What Went Wrong?. Case Histories of Process Plant Disasters and How They Could Hare Been Avoided

"What Went Wrong?" has revolutionized the way industry views safety. The new edition continues and extends the wisdom, innovations and strategies of previous editions, by introducing new material on recent incidents, and adding an extensive new section that shows how many accidents occur through simple miscommunications within the organization, and how strightforward changes in design can often remove or reduce opportunities for human errors. Kletz' approach to learning as deeply as possible from previous experiences is made yet more valuable in this new edtion, which for the first time brings together the approaches and cases of "What Went Wrong" with the managerially focussed material previously published in "Still Going Wrong". Updated and supplemented with new cases and analysis, this fifth edition is the ultimate resource of experienced based anaylsis and guidance for the safety and loss prevention professionals. * A million dollar bestseller, this trusted book is updated with new material, including the Texas City and Buncefield incidents, and supplemented by material from Trevor Kletz's 'Still Going Wrong' * Now presents a complete analysis of the design, operational and for the first time, managerial causes of process plant accidents and disasters, plus their aftermaths * Case histories illustrate what went wrong, why it went wrong, and then guide readers in how to avoid similar tragedies: learn from the mistakes of others Content: Copyright , Page iv Dedication , Pages v-vi Acknowledgments , Page xvii Preface , Pages xix-xxv Units and Nomenclature , Pages xxvii-xxxii Chapter 1 - Preparation for Maintenance , Pages 3-44 Chapter 2 - Modifications , Pages 45-70 Chapter 3 - Accidents Said to Be Due to Human Error , Pages 71-88 Chapter 4 - Labeling , Pages 89-96 Chapter 5 - Storage Tanks , Pages 97-121 Chapter 6 - Stacks , Pages 123-129 Chapter 7 - Leaks , Pages 131-148 Chapter 8 - Liquefied Flammable Gases , Pages 149-162 Chapter 9 - Pipe and Vessel Failures , Pages 163-184 Chapter 10 - Other Equipment , Pages 185-205 Chapter 11 - Entry to Vessels , Pages 207-219 Chapter 12 - Hazards of Common Materials , Pages 221-236 Chapter 13 - Tank Trucks and Cars , Pages 237-245 Chapter 14 - Testing of Trips and Other Protective Systems , Pages 247-262 Chapter 15 - Static Electricity , Pages 263-270 Chapter 16 - Materials of Construction , Pages 271-279 Chapter 17 - Operating Methods , Pages 281-296 Chapter 18 - Reverse Flow, Other Unforeseen Deviations, and Hazop , Pages 297-311 Chapter 19 - I Didn't Know That ♦ ♦ ♦ , Pages 313-321 Chapter 20 - Problems with Computer Control , Pages 323-335 Chapter 21 - Inherently Safer Design , Pages 337-347 Chapter 22 - Reactions—Planned and Unplanned , Pages 349-358 Still Going Wrong , Pages 359-360 Chapter 23 - Maintenance , Pages 361-374 Chapter 24 - Entry into Confined Spaces , Pages 375-389 Chapter 25 - Changes to Processes and Plants , Pages 391-406 Chapter 26 - Changes in Organization , Pages 407-422 Chapter 27 - Changing Procedures Instead of Designs , Pages 423-434 Chapter 28 - Materials of Construction (Including Insulation) , Pages 435-448 Chapter 29 - Operating Methods , Pages 449-458 Chapter 30 - Explosions , Pages 459-477 Chapter 31 - Poor Communication , Pages 479-489 Chapter 32 - I Did Not Know ♦♦♦ , Pages 491-505 Chapter 33 - Control , Pages 507-520 Chapter 34 - Leaks , Pages 521-529 Chapter 35 - Reactions—Planned and Unplanned , Pages 531-538 Chapter 36 - Both Design and Operations Could Have Been Better , Pages 539-554 Chapter 37 - Accidents in Other Industries , Pages 555-563 Chapter 38 - Accident Investigation—Missed Opportunities , Pages 565-576 Chapter 39 - An Accident That May Have Affected the Future of Process Safety , Pages 577-582 Appendix 1 - Relative Frequencies of Incidents , Pages 583-585 Appendix 2 - Why Should We Publish Accident Reports? , Pages 587-588 Appendix 3 - Some Tips for Accident Investigators , Page 589 Appendix 4 - Recommended Reading , Page 591 Appendix 5 - Afterthoughts , Pages 593-594 Index , Pages 595-608 Aimed at safety and loss prevention professionals, this fifth edition presents analysis of the design, operational and managerial causes of process plant accidents and disasters. Case studies are used to illustrate what and why things went wrong, how to learn from others' mistakes and how to avoid similar tragedies "The history of the process industries shows that many incidents are repeated after a lapse of a few years. People move on, and the lessons are forgotten. This book will help keep the memories alive"--Page xix