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Maintenance worker's foot pushed into infeed rolls that were not locked out

Date of incident: June 2014
Notice of incident number: 2014154970052
Employer: Planer mill

Incident summary
A worker was repairing a top blanker --- a milling machine that reduces oversized lumber to prepare it for the planer, which follows the top blanker in the milling process. The top blanker was locked out. While the worker completed the repairs the planer infeed remained energized because lumber needed to be fed through the top blanker and the planer in order to reach the trim saw. The worker was standing on an elevated platform next to the top blanker to gain better access. The flow of lumber stopped while the worker was standing on the platform. For better access to part of the top blanker, the worker then put his foot down onto the infeed table between the top blanker and the planer's infeed rolls.

The planer infeed operator, at a different location, started the planer infeed, and lumber began to feed automatically into the top blanker. As lumber came out of the top blanker onto the infeed table, it struck the worker's foot, forcing it into the planer's infeed rolls. Although another worker in the planer room activated the emergency stop, the maintenance worker sustained serious injuries.

Investigation conclusions
Cause

  • Working in proximity to energized equipment: The top blanker was de-energized and locked out, but the planer infeed remained energized. While doing repairs, the worker placed his foot on the infeed table between the blanker and the planer infeed rolls. When lumber unexpectedly began to be fed into the blanker and through to the planer, the lumber pushed the worker's foot into the planer's infeed rolls. The worker received serious injuries.

Underlying factors

  • Supervision failed to ensure lockout procedures followed: The operations manager was aware that the worker and the planer mechanic were doing repair work near energized equipment. The operations manager permitted this work to be carried out in contravention of the Occupational Health and Safety Regulation, despite his belief that the work was being done in compliance with the Regulation.
  • Lack of complete and specific lockout procedures: The employer did not have complete written lockout procedures for specific pieces of equipment. The procedures posted in the planer room were too general to ensure that proper lockout was followed when workers were repairing machinery. Consequently, workers had no specific procedures to follow to ensure that they could work safely on de-energized equipment. Procedures should have ensured that the unguarded infeed conveyer to the planer was also locked out. This would have prevented lumber from striking the worker and forcing his foot into the planer's infeed rolls.

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Publication Date: Jun 2014 Asset type: Incident Investigation Report Summary NI number: 2014154970052