Severity
Incident
Leak
Yes
Ignition
Yes
Ignition Source
contact with hot surfaces and/or spontaneous ignition

Overview: A hydrogen leak and explosion occurred due to the installation of an incorrectly sized gasket at the suction line of a hydrogen compressor in a refinery hydrodesulfurization plant. The incorrectly sized gasket was mounted during the startup of the plant in 2001 and had never being inspected nor replaced.

Incident synopsis: The operating conditions were stable when the operator received an alarm indicating pressure loss in the circuit. He immediately instructed his field personnel to inspect the area. The hydrogen leak was confined inside the compressor room because the walls and roof were not provided with ventilation devices. An explosion occurred, causing two fatalities and the destruction of the compressor room and some of the surrounding area.

Incident Date
Sep 07, 2010
Setting
Equipment
  • Motive Power Systems
  • Compressor
  • Piping/Fittings/Valves
  • Gasket
Damage and Injuries
Characteristics
When Incident Discovered
Lessons Learned

Carefully revise the risk assessment process to evaluate any confined areas where hydrogen is handled.
Separate the fire and gas detection alarm system from the process information to provide easy and clear identification.
Refresh and re-enforce personnel training on fire and gas identification and interpretation.
Retrain personnel on emergency procedures and enhance their understanding and awareness of risky, flammable, explosive, and/or toxic substances. Avoid underestimation of the hazards and complacency.
Re-enforce training and review training courses for recently hired personnel.

Key:

  • = No Ignition
  • = Explosion
  • = Fire
Hydrogen Incident Summaries by Equipment and Primary Cause/Issue
Equipment / Cause Equipment Design or Selection Component Failure Operational Error Installation or Maintenance Inadequate Gas or Flame Detection Emergency Shutdown Response Other or Unknown
Hydrogen Gas Metal Cylinder or Regulator   3/31/2012
4/30/1995
2/6/2013
4/26/2010 12/31/1969     3/17/1999
11/1/2001
12/23/2003
Piping/Valves 4/4/2002
2/2/2008
5/11/1999
4/20/1987
11/4/1997
12/31/1969
8/19/1986
7/27/1991
12/19/2004
2/6/2008
10/3/2008
4/5/2006
5/1/2007
9/19/2007
10/31/1980
2/7/2009 1/24/1999
2/24/2006
6/8/1998
12/31/1969
2/7/2009

9/1/1992
10/31/1980

10/3/2008  
Tubing/Fittings/Hose   9/23/1999
8/2/2004
8/6/2008
9/19/2007
1/1/1982 9/30/2004
10/7/2005
  10/7/2005  
Compressor   10/5/2009
6/10/2007
8/21/2008
1/15/2019
    10/5/2009 8/21/2008  
Liquid Hydrogen Tank or Delivery Truck 4/27/1989 12/19/2004
1/19/2009
8/6/2004 12/31/1969   1/1/1974 12/17/2004
Pressure Relief Device 7/25/2013
5/4/2012
1/15/2002
1/08/2007
12/31/1969        
Instrument 1/15/2019 3/17/1999
12/31/1969
2/6/2013
    11/13/73    
Hydrogen Generation Equipment 7/27/1999     10/23/2001      
Vehicle or Lift Truck   7/21/2011         2/8/2011
12/9/2010
Fuel Dispenser   8/2/2004
5/1/2007
6/11/2007
9/19/2007
  2/24/2006
1/22/2009
     
Fuel Cell Stack            

5/3/2004
12/9/2010
2/8/2011

Hydrogen Cooled Generator       12/31/1969
2/7/2009
     
Other (floor drain, lab
anaerobic chamber,
heated glassware,
test chamber,
gaseous hydrogen
composite cylinder,
delivery truck)
  11/14/1994
7/21/2011
7/27/1999
6/28/2010
8/21/2008
12/31/1969
3/22/2018
    6/10/2019
  • = No Ignition
  • = Explosion
  • = Fire