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Analysis of 2·28 KEEPER Chemical Industries Hazardous Chemical Explosion Accident Based on FTA and HFACS

机译:基于FTA和HFACS的 2·28 KEEPER化学工业危险化学爆炸事故分析

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摘要

On 28 February 2012, a guanidine nitrate explosion occurred at HEBEI KEEPER Chemical Industries Co., Ltd., China, resulting in 25 deaths, with 4 missing individuals and 46 injured. In order to explore the causal relationship hidden behind this accident, fault tree analysis (FTA) and the Human Factors Analysis and Classification System (HFACS) were used to systematically analyze the incident. Firstly, FTA was used to analyze the causes of the accident in depth, until all the basic causal events causing the guanidine nitrate explosion were identified, and a fault tree diagram of the guanidine nitrate explosion was drawn. Secondly, for the unsafe acts in the basic causal events, the HFACS model was used to analyze the three levels of factors that lead to unsafe acts, including the preconditions for unsafe acts, unsafe supervision, and organizational influences. Finally, based on the analysis results of FTA and HFACS, a complete logic diagram of the causes of the accident was obtained. The FTA and HFACS accident analysis methods allowed for the identification of human factors and the accident evolution process in the explosion accident and provide a reference for accident investigation.
机译:2012年2月28日,中国河北基珀化学工业有限公司发生了硝酸胍爆炸,造成25人死亡,4人失踪和46人受伤。为了探究事故背后隐藏的因果关系,使用了故障树分析(FTA)和人为因素分析与分类系统(HFACS)对事件进行了系统分析。首先,利用FTA深入分析了事故发生的原因,直到识别出引起硝酸胍爆炸的所有基本因果事件,并绘制了硝酸胍爆炸的故障树图。其次,对于基本因果事件中的不安全行为,HFACS模型用于分析导致不安全行为的三个层次的因素,包括不安全行为的前提,不安全的监督和组织影响。最后,基于FTA和HFACS的分析结果,获得了事故原因的完整逻辑图。 FTA和HFACS事故分析方法可以识别爆炸事故中的人为因素和事故演变过程,并为事故调查提供参考。

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