Jury looking at death of Glencore worker makes 15 safety recommendations

(ASTA Concept/Adobe Stock)

An inquest into the death of a worker at Glencore Canada in 2015 has led to 15 recommendations directed at government, the employer and Caterpillar of Canada.

Richard Pigeau, 54, was killed when a load haul dump (LHD) he was driving ran him over at the Nickel Rim South Mine in Skead, Ont., on Oct. 20, 2015.  The cause of death was listed as “crush-type blunt force injuries to torso.” According to published reports, Pigeau was ejected from the LHD after it struck a wall.

In 2017, the company pled guilty and was fined $200,000. Now, a jury from the coroner’s inquest has made recommendations in the wake of the inquest which was held in Sudbury from Aug. 29 to Sept. 2.

The jury’s recommendations

Costs for family members: It asked the Ministry of the Attorney General to examine the feasibility of using funds paid into the Ontario Victims’ Justice Fund to defray costs incurred by a deceased’s family members to attend and meaningfully participate in the inquest process.

Creation of a new office to support family: It recommended that the Ministry of Labour, Immigration, Training and Skills Development (MLITSD) and the Ministry of the Solicitor General (MSG) create an office, or a program expansion of an office, to provide family members of a workplace death assistance in navigating the inquest process and assisting in accessing grief and counselling services.

To Caterpillar of Canada (CAT): The jury directed three recommendations to Caterpillar:

• It is recommended that CAT take steps to assess the hazard of loss of control on underground LHDs when the door opens on a STIC steer equipped machine during operation. Specifically, to address a transmission shift to neutral and steer lockout.
• It is recommended that CAT explore relocation of the door latching mechanism in order to make it more visible to the operator of LHD equipment, such as flipping the hinges and the latch to opposite sides.
• It is recommended that CAT assess the risks and feasibility of allowing the orientation of the operator’s seat to swivel in order to allow operator to have more maneuverability to view the striker.

To the employer – Glencore: The jury had one recommendation to the employer in this case. It asked for training related to the management of change process take place on a regular basis (annual as a minimum) to ensure all employees are continually informed as to what requires the initiation of the management of change process.

MLITSD recommendations: It directed the following recommendations at the MLITSD:

• It is recommended that the MLITSD expedite the amendment to the Occupational Health and Safety Act, R.S.O. 1990, c. O.1, Regulation 854 (Mines and Mining Plants) proposed by the Mining Legislative Review Committee related to management of change processes.
• It is recommended that the MLITSD examine the feasibility of amending the Occupational Health and Safety Act, R.S.O. 1990, c. O.1, Regulation 854 (Mines and Mining Plants) to mandate the use of seatbelts in mobile mining equipment in underground mines.
• It is recommended that the MLITSD take steps to coordinate a risk assessment of the possible risks associated with door ajar interlock systems and subsequent loss of control on underground mining load haul dump machines in use today
• It is recommended that the MLITSD take steps to amend the Occupational Health and Safety Act, R.S.O. 1990, c. O.1, Regulation 854 (Mines and Mining Plants) to mandate that all new underground mining load haul dump machines be equipped with door ajar and unbuckled seatbelt alarm systems.
• It is recommended that the MLITSD take steps to amend the Occupational Health and Safety Act, R.S.O. 1990, c. O.1, Regulation 854 (Mines and Mining Plants) to mandate that all underground mining load haul dump machine currently in use be retrofitted with door ajar and unbuckled seatbelt alarm systems.
• It is recommended that MLITSD take steps to amend the Occupational Health and Safety Act, R.S.O. 1990, c. O.1, Regulation 854 (Mines and Mining Plants) to mandate that all mobile mining equipment be used in accordance with any operating manuals issued by equipment manufacturers as found in O. Reg. 213/91 at 5.93(3) unless any deviation from the operating manual has first been appropriately risk assessed.
• It is recommended that the MLITSD and equipment manufacturers take the steps to coordinate a risk assessment of the possible risks associated with machine steering controls mounted on doors in underground mining load haul dump machines in use today.
• It is recommended that the MLITSD and equipment manufacturers, assess the feasibility of integrating a sensor into the operator’s seat that would be part of the operator presence system.

Chief prevention officer: It recommended that the MLITSD’s chief prevention officer takes steps to examine the feasibility of creating a reporting/and or notification system to promote the rapid sharing of information between mine operators and equipment manufacturers related to mobile equipment high-potential risk incidents, such that information could be shared expeditiously to proactively prevent the occurrence of similar events at other mines.