Failed or Absent Defences » LTA brake systems

7Fatal Crush Injury on Exploration Site



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

A water truck operator sustained fatal injuries when he was crushed between the rear of his water truck and a pastoral property gate. The operator had opened the gate, driven through it and had just closed it when the truck rolled back trapping him. Preliminary investigation, testing and mechanical inspection of the truck has shown that the brakes were ineffective.

Identified Root Causes:

Ineffective park / emergency brake system.

Energy Type(s) Involved:

Caught between a moving (truck) and stationery object (gate).

Equipment Type(s):

Heavy rigid truck (1985 Mack Econodyne) and steel farm gate

Root & Contributing Cause(s):

LTA brake systems

LTA equipment

LTA hazard identification

LTA maintenance

LTA park brake system and maintenance

Stated or Potential Consequence(s):

Fatality

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

When heavy rigid type trucks are used in these conditions, it is imperative that their braking systems be subject to regular, stringent maintenance and testing; which must include dynamic testing of service brakes and appropriate testing of park / emergency brakes. Records must be kept.

Implement procedures which ensure operators carry out pre-start brake checks whenever they take control of a piece of plant.

Sections 108 and 109 of the Mining and Quarrying Safety and Health Regulation 2001, and Sections 66 and 73 (2) of the Coal Mining Safety and Health Regulation 2001 apply to the above recommendations.

Effective defect reporting systems must be developed and implemented, and should contain guidance for operators on defects affecting safety critical components and systems such as brakes or steering, (e.g. immediate removal from service and tag out).

Consider redesign to remove pedestrian interaction with mobile equipment (e.g. remove gates and replace with grids on pastoral properties).

Organisation:

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


Results

Here are the results.


Information

Reference Type:

Safety Alert #212

Mine Type:

Any Mine Type

Energy:

Potential & Kinetic - Mechanical

Equipment:

Published:

2008

Region:

Australia, Queensland



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