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Common Mistakes When Conducting a HAZOP and How to Avoid Them

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 Environmental Manager

Common Mistakes When Conducting a

HAZOP and How to Avoid Them
An important part of ensuring the success of a HAZOP study is to understand the
errors that can cause the team to lose focus
Arturo Trujillo, Walter S. Kessler
and Robert Gaither
Chilworth, a DEKRA Company

S
ince its inception in the 1960s
and its first official publica-
tion in 1977, the Hazard and
Operability Study (HAZOP)
has become one of the most power-
ful tools for identifying process haz-
ards in the chemical process indus-
tries (CPI). Utilizing systems that are
qualitative or even simplified semi-
quantitative, the HAZOP method has
been increasingly used, not only as a
tool for identifying process hazards,
equipment deficiencies or failures and
operability problems and assessing
their risk, but also as a tool for priori-
tizing actions and recommendations
for process-risk reduction. Reducing
risk is especially important in ensuring
the safety of the personnel who must
work in the plant environment each
day (Figure 1).
The HAZOP methodology is a sys-
tematic team-based technique that
can be used to effectively identify
and analyze the risks of potentially
hazardous process operations. It is
the most widely used process hazard
analysis (PHA) technique in numer-
ous industries worldwide, including
petrochemicals, pharmaceuticals,
oil-and-gas and nuclear, and is used
during the design stages of new pro-
cesses or projects, for major process
modifications and for periodic review
of existing operations. FIGURE 1. HAZOP studies are useful tools in reducing process risk, and they provide safeguards against
A HAZOP is a time-consuming ex- hazardous scenarios for the personnel who must maintain and operate the plant
ercise and should be conducted in
such a way to ensure that the results to correct these mistakes if or when Benefits of a HAZOP
justify the effort. This article overviews they occur during the course of the The advantages offered by HAZOP
some common mistakes that can HAZOP study. Therefore, the selec- over other process-risk analysis
jeopardize a HAZOP team’s task. Fre- tion of an experienced facilitator is tools are numerous, and include
quent or chronic occurrence of these an essential element for assuring the the following:
mistakes indicates potential gaps in success of the HAZOP. Without an • It is a rigorous process; it is structured,
the site’s process-management sys- adequate depth of knowledge and systematic and comprehensive
tem. However, it is ultimately the re- experience, the HAZOP can become • It is adaptable to the majority of
sponsibility of the HAZOP facilitator a “check the box” exercise. CPI and manufacturing opera-
2 Chemical Engineering www.chemengonline.com december 2015
 tions, including those in refineries
(Figure 2) and other oil-and-gas
processing plants, nuclear facili-
ties, as well as specialty chemical,
pharmaceutical and even high-
speed manufacturing
• It is team-based and allows the
interchange of knowledge and ex-
perience between the participants
• It helps to anticipate potential ac-
cidents or harm to employees, the
facility, the environment and the
surrounding community
• It functions as a type of training for
the team’s participants and leader,
who are required by the nature
of the method to look at the pro-
cess from a new perspective —
not just from the perspective of
“how should it run?,” but from the
perspective of “how can it fail to
run correctly?”
HAZOP is time-consuming be-
cause it requires the participation
of a multi-disciplinary team over ex-
tended timeframes. This investment
of time and personnel, often involv-
ing third parties, means that the per-
formance of the HAZOP needs to be
optimized to maximize its value. The
following sections detail some com-
monly found mistakes that occur
during the planning, execution and
followup stages of a HAZOP.
Planning stage
Mistake 1: Mismanagement of
time-allotment issues. One of the
most frequent mistakes of a HAZOP
is failure to manage the time allot-
ted for the study. A HAZOP is often
scheduled for a set amount of time,
neither by the HAZOP facilitator nor
the team, and sufficient time may not
have been allocated. Furthermore,
there may be little or no flexibility in
the schedule. An insufficient amount
of time for the HAZOP limits discus-
sion and brainstorming and reduces
the quality of the analysis, in turn
leading to some of the mistakes dis-
cussed in more detail below.
Estimating the duration of a
HAZOP is not an exact science, and
it requires a good knowledge of the
methodology, the complexity of the
process, the nature of the risks that
can be identified up front and the id-
iosyncrasies of the group. Although a
HAZOP should not be open-ended in
time allotment, the ideal HAZOP has
some flexibility built into the sched-
Chemical Engineering www.chemengonline.com
FIGURE 2. Many processes in the CPI are potentially hazardous if not managed correctly. HAZOP studies
seek to prioritize actions to reduce process risks, and are adaptable across a wide range of industrial
sectors
ule. The team leader should make an
estimate of the time required for the
team based on the process descrip-
tion and preliminary HAZOP node
count so that managers are aware
of the degree of personnel commit-
ment that will be required.
Mistake 2: Incomplete, inaccurate
or unavailable process-safety in-
formation. Another common mis-
take during a HAZOP is not having
all the prerequisite process-safety
information (PSI) and other valuable
information available, including out
of date or incomplete information.
This is especially critical regarding
piping and instrumentation diagrams
(P&IDs), current standard operating
procedures (SOPs), and appropriate
data on flammability, combustibility,
reactivity, toxicity, and electrostatic
properties of materials in all forms
and phases, as well as compatibil-
ity of chemicals with each other and
with the processing equipment. If
the HAZOP is conducted by an ex-
ternal facilitator, it is the responsibility
of the owner of the process to verify
the integrity of the PSI.
Related to this, it is not acceptable
that participants attend the HAZOP
for the purpose of obtaining informa-
tion on a process or project. HAZOP
participants should be well prepared
to contribute to the discussion and
have all requisite background infor-
mation with them. It is the respon-
sibility of the facilitator to instruct all
participants that they must come to
the HAZOP prepared.
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Mistake 3: Incorrect size of HAZOP
team. The HAZOP team should be
limited in size, ideally five to seven
people, excluding the HAZOP facili-
tator and the HAZOP scribe or sec-
retary. A team that is too large can
easily lose focus, dwell on a subject
or issue too long, or be disruptive. It
is human nature that all participants
seek to present their perspective,
but this can lead to excessive dis-
cussion. A group that is too small will
not likely include the right expertise
or provide enough different perspec-
tives to evaluate the process haz-
ards and controls adequately or in
the right detail.
Execution stage
Mistake 4: Lack of focus during
the meeting. A HAZOP is a com-
plex exercise that requires the con-
centrated and coordinated contribu-
tion of all the members of the team.
Distractions should be minimized
in order to ensure and maintain the
team’s focus. Therefore, team mem-
bers should not be allowed to come
and go into and out of the meeting,
take phone calls, answer emails,
or discuss issues not related to the
HAZOP during the sessions. Use of
an offsite venue may be helpful to
prevent plant operations from be-
coming a distraction.
It is the responsibility of the HAZOP
facilitator to maintain the focus of the
group and keep the HAZOP process
moving by allowing some open dis-
cussion on the issue, node and con-
3

FIGURE 3. It is crucial that a HAZOP be explicitly targeted for the specific process in question, and not
based on previous HAZOPs for similar processes, as process-safety information and controls may have
recently changed
sequence at hand, but not letting it
get out of control. Sufficient (but not
excessive) breaks for participants to
eat and drink and conduct activities
not related to the HAZOP, such as
checking their emails and voicemails,
should be planned and coordinated.
The HAZOP room should be a free
from cellphones, and distractions
like texting during the HAZOP exer-
cise forbidden.
Mistake 5: Preventing the team
from brainstorming. Another fre-
quent mistake in HAZOPs is to re-
strict the brainstorming exercise,
which is, after all, the basis (and the
power) of the method. The most
common issues in this area include
the following:
• Omitting key words, parameters
or even nodes, with the argument
that an upper bound for the con-
sequences in this node can be
easily identified, and these maxi-
mum consequences are protected
by safeguards. This clearly means
that steps or phases of the HAZOP
procedure will be skipped, and
some process hazards may not be
identified. This violates the HAZOP
methodology and overall purpose
of conducting the HAZOP in the
first place. Although on many oc-
casions, strict application of the
methodology will not identify any
hazardous scenarios other than the
obvious ones, which have already
been listed up front and used as
an argument for omitting any fur-
ther analysis. Nevertheless, some-
times a non-obvious scenario will
be identified that constitutes the
purpose of the HAZOP, and this is
where it demonstrates its power
• Carrying out a superficial review of
4 Chemical Engineering
the combinations of key words and
parameters, listing the most obvi-
ous, and often repetitive, causes of
deviation without going into detail.
In other words, repeating the same
causes, parameter after parameter
and node after node, instead of
conducting a more in-depth analy-
sis and discussion
• Carrying out HAZOPs using some
form of prior information — pre-built
templates or the HAZOP from a
similar project, for example. Again,
what the HAZOP is meant to do is
analyze the possible specific risk
scenarios (especially the non-ob-
vious ones) of the process or proj-
ect being studied at the time of the
HAZOP (Figure 3). While one can
refer to or reference previous mate-
rial, the HAZOP is to be conducted
based upon the current facility or
process, and the equipment, pro-
cess or controls may have changed
since the last HAZOP
In practice, the quality of a HAZOP
is influenced by the ability of the
HAZOP leader to ask the appropri-
ate questions to ensure that the team
identifies all the hazards of the pro-
cess being studied, not only the most
obvious hazards. This ability is based
on the leader’s experience with the
HAZOP technique and their technical
skills in process-hazard identification,
as well as human error and equipment
failure potential. It is the responsibility
of the HAZOP facilitator to manage
the team and the HAZOP study pro-
cess to ensure that the team stays fo-
cused and that no nodes or hazards
are missed by the team.
Mistake 6: Mistaking the tools for
the process. The HAZOP spread-
sheet should not be viewed as a
www.chemengonline.com
questionnaire whose boxes all have
to be filled in, even with numerous
repetitions of scenarios. The combi-
nation of pairs of key words and pa-
rameters is not intended to be an end
in itself, but to encourage discussion
and identify deviations from the de-
sired state. As would be expected,
the same deviation generally causes
the alteration of more than one pro-
cess parameter, and therefore could
be entered in more than one place in
the spreadsheet. An obvious exam-
ple is a distillation column, in which
pressure, temperature, composition
and flowrate (of reflux, for example)
are clearly interrelated. Hence, any
change in one of the parameters
automatically causes responses and
changes in the others.
It is not as important for all the
spreadsheet “boxes” to be filled in
as it is for the HAZOP group to work
effectively in identifying all the pos-
sible deviations. A HAZOP table is
not and should not be a form-filling
exercise. Rather, it should guide and
structure strategic brainstorming dis-
cussion with the intent of identifying
all hazards and operability problems
that may injure employees (Figure 4),
cause damage to property and as-
sets, impact the community or cause
environmental damage.
Mistake 7: Misrepresenting or
misunderstanding safeguards.
Documentation of effective and ap-
propriate safeguards is a key step
in the PHA team’s decision whether
additional process-risk reduction
is required for a specific scenario.
Examples of safeguards that are
neither effective nor appropriate are
given below
• Local instruments that are never
checked by field operators;
• Alarms that fail to give the operator
sufficient time to effectively halt the
consequences of the deviation.
Examples include the following:
❍❍ Alarms that fail
❍❍ Very generic alarms that are
activated in numerous differ-
ent situations. In this case,
the operator has to diagnose
which of the multiple op-
tions he or she is faced with,
thereby losing valuable time
for action
❍❍ Alarms that are activated fre-
quently, often for trivial rea-
sons, and therefore tend to
december 2015
 be ignored by the operators
❍❍ Alarms where no specific
operator response has
been given in procedures
and training
❍❍ Cascades of alarms, where
“first-in” is not obvious or
indicated
• Pressure-relief systems (such as
safety valves and rupture discs) that
were not designed for the case and
process conditions being studied.
Obviously, the purpose of a HAZOP
is not to verify the correct design of
pressure-relief systems. Neverthe-
less, if there is reasonable doubt,
a recommendation should be is-
sued to check that the scenario for
which it was listed as a safeguard
was one of the cases of design for
the relief device or system
• Operating procedures cannot be
considered safeguards when the
cause giving rise to the scenario is
human error, which presupposes
that the procedure has not been
followed properly
Mistake 8: Excessive recommen-
dations. Some HAZOP groups be-
lieve that they should issue a recom-
mendation for any scenario that has
negative consequences, whether a
hazard scenario, equipment failure or
operability problem. This is not in the
spirit of the HAZOP method. What a
HAZOP aims to do is to identify all of
the hazardous scenarios, determine
the associated risk for that particular
scenario, check whether they have
been duly protected by the safe-
guards, and only if they have not
been adequately protected, propose
recommendations for doing so.
Mistake 9: Irrelevant recommen-
dations. Sometimes, people will
suggest and utilize HAZOP recom-
mendations as a way to obtain ap-
proval for an operational or plant
design improvement, not necessarily
directly related to safety of personnel
or release of a hazardous chemical,
which has already been evaluated
and ruled out for value-added or
feasibility. While a HAZOP can and
should include recommendations re-
lated to operational and maintenance
issues, the HAZOP’s sole intent is
for the identification of issues, not
to find a solution to the problems or
redesign the facility. All recommen-
dations are made for further inves-
tigation and design considerations.
Chemical Engineering www.chemengonline.com
Therefore, the actual HAZOP is not
the best time or place to deal with
these types of issues. They should be
further investigated offline, in the cor-
rect setting and include the appropri-
ate personnel in the discussions.
Mistake 10: Excessively lax rec-
ommendations. When making rec-
ommendations in a HAZOP, it is very
important to utilize the proper word-
ing. Since the HAZOP team is com-
posed of knowledgeable people,
recommendations should be made
that involve action. Two words that
are highly over-utilized are “recom-
mend” and “consider.” “Recom-
mend” is already used in the title for
the column and most of the time, the
team’s brainstorming makes up the
“consideration” aspect of the recom-
mendation being proposed. If addi-
tional risk analysis is required, “con-
sider” is an appropriate phrase.
There are often multiple ways to re-
duce risk and the team’s time should
not be spent analyzing alternatives.
Another common phrase seen in
many HAZOP recommendations is
“Further study on what needs to be
done in order to...” — which in reality
is not specific and can be left open
for interpretation. Most of the time,
recommendations that involve an
action and have a specific purpose
should be made. Start recommenda-
tions with strong action words, such
as “install,” “investigate,” “graph,” or
“add.” Additionally, when wording
recommendations, if a recommen-
dation is being made for a specific
reason, include that reason in the
recommendation so it is not forgot-
ten when the HAZOP report is writ-
ten or being reviewed. The following
are good examples of well-worded
recommendations:
• Install a Pressure gauge and trans-
mitter on the overhead line “L12” of
the distillation column to increase
the SIL level from 1 to 2
• Graph the P/T curve for the reac-
tion process and add the accept-
able operating range. Utilize this
chart to set appropriate process
alarm and shutdown points
It should be noted how these two
recommendations are very specific
action items and also include the
reason for the action.
On some occasions, there may
be two or more divergent opinions,
and a consensus cannot be reached
december 2015
FIGURE 4. HAZOP studies intend to provide a com-
prehensive index of the hazards and operability
problems that may cause damage or put employ-
ees in danger
during the HAZOP itself. In this case,
both recommendations should be
included in the HAZOP and left for
further investigation or evaluation
by the company, based upon the
information from the HAZOP. For
scenarios such as these, the best
solution — after further investigation
and research is completed — may
be something not even mentioned or
thought about in the HAZOP itself.
Again, it should be reiterated that
except for a few unique situations,
such as the divergent opinion case,
recommendations should be clear,
specific, not open to interpretation
and include the reasoning at the time
that the HAZOP was conducted.
Mistake 11: Trying to solve the rec-
ommendation or design the solu-
tion during the HAZOP. Another
common mistake that can delay the
HAZOP and cause the group to lose
its focus is trying to solve the prob-
lem or redesign the process listed
in the recommendation during the
HAZOP study itself. This is most
common when process-design en-
gineers are team members and they
desire to make the process perfect.
Unless it is a clear and easy solution,
many recommendations require fur-
ther investigation or other actions to
complete the task, alleviate or mini-
mize the hazard, and close out the
action item based upon the recom-
mendation. It must be remembered
that a HAZOP is a brainstorming
exercise with knowledgeable pro-
cess personnel from different areas
of the plant, whose task is to identify
hazards or hazardous scenarios and
make practical recommendations
to alleviate or minimize the hazard-
ous scenarios or consequences.
As previously stated, not all recom-
mendations have clear-cut solutions,
and the HAZOP time should not be
5
 wasted with actions that may require
research and further investigation that
only one of the participants, or a qual-
ified expert, can resolve in the quiet of
his or her own office. Even HAZOP-
recommended changes to a process
should be subjected to the site’s
management-of-change (MOC) pro-
cess to prevent introduction of new
hazards. It is not uncommon for an
incident to be triggered by a change
made for safety reasons. The HAZOP
can and should result in a list of ac-
tions or recommendations, with the
designation of someone responsible
for carrying them out, but not neces-
sarily the final solution or re-engineer-
ing of the plant.
Followup stage
The output of the HAZOP study is
the set of recommendations that are
usually presented to management in
a standardized report format. At this
stage, site management is respon-
sible for responding to each recom-
mendation according to local or site
requirements and the requirements
of applicable standards, such as the
U.S. Occupational Safety and Health
Administration (OSHA) Process Safety
Management (PSM) standard Title
29, CFR Part 1910.119. Site proce-
dures should include regular followup
reports to track recommendations
to their resolution.
Mistake 12: Failure of manage-
ment to act promptly on each rec-
ommendation. Site management
must evaluate each recommendation
according to its technical feasibility,
the risk-reduction benefit versus total
cost of implementation, availability of
alternative solutions and other fac-
tors. The PSM standard allows rejec-
tion of a PHA recommendation only
for specific causes. Good industry
practices dictate that management
takes prompt action on each recom-
mendation and ensures that all rec-
ommendations are tracked to final
resolution and closure.
Mistake #13. Failure to update
HAZOPs when process knowledge
changes. A HAZOP worksheet is a liv-
ing document. Ideally, it reflects man-
agement’s current knowledge of the
process hazards, the consequences
of those hazards and the controls
necessary to reduce the process risk
to a tolerable level. HAZOPs lose their
effectiveness over time when they are
6 Chemical Engineering
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not updated promptly.
Changes in process safety infor-
mation should result in a PHA review
through the site MOC procedure. The
review will identify any new causes of
a process deviation or operability is-
sues, changes in safeguards for previ-
ously documented hazard scenarios,
and possibly new or revised recom-
mendations to address the hazards.
Recent accidents or near misses
on a site process, or a similar process
elsewhere, should trigger a HAZOP
review to ensure that the same or
similar scenario has already been
considered and documented dur-
ing the most recent HAZOP and that
effective controls are in place to pre-
vent a similar incident from occurring
in the future.
Additional applications
For the sake of simplicity, this article
has focused on common mistakes
observed during the use of the HAZOP
methodology. The discussion in this
article can be equally applied to other
scenario-based methodologies, such
as “what-if” analyses, which can be
carried out at very early stages of the
process lifecycle — HAZOP is typi-
cally reserved for late-design stage
or later-lifecycle stages when more
detailed PSI is available. The specific
PSI that is available and the expertise
needed for other hazard evaluation
methodologies may be different, but
the types of mistakes discussed here,
and their prevention are very similar.
Closing thoughts
OSHA recognizes the HAZOP tech-
nique as an acceptable methodology
for conducting PHAs of processes
covered by the PSM standard. Other
regulators around the world also ac-
cept the HAZOP methodology as
appropriate for analyzing the existing
and potential hazards of a complex
process that involves a highly hazard-
ous substance.
The HAZOP methodology repre-
sents an extremely powerful tool for
the identification, semi-quantification
and mitigation of risks in CPI produc-
tion facilities, with continuous, batch
or semi-batch processes.
The biggest inconvenience of this
technique is its relatively high cost, in
terms of time and people who need
to be involved and participate in the
brainstorming sessions. This high
www.chemengonline.com
cost means that the HAZOP needs
to be carried out to optimum effect,
avoiding the sorts of mistakes that
have been discussed in this article. It
is the responsibility of the HAZOP fa-
cilitator to make sure the group stays
focused and does not commit any
of these mistakes. Finally, the selec-
tion of a knowledgeable and experi-
enced PHA facilitator is a crucial ele-
ment for assuring the success of the
HAZOP process. n
Edited by Mary Page Bailey
Authors
Arturo Trujillo is managing direc-
tor of Chilworth Amalthea, the
Spanish subsidiary of the process
safety division of DEKRA (Gran Via
630, 4ª planta 08007 Barcelona,
Spain; Phone: (34) 934 920 450;
Email: arturo.trujillo@dekra.com).
He has facilitated more than 200
HAZOPs, and his specialities in-
clude SIL and LOPA. Prior to work-
ing at Chilworth, he served as a division manager at
Technip Iberia and as engineering director at Asesoría
Energética. He attended Universitat Politècnica de Catalu-
nya and received a Ph.D. from Johns Hopkins University.
Walter S. Kessler is a senior pro-
cess safety consultant at Chilworth
Technology Inc. (113 Campus
Drive, Princeton, NJ 08540;
Phone: 832-492-4358; Email:
walter.kessler@dekra.com).
Kessler has 20 years of experi-
ence in the refinery, gas-process-
ing, specialty-chemical, pharma-
ceutical, manufacturing and
HVACR (heating, venting, air conditioning and refrigera-
tion) industries, including five years performing process-
safety engineering functions. He was instrumental in the
design and construction of several refinery, gas and
chemical processing facilities, designing a pharmaceu-
tical filling process, improving several manufacturing
processes, and also has experience in Six Sigma and
lean manufacturing.
Robert L. Gaither is a senior pro-
cess safety specialist at Chilworth
Technology Inc. (113 Campus
Drive, Princeton, NJ 08540;
Phone: 732-589-6940; Email:
robert.gaither@dekra.com).
Gaither has more than 28 years of
experience in company opera-
tions, regulatory compliance,
management consulting and pro-
cess safety and risk management. He has led organiza-
tions at site, division and corporate levels to achieve
record safety performance and significant cost savings.
Gaither is a trained expert in HAZOP and SIL/LOPA fa-
cilitation. He holds a Ph.D. and is a certified safety
professional (CSP).
december 2015