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53Hit By Projectile



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Brief Description of Incident/Accident & Description of Consequences/Outcomes:

A fitter received a fractured skull when the hydraulic valve being replaced was ejected under pressure. The fitter, working on a longwall powered support, reduced the leg pressure to replace a gas yield valve. The staple had rusted and seized and was removed using a screw driver and hammer. The residual leg pressure, probably from canopy weight or bypassing valve, blew the component into the fitters forehead.

Energy Type(s) Involved:

Uncontrolled release of energy

Root & Contributing Cause(s):

Failure under pressure

LTA awareness

LTA hazard identification

LTA isolation

LTA pressure control

LTA work method

Stated or Potential Consequence(s):

Fracture

Potential Fatality

Preventative/Recommended/Accepted Steps of Risk Mitigation, Points of Interest:

A well written Standard Work Procedure would require:-

Full isolation of the support pressure and isolation of the return line when the leg pressure was reduced to zero.

A test of the hoses to feel for free movement indicating no residual pressure.

Position of the person out of the line of fire.

AT NO TIME SHOULD A TIGHT VALVE BE BLOWN OUT OF ITS SEAT USING SYSTEM PRESSURE.!

EMESRT Risk(s):

No verifying zero energy state

ISOLgate Checklist(s):

Download No verifying zero energy state Checklist.

Organisation:

Queensland Government Department of Employment, Economic Development and Innovation (DEEDI)


Results

Here are the results.


Information

Reference Type:

Safety Alert #CR157

EMESRT Risk(s):

No verifying zero energy state

Mine Type:

Underground Mine > Underground Coal Mine

Energy:

Potential & Kinetik - Pressure > Fluid

Equipment:

Published:

1998

Region:

Australia, Queensland

ICAM Categories

Organisational Factors

-

Task or Environmental Conditions

• Pressure

Individual or Team Actions

• LTA awareness

• LTA hazard analysis/job safety analysis

• LTA isolation

• LTA pressure control

• LTA work method

Failed or Absent Defences

-



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