Dates: May 28, 2026
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Incidents of a catastrophic nature involving failed pressure relief valves (PRVs) and flare systems are commonly caused by deficiencies in Process Safety Information (PSI) or failures within the Management of Change (MOC) documentation system. When design records are not accurate, facilities may operate equipment outside of safe limits, incorrectly configure relief valves, or send chemicals to inappropriate disposal networks.
Two specific incidents investigated by the U.S. Chemical Safety and Hazard Investigation Board (CSB) highlight how document management and outdated design bases contributed to these failures:
June 13, 2013 - Fatal fire and explosion when a heat exchanger containing flammable liquid propane violently ruptured at a petrochemical plant in Geismar, LA, fatally injuring two workers.
March 23, 2005 - Fatal explosion when a hydrocarbon vapor cloud ignited and violently exploded at the isomerization process unit at an oil refinery in Texas City, TX, resulting in the death of 15 workers.
“It might seem to an outsider that industrial accidents occur because we do not know how to prevent them. In fact, they occur because we do not use the knowledge that is available.”— Trevor Kletz
In this newsletter, learn why understanding knowledge management in the context of pressure relief and flare systems (PRFS) is crucial to ensuring operational safety and efficiency.
Bonus! This newsletter also includes access to a 31-minute presentation on It Is All About System Building, when a chemical company's annual demand had increased from 1.5 million parts to 60 million in a 4-year timeframe. Their production schedule expanded from a 5-day, 8-hour shift to a 24/7 operation. As production demands grew, it became increasingly critical to implement a more effective, long-term process safety system.
Have a great and safe day.