MSHA’s Assistant Secretary Joe Main announced at public events last week in Austin, TX and Charleston, WV his “Rules to Live By” campaign.  It’s described as  

“a new outreach and enforcement program designed to strengthen efforts to prevent mining fatalities.”

MSHA says the program will focus on the dozen or so frequently-cited safety standards identified during investigations of 589 fatal-injury incidents (2000-2008) in coal, metal and aggregate mines.   The list is no surprise.  It refers to hazards that have killed mine workers (and other workers for that matter) for decades: energized machinery, falls from elevations, struck by mobile equipment, etc., etc.  The MSHA asst. secretary explained the objective of the program as:

“having mine operators identify and correct all hazardous conditions and to have MSHA enforcement be directed toward confirming that violations related to these conditions are not present at mines.”

Wait a minute.  Isn’t this what we already expect?  

Read it again:

“having mine operators identify and correct all hazardous conditions and to have MSHA enforcement be directed toward confirming that violations related to these conditions are not present at mines.”

An I missing something about why this is a new initiative?  Mine operators are already legally bound to comply with these safety standards and MSHA inspectors are at the nation’s mines several times a year to verify operators are complying with the law.

The first thing that came to mind when I read MSHA’s “Rules to Live By” announcement was former MSHA chief Richard Stickler’s 2007 pronouncement of the “100% Plan.”   Recall that was the plan to make sure that the agency fulfilled its statutory (and funded) responsibility to inspect every underground mine four times per year, and every surface mine twice a year.   When Mr. Stickler trumpeted that plan, I wrote “News Flash: Agency announces it will do its job!”   Does Mr. Main’s announcement merit a similiar headline like “News Flash: MSHA will cite operators who violate the law.”

When I hear the phrase “Rules to Live By,” what comes to mind are tenets that go above and beyond the bear minimum.   But not for MSHA, at least not with this new initiative.  MSHA’s “Rules to Live By” are safety standards employers are already required to meet.  Instead of setting much higher safety expectations for the mining industry, MSHA is fixated on bottom demoninator items like does the truck have a seat belt, do vehicle brakes get checked regularly, and are the wheels on parked vehicles blocked to prevent roll aways.  Enforcing these basic safety standards is nothing more than MSHA has done for the last 30 years.  More of the same will not create the “cultural change” that Mr. Main says he wants.

What needs to change? 

One suggestion is for MSHA to stop saying that its fatality investigations assess “root causes.”   That lingo started under asst. secretary Dave Lauriski’s tenure and frankly there have been few MSHA investigation reports that truly dig into and then propose the root cause(s) of the workers’ deaths.   Saying the miner died because he went under unsupported roof is one thing, but asking WHY? it happened is a whole different matter.  The “whys?” will get you to genuine root causes, like workers’ fear of being fired for refusing unsafe tasks, fatigue from unsustainable workshifts, or production quotas.

Look, for example, at MSHA’s recently released report of the September 27, 2009 death of Robert C. Stewart, 28, at ASARCO’s Ray mine in Gila County, Arizona.  It says:

“The accident occurred because the truck driver did not maintain control of the haul truck he was operating. The failure of the driver to wear the provided seat belt contributed to the severity of his injuries.”

Workers at ASARCO’s Ray mine are represented by the United Steelworkers’ (USW) and the union also performed an investigation of Mr. Stewart’s death (photo of the truck).  The USW is also wondering if MSHA ever got past these initial findings to dig into the root causes at this incident. 

Well, MSHA’s report says the “following root causes were identified”:

Root Cause: The truck driver did not maintain control of the haul truck he was operating.

Root Cause: Management policies, procedures, and controls did not ensure the truck driver wore his seat belt when operating the haul truck.

With this language, MSHA offered on a platter the exact words that ASARCO’s managers wanted to hear.  

Moreover, there’s no mention in MSHA’s report that in the seven months proceeding Mr. Stewart’s death, workers at the facility had made six safety complaints to the agency. 

Further, there’s no mention of the 62 violations identified in an inspection conducted just days before Mr. Stewart’s death, including 17 deemed to be “S&S” (a violation that is reasonably likely to result in a reasonably serious injury or illness.) 

Further, there’s no mention of the inspection conducted just two months after Mr. Stewart’s death in which the operator was cited for 92 violations, including more than two dozen S&S.  

Further, there’s no mention of the 8 violations the mine operator received in December for failing to report work-related injuries or illnesses. 

And, there’s also no mention of the potential impact on safety of the ASARCO operation’s 24-hour a day, 7 day a week schedule.   [The body of evidence is growing on the role of fatigue, night work, and sleepiness on work performance, errors and accidents.  (Here's just one paper examining these factors in Iranian mine workers.)]

This short list alone tells me ASARCO’s Ray mine was not a model of safety and health excellence.   Yet MSHA’s report of Mr. Robert C. Stewart’s death inappropriately focuses on the victim, insisting on at least six occasions that his death was his own fault. 

A true culture change in our worker health and safety agencies would be assessing the systems and organizational factors that contribute to worker deaths.  A mechanical check of the truck (“the brakes were OK and there was a working seatbelt”) conducted by MSHA’s skilled engineers, only offers one small part of the story.  Asking questions like the following will tell you much more:

  • Was the window on the cab open (that he fell from) because the air conditioning on the truck wasn’t working?  The report says it was 80 degrees outside–maybe the driver needed fresh air to stay alert.
  • Had the doors been removed from the cab?  If so, why?
  • From 25 feet off the ground, did the driver need to remove his seatbelt in order to see out and around the truck and the roadway?  Were there cameras on the trucks to give him better visibility?
  • Was the seatbelt the only means in place meant to hold the driver in the cab in the case of a roll-over?  Who decided that was adequate protection?
  • Was the driver trying to escape from the track cab because the vehicle was malfunctioning? 
  • Are near-miss incidents reported and investigated (e.g., have there been other incidents, including at night, with this or other haul trucks)?
  • How responsive was management prior to the event to safety and health concerns raised by workers?

These are all items that could be recorded in MSHA’s investigation report to assemble information on organization and system failures that contribute to worker deaths and serious injuries.  These are the factors that will point to true root causes, not mere violations of bare minimum safety standards.  

A “Rules to Live By” campaign appropriate for the 21st century would set high expectations for safety system approaches to preventing injuries and illnesses.  The one announced last week by MSHA sets a low bar for mine operators by saying that mere compliance with the most fundamental bare-bones safety rules is good enough for now.

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