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Maintenance worker dies when he falls into a railroad tank car in Colorado.

Colorado Department of Public Health and Environment
Morgantown, WV: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, FACE 93CO068, 1993 Dec; :1-3
A 22-year-old maintenance worker at a railcar repair facility was fatally injured when he was overcome by diesel fumes and fell into the tank car he was inspecting. The employee was inspecting the tank car that had recently been sprayed with hot diesel fuel. When the employee knelt down and put his head into the access hatch, he was overcome by the diesel fumes in the railcar. He fell into the railcar and landed 10 feet 6 inches below the access hatch. A co-worker immediately radioed for help and then entered the tank car to assist the victim. The co-worker was overcome by the fumes and collapsed against the side of the car. A member of the company emergency response team arrived on scene and discovered that a ladder was not available to enter the tank. A ladder was obtained, but when the rescuer attempted to enter the car, there was not enough clearance to allow entry. A second ladder was brought to the scene and the rescuer entered the tank without a respirator. He immediately had trouble breathing and exited the tank. An escape respirator at the scene had a empty air bottle so another respirator mask was obtained. An airhose from a nearby air compressor was taped to the mask and the rescuer reentered the tank. When he stepped on the airhose, the hose separated from the mask. He then put the airhose under his shirt and attempted to continue with the rescue. This arrangement of the airhose was not functional, so he exited the tank again and obtained another air-supplied respirator. He reentered the tank and used the hose from the air compressor to give air to the two victims. He attached a strap around the coworker who was then pulled from the tank by other employees. The same procedure was used to pull the first victim from the tank. The rescuer was becoming dizzy by this time because there was a hole in the side of his respirator that allowed fumes to enter the mask. He managed to get to the ladder and climb up 2 steps. The other employees were able to reach the rescuer and pull him from the tank. All three employees were admitted to a local hospital where the victim expired approximately 30 hours later. Both the co-worker and the rescuer recovered. The Colorado Department of Health (CDH) investigator concluded that to prevent future similar occurrences, employers should: 1. Develop and implement a comprehensive written confined space safety program. 2. Provide lifelines and harnesses, and ensure that workers wear them when entering confined spaces. 3. Provide air testing equipment and train employees on the proper use and maintenance of the equipment. 4. Develop, implement, and enforce a written safety policy and safe work procedures designed to help workers recognize, understand and control hazards.
Region-8; Accident-analysis; Accident-prevention; Accidents; Injuries; Injury-prevention; Traumatic-injuries; Work-operations; Work-analysis; Work-areas; Work-performance; Work-practices; Safety-education; Safety-equipment; Safety-measures; Safety-monitoring; Protective-measures; Personal-protection; Personal-protective-equipment; Protective-equipment; Safety-programs; Confined-spaces; Maintenance-workers; Ladders; Breathing; Poison-gases; Fumes; Respiratory-protective-equipment; Respirators; Self-contained-breathing-apparatus
Publication Date
Document Type
Field Studies; Fatality Assessment and Control Evaluation
Funding Type
Cooperative Agreement
Fiscal Year
NTIS Accession No.
NTIS Price
Identifying No.
FACE-93CO068; Cooperative-Agreement-Number-U60-CCU-808518
SIC Code
Source Name
National Institute for Occupational Safety and Health
Performing Organization
Colorado Department of Public Health and Environment
Page last reviewed: September 2, 2020
Content source: National Institute for Occupational Safety and Health Education and Information Division