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A simplified analysis of the Chernobyl accident (2021)

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Re: A simplified analysis of the Chernobyl accident (2021)

#11

The technical reasons why Chernobyl exploded when AZ-5 was pressed were only half of the reasons for the disaster. The other half of the reasons Chernobyl failed were human reasons. It is very important when analyzing large systematic failures to not leave these things out.

Yes, the RBMK was not an inherently safe design (in fact was deeply flawed) but it could be operated safely if you didn't deviate from procedures. Which they did, because they were never told about the design flaws (it was a state secret).

Procedures are written under the assumption that the actual system behaves like the theoretical system the engineer has in their head. It never quite does. There's always a gap, and this gap nearly always requires deviating from procedures to ensure safe operation.

Deviating from procedures prevents as many accidents as it causes. Safety cannot be based on adherence to procedure. Safe systems must be designed to take advantage of (and be protected against, I suppose) human ingenuity.

Re: A simplified analysis of the Chernobyl accident (2021)

#12
post #7

The technical reasons why Chernobyl exploded when AZ-5 was pressed were only half of the reasons for the disaster. The other half of the reasons Chernobyl failed were human reasons. It is very important when analyzing large systematic failures to not leave these things out.

To me, Chernobyl is an example of the classic conundrum that engineers cannot possibly think of every single weird thing that could possibly happen so that a perfectly safe anything can be made. It applies to software design just as much as a nuclear reactor. Sometimes it takes a failure to actually happen before something can be made safer. Somethings are just more consequential when they fail making the learning fr…

Not really. Corners were cut, the ultimate issue which caused the explosion was known beforehand, and the operators violated several points of standard procedure as well as doing several basic unwise things. It was not at all a case of unknown edge cases but stupid piled on top of stupid until the damn thing exploded.

The biggest, stupidest action was trying to operate a reactor very clearly experiencing xenon poisoning including the many unsafe things they did to try to overcome the poisoning. I'm pretty sure modern reactors still shut down for 24 hours to avoid the xenon issue. This was well known, even without the design flaws this was a huge risk, and anyone with an ounce of sense would have known not to do what they did leading up to attempting to scram the reactor.

Re: A simplified analysis of the Chernobyl accident (2021)

#13

Earlier quoted context omitted.

Yes, the RBMK was not an inherently safe design (in fact was deeply flawed) but it could be operated safely if you didn't deviate from procedures. Which they did, because they were never told about the design flaws (it was a state secret).

The local engineers were effectively scapegoated by the KGB. It was disappointing to see HBO follow the same lead.

Huh, did you stop watching after episode 1? The HBO series was all about how it was the system that caused the accident to happen. The fact that it was a known failure mode was a major plot point.

It can hardly get more explicit than this scene: https://www.youtube.com/watch?v=jBwSuSuGhyk

Re: A simplified analysis of the Chernobyl accident (2021)

#14

The technical reasons why Chernobyl exploded when AZ-5 was pressed were only half of the reasons for the disaster. The other half of the reasons Chernobyl failed were human reasons. It is very important when analyzing large systematic failures to not leave these things out.

There were two high-level causes, basically:

1. The failure to scale the education quickly enough. Nation-scale nuclear energy was new when the RBMK line was introduced. The demand for nuclear engineers skyrocketed, and it was impossible to train the required amount of professionals to the same standards as nuclear scientists in just a few years. Meanwhile, the RBMK assumed deeper knowledge of its design than they had.

2. The system that made academicians (the official Academy of Sciences title) equivalent to mid-to-large caliber politicians within their area of expertise. As a result, Dollezhal's pride ran unchecked and prevented him from addressing well-known design flaws (that already caused the 1975 accident).

Both reasons are not unique to USSR at all and can be learned from. (something that is often ignored because "it can't happen here")

Re: A simplified analysis of the Chernobyl accident (2021)

#15
post #11

Earlier quoted context omitted.

Yes, the RBMK was not an inherently safe design (in fact was deeply flawed) but it could be operated safely if you didn't deviate from procedures. Which they did, because they were never told about the design flaws (it was a state secret).

Procedures are written under the assumption that the actual system behaves like the theoretical system the engineer has in their head. It never quite does. There's always a gap, and this gap nearly always requires deviating from procedures to ensure safe operation. Deviating from procedures prevents as many accidents as it causes. Safety cannot be based on adherence to procedure. Safe systems must be designed to take…

This is nonsense, especially this line.

>Deviating from procedures prevents as many accidents as it causes.

And they weren't doing some small deviation from procedure. They were doing something that was expressly forbidden and they knew why it was forbidden. In the time leading up to the accident it would be difficult to distinguish between what they were doing and trying to intentionally cause a meltdown. In a reactor experiencing xenon poisoning instead of shutting down for 24 hours (procedure) they removed every nuclear reaction moderating mechanism they could.

This isn't a smart little deviation, it's pouring gasoline on a fire and hoping for a good outcome. It is hard to describe how stupid this was.

Re: A simplified analysis of the Chernobyl accident (2021)

#16
post #11

Earlier quoted context omitted.

Procedures are written under the assumption that the actual system behaves like the theoretical system the engineer has in their head. It never quite does. There's always a gap, and this gap nearly always requires deviating from procedures to ensure safe operation. Deviating from procedures prevents as many accidents as it causes. Safety cannot be based on adherence to procedure. Safe systems must be designed to take…

This is nonsense, especially this line. >Deviating from procedures prevents as many accidents as it causes. And they weren't doing some small deviation from procedure. They were doing something that was expressly forbidden and they knew why it was forbidden. In the time leading up to the accident it would be difficult to distinguish between what they were doing and trying to intentionally cause a meltdown. In a react…

They are referring to a wider range of situations than this very specific incident. There are many accidents that have been avoided by modifying procedures on the fly. Pilots discovering letting go of the yoke/stick solved some seemingly unrecoverable spins is one example. Though obviously techniques that work eventually get adopted to the procedures.

It generally requires operators to know how the systems work in great detail which would have avoided the specific Chernobyl incident.

Re: A simplified analysis of the Chernobyl accident (2021)

#18
post #13

Earlier quoted context omitted.

The local engineers were effectively scapegoated by the KGB. It was disappointing to see HBO follow the same lead.

Huh, did you stop watching after episode 1? The HBO series was all about how it was the system that caused the accident to happen. The fact that it was a known failure mode was a major plot point. It can hardly get more explicit than this scene: https://www.youtube.com/watch?v=jBwSuSuGhyk

If you watch the court scene at the end they clearly repeat the KGB line that the local operators were primarily to blame for "reckless" decisions. Perhaps you missed this obvious conclusion of the series.

Re: A simplified analysis of the Chernobyl accident (2021)

#19

The technical reasons why Chernobyl exploded when AZ-5 was pressed were only half of the reasons for the disaster. The other half of the reasons Chernobyl failed were human reasons. It is very important when analyzing large systematic failures to not leave these things out.

There were two high-level causes, basically: 1. The failure to scale the education quickly enough. Nation-scale nuclear energy was new when the RBMK line was introduced. The demand for nuclear engineers skyrocketed, and it was impossible to train the required amount of professionals to the same standards as nuclear scientists in just a few years. Meanwhile, the RBMK assumed deeper knowledge of its design than they ha…

Re: "The failure to scale the education quickly enough" - Midnight in Chernobyl makes the case that USSR actively fought to prohibit any sort of disclosures about Soviet nuclear reactors vulnerabilities, mitigations and accidents to the nuclear reactors operators.

The soviets did not fail to educate their workforce, the soviets intentionally left their workforce in the dark.

Re: A simplified analysis of the Chernobyl accident (2021)

#20
post #19

Earlier quoted context omitted.

There were two high-level causes, basically: 1. The failure to scale the education quickly enough. Nation-scale nuclear energy was new when the RBMK line was introduced. The demand for nuclear engineers skyrocketed, and it was impossible to train the required amount of professionals to the same standards as nuclear scientists in just a few years. Meanwhile, the RBMK assumed deeper knowledge of its design than they ha…

Re: "The failure to scale the education quickly enough" - Midnight in Chernobyl makes the case that USSR actively fought to prohibit any sort of disclosures about Soviet nuclear reactors vulnerabilities, mitigations and accidents to the nuclear reactors operators. The soviets did not fail to educate their workforce, the soviets intentionally left their workforce in the dark.

My BIL was a “nukie” when he enlisted. Dumb as a box of rocks, and they kept a sub running like clockwork.

You’re absolutely right, the issue was secrecy, not “years of education” or whatever GP claimed.

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