Two fatal rollovers involving powered industrial trucks in farming and mining demonstrate the reasons why it’s important that operators are properly trained, wear seat belts and follow safety rules.
While these two tragic incidents involved powered industrial trucks specific to their relative industries, the lessons learned can be applied to any industry that uses these kinds of vehicles.
Worker on family farm killed when tractor rolls onto him
On July 28, 2020, a 56-year-old worker who was operating a tractor on his family’s farm died when his tractor rolled down an embankment and its three-point hitch pinned him to the ground.
The tractor, which had been built in 1971, didn’t have a rollover protective structure (ROPS) or a seatbelt, according to an investigation report by the Washington State Fatality Assessment and Control Evaluation (FACE) program. However, aftermarket ROPS and seatbelts that met state safety standards were available for the tractor.
He disliked using the tractor
This tractor was purchased by the worker’s father at an auction in 2019 as a training tractor for the worker’s son. The worker began using the tractor two days before the incident after the farm’s primary tractor developed engine problems.
Whether or not the worker was trained on the tractor was unknown, although he had expressed a dislike for it to some relatives.
The worker, who was considered a full-time employee under state law, had decades of experience in farm tractor and machinery operation on his father’s farm, a 50-year-old business that the worker’s wife and son also helped to operate.
Despite state requirements for small businesses, the farm didn’t have formal, written accident prevention or safety programs.
Front wheel caught unseen rut
The incident occurred when the worker was towing a 25-foot steel, single-axle lagoon pump trailer with an impeller mechanism that was used to agitate the farm’s manure pond. The pond had to be agitated at several different locations where the worker had to drive the tractor on a narrow, bumpy and rutted dirt track road on the crest of an earthen embankment that surrounded the pond. This task was often performed at night, which was the case on the date of the worker’s death.
On the morning of the incident, the worker’s wife and teenage son had been helping him perform this job. However, since it was early morning, he sent them both home before the task was complete.
It was about two hours before sunrise with the only light coming from the tractor and the nearby farm. As the worker turned the tractor sharply near the final agitation point, the tractor’s front left wheel caught a rut, causing the tractor to roll over the edge of the embankment. This caused the worker to fall to the ground as the tractor fell onto him.
Lack of seat belt, roll cage contributed to incident
The tractor’s three-point hitch fatally pinned him against his back. His wife and son found him crushed to death about four hours later. The worker’s father, the owner of the farm, had to use another tractor to lift the rolled tractor off of his son’s body so the coroner could take custody of it.
Investigators found that the key contributing factors to this incident were:
- failure to install ROPS and a seat belt, which are required by state and federal regulations
- lack of an accident prevention program or safety training, and
- operation of the tractor near the edge of a dark, narrow and rutted embankment road.
Maintenance tech dies when lube truck falls into excavation
On Feb. 14, 2022, Marissa Hill, a 34-year-old maintenance technician with 10 years of mining experience, was killed when the lube truck she was driving rolled over the edge of an open mining excavation.
The lube truck fell 60 feet to a lower level where it came to a rest on its cab.
On the day of the incident, Hill was assigned to operate the lube truck to lubricate and refuel mobile equipment in the underground mine.
No berm, broken backup camera
She conducted a pre-operational inspection of the lube truck before driving the vehicle underground. The only safety issue she, and previous operators, noted on the inspection form was a crack in the right cab window. However, investigators found that the vehicle’s backup camera hadn’t been working for a long time prior to the incident.
Based on data from the mine’s electronic tracking system, Hill stopped at a maintenance bay inside the mine for supplies before driving to a lower level. After getting to the lower level, she stopped to turn around after finding there were no vehicles to lubricate or refuel in that area.
As she was in the process of backing into a crosscut to turn around, the lube truck over-traveled the edge of the open mining excavation because there was no berm and fell 60 feet to a lower level of the mine.
Several hours later, two other miners were passing near the area where the lube truck fell and noticed that barrier chains were hanging down as if a vehicle had fallen off the edge. They looked over the edge and saw the bottom and tires of Hill’s lube truck facing upward.
Truck lands on unsupported ground
The two miners drove to the lower level where the lube truck landed but couldn’t approach it since it was in an area of unsupported ground. They called out to the driver – they didn’t know it was Hill at the time – repeatedly but didn’t receive a response.
In order to find out if the driver was OK, the two miners called a safety standdown, which compelled all miners to gather outside. They determined that Hill was missing and after ending the standdown, the mine operator scouted the area around Hill’s lube truck using drones because of the unsupported ground.
In the early morning of the next day, the mine operator recovered the lube truck. Hill was found dead in the cab. The lube truck had a functional seat belt but it hadn’t been in use when the incident occurred.
Seatbelt was functional but wasn’t worn
Investigators with the Mine Safety and Health Administration (MSHA) found that the lube truck was too damaged to determine if there were any safety defects that contributed to the incident. They were able to confirm that the truck had a functional seatbelt.
MSHA investigators reviewed the lube truck’s safety inspections for the several months prior to the incident. They found the only reported safety defect was the cracked window, which didn’t contribute to the incident. They also learned that, because of poor visibility through the rear window, the lube truck used a backup camera, which had been inoperable for several years.
The camera was difficult to maintain in a functional condition due to vibration that would dislodge the wiring, and wet, muddy conditions around the mine. Because the camera was always needing repairs, the miners stopped reporting the defect for more than two years. This did contribute to the incident, according to investigators.
MSHA found that the key contributing factors to this incident were the mine operator’s failure to:
- follow its procedures on placing berms at all open excavations
- conduct adequate workplace examinations, and
- maintain the lube truck’s backup camera.
What do these incidents have in common?
So what do these two incidents have in common? Obviously, they both involve fatalities, powered industrial trucks that rolled over in some way and a failure to use safety devices.
They also involve failure to perform adequate inspections of the area where the industrial trucks were being operated and either the employer’s complete lack of a safety program or an employer’s failure to follow the rules of its existing program.
There are five lessons to learn from these tragic incidents:
1. Make sure industrial trucks are equipped with ROPS, seat belts
This seems like a no-brainer, but there are employers out there who don’t pay attention to this obvious safety requirement.
Yes, there are certain types of powered industrial trucks that may not need ROPS or seat belts depending on certain factors – obviously a standup forklift won’t need a seat belt, for example. However, these exceptions have other safety equipment and requirements regarding the specific vehicle.
No matter what kind of powered industrial truck it is or what industry it’s being used in, ensure that at least the minimum required safety equipment is installed.
2. Ensure operators are properly trained
Another seemingly obvious point, but it boggles the mind how often this isn’t done.
Safety professionals know that powered industrial trucks often perform very differently to cars and trucks that are used for personal transportation. Since that’s not common knowledge, the people who are expected to operate these vehicles need to know the differences.
That includes being shown how to use seat belts and any other safety devices. The reason is because the seat belts and other safety devices on an industrial truck can function differently than those in an ordinary vehicle. Again, an operator needs to know the difference because, as detailed above, seat belt use could mean the difference between life and death.
Annual refresher training should be conducted to ensure all of this information stays fresh in an operator’s mind.
3. Get specific in accident prevention or safety program
Being a safety professional, you know why having an accident prevention or safety program is important. You also know why that program should have a specific section covering the powered industrial trucks your employees are expected to use.
The program should include:
- performing pre-operation inspections
- rules regarding seat belts and ROPS
- avoidance of driving near ditches, holes, embankments and steep slopes
- driving slowly on sloped, bumpy, slippery or muddy terrain
- driving smoothly, without jerky starts, stops or turns
- staying alert at all times and especially at row ends, on roads and near trees or other obstacles
- following manufacturer recommendations on how the industrial truck is meant to be used
- never carrying passengers (unless the specific industrial truck is meant to do so), and
- when parking, always set brakes securely and use a park lock if possible.
Further, if the safety program specifically points out doing things like ensuring berms are placed at the edge of a mining excavation, then the employer needs to make sure it’s done. Stopping such a practice without warning or reason, as the mine operator did in the lube truck incident, can lead to tragedy.
4. Make sure they’re well maintained
If a safety device, like a seat belt or backup camera, is broken then it’s useless in preventing an injury or fatality.
Operators need to pay attention during their pre-operation inspections and make sure to note any deficiencies that need addressed.
Employers and maintenance staff then need to pay attention to the inspection reports and make sure they take equipment out of service until it has been properly fixed. If employees notice that they’re making the effort to report maintenance issues but nothing is being done about it, they’ll eventually just stop reporting.
5. Stress the need to examine the work area
In both of these incidents, the operators and the employers failed to take the time to properly inspect the area where powered industrial trucks were supposed to operate.
Thorough examinations of the area before work starts will help operators catch and correct hazards. Things like ruts, bumps, debris, holes and the like will be found and then can be marked for the operator to avoid or removed altogether.
