COLLEGE OF CRIMINAL JUSTICE EDUCATION
INVS 326 – Fire Protection and Arson Investigation
ROOT CAUSE ANALYSIS ON FIRE-RELATED PROBLEM
Title: Root Cause Analysis: Explosion of LPG in Laundry Shop at Barangay 709 Fidel
Reyes Street, Malate, Manila
Date submitted: March 31, 2025
Submitted by: Victorio, Joyce Ann S.
Atencio, Mickaela M.
Dizon, Jhamia Liyan V.
Santos, Jerome T.
Submitted to: Prof. Jay-ar V. Lecodine, MCJE, RCrim, CRS
1. Define the Problem
A Liquefied Petroleum Gas (LPG) explosion occurred at a laundry shop on
Barangay 709 Fidel Reyes Street, Malate, Manila. The blast resulted in a fire that
caused property damage and injured some employees. This happened on January 30,
2023, at 7:19 in the evening. Ten fire trucks responded to the said accident. The
structure that housed the laundry shop had been badly damaged and had undergone
major changes by the time the fire was completely extinguished. However, the event
brought up significant issues with equipment, fire safety procedures, and adherence to
fire safety laws. Finding the core causes of the fire and suggesting preventive actions
to reduce the likelihood that it will happen again are the goals of this Root Cause
Analysis (RCA).
2. Collect Data
To understand the circumstances leading to the fire, the following data was
gathered:
a. Duration of the problem: Fire lasted about 15 minutes (from 7:19 pm to 7:34
pm) until it was brought under control by firefighting teams.
b. The affected individuals and other stakeholders: Employees and property
owners suffered from the incident.
c. Immediate and permanent consequence: harm of apparatus' (washer, dryer
and so forth.
The financial toll over time, damage to the structure and emotional damage
d. Major signs/symptoms of the problem: Burns, smoke inhalation, trauma due
to debris and shock.
e. Evidence supporting the problem: CCTV footage, fire department reports,
Injuries and damage reports, and news coverage.
3. Identify Possible Root Causes
Using problem-solving strategies, potential root causes were identified:
a. Cause-and-Effect Flowchart Analysis:
Leak from a Liquefied Petroleum Gas (LPG) tank
No periodic safety inspection on gas system
No emergency protocols for gas leak
Gas fills the sealed area
The gas mixture is ignited
b. 5 Whys Approach:
Why did the fire occur? By the fire combustibles.
What caused the materials to be get on fire? This is because
Liquefied Petroleum Gas (LPG) was spilling from a canister.
Why did this short circuit happen? When unintended conductors
touch and cause excessive current flow, it creates a short circuit.
Why was the gas leak? Due to incorrect rear connectivity of the hose.
Why was there a poor maintenance inspection? Less frequent regular
inspections and poor fire risk management.
4. Determine the Root Cause
After analyzing the data and identifying possible causes, the primary root
causes of the fire were determined as follows:
a. No frequent safety inspection on fuel system: Not performing frequent
security inspections and upkeep on gas systems, including fuel outlines,
controllers and apparatuses.
b. At the time, no emergency protocols for gas leaks had been established:
Specially, no clear plan or specific protocols existed for responding to gas
leaks or gas-related emergencies.
c. Gas fills an enclosed space: Gas escapes into a confined or enclosed area
and is not properly ventilated.
d. The gas mixture is ignited: The ignition of a gas-air mixture that has reached
a flammable concentration.
5. Recommendations/Proposed Solutions
To prevent future fire incidents, the following corrective actions are
recommended:
Proper Installation and Maintenance
Ensure LPG appliances, cylinders and gas pipes are installed only by trained
professionals. This minimizes the possibility of leaks from incorrect installation.
Perform checks: Regularly check for leaks, frayed hoses, or equipment
degradation. Detect leaks by using a gas detector and soapy water. In case of a
detected leak, shut off the gas and contact an expert.
Proper Storage of LPG Cylinders
Storage in Well-Ventilated Areas: Store cylinders in well-ventilated, shaded
areas away from direct sunlight and heat sources. Cylinders should not be
stored in basements or enclosed places where gas could accumulate in the
event of a leak.
Upright position: Avoid escape of liquid gas and keep LPG cylinders vertical.
No Smoking and Open flames: Ensure No smoking and open fire near LPG
cylinders.
c. Installation of Flame Arresters and Safety Valves
Flame Arresters: Flame arresters installed on the gas lines will prevent flames
from travelling back into the pipes or gas cylinders.
Excess Flow Valve: These have been designed to automatically disengage
gas flow if there’s a large leak or rupture, preventing a larger fire.
d. Fire Extinguishers and Safety Equipment
• Proper Fire Extinguishers: Install fire extinguishers for use on gas fires (class
B) near LPG installations. Be sure to develop and share written guidelines on
how to properly manage secrets.
• Smoke Detectors: Install smoke detectors in kitchen areas where there are
LPG appliances. If there is a leak, the detector can alert people well before it
becomes dangerous.
• Emergency Shutoff Valve: An emergency remote-operated gas shutoff valve
must be installed in the case of a leak.
e. Leak Detection and Gas Alarms
• Gas Leak Detectors: on regular based install LPG Gas leak detectors and you
could replace it with the manufacturer guide for guaranteed improvements.
Proper installation, maintenance and periodic checking of the appliances and gas
pipes can prevent fire due to LPG. Store LPG cylinders in a well-ventilated location
away from risk and use safety equipment like gas leak detectors and flame arresters.
It is very important to educate individuals about LPG being safe, have emergency
procedure ready and a practice of switching off the gas when not in use.
6. Reference Materials
a. Bibliography
https://www.facebook.com/share/v/1A8NEkR6Pd/
b. Appendices
