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What happened?
Two workers were replacing a manway degassing cover on a tank inside a dike.
Fresh air while working was required as the tank had been in sour crude service.
Instead of using a supplied air respirator, they used 5 minute escape packs to provide air.
This was dangerous and against company respiratory protection policy, which stated the packs are for emergency egress only.
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Why did it happen?
The supervisor felt rushed to get the job done as this task was already delayed due to a lightning alert.
Invalid work permit and ignoring respirator protection policy:
- The work permit for the job was initiated, but not delivered to operations the previous day.
- The supervisor decided to ‘piggyback’ on previous day’s work permit.
- The permit was for outside the dike only, so the supervisor decided not to set-up the supplied air trailer.
- The supervisor directed his crew to use the escape packs for breathing air instead.
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What did they learn?
Follow local policies on use of respirators.
Do not work without a valid work permit.
The 5 minute air packs are emergency escape systems, designed to provide air in emergency situations only.
Delays in getting a job done are acceptable, but working without a permit is not.
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Ask yourself or your crew
What other controls should have been put in place?
Why shouldn’t these workers have used 5 minute emergency air packs? What could have happened?
Why must we work with a valid work permit?
Why do you think these workers did what they did? Have you ever done something similar?
What could we do to prevent something like this happening here?
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What happened?
Two workers were replacing a manway degassing cover on a tank inside a dike.
Fresh air while working was required as the tank had been in sour crude service.
Instead of using a supplied air respirator, they used 5 minute escape packs to provide air.
This was dangerous and against company respiratory protection policy, which stated the packs are for emergency egress only.
Why did it happen?
The supervisor felt rushed to get the job done as this task was already delayed due to a lightning alert.
Invalid work permit and ignoring respirator protection policy:
- The work permit for the job was initiated, but not delivered to operations the previous day.
- The supervisor decided to ‘piggyback’ on previous day’s work permit.
- The permit was for outside the dike only, so the supervisor decided not to set-up the supplied air trailer.
- The supervisor directed his crew to use the escape packs for breathing air instead.
What did they learn?
Follow local policies on use of respirators.
Do not work without a valid work permit.
The 5 minute air packs are emergency escape systems, designed to provide air in emergency situations only.
Delays in getting a job done are acceptable, but working without a permit is not.
Ask yourself or your crew
What other controls should have been put in place?
Why shouldn’t these workers have used 5 minute emergency air packs? What could have happened?
Why must we work with a valid work permit?
Why do you think these workers did what they did? Have you ever done something similar?
What could we do to prevent something like this happening here?
Two workers were replacing a manway degassing cover on a tank inside a dike. Instead of using a supplied air respirator, they used 5 minute escape packs to provide air.
