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BUNCEFIELD MAJOR INCIDENT INVESTIGATION BOARD PUBLISHES INITIAL REPORT

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Buncefield - good progress made, lessons will be learned says report...
Buncefield - good progress made, lessons will be learned says report

Good progress has been made in identifying the root causes of the Buncefield incident, according to the initial report by the investigators out today.

The investigation board said enough was now known to set out the sequence of events on the day leading up to the incident, although uncertainty remained about why the explosion had been so violent.

Lord Hunt, minister for health and safety, said: 'It is of paramount importance to ensure all the lessons of Buncefield are learned.

Today's report does acknowledge and welcome the programme of inspections being undertaken by the Health and Safety Executive (HSE) and the Environment Agency.

'I am fully aware of the need to give local residents and businesses directly affected by the incident, answers to resolve any uncertainties.'

He added that the investigation was continuing and consideration had to be given to ensure that any potential criminal proceedings in the future were not prejudiced.

The Health and Safety Commission and Environment Agency are now considering the initial report and the board's early conclusions. Any actions identified will be taken forward without delay.

Lord Hunt added: 'The board of investigators also mentions the work being carried out by a cross-government group to determine the implications of new information being gathered by HSE about major hazard sites.

'This work has been underway since before the Buncefield incident but will take account of information arising from the investigation. Once clear conclusions emerge, the work will be the subject of consultation with stakeholders.'

The Buncefield Major Incident Investigation Board (MIIB) today published its initial report. This report summarises information from three previously published progress reports on the continuing investigation into the explosions and fires at the Buncefield Oil Depot in Hemel Hempstead, on 11 December 2005. More importantly, it draws broad conclusions about the need for action in three key areas.

The Health and Safety Commission and the board of the Environment Agency have received this report and endorsed its publication.

Lord Newton, the chairman of the Buncefield Investigation Board said:

'Though knowledge of this major incident is still incomplete, the board is in a position to identify three main issues arising from it. These are the design and operation of fuel and oil storage depots; the emergency response to incidents; and advice to planning authorities on developments round such sites. We believe these areas, together with our examination of the HSE's and the Environment Agency's roles in regulating the activities on the Buncefield site, will form the main scope of our further work.'

In relation to the design and operation of storage sites, the Buncefield incident involved failures to contain fuel at three levels. The paramount need is to ensure the integrity of the primary means of containment, ie confining the fuel to the tanks, pipes and vessels designed to hold it. This does not however lessen the need for effective secondary and tertiary containment (mainly bunds and

drains) that prevent pollutants, especially fuel and the water used for fire fighting, from escaping the site and contaminating the environment.

Overall, the board were very impressed with the emergency response to the incident, highlighting the importance of effective emergency arrangements. There are a number of reviews into the effectiveness of the emergency response to Buncefield being carried out by the agencies concerned and this provides an important opportunity to learn lessons and bring about improvements in emergency preparedness of countrywide resilience groups.

The Buncefield incident has posed fundamental questions about residential and commercial developments around sites like Buncefield.

Continuing uncertainty in this area creates serious problems for local communities, particularly those directly affected by the Buncefield incident. This is a complex issue requiring a balance to be made between the risks and benefits of development. The board intends to address these issues more fully once the preliminary conclusions of the HSE's current review of its advice to planning authorities are known.

Lord Newton continued: 'The board will continue to ensure that information on the on-going investigation is made publicly available, either through its own reports or via the HSE and Environment Agency, where it is necessary to ensure continued safety. At the same time we must preserve the integrity of any future criminal proceedings that might be brought by the relevant enforcing authorities.'

Taf Powell, the investigation manager said: 'Work on the investigation continues to ensure that all reasonable lines of enquiry are followed. Evidence continues to be gathered from different sources and the emerging information contributes to a greater understanding of the underlying root causes. This allows the investigation team to refine its enquiries further and to bring into focus elements such as wider management systems and organisational factors.

'Almost all the plant and equipment required for forensic examination has been recovered from the Buncefield site, which will allow the operators to demolish buildings, tanks and bunds. However, further investigation work will be carried out on the integrity of the floors of the bunds together with environmental monitoring of the ground underneath, in particular where tanks were located.'

Notes

1.This report is the initial report required by the terms of reference of the investigation into the explosions and fires at the Buncefield oil storage and transfer depot, Hemel Hempstead, Hertfordshire on 11th December 2005. The investigation was directed by the Health and Safety Commission (HSC) using its powers under section 14(2)(a) of the Health and Safety at Work etc. Act 1974.

2.The investigation is being carried out jointly by theHealth and Safety Executive (HSE) and the Environment Agency. The HSC appointed an independent Investigation Board, chaired by Lord Newton of Braintree, to supervise this investigation. This report has been prepared by the Investigation Board, based on information arising from the continuing HSE/Environment Agency investigation. Throughout the investigation, the board has been supplied with Progress Reports from the Investigation Manager, Taf Powell, which the Board has published.

3.This report does not repeat all the material contained in the Progress Reports, which should be read for a fuller understanding of the investigation up to May 2006. Part 1 summarises and updates where necessary key points of the investigation for completeness and to aid in understanding the Investigation Board's initial conclusions set out in Part 2. The board has included significant new findings from the investigation that have emerged since publication of the Third Progress Report on 9th May. Other new material is contained in the annexes to this report.

4.The investigation terms of reference require an initial report to be submitted to the HSC and the Environment Agency as soon as the main facts of the incident have been established. The investigation is still continuing. Nevertheless, the Investigation Board considers that, with publication of the Third Progress Report in May, enough facts have been established to set out with reasonable confidence the sequence of events leading to the incident on 11th December. In particular, enough is known for the Board to be able to identify several issues of concern for the effective regulation of fuel storage sites such as Buncefield. As well as the main facts of the incident, the Board has included in Part 2 of this report its emerging thoughts about future action to address these issues of concern.

5. The Investigation Board plans to give further consideration to these issues.

To view the 'Initial Report' visit the Buncefield Investigation website from 12pm on 13 July 2006 at:

www.buncefieldinvestigation.gov.uk

HEALTH AND SAFETY EXECUTIVE

Commission endorses publication of the initial report of the independent board's investigation into the explosions and fires at the Buncefield oil storage depot

The Health and Safety Commission (HSC) and the Board of the Environment Agency (EA) today have received and endorsed publication of the initial report by the independent Major Incident Investigation Board appointed to supervise the investigation of the explosion and fires at the Buncefield Oil Storage Depot, Hemel Hempstead, on 11 December 2005.

The Major Incident Investigation Board, chaired by Lord Newton of Braintree, concluded that sufficient knowledge of the Buncefield incident had been gathered to draw broad conclusions about the sequence of events leading to the explosion although uncertainty remains about why it was so violent.

Bill Callaghan, Chair of HSC, said:

'The Commission places on record its appreciationfor the Investigation Board's work and the thorough, objective, timely and transparent manner in which it has gone about it. The Board recognised that the severity of the incident was of great concern to the local community and industry, and has made strenuous efforts to ensure that they are kept abreast of the investigation findings as they develop. The Commission also record its thanks to the detailed work of Health and Safety Executive (HSE) and EA staff who have supported the Board.

'The report indicates that good progress has been made in identifying the root causes of the incident, in spite of the widespread damage caused by the explosions and fires. It is of paramount importance to ensure that all the lessons of Buncefield are learned to prevent recurrence of such an incident, and to ensure the maximum effectiveness of emergency arrangements if an incident does occur.

The Commission values the actions already taken by the HSE and EA following findings contained in earlier progress reports, and looks to the fuel and oil storage industry to take all appropriate measures.'

The Investigation Board identified three key issues as the focus of its work:

* The design and operation of storage sites;

* emergency response to incidents; and,

* land use planning.

The HSC and HSE are now considering the Investigation Board's report and early conclusions, and look forward to the Board's future work.

Notes

1 The Investigation Board's terms of reference are to:

* ensure the thorough investigation of the incident, the factors leading up to it, its impact both on and off-site, and to establish its causation including root causes;

* identify and transmit without delay to duty holders and other appropriate recipients any information requiring immediate action to further safety and/or environmental protection in relation to storage and distribution of hydrocarbon fuels;

* examine the HSE's and the Environment Agency's role in regulating the activities on this site under the COMAH Regulations, considering relevant policy guidance and intervention activity;

* work closely with all relevant stakeholders, both to keep them informed of progress with the investigation and to contribute relevant expertise to other inquiries that may be established;

* make recommendations for future action to ensure the effective management and regulation of major accident risk at COMAH sites. This should include consideration of off-site as well as on-site risks and consider prevention of incidents, preparations for response to incidents, and mitigation of their effects;

* produce an initial report for the HSC and the Environment Agency as soon as the main facts have been established. Subject to legal considerations, this report will be made public;

* ensure that the relevant notifications are made to the European Commission;

* make the final report public.

2 The Commission has exercised a power under Section 14(2)(a) of the Health and Safety at Work etc. Act 1974, under which it: 'may at any time direct the Executive or authorise any other person to investigate and make a special report on any matter.'

3 The Buncefield oil depot is subject to the Control of Major Accident Hazards Regulations 1999 (COMAH) and HSE and the Environment Agency are the joint Competent Authority responsible for enforcing these regulations.

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