OSHA Accident Investigation · Summary #14554372
RESPIRATORY,AMMONIA,WORK RULES,INHALATION,TOXIC FUMES,CONSTRUCTION,LOCKOUT
Event description
EXPOSURE TO AMMONIA VAPORS
Investigation abstract
THE PRODUCTION FACILITIES IN THE PLANT WERE UNDERGOING RENOVATION AND INSTALLATI ON OF NEW PARTS ON THE SECOND THROUGH FOURTH FLOORS. AN OIL FUEL LINE TO A WATER CHILLER WAS CUT SO THAT THE CHILLER COULD BE REMOVED. THE DUMP VALVE FOR THE OI L POT, WHICH IS LOCATED UNDER THE FIFTH FLOOR ACCUMULATOR, IS CONNECTED TO THIS LINE BUT WAS NOT LOCKED OUT OR TAGGED. SEVERAL DAYS AFTER THE LINE WAS CUT ANOTH ER EMPLOYEE OPENED THE VALVE TO DUMP THE OIL AND AMMONIA IN THE POT TO THE REGEN ERATOR IN THE BASEMENT. THE OIL AND AMMONIA WAS BLOWN OUT OF THE OPEN PIPE AND F ORMED A VAPOR CLOUD. EMPLOYEES #1 THROUGH #13, WORKING IN THE BASEMENT THROUGH F OURTH FLOORS, WERE EXPOSED TO THE AMMONIA FUMES. THEY WERE HOSPITALIZED.
Victims (13)
-
#1 Hospitalized Age 33 F
- Nature of injury
- 4
- Part of body
- 28
- Event type
- 8
- Source
- 9
- Occupation code
- 999
- Human factor
- 13
- Environmental factor
- 7
- Hazardous substance
- 0170
- Task assigned
- 1
-
#10 Hospitalized Age 30 M
- Nature of injury
- 4
- Part of body
- 28
- Event type
- 8
- Source
- 9
- Occupation code
- 999
- Human factor
- 13
- Environmental factor
- 7
- Hazardous substance
- 0170
- Task assigned
- 1
-
#11 Hospitalized Age 36 M
- Nature of injury
- 4
- Part of body
- 28
- Event type
- 8
- Source
- 9
- Occupation code
- 999
- Human factor
- 13
- Environmental factor
- 7
- Hazardous substance
- 0170
- Task assigned
- 1
-
#12 Hospitalized Age 49 M
- Nature of injury
- 4
- Part of body
- 28
- Event type
- 8
- Source
- 9
- Occupation code
- 999
- Human factor
- 13
- Environmental factor
- 7
- Hazardous substance
- 0170
- Task assigned
- 1
-
#13 Hospitalized Age 30 M
- Nature of injury
- 4
- Part of body
- 28
- Event type
- 8
- Source
- 9
- Occupation code
- 999
- Human factor
- 13
- Environmental factor
- 7
- Hazardous substance
- 0170
- Task assigned
- 1
-
#2 Hospitalized Age 34 F
- Nature of injury
- 4
- Part of body
- 28
- Event type
- 8
- Source
- 9
- Occupation code
- 999
- Human factor
- 13
- Environmental factor
- 7
- Hazardous substance
- 0170
- Task assigned
- 1
-
#3 Hospitalized Age 34 M
- Nature of injury
- 4
- Part of body
- 28
- Event type
- 8
- Source
- 9
- Occupation code
- 999
- Human factor
- 13
- Environmental factor
- 7
- Hazardous substance
- 0170
- Task assigned
- 1
-
#4 Hospitalized Age 23 M
- Nature of injury
- 4
- Part of body
- 28
- Event type
- 8
- Source
- 9
- Occupation code
- 999
- Human factor
- 13
- Environmental factor
- 7
- Hazardous substance
- 0170
- Task assigned
- 1
-
#5 Hospitalized Age 23 M
- Nature of injury
- 4
- Part of body
- 28
- Event type
- 8
- Source
- 9
- Occupation code
- 999
- Human factor
- 13
- Environmental factor
- 7
- Hazardous substance
- 0170
- Task assigned
- 1
-
#6 Hospitalized Age 46 M
- Nature of injury
- 4
- Part of body
- 28
- Event type
- 8
- Source
- 9
- Occupation code
- 999
- Human factor
- 13
- Environmental factor
- 7
- Hazardous substance
- 0170
- Task assigned
- 1
-
#7 Hospitalized Age 19 M
- Nature of injury
- 4
- Part of body
- 28
- Event type
- 8
- Source
- 9
- Occupation code
- 999
- Human factor
- 13
- Environmental factor
- 7
- Hazardous substance
- 0170
- Task assigned
- 1
-
#8 Hospitalized Age 50 M
- Nature of injury
- 4
- Part of body
- 28
- Event type
- 8
- Source
- 9
- Occupation code
- 999
- Human factor
- 13
- Environmental factor
- 7
- Hazardous substance
- 0170
- Task assigned
- 1
-
#9 Hospitalized Age 48 M
- Nature of injury
- 4
- Part of body
- 28
- Event type
- 8
- Source
- 9
- Occupation code
- 999
- Human factor
- 13
- Environmental factor
- 7
- Hazardous substance
- 0170
- Task assigned
- 1
Codes shown verbatim from OSHA's accident-investigation database. A human-readable decoder is coming in a future release once the accident_lookup2 dictionary is loaded.