Oregon OSHA's

Health and Safety Resource

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February 2017

Safety Notes

Accident Report

Incident: Fatality
Industry: A hardwood veneer and plywood manufacturer
Victim: A sander operator

What happened?

A forklift operator was moving a unit of melamine sheeting to a scissor lift when the load tipped and 30 sheets of melamine, weighing 100 pounds each, fell on a co-worker, who was standing nearby.

How it happened

Two workers, both sander operators, had been working on the No. 4 sander in the morning, finishing sheets of laminated material and they needed more. One of the workers got in a forklift and drove to the nearby laminate press where there were four units ready to be sanded.

The other worker walked over to the press as the forklift pulled up and watched from about 12 feet away.

The forklift operator had been running sanders for more than 12 years and driving forklifts for more than 40 years. He maneuvered the forklift into position to retrieve the top unit from a stack of three units. He wanted to put the top unit on a nearby scissor lift so that he could retrieve the lower unit in the stack (there were 40, four-foot by eight-foot sheets of melamine in each unit). He lifted the unit up about nine feet, just enough to clear the remaining two units.

He only had to back up and turn the forklift a short distance to set the load on the scissor lift. While he was lowering the load, the edge caught on the remaining two units, but he didn't know it. As he continued lowering the unit, the unsecured sheets began cascading off the forks towards his co-worker, who had no time to get out of the way.

graphic representation of accident Illustration: Patricia Young

The first two sheets pinned the worker to the floor as the remaining sheets tumbled onto his lower torso and legs. It all happened in a matter of seconds. Medical responders arrived after a 911 call and took him to a nearby hospital where he died as a result of his injuries.

Several years before this incident, there was a similar one in which melamine sheets tipped off the forks of a forklift. The company's employees knew that unsecured melamine sheets could slide easily.

Applicable standard

Rules for all workplaces, Employers' responsibilities 437-001-0760(1)(b)(C): The company did not take all reasonable means to require employees to use means and methods necessary to safely accomplish work where employees were exposed to a hazard.


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