Rubber equipment operator died after his head was caught between bars of operating machinery

Gilbert-Jones, Illa; Epstien, Barbara L.

doi:10.26616/NIOSHSFACE18OR029

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Rubber equipment operator died after his head was caught between bars of operating machinery

2019/06/01
By Gilbert-Jones, Illa ; Epstien, Barbara L.
Series: Fatality Assessment and Control Evaluation Reports (FACE)

[PDF-1.37 MB]

English

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Details:

Personal Author:

Gilbert-Jones, Illa ; Epstien, Barbara L.

Gilbert-Jones, Illa ; Epstien, Barbara L. Less -
Corporate Authors:

Oregon Fatality Assessment and Control Evaluation (Program) (OR-FACE) ; Oregon Health & Science University. Oregon Institute of Occupational Health Sciences

Oregon Fatality Assessment and Control Evaluation (Program) (OR-FACE) ; Oregon Health & Science University. Oregon Institute of Occupational Health Sciences Less -
Description:

On August 23, 2018, a 23-year-old male Caucasian rubber cutter was found caught between two bars of a festoon rubber processing line (cooling line). The event was unwitnessed; however, circumstances suggested that the employee entered the festoon area to retrieve and redirect a rubber strip on a cooling bar that had passed the point where it should have fed onto a conveyor. It is believed that the worker raised his head between the moving cooling bars, and that the bars then forced his head against a structural support for an electrical panel. He was pronounced dead at the scene. CONTRIBUTING FACTORS: Key contributing factors identified in this investigation include: 1. Inadequate equipment safeguard. 2. Inadequate lockout/tagout program and training. 3. Inadequate hazard assessment and knowledge of safeguarding equipment. 4. Inadequate training and assessing workplace hazards. RECOMMENDATIONS: Oregon Fatality Assessment and Control Evaluation (OR-FACE) investigators concluded that to help prevent similar occurrences, employers should: 1. Safeguard machinery to protect machine operators and others who work in the area from hazards. 2. Implement, enforce, and assess "control of hazardous energy (lockout/tagout)" procedures for machines, equipment and processes where unexpected energization or start-up could cause harm to personnel. 3. Establish a safety committee that meets the requirements of Oregon Occupational Safety and Health Administration (OSHA). 4. Confirm industry best practices for specialty equipment, and notify equipment manufacturers of equipment hazards identified in hazard assessments.
Subjects:

[+]

Accidents, Occupational Occupational Health Safety
Keywords:

[+]

Accident Analysis Accident Prevention Accidents Equipment Operators Fatalities Injuries Injury Prevention Lockout Tagout Machine Operation NIOSH Region 10 Recommendations Safety Practices Training Traumatic Injuries Work Analysis
FACE - NIOSH and State:

All (0000) ; Machine (All) (0011) ; Machine General (0015)

All (0000) ; Machine (All) (0011) ; Machine General (0015) Less -
Series:

Fatality Assessment and Control Evaluation Reports (FACE)
Subseries:

State
DOI:

https://doi.org/10.26616/NIOSHSFACE18OR029
Publisher:

National Institute for Occupational Safety and Health
Document Type:

Text
Funding:

Cooperative Agreement
Genre:

Field Study
Place as Subject:

Oregon
CIO:

National Institute for Occupational Safety and Health (NIOSH)
Topic:

Workplace Safety & Health
Location:

North America
Pages in Document:

1-9
Contributor:

Olson, Ryan
NIOSHTIC Number:

20059235
NTIS Accession Number:

PB2022-100313
Citation:

Morgantown, WV: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, FACE 18OR029, 2019 Jun; :1-9
Contact Point Address:

Oregon Fatality Assessment and Control Evaluation (OR-FACE)/Oregon Institute of Occupational Health Sciences, Oregon Health & Science University (OHSU), 3181 SW Sam Jackson Park Rd., L606, Portland, OR 97239-3098
Email:

orface@ohsu.edu
Federal Fiscal Year:

2019
Performing Organization:

Oregon Health & Science University
Peer Reviewed:

False
NAICS and SIC Codes:

31-33 - Manufacturing - (NAICS 2022)
Start Date:

2005/07/01
Source Full Name:

National Institute for Occupational Safety and Health
End Date:

2026/06/30
Resource Number:

FACE-18OR029
Collection(s):

National Institute for Occupational Safety and Health
Main Document Checksum:

[+]

urn:sha-512:daa116e353997293c746c9e727b702d2e9dbcaac1ca54effcbc73654083d473cc1931192a10d4e64d1be50ef96b7b2e85a5ab7b06d706886d0fa6260af58ca53
Download URL:

https://stacks.cdc.gov/view/cdc/164922/cdc_164922_DS1.pdf
File Type:

No Additional Files

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Rubber equipment operator died after his head was caught between bars of operating machinery

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