1/36

The Tutorial of Steps of Risk

Assessment for Preventing
Process Accidents
Summary of the Process - Target Operation
STEP1 Grasp of Hazards regarding the Substances and
the Process
STEP2 Implement Risk Assessment
① Identify trigger events and hazard scenarios
1 ② Estimation and evaluation of risk of the scenarios
③ Consideration of additional risk reduction measures
STEP3 Decision of the risk reduction measure

You can start from every step by Click

 2/36
【Summary of the Process】
1.Preparation

The process of having a mixing tank

was chosen. After main raw material
Ｎ
２
(powder) and auxiliaryManhole
material
open/shut
(powder) are mixed, they are unloaded
①Inside
②Nitrogen
to the following process. This is a
confirmation
replacement
general mixing process.
 3/36
【Summary of the Process】
2.Operation Loading Mixing Unloading

Main material

Open Manhole and

Load to hopper by hand
Ｎ2
①Loading of main
material by valve ②Loading
④Mixing:
③Nitrogen
of auxiliary
Operation of
operation via the material
agitator (M100)
replacement
measurement tank

⑤Unloading: Checking of
acceptance tank.
Unloading by valve Mixture End by timer.
operation Checking by viewing
 4/36
【Summary of the Process】
3.Clearning

Open manhole
Ｎ2, Ａｉｒ
Ａｉｒ

②Water
①Gas scrubbing
washing
③Drying by air
2→Air）hose
using（Nflexible

Exhaust
Drainage
 5/36

【Target Operation】
 Let‘s carry out risk assessment about
“2. Operation” – “①Loading of Main material”
out of these processes.

1.Preparation ③Nitrogen replacement

④Mixing
①Inside confirmation
⑤Unloading
②Nitrogen replacement
3.Clearning
2.Operation (Loading,
①Gas scrubbing
Mixing, Unloading)
②Water washing
①Loading
①LoadingofofMain
Main
material
material ③Drying by air
②Loading of Auxiliary
material
 6/36

Actually operations of this process

Pressurized 50% open

Air line V109 : Shut

Draining valve V105,V106 : Shut
V110,V112,V113,V114 V105 : Shut (When
are shut PS105 is OFF)
Check valves ①Loading of Main
V100,V111,V115 material：Pressurized in
are always open. the upstream.
V100 : always open
V102 : 50% open
 7/36
【 STEP1: Grasp of Hazards Regarding the
Substances and the Process 】

The whole operation and the target operation were explained.

Here, let's set up handling substances concretely.

Here, main raw material is set at Polyethylene powder.

Auxiliary material is set at polystyrene powder.
Each mean diameter is 20 ～ 40 μm.

The target operations are summarized as follows.

“2.Operation – Loading”
“Draining valve V110,V112,V113,V114 : Shut”
“Air line V109 : Shut”
“N2 line V106 : Shut”
“①Loading of Main material：Pressurized in the upstream”

Let's assemble the hazard scenarios which may

occur when these are operated.
 8/36

STEP1 Answering the questions(1)

 Q1. Is investigation of hazard or toxicity (Risk Assessment, etc.) “No”
Q5.
Q3.
Q9.
Q1.
Q2.
Q4.
Q8.
Q7.
Q6. Is the substance
investigation
GHS
Does the substance of a
combustible
suspected
classification
mandatory for the substance handled?
combustible
hazard
liquefied
have
develop
generate ofor
an
gas?to orbe
toxicity
the (e.g.
flammable?
atomic toxic organic,
(Risk
substancegroup
polymerization
peroxides? despite
other
metal)
the
related
reaction?
 Q2. Is
than
absence
Assessment) powder
toofGHS
the
“Notof
explosive applicable,”
(combustible
SDS?
mandatory
classification
orofare for “Not
dust)?
the
self-reactive
the substance
classified”
substance
other
property?
than “Not
or “No”
Since
Some neither
substances
Since neither two
of two raw
(gas, materials
raw liquid, solid)
materials found
arewithout in the
liquefied SDS list
gases,thatof is “No”
substances
are not
answer which
products
.
“TYPE
handled?
can also
generate
Since
G”?
applicable,”
cause
peroxide
neither
“Not classified” or “TYPE G”?
offire/explosion
two(reference Table
(e.g.
raw materials areA5
exhaust ), gas
found answerfrom
in the “No”
ispetroleum
list . refining,
of substances organic
which
See Table
Since
 Q3.
waste
Point
both
theretwo
: liquid,
A3
are rawand
SDS
Is thecombustible
Because
Table
materials
about two
waste.
are
liquefied combustible
substance gas
A4 organic
raw ofmaterials,
Please
is denser
powder
the reference
check
orthan gas
flammable?
answer
with
for is
in the
and"No"combustible
examples
literatures,
gaseoustest
. of atomic ,
data, “Yes”
form, etc.
develop
groups.
answer
other :thanis “Yes”
polymerization
Please
SDS. check reaction
whether
. is listed “2. (reference
the substance
to aSummary
intoTable
Table
has
A1 of A6
specific ),
hazards”
of the answer
atomic
reference.is “No”
groups. .

First, Let’s Answer to

destruction
Point
The Many
GHSnotifiable and
classification eruptions
peroxides
substances arelead
aresensitive
in listed large amount
shock and ofheat
gas. Because
and canof most liquefied
cause
SDS.
 Q4.
Point Does the substance
: Intermediates and residualhave an atomic can
materials group related
contain to
substances that “No”
are
gases
Please are
explosions.
Theexplosive
hazard check at a very
Because
whether
isornot low
shown temperature,
there
the in is no
substance
the GHS
summariesthey
is in are
category
Table
of likely
twofor
A1. to
this
raw fall under
hazard,
materials. it Q13
may as notwell.
be
suspected
Since neither
Point：Because to beof self-reactive
toxic.
two
there Because
raw
is property?
materials
no GHS most
have
categoryof them
a lackhazard
specific
for the SDS, depending
atomic ofgroup, solelyison
answer
polymerization
Two
Point raw
possible materials
to is “No”
determine
: Combustible
So, answer are plastics
whether
.dusts can powder.
the
cause explosion
Plastics
substance is apowder
whenburns
hazard based
they withon aSDS.
disperse easily.
in the
“No”
SDS
 Q5. can
reaction,
.they lead
it
Is themay to oversight
not
substancebe of
possible hazards.
to
a combustible determine whether
(e.g. organic, the
metal)substance
“Yes”
is “No”.
is a hazard
“Yes”
Since
Point up.
piled
Point
no
atmosphere
based
powder
: The
: If
Substance Hazards
on raw
This
the
actually
SDS. burn
materials
and
(combustible dust)?
probability
hazard isofhas
substance
when
be found
are ignited.
hazard
hardly an
flame
Theyinmay Table
is clear
shown
atomic in
alsoA1
approaches, answer
fire, answer
spontaneously is
when some GHS classification is
SDS.
group related toareexplosive
. when
orsubstances,
self-reactive
 Q6.
Point
shown. : Since
Does
Many
A flammable
the
of
registry thesubstancegas generate
ofnotifiable
the hazard or kerosene,
substances
is useful etc.
peroxides?
have
at step as 2.fuel
not only common
toxicity but also “No”
property, it can rapidly decompose when energy (heat, shock, friction,
and For is
etc.)
At thisisstage,
there not SDS.
explosive/flammable “Classification
However, not possible”
there
characteristics is nothatdoubtis deemed
are in theseas
hazards having
causing
leading hazard.
tofire
a process
 Q7.and
added Does the substance
cause an explosion. develop polymerization reaction? “No”
explosion.
accident. If it is yes, of
detailed description implementation
each classification, of risksee assessment
Table A2 is of decided.
the reference.However,
 Q8.
since the Isinformation
the substance liquefied
is useful gas?2 and 3, let's answer to subsequent
in steps “No”
questions.
 Q9. Is the substance suspected to be toxic despite the absence “No”
of SDS?
 9/36

STEP1 Answering the questions(2)

Q14.Are
Q10
Q11
Q12.
Q13. IsAre
there
Does
Q10. reactions
there
Arethe increase
process
reactions (including
possibilities
(includinginside/
temperature
plant ofside/ a wholesale
competition
anyreactions)
have
competition of during
the
parts some
followings
that are
“No”
generated intentionally in the process plant?
storage
reactions)
physical
due
not atto
 Q11. area?
operation
Is generated
intended
ordinary
there increase in the
intentionally
or unintended
temperatures process
in temperature and
during mixing
someplant?
inphysical
the
pressuresof process “No”
operation in the process plant?
plant?
substances
(high/low
 Q12. Next,
in the plant?
temperature, high pressure, vacuum [low
Since
The the store
process
(1)Increase
pressure], or
hasofmixing
the substance
in
repeated
unintended
Let's
Are there possibilities
operation.
temperature
mixing of
of any
is But of
notsince Answer
the
wholesale.
temperature/pressure
substances in the
followings
that is slow
plant?？
due
Answerto to
intended
, temperature “No”
is “No”.hardly
rises. Answer is “No” .
an intentional reaction
(1)Increase in temperaturedoes not occur is “No”
Since
(2)Generation
increase/decrease)?
Point : Even
hazards
of combustible
when a
(2)GenerationHazards due to
of
hazardof a
a substance
is not
substancerecorded
that falls that
in
underSDS,
classification in Table A2 of the reference (see Q.2)
ofphysical
substances GHS (e.g.classification
the
solid fuel from refuse,
, answer
falls under
storage
hazards
in Table
of of
GHS
woodA2
the
large
.
quantities
of the
chips, shredder
Point ：
Point：The 
intentional
Processes of reaction
(3)Generation of largein operations
the process
quantities of gas tends otherto than
progress under
intentional high
reaction
dust,
includereaction/mixing of substance
rubble,
Since main
temperature

tempura
reference
material
(4)Decreased
and
operations
heat accumulation.
condition, Q13.
runawayDoes (e.g.
scraps,
ismaterial
pressure.
Other
the
transported
thermal
process
reaction
When
oily
absorption,
than plant
occurs.
cloths)
(see
by of
stability
the
can
Question
compressed
the
temperature
mixing,
combustible
have parts
Temperature
lead to
substance rises
dissolution,
substances,
that are
ignition
2)
air, there
handled
not
from
and
isthe
diluting)
a large
at
high
is ”Yes”
ordinary
fire due
reaction
that can
amount
to
pressure.
of
“Yes”
Since
stored that
increase
is repeated,
(3)Generation
ammonium nitrate
the temperature
temperatures
there
ofhas
and
iscaused
large
pressures
repeated
quantities
manypressure.
(high/low
. Increase huge ofand pressure
Answer
gas
explosions.
temperature,
in temperature highcan
rise rapidly.
pressure,
cause
.

unintendedor physical conditions

(4)Decreased
vacuum
Point : Parts that are
increase/decrease)?
thermal
(low pressure),
reactions including
not at
stability
repeated
further
ordinary heating,
temperatures
ofgeneration
the
temperature/pressure
and
substance handled
of toxic/combustible
pressures experience
gas and
high/low explosions. This does not include intentional heating during operation.
 temperature,
Q14. Does theand repeated
process temperature
plant have a wholesale increase/decrease.
storage area? In“No”
terms of
By SDS, since
However,
pressure, each
pay attention
there powders
are parts toatthe is very
possibility
high pressure stable
that
vacuum substance
substances
(low pressure) may
, (1)-(4) react
and does at
not
repeated
pressure
a higher
occur. Answer is ”No”.
decrease/increase.
temperature . Presence of such a part can lead to a leak of
contents due to deterioration of sealed parts. Conversely, air or other
substances
Point : Mixing can of enter
somethe process and
substances can react
causewith the contents.
(1)-(4). Any of them can cause
unintended fire/explosions.
 10/36

STEP1 Answering the questions(3)

Q15.
Q16.
 Are
Q17. Does
Q15. there
Does the plant
effect
the process
plant have
have factorsparts
plant
parts pronefrom
haveprone
the outside
to
high-voltage/
to corrosion? world
“No”
corrosion?
(e.g.
 external
current places?
Q16. Are therecorrosion
effect factors due tooutside
from the rainwater,
world (e.g.material
“No”
external corrosion due to rainwater, material degradation
degradation due to ultraviolet ray)?
due to ultraviolet ray)?
is noispart
an agitator for mixing is “No”., there is high-voltage /
operation
There there
Since
 place.
current
Since the
Finally, let's answer to
Q17. Does
Answer
equipment
prone to corrosion.
“Yes”. plant
theisprocess
is indoors
Answer
have high-voltage/ current
, that is not influenced from ambient. Answer”Yes”
Point ： Metal
places?
equipment/devices corrode due to adoption of inappropriate steel
is “No”
types
Point hazards due to other
.use in an inappropriate environment and the like, which causes leak of
：orElectrification
themselves can causeor
the content. Air, water
is an obvious hazard, but short circuit and earth defects
other substances
ignition. maycause
Joule heat can enter explosion
through corroded pores
of electric wire
：
and react with the content. Furthermore, lowering of strength of the corroded by
Point External corrosion due to rainwater and material degradation caused
materials.
part may lead
ultraviolet
Corrosion
hazards based
raystoare
is caused
factors
rupture
effectof
not only
on defects
easily overlooked
the equipment/device
factors
by corrosive
in operation,
if pressure
substances,
defects
whenis identifying
applied to them.
but by various factors
in equipment/devices,
latent
natural
including
disasters contact
and otherof external
dissimilarfactors.
metals, swift flow of the content and the effect of
stress on the material.
 11/36

Answer of STEP1
 3. Is the substance combustible or flammable? ”Yes”
 Flammable gas is more likely to cause fire/explosions.
 5. Is the substance a combustible (e.g. organic, metal)
Explanation of Table 4, Q.3
powder (combustible dust)? ”Yes”
Some substances
Explanation of (gas, liquid, solid) without SDS
 Combustible dusts may cause explosions when they
Tablein4,theQ.5
disperse atmosphere and are ignited. They may also
that are not
Explanation
Combustible of products
fireTable
spontaneously
4, Q.17
dusts cancan
when piledalso
cause up. cause fire/explosion
explosions when
(e.g.exhaust
Electrification
13. Does the is an
process
gas obvious
from plantpetroleumhazard,
have parts arebut
not atshort
that refining, organic
they disperse in the atmosphere
ordinary temperatures and are ignited.
and pressures (high/low ”Yes”
circuit
wastemay
They and also
liquid, earth
temperature, defects
high
fire pressure, themselves
combustible waste.)
vacuum
spontaneously Amongcanpiled
(low pressure),
when cause
themup.
repeated temperature/pressure increase/decrease)? ？
ignition.
flammable  Joule
Explanation of
gasheat
Contents
Table
isQ.13
may
4,
leakcan
very causeofexplosion
commonly
by deterioration used.
sealed parts. Forof electric
this
Conversely, if air or other substances enter the process,
wire materials.
reason,
Parts that itcontents
is
are morenot likely
at ordinary
may react. to cause fire/explosions.
temperatures and
 17. Does
pressures can the lead
processto a
plant leak
have of contents
high-voltage/ currentdue”Yes”to
places?
deterioration of sealed
 Short circuit parts.
and earth defects Conversely,
themselves may cause air or
ignition. Joule heat may cause explosion of electric wire.
other substances can enter the process and react
with the contents.
All of the answer of other questions are “No”.
 12/36
The record to the implementation sheet
Implemented on YYMMDD
Implemented (entered) by ○○○○

STEP1 Grasp of hazards regarding the substances and the process

Result of grasping 3 Combustible/Flammable, 5 Combustible dust,
hazards regarding Items for which
the substances and 13 High pressure, Repeated pressure increase/ “Yes” is circled
the process decrease 17 High-voltage/current

 Point : It is desirable to use accident data base and other sources also
to investigate hazards of process accident occurrence at plant
processes that are using similar substances or processes. It is
desirable to investigate the hazards of substances and process in detail
based on worker's experience.
 The process accident which may occur according to the hazards of the
target substance and process is assumed by referring to description
and cases of Table 4 and examples of possible effects of accident of
Table 8.
 13/36

STEP2
Implement risk assessment
①Identify trigger events and hazard scenarios
 （１）Confirm the purpose of works / operations or equipment /
devices covered by Risk Assessment.

 Let's choose 2.Operation (Loading) : “Air line V109 :

Shut” from operations.
 The purpose of this operation is “Dust
explosion is
prevented by the inert-gas replacement in the tank."
 The selected operation and its purpose are recorded to the
implementation sheet.
 14/36
The record to the implementation sheet

STEP2 Implementation of risk assessment

（Operation）２．Operation（Loading /
Operation, Mixing / Unloading）：Shut the V109 of
equipment/d Air line
evices and （Purpose） Dust explosion is
their purpose prevented by the inert-gas
replacement in the tank.

Table
 5Point
Examples of discrepancies
: Trigger events must be found for investigation
without of defects
a prejudice, although related
the operation
to works/operations
which is likely to cause an accident tends to be chosen. Here, the events which
Table 6causes failure orofmiss-operation
Examples are chosen.
defects related Let's check whether there is any
to equipment/devices
event which causes the same failure or miss-operation as the past. The
（a）Damage tofault
probability of vessels/piping
is investigated systems
with reference to Table 5-7.
（b）Equipment failure
 If the purposes differ even if it is the same work/operation/equipment/devices,
（c）Loss of utility must be carried out about each.
risk assessment
Table 7 Examples of external factors
Each table is shown by Crick.
 15/36

STEP2
Implement risk assessment
① Identify trigger events and scenarios
In （２）
Risk Identify the itfollowing
Assessment, 3 types
is important as events that
to exhaustively can actualize
identify events
latent actualize
that might danger. Implement
latent danger (i) to(trigger
(iii) in any order.
events) and scenarios
 to
leading （i）aDefects
processof accident. Examine possible
the works/operations → Tabledefects
5 of all
works/operations,
 （ii） Defectsequipment and devices. →
of the equipment/devices ThisTable
does not(b)
6 (a) mean
(c)
that you need to identify all trigger events and consider and
 （iii）External
implement → Table 7all at one time.
factorsmeasures
risk reduction
You
 may
Here,narrow down the
let's consider first. “The
(i)scope of riskair assessment
line V109inis each case
opened
and implement
by mistake” measures in a few
is identified as theparts.trigger event.
 Since the V109 shut by the preparatory was opened, this
corresponds to "Unnecessary works / operations are executed
(Table 5)".
 16/36
The record to the implementation sheet

STEP2 Implementation of risk assessment

（Operation）２．Operation（Loading /
Operation, Mixing / Unloading）：Shut the V109 of
equipment/ Air line
devices and
their （Purpose）A dust explosion is
purpose prevented by the inert-gas replacement
in the tank.
① (Reference:
Trigger

Trigger events The air line V109 is opened by mistake Tables 5 to

(early events)
7)
 17/36

STEP2
Implement risk assessment
①Identify trigger events and scenarios
 （３） Compile the process from trigger event to a process accident into
scenarios.

You will air

Since find that the
always into T100 “can
substance
flows cause
by open fire/explosion”,
of V109, ③nitrogen
because the answers
replacement to Q.3 “Combustible
is insufficient . or flammable property”
and Q.5 “Combustible powder” are “Yes”.
Since
That the
is, the oxygen concentration
"combustible" of and in T100
the three may exceed
element limiting oxygen
of combustion is
Since combustible,
concentration (LOC).
air ignition source exist together,
filled, if remaining two are filled, fire/explosion may occur.
process
Let's
Then, abnormality
consider
during ⑤unloading, powderpowder
called
hazard scenarios which combustion
fills theby
is dispersed remaining "air" and
airflow in T100 and
dustAnd
"ignition
occur. cloud dust
source". explosion
is formed . occurs. Thus, the hazard
Generally
scenario
ByIfopen plastics
was
static of
electricity are
109,
is prone
valveidentified.
the to the
element
charged by be agitate,
electrically charged.
of "air" static Collision
electricity
is filled, and "dust may
of powder
cloud" caused by agitation lead to static buildup, and can
is formed.
discharge . After that, dust explosion will occur.
provide ignition source.
 18/36

Point of scenario identification

 The purpose of scenario identification is to promote awareness of
trigger events that can cause process accident. Therefore, make an
exhaustive examination as far as possible, considering everyday
concerns and worries of workers as well as the person
implementing Risk Assessment.
 When examining scenarios leading to a fire/explosion, keep in mind
whether or not there are the three elements of combustion (fuel,
oxygen and ignition source).
 When identifying scenarios, assume that the existing risk reduction
measures are not implemented. This way, you can confirm how
effective the measures are.
 It is advised to describe the situation from the trigger event to
process accident in as much detail as possible so that you can
understand the situation at a later review. Description is not
necessarily limited to writing.
 19/36
The record to the implementation sheet
STEP2 Implementation of risk assessment
Trigger events (Reference:
(early events) The air line V109 is opened by mistake Tables 5 to 7)
① Identify trigger events and hazard scenarios

Since air always flows into T100 by open

of V109, ③nitrogen replacement is
insufficient. The oxygen concentration in
Process T100 may exceed limiting oxygen
abnormalities concentration (LOC). During ⑤unloading,
(intermediate
events)
powder is dispersed by airflow in T100 and
dust cloud is formed. If static electricity is
charged by the agitate, static electricity
may discharge. After that, dust explosion
will occur.

Process accidents Dust explosion may occur in T100.

(result events)
 20/36

STEP2
Implement risk assessment
②Estimation and evaluation of risk of the scenarios
 Confirm the presence or absence of existing risk reduction measures
to prevent triggering events, process abnormalities (e.g. anomalous
propagation of deviation in process parameters) and process
accidents. If there are existing risk reduction measures, enter their
content, type and the purpose.
 Mixing in inert atmosphere is the risk reduction measure about risk
actualization of dust explosion. Because, if oxygen concentration is
kept low, explosion will not occur (Three elements of combustion).
 Since reduction of the hazard frequency by nitrogen replacement is
setting of operating condition, the type of measure is 【B)
Technological measure】. Since explosion is prevented by oxygen
removal among the abnormality propagation during the period from
the initial event to a process accident, the purpose of this is 【c)
Prevention of accidents】.
※The operation purpose is clear in STEP2①(1). This may become a hint
of judgement of the existence of the existing risk reduction measure.
 21/36
The record to the implementation sheet
STEP2 Implementation of risk assessment
Trigger events (Reference:
(early events)
The air line V109 is opened by mistake Tables 5 to 7)
① Identify trigger events and hazard scenarios

Since air always flows into T100 by open of

V109, ③nitrogen replacement is insufficient.
Process
The oxygen concentration in T100 may
abnormalities exceed limiting oxygen concentration (LOC).
(intermediate During ⑤unloading, powder is dispersed by
events)
airflow in T100 and dust cloud is formed. If
static electricity is charged by the agitate,
static electricity may discharge. After that,
dust explosion will occur.

Process accidents
(result events) Dust explosion may occur in T100.
A) Intrinsic safety
measure
② Check existing Mixing operation in inert atmosphere （B-c） B) Technological
risk reduction measure
C) Managerial measure
measures D) Use of personal
protection
 22/36

STEP2
Implement risk assessment
② Estimation and evaluation of risk of the scenarios (Part 1)
 Risk estimation and evaluation assuming there is no existing
(functioning) risk reduction measures (part 1)
 Since air flows into T100 by open of V109, during unloading, powder
is dispersed by airflow and dust cloud may be formed. Since the
perfect exclusion of ignition source is impossible, there is probability
of explosion. Therefore, it is estimated that hazard frequency
is Moderate (△). Table 11（b）
 Dust explosion is expected as a result of the hazard. Dust explosion
can inflict catastrophic damage to facilities in and out of the plant and
production. Therefore, it is estimated that hazard severity is
Fatal/serious (×). Table 11（a）
 As mentioned above, risk level is Ⅲ. Table 11（c）
 23/36
The record to the implementation sheet
STEP2 Implementation of risk assessment
●Type of risk
② Check existing risk Mixing operation in inert atmosphere reduction measure
reduction measures （B-c） A) Intrinsic safety
measure
B) Technological
measure
② Risk estimation and Severity Frequency Risk level C) Managerial
evaluation (Part 1) measure
D) Use of personal
Assuming absence of protection
existing risk reduction × △ Ⅲ ●Purpose of risk
reduction measures
measures a) Prevention of
abnormalities
② Risk estimation and Severity Frequency Risk level b) Detection of
abnormalities
evaluation (Part 2) c) Prevention of
Confirm validity of the accidents
d) Limitation of
existing risk reduction damage
measures
 24/36

STEP2
Implement risk assessment
② Estimation and evaluation of risk of the scenarios (Part 2)
 Risk estimation and evaluation assuming that the existing risk
reduction measures confirmed in (1) are functioning (Part 2)
 Although nitrogen replacement is performed before mixing operation,
there is no chance which can recognize the mistake in the operation.
It is difficult to notice the airflow into T100. Therefore, it is thought
that the frequency and severity of hazard do not change.

As mentioned above, risk level does not

change with III.
 In addition, when there is no existing risk reduction measure at (1),
“Nothing" is recorded on the implementation sheet. The column of
part 2 is recorded similarly to part 1.
 25/36
The record to the implementation sheet
STEP2 Implementation of risk assessment
●Type of risk
② Check existing risk Mixing operation in inert atmosphere reduction measure
reduction measures （B-c） A) Intrinsic safety
measure
B) Technological
measure
② Risk estimation and Severity Frequency Risk level C) Managerial
evaluation (Part 1) measure
D) Use of personal
Assuming absence of protection
existing risk reduction × △ Ⅲ ●Purpose of risk
reduction measures
measures a) Prevention of
abnormalities
② Risk estimation and Severity Frequency Risk level b) Detection of
abnormalities
evaluation (Part 2) c) Prevention of
Confirm validity of the accidents

existing risk reduction × △ Ⅲ d) Limitation of

damage
measures
 26/36

STEP2
Implement risk assessment
③ Consideration of additional risk reduction
measures
(1) The risk level Ⅲ is not permitted. Consider risk reduction
measures that should be added to lower the risk level.
B)A)
As
Intrinsic safetymeasure
Technological
Since shown abnormalities measure- a） Prevention of abnormalities
in the grayhere column are V109
of the open, the open issheet,
implementation detected.there

Then,
are Intrinsic
i) Open fouritofissafety
good
kinds
V109 measure
isof to
theclose
detected is by
types attained
thatand bythe
eliminating
automatically.
installation purposes
of factors
the limit ofindispensable
switchrisk
for reductionto the
V109. 【B)
scenario advance.
Technological In the b)Detection
measure, case of measure offor to three elements
abnormalities】. Theof interlock
combustion,system
How
measure, is the pair of
respectively. the limit
Let's switch
consider detection
various
concrete they are "No combustible", "No air", and "No ignition source".
which obtains answer back from the status of the limit switch is installed.
of
risk valve
reductionopen and
the
measures,interlock
 【B)Technological
Two system
without
raw materials by
be its
caring
measure,
must signal
about
a)Prevention
changed into?incombustible
implementation
of abnormalities】. difficulty,
for "No However,
combustible."since
That
itis,cannot
necessity operate
the processes
cost, ormust exactly ifreassembled
riskbelevel the present operation
from
reduction, the is unknown,
origin.
since areataken
In practice,
they sequence
that is almost
into
impossible.
must be installed.
consideration later. The order of consideration is A)Intrinsic safety

 B)measure,
The Incause
a similarof
Technological manner, realization
abnormalities
measure ofhere
- b） "No air"
mayis almost
Prevention be of impossible,
not a mistake
abnormalities as long
butas valve
a worker
B)Technological measure, C)Managerial
needs to approach the equipment. Because the space suit for workers will be measure,
defect,
D)Use needed.
ii) The because
of
leakage fromitV109
personal means
protection. that air
is detected by flows although
installation the valve
of the flowmeter is shut.
to the
The lineflowmeter
 Although
of V109. 【B)Technological
installed
"No ignition source" inispiping
measure, shows
not explained whether
b)Detection
in detail, airremoval
flowsisordifficult
of abnormalities】.
perfect not.
If aMoreover,
leakage
like the manual is revised
is found,
the above-mentioned repair
two. or as follows, valves must be exchanged if
replacement of the valve is needed.
leakage is detected during v109 shut. 【C)Managerial measure,
AsLet's
mentionedcorrect the
a)Prevention ofabove,
manual. the intrinsic safety measure
abnormalities】.
which can be installed was not found.
 27/36

STEP2
Implement risk assessment
③ Consideration of additional risk reduction
measures (continued)
 B) Technological measure - c） Prevention of accidents
Sinceiii)oxygen
Let's useconcentration is lowered
the oxygen concentration valuefor the dust-explosion
measured by oxygen
analyzer
prevention, XI100
let's payofattention
already installed
to theT100. 【B)Technological
oxygen concentration.measure,
Let's
b)Detection of abnormalities】. Operation of the agitator will not be
install the interlock
permitted whichifdoes
by interlock, oxygen not permit operation
concentration of the of the
is high at start-up
agitatoragitator.
when 【B)Technological
oxygen is highmeasure,
alarm. c)Prevention
Then, dustofcloud formation
accidents】
willB)be
 prevented. measure - d） Limitation of damage
Technological
One iv)
of Damage of the chemistry
the limitation of damageequipment
aboutofgasT100or
etc. is limited
dust to whenis
explosion
dust explosion occurs by installation of explosion venting.
explosion venting. Explosion
【B)Technological venting is ofwidely
measure, d)Limitation damage】used in the drying
device or the dust collector.
※ Since 【B)Technological measure】 and 【b)Detection of
abnormalities】 are considered together in many cases, let's request
cooperation to the technical expert of instrumentation.
 28/36
The record to the implementation sheet
STEP2 Implementation of risk assessment
S F R
③ Consideration of additional risk reduction measures & ③ risk

Confirm the validity of the additional risk reduction measures

i） Open of V109 is detected by installation of the limit

switch for V109.（B-b） The interlock system which
obtains answer back from the status of the limit switch
estimation and evaluation (Part 3)

is installed.（B-a）
ii） The leakage from V109 is detected by installation of
the flowmeter to the line of V109.（B-b） The manual is
revised as follows, valves must be exchanged if
leakage is detected during v109 shut.（C-a）
iii） Use the oxygen concentration value measured by
oxygen analyzer XI100 of already installed T100.（B-b），
Operation of the agitator will not be permitted by
interlock, if oxygen concentration is high at start-up of
the agitator.（B-c）
iv） Damage of T100 etc. is limited when explosion
occurs by installation of explosion venting.（B-d)
 29/36

STEP2
Implement risk assessment
③ Consideration of additional risk reduction measures
(continued)
（2）Estimate and evaluate risk again by assuming the implementation of the
additional risk reduction measures (Part 3)
i）Since the probability of the V109 open by a mistake decreases with the
installation of interlock, frequency of hazard decreases to “Rare (○)”.
Severity of hazard does not change with “Fatal / serious (×)”. Risk level is Ⅱ.
ii）Since V109 open is detected, and valves will be exchanged if leakage is
found, frequency of hazard decreases to “Rare (○)”. Severity of hazard
does not change with “Fatal / serious (×)”.Risk level is Ⅱ.
iii） Since the operation probability when the oxygen concentration in T100 is
high decreases with the installation of interlock, frequency of hazard
decreases to “Rare (○)”. Severity of hazard does not change with “Fatal /
serious (×)”. Risk level is Ⅱ.
iv） Since the breakage probability of T100 decreases with the installation of
explosion venting, the frequency of hazard decreases to “Rare (○)”. Severity
of hazard does not change with “Fatal / serious (×)”. Risk level is Ⅱ.
※ Note that measures other than 【A)Intrinsic safety measure】 only decrease
frequency of hazard, and do not change severity of hazard.
 30/36
The record to the implementation sheet
STEP2 Implementation of risk assessment

Confirm the validity of the additional risk reduction measures

S F R
③ Consideration of additional risk reduction measures &

i） Open of V109 is detected by installation of the limit

③ risk estimation and evaluation (Part 3)

switch for V109.（B-b） The interlock system which

obtains answer back from the status of the limit switch is × ○ Ⅱ
installed.（B-a）

ii） The leakage from V109 is detected by installation of

the flowmeter to the line of V109.（B-b） The manual is
revised as follows, valves must be exchanged if leakage × ○ Ⅱ
is detected during v109 shut.（C-a）

iii） Use the oxygen concentration value measured by

oxygen analyzer XI100 of already installed T100.（B-b），
Operation of the agitator will not be permitted by × ○ Ⅱ
interlock, if oxygen concentration is high at start-up of
the agitator.（B-c）

iv） Damage of T100 etc. is limited when explosion

occurs by installation of explosion venting.（B-d) × ○ Ⅱ
 31/36

STEP2
Implement risk assessment
③Consideration of additional risk reduction
measures (continued)
(3) Check whether or not the proposed additional risk reduction
measures can be implemented.
 i)～iv) Risk level decreases by all of i)～iv), since they do not interfere with the existing
Check whether
risk reduction or not
measure, the
those proposed
installation additional risk reduction
is possible.
measures
(4) Cautionscan to bebecommunicated
implemented, to considering
workers in the order balance with the
to maintain
existing risk
functioning of reduction
the existing measures
and additional and other restrictions.
risk reduction measures.
 i), iii) Check the sensor and actuator for interlock. Check operation of interlock
Not only the
periodically evaluation
(several months). result of risk level but deal-with matter
and notes
ii) Test are recorded
the leakage as concretely
of V109 periodically as possible.
(several months). That must be
If there
recorded are
iv) Check so residual
visually
thatdaily. risksthe(e.g.
Check
workers trigger
existence
can events
of abnormalities
understand the and scenarios
periodically
purpose (several
and at of
type
months).
Risk
the Level
risk II or lower,)
reduction make workers aware of possible
measure.
 ※ About check of operation or daily inspection, if each interval is clear, effectiveness will
occurrence
become good.of process accidents, while deciding on on-site
responses.
(5) Record the results of risk assessment and other information to
be communicated to workers after the start of production, if there are
any.
 32/36
The record to the implementation sheet
STEP2 Implementation of risk assessment
③ Can you
implement i)～iv) Risk level decreases by all of i)～iv), since they do not
additional risk interfere with the existing risk reduction measure, those
reduction installation is possible.
measures?
i), iii) Check the sensor and actuator for interlock. Check
③ Instructions to operation of interlock periodically (several months).
on-site workers in
ii) Test the leakage of V109 periodically (several months).
order to maintain
the functions of iv) Check visually daily. Check the existence of abnormalities
the risk reduction periodically (several months).
measures

Is there a residual risk? [Yes] / No

③ Information to How do you handle the residual risk?
be communicated Indicate the content and cause about the risk reduction
to on-site workers measures, and the possibility of dust explosion in the manual
after the start of about this work. Workers need to be educated periodically.
production Check rule and regulation about inspection, record, or
management.
 33/36

STEP2
Implement risk assessment
④Implement Risk Assessment by repeating the process from
① to ③
Repeat the process of ① to ③.
Identify a variety of trigger events in an exhaustive manner,
and identify scenarios leading to a process accident.
Consider necessary risk reduction measures for each
scenario.
It is necessary to identify trigger events and consider scenarios
as exhaustively as possible. However, you don’t need to
implement measures for everything at one time. It is important to
implement Risk Assessment on a continuing basis by narrowing
down the scope (running PDCA cycle) of risk assessment in each
case to tackle the task in incremental steps.
 34/36

STEP3
Decision on the risk reduction measure

 ① Compile the Risk Assessment implementation

sheets (Table 2) completed for individual scenarios
into one Risk Assessment implementation result sheet
(Table 3) .
Overlooking
Arrange the a whole,
Riskrisk reduction measures
Assessment can be planned
implementation by
sheets
compile of scenarios into one risk assessment implementation
completed in STEP 2 in descending order of Risk
result sheet.
If Level
there is(III => II =>
variability I). risk level judgment among scenarios,
in the
make
If ② corrections
the Decide
same riskon as needed.
risk reduction
reduction measuresmeasures based
are proposed on a
for multiple
scenarios, you can implement
comprehensive judgmentthem together. cost and other
of technical,
aspects starting from scenarios at high Risk Level.
 35/36
Person name and Date
Name YY/MM/DD
Result of grasping hazards involved in the
Operation, equipment/devices and their purpose
substances handled and the process
Result of STEP1
②Risk

③Consideration of additional risk

② Risk ③Risk estimation
estimation and
estimation and and evaluation

②Check existing risk reduction

reduction measures & risk

estimation and evaluation
evaluation
evaluation (Part 3)
(Part 1)
①Identify trigger events and (Part 2) Confirm the
scenarios
Assuming
Confirm validity validity of the ③Instructions to ③Information to
③Can you
Person name

absence of workers in order be

Remarks
measures
of the existing additional risk implement the
existing risk
to maintain the communicated
Date

risk reduction reduction

reduction
measures measures
additional risk
measures functions of the to workers after
reduction
risk reduction the start of
measures?
measures production

Frequency

Frequency

Frequency
Risk Level

Risk Level

Risk Level
Severity

Severity

Severity
Trigger Process Process
events abnormalities accidents
（early） （intermediate） （result）

STEP 2 Scenario
Please copy1 the content of implementation sheet.

STEP 2 Scenario 2 Decide on risk reduction

measures based on a
comprehensive judgment of
STEP 2 Scenario 3 technical, cost and other
aspects starting from
scenarios at High Risk Level.
 36/36

Conclusion
The record for next time.
 This tutorial material finishes here.
 Thank you for taking a look to the last.
 For details, please refer to Safety Document
or manual. (Sorry in Japanese)
 Risk assessment is not finished only at a
time. If the arrangement store of the content
of implementation is carried out, next effort
will be reduced greatly.
 37/36
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Table 5 Examples of discrepancies for investigation

of defects related to works/operations

The works/operations are not executed

The works/operations are executed in the reverse
order
Order of operations Only a part of the works/operations are executed
Unnecessary works/operations are executed
Divergent works/operations are executed
Timing of the Works/operations are executed too early
operations Works/operations are executed too late
Time period of the Work/operation time is too long
operations Work/operation time is too short
No filling
Filled quantity Excessive filled quantity
Too small filled quantity
 38/36
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Table 6 Examples of defects related to
equipment/devices
(a) Damage to vessels/piping systems
Vessels/
Vessels/ Description
Description Examples
Examplesofofdefects
defectsandandprocess
processabnormalities
abnormalitiesthat thatthey
theycause
cause
piping
piping
There are aclosable
Container large variety of or
with lid piping in terms
stopper for of Closing, increased
Leaks, leak-in, pressure
oxygen loss, reduction
deficiency, of internal
deterioration of the pressure,
content.
flow rate, pressure resistance, corrosion
transportation or storage. Because troubles insufficient pressure reduction, reverse flow,
Containers for transportation are themselves prone to leak, leak-in,
Containers resistance and other properties. Because sudden
due to insufficient maintenance are seen here deterioration change in pressure (water hammer)
Piping
vibration can
and there, accelerate
inspection anddeterioration,
management piping
are
including
important joints requires inspection and
management.
Piping component indispensable for places with Defects similar to those of piping. Common problems include
Most of them
vibration, have countermeasures
seismic larger diameter and andflow Defects
pressure similar to those
resistance, of piping.
material Generally
strength their pressure
and aging degradation
rate compared with piping. Often
expansion of handling range. Points are used as resistance and structural strength are inferior to those of piping.
Flexible hose common equipment in air supply, exhaust and When they are used as common equipment without an inflow
selection of materials with focus on
other systems.and endurance, inspection and
permeability prevention measures, reverse flow can occur under an abnormal
Duct management of loosening of joints condition. If condensable process fluid flows exceeding the
Refers to peep holes and liquid level gauge. design
Defects conditions
similar to(temperature,
those of piping. pressure andtransparent
Generally air volume)parts
the
Their weakness is in seal portions with metal fluid may condense in the duct,
(glass or plastic) are low in intensitywhich leads to leaks, deposition
Sight glass
parts, which requires maintenance or (and) generation of combustible/heat storing modification
(conversion) products.
non-durable parts to maintain sealing property Defects similar to those of piping. They are likely to cause
Generally used for gas or liquid but sometimes Leaks,
internalleak-in, rupture, change in physical properties (e.g. leak,
Gasket / seal between parts. They are replaced by parts of pressure reduction, insufficient pressure reduction,
used for powder.
the same Tanks are used for various
specification viscosity,
leak-in andtemperature,)
other defects loss of volatile components, heat-
purposes from temporary to long-term storage. retention, heating or cooling defect, uneven temperature
Tanks distribution and discrepancy between the indication of level
instrument and the actual fluid level can occur. Heat
medium/coolant can leak from a tank with a jacket or internal
coiling.
With smaller capacity compared with tanks. Defects similar to those of tanks are possible. Pressurized or
Many of them are normally pressurized or decompressed vessels require attention to their rupture, internal
Vessels
decompressed. pressure reduction, insufficient pressure reduction, and rapid
change in the pressure.
continued
 Table 6 Examples of defects related to
39/36
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equipment/devices
(b) Equipment failure
Equipment Description
Valves to reduce pressure inside the Inoperative, blocking, flow deficiency, leaks/leak-in in normal period. Counter flow of air
Pressure relief equipment
/safety valves
There are suction pumps and feeding
pumps. The point is to look at
Pump conditions of both the pump and the
feeding/receiving part.
Compresses and increases the
Compressor pressure of gas. Heat is generated
during compression.
Used to mix liquid with other liquid or
dissolve solids in liquid. There are
Agitator also mixers for separation prevention.
(mixer) Operation outside the design range
leads directly to troubles.
There are on-off valves and
regulating valves, manual types and
Valves power operation types. Some can be
remote controlled.
Measure pressure, temperature, flow
Sensors and rate, etc. Some are for control and
measuring others are for monitoring.
equipment
Require power source for action.
Control Measures such as multiplexing are
systems possible. Operation may be continued
without noticing abnormality.
Maintain balance of internal and
Vents external pressure of a vessel, etc.
Examples of defects and process abnormalities that they cause
tends to take place after atmospheric emission. Ignition can be caused by friction or
static electricity at the time of emission. Foreign matters such as rust on the emitting
part can cause trouble.
Stop of flow, change in flow rate, mixing of air bubbles, changes in pressure,
increase in suction pressure, mixing of components, leaks and leak-in can occur.
In addition, the differential pressure with the receiving part causes unintended
flow.
Same as pump but especially prone to decrease in flow rate and pressure. Use
of flammable vapor sometimes leads to ignition.
here may be separation of mixed substances, uneven
temperature/concentration, and mixing of components. Weakness is at the
agitator shaft and its sealing part, which can have fatigue breaking, leaks and
mixing.
Failure to open/close, failure to fully close leading to leaks, failure to fully open leading
to flow deficiency. In addition to the above, regulating valves may have defects such as
unchangeable opening and opening not as indicated. These defects may cause changes
in liquid/pressure level and temperature change if the valve is for heat medium.
When the measured value is out of the assumed range, measured value may be
understated or overstated. There may be time-lag in measured values, or signals
cannot be read. Measured values are unstable with variations. You need to think about
loss of signals due to external factors and defects of display devices (understatement,
overstatement, deviations, no display)
Any defects are possible in the controlled machines including behavior not as
indicated and “inoperative.” An abnormal condition is likely to cause another
abnormal condition. Sometimes it is dangerous to stop the system.
Require attention to troubles similar to those of piping, ducts and pressure relief
/safety valves
 40/36
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Table 6 Examples of defects related to
equipment/devices
(c) Loss of utility
Utility Description Examples of defects and process divergence that they cause
Just after a power outage, all electrical equipment including rotating
Wide range of use including control,
Electricity equipment will stop or decrease functions. Use of back-up power
power, lighting and heating
source can avoid loss but hours of back-up are limited.
Used for inert gas atmosphere and Immediate effect of supply stop is limited but the inert gas
regulation of oxygen concentration. environment and the space with regulated oxygen concentration are
Nitrogen
Liquid nitrogen is sometimes used disturbed. If liquid nitrogen is used to maintain very low temperature,
to keep very low temperature. the temperature is not maintained.
There is cold water, water at room Divergence from the target temperature in the case where water is
temperature and warm water used for heating or cooling. In the case where water is used for
Water based on the temperature. Water dilution, there may be divergence from the designed concentration of
is sometimes used as power the substance. When water is used as power source, supply stop
source. may cause nonfunctioning or malfunctioning of the equipment.
Cooling
Media for heat transfer. Used for Divergence from the target temperature for cooling or heating at the
/heat
heat pump. supply destination.
media
Shortage of air may cause unwanted variance in the concentration of
Used for dilution, combustion,
the substance, or defects in combustion. There may be incomplete
Air power, cooling, drying and other
drying or cooling defects. When air is used as power source, loss will
purposes.
cause stoppage or malfunction of the equipment.
Used for moving out harmful Increased concentration of harmful substances, mixing of impurities,
Ventilatio
substances, dust or the like, or increase in dust concentration, deterioration of work environment,
n
replenishing consumed air. defects in combustion or accidents due to lack of oxygen.
Steam is often used as heat
Similar to heat medium. Condensed water is prone to cause troubles
Steam medium/source but sometimes
(e.g. blocking, corrosion.)
used for power.
 41/36
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Table 7 Examples of external factors

Examples of external
Examples of defects and process variances that they cause
factors
Power outage Defects accompanying stoppage of all electrical equipment/facilities.
Heavy rain, floods, tidal waves, snow, low/high temperature damage,
Extreme weather lightening strokes, thunder damage, gust, tornadoes, hail, typhoons,
changes in barometric pressure, dew condensation, etc.
Large-scale natural
disaster (earthquakes, Stock yards require fall prevention measures. The process includes off-
tsunamis, cracks in site operations. Earthquakes and other natural disasters can trigger
the ground, ground multiple factors simultaneously – destruction of equipment and loss of
uplift/ subsidence, power/water, for example. In addition, disaster prevention/firefighting
soil avalanches,
landslides, avalanches, facilities may become unusable.
eruptions, etc.)
Effect of an accident Spread of fire, incoming flying objects, blast wave, power outage,
in the neighborhood stoppage of common utilities, combustible gas, flammable liquid, inflow of
toxic substances, etc.
Collision between vehicles involves danger of vehicle fuel and chemical
Vehicular collision substances loaded on the vehicles. Collision between a vehicle and a
facility involves danger intrinsic to the facility according to the level of
the impact, in addition to the danger of vehicle fuel.
Vandalism/sabota Defects of any equipment/facility in an area vulnerable to intrusion
ge
 42/36
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Table 11 Criteria for risk estimation
(a) Severity of hazard

Severity
Degree/indication of accident
(degree of accident)
・Fatal accidents or those resulting in permanent damage to a body part
・Accidents causing absence from work (one month or longer,) those
Fatal/serious (×) resulting in a large number of victims at one time
・Accidents inflicting catastrophic damage to facilities in and out of the
plant and production (example: restoration takes more than a year)
・Accidents causing absence from work (less than one month,) those
resulting in multiple victims at one time.
Moderate (△) ・Accidents inflicting heavy damage to facilities in the plant and a part of
production and requires a long period of time for restoration.
(example: restoration takes about a six months)
・Accidents without lost days, those involving slight wounds.
・Accidents inflicting a small damage to facilities in the plant and a part of
Slight (○)
production
(example: restoration takes about one month)
 43/36
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Table 11 Criteria for risk estimation
(b) Occurrence frequency of hazard
(likelihood)
Occurrence
Degree/indication
frequency
High or relatively ・The hazard is likely to occur.
high (×) (example: about once a year)

・The hazard can occur.

Moderate (△) (example: about once in the lifetime of the plant/facility (30 to 40
years)

・The hazard will be rare.

Rare (〇)
(example: once in 100 years)
 44/36
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Table 11 Criteria for risk estimation
(c) Risk level

Severity of hazard
Fatal/serious（×） Moderate（△） Slight（○）
High or relatively high (×) Ⅲ Ⅲ Ⅱ
freque
Moderate (△) Ⅲ Ⅱ Ⅰ
ncy
Rare (〇) Ⅱ Ⅰ Ⅰ

(d) Description of the risk levels

Risk level Priority Cautions concerning production start
There is a risk that should beDon’t start production before taking necessary
Ⅲ eliminated immediately or a measures. It is necessary to invest sufficient
serious risk. management resources (money and labor)
It is desirable not to start production before
There is a risk that requires taking measures. It is necessary to invest
Ⅱ
prompt reduction measures. management resources (money and labor) on
a priority basis.
There is a risk that requires Implement risk reduction measures as
Ⅰ
reduction measures as needed. needed.