FIRES IN THE OIL & GAS INDUSTRY

CASE STUDY
THE PETROTRIN OIL
REFINERY
by
Dr. Victor Coombs
Chief Medical Officer, Petrotrin
Consultant Occupational &
Environmental Health

Greatest Fire in History

1991
During the Gulf War 640-odd wells ignited in
Kuwait. Fires raged for more than eight
months, consumed 2 billion barrels of oil
and cost Kuwait $100 billion.. Oil wells,
refineries, pipelines and harbours were
destroyed.
Economist 11/9/91; Vol 321
Issue 7732; p84.

1970 - 1999
Type of Facility

Number of Losses

Total Amount ($MM)

Refineries

597

Chemical Plants

75

Gas Processing

200

Terminals

30

Offshore

440

* PD > $10,000,000 U.S.

MRC 2001

Oil Refinery Bombing/Fire

Oil products releases

Pollutants released
Groundwater pollution
Soil pollution
Chemical Emission
Injuries
Death

Industrial Disasters
Fire
Explosion
Toxic Release

Piper Alpha Disaster

North Sea 88.07.06. 165 fatalities from 226
on board
Death toll highest in oil an gas offshore
operations
109 died from smoke inhalation and fire, 14
died while escaping. Few died from actual
burns.

FCCU FIRE/EXPLOSION 91.06.05

Equipment Damaged/Destroyed

The slurry settler (completely destroyed)

Slurry Pumps
Steam blowdown drum
Steam Superheater exchanger
Piping

FCCU FIRE/EXPLOSION 91.06.05

Equipment Damaged/Destroyed (contd)

Structures
Instrumentation
Buildings
Electrical equipment

Documents Requested by
Insurers
Preliminary report by Accident Investigation Team
Medical Report and Injury List
Interviews
Photographs
Measurements and Weights of fragments
Engineering Report
Engineering data on by-pass valve around slurry
settler

Preliminary Report I
An explosion and fire occurred at the FCCU
at 2.53 am on Wednesday June 05, 1991.
The fire was brought under control by
Company Fire Services, TT Fire Services
and TT Methanol Company Fire Services

Preliminary Report II
There was one fatality, 12 injuries of which
2 were very serious and 10 were relatively
minor.
Several workers suffered Post
Traumatic Stress Disorder (PTSD).

Explosion Damage I
The Fire of the explosion at the slurry
settler caused extensive damage to N-S
piperacks and nearby equipment east of the
FCCU.

Explosion Damage II
Much of this ancillary damage was
apparently due to the shrapnel effect of
the slurry settler and was concentrated in
the NE the path of trajectory.

Explosion Damage III

At FCCU and Gas Con Control Rooms the
blast damaged roofs, ceiling, and windows.
Adjacent structures were relatively intact.
But breakage of windows occurred 200
metres away.

Fire Damage I
Near the base of the main fractionator the
slurry pumps were destroyed by fire.
Intense heat and flames damaged adjacent
equipment such as lines, heat exchangers
and the blower house roof.

Fire Damage II
On the FCCU main structure there was fire
damage mainly on the north side of the
reactor where the steam drum is located.

Fire Damage III

The FCCU charge pre-heater and related
piping suffered damage due to fire caused
by a ruptured feed line. The East Area
Guard Basin became ignited from flying
debris.

Some Findings
The slurry settler vessel showed tensile
failure typical of internal explosion.
Failure of the head in the area adjacent to
the reinforcing pad around the 18 manway
nozzle.

Some Findings

(contd)

The manway nozzle complete with bolted

over was found about 200m north east of
the vessels original location.

Engineering Findings I
480 565 psi pressure in slurry settler was
required for rupture.
Vessel operating temperature was 610oF.
Calculations on blast effect was equivalent
to 120-200 pounds of TNT.

Engineering Findings II
A vapour space was most likely present in
the vessel. (compressible gas bubble) 420
to 1000 cu ft.
Energy required to fracture or deform the
slurry settler vessel was about 70 million ftlbs of energy 40 to 47 pounds of TNT.

Engineering Findings III

After the slurry settler pressure vessel
exploded, there was instantaneous fire (I.e.
auto-ignition) from the hot slurry oil
released into the atmosphere.

Engineering Findings IV
Air was most likely trapped inside the
vessel during start up.
No evidence of an external explosive device
was found.

Personal Injuries
SR, age 22. Fatality
WM, age 35. Severe burns and shock.
RS, age 39. Severe burns, fracture right
arm, right foot and right hip, shock.
KL, age 44. Minor burns and shock.

Personal Injuries

contd)

HK, age 35. Injuries to right ear and right

shoulder.
KJ, age 36. Foreign body in eyes.
FH, age 28. Minor burns to both forearms.
RR, age 37. Minor burns and abrasions
from fall.

Personal Injuries

(contd)

RR, age 22. Minor burns and strained neck

muscles.
OJ, age 37. Muscular injury right thigh.
SB, age 39. Splinter in arms.
TT, age 46. Shock and elevated BP
malignant.
FA, age 32. Sprained ankle.

Fortunate Events I
Damage was mitigated because the
predominantly ballistic or impact type of
damage was confined to the NE direction
which was unoccupied hillside.

Fortunate Events II
Damage was mitigated by the fact that
several workers had gone to the canteen to
eat.

Fortunate Events III

Some rainfall occurred 20 minutes before
the explosion which resulted in several
workers delaying in returning to the FCCU.

85.10.17: Berth #5

Fire started
Fire service
Fire under control
All clear given

12.35 pm
12.45 pm
12.50 pm
3.00 pm

Background to Fire I
In June 1985 a decision was taken to
recommission the entire length of the 30inch diameter sealine (S/L No. 33) running
from the Pile Bent 80 manifold to No. 5
berth and terminating at No. 6 Berth.

Background II
The section of the line between No. 5 and
No. 6 Berths (length 1200 ft) was the only
inoperative part and was positively isolated
from the rest of the line in 1975. This
section had to be tested and repaired before
being brought back into service.

Background III
Between July and October 1985, the other
portion of the line was in crude oil service,
the last being the receipt of 319,000 bbls of
Algerian Condensate on September 1.

Background IV
By October 11, all activities related to the
repairs of the disused section were
completed.

Background V
On October 17, equipment was mobilized
and manpower allocated to the task of
completing the final job to allow the recommissioning of the entire length of S/L
33.

Background VI
The last task was to remove the 30 inch
diameter slip blind installed in 1975, from
between the bolted flanges on the riser
section of the line at No. 5 berth, located
approximately 22 inches above sea water
level at noon on the day of the fire.

Background VII
A Maintenance Work Permit was prepared
and signed off by (1) Assistant Area
Maintenance Superintendent West; (2) Port
Captain; (3) Oil Stocks Superintendent and
delivered on site just prior to start of the
job.

The Fire I
Around 12 noon after the flange was
loosened on S/L 33, heavy crude trapped in
the dead leg followed by light hydrocarbons
(Algerian Condensate API 64.9 and vapour
Pressure 9.1 psig) flowed at an estimated
rate of 40 barrels per minute for 8-9
minutes.

The Fire II
This line was under a positive pressure from
an operating crude transfer system in the
foreshore area. During the 8 to 9 minutes
period, the 30-inch slip blind, weighing 250
lbs was removed by the crew.

The Fire III

At 12.33 pm vapours from the light
hydrocarbons, which had surrounded all
floating craft were ignited by an open flame
or spark, resulting in a muffled explosion.
Flames were driven by strong winds over
20 knots and engulfed all men and
equipment on the job.

The Fire IV
The fire raged for 15 minutes after which it
was brought under control, but in all lasted
about one hour and forty-five minutes.

The Fire V
When the crude transfer operations at the
foreshore area were isolated from the sea
line the fire was finally extinguished.

Search and Rescue I

Soon after the outbreak of the fire two men
in a contractors pirogue arrived on the east
of No. 5 berth and rescued three
contractors painters who were clinging to
the east breasting dolphin clear of the water.

Search and Rescue II

Launches Star Fish and Flying Fish
were involved in the retrieval of victims.
Seven were recovered from the sea; three
charred bodies were collected from the deck
of the Pile Driver.

Fire Fighting Operations

Tug Plaisance arrived at 12.45 pm and
Tug Plein Palais arrived at 1.28 pm both
were engaged in fire fighting activity.
Foam was used to contain the fire.

Fatalities

Men assigned to the Pile Driver Atlas

Men assigned to Maintenance Crew
Launch Crew
Total Dead

= 6
= 6
= 2
= 14

All bodies were recovered within 24 hours.

Post Mortem Reports

Cause
Inhalations of Gas/Burns
Burns, Asphyxia, Drowning
Inhalation of Gas Burns/charring
Inhalation of Gas/Burns/Brain Haemorrhage

No.
4
6
3
1

Probable Cause of Ignition

A spark from the slip blind striking against
the deck of the tray barge.
The back firing of the boiler during the
process of shutting down in an emergency

Largest Property Damage Losses 1970 to 1999

(Excess of $150,000,000 property damage) - Onshore
Date

Location

Plant Type

Event Type

PD Loss ($MM)

10-23-89

Texas

Petrochemical

VCE

839

5-4-88

Nevada

Chemical

Explosion

383

5-5-88

Louisiana

Refinery

VCE

368

11-14-87

Texas

Petrochemical

VCE

285

12-25-97

Malaysia

Gas Plant

Explosion

282

7-23-84

Illinois

Refinery

VCE

268

11-9-92

France

Refinery

VCE

262

12-13-94

Iowa

Chemical

Explosion

224

9-18-89

Virgin Islands

Refinery

Hurricane

207

8-17-99

Turkey

Refinery

Earthquake

200

9-27-98

Mississippi

Refinery

Hurricane

200

5-27-94

Ohio

Chemical

Explosion

200

9-25-98

Australia

Gas Plant

Explosion

187

10-16-92

Japan

Refinery

Explosion

187

3-4-77
Gas Plant
VCE
The Loss
amounts were adjustedQatar
for inflation.
VCE Vapor Cloud Explosion
6-1-74
VCE
This listing
does not include theEngland
onshore losses to thePetrochemical
Kuwait oil fields during the Gulf
War.
Total losses are estimated at over $2,500,000,000 (US).

174
MRC 2001

164

Largest Property Damage Losses 1970 to 1999

(Excess of $150,000,000 property damage)- Offshore

Date

Location

Facility Type

Event Type

PD Loss ($MM)

7-7-88

North Sea

Platform

Explosion

1,085

8-26-92

Gulf of Mexico

Platform

Hurricane

931

8-23-91

North Sea

Concrete Jacket

MD

474

4-24-88

Brazil

Platform

Blowout

421

11-1-92

Australia

Jacket

MD

314

1-20-89

North Sea

Drilling

Blowout

273

11-2-99

Angola

Process Deck

MD

210

7-1-74

Dubai

Platform

Blowout

204

10-1-74

North Sea

Platform

MD

196

The loss amounts were adjusted for inflation.

MD Mechanical Damage

MRC 2001

Refineries Losses by Equipment Type

Equipment

Number of Losses

Average $ Loss
(US)

Percentage

Piping

25

61,600,000

20%

Heaters

46,800,000

4%

Pumps

20,800,000

6%

Tankers

15

35,000,000

12%

Compressors

37,500,000

2%

Heat Exchangers

28,400,000

4%

Vessels

25

17,600,000

20%

Other

42

30,000,000

32%
MRC 2001

Refineries Losses by Operating Unit

Unit

Number of Losses

Percentage

Alkylation

4%

Catalytic Cracking

15

12%

Coking

6%

Crude Distillation

14

11%

Hydrocracking

14

11%

Hydrotreating

15

12%

Reforming

3%

Jetties

2%

Storage

15

12%

Other

35

27%

The Loss amounts were adjusted for inflation

MRC 2001

Refineries Losses by Event Type

Event

Number of Losses

Average $ Loss
(US)

Percentage

Explosion

38

46,700,000

30%

Fire

60

32,870,000

47%

Vapor Cloud

19

83,000,000

15%

Mechanical
Breakdown

80,500,000

3%

Other

54,400,000

5%

The Loss amounts were adjusted for inflation

MRC 2001

Terminals Losses by Equipment Type

Equipment

Number of
Losses

Average $
Loss (US)

Percentage

Piping

53,400.00

18%

Tankage

33,000.00

20.5%

Ship/Barge

58,900.00

20.5%

Other

16

32,000.00

41%
MRC 2001

Terminals Losses by Event Type

Event

Number of
Losses

Average $
Loss (US)

Percentage

Explosion

13

13,300.00

33%

Fire

16

50,400.00

41%

Vapor Cloud

38,400.00

8%

Mechanical

72,900.00

13%

Other

14,200.00

5%
MRC 2001

Terminals Losses by Operating Unit

Unit

Number of
Losses

Percentage

Storage

18

46%

Pipeline

21%

Jetty

15%

Tanker

5%

Other

13%

The loss amounts were adjusted for inflation.

MRC 2001

Lessons Learned
Conduct process hazard analyses of all process units, both
old and new
Provide regular training for all employees, including
standardized re-certification training for all operators
Institute a strong mechanical integrity program that
includes equipment inspection, piping inspection, material
verification, corrosion under insulation inspection,
vibration analysis and metal thickness verification.
Provide a well-trained emergency response organization
that can include employees and/or mutual aid agreements.

Oil products released as a result of the bombing

of the NIS Oil Refinery
Substance

Estimated Release
(metric tons)3

Total Crude Oil and Oil products burned/leaked

80,000

Crude Il

56,300

LPG (Liquified Petroleum Gas)

200

Aromatics (e.g. benzene, toluene and xylene)1

400

Gasoline

1,500

Motor Gasoline

4,500

Jet Fuel

1,200

Diesel

350

Fuel Oil

7,500

SCC Gas2

6,700

Other2

1,900

Summary of pollutants released as a result of the

1999 bombings in Pancevo
Substance

Location

Amount Released
(metric tons)

Emission Route

Ammonia

HIP Azotara

250

Waste channel

Calcium ammonium
nitrate, phosphates,
potassium chloride

HIP Azotara

250

Most burned, some into

channel

Crude oil

HIP Azotara

150

Most burned, some into

channel

Vinyl chloride

HIP Petrohemija

460

Burned

1,2-dichloroethane

HIP Petrohemija

2,100

Mercury

HIP Petrohemija

7.8 metric tons to soil,

remainder to channel

Sodium Hydroxide

HIP Petrohemija

100

Soil and waste channel

Ethyl-, propylene

HIP Petrohemija

1,900

Hydrochloric acid

HIP Petrohemija

130

Crude oil and

derivatives

NIS Oil Refinery

85,000

50% to channel, 50% to

soil

Intentionally burned
Soil and waste channel
80,000 metric tons
burned, remainder
spilled onto soil

Groundwater pollution at HIP Petrohemija

Contaminant

Maximum
Concentration
(g per liter)

Sampling
Point

Depth
(meters)

Maximum
Contaminant
Levels
(U.S. EPA)
(g per liter)

Factor by
which Max.
Contaminant
Level is
Exceeded

7,500,000

B-5

18

1,500,000

Vinyl chloride

70,000

B-5

18

35,000

Dichloromethane

26,500

B-21

10.5

5,300

Chloroform

100,000

P-1

80

1,250

Tetrachloroethane

40,000

P-1

N/A

N/A

1,1-dichloroethylene

5,500

B-20

21

790

1,2-cis dichloroethylene

29,200

P-1

70

420

1,2-trans
dichloroethylene

85,600

P-1

100

860

1,1 dichloroethane

95,600

P-1

N/A

N/A

Trichloroethylene

16,500

B-21

10.5

3,300

Tetra-chloroethylene

374

B-13

7.5

75

1,1,2-trichloroethane

48,000

B-20

21

9,600

1,1,2,2-tetrachloroethane

2,220

B-13

7.5

N/A

N/A

343

B-20

21

100

3.4

1,2-dichloroethane

Chlorobenzene

Groundwater pollution at the NIS Oil Refinery

Contaminant

Maximum
Groundwater
Concentration
(g per liter)

Groundwater
Sample Depth
(meters)

Maximum
Contaminant
Levels (water)
(U.S. EPA)
(g per liter)

Factor by which
Max.
Contaminant
Level is
exceeded

Benzene

9,100

6.3

1820

Toluene

4,820

6.3

1,000

4.82

Ethyl benzene

5,330

6.3

700

7.61

Xylenes

11,500

6.3

10,000

1.15

PHCs

109,000

6.3

N/A

N/A

1,2-dichloroethane

66,900

6.3

13,380

Soil pollution at the NIS Oil Refinery

Contaminant

Maximum Soil
Concentration
(mls per kgs of soil)

Soil Sample Depth

(centimeters)

Benzene

2,230

58-68

Toluene

2,090

58-68

872

58-68

Xylenes

4,560

58-68

PHCs

3,490

58-68

Lead

95.2

0-10

Ethyl Benzene

Emission factors and estimated chemical release from

the Pancevo oil fires
Substance

Emission Factor (gram per

kilogram of oil burned)

Estimated Release (metric

tons)

Particulates (<3.5 m)

16-20

1,200-1,500

Elemental carbon (soot)

2.8-5.5

210-410

Total organic carbon

(aerosol)

4.0-8.0

300-600

Total organic carbon (vapor)

7.1-20.7

500-1,600

Carbon monoxide (CO)

51.-11.6

380-870

Carbon dioxide (CO2)

807-829

61,000-62,000

Methane (CH4)

1.6-2.8

120-210

Sulfur dioxide (SO2)

16-33

1,200-2,500

0.49-0.64

37-48

10% of Total Organic Carbon

(aerosol)

30-60

Nitrogen oxides (NOx)

Polycyclic aromatic
hydrocarbons

Estimated ground-level concentrations of selected

pollutants from the NIS Oil Refinery fires
Compound

Estimated
Emission
Intensity
(grams per
second)

Estimated
Wind
Velocity
(meters per
second)

Estimated
Crosssectional
area of
plume (km2)

Estimated
Maximum
Concentration
(g per m3)

U.S. EPA
Air Quality
Standards
(g per m3)

Sulfur
dioxide

9600

3-5

4-8

200-800

365

Nitrogen
oxides

2200

3-5

4-8

50-200

100

PAH

220

3-5

4-8

5-20

N/A

Particulates

4800

3-5

4-8

100-400

65

Medical Management of
Mass Casualty
Search, rescue and first aid.
Transport to health facility and treatment
Redistribution of patients between hospitals

Definitions
Disaster
A Disaster situation may be defined as any
emergency that overwhelms the available
medical resources.
Triage
Triage is a French work meaning to sort.

Definitions

(contd)

MCI
A Mass Casualty Incident (MCI) is defined
as any situation in which the medical care
required exceeds the ability to provide that
care.

Scene Evaluation
Safety evaluation of all possible dangers
and assuring that none still exist.
Scene evaluation of physical site e.g. no
of vehicles in crash, fire, explosion or toxic
release.
Situation what really happened here?
Why?

Three Major Rules of Triage

Only immediate life-threatening conditions
are identified and treated in the initial triage
round: i.e. airway obstruction, open chest
injuries or major external haemorrhage.

Three Major Rules of Triage

Salvage of life takes precedence over
salvage of limbs
The Triage Officer must survey all the
patients as quickly as possible in order to
determine the number of victims and to
obtain an overall evaluation of the disaster
scene.

Tagging (Colour Coded)

Priority I (Immediate) Red Critical/Life Saving
Priority II (Delayed) Yellow Serious/but can
wait
Priority III (Expectant) Yellow Severe/little
chance
Priority IV (Minimal) Green Minor/ambulant
Priority V (Dead) Black Unresponsive