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01. |
Organizational Problems |
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02. |
Inflexible Management Structure |
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03. |
Insufficient Information and Communication |
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04. |
Poor Value Perception |
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05. |
Poor Safety Awareness |
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06. |
Insuficient Education/Training for Safety |
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07. |
Organizational Problems |
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08. |
Poor Management |
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09. |
Poor Work Management |
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10. |
Non-Regular Action |
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11. |
Change |
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12. |
Change of Operation Procedure |
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13. |
Malicious Act |
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14. |
Rule Violation |
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15. |
Safety Rule Violation |
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16. |
Bad Event |
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17. |
Chemical Phenomenon |
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18. |
Abnormal Reaction |
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19. |
Secondary Damage |
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20. |
External Damage |
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21. |
Explosion |
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22. |
Bodily Harm |
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23. |
Injury |
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24. |
Loss to Organization |
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25. |
Economic Loss |
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26. |
Manetary Danage 25 million yen |
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Explosion and fire at a manufacturing plant for manufacturing a RIM raw material liquid.
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Knowledge Comment: |
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Becausee a communication, which showed a change in reaction properties after the reaction condition changed, was interrupted, the suitable operation method could not be applied. |
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