Bhopal Union Carbide Chemical Plant’s Malfunction Case Study

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Updated: Jan 27th, 2024

Failure Mode and Effect Analysis for the Union Carbide plant in Bhopal

It is necessary to note that the Bhopal disaster is one of the biggest tragedies. The number of casualties is enormous, and many companies have reviewed their safety measures to avoid such catastrophes. It is quite evident that the quality of maintenance procedures on the plant was not satisfactory, and it is one of the primary issues that have caused the incident. Failure mode and effects analysis should be utilized to evaluate how it could have been prevented (see Table 1).

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ItemFailure ModePotential CauseConsequenceSeverityDetectionFurther Investigation
Tank E610Water leakage through a pipeNegligence of one of the employees.The MIC contacted with the water, and release of a toxic gas followedCatastrophicMonitoring of pressure and temperatureEvaluate if the water is present in the tank and determine possibility of failure

Table 1. FMEA worksheet.

The analysis indicates that safety measures utilized were not satisfactory. It is understandable that some of the technologies were not as developed at that time, but it is clear that several aspects were overlooked. First of all, it would be necessary to ensure that one of the employees checks if any chemical is present in the tank. Moreover, another aspect worth highlighting is that a worker should have kept track of the procedures, and it was necessary to see if there are any issues each hour.

Temperatures also should be measured because it is a vital factor in such situations (Grazia, 2014). Indicators that would show the presence of the MIT should have been considered, and every professional should have access to such data. The fact that supervisor did not notice that anything is wrong also needs to be mentioned, and it indicates that guidelines were not well-developed or particular stages were not followed. It would be reasonable to contact an emergency team in case such issue is identified. It is necessary to understand that the level of severity of this failure is catastrophic. Therefore, it would be reasonable to stop all the processes and initiate evacuation. Emergency procedures also could be considered to cool the mass.

The Union Carbide plant malfunction

The malfunction that has been analyzed is a water leakage to the tank that contained the MIC. Such incident is quite dangerous because it is a known fact that a reaction follows if it comes into contact with water. Therefore, it would be reasonable to double-check everything before initiating the procedure because consequences are severe. Overall, it is possible to state that several contributing factors are present in this case, and the most attention should have been devoted to the elimination of the leakage if it was noticed much earlier.

The use of a failure mode and effects analysis method is appropriate in this case because this is an approach that has proven to be efficient, and may be applied in this situation. The technique is quite useful because it is possible to identify relationships between particular mechanisms and consequences. Inductive reasoning that is utilized is also reasonable, and it is much easier to develop the most efficient approach when all the pieces of data are available. The identification of root causes is vital, and it is imperative to focus on preventive measures (Stamatis, 2014). Moreover, it can be very well-detailed when it is necessary, and even the smallest details may be taken into account.

References

De Grazia, A. (2014). A cloud over Bhopal: Causes, consequences, and constructive solutions (2nd ed.). Princeton, NJ: Metron Publications.

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Stamatis, D. H. (2014). The ASQ pocket guide to failure mode and effect analysis (FMEA). Milwaukee, WI: ASQ Quality Press.

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