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A methodology for human reliability analysis of oil refinery and petrochemical operations: the hero (human error in refinery operations) hra methodology

The oil industry has grown in recent decades in terms of quantity of facilities and process complexity. However, human and material losses still occur due to major accidents at the facility. The analysis of these accidents reveals that many involve human failures that, if prevented, could avoid such...

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Main Author:	RAMOS, Marilia Abílio
Other Authors:	DROGUETT, Enrique Andrés López
Format:	doctoralThesis
Language:	eng
Published:	Universidade Federal de Pernambuco 2018
Subjects:	Engenharia Química Human reliability analysis Oil refining Safety Human error Risk analysis
Online Access:	https://repositorio.ufpe.br/handle/123456789/24864
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spelling	ir-123456789-248642019-10-26T03:21:20Z A methodology for human reliability analysis of oil refinery and petrochemical operations: the hero (human error in refinery operations) hra methodology RAMOS, Marilia Abílio DROGUETT, Enrique Andrés López MOURA, Márcio José das Chagas http://lattes.cnpq.br/9744911941117163 http://lattes.cnpq.br/7731672359030872 Engenharia Química Human reliability analysis Oil refining Safety Human error Risk analysis The oil industry has grown in recent decades in terms of quantity of facilities and process complexity. However, human and material losses still occur due to major accidents at the facility. The analysis of these accidents reveals that many involve human failures that, if prevented, could avoid such accidents. These failures, in turn, can be identified, modeled and quantified through Human Reliability Analysis (HRA), which forms a basis for prioritization and development of safeguards for preventing or reducing the frequency of accidents. The most advanced and reliable HRA methods have been developed and applied in nuclear power plant operations, while the petroleum industry has usually applied Quantitative Risk Analysis (QRA) focusing on process safety in terms of technical aspects of the operation and equipment. This thesis demonstrates that the use of HRA in oil refining and petrochemical operations allows the identification and analysis of factors that can influence the behavior of operators as well as the potential human errors that can contribute to the occurrence of an accident. Existing HRA methodologies, however, were mainly developed for the nuclear industry. Thus, they may not reflect the specificities of refining and petrochemical plants regarding the interaction of the operators with the plant, the failure modes of the operators and the factors that influence their actions. Thus, this thesis presents an HRA methodology developed specifically for use in this industry, HERO - Human Error in Refinery Operations HRA Methodology. The Phoenix HRA methodology was used as a basis, which has three layers i) a crew response tree (CRT), which models the interaction between the crew and the plant; ii) a human response model, modeled through fault trees, that identifies the possible crew failures modes (CFMs); and (iii) "contextual factors" known as performance influencing factors (PIFs), modeled through Bayesian networks. In addition to building on such a structure, HERO's development relied on interviews with HRA specialists, visitations to a refinery and its control room, and analysis of past oil refineries accidents - four accidents were analyzed in detail. The methodology developed maintains the three-layer structure and has a guideline flowchart for the construction of the CRT, in order to model the team-plant interactions in oil refining and petrochemical operations; it also features CFMs and PIFs developed specifically for this industry, with definitions that make them easily relatable by an analyst. Finally, the methodology was applied to three potential accidental scenarios of refinery operations. In one of these scenarios, it was combined with a QRA to illustrate how an HRA can be applied to a traditional QRA and to demonstrate the influence of PIFs and of human error probability on the final risk. The use of this methodology for HRA of refineries and petrochemical plants operations can enhance this industry safety and allow for solid riskbased decisions. ANP (Agência Nacional do Petróleo) Petrobras A indústria de petróleo teve grande crescimento nas últimas décadas em termos de quantidade de instalações e complexidade de processo. No entanto, perdas humanas e materiais ainda ocorrem devido a acidentes graves nas instalações. A análise desses acidentes revela que muitos envolvem falhas humanas que poderiam ser prevenidas de forma a evitar tais acidentes. Estas falhas, por sua vez, podem ser identificadas, modeladas e quantificadas através da Análise de Confiabilidade Humana (ACH), que forma uma base para priorização e desenvolvimento de salvaguardas na prevenção ou redução da frequência de acidentes. Os métodos de ACH mais avançados e confiáveis têm sido desenvolvidos e aplicados nas operações de controle de plantas nucleares; já a indústria de petróleo tem usualmente aplicado a Análise Quantitativa de Risco (AQR) com foco na segurança de processo em termos técnicos da operação e equipamentos. Esta tese demonstra que o uso da ACH em operações de refino e petroquímica possibilita a identificação e análise dos fatores que podem influenciar o comportamento do operador bem como as potenciais falhas humanas que podem contribuir para a ocorrência de um acidente. As metodologias de ACH existentes, no entanto, foram desenvolvidas para a indústria nuclear. Desta forma, elas não refletem as especificidades de refino e petroquímica no que se refere à interação dos operadores com a planta, aos modos de falha dos operadores e aos fatores que influenciam suas ações. Assim, esta tese apresenta uma metodologia de ACH desenvolvida especificamente para uso nessa indústria, a HERO - Human Error in Refinery Operations HRA Methodology. Como base, utilizou-se a Metodologia Phoenix, que possui três camadas i) uma árvore de resposta da equipe (crew response tree - CRT), que modela a interação da equipe com a planta; ii) um modelo de resposta humana, modelado através de árvores de falhas, que identifica os possíveis modos de falhas da equipe (crew failures modes - CFMs); e iii) os “fatores contextuais” conhecidos como fatores de desempenho ou performance influencing factors (PIFs), modelados através de redes Bayesianas. Além de basear-se em tal estrutura, o desenvolvimento da HERO apoiou-se em entrevistas com especialistas em ACH, visitas a uma refinaria e sua sala de controle e na análise de estudos de acidentes passados em refinarias – foram analisados em detalhe quatro acidentes. A metodologia desenvolvida mantém a estrutura de três camadas e possui um fluxograma-guia para construção da CRT, de forma a modelar as interações equipe-planta na operação de refino e petroquímicas; ela também apresenta CFMs e PIFs desenvolvidos especificamente para esta indústria, com definições que os tornam facilmente identificáveis por um analista. Por fim, a metodologia foi aplicada a três cenários acidentais de operações de refinaria. Em um destes cenários, ela foi conjugada a uma AQR de forma a ilustrar como uma ACH pode ser aplicada a uma tradicional AQR e para demonstrar a influência dos PIFs e da Probabilidade de Erro Humano no risco final. Espera-se que o uso da metodologia proposta nesta tese poderá aumentar a segurança em refinarias e petroquímicas e permitir sólidas decisões baseadas no risco. 2018-06-20T22:54:11Z 2018-06-20T22:54:11Z 2017-04-07 doctoralThesis https://repositorio.ufpe.br/handle/123456789/24864 eng openAccess Attribution-NonCommercial-NoDerivs 3.0 Brazil http://creativecommons.org/licenses/by-nc-nd/3.0/br/ application/pdf Universidade Federal de Pernambuco UFPE Brasil Programa de Pos Graduacao em Engenharia Quimica
institution	REPOSITORIO UFPE
collection	REPOSITORIO UFPE
language	eng
topic	Engenharia Química Human reliability analysis Oil refining Safety Human error Risk analysis
spellingShingle	Engenharia Química Human reliability analysis Oil refining Safety Human error Risk analysis RAMOS, Marilia Abílio A methodology for human reliability analysis of oil refinery and petrochemical operations: the hero (human error in refinery operations) hra methodology
description	The oil industry has grown in recent decades in terms of quantity of facilities and process complexity. However, human and material losses still occur due to major accidents at the facility. The analysis of these accidents reveals that many involve human failures that, if prevented, could avoid such accidents. These failures, in turn, can be identified, modeled and quantified through Human Reliability Analysis (HRA), which forms a basis for prioritization and development of safeguards for preventing or reducing the frequency of accidents. The most advanced and reliable HRA methods have been developed and applied in nuclear power plant operations, while the petroleum industry has usually applied Quantitative Risk Analysis (QRA) focusing on process safety in terms of technical aspects of the operation and equipment. This thesis demonstrates that the use of HRA in oil refining and petrochemical operations allows the identification and analysis of factors that can influence the behavior of operators as well as the potential human errors that can contribute to the occurrence of an accident. Existing HRA methodologies, however, were mainly developed for the nuclear industry. Thus, they may not reflect the specificities of refining and petrochemical plants regarding the interaction of the operators with the plant, the failure modes of the operators and the factors that influence their actions. Thus, this thesis presents an HRA methodology developed specifically for use in this industry, HERO - Human Error in Refinery Operations HRA Methodology. The Phoenix HRA methodology was used as a basis, which has three layers i) a crew response tree (CRT), which models the interaction between the crew and the plant; ii) a human response model, modeled through fault trees, that identifies the possible crew failures modes (CFMs); and (iii) "contextual factors" known as performance influencing factors (PIFs), modeled through Bayesian networks. In addition to building on such a structure, HERO's development relied on interviews with HRA specialists, visitations to a refinery and its control room, and analysis of past oil refineries accidents - four accidents were analyzed in detail. The methodology developed maintains the three-layer structure and has a guideline flowchart for the construction of the CRT, in order to model the team-plant interactions in oil refining and petrochemical operations; it also features CFMs and PIFs developed specifically for this industry, with definitions that make them easily relatable by an analyst. Finally, the methodology was applied to three potential accidental scenarios of refinery operations. In one of these scenarios, it was combined with a QRA to illustrate how an HRA can be applied to a traditional QRA and to demonstrate the influence of PIFs and of human error probability on the final risk. The use of this methodology for HRA of refineries and petrochemical plants operations can enhance this industry safety and allow for solid riskbased decisions.
author2	DROGUETT, Enrique Andrés López
format	doctoralThesis
author	RAMOS, Marilia Abílio
author_sort	RAMOS, Marilia Abílio
title	A methodology for human reliability analysis of oil refinery and petrochemical operations: the hero (human error in refinery operations) hra methodology
title_short	A methodology for human reliability analysis of oil refinery and petrochemical operations: the hero (human error in refinery operations) hra methodology
title_full	A methodology for human reliability analysis of oil refinery and petrochemical operations: the hero (human error in refinery operations) hra methodology
title_fullStr	A methodology for human reliability analysis of oil refinery and petrochemical operations: the hero (human error in refinery operations) hra methodology
title_full_unstemmed	A methodology for human reliability analysis of oil refinery and petrochemical operations: the hero (human error in refinery operations) hra methodology
title_sort	methodology for human reliability analysis of oil refinery and petrochemical operations: the hero (human error in refinery operations) hra methodology
publisher	Universidade Federal de Pernambuco
publishDate	2018
url	https://repositorio.ufpe.br/handle/123456789/24864
_version_	1648655153183588352
score	13.657419

A methodology for human reliability analysis of oil refinery and petrochemical operations: the hero (human error in refinery operations) hra methodology

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