Equipment
Rotating Machinery
Machines with rotating shafts, impellers or other moving rotary parts.
Newest 100 Documents
All 265 in search- 20261 Jul
Mechanical Failure of LACT Pump Caused Fire
An offshore production facility fire followed LACT charge-pump misalignment after motor replacement. Excessive vibration loosened casing fasteners, allowing oil leakage; coupling failure caused further damage. The alert identifies omitted angular alignment and incorrect bolt torques, and recommends manufacturer-compliant installation, personnel training, review of post-installation surveillance and investigation of abnormal operation.
- 202614 May
Machinery damaged through improper maintenance technique
An offshore vessel audit identified a fuel oil purifier that failed to self-discharge. Investigation found incompatible component swaps and bowl damage from improper dismantling without specified tools. The flash highlights adherence to manufacturer instructions, compatible genuine parts, planned maintenance intervals, repair records and stop-work authority.
- 20266 May
Catastrophic engine failure and subsequent fire on board the site investigation vessel Kommandor Susan
Investigates a diesel generator failure and engine-room fire aboard Kommandor Susan during sea trials in the Firth of Forth. The report links premature bearing wear to substitute components and inappropriate extended service intervals, examines contractor oversight, and describes successful firefighting alongside emergency anchoring difficulties caused by dependence on electrical power.
- 202611 Mar
Loss of propulsion in heavy weather experienced by the passenger vessel Spirit of Discovery, leading to over 100 injuries and one fatality
Investigation of Spirit of Discovery’s repeated propulsion losses in heavy weather in the Bay of Biscay. It examines pod overspeed protection, automatic pod parking, weather routing, furniture securing and medical response. Violent vessel motion injured 115 passengers; one passenger sustained a spinal injury and died four days later.
- 202613 Feb
Fall from height during mooring due to rope tension reaction
A tanker’s propeller caught a mooring rope, loading a jetty dolphin platform until the line parted. The platform recoiled and a kneeling worker fell onto a lower platform about 1.8 metres below, sustaining minor scratches. The flash examines barrier design, body positioning, communication and keeping clear of tensioned lines.
- 202613 Feb
Small engine room fire – flammable object ignited
A small flammable foreign object ignited during post-drydock engine load testing. The crew stopped the engine, isolated fuel and extinguished the fire; nobody was injured. The flash identifies poor housekeeping and absent post-maintenance checks, emphasising machinery-space cleanliness, checks before load testing and regular emergency drills.
- 20257 Nov
Hull crack arising from vibration
An aluminium vessel continued operating despite propeller vibration, later developing a skeg crack and water ingress into the steering room. Crew fitted a cement box, and management required repairs. The flash highlights aluminium’s susceptibility to repetitive stress and urges investigation of changed or increased vibration.
- 202516 Oct
Fatal injury to a recreational diver following contact with the motor vessel Karin operating as a recreational dive support vessel
Investigates a recreational diver’s fatal propeller strike during a drift decompression stop in Scapa Flow. Examines Karin’s obstructed forward visibility, ineffective lookout, marker-buoy attachment, vessel coordination and absent documented safety arrangements. Recommendations address harbour oversight, while the annexed bulletin discusses safe vessel separation and hand-held marker-buoy lines.
- 202518 Sep
Auxiliary engine room fire on board the ro-ro cargo ship Finnmaster
Investigation of Finnmaster’s auxiliary engine room fire during departure from Hull. Partial fuel injection pump coupling failure and leaking hot exhaust preceded fuel hose failure and ignition. The report examines defective emergency power, incomplete carbon dioxide suppression, maintenance and supplier assurance, system testing and crew response. No injuries were reported.
- 20253 Jul
LTI: Hand injury during capstan maintenance
A crew member suffered a serious hand injury while greasing a vessel capstan when rotation trapped his hand between an underside wire clamp and the deck. The flash examines difficult access and grease-gun design, describing grease-point extensions, clamp removal, revised maintenance procedures and wider inspections for line-of-fire hazards.
- 202520 Jun
BSEE Safety Alert 503 - Personnel Burned by Fire due to Improper Venting of Gas Starters on Engines
BSEE describes two flash fires during attempts to start gas engines driving pipeline pumps. Improperly secured or absent starter exhaust piping allowed gas to accumulate before backfires ignited it, burning workers. Recommendations address safe exhaust routing, component checks, training, startup and maintenance procedures, gas detectors and consideration of temporary fire watches.
- 202510 Jun
BSEE Safety Alert 502 -Fatigue Cracking of Three-Quarter-Inch Pipe Nipple Results in Gas Release
An offshore gas release followed fatigue failure of a threaded ¾-inch pipe nipple on a compressor suction scrubber, prompting platform shut-in and personnel muster. The alert discusses possible installation stresses, vibration and unsupported bridle weight, and recommends considering structural support, proper tightening, regular inspection, vibration monitoring and maintained dampers.
- 202526 Feb
Contact with pier by paddle steamer Waverley
Investigation of Waverley’s contact with Brodick pier on 3 September 2020, injuring 24 passengers and crew. Engine dead centre delayed astern propulsion. The report examines piston valve securing, lost engineering expertise, informal training and unassessed closed-end berthing risks. It records subsequent maintenance and operational changes, with no recommendations made.
- 202417 Dec
NTSB: diesel generator engine failure
An offshore supply vessel suffered diesel generator failure and an engine-room fire during post-maintenance sea trials. An incorrectly sized replacement main bearing reduced lubrication pressure to adjacent connecting rod bearings. Effective crew firefighting limited the spread. The flash stresses identifying and documenting removed component part numbers to support correct replacement selection.
- 202414 Oct
Near Miss: Smoke and fire on Main Engine Exhaust
During sea trials after docking, smoke and fire emerged at an engine’s turbocharger flange. A damaged, incorrect gasket rated below 300°C had been fitted instead of one resistant above 500°C. The flash highlights spare-part specification checks and the visible wire mesh distinguishing gaskets designed for temperatures above 500°C.
- 202419 Sep
Injury to person during deck crane operations on board survey and supply vessel Kommandor Orca
This investigation examines a second officer’s leg injury during rail-mounted crane operations aboard Kommandor Orca at Portland. It analyses use of emergency-only local controls, entanglement in unguarded rack and pinion gearing, deficient vessel-specific procedures and training, and overlooked hazards. Company actions included remote operation, revised procedures and additional guarding.
- 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.
- 202422 May
Engine failure and subsequent engine room fire
A diesel generator failed catastrophically aboard an offshore-working vessel, ejecting components and starting an engine-room fire. Nobody was harmed. The flash reviews effective Hi-Fog suppression, protective equipment and emergency leadership, and recommends procedural familiarity and revised response communications. It also suggests thermal imaging support and fire-station booklets.
- 202430 Apr
UK MAIB: Crew member injured by rotating crank handle – LTI
A tug crew member suffered a fractured wrist when a coupling winch’s attached crank handle spun as tensioned barge lines were released. The flash examines failure to remove the handle under the operating procedure, restricted supervisory visibility, dynamic risk assessment and toolbox talks, noting that CCTV could help.
- 202425 Apr
Loss of control of powerboat Awesome with loss of 2 lives
MAIB investigates Awesome’s fatal loss of control near Little Thatch Island in the British Virgin Islands. A worn universal joint failed and the flailing drive shaft severed a hydraulic steering hose. The report examines lubrication, stepped-hull behaviour, seating, flotation devices, kill cords and rescue actions. Two occupants drowned; no recommendations were made.
- 202419 Feb
Vessel damaged in contact with platform
A crew transfer vessel struck a fixed platform after its port inner main engine remained driving forward. Worn carbon brushes caused the propulsion actuator to freeze. Control was regained too late to prevent wheelhouse damage; nobody was injured. Actions included fleet motor checks, revised maintenance arrangements and renewed emphasis on loss-of-power drills.
- 20249 Jan
Chain hoist paid out unsupervised near running main engine
An unattended electric chain hoist aboard a vessel paid out onto a running main engine near the generator drive shaft. A defective pendant button issued a continuous payout command. The flash examines operator assumptions, unsecured stowage and the unused emergency stop, and recommends checks, isolation review and maintenance review.
- 2024
CHIRP Annual Digest 2024
This annual compilation brings together anonymised maritime incident reports and commentary on crew welfare, vessel design, engineering, deck work and navigation. Cases examine enclosed-space entry, mooring injuries, pilot ladders, machinery hazards and groundings. Discussion emphasises leadership, communication, work permits, training and lessons for conventional and autonomous vessel operations.
- 2024
CHIRP Maritime FEEDBACK 75 (Summer 2024)
Confidential maritime reports examine commercial pressure over damaged anchors, laundry and cargo fires, machinery and mooring hand injuries, inadequate provisions and a grounding. Commentary addresses escalation of concerns, bridge coordination, laundry practices, dangerous-goods stowage, machinery isolation and guarding, and keeping hands clear during mooring.
- 2024
CHIRP Maritime FEEDBACK 76 (Autumn 2024)
This maritime digest examines unauthorised enclosed-space entry, tug propulsion failure during LNG berthing, suspected officer fatigue, rotating-shaft hazards, inadequate provisions, deficient dynamic-positioning capability and departure in strong winds. Case commentary contrasts effective teamwork and stop-work intervention with commercial pressure and weak safety culture, highlighting entry permits, towing configuration and position-reference requirements.
- 20236 Dec
Didion Milling Company Explosion and Fire
CSB investigates fatal combustible corn dust explosions at Didion’s Cambria mill. It examines propagation through interconnected dust collectors and pneumatic conveying systems, secondary explosions and building collapses. Comparative mill teardown, dust testing and explosion modelling support analysis of deficient safeguards, change management, housekeeping, emergency preparedness and regulatory oversight.
- 202330 Nov
Yenkin-Majestic Resin Plant Vapor Cloud Explosion and Fire
Investigation of a fatal resin-plant explosion and fire following solvent vaporisation and release through an altered reactor manway. The report examines pressure-containment design, inadequate alteration assurance, agitator-dependent safeguards, alarm deficiencies and evacuation preparedness. Recommendations address low-pressure vessel guidance, safer process design and flame-resistant clothing.
- 202316 Oct
Fire in the laundry room
An industrial tumble dryer fire was extinguished while personnel were mustering. The flash identifies maintenance changes and absent laundry smoke detection as causes, and describes possible particulate transport through heating elements. Actions address recognised equipment standards, compatible spare parts and review of fire and smoke detection.
- 202312 Sep
Finger injury while setting up pipe cutting operation
A crew member’s middle finger was trapped between a scaffold tube and a pipe cutting machine during vertical setup for jumper repair. A defective inlet valve allowed air to energise the machine. The flash discusses omitted manual setup validation, unsafe hand positioning, revised procedures, toolbox talks, operator training and pre-use inspections.
- 202315 Aug
Unplanned rotation of drilling machinery
A subsea drill unexpectedly rotated during planned maintenance on a vessel’s deck, breaking retention fastenings without injuring anyone. The flash identifies an unreconciled switch position, inadequate handover and excessive reliance on administrative controls. Subsequent actions included an isolation interlock, revised switching-off procedures and improved team communication and compliance monitoring.
- 202324 Jul
Fire in diesel generator following tests
A vessel’s diesel generator caught fire during operational-speed testing after alternator bearing replacement in port. A misaligned bearing cover caused shaft friction and sparking; insufficient contractor supervision was considered the root cause. The flash emphasises thorough supervision and post-maintenance testing beyond idling speed.
- 202316 May
Fire alarm activation in engine room
A supply vessel experienced a small engine-room fire with no injuries and little damage. Bearing failure produced smoke, while remote CO2 activation failed and the cement compartment appeared to lack a discharge point. The flash highlights unreported sensor inconsistencies, crew practice and accurate documentation of firefighting system limitations.
- 202327 Feb
Compressor fire
A rented diesel-driven screw compressor caught fire aboard a diving support vessel. An electrical short circuit damaged cable insulation; radiant heat compromised an oil scavenger line, releasing oil that ignited. No injuries occurred. The flash discusses maintenance testing gaps, pre-mobilisation checks, equipment assessments, fire suppression and deck positioning.
- 202229 Dec
Husky Energy Superior Refinery Explosion and Fire
Investigation of the Superior refinery explosion during fluid catalytic cracking shutdown. It examines air entering hydrocarbon equipment, missing steam-barrier and purge safeguards, eroded slide valves, procedural and training deficiencies, and brittle vessel fragmentation. Debris punctured an asphalt tank, escalating the event into fire; recommendations address transient-operation safeguards and emergency preparedness.
- 202221 Dec
Clogged tumble-dryer exhaust fan – potential for fire
A vessel laundry inspection found intertwined rags and lint in a dryer exhaust fan, with further checks revealing an almost blocked outlet pipe. The flash describes potential overheating and fire where routine cleaning was absent, and recommends regular exhaust and filter maintenance together with accessible installation design.
- 20223 Oct
Diver Finger Injury – Scrubber Blower Fan
A diver checking a vessel’s diving bell sustained a minor thumb injury from an exposed running scrubber fan with its canister removed. The flash identifies an omitted risk assessment hazard, records a requirement to switch off the fan during canister removal and discusses possible guarding and design changes.
- 202226 Sep
BSEE – “Green hats” – training and supervision of short service employees
This safety flash summarises BSEE concerns about incidents involving short service employees, including maintenance and rig-floor hand injuries and gaps in safety-system testing competence. Recommendations address practical training, competency assessment, qualified mentoring, limits on new-to-experienced crew ratios, workload evaluation and adequate supervision of inexperienced personnel.
- 20225 May
Person overboard from motor cruiser Diamond Emblem 1 with loss of 1 life
Investigates a fatal overboard accident involving a self-drive hire cruiser on the River Bure. Embankment impact threw a passenger into the water, where rope and propeller entanglement caused injuries and drowning. Analysis examines dual-helm controls, labelling, stern protection, handover competence, risk assessment and regulatory oversight.
- 202228 Apr
Two catastrophic engine failures, one resulting in a fire, on board ro-ro passenger ferry Wight Sky
Investigation of Wight Sky’s August and December 2018 engine failures, extended to related fleet failures. It distinguishes lubrication loss from a factory bearing-cap assembly error and examines maintenance records, oil and coolant monitoring, contractor support, delayed declutching and missing engine protection. Effective crew response limited the consequences.
- 20224 Apr
Improper Fan and Other Equipment Used in Hazardous (Classified) Locations During Coiled Tubing Operations
BSEE inspectors found an unsuitable fan and extension cord beside a gas buster during coiled tubing operations. Changing the plug had not changed the fan’s rating. The alert recommends considering classification drawings, equipment approval markings, applicable standards and checks for damage or improper electrical modifications.
- 20221 Apr
NTSB: Dangerous engine failure – improper torquing
A ferry engine failed during a post-maintenance sea trial in Puget Sound, ejecting components and causing an engine-room fire. The NTSB identified insufficient tightening of a connecting-rod bolt during overhaul as the probable cause. The flash describes successful fire containment and recommends calibrated torque tools, manufacturer guidance and verification of tightening requirements.
- 202210 Feb
NTSB: Engine Failure leads to fire aboard offshore supply vessel
This safety flash summarises an NTSB finding on a generator engine failure aboard an anchored offshore supply vessel. Bearing seizure was identified as the probable cause of rod ejection, oil release and an engine-room fire. Crew removed fuel and oxygen sources, containing the fire without injuries or pollution.
- 20219 Dec
MSF: Crankcase failure
A vessel’s diesel generator suffered crankcase failure, causing two small fires and extensive engine damage without personnel injury. Investigation identified a worn main bearing and interrupted lubrication, probably initiating the failure. Plexiglass guards, restrictions on prolonged work beside running generators and an effectively implemented emergency response plan limited consequences.
- 20219 Dec
Oil leakage from cylinder head cover
Following planned maintenance, a misaligned main-engine cylinder cover left a 3 mm sealing gap. Vessel list concealed the oil leakage until a turn to port. Engineers repositioned the cover and removed spilled oil, which was beginning to vaporise beneath the exhaust gas line, then established a fire watch.
- 202122 Sep
MSF: Hand Injury Sustained During Routine Checks
An operator testing an emergency generator during weekly checks injured three right-hand fingers on cooling-fan blades while investigating an abnormal noise. The flash identifies exposed rotating parts, limited situational awareness and lone working, and describes guard modifications, warning signs, further crew training and task-specific risk assessment and toolbox discussions.
- 202122 Sep
UK HSE: Employee scalped when hair trapped in a pillar drill
An employee sustained life-changing scalp and ear injuries when her hair became entangled in a rotating pillar drill. The flash reports absent guarding despite a company risk assessment identifying the need for a guard, and evidence that the drill had operated unguarded for several years.
- 202113 Sep
Yawing of wind turbine nacelle placed ship in line of fire
A turbine crew yawed a nacelle without communicating with the vessel bridge, placing a blade in the ship’s intended astern path after personnel and cargo transfers. The vessel moved clear without further event. Actions strengthened communication protocols and procedural controls, requiring positive confirmation that vessels were clear before nacelle movement.
- 20219 Jun
MSF: Engine damage after routine maintenance
An offshore platform supply vessel stopped an engine following a high-temperature alarm. Inspection found valve-gear damage, 86 running hours after valve adjustments. Evidence indicated a loose adjusting-screw locking nut, most likely insufficiently tightened during reassembly. Lessons emphasise manufacturer requirements, careful reassembly checks and torque-wrench verification.
- 202127 Apr
Safety Alert 420 - Employee Injures Hand in Rotating Equipment
A mechanic responding to an after-hours compressor shutdown entered the unit while its cooling fan was slowing. Placing his hand on the belt pulled him into a sheave, fracturing two fingers. The alert recommends considering reviews of after-hours work controls, including job safety analysis, lockout/tagout and stop-work practices.
- 202122 Apr
EC175B Accessory Gearbox Bearing Failure During Post-Maintenance Ground Run
An AAIB investigation examines an EC175B accessory gearbox bearing failure during a post-maintenance ground run at Aberdeen Airport. Excess grease and trapped air imposed excessive axial loading during alternator installation. Manufacturer testing informed revised maintenance instructions covering grease removal and V-band clamping. A subsequent similar event is also discussed.
- 202119 Apr
MAIB: Engine failure and subsequent fire
This flash summarises MAIB findings on Finlandia Seaways’ main engine failure and engine-room fire. A broken connecting rod preceded the fire, and an engineer suffered serious smoke-related injuries. It highlights maintenance management and manufacturer instructions, successful carbon dioxide suppression, absent escape breathing devices and difficulties confirming gas-bottle discharge.
- 20218 Apr
Near miss: Vessel approach to wind turbine tower
Two near misses involved turbine nacelle movement during vessel approaches for offshore personnel transfer. Neither caused harm. The flash examines autonomous-mode selection, cable unwinding and alarm resetting, alongside inadequate warnings, verification, procedures and communication. It explains why turbine STOP mode is necessary for safe docking and transfer.
- 202125 Feb
Engine failure and subsequent fire on ro-ro cargo vessel Finlandia Seaways with 1 person injured
Investigation annexes examine a vessel’s main-engine failure and engine-room fire through connecting-rod fracture analysis, microscopy and material testing. Fatigue was identified, but consequential damage limited precise initiation-site identification. Supporting documents address connecting-rod ovality, recommended replacement intervals and machinery survey examinations credited through Chief Engineers.
- 20212 Feb
Hand injury when caught in machinery
A crew member suffered hand and arm fractures during humidifier maintenance when airflow drove an electrically isolated fan and belt. His glove became entangled, drawing his hand and forearm into the machinery. Re-enactment identified an open ventilation outlet condition; the flash calls for procedures to address the previously unrecognised hazard.
- 202016 Oct
Deficiencies in Process Piping Cause Gas Release Incidents
BSEE describes several Gulf of Mexico gas releases involving cracked welds, leaking gaskets and corrosion beneath insulation. The alert links incidents to quality assurance and mechanical integrity deficiencies, with vibration-related fatigue a possible contributor in one case. Recommendations address piping integrity programmes, leak detection, reporting, training and maintenance of compressors and pulsation dampeners.
- 202014 Jul
Catastrophic Failure of Mud Centrifuge
A mud centrifuge failed catastrophically during drilling-fluid processing, ejecting a 65 lb pillow block bearing assembly. It travelled approximately 190 ft and struck living-quarter trailer steps. The gearbox, back-drive electric motor, coupler and associated components also became dislodged but remained within the centrifuge platform.
- 20201 Jun
Fire in the engine room
A vessel experienced a diesel-generator fire after leaving port. Engine bearing failure was identified, with a suspected potential fault in recently replaced components. Crew firefighting and the Flexifog system extinguished the fire without injuries. The flash highlights emergency drills, familiarity with fire shutdown mechanisms and water-mist protection.
- 202022 May
Pedestal Drill Chuck Assembly Detached Causing Head Injury
A crewman suffered a forehead laceration when a benchtop drill’s chuck assembly was ejected in a vessel’s engine room. An unauthorised bolt substitution for the spindle sleeve, inadequate supervision and an unsafe work system were identified. Lessons address avoiding modified tools, inspecting equipment and removing unfit machinery from use.
- 202018 May
Turbo and Exhaust Manifold Fires Related to Engines
This alert reviews more than 20 compressor and generator fires involving hot turbocharger and exhaust components. Common factors include defective components, hose failures, loose electrical connections and oil entering exhaust or compressor systems. Recommendations for consideration address shielding, insulation, leak checks, temperature shutdowns, fire detection, pressure protection and operator competence.
- 202031 Mar
Agitator started moving during mud tank cleaning – leading to injury
A contractor cleaning a vessel’s mud tank was struck by an unexpectedly starting agitator, suffering bruising and a broken rib. The flash examines omitted isolation, inadequate risk-assessment review and unclear departmental and contractor responsibilities. Actions address physical verification, lockout and tagging, isolation certification and improved communication.
- 202013 Feb
High potential near miss dropped object
During hydraulic jumper trans-spooling, an 11 kg termination head fell from approximately three metres, missing five nearby workers. The flash identifies inadequate securing, insufficient working space, shortcomings in task-plan implementation and hazard communication, and untrained personnel. It recommends risk assessment, conditional secondary retention and task competence assurance.
- 201911 Dec
Safety Alert 374 - Air Compressor Flaws Lead to Engine Fire
An air-compressor fire on a Gulf of Mexico production platform followed regulator diaphragm rupture and hydraulic fluid release through PSV outlets. Fluid ignited on the hot exhaust manifold after shutdown. The alert recommends considering condition checks, additional pressure shutdown protection, controlled discharge arrangements and periodic diaphragm inspections.
- 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.
- 201923 Aug
Near miss: Diver’s umbilical trapped
During near-shore diving, an untended umbilical drifted against a seawater intake screen and became trapped when the automated bar started. Emergency stopping and manual reversal freed it; neither diver was injured. The flash identifies absent isolation and inadequate supervision, and records reviews of risk assessment, dive planning and permit requirements.
- 20195 Jul
LTI: Foot injury after standing on rotating winch drum
An able seaman sustained a fractured foot and severe abrasions after standing on a rotating tugger winch drum during wire re-spooling. His boots limited injury severity. The flash highlights unrecognised winch hazards, inadequate risk assessment and absent intervention, with actions focused on hazard identification, assessment reviews and stopping unsafe work.
- 20191 Jul
Main engine turbocharger lagging on fire
A vessel’s main-engine turbocharger lagging caught fire following recent replacement work using inappropriate materials and workmanship. The crew extinguished the fire without injury after reaching emergency anchorage. Lagging on both engines was renewed, and engine trials checked for exhaust leaks and confirmed the repaired lagging’s effectiveness.
- 201918 Jun
Three hand injuries
This safety flash summarises HSE findings concerning three companies and serious hand injuries involving saws, a planer thicknesser and defective hydraulic cutters. It describes failures in machinery guarding, risk assessment and safe working arrangements, alongside inconsistent lock-off and isolation procedures. One company’s account includes two separate finger-amputation incidents.
- 201925 Apr
Fishing nets caught in propellers
Unmarked fishing nets disabled both main propellers of a vessel preparing to resume inshore survey work at night. The crew used the bow thruster and anchored safely pending assistance. Operations were suspended for risk-assessment improvements; lessons address maintaining a proper lookout and considering suspension when significant hazards are observed.
- 201913 Feb
LTI: Finger injury during work with rotating machinery
An electrician suffered serious finger injuries when a cotton glove became entangled in a pillar drill while enlarging a cable shoe hole without properly securing the workpiece. The flash identifies absent risk assessment and toolbox discussion, ignored signage and rushing, and advises against gloves and loose clothing around rotating machinery.
- 201915 Jan
Cement Unit Agitator Severs Fingers
An alert describes a cementer losing three fingers on his left hand while washing down a cement unit after a first-stage cement job. His hand was inside the mini batch tank sampling outlet while the agitator ran; dried cement on its upper flange severed the fingers. Investigation remained in progress.
- 201818 Dec
UK HSE: Worker suffers life-changing crush injuries – rotating machine
An IMCA safety flash reports a printing worker being drawn into rotating rollers when a cleaning cloth became caught. Injuries included finger amputation, fractures and skin degloving. The HSE investigation identified inadequate guarding and emphasised assessing machinery risks and applying suitable guards.
- 201825 Sep
Serious Injury from Rotating Winch
During wire spooling on a crane tugger winch, a worker placed his foot beyond a handrail and a rotating anchor block struck his boot, amputating all five toes. Findings identified inadequate task risk assessment, deficient toolbox discussion and absent guarding. Actions reinforced hazard identification, safety-control review and stop-work authority.
- 201817 Sep
Costly damage to azimuth thruster caused by fishing gear
Fishing nets and rope fouled a vessel’s starboard azimuth thruster. Net damage to a seal allowed seawater into the hydraulic system, degrading lubrication and damaging components. The flash describes dry-dock repairs, spare-parts delays, missing planned-maintenance tasks, recommended water-content sampling and a proposal for the manufacturer to study a net cutter.
- 2018Aug
What if your agitator fails? — Process Safety Beacon, August 2018
This bulletin examines a German batch-reactor incident in which restarting agitation mixed accumulated reactants, rapidly raising temperature and releasing contents through a relief valve. It explains mixing and heat-transfer hazards, including in non-reacting vessels, and recommends obtaining technical assistance and reviewing operating history before restarting an agitator after loss of agitation.
- 201818 Jul
Catastrophic engine failure and fire on board ro-ro passenger ferry Wight Sky
This investigation examines Wight Sky’s rebuilt propulsion engine failure, explosion and fire near Yarmouth, which seriously burned the engineer. It analyses probable debris-related bearing failure, engine assembly arrangements, oil and filter tests, and loss of essential electrical services. Actions address rebuild cleanliness and load testing; the recommendation asks Volvo to consider wear particle detection.
- 20189 Jul
Vessel engine block blown open in and around cylinder
A vessel engine connecting rod separated and breached the block following failure to replace and correctly torque four temporary bolts. Preliminary findings identified schedule pressure, poor handovers, missing checklists and incorrect cylinder marking. Lessons emphasise change management, handovers, checklists and limiting personnel exposure during engine start-up. No injuries, fluid spill or fire occurred.
- 201814 Jun
USCG: Role of the main propulsion lube oil system in the loss of the El Faro
This flash summarises USCG findings on El Faro’s propulsion loss and sinking. Static modelling indicated that severe inclination and relatively low sump oil volume would likely cause pump suction loss; sloshing was excluded. Operators are urged to review machinery procedures and limitations and verify compliance with applicable standards.
- 201811 Apr
Rope on propeller causing partial loss of propulsion
A platform supply vessel suffered partial loss of propulsion after a mooring rope entered the water and fouled its port propeller. The flash identifies deficient planning, risk assessment and communication during mooring, including delayed notification to the bridge. Lessons emphasise coordinated communication, more detailed risk assessment and stopping work when in doubt.
- 201828 Feb
Catastrophic engine failure resulting in a fire on crew transfer vessel Windcat 8
Investigates Windcat 8’s engine failure and fire off Lincolnshire. A connecting rod bearing failed, releasing the assembly through the crankcase and igniting oil vapour. Analysis examines engine loading, the response to an unexplained oil temperature alarm, passenger evacuation and ineffective aerosol suppression caused by open vents, with recommendations for crew training.
- 201721 Dec
Arm injury whilst using pillar drill
A crew member sustained a left-arm injury when a metal plate escaped a pillar-drill vice and was thrown from the drill bit while making a blank for a vessel’s hot-water pipe. The flash identifies inadequate risk assessment, unsuitable tool selection, insufficient vice tightening, incorrect drill speed and incorrectly worn PPE.
- 201712 Dec
Four hand and finger injury incidents
Four cases cover hand-arm vibration exposure, crushed fingers during manual frame handling, glove entanglement in a metalworking lathe and hand trapping in printing rollers. The flash discusses shortcomings in exposure limitation, health surveillance, manual-handling assessment, safe working methods, machinery guarding, training and supervision.
- 20177 Nov
Finger injury during work with rotating machinery
A cargo-vessel crewman dislocated his left thumb when his leather glove became entangled in a pillar drill while removing metal chips. The flash describes onboard treatment, absent risk assessment and toolbox discussion, and ignored glove restrictions. Actions address risk assessment, hazard communication, visible warnings and consideration of additional supervision.
- 20172 Aug
Hand injury whilst using pillar drill
An engineer changing a pillar-drill bit inadvertently started the machine, catching his glove and injuring his hand. The flash examines unmarked controls and unclear emergency-stop and energisation indications. It records familiarisation training and recommends risk assessment, alongside function checks of guard interlocks fitted to a newer model.
- 20172 Aug
Two cases of hand injuries – UK HSE
This flash reviews two HSE cases involving engineering firms: a hand injury during lathe polishing with emery cloth and gloves, and vibration-related symptoms among workers using powered hand tools. It highlights inadequate risk assessment, safe working guidance and training, alongside continued vibration exposure after symptoms arose.
- 201713 Jul
Worker suffers hand injury
A worker’s hand became entangled with a rotating metalwork lathe workpiece, leading to surgical amputation of part of his left index finger. The flash highlights unsafe hand application of emery cloth and a previously reported faulty emergency footbrake on a lathe that remained in service.
- 201712 Jul
Drill Pipe Screen Lodging in Top Drive Results in Near Hit
The supplied account describes several incidents involving drill pipe screens lodging in top drives after pressure release from a mud pump pressure relief system. In some cases, screens subsequently became dislodged while the top drive travelled overhead, resulting in significant near hits.
- 20173 May
ExxonMobil Torrance Refinery Explosion
CSB investigates the Torrance refinery electrostatic precipitator explosion during FCC Safe Park operation and expander isolation. It examines failed catalyst and steam barriers, slide-valve erosion, hydrocarbon backflow, inadequate procedures and detection, and ignition within the energised precipitator. Recommendations address isolation, safeguard assurance, maintenance, operating modes and equipment siting.
- 201712 Apr
Serious finger injury: Procedures during engine maintenance
An engineer’s little finger was trapped between a connecting rod and crank counterbalance during a ship’s main-engine overhaul. The flash examines hand placement, protective gloves, risk assessment and limitations of maintenance instructions. Crew questions clarify electric turning-gear operation and possible alternatives for supporting components without placing hands inside.
- 201630 Jun
Mooring rope fouled the propeller and parted
During berthing, excessively slackened mooring ropes fouled a turning propeller, became taut and parted. Near-vertical recoil missed crew standing in the snapback zone. The flash identifies communication, awareness and supervision shortcomings, and records preventive actions involving risk assessment, briefings, crew retraining and ship-specific constraints.
- 201613 Apr
Serious hand injury: Worker injured by machinery
This safety flash describes a maintenance worker whose gloved hand was drawn into pinch rollers while rethreading broken plastic sheeting. His right first finger required surgical removal below the knuckle. The HSE investigation found inadequate machinery guarding despite the company having identified the risks; the incident occurred in 2012.
- 2016Apr
MAIB Safety Digest 1/2016
Marine accident case studies cover merchant vessels, commercial fishing and recreational craft, examining navigation, fatigue, flooding, fires, machinery entanglement and overboard emergencies. Lessons address risk assessment, training, maintenance and emergency preparation. A reproduced bulletin examines premature failure of jacketed synthetic mooring ropes and limitations of internal condition assessment.
- 201631 Mar
Mooring: Port operator fined after worker injured by capstan
A worker sustained a serious arm injury involving a powered capstan while a three-person team secured vessel mooring ropes at a maritime terminal. The flash reports inadequate risk control, instruction, training, supervision and safety monitoring, alongside failures to heed workers’ earlier warnings, and points readers towards mooring training resources.
- 201528 Aug
Near-miss (HIPO): Engine started and running whilst crew member working on shaft generator
A crew member escaped without injury when a vessel’s propeller shaft began rotating during monthly carbon-brush maintenance beneath the shaft generator. The flash examines absent isolation and permits, inadequate supervision, and failures to communicate a change in vessel operations. Lessons address work authorisation, isolation, coordination and stopping unsafe tasks.
- 20152 Jun
MSF: Bulk hose drawn into thruster – severe damage and delay
This safety flash summarises a Marine Safety Forum incident involving a vessel’s port azipod thruster. Around 100 m of bulk transfer hose, including fittings, was drawn into the thruster, destroying the hose and significantly delaying operations. The supplied account gives no cause or preventive measures.
- 201529 May
Second-hand equipment causes engine breakdown
An offshore wind crew transfer vessel returned to harbour on one engine after a second-hand belt tensioner seized and the auxiliary belt failed. The flash examines unknown component history, limitations of sealed-bearing inspection and missing replacement communications, with lessons on servicing procedures and maintenance records.
- 20158 May
Failure of underwater pan and tilt rotator unit
An ROV camera pan-and-tilt unit exploded after recovery following minor subsea problems, ejecting its attached driver assembly and camera. Flames were extinguished and nobody was injured. The overpressure origin remained under investigation. Lessons address line-of-fire exposure, reducing maintenance work to ALARP, and assessing changed circumstances through management of change.
- 201520 Mar
Near-miss: Drawstring on storm jacket nearly drawn into rotating equipment
An offshore construction team fitting pipe supports identified a storm-jacket drawstring hanging close to a magnetic drill’s revolving spindle. Work was stopped before entanglement occurred, drawstrings were removed, and the hazard was shared with crews. The flash recommends alternative clothing without drawstrings as far as possible.
- 201410 Dec
Controlled Helicopter Ditching Following Main Gearbox Lubrication Warnings
This interim AAIB bulletin examines the controlled ditching of G-REDW following main gearbox lubrication warnings. It reports fatigue fracture of the bevel gear vertical shaft, corrosion and manufacturing inspection findings, and continuing investigation of the emergency lubrication warning. Fracture examination, dimensional measurements, fatigue testing and vibration monitoring inform the ongoing work.
- 201410 Dec
EC225 Emergency Gearbox Lubrication Continued Despite Failure Warning During Testing
This tentative AAIB investigation bulletin examines the EC225 LP emergency gearbox lubrication system following G-REDW’s ditching. Component tests indicated that lubrication continued despite a failure warning. Analysis identified a possible pressure-sensor tolerance issue, and the bulletin recommends a design review to ensure accurate crew indications.
- 201410 Dec
Two EC225 LP Helicopter Ditchings in the North Sea
Combined investigation of two EC225 LP helicopter ditchings in the North Sea in 2012. Corrosion-pit initiated fatigue failures interrupted gearbox oil-pump drive. The report examines stress modelling, welding residual stresses, condition monitoring, misleading emergency lubrication warnings, evacuation and liferaft deployment, and records corrective actions and safety recommendations.