A report detailing a repeat of a known hazard that had previously been identified and actioned by the Company.
What the Reporter told us:
During a night time routine safety fire patrol, a watchman reported to the OOW that he smelled melting cable coming from a light fixture in the accommodation spaces. The Electrician was immediately called to investigate the causes of this incident. It was found that a fluorescent light capacitor had overheated. This in turn resulted in nearby cables becoming burnt. The Electrician replaced the capacitor and additionally renewed the burnt cables. Normal operation of the light fitting was restored without further incident.
Using the internal near miss reporting system, the company management were notified, and the safety department duly followed up. The following points were highlighted:
Within the previous twelve months, two similar incidents had occurred on company vessels and both were specific to this particular capacitor that had originated from a single manufacturer. These two failures led the company to take the following action;
- All fleet vessels fitted with this particular light-fitting were to replace the capacitors with an updated product.
- The Planned Maintenance System for all vessels with this fitting were modified to provide instructions for inspection every six months, and to renew the capacitors every four years.
- 500 capacitors were delivered to the affected vessels by the manufacturer.
In this particular case, and prior to the incident, the replacement capacitors had been received on board but not fitted. Further, the vessel’s last routine report to the company management indicated that inspection and maintenance on the accommodation lights had recently been carried out with no problems being reported.
After examining the defective capacitor, it was found that this type of capacitor was still fitted on board. The company instructed that all of the old capacitors be replaced, with appropriate spares ordered.
Overheating and failure of capacitors in fluorescent lights constitute a fire risk. It is important to use capacitors made from flame retardant materials fitted with an appropriate thermal fuse. The lighting fixtures in the engine room and in the accommodation should be subject to regular inspections to confirm their good condition.
Proper implementation of PMS requirements and implementation of instructions from the company, especially those deriving from hazardous incidents, should be promptly arranged.
This report highlights the value of companies having an effective near miss reporting system. It also shows that even with a reporting system, things can go wrong. If a hazard has been identified and actions taken to rectify the problem (which may take a certain amount of time to implement), then these should form part of the handover notes for onboard personnel. In addition, a company could request positive confirmation of remedial action. If this had been done, then it would effectively ensure that a closed loop instruction had been properly implemented.