13 replies to this topic

[Don Hudson]

Roger Boisjoly dies at 73; engineer tried to halt Challenger launch

The night before the 1986 explosion, Boisjoly and four others argued that joints in the shuttle's boosters couldn't withstand a cold-weather launch.

  
By Ralph Vartabedian, Los Angeles Times
February 7, 2012

The 1986 explosion that destroyed the space shuttle Challenger and killed seven astronauts shocked the nation, but for one rocket engineer the tragedy became a personal burden and created a lifelong quest to challenge the bureaucratic ethics that had caused the tragedy.

Roger Boisjoly was an engineer at solid rocket booster manufacturer Morton Thiokol and had begun warning as early as 1985 that the joints in the boosters could fail in cold weather, leading to a catastrophic failure of the casing. Then on the eve of the Jan. 28, 1986, launch, Boisjoly and four other space shuttle engineers argued late into the night against the launch.

In cold temperatures, o-rings in the joints might not seal, they said, and could allow flames to reach the rocket's metal casing. Their pleas and technical theories were rejected by senior managers at the company and NASA, who told them they had failed to prove their case and that the shuttle would be launched in freezing temperatures the next morning. It was among the great engineering miscalculations in history.

A little more than a minute after launch, flames shot out of the booster joint, melted through the nearby hydrogen fuel tank and ignited a fireball that was watched by the astronauts' families and much of the nation on television. Boisjoly could not watch the launch, so certain was he that the shuttle would blow up. In the months and years that followed, the disaster changed his career and permanently poisoned his view that NASA could be trusted to make the right decisions when matters came to life and death.

Boisjoly, 73, died of cancer Jan. 6 in Nephi, Utah, though news of his passing was known only in the southwest Utah community where he retired.

The Challenger disaster and the resulting investigation pulled back the curtain on NASA's internal culture, revealing a bureaucracy that had made safety secondary to its launch objectives and to the political support it needed to continue the shuttle program.

"It was the end of the dream," said John Pike, executive director of GlobalSecurity.org and a longtime analyst of U.S. aerospace. "Before the Challenger, you could think about the idea of going boldly where no one had gone before. The accident ended it."

Boisjoly was not the only engineer who attempted to stop the launch and suffered for blowing the whistle. Allan J. McDonald was Thiokol's program manager for the solid rocket booster and became the most important critic of the accident afterward. When he was pressed by NASA the night before the liftoff to sign a written recommendation approving the launch, he refused, and later argued late into the night for a launch cancellation. When McDonald later disclosed the secret debate to accident investigators, he was isolated and his career destroyed.

The tragedy was particularly hard on Boisjoly, who would sometimes chop wood in the Utah winter to work out his anger. In a 2003 interview with The Times, he recalled that NASA tried to blackball him from the industry, leaving him to spend 17 years as a forensic engineer and a lecturer on engineering ethics.

When the space shuttle Columbia burned up on reentry in 2003, killing its crew of seven, the accident was blamed on the same kinds of management failures that occurred with the Challenger. By that time, Boisjoly believed that NASA was beyond reform, some of its officials should be indicted on manslaughter charges and the agency abolished.

NASA's mismanagement "is not going to stop until somebody gets sent to hard rock hotel," Boisjoly said. "I don't care how many commissions you have. These guys have a way of numbing their brains. They have destroyed $5 billion worth of hardware and 14 lives because of their nonsense."

Boisjoly was born April 25, 1938, and raised in Lowell, Mass., where he graduated from the University of Massachusetts Lowell with a degree in mechanical engineering.

He is survived by his wife of 49 years, Roberta; daughters Norma Patterson and Darleen Richens, eight grandchildren and three brothers.

[J.O.]

How does trying to do the right thing result in the rest of your life being turned upside down? I suspect that he lived with some level of regret every day for close to 26 years. I can only hope that the NASA and Thiokol managers who ignored his assertions have had 26 years of sleepless nights. Somehow though, I doubt it.

[Don Hudson]

I wonder if it was the isolation and loss of reputation that resulted from his actions, correct though they were? Stress that is unresolved/unresolvable (fight or flight has nothing to do or nowhere to go) causes disease, chief among them cancer, cardio-vascular and autoimmune disorders. I wonder how Laurence Malloy sleeps?

There are others I wonder about too, not at NASA.

Re, "I can only hope that the NASA and Thiokol managers who ignored his assertions have had 26 years of sleepless nights. Somehow though, I doubt it."

I doubt it too. It proves that corporations aren't people after all... ;-)

[DEFCON]

I think you're right on the mark with respect to 'stress', Don.

[Specs]

You'd be amazed how often the engineers concerns are readily or easily dismissed.  Sometimes the concern is proven irrelevant or not to be a factor, thankfully most of the time, but sometimes it isn't.  The innocuous question brings to light a deeper more serious flaw and a risk is subsequently eliminated or reduced,  Nonetheless, the reputation the Engineer gets for asking the question or insisting on additional safeguards is one of being a troublemaker.  They're viewed by the higher ups as being reluctant to change or 'not being with the program' or being unable to appreciate commercial issues and they're eventually replaced or passed over.  It happens in airlines often enough that it is a recognizable scenario.  Not to myself that I'm aware of, but there have been more than a few uncomfortable moments where I walked in to a meeting wondering if I'd be coming out with my walking papers.

Edited by Specs, 13 February 2012 - 03:50 PM.

[J.O.]

You said it better Don, but that is what I was thinking. Did the stress of the Challenger accident act as the catalyst that started his cancer?

[Don Hudson]

"Did the stress of the Challenger accident act as the catalyst that started his cancer?"

"Catalyst" is a helpful notion, because one doesn't "catch" cancer, heart disease or autoimmune disorders such as rheumatoid arthritis. He knew (and saw first-hand) that the organizational factors contributing to the Challenger accident had not been addressed and led to the Columbia accident so yes, I suspect both, given Boisjoly's strong sense of what's right...a sense which could never be released from haunting him.

Specs;

Re, "You'd be amazed how often the engineers concerns are readily or easily dismissed."

The Fukushima Dai-ichi nuclear accident was a direct result of dismissing concerns regarding back-up power and the effects of a tsunami from numerous engineers over a period of years, concerns which were made clear and known to the Japanese private authority in charge of nuclear power in Japan. The New York Times ran many good articles on the history of nuclear power in Japan. These specific concerns were placed before the Japanese authorities in 2006.

The Douglas engineers' concerns regarding the effects of a depressurization on the integrity of the cabin floor and the routing of the control cables was ignored even after fuselage #1 blew its cargo door and the floor collapsed when in the huge liquid test tank at Douglas Aircraft in Long Beach, Calif.

In one way, this is why SMS is problemmatic, although I have recently seen it working extremely well at one particular company. When financial pressures are high and the regulator is either absent or cozy, one cannot put politicians, economists, operations managers or financial people directly in charge of safety or risk management decisions without result. I know this for a fact and have seen the conflict occur and a commercial vice a safety decision made and defended. In fact I cited the Challenger accident but it made no difference. Regarding meetings, I understand what you're saying, Specs.

Don

[Bobcaygeon]

3 years ago I was lucky enough to be a part of a group phone interview with Mr. Boisjoly as a part of my MBA class involving Ethical management. His regrets were clealry visible even 24 years later. It was scary how much it reminded me about parts of my aviation career, particularly early on.

Other speakers in that course included an engineer for the Ford Pinto, he drove one and gave his mom one too. Completely different attitude from Roger as he truly belived the vehicle was safe.

The ironic part of the course was that the first semester of the course focused highly on Jack Welch and his GE career and his successes. I have no doubt it was not a coincidence.

[Don Hudson]

Bobcaygeon;

Fascinating post, thank you.

Were these notions in your awareness during or in the days after the group phone interview. Can you tell me, did your experience in the phone call alter your approach to your MBA? Business ethics is a deadly serious affair with material effects. How is it achieved under great pressures of time and performance?

I have no doubt that thousands of enterprises quietly do the right thing all the time yet remain unsung and do not produce headlines. In fact I know one organization that does truly does this but, and we can all name at least a dozen examples, the evidence for absence of ethics is damning. Is there an argument for ethics nevertheless and if so, does it carry over to affect such daily pressures?

Thanks,

Don

Edited by Don Hudson, 14 February 2012 - 12:10 AM.

[Don Hudson]

Speaking of engineers being dismissed and whistleblowers being placed at risk, this, from the New York Times today on the Fukushima Dai-ichi nuclear plant:

Quote

Japan Ignored Nuclear Risks, Official Says

http://www.nytimes.c...lawed.html?_r=1

New York Times
Asia Pacific

By HIROKO TABUCHI

Published: February 15, 2012

TOKYO — In surprisingly frank public testimony on Wednesday, Japan’s nuclear safety chief said the country’s regulations were fundamentally flawed and laid out a somber picture of a nuclear industry shaped by freewheeling power companies, toothless regulators and a government more interested in promoting nuclear energy than in safeguarding the health of its citizens.

Itsuo Inouye/Associated Press

In his testimony on Wednesday, Haruki Madarame, Japan's nuclear safety chief, described a complacency with lax standards.

The disaster at the Fukushima Daiichi plant, stricken by an earthquake and a tsunami last March, has led to widespread criticism of nuclear officials for their lax approach to safety, as well as for a bungled response that allowed meltdowns to occur at three of the plant’s six reactors.

The scale of the accident, which forced almost 100,000 people from their homes and contaminated a wide area of northeastern Japan, has put pressure on the government to explain why warnings about the plant’s safety went unheeded and global safety standards were ignored, even as officials promoted nuclear power as the country’s most reliable source of electricity.

Haruki Madarame, head of a panel of nuclear safety experts who provide technical advice to the government, told a Parliament-sponsored inquiry on Wednesday that Japanese officials had succumbed to a blind belief in the country’s technical prowess and failed to thoroughly assess the risks of building nuclear reactors in an earthquake-prone country.

For example, officials did not give serious consideration to what would happen if electric power were lost at a nuclear station, because they believed that Japan’s power grid was far more reliable than those in other countries, he said. The March earthquake and tsunami cut off the Fukushima plant from the grid, leaving operators unable to keep the reactor cores from overheating.

“Though global safety standards kept on improving, we wasted our time coming up with excuses for why Japan didn’t need to bother meeting them,” Mr. Madarame said.

Officials also gave too little attention, he said, to new studies raising the possibility of large earthquakes off the coast of Fukushima Prefecture. Mr. Madarame said he was to blame for some of the lapses, but that the Nuclear Safety Commission had a culture of complacency long before he took over in mid-2010.

His candid testimony comes at a time when the government is pushing to restart reactors around the country that were shut down following the accident. Only 3 of Japan’s 54 reactors are operating; the rest have been kept idle by local governments worried about safety.

To quell opposition, the central government has ordered new “stress tests” to assess whether the plants can withstand a major natural disaster. But the investigative commission’s hearings could undermine efforts to restart more reactors.

Mr. Madarame said the government should go far beyond the lax safety checks that Japanese regulators performed for years, which he said were still being carried out in some cases using “technology three decades old.” He said that regulators had been too cozy with the industry. Mr. Madarame also criticized Tokyo Electric Power, the operator of the Fukushima plant, for saying that it could not possibly have prepared for a tsunami as strong as the one last March, which killed 20,000 people along Japan’s northeast coast.

A version of this article appeared in print on February 16, 2012, on page A11 of the New York edition with the headline: Japan Ignored Nuclear Risks, Official Says.

Link to the NYT's article referring to the 2006 engineers' warnings regarding tsunamis: http://www.nytimes.c...sia/27nuke.html

This article by Charles Perrow ("Normal Accidents" - 1984, "The Next Catastrophe - 2011"), appeared in Fortune Magazine, March, 2011:
http://features.blog...from-fukushima/

Edited by Don Hudson, 15 February 2012 - 11:51 PM.

[DEFCON]

Don

I’m sure everyone shares a sense of ‘disgust’ with respect to the revelations coming from the Fukushima plant investigation. Nevertheless and regardless of the fact, the plants the US NRC ‘regulates’ are too full of all the same ‘weaknesses’, nothing is being done to address the homegrown shortcomings? Oh-well, what does the health of the planet we all depend on mean anyway?

With respect to cancer; ‘stress’, causes an increase in the production & circulation of ‘pro-inflammatory cytokines’ which is one of the ‘triggers’ believed responsible for the development of various cancers.

Edited by DEFCON, 17 February 2012 - 12:29 PM.

[Don Hudson]

DEFCON;

Re, "I’m sure everyone shares a sense of ‘disgust’ with respect to the revelations coming from the Fukushima plant investigation. Nevertheless and regardless of the fact, the plants the US NRC ‘regulates’ are too full of all the same ‘weaknesses’, nothing is being done to address the homegrown shortcomings? Oh-well, what does the health of the planet we all depend on mean anyway?"

"Disgust" needs some foundation beyond a general malaise because it is too easy to turn the page or change the channel when inconvenient facts like those which existed pre-Fukushima.

Denial, for lack of a tidier name, is, I think, a functioning "necessary" element in our peculiar brand of political economy - a "healthy" economy is one in which there is lots of profit for giant corporations, low wages for ordinary workers, very little in the way of legal or societal impediments to same such as regulatory interference or ordinary people taking the time to become aware of risk and actually choosing to do something about it. The absence of environmental and labour regulation in China and India is "admirably suits" such priorities but is much too obvious to be realistically sought here except as small changes over time. I know there are still vast differences in which our tighter regulations continue to elicit complaint.

By "ordinary people" I don't mean a rag-tag group of left-wingnuts marching or barking into the shadows with no visible means of getting angry, I mean those who actually have a handle on the bountiful economy we nevertheless have yet who know their stuff in broader terms than through the language of business but through the formal politicized processes of institutional denial, cannot make progress or create the grounds for reducing risk.

The nuclear industry is a prime example of this phenomenon, with little differences in the approach taken from country to country around the world. In other words, even as regulations may be on the books, in terms of a duty of care and a parity with what is known about the demonstrated (through accidents) risks of nuclear energy the U.S. is no different than Japan, than the C.I.S. (Содружество Независимых Государств, СНГ), than France. I was going to include Germany, but Germany has recently stated that they are outlawing any further nuclear power development; - wise and intelligent choice, not because nuclear energy isn't a superb and obvious solution to hugely increasing energy needs but because governments and their private corporate partners have clearly demonstrated that they are incapable of managing the risks that nuclear energy brings. While the actual number of nuclear accidents is low, (four, IIRC), the possibility (the notion of probability is quite different and, in assessing this kind of risk, is an entirely inappropriate measure upon which to justify nuclear energy), the outcomes of such accidents are unacceptable, just as accidents such as BP's in the Gulf are unacceptable.

You ask about the United States' nuclear industry and Fukushima. The story is actually closer to home in a series of events already discussed on this forum regarding the firing of the President of the Canadian Nuclear Safety Commission Linda Keen by Stephen Harper, (http://en.wikipedia....fety_Commission), and, (http://www.canada.co...65-8b0efd4dfcaa ). I understand the political and even health justifications for the actions better than I did when I first posted this particular story but the concerns of a Canadian Safety Commission duly constituted and supposedly independent from Parliament were set aside, its leader fired by the head of the Canadian government and the original questions of nuclear safety never addressed. That certainly sets one standard among many, regarding approaches to the safety of nuclear technologies.

Other links of interest. The first concern Diablo Canyon in California, which is a well-known but ignored risk:

http://www.energy-ne...UKE/DIABLO1.HTM

http://www.newtimess...-canyon-debate/

The east coast is not seismically inactive:

http://www.guardian....-nuclear-plants


Almost a year after Fukushima, the NRC has sent just today a notice to all operators,

"The Nuclear Regulatory Commission has issued a Request for Information (RFI) to 11 nuclear power plants, requesting analyses of the effects of irradiation on nuclear fuel’s physical properties under certain postulated accident conditions."

http://www.nrc.gov/r...2012/12-017.pdf

The NRC makes ROP's (Reactor Oversight Process) reports available online and has done so since mid-2006.

MSNBC reports at http://www.msnbc.msn...ked-quake-risk/ on,  

"What are the odds? US nuke plants ranked by quake risk. So much for San Andreas: Reactors in East, Midwest, South have highest chance of damage"

Last item is unrelated except indirectly, to nuclear accidents, (mainly because it relates to all risks / accidents), is a link to Lee Clark's book, "Worst Cases" (http://worstcases.com/) which, despite its gloomy-sounding title is actually a good read on the notion of "possibilism"...or how thinking and perception of risk changes when one shifts one's POV from what's 'probable', to what's 'possible'. At Fukushima, an earthquake large enough to create a tsunami large enough to breach Daiichi's defences was considered "improbable" and thinking, and therefore defence design stopped there. However, it isn't always an expensive, open-chequebook process to consider what is possible. The first is assumed to be a mathematical process whereas the second is a more human imagination process, followed by rational analysis in terms of assigning risk levels to the event under consideration.

Was it too much to ask the Japanese private authority responsible for the country's nuclear energy to consider the outcome of a possible 9.0 earthquake and subsequent tsunami, especially when the backup diesel generators required to maintain cooling would be inundated by any water that flowed behind the 18-foot wall between the ocean and the plant? The possibility was imagined in 2006 and dismissed.

Cheers,
Don

Edited by Don Hudson, 17 February 2012 - 12:41 PM.

[DEFCON]

Don

"Disgust" needs some foundation beyond a general malaise because it is too easy to turn the page or change the channel when inconvenient facts like those which existed pre-Fukushima.”

Your description is today’s perfect representation of the attitude of ‘we, the people’.
  

“governments and their private corporate partners have clearly demonstrated that they are incapable of managing the risks that nuclear energy brings”

Amen!

“While the actual number of nuclear accidents is low, (four, IIRC), the possibility (the notion of probability is quite different and, in assessing this kind of risk, is an entirely inappropriate measure upon which to justify nuclear energy), the outcomes of such accidents are unacceptable, just as accidents such as BP's in the Gulf are unacceptable.”

‘Certainty’ is another way to describe the ‘true’ risk professional calculations have demonstrated. (See: http://www.fairewinds.com)

“Last item is unrelated except indirectly, to nuclear accidents, (mainly because it relates to all risks / accidents), is a link to Lee Clark's book, "Worst Case" which, despite its gloomy-sounding title is actually a good read on the notion of "possibilism"...or how thinking and perception of risk changes when one shifts one's POV from what's 'probable', to what's 'possible'.”

‘Industry’ has no inkling whatsoever to include design criteria incorporating ‘what’s possible’ considerations. They believe it’s just too expensive a concept? I think ‘they’ may be correct in some respects, but it’s clear; the people charged with making decisions as to where the safety cut-off-point is, always seem to come up short, erring on the side of profit?

[Don Hudson]

"They believe it’s just too expensive a concept?"

Perhaps another way to understand this peculiar legitimacy of not accepting responsibility for the entire production process is the wide acceptance by government and oddly by ordinary people, that private corporations can and do download onto society, (ie, the taxpayer) the enormous physical, (and fiscal) waste and costs and associated physical harm to those living "beyond the product itself".

Because they can (it is 'good for business'), private corporations rarely accept the growing notion that part of the cost of doing business is 'doing no harm' which means a million things, like responsible packaging, correct treatment of the by-products of production processes, cleaning up after oneself, etc, etc. But that "expense" is completely downloaded onto society, as though the air, streams and oceans were private property.

Old, old, re-bottled notions I know but age doesn't make such behaviours more benign. In fact, profit-seeking has such legitimacy for most, that "the commons as dumping ground for the 1%" may not seem like such an outlandish and extremist notion after all.

The 'fairewinds' site is a relevant site to these concerns.

These issues simply aren't part of this election-year's discussion or debating process. In fact, the present U.S. "election", (in quotes because the process is more like making bad sausage than it is to do with finding the best and brightest) and especially those "representing" (in quotes just because) the Republican (supposed "conservative" view) has yet to discuss serious matters like these and instead Republicans are trying to outlaw birth control (making it murder in some states) because the Democrats are infringing on religious freedoms and rights when they require employers to provide same along with other healthcare benefits. For once, one may be supremely thankful that "the bureacracy" is in place to ensure public safety while the Republicans are down a quart of blood mostly in the head.