A Review of Criticality Accidents A Review of Criticality Accidents

A Review of Criticality Accidents A Review of Criticality Accidents A Review of Criticality Accidents A Review of Criticality Accidents

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established that in addition to the error in judgment, the specialist violated several operational procedures. For the evening assembly, the lower half of the uranium reflector was not positioned 20 mm above its lower stop as required to ensure an adequate margin of criticality safety for the assembly process. Instead, the lower reflector was positioned 90 mm above its lower stop which is 30 mm below its upper stop. The upper stop corresponds to the lower reflector making contact with the lower core. The failure to reposition the lower reflector following the daytime assembly was identified as the primary cause of the accident. The investigation revealed several additional violations of procedures: • The instrument system designed to be sensitive enough to alert the specialist that system multiplication was rapidly increasing as they lowered the upper reflector half was not operating. This system had been switched off following the daytime assembly and not switched back on for the evening assembly. • A third specialist was required to be present in the control room, but the control room was unmanned. • The assembly required the presence of a health physicist. The health physicist was not present because he was not notified of the evening assembly. Following the excursion, the two specialists remained conscious and maintained their self-control. They were able to inform administrative officials that the accident had occurred and to place a phone call requesting an ambulance. The senior specialist carried out dose estimates for himself and the junior specialist. The senior specialist made the following entry into his experimental log. “Eighty-mm diameter plug * was removed. The gap was 30 mm. Polyethylene was inserted. When moving the shell down a pulse was produced. Safety system was actuated. The operator was at the distance of 0.5 meters away from the shell. The responsible person - at 1.7 meters away from the overhead-track hoist pendant. There was a flash, a shock, a stream of heat in our faces. The polyethylene contribution exceeded the expected magnitude.” The two criticality safety specialists working with this assembly at the time of the excursion were knowledgeable in neutron physics and the experimen- 88 tal procedures required for criticality measurements. The senior specialist was born in 1929, joined the facility in 1955, and became qualified to handle fissile material in 1958. The junior specialist was born in 1938, joined the facility in 1961, and became qualified to handle fissile material in 1962. Both were qualified to carry out the experimental procedures taking place at the time of the accident. At the time of the excursion, the junior specialist was standing approximately 0.5 m from the assembly axis. The senior specialist was located approximately 1.7 m away. The junior specialist received an accumulated neutron plus gamma dose in the 20–40-Sv range. The senior specialist received an accumulated neutron plus gamma dose in the 5–10-Sv range. Following the accident, both specialists were taken to the local hospital and then immediately flown to the Bio-Physics Institute in Moscow. The junior specialist died three days after the excursion. The senior specialist survived for 54 days after the excursion. The estimated yield of the excursion was 6 × 10 16 fissions. At the beginning of the excursion, the upper half of the natural uranium reflector was descending on the core at approximately 100 mm/s, driving the assembly above prompt critical. This closure speed corresponds to a reactivity insertion rate of about 40 β/sec. A 5.2 × 10 6 (neutrons per second) 238 Pu-Be source was located off-center outside of the uranium core of the assembly. The investigation concluded that although the specialists were highly experienced in working with critical assemblies, it was their overconfidence and haste that resulted in their loss of life. Both specialists had theater tickets for the same evening as the accident. The senior specialist prepared the procedure for the evening assembly disregarding a principle rule for criticality safety which stated: Every unmeasured system is assumed to be critical. The investigation concluded that the accident was caused by “severe violations of safety rules and regulations which occurred due to insufficient control by facility managers and health physics personnel.” * This plug was located at the north pole of the upper reflector and passed through the full thickness of the reflector.

14. Aberdeen Proving Ground, 6 September 1968 59 Uranium–molybdenum metal fast burst reactor; single excursion; insignificant exposures. The Army Pulse Radiation Facility Reactor (APRFR), located in Maryland in the United States, was another of the series of Godiva-like reactors. The APRFR design evolved from the Health Physics Research Reactor of the Oak Ridge National Laboratory and was intended to provide large values of neutron flux and fluence. During pre-operational testing, several minor variations in the reactor configuration were studied in a program to optimize performance. During this testing, an unexpectedly large burst (6.09 × 10 17 fissions) occurred. It exceeded, by about a factor of three, the maximum burst size the reactor was expected to withstand without damage. Internally the core reached the melting point of the fuel, 1150°C. The initial period was measured as 9.1 µs, and the reactivity was estimated to have been about 18 ¢ above prompt criticality. The planned excess reactivity for this burst was 8.05 ¢, which was expected to result in a burst of 1.68 × 10 17 fissions. 15. Sarov (Arzamas-16), 17 June 1997 49,60,61,62 U(90) metal, copper reflected, assembly; multiple excursions; one fatality. This accident occurred at 10:40 on 17 June 1997 as an experimental assembly was being hand constructed on a vertical split machine, FKBN-2M. FKBN-2M is located in an experimental cell (12 m × 10 m × 8 m) of a dedicated building (Figure 54) at a reactor site. 60 A schematic of FKBN-2M is shown in Figure 55. The lower part of a research assembly is constructed on a table that can be moved vertically up and down using hydraulics, although the table had to be in the up position during construction of an assembly. The upper part is placed on a stand consisting of a ring, upper and lower support, and a carriage that can be moved horizontally and into position over the lower part of the system. Closing of the assembly (by moving the carriage over and the table up) is performed remotely from a control room behind an ~3 meter thick concrete shielding wall (Figure 54). FKBN-2M is equipped with a fast acting gravity driven scram that automatically causes the table to drop to its down position if the neutron flux exceeds a preset value. Post accident analysis indicates that the extra reactivity resulted from a reactor configuration such that the burst rod passed through a reactivity maximum before seating. This condition had not been recognized; apparently on previous operations the burst rod had reached its seated position before the arrival of an initiating neutron. In the absence of a strong neutron source, wait times before an excursion occurs can be long. 97 Damage was limited to the fuel components of the reactor and included some warping and spalling as well as elongation of bolts. The four central rings fused together at the inner surface and experienced some cracking. There were no detectable external or airborne radiation hazards and no personnel overexposures. Various sets of nesting fissile (uranium, plutonium) and nonfissile hemishells (steel, copper, polyethylene, etc.), standardized in size, exist to allow for a variety of experimental configurations. Assemblies are constructed by consecutively stacking the hemishells together into the desired configuration. On 17 June 1997, an experimenter working alone and without having completed the proper paper work (both violations of safety requirements), was constructing an experimental assembly consisting of a core of uranium, U(90) reflected by copper. 61,62,63 The experimenter was an expert who was confident that he was recreating an assembly that had been the focus of an experiment performed successfully in 1972. He had taken the dimensions for all of the system components from the original 1972 logbook. However, when he copied down the inside and outside dimensions of the copper reflector (167 and 205 mm, respectively) he incorrectly recorded the outside dimension as 265 mm. Using this incorrect information, the experimenter had 89

14. Aberdeen Proving Ground, 6 September 1968 59<br />

Uranium–molybdenum metal fast burst reactor; single excursion; insignificant exposures.<br />

The Army Pulse Radiation Facility Reactor<br />

(APRFR), located in Maryland in the United States,<br />

was another <strong>of</strong> the series <strong>of</strong> Godiva-like reactors. The<br />

APRFR design evolved from the Health Physics<br />

Research Reactor <strong>of</strong> the Oak Ridge National Laboratory<br />

and was intended to provide large values <strong>of</strong><br />

neutron flux and fluence.<br />

During pre-operational testing, several minor<br />

variations in the reactor configuration were studied in a<br />

program to optimize performance. During this testing,<br />

an unexpectedly large burst (6.09 × 10 17 fissions)<br />

occurred. It exceeded, by about a factor <strong>of</strong> three, the<br />

maximum burst size the reactor was expected to<br />

withstand without damage. Internally the core reached<br />

the melting point <strong>of</strong> the fuel, 1150°C. The initial period<br />

was measured as 9.1 µs, and the reactivity was estimated<br />

to have been about 18 ¢ above prompt criticality.<br />

The planned excess reactivity for this burst was 8.05 ¢,<br />

which was expected to result in a burst <strong>of</strong> 1.68 × 10 17<br />

fissions.<br />

15. Sarov (Arzamas-16), 17 June 1997 49,60,61,62<br />

U(90) metal, copper reflected, assembly; multiple excursions; one fatality.<br />

This accident occurred at 10:40 on 17 June 1997 as<br />

an experimental assembly was being hand constructed<br />

on a vertical split machine, FKBN-2M. FKBN-2M is<br />

located in an experimental cell (12 m × 10 m × 8 m) <strong>of</strong><br />

a dedicated building (Figure 54) at a reactor site. 60 A<br />

schematic <strong>of</strong> FKBN-2M is shown in Figure 55. The<br />

lower part <strong>of</strong> a research assembly is constructed on a<br />

table that can be moved vertically up and down using<br />

hydraulics, although the table had to be in the up<br />

position during construction <strong>of</strong> an assembly. The upper<br />

part is placed on a stand consisting <strong>of</strong> a ring, upper and<br />

lower support, and a carriage that can be moved<br />

horizontally and into position over the lower part <strong>of</strong> the<br />

system. Closing <strong>of</strong> the assembly (by moving the<br />

carriage over and the table up) is performed remotely<br />

from a control room behind an ~3 meter thick concrete<br />

shielding wall (Figure 54). FKBN-2M is equipped with<br />

a fast acting gravity driven scram that automatically<br />

causes the table to drop to its down position if the<br />

neutron flux exceeds a preset value.<br />

Post accident analysis indicates that the extra<br />

reactivity resulted from a reactor configuration such<br />

that the burst rod passed through a reactivity maximum<br />

before seating. This condition had not been recognized;<br />

apparently on previous operations the burst rod had<br />

reached its seated position before the arrival <strong>of</strong> an<br />

initiating neutron. In the absence <strong>of</strong> a strong neutron<br />

source, wait times before an excursion occurs can be<br />

long. 97<br />

Damage was limited to the fuel components <strong>of</strong> the<br />

reactor and included some warping and spalling as<br />

well as elongation <strong>of</strong> bolts. The four central rings fused<br />

together at the inner surface and experienced some<br />

cracking.<br />

There were no detectable external or airborne<br />

radiation hazards and no personnel overexposures.<br />

Various sets <strong>of</strong> nesting fissile (uranium, plutonium)<br />

and nonfissile hemishells (steel, copper, polyethylene,<br />

etc.), standardized in size, exist to allow for a variety <strong>of</strong><br />

experimental configurations. Assemblies are constructed<br />

by consecutively stacking the hemishells<br />

together into the desired configuration.<br />

On 17 June 1997, an experimenter working alone<br />

and without having completed the proper paper work<br />

(both violations <strong>of</strong> safety requirements), was constructing<br />

an experimental assembly consisting <strong>of</strong> a core <strong>of</strong><br />

uranium, U(90) reflected by copper. 61,62,63 The<br />

experimenter was an expert who was confident that he<br />

was recreating an assembly that had been the focus <strong>of</strong><br />

an experiment performed successfully in 1972. He had<br />

taken the dimensions for all <strong>of</strong> the system components<br />

from the original 1972 logbook. However, when he<br />

copied down the inside and outside dimensions <strong>of</strong> the<br />

copper reflector (167 and 205 mm, respectively) he<br />

incorrectly recorded the outside dimension as 265 mm.<br />

Using this incorrect information, the experimenter had<br />

89

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