 lives to contemplate. Of the 36 injured, some clung to life; certainly all would be scarred physically or emotionally from the tragic event.
Flixborough, England, June 1, 1974: A Nypro UK facility was about to be ground zero for another type of industrial revolution, one that would span the globe and forever link safety to engineering, plant maintenance to plant operations, and supervisors to employees.
This was an accident that had everything: a highly sought after chemical—caprolactam (a precursor chemical used in the manufacture of nylon), the rupture of a temporary bypass valve, a fire on an adjacent pipeline that had been burning for an hour, a vapor cloud, an explosion, a plant destroyed, and 1,800 neighboring buildings severely damaged.
It was this event, almost 30 years ago, that some call the genesis of what we in the United States know as Process Safety Management. More likely, the Flixborough incident was just one more in a string of horrific and catastrophic incidents that marred industrial processes and left scores dead and injured.
In fact, since that fateful afternoon an ocean away, we’ve had other major industrial accidents around the globe—Bhopal, India (1984) and Texas City (2005), just to name a few. It takes significant causes to lead to significant effects. Sometimes, having many bad things happen (causes) can force us to take positive and preventive steps for change (effects).
Such has been the charge with the Department of Labor’s efforts to field, through OSHA, a formal Process Safety Management (PSM) program, and a more focused National Emphasis Program (NEP). Three years into the second decade of the 21st century, both PSM and NEP are relatively new to U.S. manufacturing. While PSM-NEP makes sense, we must begin to make sense of it.
History and purpose
OSHA promulgated the PSM standard (CFR 1910.119) in 1992 as a way to address and combat a number of catastrophic incidents that occurred throughout the world. Several aspects of the process safety discipline itself were already being used by some larger petroleum refiners and petrochemical companies since before 1992.
In the fall of 1994, OSHA issued its compliance guidelines and enforcement procedures. Instruction CPL 02-02-045 established the policies and procedures for enforcement and provided clarification and general guidance. This “instruction” also provided a first glimpse into what can now be described as PSM and its ineffectual bureaucracy.
Because the initial inspections under what was then called the Program Quality Verification (PQV) were so resource intensive, this ultimately meant that very few inspections would be conducted. The well-intended program was mired under its own weight and could hardly deliver the desired safety results.
In 2007, after a decade and a half of continual horrendous incidents in the petroleum refining industry involving highly hazardous chemicals (HHCs), OSHA initiated a refinery NEP. OSHA had hoped that by taking a more in-depth and more frequent look at certain aspects of PSM, the hazards involving HHCs in the petroleum workplace would be greatly reduced or even eliminated. This effort moved the organization from resource-extreme inspections to nimble audits.
This laser focus provided just the positive results OSHA was looking to find. In the first year alone, OSHA completed inspections in 14 refineries in six of OSHA’s 10 regions. This was an exceptional volume of inspections when compared to the “few inspections” accomplished with the initial PSM audit team prior to NEP. This approach was the scalpel OSHA needed to cut to the chase on practices and processes that were endangering people and equipment in American refineries.
The new NEP was applicable to all federal, non-voluntary protection program (VPP) refineries. All state plans had to adopt the NEP or develop an equivalent program.
Twenty-five states, Puerto Rico, and the Virgin Islands adopted OSHA-approved state plans. Many are identical to the federal guidelines, but sometimes they have different enforcement policies. The states that chose the state plans are mandated to communicate with the federal OSHA on the details of their plan and additions to and changes from the original intent of the federal guidelines.
With the refinery NEP, inspectors were better able to get to the heart of process safety issues quickly by asking questions from a prepared list of 100 static and 15 dynamic questions. The list of 100 static questions is available on the OSHA website. The 15 dynamic questions are not published and change from time to time.
The findings from those initial 14 refinery inspections were heavily technical, involving faults with operators, engineering, and maintenance. In fact, 80% of the 348 resulting citations were related to operating procedures, mechanical integrity, process hazard analysis, process safety information, and management of change. Recent statistics indicate that this was no fluke.
In 65 inspections conducted through March 2011, 53% of the citations were written for engineering and maintenance categories: mechanical integrity, process safety information, and process hazard analysis.
In August, 2009, OSHA issued Instruction CPL 03-00-010, Petroleum Refinery Process Safety Management National Emphasis Program, its most recent guideline on the subject of refinery NEP. Like all its predecessors, this “instruction describes policies and procedures for implementing a National Emphasis Program (NEP) to reduce or eliminate the workplace hazards associated with the catastrophic release of highly hazardous chemicals at petroleum refineries.”
As a result of the success in reducing catastrophic incidents, loss of life, and loss of property in the refinery industry, OSHA initiated a pilot program in mid-2009 to cover other plants making or using HHCs in their process. Through experiences gained in the refinery industry, OSHA was able to improve its approach for inspecting PSM-covered facilities that “allowed for a greater number of inspections using better allocation of OSHA resources” (CPL-03-00-014).
The pilot program was intended to run for a year and include programmed inspections in three OSHA regions:
- Region I: CT, MA, ME, NH, RI
- Region II: NE, KS, MO
- Region III: ID
The pilot program was superseded in late 2011 with an OSHA instruction, directive CPL-03-00-014, PSM Covered Facilities National Emphasis Program. This made the pilot program official and nationwide, with mandates that state plans adopt a similar program. The nation’s refineries were now covered under one National Emphasis Program, and other, nonrefinery facilities making or using HHCs were covered under the CHEMNEP (Chemical National Emphasis Program).
Refineries are pretty self-explanatory; other facilities were broken down into three types to ensure all types of facilities were covered: ammonia, chlorine, and all others. CPL-03-00-014 gave direction for how plants would be targeted for inspection:
- U.S. Environmental Protection Agency’s (EPA) Chemical Accident Prevention Provisions, Program 3 Risk Management (RMP)
- Explosives manufacturing NAICS codes
- OSHA’s IMIS database
- OSHA Area Office knowledge of local facilities.
The guideline also gave OSHA authorization to conduct a full NEP inspection if it happened to be in a facility for another cause, complaint, or referral, for example. Also, if a facility had an accident or catastrophe that required action from OSHA, it could take advantage of the door being open and perform a full NEP at that time.
OSHA already had an aggressive schedule requirement to complete three to five programmed inspections per Area Office per year; these nonprogrammed inspections presented other opportunities to test process safety.
The CHEMNEP relied on dynamic questions. The questioning was streamlined in the CHEMNEP to cover more ground with limited resources. Also, through its work in refineries, OSHA found a better method to uncover the problem areas. OSHA found that refineries had extensive written process safety management programs but insufficient implementation. In other words, what refineries said they did was not what they did. A short riff of questioning could quickly point to the troubled processes in a plant.
Learn more about NEP standards and about process safety from the Marshall Institute below.