Nov 132010

Checklists make good condoms

Checklists are like condoms: Used properly they’ll protect you against deadly hazards, if not used properly they give a false sense of security. That is, perhaps, the key lesson to be learned from the death of a chief mate aboard the New Golden Shipping-owned chemical tanker Bow De Jin in Hong Kong on 22 November 2009..

The incident also re-enforces the basic brutal truth that confined spaces kill regardless of experience, rank or age. In this case the victim was 41, had been a seafarer since 1993. He had sailed as a ship’s officer since November 1995 and first sailed as chief mate in September 2003. He joined Bow De Jin in Singapore on 26 May 2009.

Says the just-released report from the Australian Transport Safety Bureau: “22 November 2009: “The ATSB investigation was unable to determine why the chief mate, who had sailed on tankers for most of his seagoing career, did not follow industry standard and specific company safety procedures before he entered the cargo tank.“The investigation found that while enclosed space entry checklists were being filled out by the crew members on board the ship, the checklist system was not being used as a proactive means to ensure that the necessary safety requirements were being met prior to tank entries”.

Nobody knew he had entered the tank. No confined space entry checklist was completed and, self-evidentally, no test of the atmosphere in the tank was carried out.

He climbed down into a tank that was oxygen-deficient, it contained 16% oxygen in the bottom section and 12% in the middle section, and which contained toxic vapours from the previous cargo, Hexene-1.  n atmosphere of less than 21 per cent oxygen is deadly amd, additionally, Hexene-1 which is narcotic in high concentrations and can act as an asphyxiant. The vapours affect the human central nervous system; irritate the eyes, the skin and the respiratory tract.

The checklist system was not being used as a safety measure so the chief mate was doomed from the moment he stepped inside the tank.

To put the issued in context, ten to 15 times as many seafarers die in confined/enclosed spaces every year than are killed by all the pirates in the world in the same period.

And while individual seafarers can do little about piracy they can certainly do a lot to avoid to avoid dying in confined spaces.

Read the ATSB report here

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