OSHA Accident Investigation · Summary #606871
BURN,STEEL,WORK RULES,STRUCK BY,FLYING OBJECT,MILL--PLANT,HIGH TEMPERATURE
Event description
One employee killed, one burned by cobble (hot steel)
Investigation abstract
At 2:50 a.m. on August 10, 1988, Employees #1 and #2 and coworkers at a steel mi er) put on the new entry guide box. He aligned the new entry guide box on the fo urth pass from the west side, which looked rusty and used. The third and fourth passes were both capable of running the 1.375-in. plain round bars that were bei ng produced. The mill was restarted. Employee #1 was standing near the new deliv ery guide box on stand #15 so that he could chalk the top side of the bar. Emplo yee #2 was observing stand #13, which was 9 feet away from stand #15. The bar en tered the guide box on stand #15, which was set up on the fourth pass from the w est. When the bar exited, it struck the east side of the delivery guide box, whi ch was set up on the third pass from the west. The bar cobbled. Employee #1 was struck by the bar and trapped by the twisted metal. He was burned over 75 percen ll were going to change out the entry guide box on stand #15, the last stand in t of his body and died 16 hours later. Employee #2 sustained burns on his legs. There was no procedure for checking the proper alignment of the entry and delive ry guide boxes. The special instructions for dealing with cobbles, which occurre d at least once per shift per day, averaging three cobbles per shift, were to ru n if a cobble occurs. Employees had been injured by them before. the mill. The 13-in. mill took 3-in. by 4-in. or 4-in. by 5-in. steel billets he ated to approximately 2200 degrees F and ran the billets through up to 15 stands . Each stand consisted of two horizontal or vertical rollers with seven to eight passes on the rollers that determined the shape (flat or round) and the size of the finished product. At each stand there was an entry guide box and a delivery guide box, which guided the billet in and out of the correct pass. Employee #1, a mill builder, took off the old entry guide box. A coworker (the #1 mill build
Victims (2)
-
#1 Fatality Age 44 M
- Nature of injury
- 5
- Part of body
- 19
- Event type
- 1
- Source
- 23
- Occupation code
- 999
- Human factor
- 1
- Environmental factor
- 13
- Task assigned
- 1
-
#2 Non-hospitalized injury Age 41 M
- Nature of injury
- 5
- Part of body
- 16
- Event type
- 1
- Source
- 23
- Occupation code
- 999
- Human factor
- 1
- Environmental factor
- 13
- 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.