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事故调查是吸取经验教训、预防类似事故的重要途径。但是目前国内的化学品事故调查普遍缺乏系统、科学、一致的方法论,进而导致了事故调查报告的根本原因分析不彻底、不清晰的问题,妨碍了从事故调查报告有效吸取经验教训,使得类似的事故反复重演。根据现代事故原因链模型,本文阐明了重大化学品事故与过程安全管理(PSM)系统的辨证关系,明确提出重大化学品事故调查应该深入到过程安全管理系统的各个要素。为指导事故调查和便于事故管理,本文将对比已知模型和逻辑分析构建方法相集成,开发了对化学品事故根本原因分析具有指导功能的化学品事故调查与管理软件平台(iTAIM)。相比国内外成熟商业化软件,iTAIM在事故调查和事故管理上具有化学品事故根本原因分析指导性强、事故信息呈现直观等优势特点。
Accident investigation is to learn lessons learned, an important way to prevent similar accidents. However, at present, there is a general lack of a systematic, scientific and consistent methodology in the investigation of chemical accidents in our country, which in turn leads to incomplete and unclear analysis of the root causes of accident investigation reports, which impedes the effective learning of lessons learned from incident investigation reports and makes similar The accident repeated itself. According to the chain model of modern accident causes, this paper clarifies the dialectical relationship between major chemical accidents and process safety management (PSM) systems and clearly states that major chemical accident investigations should go deep into the various elements of the process safety management system. In order to guide accident investigation and facilitate accident management, this article will compare the known model with the method of logical analysis construction, and develop a chemical accident investigation and management software platform (iTAIM) which has the guidance function for root cause analysis of chemical accidents. Compared with mature commercial software at home and abroad, iTAIM has the advantages of guidance in analyzing root causes of chemical accidents and visualization of accident information in accident investigation and incident management.