ftl2013c02On Wednesday, February 6, 2013, at approximately 4:00 p.m., a 34-year-old company engineer was killed at a coal preparation facility when he was struck by one of the hydraulic cylinders on a plate-type filter press. A hydraulic cylinder catastrophically failed while the press was in operation. The victim was positioned near the hydraulic cylinders, troubleshooting the operation of the filter press, when the accident occurred. The filter press de-watered the fine coal refuse material generated during the coal cleaning process.

Best Practices

  • When troubleshooting or testing pressurized systems, position yourself in a safe location, away from any potential sources of failure.
  • When possible, block access to areas where pressurized cylinders, tanks, or other vessels are located while the equipment is in operation and under pressure.
  • Train miners in the proper maintenance of and the dangers associated with working around pressurized cylinders, tanks, and other vessels that have the potential to explode or rupture.
  • Ensure the ratings of hydraulic components are compatible with their intended use.
  • Use the proper tools and equipment for the job.
  • Inspect, examine and evaluate all materials that are being used in the installation, replacement, or repair of pressurized systems to ensure they are suitable and meet minimum manufacturer’s specifications.
  • Examine and inspect hydraulic components for defects periodically.

Click here for: MSHA Preliminary Report (pdf), MSHA Investigation Report (pdf).


On January 18, 2012, a 44-year-old utility/diesel tram operator with 1 year and 8 months mining experience, died from injuries he received on January 11, 2012. The miner was repairing a damaged water outlet (fire valve manifold) when a 1.5 inch bronze ball valve (quarter turn valve) catastrophically failed, propelling the steel manifold into the miner’s face/head. This fire valve manifold was originally damaged when an oversized load being transported on the adjacent mine track haulage system contacted the outlet causing it to separate from the 6″ mine water supply. The failure resulted from the internal threaded body of the valve separating from the external threaded portion of the valve.

Best Practices

  • When performing work on pressurized water supply piping systems, STOP ALL water flow into the pipe being worked on; BLEED ALL residual pressure from the pipeline, and when possible, OPEN A VALVE at an alternate location to ensure constant pressure relief. LOCK OUT and TAG OUT these valves to ensure safety while repairs are made.
  • NEVER REUSE components in a pressurized line that may have been damaged or compromised.
  • Ensure that components, such as valves, couplings etc. used in a pressurized water system are compatible with the highest measured or expected STATIC pressure in the system.
  • Implement a Standard Operating Procedure for the design, installation, testing, and maintenance of pressurized fluid systems that is consistent with National Fire Protection Association (NFPA) standards.
  • Install slow closing indicating valves. When opening a valve to put water flow into a pressurized system, do it slowly and minimize your exposure to pressurized components. See slow closing indicating valves on MSHA’s Belt Fire Suppression Simulator at the National Mine Health and Safety Academy. http://www.msha.gov/alerts/SafetyFlyers/ScoreaTDMineFire2009.pdf
  • Inspect, examine, and evaluate all materials that are being used during installation, replacement, or repair of pressurized water systems to ensure suitability.
  • Properly train all miners on the hazards associated with working on or around pressurized fluid piping systems.
  • Maintain safe and adequate clearance to prevent mobile equipment and machinery from contacting pressurized lines, valves, etc.
  • Install barriers to prevent equipment from damaging piping and valves.
  • Ensure adequate supervision is in place when moving oversized equipment in haulage entries.
Click here for: MSHA Preliminary Report (pdf), MSHA Investigation Report (pdf).

On May 14, 2010, a 35 year-old mechanic/welder with 4 years of experience was fatally injured at a cement operation. The victim was using an oxy- acetylene torch to cut a damaged drill steel to salvage the drill bit. The drill steel exploded causing metal fragments to strike the victim.

Best Practices

  • Always examine materials before applying heat, cutting or welding.
  • Never apply heat to materials without ensuring that flammables/combustibles/explosive materials are not present.
  • Always examine materials with hollow spaces or cavities to ensure gases can vent before applying heat.
  • Never apply heat to materials where pressure build up is possible.

Click here for: MSHA Investigation Report(pdf), Overview(powerpoint), Overview(pdf), Spanish Fatalgram (pdf)