OSHA Accident Investigation · Summary #14459390
BURN,FLAMMABLE VAPORS,STORAGE TANK,TORCH,BACK,FACE,TANK,LEG
Event description
CUTTING TORCH IGNITED FIRE IN STORAGE TANK; EMPLOYEE BURNED
Investigation abstract
ABOUT 8:15 AM ON NOVEMBER 26, 1985, EMPLOYEE #1, A MECHANIC, WAS ASSIGNED THE TA BACK OF HIS LEFT LEG. HIS TORCH MAY HAVE CAUSED OTHER BURNS ON HIS RIGHT FOREARM . THE EXACT CAUSE OF THE FIRE IS NOT KNOWN. IT IS POSSIBLE THAT BENZOYL PEROXIDE VAPORS MAY HAVE, AT SOME EARLIER DATE, LEAKED FROM THE FLANGE AND IMPREGNATED T HE PIPE INSULATION. WHEN BPO DRIES IT LOOKS LIKE INSULATION, CANNOT BE DETECTED BY A GAS CHECK AND IS SHOCK SENSITIVE. IT ALSO IS QUICKLY REDUCED TO A FLAMMABLE VAPOR WHEN HEATED. IT IS ALSO POSSIBLE THAT CARBON TETRACHLORIDE REACTED WITH A NITROGEN BLANKET TO FORM NITROGEN TRICHLORIDE, WHICH IS ALSO SHOCK SENSITIVE. SK OF BURNING OFF A BEARING RING SO THAT AN AGITATOR SHAFT COULD BE REMOVED FROM A T200 STORAGE TANK. THE TANK HAD PREVIOUSLY CONTAINED CARBON TETRACHLORIDE (CC L4) AND BENZOYL PEROXIDE (BPO). TWO OTHER EMPLOYEES AND A SUPERVISOR WERE ASSIGN ED AS FIRE WATCHES. THE EMPLOYEES POSSESSED FIRE AND VESSEL ENTRY PERMITS, HAD C LEANED THE TANK, PURGED AND BLANKED ALL PIPES, COVERED ALL SEWERS, MADE GAS CHEC KS AND SPARK TESTS. SHORTLY AFTER BURNING BEGAN, A FLASH FIRE, WITH DENSE SMOKE, ERUPTED, APPARENTLY COMING FROM A ONE INCH PIPE FLANGE LOCATED FIVE FEET FROM E MPLOYEE #1. EMPLOYEE #1 SUFFERED SECOND DEGREE BURNS ON HIS FACE, BACK, AND THE
Victim
-
#1 Hospitalized Age 48 M
- Nature of injury
- 5
- Part of body
- 4
- Event type
- 14
- Source
- 16
- Occupation code
- 544
- Human factor
- 14
- Environmental factor
- 10
- Hazardous substance
- 0335
- Task assigned
- 1
Codes shown verbatim from OSHA's accident-investigation database. A human-readable decoder is coming in a future release once the accident_lookup2 dictionary is loaded.