Accidental Production of Hydrogen in an Manufactory of Electronics Products
The event occurred at the factory producing multilayer circuit boards by a multistep dip operation. An employee inadvertently mixed 55 gal of 50 percent hydrogen peroxide into 110 gal of 30 percent formaldehyde. This resulted in a carbon monoxide and hydrogen release. The facility was evacuated and the local fire department and ambulance responded. 14 workers, out of whom three were from temporary employment agencies, were treated for inhalation and released.The employee did not look carefully at the label on the hydrogen peroxide drum. Both hydrogen peroxide and formaldehyde are in similar black 55 gal poly drums with labels on one side.
Event Date
April 13, 1995
Record Quality Indicator
Region / Country
Event Initiating System
Classification of the Physical Effects
Nature of the Consequences
Causes (Select all applicable options):
Cause Comments
The immediate cause was that staff advertently mixed two chemicals which produced and released of carbon monoxide and hydrogen.The fact that the two products containers were not easily distinguishable hints at a management and/or job factor.
Application Type
Application
Specific Application Supply Chain Stage
Components Involved
multilayer circuit boards manufactory, chemicals
Location Type
Location description
Unknown
Lessons Learned
It is unknwon if the operator adopted correctiove actions. In general, it appears clear that the procedures shuld be made more effective. The risk of confusing containers with different chemicals should be reduced. At the same time, staff should be better trained and follow operating instructions more carefully.
Emergency Action
Unknown
Release Type
Detonation
No
Deflagration
No
High Pressure Explosion
No
High Voltage Explosion
No
Source Category
References
OSHA Accident Summary Nr: 170620488 - Fourteen Employees Exposed To Carbon Monoxide And Hydrogen
https://www.osha.gov/ords/imis/accidentsearch.accident_detail?id=170620…
(accessed May 2023)