In the case of Piper Alpha following are the major Safety Lapses:

• Prevention through Design was not followed during retrofitting of Rig with Gas exploration equipment. The rig was originally designed for oil exploration and later Gas exploration process was added without sufficient Risk and Hazard mitigation.
• Lapses in Permit to Work System (PTW)- It was based on informal communication and during shift handover critical information regarding Fire Pumps was not clearly relayed, leading to dangerous assumptions.
• Rescue and Emergency Systems were poorly designed. The emergency fire pump was offline, and other measures were ineffective. The team depended on evacuation boats or helicopters, but these could not be used due to the smoke and fire covering the rig. There was no safe place for workers to wait for rescue, and the living quarters were inadequate, leading to certain death from smoke and heat.
• Lack of Communication and Transport Resources The explosion cut off all communication lines to onshore resources and other rigs, leaving personnel unable to deploy multifunctional vessels or lifeboats for firefighting or rescue efforts.
• Complacent approach towards Safety: The Personnels and Management approach to Safety was limited to meeting the bare minimum regulations imposed by the authorities.

Similar stories can be found in other industrial disasters, such as a recent incident at a pharmaceutical company in Andhra Pradesh that resulted in multiple fatalities. These examples highlight that organisational resilience is closely tied to the maturity of a company's safety culture.

Safety Culture within organisation is a gradual process. The stages are classified as – Reactive, Dependent, Independent, and Interdependent.

• Reactive Stage - remedial actions are only taken after an incident occurs and the momentum is lost. Management views safety as a cost rather than an investment and there is less accountability for safety.
• Dependent Stage - The organisation treats safety as a matter of compliance driven by supervision, relying heavily on punitive actions to reduce incidents. It focuses on meeting set safety targets and has little internal capability for risk assessment and mitigation.
• Independent Stage- There is a proactive approach towards identifying, assessing, and mitigating risks and hazards faced by a business. Employees start taking individual responsibility for safety. It becomes a shared value amongst workers leading to a subsequent decrease in incident rates.
• Interdependent Stage- A strong safety culture is deeply embedded in the organisation. Safety is a core value, and employees actively look out for each other. The organisation has developed effective skills and capabilities for identifying, assessing, and mitigating risks. There is an elevated level of collaboration and communication about safety concerns, which leads to continuous improvement.

When an organisation reaches the Interdependent or Generative stage of safety culture, it develops two key traits. Centralised Control ensures that safety policies are cohesive and aligned with core values, supported by strong leadership and robust systems. Guided Adaptability, on the other hand, empowers employees and fosters a culture of innovation and effective communication, allowing the organisation to respond flexibly to new challenges.

These traits enable the organisation to leverage insights from past incidents to refine safety plans, enhance collaboration across teams, and build cross-functional capabilities for ongoing risk monitoring. As a result, the organisation becomes more adaptable and resilient to future challenges. This presents an opportunity for everyone to assess their current position on the safety maturity curve and determine how quickly they can advance.

The writer is Group Head, Safety.