CONCLUSION

Looking at the Phillip 66 Explosion Cause Map, one can see how a series of a
procedural errors occurred that fateful day. Contracts workers were busy performing a
routine maintenance of clearing out a blockage in a collection tank for the plastic
pellets produced by the reactor. The collection tank was removed, and work
commenced that morning. However at some point, just after lunch, the valve to the
reactor system was opened ,releasing a enormous gas cloud which ignited less than
two minutes later.

The subsequent OSHA investigation highlighted numerous errors. First the air
hoses used to activate the valve pneumatically were left near the maintenance site.
When the air hoses were connected backwards, this was automatically opened the
valve, releasing a huge volatile gas cloud into the atmosphere. Second, a lockout
device had been installed by Phillips personnel the previous evening, but was
removed at some point prior to the accident. A lockout devices actually can prevent
someone from opening a valve. According to the investigation, the worker had not
been trained well in the procedures the were charged with performing.

Moreover, there were significant design flaws in the reactor or the collector
system. The valve system used had no mechanical redundancies which the single
Demco ball valve was the sole cut-off point between the highly-pressurized reactor
system and the atmosphere. Additionally, there was a significant design flaw with the
air hoses,as alluded to the earlier. In hindsight, one can see how multiple problems
led to such devastating result.

As a conclusion, the Phillips 66 explosion was a tragedy that could have been
avoided. The industrial safety standards that OSHA is charged with enforcing aim to
prevent future tragedies like this one. While a gradual safety-oriented transformation
has come with some pain and a price tag, few will argue that such standards are
unnecessary.Industrial workers deserve to work in an environment where risk to their
health has been reduced to the most practical level.