Major Hazard Risks Euan Fenelon Global Operational Integrity and RD&I Manager Doreen Gray Operational Integrity Project Manager 18 June 2013 Safety Contact August 2009 Sayano-Shushenskaya Hydro Plant, Russia turbine top cover failed, resulting flood killed 76 workers. Investigation found lack of maintenance, flawed plant modifications and a culture of risk taking. The Drivers Events that drive Operational Integrity BP Texas City Deep Water Horizon Piper Alpha Kleen Energy Duhva Sayano-Shushenskaya Longannet Castellon Arcos W o r l d w i d e
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Process Safety Visibility Which warning signs are most likely to help you avoid an incident? Immediate Visibility Competency Checks Incident Reporting Management of Change Technical Risk Management Operating and Engineering Standards Technical Recommendations Maintenance management Shift Handover Process Plant Limiting Conditions Audit Support Supporting Documentation The Baker Report investigation into BP Texas City UK Health and Safety Executive: HSE HSG254 Developing Process Safety Indicators HSE RR509 Plant Ageing Report GENSIP formed Generators Safety Integrity Programme PAS-55 publicly accessible standard for Asset Management Energy Institutes High Level Framework for Process Safety Management OECD guidance on Safety Performance Indicators COMAH Guide APIs guidance on PSPIs Process Safety and Asset Management now a major focus Generator Safety Integrity Partnership: Hazard Identification R a n k i n g R e f e r e n c e F r e q u e n c y C o n s e q u e n c e P r o b a b i l i t y P r o d u c t Hazard 1 PS17. 3 10 0.1 0.1 Failure of HP feed system pipework 2 PS 2 3 10 0.1 0.1 Major Loss of Containment from a High Temperature Pipework 3 PS5. 3 10 0.1 0.1 Pipe rupture and catastrophic weld failure from a major low temperature steam line 4 PS7. 4 1 0.1 0.1 Explosive External Boiler Tube Rupture 5 EWG5 3 1 1 0.1 Switchgear arc flash explosion whilst locally operated 6 CSW3 3 1 1 0.1 Walkways and Gratings 7 PS3. 3 3 0.1 0.03 Rupture of boiler integral furnace circulating and saturated steam pipework, fabricated in C steel materials with an internal diameter > 65mm 8 PS10. 2 10 0.1 0.01 Catastrophic failure of boiler feedwater pipework. 9 PS8. 2 10 0.1 0.01 De-Aerator Vessel Rupture 10 PS4. 4 1 0.01 0.01 Rupture of boiler drains pipework systems including blowdown systems. 11 PS25. 4 1 0.01 0.01 Auxiliary Steam and minor systems 12 PS11. PFS2 4 1 0.01 0.01 Combustion generated over pressurisation of enclosures and pipework 13 EWG6 2 1 1 0.01 Electrocution due to contact with live conductors 14 CSW11 5 1 0.001 0.01 Falling claddings and objects from buildings 15 CSW12 2 1 1 0.01 Integrity of buildings fabric to personnel access. 16 CSW17 5 1 0.001 0.01 Spalling of concrete from structures Understanding hazards & creating barriers (People, Process & Plant)... James Reasons Swiss Cheese Model To stop events from happening Controls To reduce the consequence from events Training PMP Maintenance Mitigations Insurance Fire Deluge System 100% Standby Bunding Communication People Threats: Operating Plant outside design limits Profit & Loss: Cost to fix failure H & S: Fire Operations: Loss of pump Environment: Oil loss through pump Failure Stakeholder: Negative publicity from failure HAZARD: Kinetic Energy Steam, Fire, Potential & Kinetic Energy, Electricity, Noise, Heat, Chemicals, Vehicles Process Threats: Ad hoc Changes to plant Plant Threats: High Vibration on Failure Event: Catastrophic pump failure Event that will release Hazard to the work environment Threats that will lead to plant Failures Consequences as a result of Failure Event Process Safety Dashboard Philosophy is to visualise Swiss Cheese Model...... Understanding hazards & creating barriers (People, Process & Plant )... Risk Control Areas 2 Technical Risk Management Plant Modification Procedure Plant Status Review / Technical Risk Register Strategic Spares Engineering Standards Technical Knowledge Management Design Review Asset Investment Civil Inspections Pressure System Safety Regulations 3 Critical Systems Emergency Supplies Fire Systems HV Electrical Systems Main Protection Systems Oil Separation Systems 4 Alarm and Instrument Management Control Systems Critical Instrumentation Protective Systems / Devices Alarm Systems 5 Maintenance Management Work Prioritisation Work Identification, Routine Plant Inspections Work Planning, Scheduling Work Execution Personal Risk Assessment 6 Operations Management Start-up /Shutdown Procedures Routine Plant Checks Routine Testing Shift Handover Company Safety Rules Management Plant Limiting Conditions 7 Staff Competence Communications Leadership Training Needs Analysis Training Plan Competency Assurance Staff Knowledge Management 8 Emergency Preparedness Emergency Planning Business Continuity Planning Environmental Containment Systems Plant Process People Recovery 1 Operation & Compliance Audit External Audit Integrated Internal Audit Action Tracking Controlled Documents (Policies, Procedures, Standards) Key Performance Indicators Fully defined KPI, including: Objective Definition Data Source Data Aggregation / Calculation Targets Data Recording Guidelines Formal sign off by senior managers KPI Categorisation Best Practice Performance Performing At Or Above Requirement Performing Below Requirement Performing Significantly Below Requirement No Process Safety Incidents Minor Process Safety Incident Significant Process Safety Incident Major Process Safety Incident Leading Indicators Lagging Indicators Classification Of Process Safety Incidents 3 tier approach based on API guidance... (Lagging Indicators)
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3 tier approach based on API guidance... +100 Leading Indicators 42 Risk Control Systems 3 Classifications Of Lagging Indicators +90 Hazards Feed Incident Reporting Process R a n k i n g R e f e r e n c e F r e q u e n c y C o n s e q u e n c e P r o b a b i l i t y P r o d u c tHazard 1 PS17. 3 10 0.1 0.1 Failure of HP feed system pipework 2 PS 2 3 10 0.1 0.1 Major Loss of Containment from a High Temperature Pipework 3 PS5. 3 10 0.1 0.1 Pipe rupture and catastrophic weld failure from a major low temperature steam line 4 PS7. 4 1 0.1 0.1 Explosive External Boiler Tube Rupture 5 EWG5 3 1 1 0.1 Switchgear arc flash explosion whilst locally operated 6 CSW3 3 1 1 0.1 Walkways and Gratings 7 PS3. 3 3 0.1 0.03 Rupture of boiler integral furnace circulating and saturated steam pipework, fabricated in C steel materials with an internal diameter > 65mm 8 PS10. 2 10 0.1 0.01 Catastrophic failure of boiler feedwater pipework. 9 PS8. 2 10 0.1 0.01 De-Aerator Vessel Rupture 10 PS4. 4 1 0.01 0.01 Rupture of boiler drains pipework systems including blowdown systems. 11 PS25. 4 1 0.01 0.01 Auxiliary Steam and minor systems 12 PS11. PFS2 4 1 0.01 0.01 Combustion generated over pressurisation of enclosures and pipework 13 EWG6 2 1 1 0.01 Electrocution due to contact with live conductors 14 CSW11 5 1 0.001 0.01 Falling claddings and objects from buildings 15 CSW12 2 1 1 0.01 Integrity of buildings fabric to personnel access. 16 CSW17 5 1 0.001 0.01 Spalling of concrete from structures Understanding hazards & creating barriers (People, Process & Plant )... Applying the KPIs Further Guidance Not All Indicators are of Equal Importance...
Operational Control Indicators Lagging Indicators Active Monitoring and Logging: Breaches Of Plant Limiting Conditions (eg overpressure, overspeed, overtemp) Control Loops Out Of Control Equipment In Manual Operation of protection systems Failure of protection systems Leading Indicators Inspection and Maintenance of Control Systems and Critical Systems Alarm Management Control Loop Performance Completion Of Operational Routine Checks / Testing Shift Logging & Handover Plant Overrides and Defeat of interlock Safety Critical Systems not available Generic Lagging Indicators Incident Reporting and Investigation: Near Misses (eg demand on safety system) Loss Of Containment (eg release of high pressure steam) Process Safety Incident (eg major equipment damage) Leading Indicators Critical processes undertaken correctly Operations Maintenance Engineering Programme Indicators Leading Indicators Statutory Inspections Completed (eg PSSR) Audits To Programme Action Closure Training and Competence Procedures Up To Date Improvement programmes
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Predictive of Incident KPI Development Based on Key Concepts in HSG 254... Measuring the Gaps Overall Site Matrix Measuring the Gaps Risk Control Area status Measuring the Gaps Monthly Reports for Governance Future development: Controls linked to Hazard: Review Level Scottish Power Generation Generation Groups Power Stations Governance Body Health and Safety Steering Group Generation Risk Review Meeting Coal RRM LN Gas RRM RH , DC, SH, BB, COGEN Hydro RRM CN, GW, LK Review Guidance Consolidated Indicators Major or Key Incidents Business Wide Indicators Significant Incidents Trends Group Indicators Significant & Moderate Incidents Close-out rates Local Indicators All Incidents Frequency Monthly Monthly Monthly Daily Group Governance Process Cascade up approach... 21 Generation Risk Review Meeting GRRM Leading Indicators Performance (KPI Dashboard) Incident Reviews (Cintellate) Risks Action Tracking Operational Governance Process Visibility Immediate Visibility Quality Plant Limiting Conditions Incident Reporting Management of Change Technical Risk Management Operating and Engineering Standards Technical Recommendations Maintenance management Staff Competency Operations Management Shift Handover Process Near real-time measurement of business processess ...
What if PS risks were as visible as Health & Safety risks? Measuring Process Safety Immediate Visibility Competency Checks Incident Reporting Management of Change Technical Risk Management Operating and Engineering Standards Technical Recommendations Maintenance management Shift Handover Process Plant Limiting Conditions Audit Support Near-time visibility of leading indicators for key risk control systems across all power stations providing at a glance assessment of plant condition and the performance of key processes; Risk Ranking of KPIs based on risk and Alarp principles Improved reporting of incidents and near misses, enabling information to be shared more widely and repeat incidents to be prevented; Provision of timely, accurate and comprehensive information to support the governance of process safety through early identification and proactive management of risks; A governance framework to ensure that performance and actions are reviewed on a monthly basis. Delivering Operational Capability Successful Outcome Criteria Key success factors Buy in and commitment from senior management Involvement of staff in designing, developing and embedding Clear definition of each KPI is essential Common processes across all business units Delivery of sustainable solution can only be achieved using integrated IT platforms i.e. automatic generation of KPIs