CSB Finalizes Investigation of Fatal Nitrous Oxide Explosion

Published April 26, 2017

Safety management system and regulatory deficiencies contributed to the 2016 nitrous oxide explosion at the Airgas manufacturing facility in Cantonment, Fla., the U.S. Chemical Safety Board (CSB) concludes. The nitrous oxide trailer truck explosion killed the only worker at the facility that day and caused heavy damage to the plant, which halted its manufacturing of nitrous oxide indefinitely. According to CSB, the most likely immediate cause of the explosion was that, during the initial loading of the truck, a pump heated nitrous oxide above its safe operating limits.

The agency’s final report notes that all causes contributing to the explosion stemmed from the facility’s lack of an effective process safety management system. Investigators found that, although heat from the pump was a known hazard, Airgas did not evaluate safer design options that could have eliminated the need for the pump. Further, the company did not perform a management of change review or hazard analysis prior to installing the pump. In the end, safeguards installed at the facility failed to prevent the incident.

CSB also found that, while federal regulations require some chemical facilities that manufacture hazardous substances to have process safety management systems in place, a majority of these specialized rules are not required for nitrous oxide facilities.

In 2002, CSB recommended that OSHA amend its process safety management standard “to achieve more comprehensive control of reactive hazards that could have catastrophic consequences.” CSB’s recommendation included language to broaden the coverage of self-reactive chemicals, including chemicals like nitrous oxide. In its new final report, CSB urges OSHA to reconsider its decision to not implement these recommendations.

For more information or to download the final report, visit CSB’s investigation page for the 2016 Airgas explosion.