A petroleum refinery experienced a catastrophic rupture at one bank of three heat exchangers in a catalytic reformer/naphtha hydrotreater unit because of high temperature hydrogen attack (HTHA). Hydrogen and naphtha at more than 500F were released from the ruptured heat exchanger and ignited, causing an explosion and an intense fire burned for more than three hours.

The rupture fatally injured seven employees working in the immediate vicinity of heat exchanger at the time of the incident. The workers were in the final stages of a start-up activity to put a parallel bank of three heat exchangers back in service following cleaning. Such start-up activities had resulted in frequent leaks and occasional fires in the past and should have been considered as hazardous and nonroutine. view more

Overview: A pipe end containing fuel oil corroded at the outlet of a heat exchanger on the outlet side of a desulfurization reactor. The corroded pipe end leaked hydrogen gas, which exploded, causing oil to leak from the heat exchanger. The leaking oil developed into an oil fire, and the damage spread. The causes of the pipe end corrosion include the following:

There was a high concentration of corrosive substances in the process injection water.
The concentration of corrosive substances increased due to re-molding the heat exchangers.
The shape of the pipe cap was dead end piping.

Incident: During normal operations at a fuel oil refinery, a pipe end in a desulfurization unit developed a hydrogen leak, which led to an explosion. The pipe end was located on view more