Control
Control of Work
Formal systems coordinating safe execution of work.
Documents
- 202615 May
Safety Bulletin - Lifting Operations Dangerous Occurrences and Injuries
NOPSEMA reviews recurring failures identified in offshore lifting incident investigations over the preceding five years. The bulletin highlights change management, role-specific competence, manufacturer guidance, drop-zone boundaries and control-of-work interfaces. It calls for rigorous application of systems to routine and non-routine lifts and consideration of control effectiveness and assurance.
- 20253 Jul
Near miss: worker suffers electric shock
A vessel crew member received an electric shock during oil clean-up on a crane pedestal after brushing an exposed, energised cable. The worker was unharmed. Failed assurance following yard work left disconnected cables live. Actions address electrical commissioning oversight, preferably assigning work to company electricians rather than third-party contractors.
- 202520 Feb
Crew transfer vessel (CTV) drifts onto turbine tower
After a successful personnel transfer, a crew transfer vessel drifted into a turbine structure at 0.5 knots while crew completed administrative tasks. No injuries occurred; paintwork damage was noted. The flash examines situational awareness, bridge instrumentation and inappropriate transfer authorisation, emphasising lookout and consideration of vessel position and conditions.
- 202414 Aug
LTI: fingers severed by spinning fan blade
A vessel worker lost three fingers while moving a portable blower during engine-room housekeeping after switching off its power. The fan remained in motion, its guard was inadequate and its handle obstructed. The flash highlights residual momentum, unseen moving parts and the importance of using designated handles and guards.
- 202419 Mar
Person struck and injured during lifting operations
During spar decommissioning, a partially attached fire water pump skid came free on a second lifting attempt and struck a nitrogen vessel previously cut 95% loose. The vessel struck a worker. The flash identifies unknown welds, inadequate work and change controls, and ignored crew concerns, emphasising preparation, listening and reassessment.
- 20236 Dec
UK MAIB: Electrician injured in explosion
An electrician suffered serious burns aboard a ship after a spanner bridged live switchboard conductors, causing a short-circuit and arc flash. The flash highlights unfamiliarity with the circuit-breaker assembly, disregarded instructions, unplanned work without a permit or lockout/tagout, and unsuitable tools and protective equipment.
- 202327 Feb
Poor control of work in dry dock
This safety flash describes several cases of inadequately controlled contractor work on a vessel hull during dry-dock maintenance, including mesh cutting and pad-eye welding. Crew misunderstood vessel management’s responsibilities for external work. Contractors were unattended, task risk assessments were too generic, and company procedures and local safety requirements were not followed.
- 20239 Feb
Dropped objects in dry dock
Two vessel dry-dock incidents involved a steering tube falling after chain-block slack caused shock loading, and a hydraulic cylinder pin cap sliding through an uncovered gap. The flash identifies shortcomings in task assessment, permit compliance and interfaces between work teams, emphasising detailed planning, clear responsibilities and coordinated control of work.
- 202214 Jul
Don’t ASSUME – verify and check
This safety flash examines three incidents involving an unverified slip-ring isolation, a scaffold plank falling when a roller box opened, and workers exposed to moving machinery. It identifies assumptions and incomplete work-control documentation, emphasising completion of authorisation processes, verification of safeguards and speaking up to stop unsafe work.
- 202228 Feb
MSF: LTI – Fall from Height (control of work during SIMOPS)
A crew member fell 3 m through removed gantry grating during vessel superstructure maintenance, in an incident classified as a lost-time injury. The flash identifies ineffective work-control systems, poor situational awareness and communication, and absent barriers or signage. Actions address simultaneous operations planning, pre-task risk assessment and toolbox talks.
- 20212 Dec
UK HSE: Employee in shipyard killed by falling steel post
An IMCA safety flash describes a fatal incident during adaptation of a vessel-launching bogie. A steel side-post weighing approximately 1800 kg fell and struck an employee. HSE found slackened securing bolts, absent support and deficiencies in risk assessment, safe working arrangements, training and supervision.
- 202131 Aug
UK HSE: Poorly maintained electrical installation caused fatality
An IMCA safety flash describes a fatal electrocution during planned air-compressor maintenance and the subsequent HSE prosecution. Findings included inadequate electrical-contact controls, absent testing and visual inspection since installation, and an unidentified incorrect isolating switch. The account highlights correct isolation points, training, supervision and safe systems of work.
- 20214 Mar
Bypassing safety controls – violation of working at height requirements
This flash describes hull painting in dry dock using a shipyard crane and personnel basket without supplied safety harnesses or valid equipment test certificates. Work was stopped and certified equipment provided. Preliminary findings identify unclear oversight and failures to follow agreed requirements; actions address pre-docking checks and shipyard–contractor bridging agreements.
- 202016 Dec
Unexpected truck movement caused rigger to fall off a ladder
A rigger bruised his leg after a container truck moved while he was removing its final chain hook from a ladder. The flash identifies missing driver briefing, incomplete risk assessment and non-use of the permitted work platform, and calls for clearer communication and formal work controls for third-party drivers.
- 202015 Sep
UK HSE: Two workers suffer multiple burn injuries
Two workers, including an apprentice, suffered life-changing burns during reassembly of high-pressure steam pipework following maintenance of a steam turbine driven pump. Steam was released uncontrollably at around 250°C. The investigation identified safe-system-of-work failures, including incomplete checks and verifications required by the steam isolation procedure.
- 20201 Jun
UK HSE: Workers injured by unplanned release of mud slurry
Three contractors suffered multiple fractures when approximately 39 cubic metres of diluted slurry escaped during recirculation pump removal for maintenance. A blocked drain had prevented discharge of pressurised contents before work began. The flash reports inadequate risk assessment and failure to implement a safe system of work.
- 202028 Apr
Fire in engine room and subsequent collision with structure on transport barge
A tug suffered an engine-room fire after fuel oil escaped during pressure testing and ignited on hot engines. A blackout preceded collision with a structure protruding from the transport barge. The flash examines failed emergency and fire systems, permit shortcomings and recommendations for controlling non-standard work and improving crew familiarisation.
- 201930 Sep
Near miss – Diving operations while alongside
A main engine started while a diver cleared bow-thruster debris in a dockyard; the bridge immediately shut it down and the diver escaped unhurt. The flash identifies failures in communication, permits, lockout/tagout and risk assessment, and recommends physical isolation and verified control-of-work arrangements before diving.
- 20191 Jul
Well drilled in the wrong place breaches railway tunnel
An exploratory well drilled during a Paris underground railway extension breached an existing tunnel, admitting groundwater and mud and closing the line for three days. No injuries were reported. The flash identifies missing client approval and surveyor validation, and recommends obtaining professional surveying advice for positioning operations.
- 201823 Aug
High potential near miss: working on pressurised pipeline
A foam pig narrowly missed personnel after residual pressure ejected it during removal of a flexible jumper’s pull head. The flash identifies a closed vent valve, absent pressure confirmation and weaknesses in procedural sign-off and handover. Lessons emphasise verified ambient pressure, isolation, venting and supervision of safety-critical steps.
- 201723 Aug
Uncontrolled movement of crane block and pennant during lifting operations at sea
During bunkering at sea, vessel roll caused a crane hoist block to strike a platform, setting its pennant and hook swinging into a workstation near deck crew. The flash examines rejected arrangements, limited communication and inadequate interdepartmental planning, and records stopping, reassessing and rerouting the hose before completion.
- 201715 Jun
Equipment failure leading to crane collapse
A vessel crane collapsed after a hydraulic line burst during a container-cabin lift in port. The container fell between the jetty and vessel and was badly damaged; nobody was injured. The flash highlights planned inspection and replacement of hydraulic lines and missing assurance of crane condition when used by another vessel’s crew.
- 201613 Sep
Dropped object fell from crane – Poor communication/lack of awareness/control of work
A vessel crane’s rotating ladder caught a CCTV camera temporarily secured after maintenance. The 5.8 kg camera fell approximately 3 m before its data cable arrested it. The flash examines missed shift-handover communication, inadequate pre-use inspection and failures in routine-duty approval, alongside permit-to-work and access-control lessons.
- 20164 Jul
Stored pressure release near-miss: Small part expelled from hydraulic winch
A hydraulic winch expelled a sensor and approximately two litres of oil during wire-rope installation. Findings identified reversed hydraulic hoses, improper commissioning, unauthorised testing and missed handover issues. Recommendations address crew communication, formal testing authorisation, risk assessment, pre-use checks and defining equipment condition before planned maintenance.
- 201630 Jun
Near-miss: Bilge cover left open
Crew found an unguarded open bilge cover in a vessel’s engine room after brine pump maintenance was interrupted. Similar earlier near misses had already been discussed across the fleet. The flash describes closing the covers and a safety stand down, and stresses risk assessment, control of openings and effective supervision.
- 20165 Feb
Finger injury during maintenance work – restricted work case
A seaman sustained a crushed fingertip while two workers manually replaced a 44 kg shackle on a rack, releasing it on an agreed count. The flash examines missing mechanical handling measures despite risk assessment and toolbox discussions, and stresses implementing controls, speaking up and stopping unplanned work.
- 20153 Dec
Crewman falls down open hatchway during simultaneous operations
A crewman sustained a minor ankle injury after stepping into an open engine hatch while sanding a crew transfer vessel in port. Concurrent engine-bay maintenance created an interacting hazard. The flash identifies poor situational awareness and recommends better work coordination, toolbox talks, agreed work plans and risk assessment where new or unknown risks are suspected.
- 201523 Nov
Vessel made contact with installation
During cargo operations alongside a well-head installation, a vessel drifted after its Master switched to manual control and left the controls unattended. Its stern roller struck an installation leg, damaging both assets. The flash highlights complacency, inadequate risk assessment, bridge staffing procedures and failure to exercise stop-work authority.
- 20143 Oct
MSF: Near-miss incident involving dry bulk pressure system
This safety flash describes a near miss during live testing of a pressurised dry bulk cargo system aboard a vessel. A stop-work intervention occurred without injury or damage. Inadequate work control was identified as the root cause, with poor communication between engine-room and bridge staff contributing.
- 20148 Sep
440V electrical shock incident
A technician received a 440V electric shock while investigating an ROV power distribution unit aboard a vessel, without harm or medical follow-up. The flash identifies unrecognised dual supplies, missing labelling and cover, inadequate familiarisation, and deficient work authorisation and risk assessment. Lessons address supervision, work control and equipment acceptance.
- 20148 Jul
Near-miss: Collapse of ROV launch and recovery system (LARS)
An ROV launch and recovery A-frame collapsed during demobilisation after securing bolts were removed from both supporting hydraulic rams and their feet struck with a sledge hammer. Two supervisors escaped injury. The flash highlights ignored procedures, inadequate work control and competence, and a missed opportunity to stop unsafe work.
- 201413 Mar
Fire and subsequent foundering of wind farm support workboat
This safety flash summarises a fire aboard ECC Topaz, a 14 m wind farm support catamaran. Rapid fire spread forced three crew members to abandon into a liferaft; one sustained a slight injury. The account highlights the complete absence of control-of-work arrangements, including permits, isolations, risk assessment and toolbox communication.
- 201318 Jun
Failure of lifting equipment: Dropped ROV
An offshore lifting incident involved a fibre sling failing and an ROV/TMS assembly dropping from 30 cm onto a vessel’s deck, damaging the ROV without injuries. Findings included unsuitable rigging, an unprotected sharp edge, absent supervision and no lift plan. Preventative actions address planning, supervision, certified equipment and sling protection.
- 201321 May
Crewman injured – no control of work
This safety flash summarises a Marine Safety Forum incident involving debris under pressure striking a person’s face and arm, requiring hospital treatment to remove embedded particles. It reports a complete absence of work controls, including permits, isolation, barriers, risk assessment and a toolbox talk.
- 201211 Dec
Lost time injury (LTI) caused by inadvertent activation of expired line throwing device
A crewman suffered a deep cut to his left leg when a rocket-assisted line-throwing device activated after being dropped during rope retrieval. The flash identifies missing inventory control, safety pin and markings, and recommends controlled pyrotechnic storage, trained users, intended use, disposal procedures and improved stock management.
- 201123 Sep
Preventing inrushes at underground mines
This safety alert reminds mine owners and managers about precautions against uncontrolled inrushes following the fatal Gleision event, whose investigation remained ongoing. It requires accurate underground plans, identification of potentially hazardous areas, compliance with prevention schemes and advance submission to HSE, alongside confirmation of arrangements within 30 days.
- 20032 Sep
Near-miss involving diver’s neck dam
A saturation diver discovered missing and loose neck-dam retaining screws during preparations to enter the bell. Inspection identified stripped threads and fitting contrary to company procedures. The flash describes maintenance authorisation and access controls, while clarifying that the fitting method was not necessarily incorrect under other companies’ or manufacturers’ procedures.
- 2002
A comprehensive guide to managing asbestos in premises
Guidance for premises dutyholders on identifying, assessing and managing asbestos-containing materials. It explains survey approaches, combined material and priority scoring, management plans and controls for maintenance and contractors. Organisational case studies and worked assessments illustrate prioritisation, while appendices discuss repair, enclosure, encapsulation, removal and checking completed work.
- Undated
Uncontrolled Man-Rider Descent During Drillship Hose Maintenance
BSEE investigates an uncontrolled man-rider descent during hose maintenance on the Noble Globetrotter 1 drillship. Altered control settings bypassed safety functions, while corrosion, inadequate maintenance and inspection deficiencies were identified. The worker underwent precautionary medical evacuation and was cleared for full duty. BSEE distinguished administrative deficiencies from equipment-failure factors.
- Undated
Lever Hoist Broke and Dropped Part During Crane Boom Raising
An investigation examines a crane incident on the Nansen Spar involving lever hoists connecting scaffolding to the crane boom. Raising the boom broke a hoist, dropping part approximately 30 feet. Findings address communication, simultaneous operations and inspection arrangements; operator corrective actions cover anchor-point approval and crane inspections.
- Undated
Inspection of Control of Work arrangements
Inspection guidance for assessing offshore control-of-work arrangements through observation of actual practice. It examines hazard assessment, permits, isolation and reinstatement, competence, work coordination and auditing. Case studies and inspection questions illustrate implementation weaknesses, while discussion of electronic systems stresses meaningful hazard identification and effective monitoring rather than reliance on documentation.
- Undated
Odfjell – Linus – investigation of incident with personal injury during work on drag chain
Investigation of a drag-chain collapse during repair on the Linus jack-up drilling facility. Falling chain parts crushed a worker’s head and left arm, which was subsequently amputated. The report examines deficient maintenance planning, risk assessment, procedural compliance and handovers, alongside crane-assisted rescue and communication difficulties.