Adaptum aut pereo: Adapt or Perish – Why Robust Management of Change is Essential

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Adaptum aut pereo

Adapt or Perish

This simple Latin phrase — Adaptum aut pereo — captures a harsh reality that applies as much to process safety as it does to evolution. Organizations that fail to properly manage change often suffer the same fate as the dinosaurs — possibly catastrophic extinction of safe operations.


Managing technical and other changes is not optional.

In process safety, Management of Change (MOC) is the critical mechanism that helps us adapt safely when conditions, equipment, procedures, people, or organizations shift. When done well, MOC prevents modifications from becoming major disasters. When done poorly, the consequences can be fatal.

The Dinosaur Analogy

Dinosaurs dominated the Earth for millions of years but could not adapt quickly enough to the massive environmental changes caused by the asteroid impact 66 million years ago. In our facilities, “asteroids” arrive in many forms: equipment modifications, new technology, procedural updates, organizational restructuring, and personnel changes.

Hazards are like wild animals — they can change behaviors both obviously (a new piece of equipment or major process alteration) and subtly (a gradual shift in operating conditions or equipment, a small organizational change, or a personnel transition that slowly erodes knowledge and vigilance). If we don’t rigorously evaluate and manage these changes, especially the subtle ones, we risk awakening a sleeping hazard with deadly results.

Real-World Warnings

One of the clearest modern examples is the Williams Olefins Plant explosion in Geismar, Louisiana on June 13, 2013. Two workers were killed and many others injured when a reboiler ruptured catastrophically.

What went wrong with MOC, according to the CSB investigation?

  • Significant changes had been made over time to the reboiler system, including the installation of block valves that could isolate the reboiler from its pressure relief device.
  • These changes were not properly evaluated through a formal MOC process.
  • The CSB determined that deficiencies in the Management of Change program were a key contributing factor: Robust Management of Change (MOC) practices are needed to ensure the review analyzes hazards in the entire process affected by the change. Similar to PHAs, conducting MOC reviews as a multidisciplinary group—composed of individuals with different experiences and different areas of expertise—can assist in identifying hazards introduced by a process change. Companies must conduct MOCs before implementing a change in the field, and should not treat them as a paperwork or check-the-box exercise. 

This incident shows how gradual, seemingly minor changes — when not properly reviewed — can accumulate into a deadly hazard.

A classic historical example is the Flixborough disaster in the United Kingdom in 1974. A temporary bypass pipe was installed to replace a damaged reactor without proper engineering review or hazard analysis. The poorly designed bypass failed catastrophically, releasing a large cloud of cyclohexane that ignited, killing 28 people and injuring many more. This incident was a major wake-up call for the chemical industry and led to significantly greater awareness and formalization of process safety management, including the importance of rigorous Management of Change.

Why Organizational and Personnel Changes Can Be Especially Dangerous

Many organizations focus MOC primarily on equipment and process changes, but two of the riskiest categories are often under-managed:

  • Organizational Change: Restructuring, mergers, downsizing, or shifts in reporting lines can dilute process safety knowledge, reduce experienced oversight, and weaken safety culture.
  • Personnel Change: Replacing key operators, engineers, or supervisors introduces new skill levels, different work habits, and gaps in site-specific knowledge. Even “like-for-like” replacements can be risky if the new person lacks critical experience with the specific hazards and safeguards.

Both types of change require formal MOC review, including assessment of safety impacts, updated training, revised procedures, and verification that the organization remains competent to operate safely.

Practical Recommendations for MOC Systems

A robust MOC process must answer several critical questions for every change, including organizational and personnel changes:

  • What is the technical and safety basis for the change?
  • How might it impact hazards, safeguards, and operating limits — both obviously and subtly?
  • Have we conducted an appropriate hazard review?
  • Are procedures, training, documentation, and roles/responsibilities updated?
  • Is there a Pre-Startup Safety Review (PSSR) where needed?
  • How will we verify the change has been fully implemented and is working as intended?

Temporary changes, emergency bypasses, and “like-for-like” replacements deserve special scrutiny because they often bypass formal review.

Final Thought

Adaptum aut pereo is not just a catchy phrase — it is a survival imperative in process safety. Organizations that treat Management of Change as a bureaucratic checkbox, especially for organizational, personnel, and subtle hazard changes, are choosing the path of the dinosaurs. Those that embrace MOC as a living, rigorous system — applied consistently to all types of change — give themselves the best chance to thrive safely for decades to come.

How robust is your site’s MOC process for equipment, procedural, organizational, and personnel changes? Have you seen subtle changes slip through the cracks? Share your experiences in the comments.

References

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