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The article provides a summary of a recent Health and Safety Executive (HSE) Report of a major accident at an oil refinery and highlights some lessons for control engineers. It reviews an HSE survey into the management of alarm systems in chemical and power plants. The accident described in the article was serious-but if it had occurred on a weekday it could have been much worse with multiple deaths occurring. It would have been headline news. Then the causes of the accident would have quickly become common knowledge among electrical and control engineers. Many companies operating many different process plants would have responded by reviewing their systems and practices, Perhaps the key lesson for engineers is that it should not take disasters to provide the incentive to improve practices. The financial losses involved in this incident could have paid for considerable preventive action.
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