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Case analysis Hussainara Khatoon and Ors. V. Home Secretary, State of Bihar, Patna
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How to learn a case study approach and to have a holistic case analysisFull description
Case for Safety RUSSEL A REBELLO FIIRSM-RSP WSO CSS-CSM GIFireE
Case for Safety •
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Cases Cases for for Saf Safet ety y are used for the Control of Major Accident Hazards ( COMAH ) Appli Applica cabl ble e to sites sites wher where activi activitie tiess have have the the potential to cause multiple fatalities or significant environmental damage.
Case for Safety •
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They are a mechanism to demonstrate that all major accident hazards (MAH) relating to the operation have been identified. They help to ensure that arrangements are in place to reduce the risks to a level that is As Low As is Reasonably Practicable (ALARP).
Case for Safety Part 1: The Introduction describes the scope, objectives and structure of the Case. Part 2: Is a comprehensive description of the facilities, the equipment and an inventory of hazardous materials. Most of these descriptions were written by offshore operations personnel and can be used as a reference document to guide personnel unfamiliar with the installations. Part 3: Provides a description of the HSE system in place.
Case for Safety Part 4: Details the audit process that systematically reviews the effectiveness of its Health and Safety Management Systems, Standards and Procedures. It also tracks actions arising from internal and external audits to completion. Action tracking register to be developed to ensure monitoring & tracking for completion. Note:
This will include review verification audits of the Safety Critical Elements performance Standards
Case for Safety Part 5: Hazard Assessment. It provides a demonstration that: •
All potential major hazards have been identified.
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The risk from the hazards evaluated and understood.
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The controls to manage the cause and consequences are in place.
Case for Safety Part 6: Details HSE-Critical Task Catalogue & Emergency Response:
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The identification of the barriers and controls in the hazard bow-tie diagrams is to be linked to those HSE-critical tasks carried out prior to, or during, operations. It is only by conducting these tasks (design, inspection and maintenance, operational or administrative ) that assurance is provided that the major accident hazards will be managed.
Case for Safety The Emergency response plan is established as part of identified controls to prevent the consequence/ reduce effect of consequence. Part 7: Remedial action plan. •
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Established to resolve any outstanding actions. Records improvements or shortfalls identified. Ensures improvements to the operations are made. It is the responsibility of the Case Custodian to ensure that these actions are satisfactorily completed.
5 Hazard Assessment Process •
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Step 1: Identification of major accident hazards through HAZID. A HAZID is a structured brainstorming technique using personnel from a variety of backgrounds to identify and provide initial scoping of hazards present within an operation or process
Step 2: Bowtie Analysis - This analysis took the form of structured, specialist brainstorming sessions to develop the hazard “bow-tie” diagrams, which identify the controls to be put in place for the identified hazards.
Bow Ties - MAH and Top Event (from HAZID) •
From the results of the HAZID, credible ‘Top Events’ are identified for each major accident hazard.
Bow-tie - Threats •
The threats that might cause the ‘top event to be realised are identified like so:
Bow-tie - Barriers to Threats The systems in place as barriers against each threat are inserted into the threat branch.
Bow-tie – Escalation Factors •
Some barriers are weakened by current circumstances.
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This is termed an ‘escalation factor’.
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In this case the fact that no Responsible Electrical Person (REP) is appointed ‘weakens’ the maintenance barrier. However, the E&I Supervisor’s role in electrical maintenance becomes a control against the escalation factor. AS DETAILED OVERLEAF:
Bow-tie – Escalation Factors
Bow-tie – Escalation Factors (cont’d) •
When there are no controls against escalation factors the barrier remains weakened.
CONTROLS Threat Barriers
INTOLERABLE
ALARP ZONE
LOW RISK
RISK HAZARDS
HAZARDS
HAZARDS
Minimum of 3 Independent
Minimum of 2 independent
No acceptance criterion
effective barriers to be in
effective barriers to be in
because outside of scope of
place for each identified
place for each identified
threat
Recovery Preparedness Barriers
hazard analysis
threat
Minimum of 3 independent
Minimum of 2 independent
No acceptance criterion
effective recovery measures
effective recovery measures
because outside of scope of
required for each identified
required for each identified
hazard analysis
consequence (including one
consequence (one to detect
to detect automatically
occurrence of top event and
occurrence of top
other to prevent further
event, and one other to
escalation)
prevent automatically further escalation)
Escalation Factor Controls
Minimum of 1 independent
Minimum of 1 independent
No acceptance criterion
effective recovery measure
effective recovery measure
because outside of scope of
for each identified escalation
for each identified escalation hazard
factor
factor
analysis
Bow-tie – Remedial Action Plan •
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The absence of a formal verification scheme weakens the Safety Critical status of electrical equipment in that nobody is verifying that we maintain it to assure continued fitness for purpose. This escalation factor becomes an item in Part 7 of the case, the Remedial Action Plan.
Case for Safety - Consequences Similarly the consequences of the ‘top event’ should it be realised are evaluated.
Safety Critical Elements •
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Systems and equipment identified in the bowties as being able to cause or contribute to, or prevent, detect or mitigate a MAH are given SAFETY CRITICAL status. A list of Safety Critical Elements has been developed and Technical Authorities Appointed.
Case for Safety - Conclusions •
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The Case for Safety is a tool used to assure a Company that personnel working on the offshore assets are not subject to intolerable risks. Tool that helps to manage continual improvement. It was prepared on behalf of the offshore workforce and is a living document that will be updated as changes occur. Please use it and share the knowledge with other personnel who may not be aware of its existence.
References: BowTieXP v5.2–CGE Risk Management Solutions http://www.cgerisk.com/support-a-downloads/support/bowtie-method-support/56the-bowtie-method Offshore Installation Regulations ( Safety Case) 2005 http://www.legislation.gov.uk/uksi/2005/3117/pdfs/uksi_20053117_en.pdf COMAH - Safety Report Assessment Manual (V2) http://www.hse.gov.uk/comah/sram/index.htm GAS SAFETY (SAFETY CASE) REGULATIONS 2008 http://www.austlii.edu.au/au/legis/vic/consol_reg/gscr2008318/ Review of Safety Case contents at least every three years. http://www.legislation.gov.uk/uksi/1996/551/regulation/4/made