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绒国
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27 BS EN 388 : 2003 BS EN

1082-1 : 1997 BS EN 13287 : 2007 1. 2,500 2. 310 www.

28 : 1997 BS EN : , i) ii) iii)

38 3. The D/P first removed the old fluorescent tube fitting from the wall. He then mounted the new fitting in the same position. Afterwards, he started to connect the electric wires (i.e. neutral, earth and live wires) to the new fitting. When doing so, he stood on the second and third rung of a wooden ladder (height 1.58m), which was placed between a metal rack and the wall. 4. At that time, all the lighting (i.e. the five sets of fluorescent tubes) inside the room were still switched on. To connect the electric wires, the D/P first connected the neutral and earth wires to their respective positions. He then used a cable cutter to cut and strip off the sleeve of the live wire. In the course of work, the D/P received an electric shock. He fell backwards and was rescued and sent to hospital for treatment. He passed away three days later. Findings and observations 1. The accident scene referred to a room located in the basement of a building. There were four sets of old fluorescent light fittings found outside the room. 2. Inside the basement room, three out of five fluorescent tube fittings were completely replaced by new fittings. The fourth set of fluorescent light fitting had been substantially replaced except the electric wire connection. 3. An ordinary wooden folding ladder was used for the work. A metal rack for storing equipment was placed at a distance of about 0.5m in front of the wall and opposite to the fourth fluorescent tube fitting. The size of the metal rack was 1.0m(L) X 0.5m(W) X 1.8(H). The metal rack was securely fixed on the ground and earthed. 4. All the five fluorescent light fittings (including the fitting in question) were connected in series and controlled by a switch mounted on the wall near the entrance of the room. The switch controlling all the fluorescent tube fittings was found in the ON position. 5. The power supply to the lighting was obtained from a singlephase 10A Miniature Circuit Breaker (MCB) at the low voltage distribution board which was located in the meter room on 1/F of the same building. 6. The electric wire connection of the fourth fluorescent light fitting was found at the final stage of installation as both the neutral and earth wires had been connected to the appropriate position of a transformer inside the fitting while the live wire was not. The work remaining to be done was the connection of the live wire to a connector which would in turn be connected to the transformer of the fitting. 7. The live wire in question consisted of two single-core PVC insulated cables with conductors at the end twisted together. Near the twisted ends, a dent was found on the cable. 8. There lacked a safe system of work for the replacement and installation of fluorescent tube fittings. Risk assessments was not conducted beforehand. The D/P s supervisor only told the D/P the location of work but not the information on the circuitry. The fluorescent tubes inside the basement room were switched on while the D/P was carrying out the replacement and installation work. The cable cutter used by the D/P was an ordinary type and was not suitable for working with live wires. 9. Neither an electrical insulation glove nor an electrical insulation mat/sheet were found at the accident scene.

41 2) 313X 5(1) 3) 313X 5(2) 1 4) 313X 9(1) (a) (b) (c) ) 313X 9(3) (1) The Incident Container vessels are designed not only to carry containers in their cargo holds, but also stacks of multi-tier containers on top of the cargo hatches. Containers loaded into cargo holds are stowed in fixed slots without manual intervention, but containers stowed on top of cargo hold hatch covers require securing by stevedore workers using lashing tools, this is known as a lashing operation. A stevedore engaged in lashing on board an ocean-going container vessel berthed at the Kwai Chung Container Terminal fell to his death from a height of 20 meters down to the bottom of a cargo hold. Prior to the incident, the deceased was working on the deck around the No. 6 cargo hold collecting lashing tools to prepare for the container lashing operation after containers were loaded on top of the No. 6 cargo hold hatch cover. When a quay crane operator was loading a container into the No. 6 cargo hold, he found the deceased lying on its bottom where he was later declared dead. A foreman rushing to the scene sustained an electric shock on the walkway between the No. 5 and No. 6 cargo holds. Circumstances One night in 2008, an oceangoing container vessel was berthed at Kwai Chung Container Terminal for the loading and unloading of containers. As soon as the vessel was secured, stevedores went on board to work and a group of four stevedores were assigned to carry out lashing at the No. 6 cargo hold. They first worked on the deck around the No. 6 cargo hold, collecting tools for lashing containers, including lashing rods and turnbuckles. Meanwhile, the hatch cover of the No. 6 cargo hold was removed and placed ashore so that containers could be loaded into it. The stevedores placed the collected lashing tools on the walkway between the No. 5 and No. 6 cargo hold so that they could be used in the lashing at the top of the hatch of the No. 6 cargo hold. 20 minutes after starting work, a quay crane carried a container to the No. 6 cargo hold, but as the crane operator prepared to load the container into the cargo hold he found a worker wearing reflective vest lying on the bottom. The crane operator immediately reported to the terminal office. A foreman who over-heard the accident hurried on board and rushed to the walkway between the No. 5 and No. 6 cargo holds. The foreman identified the man laying on the bottom of the cargo hold as one of the four workers assigned to carry out container lashing at the No. 6 cargo hold and he immediately informed terminal management to summon help. As the foreman was leaving the walkway he

42 suddenly felt a pain on his neck, his feet lost strength and his body fell on the walkway. People arriving later found the fallen foreman still conscious and he was able to point out that there were exposed live wires hanging above his head and that he had suffered an electric shock. The worker lying on the bottom of the cargo hold was confirmed dead by the rescue team arriving on the scene. Findings and observations While no one witnessed the incident, after investigation it was found that the following hazards might be contributory causes of the accident: 1) On the walkway where the deceased had been working part of the fencing had been removed. 2) No lighting was provided at the walkway. 3) There were lashing tools such as lashing bars lying on the walkway floor, which created trip and fall hazards. 4) Disconnected live electric cables were left exposed in the walkway creating a serious hazard. Recommendations The person in charge of works should carry out risk assessments on the workplace and the access to workplace prior to the commencement of a cargo operation on board vessels. The operation should not be started unless all the identified potential hazards have been corrected or appropriate protective measures are in place and, in particular, it should be ensured that: i) If there is a risk of falling from height, adequate fencing is provided at the workplace and at the access to the workplace. ii) Sufficient lighting must be provided in the workplace and at the access to the workplace. iii) Objects should not be placed haphazardly on the access to the workplace to avoid tripping hazards. iv) Electric cables must be well protected and live electric cables must not be exposed. Applicable legislation 1) Shipping and Port Control Ordinance (CAP 313), section 44(1) A person in charge of works shall not carry out, or cause to be carried out, any works in a condition or manner that does not provide adequately against unnecessary risk of accident or bodily injury. 2) Shipping and Port Control (Works) Regulation (CAP 313X), section 5(1) There shall be provided safe means of access to a workplace. 3) Shipping and Port Control (Works) Regulation (CAP 313X), section 5(2) All breaks, dangerous corners and other dangerous parts of a workplace shall, in so far as reasonably practicable having regard to the works concerned, be securely fenced, and the fence shall be maintained in good condition ready for use and in no place be less than 1 m in height. 4) Shipping and Port Control (Works) Regulation (CAP 313X), section 9(1) Where works are being carried out on a vessel: (a) every workplace of the vessel; (b) every other part of the vessel to which a person employed may be required to proceed in the course of his employment; and (c) every means of access provided under sections 4, 5, 6 and 7, shall be efficiently lighted, having regard to the safety of the vessel and cargo concerned, the person employed and the navigation of any other vessel. 5) Shipping and Port Control (Works) Regulation (CAP 313X), section 9(3) Where the employer is not the person in charge of works, if there is a contravention of subsection (1), the employer shall take the measures required by that subsection as soon as reasonably practicable after the contravention occurs.

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