HSE inspector Alex Nayar speaks to IOSH magazine about how a lack of vehicle and pedestrian segregation led to the death of a 19-year-old worker.

On 12 April 2021, Ben Spencer was only two weeks into his job at Sunrise Poultry Farms – his first proper job since leaving school – when he was fatally crushed between an HGV and a wall. Health and Safety Executive (HSE) Inspector Alex Nayar, who investigated this extremely sad case, explained how such a tragedy could occur.

THE INCIDENT

Ben lived in Sileby in Leicestershire and he had been taken on by a relatively large employer in the area, Sunrise Poultry Farms, two weeks before.

There were two elements to the egg farm, explained Alex: the farm itself where the chickens laid eggs; and then on the other side of the site was a very sophisticated and technical packing facility. Also on-site was a maintenance garage or workshop. That wasn’t owned by the company – it was owned by an independent maintenance engineer – but it was on the Sunrise site and it was used to maintain Sunrise vehicles.

'In order to navigate vehicles to the workshop, they would often drive along a fairly narrow thoroughfare,' he said. 'It was noticed that there might be a problem with one of the HGV vehicles parked in the loading bay, and arrangements were made to take it to the workshop. The problem on this occasion was that there was another vehicle in the way.

'During the mid-afternoon on April 12th 2021, the driver of the HGV began to move the vehicle but had to undertake a relatively complex manoeuvre to negotiate into the gap between the parked truck and the wall of the building. It was all done at slow speed, he was a qualified HGV driver and there was nothing incompetent about his driving.

'Ben was walking towards the vehicle from the opposite direction. He had no high-visibility vest on and, from what we gather, his clothing was dark. The driver didn’t see him but did notice what he said was a ‘flash’ on his righthand side. He climbed out of the vehicle and he immediately saw Ben on the ground.'

THE INVESTIGATION

Alex attended the site the day after the incident and there was very heavy police presence, he noted.

'I immediately established that Sunrise’s methods that were in place to ensure effective vehicle and pedestrian segregation were inadequate, so HSE issued an improvement notice.'

The improvement notice set out the following required measures:

1. Review and revise your current risk assessment in relation to workplace transport safety with a view to identifying any deficiencies contained therein with respect to additional risk control measures that could be applied to reduce the potential for injury or death from pedestrian contact with moving vehicles, as far as is reasonably practicable. The review shall be recorded in writing.
   AND
2. Implement any additional risk control measures identified arising out of the requirements of 1. above
   OR
3. Take any other action equally effective measures to remedy the identified deficiencies.

'The company full cooperated and Sunrise invested a lot of resources in complying with the improvement notice. Eventually, compliance was achieved and the standards of workplace transport safety were significantly improved,' Alex noted.

When there is a workplace fatality, the work-related death protocol comes into effect. In such cases, the police will always take primacy and we will support the police in their endeavours.

The police’s objective is to establish if there are grounds for gross negligence or corporate manslaughter – the HSE cannot prosecute that, only the police can.

'Once the police established there were no grounds for corporate manslaughter or gross negligence, they handed the case over to us at the HSE. In this case, that happened in January 2022 and we carried the case forward to prosecution.'

THE FINDINGS

The HSE's investigation found that Ben hadn’t been given any training about yard safety and he wasn’t wearing a high-visibility vest,' Alex said.

However, the investigators' main finding was that there wasn’t an effective system of segregating vehicle and pedestrian traffic. 'That is what vehicle and transport safety is all about: keeping people and vehicles apart,' he added.

'In terms of the fatal incident, there was no CCTV that captured the moment itself but the most likely scenario – and this is only conjecture – is that Ben was struck by the corner of the HGV trailer unit and the wall. We don’t know what Ben was doing when he was struck, but it doesn’t really matter: the important point is that there should have been systems in place to ensure the effective segregation of people and vehicles.'

THE PROSECUTION

Last month at Leicester Magistrates’ Court, Sunrise Poultry Farms pleaded guilty to breaching regulation 17 of the Workplace (Health, Safety and Welfare) Regulations. It was ordered to pay a fine of £233,000 plus prosecution costs of £8,841.

WHAT SHOULD HAVE HAPPENED?

There are a number of steps that could have been taken to minimise or reduce risk, Alex said. 'One option is using a banksman to assist driver with manoeuvring their vehicles. Another is prohibition of vehicles along certain routes. Another is mandatory use of hi-viz clothing. And another is pedestrian crossings.

'My preferred option is the use of demarcated walkways and especially the use of physical barriers to create segregated walkways. Well thought-out walkways that help pedestrians to know exactly where they are and where they are not allowed to walk are vital.

'Although it’s not applicable to this case, another option is employing one-way systems. Very often people are killed in workplace transport incidents when vehicles are reversing because the driver simply doesn’t have the visual acuity that he would have when he is looking forward. If you can implement a one-way system that negates the need for vehicles to reverse, you significantly reduce the risk.'

Comment: "Suitable factors should have been considered with vehicle movements in the working area. Adequate planning for vehicle movements and engineering controls such as the installation of barriers and lighting, sufficient awareness training for working near moving vehicles, the supply of PPE, instruction and supervision in place would have prevented this incident from occurring."

Source: IOSH Magazine