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Sampoong Department Store Collapse


Background
Incident Investigation Report
“The Sampoong
Department Store
Collapse was a
structural failure
that occurred on
June 29, 1995 in
the Seocho-gu
district of Seoul,
South Korea. The
collapse is the
largest peacetime
disaster in South
Korean history –
501 people died
and 937 were
injured.” [1]

Incident Investigation Team Members:


Team #9 Lukasz Glistak
Shannon MacDonald
ENGG 404 Cody McIntyre
Engineering Safety &
Loss Management Linda Nguyen
Brett Schroh
November 24th, 2010
ENGG 404 – Engineering Safety & Loss Management
Sampoong Department Store Collapse – Incident Investigation Report – Team #9
November 24th, 2010

Table of Contents
Executive Summary…………………………………………………………………………..Page 1

Overview of the Incident……………………………………………………………….Page 1

Losses with Respect to P.E.A.P.s.s……………………………………………………. Page 1

Determination of the Immediate Cause……………………………………………….. Page 2

Process Used to Determine Basic Causes……………………………………………... Page 2

Main Basic Causes Leading to Important Recommendations………………………… Page 2

Conclusions..................................................................................................................... Page 5

Appendix A – PowerPoint Presentation……………………………………………………... Page 7

Appendix B – Event Tree……………………………………………………………………. Page 16

Appendix C – Fault Tree…………………………………………………………………….. Page 18

Appendix D – Immediate & Basic Causes…………………………………………………... Page 21

Appendix E – Losses with Respect to P.E.A.P.s.s………………………………………….. Page 23

Appendix F – Recommendations……………………………………………………………. Page 25

Appendix G – Conclusions…………………………………………………………………... Page 32

Appendix H – References…………………………………………………………………… Page 34

Appendix I – Progress Report………………………………………………………………. Page

List of Figures
Figure 1 – Event Tree………………………………………………………………………... Page 17

Figure 2 – Fault Tree………………………………………………………………………… Page 19


ENGG 404 – Engineering Safety & Loss Management
Sampoong Department Store Collapse – Incident Investigation Report - Team #9
November 26th, 2010

Executive Summary

Overview of the Incident

The Sampoong Department Store collapse was a structural failure that occurred on June 29, 1995 in the Seocho-
gu district of Seoul, South Korea. This event is documented as the largest peacetime disaster in South Korean
history.
On the morning of June 29, just after 8:00 AM, the Sampoong Department Store facilities manager discovered a
note on his desk left by the night guard. The guard stated that he had heard strange noises coming from the roof.
Upon investigation, the manager noticed large cracks in the rooftop, well aware that they had been caused by
the improper removal of three air conditioning units two years prior.
Approximately two hours later, the manager’s presence was requested in a restaurant on the fifth floor. Workers
had noticed a large crack and sinking of the floor around the base of one of the columns. The manager
instructed the workers to keep this information classified for now, as to not start any gossip that would
negatively affect the reputation of the store.
As noon approached, individuals on the 5th floor heard a disturbing sound and the rest of the building underwent
mild vibrations. At 12:30 PM, the facilities manager decided to turn off the air conditioning unit, thinking that
that was the source of the vibrations.
By 4:00 PM, the cracks in the restaurant had widened to four inches and the facilities manager called a meeting
between himself, the store owner and the structural engineer. The engineer recommended that the store be
closed for repairs but the owner refused so that shopping would continue.
At 5:40 PM, a loud bang was heard from the top floor and the ceiling shifted. At 5:47 PM, an even louder bang
roared from the top floor.
Finally, at 5:52 PM, a massive shock wave rocked the entire building and the five-storey building began to
crumble. In less than twenty seconds, the entire building had collapsed to the ground. Approximately 1500
people were trapped inside.
By the end of the rescue efforts, it was determined that 501 people died and 937 were injured.

Losses with Respect to P.E.A.P.s.s.

The Sampoong Department Store Collapse resulted in devastating consequences, which included the deaths of
501 people and 937 others being injured. Approximately $216 million USD worth of property was damaged,
which included the department store, public and neighbouring property. After the collapse, the building was
irreparable and all assets, including furniture, equipment, and products, were destroyed and as a result,
production was completely lost. Due to the building being irreparable, no assets or capital being available and a
dire public relationship, the department store has no sustainable future.

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ENGG 404 – Engineering Safety & Loss Management
Sampoong Department Store Collapse – Incident Investigation Report - Team #9
November 26th, 2010

Determination of the Immediate Cause

The immediate cause was determined to be the structural degradation of Column 5E. This conclusion was
reached following examination of evidence and active discussion. The team started by reviewing the building’s
history. The team found an overwhelming number of substandard practices, such as poor construction materials
and a complete disregard of engineering load-bearing calculations. All of these events led to the utter failure and
structural degradation of Column 5E. The consensus of this immediate cause was further supported by the fact
that it was the event that triggered the resulting collapse of the department store. Furthermore, the team was able
to suggest other possible outcomes (which are outlined in the Event Tree in Appendix B) and identify many
basic causes of this incident. Additional detail regarding the immediate cause is given in Appendix D.

Process Used to Determine the Basic Causes

After establishing the immediate cause of the incident, the group proceeded to determine the basic causes by
scrutinizing the building’s history. Specific events were then categorized into the type of effect they had on the
immediate cause. These events were further examined to suggest where management failed to be accountable
and committed to safety. Once all of the events were fully investigated, they were organized into the Fault Tree,
which is given in Appendix C.
The basic causes were determined to be the following:
- No engineering analysis was applied
- Management prioritized profit over safety
- Poor management of change was utilized
- Contractor opinions were not respected
These basic causes were decided based on the areas where management failed to meet the 13 elements of a
typical safety and risk management program (refer to Appendix F). They also clarified why substandard
practices occurred and why substandard conditions existed. Consequently, they were correlated to where
management failed to permit such practices and conditions and formed the basis for where the team established
key recommendations. A detailed account of all of the basic causes is given in Appendix D.

Main Basic Causes Leading to Important Recommendations

All four main basics causes have significant recommendations that will prevent similar incidents from occurring
(see Appendix F for a comprehensive explanation of all recommendations).

Basic Cause: Management Prioritized Profit over Safety

The Sampoong group prioritized profit over safety. They failed to realize that any profits gained would
eventually be lost due to additional costs resulting from an incident, such as the collapse of the department
store. These additional costs include the money spent on compensation costs, asset damage, loss revenue, loss
business due to tarnished reputations, along with a variety of other costs. They also failed to realize that
implementing safety features, utilizing proper management of change, adhering to correct engineering designs
and using adequate materials were small investments for the safety and well-being of future patrons and staff.

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November 26th, 2010

Additionally, they ignored their moral responsibility to ensure that their future department store was structurally
sound and would not result in the unnecessary deaths of countless people.

Recommendation: Implement a coherent safety and loss management program

This recommendation is crucial to the prosperity of the Sampoong group. Implementing such a program would
allow for revenue to be made without sacrificing the safety of people. Ultimately, by applying this program,
management is able to recognize that essential notion that safety is much more valuable than profit.

Recommendation: Implement a safety culture in which safety is always considered a greater priority than
profits

Suggested Timeline: Immediately and ongoing


Estimated Cost: Wide-ranging, dependant on possible loss of revenue

A safety program is futile without a safety culture. A safety culture ensures that everyone from management to
store employees understands that safety is the highest priority and that the actions and decisions of management
are made with that notion in mind. If management fails to engage in the safety culture, then employees also
have no reason to, since the safety culture begins with the actions and motives of management.

Basic Cause: Poor Management of Change was Utilized

Changes are inevitable with the execution of any plan. Thus, in order to accommodate changes, a thorough
management of change procedure should be implemented. However, the Sampoong management failed to
accommodate for the changes described below. When management decided to fill the extra fifth floor with
restaurants instead of a roller rink, they failed to anticipate the associated implications, such as a thicker
concrete base and the extra weight from the heavy restaurant equipment. As a result, the building stress was
increased and management failed to increase the structural integrity of the building. Also, management did not
comprehend the impact on the building’s integrity when cutting into support columns to install fire shields.

Recommendation: Risks analyses must be conducted with a possible hazard and decisions to accept a given risk
should not be made lightly

Suggested Timeline: Immediately and ongoing


Estimated Cost: $1000/analysis

Any change in the planning stage of a building should always be accompanied by a management of change
procedure, whereby risks analyses are critical. Risks analyses will identify possible hazards and aide in
mitigating that risk to a satisfactory level. If a risk cannot be mitigated, then the change should not be carried
out, for the consequences far outweigh the change’s advantages.

Recommendation: Form or hire a team whose sole responsibility is to ensure safe work practices are being
conducted

Suggested Timeline: Three months and ongoing


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Estimated Cost: $300,000/year

Through this team, management ensures that safe work practices are being carried out and that any risks are
eliminated or reduced to a satisfactory level. If management expects that a change results in negligible risk, then
this team can verify that claim. In doing so, any changes can be accommodated for by at least two separate
groups of people.

Basic Cause: No Engineering Analysis was Applied

Throughout the building of the Sampoong Department Store, there were many cases where no engineering
analysis was applied. Such instances were when management approved the use of inadequate construction
materials or the approval of the column designs that had incorrect diameters and the incorrectly spaced and
reduced amounts of reinforcing steel bars. Any change in design will always lead to a change in the engineering
load-bearing calculations. Management failed to acknowledge this fact. Had management pursued new
engineering calculations, they would have realized that their designs were not feasible due to the fact that the
building would not be able to accommodate the amount of stress, thus preventing the collapse of the department
store.

Recommendation: Design changes must be made as to not jeopardize the integrity of the building and must
comply with government standards

Suggested Timeline: Immediately


Estimated Cost: Wide-ranging, dependent on the financial impact those changes might have on the ability to
generate revenue

Design changes should always accompany new engineering calculations to determine whether a design
complies with governmental standards. They should either facilitate to meet an engineering calculation
requirement or improve the structural integrity of the building. By redoing the engineering calculations,
management can prevent certain incidents from occurring, thus allowing for not only ongoing revenue, but also
for a commitment to safety to be established.

Recommendation: Construction materials must be approved by and comply with government and company
standards

Suggested Timeline: Immediately


Estimated Cost: $1,000,000 per building to be constructed (as opposed to ‘cutting corners’ with building
material)

Management must not exchange the quality of building materials for a savings in cost. Building materials
should be chosen based solely on their ability to significantly improve structural integrity. By doing so,
management ensures that safety is not compromised. Additionally, the costs saved with preventing incidents far
outweigh the costs saved by choosing inadequate materials.

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ENGG 404 – Engineering Safety & Loss Management
Sampoong Department Store Collapse – Incident Investigation Report - Team #9
November 26th, 2010

Basic Cause: Contractor Opinions were not Respected

When contractors informed management that certain designs were unsafe due to compromising the building’s
structural integrity, management fired those contractors and replaced them with ones that did not question the
designs. Management failed to consider the opinions of contractors and did not respect the fact that contractors
act with an abundance of experience and knowledge. Moreover, contractors would not bring up any disputes,
had they no concerns about affecting the safety of the building employees and future patrons. Additionally, the
actions of firing noncompliant contractors develops a hostile work environment, since if management refuses to
consider the opinions of highly trained and experienced individuals, then they are definitely not going to
consider the opinions of any of their own employees.

Recommendation: Respect and hold with the upmost consideration the opinions of hired contractors and
engineers.

Suggested Timeline: Immediately and ongoing


Estimated Cost: Nil

Contractors and engineers act upon their technical knowledge, training, and experience. Therefore, when
suggestions are made by them, their main motive is to prevent unfavorable outcomes and ensure that work is
executed in a safe manner. It is critical that their opinions are respected, for they are professionals. By
considering the opinions of contractors and engineers, management is supplied with ideas and suggestions that
they might not have ever thought of. Furthermore, by respecting their opinions, management develops a more
favorable work environment where open communication exists, thus allowing other employees and contractors
to not fear the loss of their jobs if they present any concerns. Nevertheless, suggestions and concerns of
contractors and engineers are only proposed because they feel that the current design can be improved,
especially if it is in a manner that does not compromise the safety of anybody.

Conclusions
The Sampoong Department Store Collapse was a preventable tragedy that was driven by greed, ignorance, and a
complete disregard for the safety of people. The collapse was the direct result of the structural degradation of
Column 5E, which in turn, was ultimately the consequence of many negligent actions. Following an in-depth
incident investigation, the basic causes were determined to be management being solely driven by profit and
poor utilization of management of change where new potential risks were not considered. As well, no
engineering analyses were applied to changes in design and management bluntly ignored the concerns and
opinions of contractors and engineers.

To prevent future similar incidents from occurring, a few key recommendations should be fulfilled.
Most importantly, a safety and risk management program must be implemented to ensure that safety is always a
higher priority than profit. To support this program, a safety culture should be instilled in the workplace.
Additionally, a team should be formed with the main responsibility of ensuring that safe work practices are
being followed through and safe work conditions exist. Moreover, risk analyses must be made whenever a
change in design occurs and new engineering calculations should be calculated to reflect those new changes.
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November 26th, 2010

Lastly, the opinions of contractors should always be held with the upmost respect, for they are experts in their
field.

The Sampoong Department Store Collapse had catastrophic consequences that questioned the safety and
structural stability of many other buildings. Thus, when analyses and investigations were performed, it was
discovered that many South Korean buildings and facilities were built risking huge implications. These
building deficiencies were the direct result of corrupted government safety inspectors. It is unfortunate that it
took one immense tragedy, such as the Sampoong Department Store Collapse, to realize the numerous existing
structural inadequacies in other buildings and the corresponding governmental corruption.

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Appendix A

PowerPoint Presentation

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Appendix B

Event Tree

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Event Tree

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Appendix C

Fault Tree

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Appendix D

Immediate & Basic Causes

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Sampoong Department Store Collapse – Incident Investigation Report - Team #9
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Immediate & Basic Causes

Immediate Cause
The immediate cause is the structural degradation of Column 5E. Two years before the collapse of the building,
management received noise complaints regarding working air conditioning (A/C) units. In response, the A/C
units were moved using rollers instead of cranes, which in turn, caused visible cracks on the roof. Due to each
A/C unit weighing 15 tons, the roof experienced more stress, which propagated to each of the columns.
Additionally, when the new A/C units were turned on, vibrations were sent along the roof and the supporting
columns, whereby Column 5E seemed to be affected the most. Eventually, cracks around Column 5E widened
until the column could no longer withstand the stress incurred, thus causing the fifth floor concrete slab to
crumble and the entire building to collapse.

Basic Causes
The immediate cause along with many other substandard practices led to the collapse of the building. One of the
basic causes includes the approval of the extra fifth floor and then the approval of using restaurants to fill that
extra fifth floor. Originally, the building was intended to have only four floors. However, management wanted
to have more space, and therefore concluded on adding an additional 5th floor. The floor's initial plan was
mainly comprised of a roller skating rink, but later changed to include eight restaurants. Incorporating the eight
restaurants required a thicker concrete slab to accommodate floor heating. When the contracting construction
company was informed of this change, they informed management that this change was not feasible due to the
structure not designed to support the extra weight. Consequently, management fired and replaced the contractor.
Another basic cause is the use of poor construction materials and poor building designs. It was determined that
the concrete used for the columns and floor slabs was of substandard quality. Furthermore, the building designs
did not reflect engineering load-bearing calculations, possibly due to time and budget constraints. Nevertheless,
management was well informed of these inadequate materials and designs, but continued with the construction
of the building.
Design changes, poor materials, and incompetent designs ultimately relate to the basic cause of an ineffective
safety program. It appears as though the safety program was nonexistent for the fact that any person or company
that reported any flaws in design or materials was quickly removed and replaced with ones who complied. Also,
management failed to fully reevaluate potential hazards for each change in design. Accordingly, there was little
priority placed on the safety and wellbeing of not only current construction workers, but also future patrons of
the department store. Management was driven solely by profit and disregarded the building regulations that are
in place to prevent harm against society.

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Appendix E

Losses with Respect to P.E.A.P.s.s.

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Losses with Respect to P.E.A.P.s.s.

People - Injury and death of many company employees, contractors, visitors, and public in close
proximity to the site at the time of collapse; 501 people died and 937 were injured
- Short and long-term suffering to victims and families

Environment - Damage to public and neighbouring property

Assets - All assets (e.g. furniture, equipment, products, etc.) were destroyed
- The building itself was demolished beyond repair

- Resulted in about $216 million USD worth of property damage


Production - Complete loss of production due to desire for increased sales

Sustainability - The department store has no sustainable future (i.e. no assets or capital to work with and
extremely negative public relationships)

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Appendix F

Recommendations

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Long-Term Recommendations

1) An overall safety and loss management program should be implemented, including, but not
limited to, these basic elements:

- Management leadership, commitment, and accountability


- Objectives, targets, and standards
- Incident investigations and trend analysis
- Field inspections and action plans
- Effective organization and communication
- Field safety practices
- Training (at all levels of the organization)
- Task analysis, risk analysis, and risk management
- Rules, regulations, and guidelines
- Emergency preparedness and community awareness
- Performance, stewardship, and reward systems
- Contractor program
- Pace and dedication to the program

The following recommendations outline some of these basic elements.

2) A company policy statement on safety and loss management should be written, ensuring that
employees at all levels of the organization understand, and are committed to, these new policies.

Suggested Timeline: Two months and ongoing

Estimated Cost: $5,000

This recommendation falls into the category of management, leadership, and accountability, as well as
objectives, targets, and standards of the basic elements in the safety and loss management program
listed above. Ultimately, it is management’s responsibility to set the policies on safety and ensure that
all employees, including themselves, are complying with these standards.

3) Implement a safety culture in which safety is always considered a greater priority than profits.

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Suggested Timeline: Immediately and ongoing

Estimated Cost: Wide-ranging, dependant on possible loss of revenue

Making safety the top priority in a company is an example of field safety practices. It should be made
known to all employees, even management, that the safety of people and assets should be the governing
hand in every task that is performed and in every decision that is made. The fear of revenue loss should
never be a larger concern than the safety of thousands of employees and customers.

4) A team should be formed whose sole responsibility is to ensure that safe work practices are being
conducted and that the rules outlined in the new policy statement on safety and loss management
are being implemented.

Suggested Timeline: Three months and ongoing

Estimated Cost: $300,000/year

This particular recommendation falls under the realm of two basic elements of the suggested safety and
loss management program: field safety practices and task analysis, risk analysis, and risk management.
The purpose of this team would be to make sure that field safety practices are being followed on a
regular basis and that any possible risks associated with any given job are eliminated or reduced to a
satisfactory level.

5) Safety inspections during construction and throughout operation of the building will be
performed on a regular basis and infractions found during said inspection should be rectified in a
given time frame.

Suggested Timeline: Three months and ongoing

Estimated Cost: $20,000/site

The recommendation that safety inspections be conducted exemplifies the field inspections and action
plans element. This is an extremely important element in this particular case, because had field
inspections been carried out throughout the construction of the building and any time after, it would

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have been well documented that the building was doomed for collapse. Therefore, should this
recommendation be carried out, any incidents of this magnitude will easily be prevented.

6) The opinions of hired contractors and engineers must be held with the upmost consideration and
respect.

Suggested Timeline: Immediately and ongoing

Estimated Cost: Nil

This recommendation falls under the effective organization and communication and contractor program
elements of a risk management program. It is extremely important that all opinions and suggestions in a
company are taken seriously and respectfully. It is even more critical that there is open communication
when dealing with a contractor or hired engineer. Disagreeing with the professional opinion of a hired
engineer should not be done so lightly, especially when there are safety concerns.

7) Hired management employees must be responsible and competent. Management must be able to
make decisions that best serve the safety of both employees and customers if/when hazardous
conditions arise. Training may be required to ensure this is the case.

Suggested Timeline: 6 months and ongoing

Estimated Cost: $300,000

This mainly refers to the training element of a successful safety and loss management program. All
employees, including management, must be equipped with the knowledge and training to be able to
analyze a situation and determine the best course of action. Management must be able to make
decisions that will ensure the safety of employees and customers when situations like this arise.

8) Risk analyses must be conducted when confronted with a possible hazard, especially one of great
magnitude, and decisions to accept a given risk should not be made lightly.

Suggested Timeline: Immediately and ongoing

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Estimated Cost: $1000/analysis

This recommendation falls under the category of task analysis, risk analysis, and risk management.
When a potential hazard is identified, a risk analysis should be conducted, and if it is decided that a risk
is acceptable, it should be managed in a way that minimizes its impact should an incident occur. If a
possible outcome of any given risk is catastrophic, as was the case for this incident, the risk should not
be acceptable no matter how small the probability of its occurrence might be.

9) An evacuation plan should be created and tested so that all employees and customers can safely
exit the building in the case of an emergency.

Suggested Timeline: 1 month and ongoing

Estimated Cost: $10,000

In the case that all other basic elements of a risk management program fail, the element emergency
preparedness and community awareness is aimed at ensuring an incident is dealt with in a safe and
timely manner so that its damage to people and assets is at a minimum. The above recommendation
refers to this element, and is ultimately the last line of defence in managing losses.

Short-Term Recommendations

1) During the construction of a building, any changes that are made to the engineering design must
not jeopardize the integrity of the building and must comply with government standards (i.e.
changing the purpose of an upper level floor from a roller rink to a restaurant).

Suggested Timeline: Immediately

Estimated Cost: Wide-ranging, dependant on the financial impact those changes might have on the
ability to generate revenue

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The above recommendation is best exemplified by the objectives, targets, and standards and field safety
practices. If any design changes are made, it is absolutely necessary to redo any engineering
calculations that are affected by the change, that way it is possible to determine whether or not the new
design complies with government standards. As a side note, it is beneficial to a company to exceed the
standards set by government.

2) The building should be constructed with materials that are approved by government and
company standards, and used in a manner that also complies with said standards (i.e. using
concrete mixed with freshwater rather than saltwater).

Suggested Timeline: Immediately

Estimated Cost: $1,000,000 per building to be constructed (as opposed to ‘cutting corners’ with building
material)

Again, the above recommendation refers to the objectives, targets, and standards and field safety
practices elements of a safety and loss management program. Building material standards are set by the
government and should be followed at all times. It is the responsibility of management that these
standards are being met.

3) Any additional changes after the original construction must not, in any way, degrade, or render
inadequate, any load-bearing structures (i.e. columns).

Suggested Timeline: Immediately

Estimated Cost: Wide-ranging, dependant on the financial impact those changes might have on the
ability to generate revenue

Similar to the above two recommendations, this falls under the categories of objectives, targets, and
standards and field safety practices. Again, any design changes that might affect the stability of a
building requires the recalculation of engineering equations in order to determine whether or not it
complies with government standards.

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4) Any large-scale procedures must be done so in a fashion that maximizes the safety of people and
assets, even if this course of action proves more difficult or more expensive (i.e. moving large air
conditioning units on the roof with a crane rather than sliding them on rollers).

Suggested Timeline: Immediately

Estimated Cost: $10,000 - $50,000

The above recommendation exemplifies the safety and loss management program elements field safety
practices and task analysis, risk analysis, and risk management. Before any task is performed, small- or
large-scale, a risk analysis should be carried out in order to determine whether or not completing the task
is worth the risk. In addition, as mentioned in one of the above recommendations, management must
show, through their actions, that safety takes priority over cost.

5) Upon sight of structural degradation of a building or facility, proper risk analyses should be
conducted in order to ensure the safety of the employees and customers inside.

Suggested Timeline: Immediately

Estimated Cost: $4000/analysis

This recommendation mainly falls into the category of the Task analysis, risk analysis, and risk
management element of an effective safety and loss management program. Proper risk analyses must be
performed on any new hazard that is identified so that the proper course of action can be carried out. A
risk should never be acceptable if it could potentially cause the kind of destruction found in this incident,
regardless of how improbable the event may be.

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Appendix G

Conclusions

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Conclusions

The Sampoong Department Store, located in the Seocho-gu district of Seoul South Korea, collapsed due to the
structural failure of column 5E. This was only the immediate cause of the incident and, like all other incidents,
this was completely preventable. The death toll was catastrophic with 501 people losing their lives and another
937 people receiving injuries. Many of the survivors were left with lifelong debilitating injuries. The entire
department store was lost with a total of $216 million dollars in property damage. This was the largest
peacetime disaster in South Korean history.
An in-depth investigation into the incident, considering engineering analysis, construction history, witness
statements and managerial decisions, was conducted to determine the basic causes of this incident. All evidence
pointed at greed, cutting costs and increasing capacities to maximize profitability. The owners and management
were preoccupied with profitability and completely neglected to consider implementing a safety program to
protect the public. Changes were made without considering the risk that would result and the expertise of
designers and engineers was ignored. Rather than listening to the warnings and concerns of industry experts,
management terminated their contracts and employment. The department store was essentially constructed
without any engineering analysis. The changes made to the design by management and owners were outside of
any calculations done.
Recommendations made to prevent this tragedy and tragedies like it include: implementing a 13 element safety
program and ensuring safety inspections are conducted by competent inspectors, utilizing risk/hazard analysis,
implementing a management of change protocol and ensuring a proper safety culture is present. In this case, the
recommendations came too late. However, lessons must be learned to prevent tragedies like this from occurring
in the future. The Sampoong Department Store collapse had far reaching implications. Analysis and
investigations resulted in the discovery of many South Korean buildings and facilities with substandard
construction. It was found that these structural deficiencies were a result of failed government safety inspection
programs. Inspectors were bribed into passing buildings and allowing structural deficiencies to go unnoticed.
Unfortunately, this was another instance of failed management, this time at the highest level.

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ENGG 404 – Engineering Safety & Loss Management
Sampoong Department Store Collapse – Incident Investigation Report - Team #9
November 26th, 2010

Appendix H

References

Page 34 of 36
ENGG 404 – Engineering Safety & Loss Management
Sampoong Department Store Collapse – Incident Investigation Report - Team #9
November 26th, 2010

References
[1] Sampoong Department Store Collapse. (2010, October 6). Received from Wikipedia:
http://en.wikipedia.org/wiki/Sampoong_Department_Store_collapse

[2] Wilson, L., McCutcheon, D. (2003). Industrial Health, Safety and Risk Management – The Integrated
Approach. In Industrial Safety and Risk Management (Chapter 1). Retrieved from
http://books.google.ca/books?id=_Rr_BRvp30EC&lpg=PA5&ots=fNcOnZE8My&dq=peap%20people
%20environment%20assets%20production&pg=PA6#v=onepage&q&f=false

[3] Oshiro-Momohara, A., Watanabe, B., Miyahara, R. Sampoong Department Store Collapse [PDF
Document]. Retrieved from http://students.seattleu.edu/watanab5/web/Sampoong%20Powerpoint.ppt

[4] National Geographic. (2006). Seconds from Disaster – Superstore Collapse. United States: National
Geographic Society and Darlow Smithson Productions. Retrieved from: previously published
information in the public domain.

[5] Sampoong Department Store Collapse. (2010, October 16). Wikipedia. Retrieved October 19, 2010,
from http://en.wikipedia.org/wiki/Sampoong#investigation

[6] Winkel, G. (2010). Faculty of Engineering – ENGG 404 – Engineering Safety and Risk Management –
Fall Term 2010. University of Alberta, Custom Courseware.

[7] Gardner, N.J., Huh, J., Chung, L. (2002). Lessons from the Sampoong Department Store Collapse.
Cement and Concrete Composites 24 (2002) 523-529.

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ENGG 404 – Engineering Safety & Loss Management
Sampoong Department Store Collapse – Incident Investigation Report - Team #9
November 26th, 2010

Appendix I

Progress Report

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