Blog Post #167 – Communication Lapse at Heart of Accident

Excerpt from the OH&S Canada Magazine

Quebec investigators say a lack of communication contributed to the death of a worker in 2006 when his head became stuck in a piece of equipment during a pool installation project.

The deadly accident occurred on October 26, 2006 during a landscaping project at a house in Saint-Augustin-de-Desmaures, Quebec, says a report by the Commission de la sante et de la securite du travail (CSST). Investigators believe that Jean-Yves Pelletier, who worked for Piscines Pro et Patios NV, wanted to pass on some information to the operator of a digger known as a tow hoe, says CSST spokesperson Eric Arsenault.

It appears the worker climbed on top of the equipment to speak with the operator, Arsenault reports. “The operator didn’t see Mr. Pelletier and continued to do his manoeuvres,” he says. “The worker got his head stuck between the mast and the frame of the tow hoe.”

The team installing the pool was using a municipal trail beside the house to complete the work, Arsenault says. Over the course of the project, the trail became damaged and Pelletier was directed to use a small tractor to remove damaged asphalt.

CSST investigators believe the design of the digger created a danger because of the ease with which the worker could access a danger zone. As a result, Arsenault reports, manufactures of similar diggers will be informed of the findings.

Piscines Pro et Patios has been directed to provide training to employees about the associated hazards of such work and to ensure appropriate supervision, Arsenault says.

My opinion

Any employee in Ontario, to be competent on the job site needs these three things:

1) They must have the training, knowledge and experience to organize the work; and
2) They must know the ACT and the appropriate regulations; and
3) They must know the associated hazards with any particular workplace training.

It seems that Quebec adheres to the same standard as we do in Ontario. It seems the age old problem of enforcement is rampant there as it once was here. Mind you, this was a few years ago and the workplace safety ethics in Quebec HAD to have improved by now. The CSST has a good reputation.

The issue of a possible design flaw in the machine may send quite a ripple to the manufacturers of such machines. In Ontario, section 31 of the ACT states that a supplier,

“Shall ensure that the machine, device or equipment comply with this ACT and the regulations.”

A design flaw would, at least, cast doubt in this area. One cannot design a machine that can be unsafe in the workplace! What were they possibly thinking!

It will be interesting to find out if the permanent corrective action plan includes a machine design change. If this becomes true, I wonder if the landscaping company is found innocent and blame passed to the design.

One can only hope!


A company is best served when health and safety is built in at the beginning or the design stage. Someday, all companies will work this way.

Remember — In Canada, “ALL Accidents are Preventable”

‘Work’ and ‘Play’ safe.

Daniel L. Beal
CHSEP – Foundation Level
VP & Senior Trainer
HRS Group Inc.

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