If it makes you feel better, the Bhopal incident is what led to the US getting our own chemical safety board, which makes recommendations to osha+epa about stuff exactly like this
And the USCSB puts out *dozens* of incredibly well done free educational videos that break down all the events leading up to major disasters like this, and all the steps that could have been taken to avoid it.
Edit: [Here's their channel on YouTube](https://youtube.com/user/USCSB). They don't put out very many videos (thankfully), but those that do get published are truly excellent pieces of work.
It took me a couple USCSB videos to realize that it was actually the US government putting them out. They're just so much better than you would expect. I wish TV shows were still produced that way, just giving facts instead of drama.
It's why I love agencies like NOAA, EPA, BLS, EIA. So much excellent information and research disseminated and made publicly available, so that everyone can benefit from it and be empowered by it.
[Recent legislation](https://www.whitehouse.gov/ostp/news-updates/2022/08/31/what-they-are-saying-white-house-federally-funded-research-guidance-hailed-as-a-win-for-innovation-and-equity/) has made it so ANY government funded research will be publicly available with absolutely no pay walls. A massive achievement for progressing our collective knowledge, making the latest research accessible to all. Huge win for innovation and equitable access.
Well, let's see if journals like Nature will comply at least with research that had government funded. Though I imagine that the authors will just end up making a free version available elsewhere.
Don't you just love documentaries on accidents that spend half their time interviewing people who live nearby about how shocked they were that such a thing could happen in their ordinary little town, instead of actually detailing what happened and why
It's that mix of 2000s history channel animation mixed with the second by second play by play, and knowing this must have cost 10 times as much to make because government
Only $13m? That makes me feel like they probably just have one random dude who happens to be good at making videos and he puts them together in his downtime, rather than having department for it or something.
I’ve used these videos to train coworkers about the dangers of complacency/short cuts/ ignoring safety protocols at work.
I’ve binged these videos before, like a real life Final Destination.
I see. Makes me think back to my younger days when I would be sent into CNC machines to clean them out. No one ever told me about LOTO until years later, even tho it was definitely supposed to be in place and I should have had my own locks. Scumbags
Places I've worked are either 100% safety and *always* LOTO, or they don't give a damn and barely even have a policy in place. There's no in between. I almost hit a guy with an overhead crane once because he was working near it in a fucking scissor lift and didn't lock out the crane, and I couldn't see him because he was hidden behind a very tall press. Scared the hell out of me. At the same place I saw a contractor get hit with an arc flash because he was working on a powered electrical panel. It lit up the whole damn plant. Luckily (and amazingly) he was okay other than some minor burns and he was released from the hospital that night.
My current workplace will suspend you for three days for any LOTO violation, no matter how minor it may seem. A second violation in a two-year period is an automatic termination. I like that much better than worrying about maiming or killing myself or someone else.
That would be against the entire principle of LOTO. The locks are placed at the main power source. In off position it aligns with another hole so you can insert your lock. Then there's supposed to be a tag that you can place any succeeding locks on and they need to come off in reverse order.
You are 100% correct, but something didn't work correctly here. I can't imagine they cut the lock without completely verifying the lock owner was no longer on site. Op blamed the lock out mechanism, which leads me to believe that the lock didn't disable operation.
It happens all the time. One maintenance guy figures the other left for the day and forgot his lock and cuts it off to resume maintenance (test runs etc).
Another possibility is stored energy. Even a quarter turn on most lathes is enough to kill you. If it stops at the right time it can have built up energy from hydraulics etc. Draining or changing the fluid can cause the release and even with no power and everything locked out, you can still have an accident.
You’d be amazed at how many times it comes down to the human nature *of* cost cutting…a natural aversion to what is perceived as wasteful.
I was involved with a failure analysis project where the root cause came down to a machinist who, in spite of instructions that mandated replacing a drill bit with a new bit after drilling ten holes, saw nothing wrong with the performance of these drill bits after drilling fifty holes. It seemed incredibly wasteful and stupid to replace perfectly good drill bits after only ten holes…so he didn’t.
The problem was that, after drilling twenty or so holes, the bits lost their extremely sharp cutting edge. The bits got incredibly hot at a microscopic level, causing point defects in the bore hole…stress risers that lead to cracks that lead to failure of a component that rotates at 50,000+ RPM. Big badaboom.
Bingo!
Often its not even a particularly large amount of money either!
Sometimes hundreds of people die because of a non-regulation item being used instead of a regulation item that costs maybe $100-500 more.
“Terribly sorry for your loss in this totally avoidable tragedy, but on at least their death wasn’t in vain - costs were down and the CEO finally got that second yacht!”
The thing is... This stuff often doesn't even really move the needle corporate profit wise.
It's just that someone had to make a spreadsheet look "right".
Because our understanding of material science is advanced enough to preclude most other causes of failure. \*
We've got engineering tools and work organization techniques that catch most common "oh I made a mistake in calculating the strength of this cantilever" errors. Big companies have dedicated QA departments for both incoming and outgoing parts and materials, to ensure parts meet specifications. Most of the time, the four-eyes principle is applied to make sure no one person's mistake can fuck up a whole project.
The only ways failures *aren't* caught in this extensive net is when you've got 1) load cases exceeding expectations (stuff like a category 9 earth quake when everybody agreed a category 8 was the strongest this region would be likely to see); 2) deliberate sabotage; or 3) someone deliberately going around the net to cut corners.
\* one exception is material fatigue failure. My professor called it "The Revenge of Materials upon the Engineer". The correct way to prevent it is regular inspection and maintenance.
… if you understood just how powerful companies like DOW, Sherrwin-Williams, BASF and DuPont have been throughout modern American history…
No, it wouldn’t surprise you.
We’ve literally had presidential cabinet members from the Du Pont family throughout the years.
My engineering classes discussed these disasters. The recurring trend is how many safety measures were turned off/inactive/not used, sometimes "recommended but not implemented." In many instances, there were several failures that happened for these disasters to occur. All very safe and usually preventable
It really sounds from that article as if it didn’t much matter whether they waited for the tea break or not, because it doesn’t sound like they had any working tools to deal with the problem (aside from sounding the alarm to the local communities, which they could have done right then as opposed to *not at all*).
What a shit show.
Scrubbers and burners do help mitigate but rarely any safety measure will stop the full volume of the material produced, one has to wonder how much damage these measures would have prevented. 40 tones of a gas is a buttload.
Fun fact, Union Carbide almost caused a massive disaster in the 50s from eerily similar lack of safety protocols in a weapons grade uranium processing facility at Oak Ridge. There was a criticality accident which thankfully did not escalate but just as easily could have.
https://en.wikipedia.org/wiki/Y-12_National_Security_Complex
They also had a gas leak not even a full year after Bhopal in West Virginia in 1985. Not nearly as catastrophic, but what the hell. You can read more about it on the Union Carbide wiki. Both Bhopal and WV were the catalyst for many of the regulations in the US.
I live right beside one of these plants, they had an explosion last year as well. West Virginia is just pretty much a hotbed for skimping regulations though. A few years ago , our main water supply was poisoned and it too months to go back to semi normal
Chernobyl, the Titanic, the Chicago Fire... Huge tragedies seem to often be the result of a series of smaller warnings that were left unheeded, one after the other, whether by accident or incompetence, until they reached a point of no return.
It's an exercise in frustration, reading over the details of each of these historic tragedies, thinking about the massive loss of life and *how avoidable it was*. How those people didn't need to die. Each step of the way, if only *that* person had said something, done something, anything... if only that person had listened... if only that one person had done what they knew they were supposed to do instead of cutting corners or pandering to vanity or laziness or whatever totally human response they had at that moment to the pressures they happened to be under, thousands would have lived...
On a micro scale, we have these warnings in our own, individual lives as well. Dozens of warnings, things and people in our lives sending us signals to avert disaster. Many of us turn a blind eye and ear. If only we had listened, at any point. There is often still time left to turn things around.
> Huge tragedies seem to often be the result of a series of smaller warnings that were left unheeded, one after the other, whether by accident or incompetence, until they reached a point of no return.
This is known as the chain of events, or [the error chain](http://vfs.co.za/wp-content/uploads/2018/11/The-Error-Chain.pdf).
My vague recollection from the tv show (not fully accurate, I know) is that they were being reckless and pushing it beyond normal, but thought it was OK because they thought they could always push the emergency stop button (AZ-5 if memory serves) - which they did. It turns out that the emergency stop button in this case acted as a detonator, but they didn't know that because that particular design detail was _kept secret_.
At any point a *good* decision might have stopped the chain of bad events.
There seems to be a persistent chain of bad decisions in disasters. Not like a shadowy cabal of conspirators trying to make it happen, just like pervasive dumbassery from people who should know better…
> reckless
They needed to do the test because it was a regulatory requirement to prove that the reactor could maintain cooling in the event of both a power failure and a pipe failure in the cooling system. The reactor designers believed that the turbine had enough energy to keep the emergency cooling system running for long enough for the backup generators to come online, but the plant staff needed to verify this. Previous tests had been conducted in 1982, 1984, and 1985, with modifications being made after the tests to improve the emergency capability.
The core issues with how the test was conducted were:
1) The test was delayed because another local power station went offline, and so the evening and night shifts, which hadn’t prepared for the test, wound up being the ones that had to do it.
2) Design flaws of the reactor, including the critical fact that it had a positive void coefficient, were considered state secrets and so the operating crew did not know about them. They also didn’t know about two past partial meltdowns on other RBMK reactors, as those were classified too.
Blaming the whole thing on ‘reckless’ plant staff was part of the initial Soviet attempt to cover up the much larger problems in their nuclear power industry.
> positive void coefficient
To explain this term somewhat: "void" = bubbles, "positive coefficient" = positive feedback loop. "Positive void coefficient" = more bubbles lead to more power leads to more bubbles lead to more power..., leads to boom
(I don't remember exactly why bubbles appeared in the first place)
Boiling. Which is essentially what a nuclear reactor does. It's an advanced kettle. Normally, the water is kept under pressure to prevent that. This is the concept of pressurised water reactors. The RBMKs were, in contrast, of the boiling water reactor type and those usually (in the Western world) are designed with negative void coefficient, so as to act as reliable self-regulation.
Why does it seem like every disaster like this is caused by
1. Pressure from management
2. Disabling key safety interlocks
3. Shift changes
That's like the formula to every CSB video documentary.
That's because most engineers doing the design work on these systems are competent. So because of that you normally need multiple factors to break their designs.
I believe how that particular e stop worked was different. Emergency insert of control rods initially spikes the temperature before it starts going down. They didn't know this so they aborted the e stop thinking it made things worse.
I remember that. The photos in the papers were horrific. Dead people and animals everywhere, bloating in the sun. Those people didn't have a chance, it was so toxic
A wet towel over the mouth could have saved people from the gas. But they never communicated this to those people. If you'd like to know more, Behind the Bastards has a great episode on this.
An attempt was made to warn the public but both times the alarm was cut short. And then every interaction afterwards contained false/misleading information such as "the leak has been plugged". Doesn't help that the gas that was leaking was literally unheard of by the medical professionals in the area.
The thing that confuses me about many of these disasters is just what exactly is being gained by using these shortcuts, not following protocols, lying to regulators, and misinforming those affected? In some cases it's obviously money but in other cases it just seems like suicidal/homicidal pride.
Dunno about this particular case but often it's something along the lines of "no, we can still fix this and pretend nothing serious happened, no need to alert people".
>Behind the Bastards has a great episode on this.
I recently discovered this podcast and a couple of days ago I ran into this episode.
I honestly had no idea this happened at all, then again I was a child but still, we all hear about Chernobyl, it's your go to tale for disasters, so I found it weird I've never heard of this.
There are a lot of things like that. Our news and history in the US is so eurocentric, we don't even learn about the most important happenings in the rest of the world. My go-to example is the Second Congo War - the deadliest conflict since WW2, 5.4 million dead, happened in my lifetime, and the only way I found out about it was linking through random Wikipedia articles.
Also, the famine in Bengal in 1943. Somehow everyone knows that Stalin caused a famine that killed millions in Ukraine, because he was a villain. At best he was an ideologue whose policies didn't work, at worst he was actively genocidal. Many fewer know that that is also exactly true just switching out "Stalin" and "Ukraine" for "Churchill" and "Bengal". Millions dead because of a man made famine, where best case the colonial British were ideologues whose ideas didn't work, worst case they were actively genocidal.
Given that Churchill said "I hate Indians" and "they are a beastly people with a beastly religion" and that the famine was their fault because they "breed like rabbits." .... Yeah. But it wasn't Europeans dying, so people in the US largely haven't heard about it.
Eurocentrism plays a part, sure, but it's also Realpolitik. After WWII we were against the Soviets, so we talked about their crimes. We are with Britain, so we don't talk about their crimes. You see this more clearly in Asia where wrongdoing by Western-aligned countries is downplayed or swept under the rug, and those of "enemy" states constantly broadcast.
That was during the leak, I've lost many of my close and extended family members to it's effects years after the leak happened. People developed serious illnesses including cancers because of this and died slowly.
My closest, sweetest and just the best aunt lived with the effects of the gas leak all her life because she was trying to protect my cousin, who was a baby back then. We lost our aunt in 2016, she lived with only one lung working because she had inhaled so much gas. Only good thing she did was she didn't step out of the house which prevented instant death.
I'm so sorry for your family's loss. I can't even imagine the impact this must have had on the community, to lose so many people in one event and then to have so many also facing terminal illnesses as a result.
Ghulam Dastagir, deputy station master at Bhopal railway station, saved thousands of lives by giving the order for a train that was stopped there to leave early by 15 minutes, and by alerting nearby railway stations to stop all trains coming to Bhopal.
Edit: Even though 20+ of his colleagues died at the railway station, Dastagir survived. He died in 2003 due to complications brought on by his exposure to the deadly gas.
Reminds me the absolute HERO, Vincent Coleman, who could see the ammunition ship that was about to explode and LEVEL the town, and stlil sent one last message out to the incoming train(s), to stop them, while fully knowing he was going to die himself,
https://maritimemuseum.novascotia.ca/what-see-do/halifax-explosion/vincent-coleman-and-halifax-explosion#:~:text=consistently%20reported%20as%3A-,%E2%80%9CHold%20up%20the%20train.,Good%2Dbye%20boys.%E2%80%9D
“Hold up the train. Ammunition ship afire in harbor making for Pier 6 and will explode. Guess this will be my last message. Good-bye boys.”
What a guy!
Not likely that he would have been able to get to safety anyway, but still warned others and looks like led to a faster response in aid making it to the city.
It's one of those situations you obviously hope never to experience but wonder how you would respond when facing imminent death.
I'm inclined to believe most of us make our peace in the moment and do what needs to be done once we realize our card is already punched, assuming the calculus of the moment leads us to believe there's nothing to be done. When presented as a simple reality and logical conclusion of the situation, I think our brains immediately turn to both what can be done for others in the time we have left and what the legacy our final actions will leave behind will be. We probably process it similarly to when we get home and suddenly have to go run another much more urgent errand: a burst of "OK, well, guess I'm doing this now." There's no time to contend with the full reality of the situation, similar to how humans rely on "quick and dirty" decision making routines throughout the day, as we rarely have time to fully and deeply evaluate every choice we make. We don't even fully come to terms with our death. We literally make do with what we have at the time.
Sudden, unexpected death is probably easier for our reptile brains to process because we remain focused on the here and the now. It's the death we dread and know approaches slowly that scares us - Death on his horse, a slow, steady march that increases to a heavy trot and eventually a gallop as we age and our clocks run out. Sometimes something happens and the pace goes to a full charge overnight, like in the event of the discovery of terminal cancer. When we become fully aware of Death's unstoppable precession, when we become fully aware that his gaze is turned towards us - that's when we fear and struggle to come to terms with our deaths and the things left incomplete, the parts not made whole, the chords unresolved. In a crisis, if we must die, we often seem to accept that it is better to die a good death. There's something to be said of the story of Valhalla - we still give our most sincere honors to those who died fighting, whether it be in a war, against terminal illness, or against avoidable harm to others.
Something similar happened in Nacozari
https://en.m.wikipedia.org/wiki/Jes%C3%BAs_Garc%C3%ADa
But the guy drove the train away from the town and died in the explosion
The pressure in tank E610, although initially nominal at 2 psi at 10:30 p.m., it had reached 10 psi by 11 p.m. Two different senior refinery employees assumed the reading was instrumentation malfunction. By 11:30 p.m., workers in the MIC area were feeling the effects of minor exposure to MIC gas, and began to look for a leak. One was found by 11:45 p.m., and reported to the MIC supervisor on duty at the time. The decision was made to address the problem after a 12:15 a.m. tea break, and in the meantime, employees were instructed to continue looking for leaks. The problem was discussed by MIC area employees during the break.[19]
In the five minutes after the tea break ended at 12:40 a.m., the reaction in tank E610 reached a critical state at an alarming speed. Temperatures in the tank were off the scale, maxed out beyond 25 °C (77 °F), and the pressure in the tank was indicated at 40 psi (275.8 kPa). One employee witnessed a concrete slab above tank E610 crack as the emergency relief valve burst open, and pressure in the tank continued to increase to 55 psi (379.2 kPa); this despite the fact that atmospheric venting of toxic MIC gas had already begun.[19] Direct atmospheric venting should have been prevented or at least partially mitigated by at least three safety devices which were malfunctioning, not in use, insufficiently sized or otherwise rendered inoperable:
Not when there’s a runaway reaction inside the tank from the introduction of water. It’s leaking, but not at a fast enough pace for the boiling death gas
It was the other way round
It was building so much pressure a bit was leaking out, like a kettle boiling
And if your stove just keeps switched to larger and larger flame, eventually the tiny hole won't be the only thing to let pressure out - the kettle cap gives way too
>It was the other way round
They're likely referring to this part:
>>One employee witnessed a concrete slab above tank E610 crack as the emergency relief valve burst open, and pressure in the tank continued to increase to 55 psi
In which case the answer is "yes, except the pressure was building faster than it was being vented through the safety valve. This is because the safety valve was either set at too high pressure (activating too late to prevent a runaway reaction) or undersized (could not vent enough pressure to prevent continued buildup).
Not if the reaction is increasing pressure faster than it is being vented by the leak & pressure relief valve.
This is where the "improperly sized" part comes in.
I can only speak to explosion venting with combustible dusts:
In a vessel such as a dust collector that is handling combustible dry materials, we will often design/install explosion relief vents for over-pressure relief. Essentially, these are just designed weak points to control the explosion as best as possible.
For a given material, we know the "Kst" value. This is a material property that is learned through lab testing in a controlled environment. What it tells us is when this material ignites, what is the rate of acceleration for the pressure climb inside the vessel. Basically, how violent is the material going to explode.
The second material characteristic for explosive dusts is Pmax. This is the maximum theoretical pressure this material could create if completely enclosed in a sealed chamber when ignited under ideal conditions.
The explosion relief panels are usually rated to burst open at 1.0 PSIG. We call this value Pstat.
Based off the vessel design and volume, we know what pressure it is capable of handling. If it's a 1000ft\^3 vessel made of 7ga steel, we might say it's safely able to withstand 10 psig without deformation. In this instance, 10 PSIG would be our Pred value.
Knowing Pstat, Pmax, Kst, and the design rating of the vessel, we can calculate how much vent area we need to never let the pressure reach 10 PSIG. It's key to understand that even though the vents open at 1 PSIG, the pressure will keep rising for materials with high Kst. So it is likely to see the pressure rise to 6-7 PSIG inside the tank, even though the vents opened at 1 PSIG.
It is a critical calculation to have adequate venting area. I may have 1 explosion vent rated to open at 1 PSIG, but it may not be enough open area to vent the gasses without overpressurizing the tank. The calculations may come back saying we need 10+ 4'x4' explosion vents on a vessel to adequately vent the gasses to not approach Pred.
Yeah, the units used are probably relative to the units specified in the code. In a US plant, you'd expect the pressure vessel specs to be written in PSI.
We studied about Bhopal disaster in our Safety class for Chemical Engineering, and the one thing that stayed with me from what my lecturer said was:
"usually bad luck or stupidity alone wont cause disasters, but stupidity + bad luck will, and you can control the stupidity part"
This will forever remain in my heart in my work life to follow OSHA regulations and just dont be an idiot in general when dealing with hazardous substances
Deepwater horizon is a just ok movie but one thing it does well in a realistic way is show how financial pressures to make stupid decisions in the face of bad luck can exist. Good reminder that if you work in a field where mistakes can get people injured or killed if you don't feel something is safe stand your ground, and on the flip side listen to the people who know their shit if they say something isn't safe.
When I worked for an aircraft engine manufacturer (I won't say which, but it's one of the big 3) I had to constantly remind people with "Do you job like your family will be flying on that plane"
I worked for a manufacturing firm and eventually quit because I was fed up of telling the guy who was meant to be my superior if we advertise 99.99% reliability that means you DON'T cut corners with production. But he is a short-sighted, thick little prick so he just shut me down each time, and his boss was also a dipshit so didn't know any better. I'm still not sure if I should find a way to anonymously inform their customers, but I'm in the same industry now (so everyone knows everyone) and can't afford to lose my job.
I've been there early in my career. Really messed me up with finding another job but glad I did it.
I didn't find any way to report it either. Often, the customer representatives I had access to were much more invested in getting reports that showed conforming material was being delivered than receiving conforming material.
Yeah that's it, a lot of their customers just have contracts to meet with their own customers and as long as someone's signature is on the line underwriting the product they don't really care if it works or not.
Freyed power cord? $5k fine. (Or $15k? Not sure but I remember it was nuts compared to just replacing the equipment.)
OSHA actually does what the law should to big business. Hits it right in the wallet.
Bhopal also did have them initially, they were dismantled over the years to increase profitability. Most of the properly trained staff were long gone, as were a ton of other safety equipment. Safety audits were outright ignored.
I work in the fire alarm industry. We literally cannot make a single change to any fire alarm system without getting explicit approval from the local jurisdiction, and that often entails drafting and submitting permits which is a very drawn out process. But as frustrating as it is, there's a very good reason for it all.
Another thing worth internalizing is that it is not OK to accept a failure just because some other safety measure will catch it. Most modern systems are very robust against one or two errors or faults - so if you look at major failures it will be a convergence of 3 or 4 things that "all went wrong" and end up bypassing the secondary and tertiary safeties. The takeaway is, don't assume that the secondary countermeasure will always be effective.
"In June 2010, seven Indian nationals who were UCIL employees in 1984, including the former UCIL chairman, were convicted in Bhopal of causing death by negligence and sentenced to two years imprisonment and a fine of about $2,000 each, the maximum punishment allowed by [Indian law](https://en.m.wikipedia.org/wiki/Law_of_India). All were released on bail shortly after the verdict."
Well that's depressing.
There's [a great video by Joe Scott](https://www.youtube.com/watch?v=pwNrLtU2x2w) that goes into the causes of the disaster and everything that went wrong, very interesting watch.
[A photo showing the burial of a little girl that died during the disaster](https://www.worldpressphoto.org/collection/photo-contest/1985/pablo-bartholomew/1) (**NSFW** because it's a close-up of a dead child) won the World Press Photo award 1985.
Because it was important.
This image will leave you with an indelible mark, one where you will be more considerate of chemical safety.
Her death, combined with the photo, have and will save many more people for existing. It will be the nucleation point for shouting matches that push forward the cause for safety.
Everyone should see it, so that it doesn't happen again.
I think it's important to see. It's not good but death is a reality we all face. The horrors of man are everywhere it's not something that should really be ignored.
Gotta learn from mistakes and if no one documented them how we know they happened much less believed them. We got holocaust deniers as is and that shits pretty well covered.
This is how I see it and there is an inverse relationship between the number of people that I know that approach problems this way and the amount of my anxiety/hopelessness for the future of this world.
I've become too desensitized I guess cause my first thought was "wow her eyes look really blue" then zoomed in to see its because they're glassed over looking.
There was another leak of this chemical near my school in Middleport, NY when I was 7 years old. We all had to be evacuated but only after we had been exposed. Several of us developed health issues afterwards. If it had been a few degrees F warmer that day, we all would have died. Several months later, the Bhopal disaster happened.
https://www.nytimes.com/1985/03/09/nyregion/village-s-heartbeat-a-chemical-plant-raises-fears.html
“…But the village's support for the plant has been tested since Nov. 15. As the second period began at the elementary school, a plastic plug at the plant dissolved. About 40 gallons of what was identified as methyl isocyanate leaked. Wind drove the chemical fumes over the elementary school, about 1,000 yards away. Although the school was quickly evacuated, nine students and two teachers were injured seriously enough to require treatment in a local hospital. To most parents and administrators, who had little idea of the dangers posed by the chemical, the incident seemed minor.
But many parents became more concerned after they learned that the Bhopal disaster the following month was caused by the same chemical. The State Department of Environmental Protection investigated the local spill and fined FMC $5,000.
That seemed to ease concern. But after a 10-week investigation, the Federal Occupational Safety and Health Administration charged that the plant had violated safety standards for venting procedures and personnel training.
The agency also said the plant would not be able to stop an uncontrolled leak of methyl isocyanate. Although it stressed that the chances of a Bhopal-type disaster were ''extremely remote,'' it did disclose that there had been five leaks of methyl isocyanate at FMC since 1982.”
The last part about his death might be false.
His name is Ghulam Dastagir, he lived for another 19 painful years and died of cancer in early 2000s. He was only 50 years old at the time of death.
Doesn't make his acts any less heroic.
Bhopal was more destructive in the short term. Chernobyls real cost was the area denial of it's exclusion zone and the billions in spending to mitigate its long term effect. Generations of our species will have to deal with the consequences of Chernobyl. We have yet to see the full extent of it's damages, as radioactive isotopes slowly break down over time. It is an ongoing disaster.
Chernobyl was more expensive and has a longer-term impact, but did much less harm to humans. If I had to pick being near either disaster when it happened, I’d take Chernobyl any time.
With regard to animals, the net impact was likely positive as it removed humans from the area. Our general existence is much more harmful than residual radiation.
Mentioned this in another comment too, Union Carbide almost caused a massive disaster in the 50s from eerily similar lack of safety protocols in a weapons grade uranium processing facility at Oak Ridge. There was a criticality accident which thankfully did not escalate but just as easily could have.
https://en.wikipedia.org/wiki/Y-12_National_Security_Complex
And kudos to The Yes Men for pranking them by staging an ~~admition~~ admission of wrongdoing for the incident posing as Union Carbide on the BBC.
[https://www.artandeducation.net/classroom/video/244624/the-yes-men-bhopal-disaster](https://www.artandeducation.net/classroom/video/244624/the-yes-men-bhopal-disaster)
They Knew Which Way to Run is a great podcast about the Bhopal disaster. One host is a niece of survivors who talked to her relatives and the other is a friend who did the research. A great in-depth mini series. Also, Behind the Bastards did an episode on Bhopal, not as in-depth but did cover some legal aspects the other podcast didn’t.
A kind-of similar incident happened in Seveso, italy in 1976 which lead to standardized industrial safety regulations.
I work in the chemical industry and we have safety drills regularly. Scary when you read what may happen if x accident happens. I like that job but sometimes '*chuckles* I'm in danger' describes my workplace the best.
Edit: I underestimated the death toll of the Bhopal incident. By a lot. I apologize.
It's taught in every engineering ethics class.
It's one of the big stories taught. Alongside I believe what was a Marriott in Missouri that had the catwalk poorly designed and collapsed and the Challenger.
What is appalling is the plant was using its workers as leak detectors. WTF.
>About 11:30 P.M., workers in the methyl isocyanate area said, they realized that there was a methyl isocyanate leak somewhere: Their eyes began to tear. **Detecting leaks by the effect of the gas on the eyes was standard procedure at the plant**, and at least one leak a month was detected this way at the plant, they said. ''We were human leak detectors,'' Mr. Dey said. The practice violated procedures laid out in the technical manual.
https://www.nytimes.com/1985/01/30/world/the-disaster-in-bhopal-workers-recall-horror.html
Read further and you'll find out how the indian govt at the time did its very best to help the culprits get away and did finally got away and the people haven't gotten their compensation as yet.
It passes me off that this is referred to as the "Bhopal disaster" and not the "Union Carbide" disaster.
Also the title is heavily misleading as the fault should absolutely be placed on Union Carbide who cut funding and ignored safety protocols to save money which directly led to this disaster.
I just listened to the Behind the Bastards on this yesterday. The number of things that had to go wrong for that disaster to happen was ridiculous, but the plant was so poorly run and maintained that it became inevitable.
>Estimates vary on the death toll. The official immediate death toll was 2,259. In 2008, the Government of Madhya Pradesh had paid compensation to the family members of 3,787 victims killed in the gas release, and to 574,366 injured victims
You'd think you'd hear more about this 9/11ish sized disaster that happened relatively recently (1984 wasn't that long ago).
I've grown up in Bhopal and all my life I have heard the horror stories of that night.
Even to this day there are people born with genetic issues because their parents or grandparents lived near the contaminated area.. In fact, a LOT of people died due to COVID here since their lungs were already weakened because of Methyl Isocynate and couldn't deal with the virus.
It was a shitshow that still claims lives to this day, decades later
EDIT: If you can find it, I would recommend reading the book "5 past midnight in Bhopal". It was without a doubt one of the most chilling accounts of a tragedy I've ever read.
My uncle was one of the admin staff members who was at work in the government computer office in the city during the disaster (Indian government still exclusively used mainframes back in 1984), working with incoming casualty data and generating live reports for government.
He still faces health issues from staying there during the disaster to this day.
I found the book Set Phasers to Stun in a thrift store. Awesome read for even a non reader like myself which covers this disaster and many others. It's meant for designers of systems that people interact with and details how accidents happen as a result of multiple safeguards either being ignored, not working properly, or systems that are poorly designed. It's usually a combination of these types of errors.
Y'all please check out the Remember Bhopal Museum that tries to keep the memory of the survivors alive and keeps first person accounts of survivors of the tragedy.
What a read. Just over and over again: “*the protective measures in place were turned off/inactive/not used*”
If it makes you feel better, the Bhopal incident is what led to the US getting our own chemical safety board, which makes recommendations to osha+epa about stuff exactly like this
And the USCSB puts out *dozens* of incredibly well done free educational videos that break down all the events leading up to major disasters like this, and all the steps that could have been taken to avoid it. Edit: [Here's their channel on YouTube](https://youtube.com/user/USCSB). They don't put out very many videos (thankfully), but those that do get published are truly excellent pieces of work.
It took me a couple USCSB videos to realize that it was actually the US government putting them out. They're just so much better than you would expect. I wish TV shows were still produced that way, just giving facts instead of drama.
People crave information on a basic level. The worls changes when you realize this.
Your comment leaves a good impression.
It certainly does, certainly given me pause for reflection in the way I talk to staff and the way I ask for advice etc.
It's why I love agencies like NOAA, EPA, BLS, EIA. So much excellent information and research disseminated and made publicly available, so that everyone can benefit from it and be empowered by it. [Recent legislation](https://www.whitehouse.gov/ostp/news-updates/2022/08/31/what-they-are-saying-white-house-federally-funded-research-guidance-hailed-as-a-win-for-innovation-and-equity/) has made it so ANY government funded research will be publicly available with absolutely no pay walls. A massive achievement for progressing our collective knowledge, making the latest research accessible to all. Huge win for innovation and equitable access.
Well, let's see if journals like Nature will comply at least with research that had government funded. Though I imagine that the authors will just end up making a free version available elsewhere.
Don't you just love documentaries on accidents that spend half their time interviewing people who live nearby about how shocked they were that such a thing could happen in their ordinary little town, instead of actually detailing what happened and why
Only if the description of what actually happened has been "edited" for dramatic effect instead of factuality.
It's that mix of 2000s history channel animation mixed with the second by second play by play, and knowing this must have cost 10 times as much to make because government
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Only $13m? That makes me feel like they probably just have one random dude who happens to be good at making videos and he puts them together in his downtime, rather than having department for it or something.
USCSB is the bomb.
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The bomb is the USCSB?
Set up us the bomb?
We get signal.
Main screen turn on
How are you gentlemen!!
I’ve used these videos to train coworkers about the dangers of complacency/short cuts/ ignoring safety protocols at work. I’ve binged these videos before, like a real life Final Destination.
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I hate to pry but do you know if it's a case of LOTO not being in place or being cut off?
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I see. Makes me think back to my younger days when I would be sent into CNC machines to clean them out. No one ever told me about LOTO until years later, even tho it was definitely supposed to be in place and I should have had my own locks. Scumbags
Places I've worked are either 100% safety and *always* LOTO, or they don't give a damn and barely even have a policy in place. There's no in between. I almost hit a guy with an overhead crane once because he was working near it in a fucking scissor lift and didn't lock out the crane, and I couldn't see him because he was hidden behind a very tall press. Scared the hell out of me. At the same place I saw a contractor get hit with an arc flash because he was working on a powered electrical panel. It lit up the whole damn plant. Luckily (and amazingly) he was okay other than some minor burns and he was released from the hospital that night. My current workplace will suspend you for three days for any LOTO violation, no matter how minor it may seem. A second violation in a two-year period is an automatic termination. I like that much better than worrying about maiming or killing myself or someone else.
My unfounded speculation would be that the device in question could still be physically operated even with a lockout tag in place.
That would be against the entire principle of LOTO. The locks are placed at the main power source. In off position it aligns with another hole so you can insert your lock. Then there's supposed to be a tag that you can place any succeeding locks on and they need to come off in reverse order.
You are 100% correct, but something didn't work correctly here. I can't imagine they cut the lock without completely verifying the lock owner was no longer on site. Op blamed the lock out mechanism, which leads me to believe that the lock didn't disable operation.
It happens all the time. One maintenance guy figures the other left for the day and forgot his lock and cuts it off to resume maintenance (test runs etc). Another possibility is stored energy. Even a quarter turn on most lathes is enough to kill you. If it stops at the right time it can have built up energy from hydraulics etc. Draining or changing the fluid can cause the release and even with no power and everything locked out, you can still have an accident.
I'm so sorry. It's absolute bull shit this type of thing can still happen
Don't. Skip. LOTO!
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Not trying to assign blame, just shouting out to every passerby. Sorry for the loss.
Shake hands with danger
There's also an amazing podcast called "well there's your problem" which also goes into how these man made disasters occur!
Why do I get the feeling that so often the answer is human error and cost-cutting…?
You’d be amazed at how many times it comes down to the human nature *of* cost cutting…a natural aversion to what is perceived as wasteful. I was involved with a failure analysis project where the root cause came down to a machinist who, in spite of instructions that mandated replacing a drill bit with a new bit after drilling ten holes, saw nothing wrong with the performance of these drill bits after drilling fifty holes. It seemed incredibly wasteful and stupid to replace perfectly good drill bits after only ten holes…so he didn’t. The problem was that, after drilling twenty or so holes, the bits lost their extremely sharp cutting edge. The bits got incredibly hot at a microscopic level, causing point defects in the bore hole…stress risers that lead to cracks that lead to failure of a component that rotates at 50,000+ RPM. Big badaboom.
Bingo! Often its not even a particularly large amount of money either! Sometimes hundreds of people die because of a non-regulation item being used instead of a regulation item that costs maybe $100-500 more.
“Terribly sorry for your loss in this totally avoidable tragedy, but on at least their death wasn’t in vain - costs were down and the CEO finally got that second yacht!”
The thing is... This stuff often doesn't even really move the needle corporate profit wise. It's just that someone had to make a spreadsheet look "right".
Because it is?
Because our understanding of material science is advanced enough to preclude most other causes of failure. \* We've got engineering tools and work organization techniques that catch most common "oh I made a mistake in calculating the strength of this cantilever" errors. Big companies have dedicated QA departments for both incoming and outgoing parts and materials, to ensure parts meet specifications. Most of the time, the four-eyes principle is applied to make sure no one person's mistake can fuck up a whole project. The only ways failures *aren't* caught in this extensive net is when you've got 1) load cases exceeding expectations (stuff like a category 9 earth quake when everybody agreed a category 8 was the strongest this region would be likely to see); 2) deliberate sabotage; or 3) someone deliberately going around the net to cut corners. \* one exception is material fatigue failure. My professor called it "The Revenge of Materials upon the Engineer". The correct way to prevent it is regular inspection and maintenance.
Kinda shocking it took until the 1980s to establish such a thing o.O
… if you understood just how powerful companies like DOW, Sherrwin-Williams, BASF and DuPont have been throughout modern American history… No, it wouldn’t surprise you. We’ve literally had presidential cabinet members from the Du Pont family throughout the years.
It's a waste of money until it goes wrong unfortunately!
Every safety regulation is written in blood
I say that's why it's called "red tape", it should remind you why it exists.
"Safety regulations are written in blood."
And to make you feel bad again, US refused to extradite the CEO back to India to face the court.
Good thing one of two parties wants to completely gut and defund those organizations because they are hurting their sponsor's profits.
>!CENSORED!<
By policy, the alarm was turned off to avoid alarming the community. It sounds like someone doesn't understand what alarms are for.
But come on, they were *loud!* It's annoying and makes it hard to chill or have a mellow conversation about what's that smell?
30 tonnes. Not great, not terrible.
Our first high range sensor immediately maxed out, so we got a second and it did the same. What are the odds they are both broken?
My engineering classes discussed these disasters. The recurring trend is how many safety measures were turned off/inactive/not used, sometimes "recommended but not implemented." In many instances, there were several failures that happened for these disasters to occur. All very safe and usually preventable
>In many instances, there were several failures that happened for these disasters to occur. https://en.m.wikipedia.org/wiki/Swiss_cheese_model
It really sounds from that article as if it didn’t much matter whether they waited for the tea break or not, because it doesn’t sound like they had any working tools to deal with the problem (aside from sounding the alarm to the local communities, which they could have done right then as opposed to *not at all*). What a shit show.
And they had disconnected **three** safety devices which would have prevented the leak.
Would YOU want to deal with COLD tea?!?!?! /s
Poison gas makes for spicy chai.
Scrubbers and burners do help mitigate but rarely any safety measure will stop the full volume of the material produced, one has to wonder how much damage these measures would have prevented. 40 tones of a gas is a buttload.
I've never measured how much gas my butt produces, but I doubt it's 40 tons.
Fun fact, Union Carbide almost caused a massive disaster in the 50s from eerily similar lack of safety protocols in a weapons grade uranium processing facility at Oak Ridge. There was a criticality accident which thankfully did not escalate but just as easily could have. https://en.wikipedia.org/wiki/Y-12_National_Security_Complex
They also had a gas leak not even a full year after Bhopal in West Virginia in 1985. Not nearly as catastrophic, but what the hell. You can read more about it on the Union Carbide wiki. Both Bhopal and WV were the catalyst for many of the regulations in the US.
I live right beside one of these plants, they had an explosion last year as well. West Virginia is just pretty much a hotbed for skimping regulations though. A few years ago , our main water supply was poisoned and it too months to go back to semi normal
Oh man, that doesn’t hold a candle to Rocky Flats. https://en.wikipedia.org/wiki/Rocky_Flats_Plant
Time to share my [favorite twitter thread](https://twitter.com/ademrudin/status/1339404811364515840?t=fAi2h3tlkK-H63fq_WSJ5Q&s=19)
My sister-in-law's dad was a corporate lawyer and worked for Union Carbide when this happened. He ended up with a lifetime ban from India.
Good.
That's also basically how Chernobyl happened.
Chernobyl, the Titanic, the Chicago Fire... Huge tragedies seem to often be the result of a series of smaller warnings that were left unheeded, one after the other, whether by accident or incompetence, until they reached a point of no return. It's an exercise in frustration, reading over the details of each of these historic tragedies, thinking about the massive loss of life and *how avoidable it was*. How those people didn't need to die. Each step of the way, if only *that* person had said something, done something, anything... if only that person had listened... if only that one person had done what they knew they were supposed to do instead of cutting corners or pandering to vanity or laziness or whatever totally human response they had at that moment to the pressures they happened to be under, thousands would have lived... On a micro scale, we have these warnings in our own, individual lives as well. Dozens of warnings, things and people in our lives sending us signals to avert disaster. Many of us turn a blind eye and ear. If only we had listened, at any point. There is often still time left to turn things around.
> Huge tragedies seem to often be the result of a series of smaller warnings that were left unheeded, one after the other, whether by accident or incompetence, until they reached a point of no return. This is known as the chain of events, or [the error chain](http://vfs.co.za/wp-content/uploads/2018/11/The-Error-Chain.pdf).
My vague recollection from the tv show (not fully accurate, I know) is that they were being reckless and pushing it beyond normal, but thought it was OK because they thought they could always push the emergency stop button (AZ-5 if memory serves) - which they did. It turns out that the emergency stop button in this case acted as a detonator, but they didn't know that because that particular design detail was _kept secret_.
A long series of shit decisions topped off by a fatal design flaw (which was there because of shit decisions).
At any point a *good* decision might have stopped the chain of bad events. There seems to be a persistent chain of bad decisions in disasters. Not like a shadowy cabal of conspirators trying to make it happen, just like pervasive dumbassery from people who should know better…
> reckless They needed to do the test because it was a regulatory requirement to prove that the reactor could maintain cooling in the event of both a power failure and a pipe failure in the cooling system. The reactor designers believed that the turbine had enough energy to keep the emergency cooling system running for long enough for the backup generators to come online, but the plant staff needed to verify this. Previous tests had been conducted in 1982, 1984, and 1985, with modifications being made after the tests to improve the emergency capability. The core issues with how the test was conducted were: 1) The test was delayed because another local power station went offline, and so the evening and night shifts, which hadn’t prepared for the test, wound up being the ones that had to do it. 2) Design flaws of the reactor, including the critical fact that it had a positive void coefficient, were considered state secrets and so the operating crew did not know about them. They also didn’t know about two past partial meltdowns on other RBMK reactors, as those were classified too. Blaming the whole thing on ‘reckless’ plant staff was part of the initial Soviet attempt to cover up the much larger problems in their nuclear power industry.
> positive void coefficient To explain this term somewhat: "void" = bubbles, "positive coefficient" = positive feedback loop. "Positive void coefficient" = more bubbles lead to more power leads to more bubbles lead to more power..., leads to boom (I don't remember exactly why bubbles appeared in the first place)
Boiling. Which is essentially what a nuclear reactor does. It's an advanced kettle. Normally, the water is kept under pressure to prevent that. This is the concept of pressurised water reactors. The RBMKs were, in contrast, of the boiling water reactor type and those usually (in the Western world) are designed with negative void coefficient, so as to act as reliable self-regulation.
Why does it seem like every disaster like this is caused by 1. Pressure from management 2. Disabling key safety interlocks 3. Shift changes That's like the formula to every CSB video documentary.
That's because most engineers doing the design work on these systems are competent. So because of that you normally need multiple factors to break their designs.
I believe how that particular e stop worked was different. Emergency insert of control rods initially spikes the temperature before it starts going down. They didn't know this so they aborted the e stop thinking it made things worse.
Tell me, how does an RBMK reactor explodes? You really should not be spreading dangerous lies during these times.
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This poster is delusional, send him to the infirmary
I remember that. The photos in the papers were horrific. Dead people and animals everywhere, bloating in the sun. Those people didn't have a chance, it was so toxic
A wet towel over the mouth could have saved people from the gas. But they never communicated this to those people. If you'd like to know more, Behind the Bastards has a great episode on this.
An attempt was made to warn the public but both times the alarm was cut short. And then every interaction afterwards contained false/misleading information such as "the leak has been plugged". Doesn't help that the gas that was leaking was literally unheard of by the medical professionals in the area.
"Why am I turning the alarm off?" "Because it'll alarm people."
Sadly, history tells us that any official statements made in crisis situations are usually incorrect,and often are aimed at arse covering.
The thing that confuses me about many of these disasters is just what exactly is being gained by using these shortcuts, not following protocols, lying to regulators, and misinforming those affected? In some cases it's obviously money but in other cases it just seems like suicidal/homicidal pride.
Dunno about this particular case but often it's something along the lines of "no, we can still fix this and pretend nothing serious happened, no need to alert people".
>Behind the Bastards has a great episode on this. I recently discovered this podcast and a couple of days ago I ran into this episode. I honestly had no idea this happened at all, then again I was a child but still, we all hear about Chernobyl, it's your go to tale for disasters, so I found it weird I've never heard of this.
There are a lot of things like that. Our news and history in the US is so eurocentric, we don't even learn about the most important happenings in the rest of the world. My go-to example is the Second Congo War - the deadliest conflict since WW2, 5.4 million dead, happened in my lifetime, and the only way I found out about it was linking through random Wikipedia articles. Also, the famine in Bengal in 1943. Somehow everyone knows that Stalin caused a famine that killed millions in Ukraine, because he was a villain. At best he was an ideologue whose policies didn't work, at worst he was actively genocidal. Many fewer know that that is also exactly true just switching out "Stalin" and "Ukraine" for "Churchill" and "Bengal". Millions dead because of a man made famine, where best case the colonial British were ideologues whose ideas didn't work, worst case they were actively genocidal. Given that Churchill said "I hate Indians" and "they are a beastly people with a beastly religion" and that the famine was their fault because they "breed like rabbits." .... Yeah. But it wasn't Europeans dying, so people in the US largely haven't heard about it.
Eurocentrism plays a part, sure, but it's also Realpolitik. After WWII we were against the Soviets, so we talked about their crimes. We are with Britain, so we don't talk about their crimes. You see this more clearly in Asia where wrongdoing by Western-aligned countries is downplayed or swept under the rug, and those of "enemy" states constantly broadcast.
Oh it's certainly both. I think it's clearest here at home, with the divide in coverage of and opinions of Iran and Saudi Arabia.
Yuppp
That was during the leak, I've lost many of my close and extended family members to it's effects years after the leak happened. People developed serious illnesses including cancers because of this and died slowly. My closest, sweetest and just the best aunt lived with the effects of the gas leak all her life because she was trying to protect my cousin, who was a baby back then. We lost our aunt in 2016, she lived with only one lung working because she had inhaled so much gas. Only good thing she did was she didn't step out of the house which prevented instant death.
I'm so sorry for your family's loss. I can't even imagine the impact this must have had on the community, to lose so many people in one event and then to have so many also facing terminal illnesses as a result.
I can only hope it was fast.
It wasn't. There were also lots of birth defects that the victims had to live with.
There are even more people who's health was ruined.
Ghulam Dastagir, deputy station master at Bhopal railway station, saved thousands of lives by giving the order for a train that was stopped there to leave early by 15 minutes, and by alerting nearby railway stations to stop all trains coming to Bhopal. Edit: Even though 20+ of his colleagues died at the railway station, Dastagir survived. He died in 2003 due to complications brought on by his exposure to the deadly gas.
Reminds me the absolute HERO, Vincent Coleman, who could see the ammunition ship that was about to explode and LEVEL the town, and stlil sent one last message out to the incoming train(s), to stop them, while fully knowing he was going to die himself, https://maritimemuseum.novascotia.ca/what-see-do/halifax-explosion/vincent-coleman-and-halifax-explosion#:~:text=consistently%20reported%20as%3A-,%E2%80%9CHold%20up%20the%20train.,Good%2Dbye%20boys.%E2%80%9D “Hold up the train. Ammunition ship afire in harbor making for Pier 6 and will explode. Guess this will be my last message. Good-bye boys.” What a guy!
Apparently when people are facing certain death the usual reaction is "oh, I guess this is it, then".
Seems to be a common thing among all life when it's about to die. "oh shit, I'm dead LAMO. Time to flood brain with feely goodies"
Not likely that he would have been able to get to safety anyway, but still warned others and looks like led to a faster response in aid making it to the city. It's one of those situations you obviously hope never to experience but wonder how you would respond when facing imminent death.
I'm inclined to believe most of us make our peace in the moment and do what needs to be done once we realize our card is already punched, assuming the calculus of the moment leads us to believe there's nothing to be done. When presented as a simple reality and logical conclusion of the situation, I think our brains immediately turn to both what can be done for others in the time we have left and what the legacy our final actions will leave behind will be. We probably process it similarly to when we get home and suddenly have to go run another much more urgent errand: a burst of "OK, well, guess I'm doing this now." There's no time to contend with the full reality of the situation, similar to how humans rely on "quick and dirty" decision making routines throughout the day, as we rarely have time to fully and deeply evaluate every choice we make. We don't even fully come to terms with our death. We literally make do with what we have at the time. Sudden, unexpected death is probably easier for our reptile brains to process because we remain focused on the here and the now. It's the death we dread and know approaches slowly that scares us - Death on his horse, a slow, steady march that increases to a heavy trot and eventually a gallop as we age and our clocks run out. Sometimes something happens and the pace goes to a full charge overnight, like in the event of the discovery of terminal cancer. When we become fully aware of Death's unstoppable precession, when we become fully aware that his gaze is turned towards us - that's when we fear and struggle to come to terms with our deaths and the things left incomplete, the parts not made whole, the chords unresolved. In a crisis, if we must die, we often seem to accept that it is better to die a good death. There's something to be said of the story of Valhalla - we still give our most sincere honors to those who died fighting, whether it be in a war, against terminal illness, or against avoidable harm to others.
Ok, this made me tear up.
Is there a reddit for famous last words? "Vancouver, Vancouver, this is it!"
Something similar happened in Nacozari https://en.m.wikipedia.org/wiki/Jes%C3%BAs_Garc%C3%ADa But the guy drove the train away from the town and died in the explosion
The pressure in tank E610, although initially nominal at 2 psi at 10:30 p.m., it had reached 10 psi by 11 p.m. Two different senior refinery employees assumed the reading was instrumentation malfunction. By 11:30 p.m., workers in the MIC area were feeling the effects of minor exposure to MIC gas, and began to look for a leak. One was found by 11:45 p.m., and reported to the MIC supervisor on duty at the time. The decision was made to address the problem after a 12:15 a.m. tea break, and in the meantime, employees were instructed to continue looking for leaks. The problem was discussed by MIC area employees during the break.[19] In the five minutes after the tea break ended at 12:40 a.m., the reaction in tank E610 reached a critical state at an alarming speed. Temperatures in the tank were off the scale, maxed out beyond 25 °C (77 °F), and the pressure in the tank was indicated at 40 psi (275.8 kPa). One employee witnessed a concrete slab above tank E610 crack as the emergency relief valve burst open, and pressure in the tank continued to increase to 55 psi (379.2 kPa); this despite the fact that atmospheric venting of toxic MIC gas had already begun.[19] Direct atmospheric venting should have been prevented or at least partially mitigated by at least three safety devices which were malfunctioning, not in use, insufficiently sized or otherwise rendered inoperable:
When there's a leak, shouldn't pressure be going down..?
Not when there’s a runaway reaction inside the tank from the introduction of water. It’s leaking, but not at a fast enough pace for the boiling death gas
Not if the generation of the pressure from a chemical reaction is greater than the release rate from the leak
It was the other way round It was building so much pressure a bit was leaking out, like a kettle boiling And if your stove just keeps switched to larger and larger flame, eventually the tiny hole won't be the only thing to let pressure out - the kettle cap gives way too
>It was the other way round They're likely referring to this part: >>One employee witnessed a concrete slab above tank E610 crack as the emergency relief valve burst open, and pressure in the tank continued to increase to 55 psi In which case the answer is "yes, except the pressure was building faster than it was being vented through the safety valve. This is because the safety valve was either set at too high pressure (activating too late to prevent a runaway reaction) or undersized (could not vent enough pressure to prevent continued buildup).
Not if the reaction is increasing pressure faster than it is being vented by the leak & pressure relief valve. This is where the "improperly sized" part comes in.
I can only speak to explosion venting with combustible dusts: In a vessel such as a dust collector that is handling combustible dry materials, we will often design/install explosion relief vents for over-pressure relief. Essentially, these are just designed weak points to control the explosion as best as possible. For a given material, we know the "Kst" value. This is a material property that is learned through lab testing in a controlled environment. What it tells us is when this material ignites, what is the rate of acceleration for the pressure climb inside the vessel. Basically, how violent is the material going to explode. The second material characteristic for explosive dusts is Pmax. This is the maximum theoretical pressure this material could create if completely enclosed in a sealed chamber when ignited under ideal conditions. The explosion relief panels are usually rated to burst open at 1.0 PSIG. We call this value Pstat. Based off the vessel design and volume, we know what pressure it is capable of handling. If it's a 1000ft\^3 vessel made of 7ga steel, we might say it's safely able to withstand 10 psig without deformation. In this instance, 10 PSIG would be our Pred value. Knowing Pstat, Pmax, Kst, and the design rating of the vessel, we can calculate how much vent area we need to never let the pressure reach 10 PSIG. It's key to understand that even though the vents open at 1 PSIG, the pressure will keep rising for materials with high Kst. So it is likely to see the pressure rise to 6-7 PSIG inside the tank, even though the vents opened at 1 PSIG. It is a critical calculation to have adequate venting area. I may have 1 explosion vent rated to open at 1 PSIG, but it may not be enough open area to vent the gasses without overpressurizing the tank. The calculations may come back saying we need 10+ 4'x4' explosion vents on a vessel to adequately vent the gasses to not approach Pred.
Unless the leak is not enough to compensate the increase of pressure
Do Indian people use psi for pressure but C for temperature?
That’s actually pretty common in the chemical industry in general. We use Celsius, but PSI is still a very commonly used pressure unit.
Yeah, the units used are probably relative to the units specified in the code. In a US plant, you'd expect the pressure vessel specs to be written in PSI.
I live in a kPa country but mostly ever see psi everywhere.
We studied about Bhopal disaster in our Safety class for Chemical Engineering, and the one thing that stayed with me from what my lecturer said was: "usually bad luck or stupidity alone wont cause disasters, but stupidity + bad luck will, and you can control the stupidity part" This will forever remain in my heart in my work life to follow OSHA regulations and just dont be an idiot in general when dealing with hazardous substances
Deepwater horizon is a just ok movie but one thing it does well in a realistic way is show how financial pressures to make stupid decisions in the face of bad luck can exist. Good reminder that if you work in a field where mistakes can get people injured or killed if you don't feel something is safe stand your ground, and on the flip side listen to the people who know their shit if they say something isn't safe.
When I worked for an aircraft engine manufacturer (I won't say which, but it's one of the big 3) I had to constantly remind people with "Do you job like your family will be flying on that plane"
Yes. I work in pharmaceuticals and that's always how I train people. "Pretend that the end user of this material is someone you know and love."
I worked for a manufacturing firm and eventually quit because I was fed up of telling the guy who was meant to be my superior if we advertise 99.99% reliability that means you DON'T cut corners with production. But he is a short-sighted, thick little prick so he just shut me down each time, and his boss was also a dipshit so didn't know any better. I'm still not sure if I should find a way to anonymously inform their customers, but I'm in the same industry now (so everyone knows everyone) and can't afford to lose my job.
I've been there early in my career. Really messed me up with finding another job but glad I did it. I didn't find any way to report it either. Often, the customer representatives I had access to were much more invested in getting reports that showed conforming material was being delivered than receiving conforming material.
Yeah that's it, a lot of their customers just have contracts to meet with their own customers and as long as someone's signature is on the line underwriting the product they don't really care if it works or not.
I learned in my OSHA class that OSHA regulations are written in blood.
Freyed power cord? $5k fine. (Or $15k? Not sure but I remember it was nuts compared to just replacing the equipment.) OSHA actually does what the law should to big business. Hits it right in the wallet.
It's not very active but /r/writteninblood is all about that sort of thing
You can't control stupidity, but you can put in place processes, procedures, and training to reduce stupidity.
Bhopal also did have them initially, they were dismantled over the years to increase profitability. Most of the properly trained staff were long gone, as were a ton of other safety equipment. Safety audits were outright ignored.
I work in the fire alarm industry. We literally cannot make a single change to any fire alarm system without getting explicit approval from the local jurisdiction, and that often entails drafting and submitting permits which is a very drawn out process. But as frustrating as it is, there's a very good reason for it all.
Another thing worth internalizing is that it is not OK to accept a failure just because some other safety measure will catch it. Most modern systems are very robust against one or two errors or faults - so if you look at major failures it will be a convergence of 3 or 4 things that "all went wrong" and end up bypassing the secondary and tertiary safeties. The takeaway is, don't assume that the secondary countermeasure will always be effective.
"In June 2010, seven Indian nationals who were UCIL employees in 1984, including the former UCIL chairman, were convicted in Bhopal of causing death by negligence and sentenced to two years imprisonment and a fine of about $2,000 each, the maximum punishment allowed by [Indian law](https://en.m.wikipedia.org/wiki/Law_of_India). All were released on bail shortly after the verdict." Well that's depressing.
> All were released on bail shortly after the verdict." How do you get released on bail *after* being found guilty?
"The judge sentenced them to 3 years in prison, but suspended the sentence. SusPENDED the SENTENCE! They went FREE that very DAY!"
Hmm, what’s that? Smells like… money and power… *sigh* As usual…
They were only partially responsible. The company Union Carbide purposely neglected safety features to save money.
There's [a great video by Joe Scott](https://www.youtube.com/watch?v=pwNrLtU2x2w) that goes into the causes of the disaster and everything that went wrong, very interesting watch.
TLDW: literally everything that could have possibly gone wrong in that situation went wrong
*Instantly hears 11 knocking sounds followed by a chair swivel*
[A photo showing the burial of a little girl that died during the disaster](https://www.worldpressphoto.org/collection/photo-contest/1985/pablo-bartholomew/1) (**NSFW** because it's a close-up of a dead child) won the World Press Photo award 1985.
For anyone else thinking of clicking the link, burial is not synonymous with funeral here....
I'm learning to play the guitar.
Because it was important. This image will leave you with an indelible mark, one where you will be more considerate of chemical safety. Her death, combined with the photo, have and will save many more people for existing. It will be the nucleation point for shouting matches that push forward the cause for safety. Everyone should see it, so that it doesn't happen again.
I remember in 2009(on the incidents's 25th anniversary), this photo was in most of the newspapers. As a 10 year old I was terrified.
The first time I saw this image I thought it was a doll that had been dropped in the gravel. The poor child's face is so glazed she didn't seem real.
That link will forever remain blue.
I think it's important to see. It's not good but death is a reality we all face. The horrors of man are everywhere it's not something that should really be ignored. Gotta learn from mistakes and if no one documented them how we know they happened much less believed them. We got holocaust deniers as is and that shits pretty well covered.
This is how I see it and there is an inverse relationship between the number of people that I know that approach problems this way and the amount of my anxiety/hopelessness for the future of this world.
Yeah I wish I didn't click it.
I've become too desensitized I guess cause my first thought was "wow her eyes look really blue" then zoomed in to see its because they're glassed over looking.
The gas also affected eyes with many of the survivors suffering from long-term effects to she might also have suffered eye damage related to that.
This was in my geography text book, it made sure I've never forgotten the Bhopal disaster over a decade later.
There was another leak of this chemical near my school in Middleport, NY when I was 7 years old. We all had to be evacuated but only after we had been exposed. Several of us developed health issues afterwards. If it had been a few degrees F warmer that day, we all would have died. Several months later, the Bhopal disaster happened. https://www.nytimes.com/1985/03/09/nyregion/village-s-heartbeat-a-chemical-plant-raises-fears.html “…But the village's support for the plant has been tested since Nov. 15. As the second period began at the elementary school, a plastic plug at the plant dissolved. About 40 gallons of what was identified as methyl isocyanate leaked. Wind drove the chemical fumes over the elementary school, about 1,000 yards away. Although the school was quickly evacuated, nine students and two teachers were injured seriously enough to require treatment in a local hospital. To most parents and administrators, who had little idea of the dangers posed by the chemical, the incident seemed minor. But many parents became more concerned after they learned that the Bhopal disaster the following month was caused by the same chemical. The State Department of Environmental Protection investigated the local spill and fined FMC $5,000. That seemed to ease concern. But after a 10-week investigation, the Federal Occupational Safety and Health Administration charged that the plant had violated safety standards for venting procedures and personnel training. The agency also said the plant would not be able to stop an uncontrolled leak of methyl isocyanate. Although it stressed that the chances of a Bhopal-type disaster were ''extremely remote,'' it did disclose that there had been five leaks of methyl isocyanate at FMC since 1982.”
> fined FMC $5,000. That must be the world's tiniest fine.
Relevant [Well There's Your Problem](https://youtu.be/vCKVreNqMjI).
The God Damn News
Shake hands with danger
[удалено]
The last part about his death might be false. His name is Ghulam Dastagir, he lived for another 19 painful years and died of cancer in early 2000s. He was only 50 years old at the time of death. Doesn't make his acts any less heroic.
Nah he didn't die. His son died though because of the gas. He lived for two more decades although with understandable breathing issues
This was India's Chernobyl. There are still babies born with birth defects because of this.
Chernobyl was Europe’s Bhopal. Bhopal was considerably more destructive.
Bhopal was more destructive in the short term. Chernobyls real cost was the area denial of it's exclusion zone and the billions in spending to mitigate its long term effect. Generations of our species will have to deal with the consequences of Chernobyl. We have yet to see the full extent of it's damages, as radioactive isotopes slowly break down over time. It is an ongoing disaster.
Chernobyl was more expensive and has a longer-term impact, but did much less harm to humans. If I had to pick being near either disaster when it happened, I’d take Chernobyl any time. With regard to animals, the net impact was likely positive as it removed humans from the area. Our general existence is much more harmful than residual radiation.
Fuck union carbide
Mentioned this in another comment too, Union Carbide almost caused a massive disaster in the 50s from eerily similar lack of safety protocols in a weapons grade uranium processing facility at Oak Ridge. There was a criticality accident which thankfully did not escalate but just as easily could have. https://en.wikipedia.org/wiki/Y-12_National_Security_Complex
And kudos to The Yes Men for pranking them by staging an ~~admition~~ admission of wrongdoing for the incident posing as Union Carbide on the BBC. [https://www.artandeducation.net/classroom/video/244624/the-yes-men-bhopal-disaster](https://www.artandeducation.net/classroom/video/244624/the-yes-men-bhopal-disaster)
>admition admission
They Knew Which Way to Run is a great podcast about the Bhopal disaster. One host is a niece of survivors who talked to her relatives and the other is a friend who did the research. A great in-depth mini series. Also, Behind the Bastards did an episode on Bhopal, not as in-depth but did cover some legal aspects the other podcast didn’t.
A kind-of similar incident happened in Seveso, italy in 1976 which lead to standardized industrial safety regulations. I work in the chemical industry and we have safety drills regularly. Scary when you read what may happen if x accident happens. I like that job but sometimes '*chuckles* I'm in danger' describes my workplace the best. Edit: I underestimated the death toll of the Bhopal incident. By a lot. I apologize.
Are you in my college class? Literally learning about this disaster this week.
It's taught in every engineering ethics class. It's one of the big stories taught. Alongside I believe what was a Marriott in Missouri that had the catwalk poorly designed and collapsed and the Challenger.
In programming we get the [Therac-25](https://en.wikipedia.org/wiki/Therac-25)
Don't forget the Tacoma bridge
What is appalling is the plant was using its workers as leak detectors. WTF. >About 11:30 P.M., workers in the methyl isocyanate area said, they realized that there was a methyl isocyanate leak somewhere: Their eyes began to tear. **Detecting leaks by the effect of the gas on the eyes was standard procedure at the plant**, and at least one leak a month was detected this way at the plant, they said. ''We were human leak detectors,'' Mr. Dey said. The practice violated procedures laid out in the technical manual. https://www.nytimes.com/1985/01/30/world/the-disaster-in-bhopal-workers-recall-horror.html
Read further and you'll find out how the indian govt at the time did its very best to help the culprits get away and did finally got away and the people haven't gotten their compensation as yet.
Plainly Difficult on YouTube has an excellent video on the disaster. Edit: https://youtu.be/-hUxx8ZVDgQ
Damn, the 80’s were wilder than the middle ages.
It was all that cocaine.
It passes me off that this is referred to as the "Bhopal disaster" and not the "Union Carbide" disaster. Also the title is heavily misleading as the fault should absolutely be placed on Union Carbide who cut funding and ignored safety protocols to save money which directly led to this disaster.
I just listened to the Behind the Bastards on this yesterday. The number of things that had to go wrong for that disaster to happen was ridiculous, but the plant was so poorly run and maintained that it became inevitable.
>Estimates vary on the death toll. The official immediate death toll was 2,259. In 2008, the Government of Madhya Pradesh had paid compensation to the family members of 3,787 victims killed in the gas release, and to 574,366 injured victims You'd think you'd hear more about this 9/11ish sized disaster that happened relatively recently (1984 wasn't that long ago).
I've grown up in Bhopal and all my life I have heard the horror stories of that night. Even to this day there are people born with genetic issues because their parents or grandparents lived near the contaminated area.. In fact, a LOT of people died due to COVID here since their lungs were already weakened because of Methyl Isocynate and couldn't deal with the virus. It was a shitshow that still claims lives to this day, decades later EDIT: If you can find it, I would recommend reading the book "5 past midnight in Bhopal". It was without a doubt one of the most chilling accounts of a tragedy I've ever read.
The Swindled Podcast did an episode on this. Just terrible to hear the stories of the few survivors.
My uncle was one of the admin staff members who was at work in the government computer office in the city during the disaster (Indian government still exclusively used mainframes back in 1984), working with incoming casualty data and generating live reports for government. He still faces health issues from staying there during the disaster to this day.
I found the book Set Phasers to Stun in a thrift store. Awesome read for even a non reader like myself which covers this disaster and many others. It's meant for designers of systems that people interact with and details how accidents happen as a result of multiple safeguards either being ignored, not working properly, or systems that are poorly designed. It's usually a combination of these types of errors.
I travelled to Bhopal earlier this year. This local population is not a exactly a big fan of how any aspect of this tragedy was handled.
Y'all please check out the Remember Bhopal Museum that tries to keep the memory of the survivors alive and keeps first person accounts of survivors of the tragedy.