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All workers suffered from carbon monoxide poisoning during dishwashing work in a
|[Discription of Incident]
This accident occurred during dishwashing work in a hotel
kitchen where a gas water heater was installed.
Three workers started dishwashing work at 8:30 a.m. As the amount of dishes
was several times greater than that on a usual day due to the large banquet
held on the previous day, a total of eleven workers including eight supporting
workers were carrying out dishwashing work in the kitchen from 1:00 p.m.
The procedures taken in the dishwashing work consisted of:
1. Pre-rinsing the dirty dishes by hand in a water tank.
2. Washing the pre-rinsed dishes in the automatic dishwasher.
3. Draining the washed dishes, and placing them in cupboards.
Starting around 2:00
p.m., however, workers began complaining of such symptoms as headaches and
dizziness one after another. As all workers showed the same symptoms by the time
they stopped work around 2:30 p.m., two seriously affected workers were taken to
the hospital by ambulance and the other nine workers were also taken to the
hospital by microbus for treatment. All the workers were diagnosed as suffering
from carbon monoxide poisoning.
Although two systems were installed in the kitchen as ventilation facilities
- a suction type hood (two units) for the kitchen and a local ventilator
for the gas water heater - neither of these systems was in operation. Only
two fans attached to the ceiling above the automatic dishwashing machine
were being used at the time.
1.Carbon monoxide gas generated by incomplete combustion in the gas water
heater gradually accumulated.
- 2. Ventilation was insufficient, and the following can be cited as the
causes for such insufficient ventilation.
(1) The room was closed to outside air as the windows were shut because
of rain, and the two fans that were in operation simply circulated the
(2) The local ventilator to discharge gas such as carbon monoxide gas generated
by the gas water heater was not in operation.
(3) The exhaust ventilator for the kitchen was not in operation either.
3. Work supervision was not conducted. In particular, the eleven workers
were odd-jobbers. As a majority of these workers were part-timers, they
did not know how to operate the ventilation facilities.
|[Type of business]
|[Type of accident]
|Contact with harmful substances, etc.
|[Number of victims]
|Eight injuries (requiring an absence from work)
Three injuries (not
requiring an absence from work)