Reducing the risk of oxygen-related fires and explosions in hospitals treating Covid-19 patients.

On 24 April 2021, a disastrous fire in an Iraqi hospital took the lives of 82 people. Since the outbreak of the pandemic in March 2020, incidents of oxygen-related hospital fires in various countries around the world have caused over 200 deaths, the majority of whom were patients extremely ill with the novel Coronavirus. Fires involving medical oxygen are not a new phenomenon but are more common in the operating theatre where oxygen is routinely administered. In these settings, strict safety protocols are normally enforced and surgical staff are well trained in dealing with oxygen hazards. It appears that some hospitals may not have been fully prepared for the elevated risk of oxygen-related fire in intensive care units due to the high demand for oxygen therapy in severely ill Covid-19 patients. Indeed, gas producers and public health authorities were also slow to recognize and alert hospitals to the potential dangers. Oxygen is essential to life and generally makes up about 21 % of the gases in the air we breathe. Pure oxygen reacts with common materials such as oil and grease to cause fires, and even explosions, when released at high pressures. A leaking valve or hose, and openings at interfaces of masks and tubes, when in a confined space or where air circulation is low, can quickly increase the oxygen concentration to a dangerous level. Even a small increase in the oxygen level in the air to 24 % can create a fire hazard. In an oxygen-enriched environment, materials become easier to ignite and fires will burn hotter and more fiercely than in normal air. There is also a potentially heightened risk of using ethanol-based and organic solvents as cleaning agents in an oxygen rich atmospheres. This paper will provide an overview of oxygen accident scenarios that may be relevant for hospital intensive care units, with particular reference to recent events and similar accidents that have occurred in the past. The paper will recommend that hospitals recognize their chemical risks as part of their risk governance responsibility and assign chemical risk management a prominent role in their overall management. Investigation of dangerous events to extract causes and lessons learned should be utilized to highlight opportunities for prevention as well as emergency response. The industrial gas industry also needs to actively support hospitals in adoption of more rigorous risk management approaches, building on lessons learned in chemical process safety for managing flammable and explosive atmospheres.

Survey on methodologies in the risk assessment of chemical exposures in emergency response situations in Europe.

A scientifically sound assessment of the risk to human health resulting from acute chemical releases is the cornerstone for chemical incident prevention, preparedness and response. Although the general methodology to identify acute toxicity of chemicals has not substantially changed in the last decades, there is ongoing debate on the current approaches for human health risk assessment in scenarios involving acute chemical releases. A survey was conducted to identify: (1) the most important present and potential future chemical incident scenarios and anticipated changes in chemical incidents or their management; (2) information, tools and guidance used in different countries to assess health risks from acute chemical releases; and (3) needs for new information, tools, guidance and expertise to enable the valid and rapid health risk assessment of acute chemical exposures. According to the results, there is an obvious variability in risk assessment practices within Europe. The multiplicity of acute exposure reference values appears to result in variable practices. There is a need for training especially on the practical application of acute exposure reference values. Although acutely toxic and irritating/corrosive chemicals will remain serious risks also in future the development of plausible scenarios for potential emerging risks is also needed. This includes risks from new mixtures and chemicals (e.g. nanoparticles).

The Seveso II experience in the application of generic substance criteria to identify major hazard sites.

Europe is currently in the process of finalising legislation to align its criteria for classifying and labelling dangerous substances with the new Globally Harmonised System of Classification and Labelling of Chemicals (GHS), replacing the criteria that have been in place within the European Union since the establishment in 1967 of Directive 67/548/EC on the Classification and Labelling of Dangerous Substances. The Seveso II Directive is potentially the piece of EU legislation most affected by this re-classification because coverage of sites under the Directive is determined to a large extent on the basis of the presence of certain generic categories of substances on site as defined by 67/548/EC. The European Commission in concert with the Member States has launched an initiative to review the current Seveso generic classifications with the view to adjusting these provisions as appropriate in light of the pending GHS-EU harmonisation. In doing so, it must foresee and take into account the inevitable inequalities that may result when the general conditions of a generalised approach are altered. This paper gives an overview of the Seveso qualifying criteria and corrective measures that have been used in the past to address its limitations in relation to specific substances and categories of substances. Adaptation of the criteria to the GHS classification is not likely to alter these limitations, but could generate new cases where they are again in evidence. Therefore, this analysis offers insight on what types of potential unforeseen and unintended consequences that changes to the current generic criteria (i.e., certain sites are inappropriately covered or not covered, as the case may be) may entail, while also highlighting how well different structural and administrative elements may function to address these situations.

Writing Seveso II safety reports: new EU guidance reflecting 5 years' experience with the Directive.

Since the coming into force of the Seveso II Directive, considerable experience has been acquired in regard to preparation of safety reports for establishments that fall under the requirements of this Directive. In light of this experience, the Amendment of the Seveso II Directive adopted by the European Parliament and the Council on 16 December 2003, gave the European Commission the mandate "to review by 31 December 2006 in close cooperation with the Member States, the existing Guidance on the Preparation of a safety report (EUR 17690)". As a result, a technical working group of Member States representing the Seveso competent authorities and the European Commission's Major Accident Hazards Bureau was established to review and re-examine the guidance. The new guidance maintains the high-level and overarching character of the older version, but improves the document through better definition of conceptual elements of the safety report and greater alignment with Annex II of the Directive, which describes the essential elements of the safety report. This paper describes the new guidance in terms of its contribution to developing a harmonized conceptual framework for preparing and reviewing safety reports within the context of Seveso II implementation. Overall, the aim of the guidance is to provide concrete advice to operators and competent authorities on the logic and expectations underlying the safety report, so as to make both preparation and review of the report a more efficient and useful exercise for all parties involved.