In a grassland in Huaihua City, Anhui Province, a worker was repairing a shredding machine when the equipment's power distribution box was not locked out and tagged out, causing the machine to start unexpectedly. The worker was caught in the transmission system and died on the spot. This accident once again highlights the importance of the lockout tagout system in electrical energy isolation.
Accident details and direct cause
Before repairing the shredding machine, the worker only turned off the on-site control switch of the equipment but did not cut off the higher-level power supply or lock out the power distribution box. During the maintenance process, another employee mistakenly opened the control switch, causing the equipment to suddenly start, resulting in casualties. The direct cause of the accident was the incomplete electrical energy isolation and the failure to adopt the lockout tagout dual guarantee measures, which led to the equipment being in an unsafe state during maintenance and prone to accidental operation.
Deep cause of the accident
Disorderly energy isolation management: The company did not establish a lockout safety management system for equipment maintenance operations, and lacked clear regulations on the energy isolation process for electrical equipment maintenance.
Employees' safety awareness was weak: The workers did not have sufficient understanding of the risks of electrical energy release during maintenance operations and did not develop the habit of lockout tagout.
There were loopholes in on-site management: The workshop did not set up a dedicated safety supervisor, lacked effective supervision of high-risk maintenance operations, and was unable to promptly detect and correct violations.
Accident lessons and rectification measures
Strictly implement the lockout tagout system: All electrical equipment maintenance must be carried out after cutting off the higher-level power supply, locking out the power distribution box, with the lock key uniquely corresponding to the operator, and marking it for warning. The principle of "whoever marks, whoever unlocks, and whoever energizes" must be followed.
Improve management systems: Revise the "Equipment Maintenance Energy Isolation Management Regulations" to detail the energy isolation process for different types of equipment, clarify the responsibilities of each level of personnel, and ensure that "each lock has a responsible person, and each tag has a warning effect".
Strengthen training and assessment: Conduct practical training on electrical energy isolation, explain the importance and operation methods of lockout tagout through accident cases, and ensure that each employee masters it proficiently through theoretical examinations and practical assessments. The execution of energy isolation should be included in performance evaluations, and violations should be dealt with seriously.
Enhance on-site supervision: Set up safety supervisors to conduct on-site supervision of equipment maintenance operations, focusing on checking the implementation of energy isolation measures, and stopping and rectifying violations immediately upon discovery.