The August 28, 2016, nitrous oxide explosion at the Airgas manufacturing facility in Cantonment, Florida was caused by an ineffective process safety management system (PSM), according to the U.S. Chemical Safety Board’s (CSB) final report on the incident, which killed the only Airgas employee working at the facility that day and heavily damaged the plant. The problem: a majority of PSM’s specialized rules are not required for nitrous oxide facilities.

Nonetheless, facilities should have good safety management systems in place to mitigate the risks of nitrous oxide, said CSB Chairperson Vanessa Allen Sutherland. “Safety management systems standards are critical to identify, evaluate, and control process safety hazards. This tragedy in Cantonment should not be repeated.”