Scenario

01. Poor Value Perception
02. Poor Safety Awareness
03. Inadequate Risk Recognition
04. Organizational Problems
05. Inflexible Management Structure
06. Maintenance Based on the Experience only
07. Carelessness
08. Insufficient Precaution
09. Inadequate Inspection
10. Planning and Design
11. Poor Planning
12. Selection Mis of Parts
13. Failure
14. Fracture/Damage
15. Crack of Glass
16. Secondary Damage
17. External Damage
18. Fire

Fire caused due to damaged glass of a level gauge at a hydrogen sulfide absorption column of a kerosene hydrodesulfurization unit
Case Details

Knowledge Comment:
Prevention of trouble is not obtained by the maintenance that depends on experience based on the result only.

Field Chemicals and Plants
Author WAKAKURA, Masahide (Kanagawa Industrial Technology Research Institute)
TAMURA, Masamitsu (Center for Risk Management and Safety Sciences, Yokohama National University)