202309 - A fall too far

The deck crew of a bulk carrier were undertaking hold cleaning while at sea in ballast. Based on the completed risk assessment, the PPE required for the job included a safety harness with lifeline.

As edited from Marshall islands report published 16 February 2022

The Australian ladders (Editor’s note: ladders with intermediate platforms) were to be used to enter and exit the holds and the vertical ladders were to be used only as an emergency exit.

Holds 1 to 5 were cleaned without incident. The atmosphere in the holds was tested before entry, as required by the enclosed space procedures, and the Australian ladders were used for entry and exit. The Bosun and two crew then moved on to cleaning hold 6, before breaking for lunch. After lunch, the two crew returned to hold 6 and started their descent into the hold via the Australian ladders. Before they arrived at the bottom of the hold they saw the Bosun lying motionless on the tank top of the hold at the bottom of the vertical ladder forward.

The alarm was raised, and first aid was delivered, but the victim had no pulse and was not breathing. CPR was administered for some time, but with no response, and was eventually declared deceased. The victim’s body was removed from hold 6 and, when examined, both legs appeared broken just above the ankles. Bones could be observed sticking through the skin near the heels of both feet. No other bleeding or external injuries were noted. These injuries point to a fall from a substantial height; the hold was about 16 metres deep.

It could not be determined why the victim, a very experienced seafarer, chose to descend the vertical ladder instead of the Australian ladder. This went against recent practice and the agreed method to enter and exit the hold. The investigation found that although the victim was wearing a safety harness, it was of the single strap/clip variety, not a double strap/clip. There were no indications that the safety harness, lifeline, or clip had failed.

Lessons learned

• The only way to reduce the risk of falling from a vertical ladder is to use either a double strap/clip arrangement such that one clip is always attached to a secure point or, if a single strap/clip, to use it in combination with a vertical continuous safety line/rail and fall arrestor, as in the photo left.
• If such equipment is not on board, Australian ladders should always be used to enter and exit a hold.
• Never climb or descend a vertical ladder without continuous fall protection. Your life depends on it.