CSB cites lack of safety management in final report on California refinery explosion

Torrance, CA – A breakdown in safety management played a major role in an explosion at a refinery in Torrance a little more than two years ago, the Chemical Safety Board stated in its final report released May 3.

The explosion occurred Feb. 18, 2015, while workers were attempting to perform maintenance on equipment in the fluid catalytic cracking unit, a key piece in the refining process. The CSB report said an eroded valve and faulty procedures from refinery personnel were the main causes in hydrocarbons flowing into the electrostatic precipitator, a pollution control device that sparked the blast.

Four contractors were treated for injuries as a result of the explosion.

CSB made several recommendations to the Torrance Refining Co., ExxonMobil (which owned the refinery at the time of the explosion) and the refining industry:

• Identify all safety-critical equipment and the consequences of failure for each mode of operation.
• Evaluate safety-critical equipment that is operating past the proper time for inspection or maintenance, as well as perform risk analysis of equipment and machinery positioning.
• Implement safeguards to keep flammable gases from reaching the electrostatic precipitator.
• Develop a program to ensure operating procedures are written and available for each mode of operation and that operators are trained for their use.
• Ensure all procedure deviations are analyzed by a diverse, experienced team before approval and implementation.

The agency also recommended that American Fuel and Petrochemical Manufacturers, a trade association, host forums for organizations to talk about the factors in this incident.

“The 2015 explosion had the potential to be catastrophic. Such events are preventable with the implementation of a robust safety management program,” CSB Chairperson Vanessa A. Sutherland said during a May 3 press conference. “The refining industry as a whole must take these lessons and examine their own safety management processes. Safety is continuous improvement. Good safety management is good business management and good public policy.”

The Torrance refinery has experienced four incidents since the explosion, including two fires in February. No injuries or damage were reported in those incidents.

CSB also released an animated, 3-D analysis of the explosion.