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<td><a href="https://misportal.jlab.org/ll/index.jsf?function=view&lessonId=912">Plastic Suit and Rubber Glove Liner Punctured during Unscoped Work - Savannah River Remediation (SRR) </a></td>
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<h2 style="white-space:nowrap">Statement of Lessons Learned</h2>
<pre>For a copy of the original report, see ¿Attachments¿ on Lessons Learned page.
When new tasks are introduced to work assignments, suspend work, analyze the associated hazards, and initiate appropriate mitigation before recommencing activities.
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<h2 style="white-space:nowrap">Discussion of Activities</h2>
<pre>On July 28, 2015, because of an elbow joint in the HDB-6 Jumper, a camera inspection was found to be required. Fish tape was attached to the camera¿s cable to make it more rigid and enabled it to be pushed forward. After the inspection, while retrieving the camera, the fish tape¿s hook snagged on a seam of the cameraman¿s plastic suit, between the thumb and index finger, resulting in a puncture to both the suit and inner rubber glove. There were no injuries, nor spread of contamination to the worker.
The work package¿s Activity Hazard Analysis (AHA) required the use of HyFlex 11-511 gloves during work involving welding rods and other (not specified) equipment that could cause a cut or puncture. The cameraman had read the AHA but did not use the HyFlex 11-511 gloves because he did not perceive the potential for cut or puncture when using the fish tape.
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<h2 style="white-space:nowrap">Analysis</h2>
<pre>While the work control documents recognized the need for protective gloves for puncture hazards, workers failed to analyze the newly identified camera inspection activities for potential hazards. The inspection was not part of the original scope of work and was not specifically mentioned as an activity nor evaluated for hazards. When the requirement was discovered associated activities should have been evaluated and proper tools and controls initiated. Had the cameraman perceived the potential for puncture when using a fish tape, he probably would have worn the HyFlex 11-511 gloves as the AHA directed.</pre>
<h2 style="white-space:nowrap">Recommended Actions</h2>
<pre>Below are the consequences of the above event. They are provided for information and discussion purposes only.
Program Coordinators are to share this information with workers within their organizations, including: Managers, Work Control Personnel, Maintenance Personnel, Others as applicable.
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<h2 style="white-space:nowrap">JLab Preventive Measures</h2>
<pre>In accordance with Jefferson Lab¿s Work Planning Control and Authorization Process (outlined within ES&H Manual Chapter 3210) all tasks are to be evaluated for hazards prior to performance. A determination of risk is then assigned which dictates relevant mitigation. All individuals have the responsibility, and authority, to suspend work when conditions appear to pose a hazard (this would include newly identified task). ¿ES&H Manual Chapter 3330 Stop Work and Re-Start for Safety Program¿ outlines the process used to effectually suspend work, review the new conditions, appropriately mitigate any hazards, and recommence work activities.</pre>
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<h2>Comments</h2>
<h5 style="white-space:nowrap">10/12/2015 10:37:47 AM by Bailey, Mary Jo</h5>
<pre>Submitted to those with the following training:
SAF117: EH&S MANAGEMENT TRAINING
GEN020: SOTR QUALIFICATION</pre>
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<legend>Summary</legend>
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<td class="label" nowrap>Lesson ID:</td>
<td class="dataval">912</td>
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<td class="label" nowrap>Status:</td>
<td class="dataval">OK</td>
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<td class="label" nowrap>Doc ID:</td>
<td class="dataval">2015-JLAB-912</td>
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<td class="label" nowrap>Priority:</td>
<td class="dataval">Info</td>
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<td class="label" nowrap>Safety Related:</td>
<td class="dataval">YES</td>
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<td class="label" nowrap>Originator:</td>
<td class="dataval">Bailey, Mary Jo</td>
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<td class="label" nowrap>Issued:</td>
<td class="dataval">10/12/2015 10:32:52 AM</td>
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<td class="label" nowrap>Approved By:</td>
<td class="dataval">Bailey, Mary Jo</td>
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<td class="label" nowrap>Approved On:</td>
<td class="dataval">10/12/2015 10:37:47 AM</td>
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<td class="label">Source:</td>
<td class="dataval">
DOECRD
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<td class="label" nowrap>Location:</td>
<td class="dataval">OTHER</td>
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<td class="label" nowrap>Cost Savings:</td>
<td class="dataval"></td>
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<td class="label" nowrap>Contact:</td>
<td class="dataval">Phillip Brandt Savannah River Remediation (SRR) (803) 208-1283</td>
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<td class="label" nowrap>Queued Emails:</td>
<td class="dataval">0</td>
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<td class="label" nowrap>Sent Emails:</td>
<td class="dataval">0</td>
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<td class="label" nowrap>Viewings:</td>
<td class="dataval">1 times</td>
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<legend>Attachments</legend>
<a name="attachments"></a>
<ul class="lesson_attribute_listing">
<li><a target="_blank" href="https://misportal.jlab.org/ll/downloadAttachment?attachmentId=4102">DOE - Puncture Glove.pdf</a></li>
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<legend>Hazard Issues</legend>
<ul class="lesson_attribute_listing">
<li>Portable Hand Tools</li>
<li>Sharp Edges</li>
<li>Other: Work Planning and Communication,</li>
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<legend>Skills</legend>
<ul class="lesson_attribute_listing">
<li>SAF117: EH&S MANAGEMENT TRAINING</li>
<li>GEN020: SOTR QUALIFICATION </li>
</ul>
</fieldset>
<fieldset>
<legend>Distribution/Notification</legend>
<ul class="lesson_attribute_listing">
<li>*Division Safety Officers (DSOs)</li>
<li>*Safety Wardens</li>
<li>*DOE Notification</li>
<li>*ESH&Q Liaisons</li>
</ul>
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Do you have a lesson learned you would like to contribute? Contact the <a href="mailto:sjsmith@jlab.org,mbailey@jlab.org,cjohnson@jlab.org">Lesson Learned Coordinator</a>.