WA Mines and Petroleum Minister Norman Moore has released the long-awaited report into the 2008 Varanus Island failure. The government announcement is here, with a link to the report itself at the bottom.
The report is very wide-ranging and extends to nearly 500 pages (including numerous appendices) and so far I have only read the executive summary and skimmed major section headings. Suffice to say it is very impressive – I recommend a look by anyone interested in management of technical safety of pipelines or other major hazard industries.
The authors have fully taken on board the principles of the sociology of safety and make extensive use of the work of people such as Andrew Hopkins (well known for “Lessons from Longford” and other works including his contributions to the EnergyPipelines CRC) and James Reason (originator of the “Swiss Cheese” failure model among other more notable achievements). This reinforces the importance of the work of Energy Pipelines CRC Research Program 4 on the sociology of safety as applied to pipelines.
The report puts a great deal of emphasis on the regulatory regime and is quite critical: “We encountered a confusing mishmash of jurisdictional, legal, process and regulatory interfaces upon which was overlaid poor relationships among regulators. In such an environment, even serious operator shortcomings were far less likely to be found and addressed to reduce the risk of a major accident event.” It is equally critical of Apache (operator and major shareholder of the Varanus Island plant and failed pipeline).
I have previously written in glowing terms about the US National Transportation Safety Board and its impressive independence and skills, with a follow-up post on what a good accident investigation should include. So I find it particularly interesting that the very first recommendation of the Varanus Island report is “… establishment of a properly resourced independent national safety investigation body to investigate serious offshore oil and gas and onshore petroleum pipeline accidents and incidents. The body should be empowered to compel documents and witnesses and be required to make public a professional systemic no-blame investigation report that is appropriately protected from legal action for the purpose of improving future safety.”
Now that it is out in the open I think the ramifications of this important report will bounce around the hydrocarbon industry for quite some time.