Recent High Potential Incidents and Recommendations - Queensland Coal Mines Inspectorate

July 2022
Incident periodical
Recent High Potential Incidents**
Learnings and Recommendations
Communications and Safety Notices
Queensland Coal Mines Inspectorate
**Selection of the 127 HPIs
reported during the period
Coal Inspectorate
A rear dump truck was totally destroyed by fire
The truck 
was being escorted to a hot tyre bay
when a CMW noticed flames coming from Pos 4
wheel and called the emergency
The operator safety exited the truck
Investigations identified likely tyre damage (cuts &
tread separation) due to poor road conditions,
potentially exacerbated by wet weather
Prior to the incident two other trucks had been
stood down for suspected hot tyres
Travel s
peed and distance to a hot tyre bay were
not considered when relocating the truck
Internal tyre temp & pressure sensors did not
indicate the likelihood of an external tyre tread fire
 
1
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Recommendations
A CMW suffered serious crush injuries 
to their right leg
and hip when pinned between a Load Haul Dump (LHD)/
concrete kibble and a Jacon concrete pump
.
CMWs were 
c
onstructing a Longwall goaf seal. A load of
concrete had been delivered by the LHD/kibble and
pumping of the load had been completed.
The LHD/kibble backed out from pump and on re-entry
the LHD/kibble operator heard the injured person shout
out.
The injured CMW was found trapped between 
the
kibble and the Jacon concrete pump.
2
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Recommendations
Failure of a surface 
gas drainage plant resulted in methane exceeding 2.5%  being recorded in areas
of an underground coal mine.
At the time of the incident the longwall 
s
hearer was heading towards the 
tailgate
. 
The m
ethane level
at the 243A detector (TG 150m monitor) was rising when the goaf drainage plant tripped. When
methane levels reached 1.7% at the 
243A detector
 the shearer haulage tripped.
At about the same time the control 
r
oom 
o
perator contacted the 
longwall
 and informed them of the
situation with the goaf drainage plant and the increasing gas levels in the 
tailgate, instructing
 the
crew to cease production. 
Methane a
t the 
243A detector
 continued to rise, exceeding 2.5% 
and
peaking at 3.08%.
Once the 
methane
 
d
rainage plant was restarted with all streams back on line the gas readings in the
LW 
tailgate
 reduced to normal levels.
The investigation identified multiple engineering failures in the drainage plant, inexperienced
operators and inconsistencies in risk, commissioning and swp documentation.
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Recommendations
CMWs were using a cable tractor to position cable
The cable tractor moved a loop of cable and was repositioned to
move another cable loop.
The dragline operator assumed the tractor to be clear of the “no-
go” zone and started to swing the dragline at slow speed.
T
he  dragline contacted the cable tractor reeler
 and 
cab mirror
The cable tractor operator has then called on the 2 way twice to
stop the dragline, however the dragline operator could not hear
him clearly.
The cable tractor operator exited the tractor and waved at the
dragline operator to get his attention.
At this point the dragline operator has stopped the dragline from
swinging
.
4
.
 
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There have been 22 reported HPIs between 2017 and 2021
involving interactions between draglines and vehicles / machinery.
A further two incidents have been reported in June and July 2022
Recommendations
A bucket wheel reclaimer/stacker derailed whilst the machine was being
repositioned to begin stacking.
The stacker boom was slewed and lowered contacting the stockpile.
During this action, bogie wheels were partially derailed and the machine
power tripped.
The front bogie came off the rail and moved about 250 mm sideways
when machine power was reset and the stacker boom slewed back into
the park position.
The control room operator was undertaking other production tasks at
the time of the incident and did not stop the machine 
prior to the
derailment occurring.
Investigation identified PLC control system design defects.
5
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B
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Recommendations
Reporting sexual assault or harassment to RSHQ
RSHQ has a dedicated response team for complaints and
notifications of sexual assault or sexual harassment
To contact the team call 
1300 581 077 
or email
complaints@rshq.qld.gov.au
.
If you are in immediate danger or your health and wellbeing
has been threatened, contact the police (phone 000) and
seek medical advice.
Further information is available on 
RSHQ’s website
 by
scanning the QR code.
What RSHQ can help with
RSHQ’s role is to ensure operators have
effective controls and processes in place
to:
reduce the risk of sexual harassment
and assault in the workplace
receive and respond to complaints
and incidents.
RSHQ can also assist workers with
referral to support services.
What RSHQ 
can’t
 help with
legal advice
workers’ compensation
jurisdiction of other agencies (e.g.
incidents occurring off-site)
industrial relations
Letter from the CICM to OCEs on the Certificate of proficiency in Mine Gases
and Gas Testing
Letter from the CICM - Ventilation Officer Certificate of Competency
Requirements 
Letter from the CICM – Implementation of BoI Recommendations
C
o
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To subscribe to communications from the Queensland Mines Inspectorate please email
QldMinesInspectorate@rshq.qld.gov.au
Safety Alert 415
Bolt projectile from
final drive
Safety Alert 414
Hauling equipment
failure during conveyor
belt change out
Safety Alert 413
Underground grader
unplanned movement
Safety Bulletin 204
Spontaneous
combustion monitoring
and response systems
Fast facts for July 2022
127 HPI & serious accident
reports received
11 Non-reportable incidents
10 Cases of COPD not
attributable to mines
Petroleum & Gas
Safety Alert 108
Finger Crush Injury
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The July 2022 incident periodical by the Queensland Coal Mines Inspectorate highlights two significant incidents involving a tyre fire and a CMW crush injury. Recommendations include improving road conditions, enhancing emergency response procedures, and ensuring proper task planning and risk assessment to prevent such incidents in the future.

  • Incidents
  • Recommendations
  • Safety Notices
  • Queensland
  • Coal Mines

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  1. July 2022 Incident periodical Recent High Potential Incidents** Learnings and Recommendations Communications and Safety Notices Queensland Coal Mines Inspectorate **Selection of the 127 HPIs reported during the period Coal Inspectorate

  2. 1. Incident tyre fire A rear dump truck was totally destroyed by fire The truck was being escorted to a hot tyre bay when a CMW noticed flames coming from Pos 4 wheel and called the emergency The operator safety exited the truck Investigations identified likely tyre damage (cuts & tread separation) due to poor road conditions, potentially exacerbated by wet weather Prior to the incident two other trucks had been stood down for suspected hot tyres Travel speed and distance to a hot tyre bay were not considered when relocating the truck Internal tyre temp & pressure sensors did not indicate the likelihood of an external tyre tread fire

  3. Recommendations Make sure road standards and conditions meet or exceed the site standards Understand and communicate to CMWs current site procedures for dealing with hot tyres including emergency response procedures Review mine road design and operating standards. Including location of hot tyre bays. Confirm vehicle tyre selection is appropriate Review hot tyre response procedures including defect identification, use of thermal imaging, proximity to hot tyre areas and relocation requirements Review emergency response capability for dealing with hot tyres Site Senior Executive Understand and comply with site roadway operating standards Understand and follow site procedures for dealing with hot tyres , including emergency response requirements Coal Mine Workers Supervisors

  4. 2. Incident CMW crush injury A CMW suffered serious crush injuries to their right leg and hip when pinned between a Load Haul Dump (LHD)/ concrete kibble and a Jacon concrete pump. CMWs were constructing a Longwall goaf seal. A load of concrete had been delivered by the LHD/kibble and pumping of the load had been completed. The LHD/kibble backed out from pump and on re-entry the LHD/kibble operator heard the injured person shout out. The injured CMW was found trapped between the kibble and the Jacon concrete pump.

  5. Recommendations Ensure work tasks are properly planned, prepared and risk assessed prior to being undertaken. Make sure that tasks are properly resourced and competently supervised To have systems in place that ensure requirements for spotters and no-go zones are implemented and enforced. Consider higher order controls which eliminate people/machine interface such as collision avoidance or pumping concrete from the surface Site Senior Executive To ensure tasks are not allocated or proceed unless they have been properly planned, prepared and risk assessed. To make sure CMWs understand systems and procedures including site requirements for spotters and No-go "zones when working around machinery Enforce compliance with critical controls identified that would prevent injury Must follow site procedures and work instructions Carry out their activities and work in a way that does not expose themselves or someone else to an unacceptable level of risk Coal Mine Workers Supervisors

  6. 3. Incident Methane drainage plant Failure of a surface gas drainage plant resulted in methane exceeding 2.5% being recorded in areas of an underground coal mine. At the time of the incident the longwall shearer was heading towards the tailgate. The methane level at the 243A detector (TG 150m monitor) was rising when the goaf drainage plant tripped. When methane levels reached 1.7% at the 243A detector the shearer haulage tripped. At about the same time the control room operator contacted the longwall and informed them of the situation with the goaf drainage plant and the increasing gas levels in the tailgate, instructing the crew to cease production. Methane at the 243A detector continued to rise, exceeding 2.5% and peaking at 3.08%. Once the methane drainage plant was restarted with all streams back on line the gas readings in the LW tailgate reduced to normal levels. The investigation identified multiple engineering failures in the drainage plant, inexperienced operators and inconsistencies in risk, commissioning and swp documentation.

  7. Recommendations Initiate reviews of engineering designs and installations, including commissioning, operations and maintenance processes of safety critical plant aimed at identifying and eliminating operational reliability issues Review applicable TARPs, ensuring detailed response information is available to enable CMWs to respond to triggers Make sure sufficient trained and competent personnel available to operate and maintain plant required for safe operations Make sure up to date TARPs and supporting documentation for installations are available and accessible Make sure CMWs have been trained and competent in works they are undertaking CMWs should make sure they have received sufficient training before undertaking work Coal Mine Workers Site Senior Executive Supervisors

  8. 4. Incident Dragline contacting tractor CMWs were using a cable tractor to position cable The cable tractor moved a loop of cable and was repositioned to move another cable loop. The dragline operator assumed the tractor to be clear of the no- go zone and started to swing the dragline at slow speed. The dragline contacted the cable tractor reeler and cab mirror The cable tractor operator has then called on the 2 way twice to stop the dragline, however the dragline operator could not hear him clearly. The cable tractor operator exited the tractor and waved at the dragline operator to get his attention. At this point the dragline operator has stopped the dragline from swinging. There have been 22 reported HPIs between 2017 and 2021 involving interactions between draglines and vehicles / machinery. A further two incidents have been reported in June and July 2022

  9. Recommendations Implement higher level controls, over and above positive communications, that ensure inadvertent contact between draglines and machinery, and / or personnel does not occur. Ensure No Go Zones are defined and clearly delineated. Ensure compliance with procedures regarding personnel and equipment entering areas where they may be struck by operating equipment are adequate and effective. Site Senior Executive Should ensure compliance with procedures and processes. This includes conducting behavioural observations during dragline operations. Carry out their activities and work in a way that does not expose themselves or someone else to an unacceptable level of risk. Must follow site procedures and work instructions. If in doubt STOP outside of the No Go Zone Coal Mine Workers Supervisors

  10. 5. Incident Bucketwheel stacker/reclaimer derailment A bucket wheel reclaimer/stacker derailed whilst the machine was being repositioned to begin stacking. The stacker boom was slewed and lowered contacting the stockpile. During this action, bogie wheels were partially derailed and the machine power tripped. The front bogie came off the rail and moved about 250 mm sideways when machine power was reset and the stacker boom slewed back into the park position. The control room operator was undertaking other production tasks at the time of the incident and did not stop the machine prior to the derailment occurring. Investigation identified PLC control system design defects.

  11. Recommendations Don t multi-task when critical tasks are being undertaken Ensure plant and equipment is fit for purpose. Initiate safety reviews of automated or semi-automated control systems with the aim of identifying and controlling foreseeable errors. Consider collision avoidance detection, code error checking, ground force protection systems Communicate with CMWs the importance of monitoring remote operations Undertake periodic functional safety audits of PLC codes Site Senior Executive Coal mine workers Engineering

  12. Reporting sexual assault or harassment to RSHQ RSHQ has a dedicated response team for complaints and notifications of sexual assault or sexual harassment To contact the team call 1300 581 077 or email complaints@rshq.qld.gov.au. If you are in immediate danger or your health and wellbeing has been threatened, contact the police (phone 000) and seek medical advice. Further information is available on RSHQ s website by scanning the QR code.

  13. What RSHQ can help with What RSHQ can t help with RSHQ s role is to ensure operators have effective controls and processes in place to: reduce the risk of sexual harassment and assault in the workplace receive and respond to complaints and incidents. legal advice workers compensation jurisdiction of other agencies (e.g. incidents occurring off-site) industrial relations RSHQ can also assist workers with referral to support services.

  14. Communications from the Coal Mines Inspectorate Letter from the CICM to OCEs on the Certificate of proficiency in Mine Gases and Gas Testing Fast facts for July 2022 127 HPI & serious accident reports received 11 Non-reportable incidents 10 Cases of COPD not attributable to mines Letter from the CICM - Ventilation Officer Certificate of Competency Requirements Letter from the CICM Implementation of BoI Recommendations Safety Alert 414 Hauling equipment failure during conveyor belt change out Safety Alert 414 Hauling equipment failure during conveyor belt change out Safety Bulletin 204 Spontaneous combustion monitoring and response systems Safety Bulletin 204 Spontaneous combustion monitoring and response systems Safety Alert 415 Bolt projectile from final drive Petroleum Gas Safety Alert 108 Finger Crush Injury Safety Alert 413 Underground grader unplanned movement Petroleum & Gas Safety Alert 108 Finger Crush Injury Safety Alert 415 Bolt projectile from final drive Safety Alert 413 Underground grader unplanned movement To subscribe to communications from the Queensland Mines Inspectorate please email QldMinesInspectorate@rshq.qld.gov.au

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