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01. |
価値観不良 |
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02. |
安全意識不良 |
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03. |
リスク認識不良 |
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04. |
調査・検討の不足 |
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05. |
仮想演習不足 |
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06. |
想像力不足 |
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07. |
その他の反応 |
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08. |
計画・設計 |
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09. |
計画不良 |
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10. |
設計不良 |
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11. |
非定常操作 |
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12. |
緊急操作 |
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13. |
予備機起動 |
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14. |
機能不全 |
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15. |
システム不良 |
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16. |
流量異常 |
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17. |
不良現象 |
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18. |
化学現象 |
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19. |
異常反応 |
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20. |
二次災害 |
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21. |
損壊 |
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22. |
爆発 |
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23. |
身体的被害 |
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24. |
負傷 |
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25. |
5名負傷 |
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原料仕込み量の誤りによるニトロアニリン製造装置の爆発
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◆ |
知識化コメント |
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原料供給速度の変化は系の不安定化の最大要因、設計時から考えよう。 |
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