Handbook for Process Safety in Laboratories and Pilot Plants

25 Investigating Incidents

Incident investigations identify, analyze, communicate, and track actions and trends related to unplanned and undesired events affecting both personal and process safety in the LAPP. The purpose of the investigation is to address and resolve the underlying, management system‐related causes. For a thorough LAPP incident investigation, there should be a written procedure, adequate investigator training, and support from the LAPP leadership. Developing and following the written incident investigation procedure will help the LAPP staff address and resolve issues, reducing the risk of experiencing a similar incident in the future.

This chapter begins with the standard incident terminology used throughout this guideline. Once an incident occurs, the staff follow the LAPP's six investigation steps described in Section 1.3. These steps should be modified and enhanced, as needed, by each LAPP. These six steps are strongly recommended to be in the LAPP's incident management system. This chapter concludes with methods to help a LAPP apply the learnings from the investigation.

25.1 Incident Terminology

The terms presented and defined in this section apply throughout this guideline. Although other descriptions may be used for these terms, recognize that the goals of the investigation are the same: to learn from incidents and put measures in place to prevent them from happening again. Definitions applicable to incident investigations are as follow (italics provided ...