22 Apr 2024 Mr David John CARPENTER · Prevention of Future Deaths report Coventry
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Concerns raised 3
Unavailability of safety modification software as a standard feature for comparable bin lorries View source Risk of inadvertent whole-body lifting of a person from the rear danger zone into the bin lorry hopper View source Failure of automatic bin lift systems to differentiate between a bin and a person View source
This report raised 4 other concerns. They are not shown here because they do not form part of this recurring concern.
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Mr David John CARPENTER · Prevention of Future Deaths report
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Report summary
Mr David John Carpenter, a refuse collector, was lifted into the rear hopper of a bin lorry after activating a proximity start sensor, and his coat became caught on the lifting chair comb tooth. The automatic compaction cycle caused fatal injuries. The report raises concerns about risks from automatic bin-lift machinery, including inadvertent whole-body lifting, inaccessible emergency stops, inadequate warnings and the continued use of many machines with suboptimal safety.
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How this individual concern was interpreted PFD Monitor created a concise, searchable interpretation from the report wording shown below.
PFD Monitor interpretation Unavailability of safety modification software as a standard feature for comparable bin lorries
Wider context from the report “i. The inquest explored issues such as the safety of the machinery (the bin lorry, in particular the bin lift system in automatic mode).
ii. The life span of this type of machinery i.e. Bin lorries is 8 – 12 years. There are thousands of bin lorries of this or similar design still in circulation in April 2024. The evidence was as it is estimated 4 to 6 million residential bins are lifted every day by bin lorries provided by the manufacturers.
iii. It was/ is foreseeable that both workers (e.g. refuse collectors) and members of the public will approach the danger zone at the rear of the RCV. In the case of workers, for example, to remove debris/ detritus which occurs frequently on residential waste collection rounds.
iv. The circumstances of this inquest touching upon the death of David Carpenter in January 2023 accentuated this point.
v. A risk of inadvertent whole-body lifting into the manufactures bin lorry hopper of a person in the danger zone carries with it a risk of death.
vi. Since the incident “new” machine designs [ as of January 2024] deal with some, but not all issues, as arose in the inquest e.g. differentiation between a bin and a person; warning signs easily visible to the public and reminding bin operatives; additional estops being more accessible from within the danger zone unlike the design in January 2023 in which transparent screens were adjacent to the bin lift controls and the emergency stop and thereby an obstacle to the accessibility of the emergency stop when an emergency arose with a person located within the danger zone; audible bleeps confirming the engagement and disengagement of automatic mode. The “new” machines however are very few when considered in totality of huge number of the manufactures RCV in circulation.
vii. The availability of “modification software” (this software (amongst other functional changes) monitoring the RCV sensors [bin lost function] with the effect that a person may still be inadvertently lifted into the hopper but the automatic compaction cycle now not engaging and thus some risk of death is reduced) in relation to vehicles of the same or similar specification to that in the inquest is at choice and cost to the user .
viii. The cumulative effect being potentially important changes in the machinery in this hazardous working environment are inordinately slow, thus significant mechanical risks (best managed by the manufacturers) remain in April 2024 and compounded by the fact that the volume of work is high in this aspect of the waste industry i.e. millions of bin lifted daily.
ix. In addition there are example of issues which remain insufficiently considered/ actioned in relation to these ‘machines of suboptimal safety’ which include “sun glare on monitors” in the drivers cab which impact upon the ability of a driver to more clearly see the rear of the bin lorry and observe refuse collectors and thereby enhance safety in the hazardous job of refuse collection, mindful an emergency stop button is readily accessible in the drivers cab; clearly visible public warning signs about the danger zone remain deficient; the continued use of a Perspex/ transparent screen between the rear bin lift controls and the danger zone which amounts to an obstacle to a person activating the emergency stop in an emergency.
x. There remains (now 15 months post Mr Carpenters death) thousands of machines of ‘sub optimal’ safety on UK roads. The bin lorry manufacturers with some 8- 10 thousand lorries (albeit not all at automatic mode RCVs) on UK streets.
xi. The evidence was customers are most, if not all Local Authorities in UK. The manufacturers sell to waste contractors who collect on behalf of Local Authorities and sell to hire company from who Local Authorities hire vehicles. The cumulative effect is such that a concern as to future deaths exists as of April 2024.
” Source location Mr David John CARPENTER · Prevention of Future Deaths report
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How this individual concern was interpreted PFD Monitor created a concise, searchable interpretation from the report wording shown below.
PFD Monitor interpretation Risk of inadvertent whole-body lifting of a person from the rear danger zone into the bin lorry hopper
Wider context from the report “i. The inquest explored issues such as the safety of the machinery (the bin lorry, in particular the bin lift system in automatic mode).
ii. The life span of this type of machinery i.e. Bin lorries is 8 – 12 years. There are thousands of bin lorries of this or similar design still in circulation in April 2024. The evidence was as it is estimated 4 to 6 million residential bins are lifted every day by bin lorries provided by the manufacturers.
iii. It was/ is foreseeable that both workers (e.g. refuse collectors) and members of the public will approach the danger zone at the rear of the RCV. In the case of workers, for example, to remove debris/ detritus which occurs frequently on residential waste collection rounds.
iv. The circumstances of this inquest touching upon the death of David Carpenter in January 2023 accentuated this point.
v. A risk of inadvertent whole-body lifting into the manufactures bin lorry hopper of a person in the danger zone carries with it a risk of death.
vi. Since the incident “new” machine designs [ as of January 2024] deal with some, but not all issues, as arose in the inquest e.g. differentiation between a bin and a person; warning signs easily visible to the public and reminding bin operatives; additional estops being more accessible from within the danger zone unlike the design in January 2023 in which transparent screens were adjacent to the bin lift controls and the emergency stop and thereby an obstacle to the accessibility of the emergency stop when an emergency arose with a person located within the danger zone; audible bleeps confirming the engagement and disengagement of automatic mode. The “new” machines however are very few when considered in totality of huge number of the manufactures RCV in circulation.
vii. The availability of “modification software” (this software (amongst other functional changes) monitoring the RCV sensors [bin lost function] with the effect that a person may still be inadvertently lifted into the hopper but the automatic compaction cycle now not engaging and thus some risk of death is reduced) in relation to vehicles of the same or similar specification to that in the inquest is at choice and cost to the user.
viii. The cumulative effect being potentially important changes in the machinery in this hazardous working environment are inordinately slow, thus significant mechanical risks (best managed by the manufacturers) remain in April 2024 and compounded by the fact that the volume of work is high in this aspect of the waste industry i.e. millions of bin lifted daily.
ix. In addition there are example of issues which remain insufficiently considered/ actioned in relation to these ‘machines of suboptimal safety’ which include “sun glare on monitors” in the drivers cab which impact upon the ability of a driver to more clearly see the rear of the bin lorry and observe refuse collectors and thereby enhance safety in the hazardous job of refuse collection, mindful an emergency stop button is readily accessible in the drivers cab; clearly visible public warning signs about the danger zone remain deficient; the continued use of a Perspex/ transparent screen between the rear bin lift controls and the danger zone which amounts to an obstacle to a person activating the emergency stop in an emergency.
x. There remains (now 15 months post Mr Carpenters death) thousands of machines of ‘sub optimal’ safety on UK roads. The bin lorry manufacturers with some 8- 10 thousand lorries (albeit not all at automatic mode RCVs) on UK streets.
xi. The evidence was customers are most, if not all Local Authorities in UK. The manufacturers sell to waste contractors who collect on behalf of Local Authorities and sell to hire company from who Local Authorities hire vehicles. The cumulative effect is such that a concern as to future deaths exists as of April 2024.
” Source location Mr David John CARPENTER · Prevention of Future Deaths report
Open source report × Source evidence
How this individual concern was interpreted PFD Monitor created a concise, searchable interpretation from the report wording shown below.
PFD Monitor interpretation Failure of automatic bin lift systems to differentiate between a bin and a person
Wider context from the report “i. The inquest explored issues such as the safety of the machinery (the bin lorry, in particular the bin lift system in automatic mode).
ii. The life span of this type of machinery i.e. Bin lorries is 8 – 12 years. There are thousands of bin lorries of this or similar design still in circulation in April 2024. The evidence was as it is estimated 4 to 6 million residential bins are lifted every day by bin lorries provided by the manufacturers.
iii. It was/ is foreseeable that both workers (e.g. refuse collectors) and members of the public will approach the danger zone at the rear of the RCV. In the case of workers, for example, to remove debris/ detritus which occurs frequently on residential waste collection rounds.
iv. The circumstances of this inquest touching upon the death of David Carpenter in January 2023 accentuated this point.
v. A risk of inadvertent whole-body lifting into the manufactures bin lorry hopper of a person in the danger zone carries with it a risk of death.
vi. Since the incident “new” machine designs [ as of January 2024] deal with some, but not all issues, as arose in the inquest e.g. differentiation between a bin and a person ; warning signs easily visible to the public and reminding bin operatives; additional estops being more accessible from within the danger zone unlike the design in January 2023 in which transparent screens were adjacent to the bin lift controls and the emergency stop and thereby an obstacle to the accessibility of the emergency stop when an emergency arose with a person located within the danger zone; audible bleeps confirming the engagement and disengagement of automatic mode. The “new” machines however are very few when considered in totality of huge number of the manufactures RCV in circulation.
vii. The availability of “modification software” (this software (amongst other functional changes) monitoring the RCV sensors [bin lost function] with the effect that a person may still be inadvertently lifted into the hopper but the automatic compaction cycle now not engaging and thus some risk of death is reduced) in relation to vehicles of the same or similar specification to that in the inquest is at choice and cost to the user.
viii. The cumulative effect being potentially important changes in the machinery in this hazardous working environment are inordinately slow, thus significant mechanical risks (best managed by the manufacturers) remain in April 2024 and compounded by the fact that the volume of work is high in this aspect of the waste industry i.e. millions of bin lifted daily.
ix. In addition there are example of issues which remain insufficiently considered/ actioned in relation to these ‘machines of suboptimal safety’ which include “sun glare on monitors” in the drivers cab which impact upon the ability of a driver to more clearly see the rear of the bin lorry and observe refuse collectors and thereby enhance safety in the hazardous job of refuse collection, mindful an emergency stop button is readily accessible in the drivers cab; clearly visible public warning signs about the danger zone remain deficient; the continued use of a Perspex/ transparent screen between the rear bin lift controls and the danger zone which amounts to an obstacle to a person activating the emergency stop in an emergency.
x. There remains (now 15 months post Mr Carpenters death) thousands of machines of ‘sub optimal’ safety on UK roads. The bin lorry manufacturers with some 8- 10 thousand lorries (albeit not all at automatic mode RCVs) on UK streets.
xi. The evidence was customers are most, if not all Local Authorities in UK. The manufacturers sell to waste contractors who collect on behalf of Local Authorities and sell to hire company from who Local Authorities hire vehicles. The cumulative effect is such that a concern as to future deaths exists as of April 2024.
” Source location Mr David John CARPENTER · Prevention of Future Deaths report
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How this respondent action was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Implement software safeguards that stop lifting, disable automatic mode and interrupt compaction when bin-container sensors lose signals.
Verbatim wording from the response “The “modification software” refers to a solution called “bin-lift compaction control upgrade” (BCCU), which uses software to verify that a bin container remains present on the bin-lift chair during an emptying cycle. This is completed by monitoring signals from: (i) the N1 (start) sensor, which detects the presence of a bin container as it approaches the rear bin-lift mechanism and begins the automatic bin-lift cycle; and (ii) the N6 (security) sensor detects when a bin container is engaged by the bin-lift comb/teeth (each, as pictured below).” Source location Response from Dennis Eagle
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How this respondent action was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Offer free retrospective fitting of the bin-lift compaction control upgrade to existing customer vehicles.
Verbatim wording from the response “The BCCU solution shall be offered for retrospective fitment on a free of charge basis to all customers with existing products in service.” Source location Response from Dennis Eagle
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How this respondent action was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Add linked-chain manual-mode control and a two-minute inactivity timer to deactivate automatic operation.
Verbatim wording from the response “(1) when an operator switches from automatic mode to manual mode on either control panel (at either side of the vehicle), both nearside and offside lifting chains are placed into manual mode; and” Source location Response from Dennis Eagle
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How this respondent action was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Equip new OmniDEKA bin-lifts with audible person-detection warnings and additional safety decals.
Verbatim wording from the response “As of January 2024, all new “OmniDEKA” bin-lift mechanisms have additional safety features, including: (i) a clearly-audible warning sound if an object is detected in the bin-lift operating zone that is not a bin (i.e., a person); and (ii) a number of additional safety decals (pictured below) around the bin-lift which warns against hazardous and unauthorised use.” Source location Response from Dennis Eagle
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PFD Monitor interpretation Participate in the BSI working group developing UK safety standards for refuse-collection equipment and automatic bin-lifts.
Verbatim wording from the response “• Dennis Eagle has direct representation on the British Standards Institution (BSI) working group to develop UK standards for refuse collection equipment, in particular automatic bin-lift mechanisms. This group is actively working on the introduction of standards aimed at improving operational safety, and one of the key objectives for this standard is to introduce technology which is reliably able to distinguish between a person and a refuse bin container, with the aim of preventing bin-lift operation when a person is present within the operating zone.” Source location Response from Dennis Eagle
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1 Apr 2022 Corrie McKeague · Prevention of Future Deaths report Suffolk
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Concerns raised 2
Failure of bin locks to prevent individuals entering bins View source Failure of compaction processes to allow hopper inspection before compaction View source
This report raised 3 other concerns. They are not shown here because they do not form part of this recurring concern.
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Each statement is shown once, even when linked to more than one concern.
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Corrie McKeague · Prevention of Future Deaths report
This summary was generated using AI from the published report. Please read the original report for the complete account.
Report summary
Corrie McKeague disappeared in Bury St Edmunds on 24 September 2016 after entering a commercial waste-bin area, and was later determined to have died in the back of a refuse lorry. The inquest identified concerns including ineffective bin locks and bin searches, lack of safe search equipment for drivers, and poor visibility through the lorry’s viewing window.
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How this individual concern was interpreted PFD Monitor created a concise, searchable interpretation from the report wording shown below.
PFD Monitor interpretation Failure of bin locks to prevent individuals entering bins
Wider context from the report “1. Ineffective bin locks.
The court heard that bin locks were designed to keep waste within the bin, keep inclement weather out, but were not designed to keep individuals out . The locks were described as not robust, and a determined or strong individual would get in . Due to their design the locks were also frequently broken .
Stronger locks (such as snap locks) had been considered, but due to the risk of entombing (an individual inadvertently becoming locked inside a bin) stronger locks had been discounted. However, the choir heard there are currently no stronger bin locks available which would allow an individual to open them from the inside should they become entombed in a bin.
There were 740 reported incidents of people in bins over a 6-year period (i.e. 10 per week), which are likely to be reduced if stronger locks are fitted.
” Source location Corrie McKeague · Prevention of Future Deaths report
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How this individual concern was interpreted PFD Monitor created a concise, searchable interpretation from the report wording shown below.
PFD Monitor interpretation Failure of compaction processes to allow hopper inspection before compaction
Wider context from the report “4. Poor visibility through the Perspex viewing window on the lorry
In relation to the poor visibility through the Perspex viewing aperture/window on the lorry two factors were identified:
Firstly, it is physically impossible to undertake a check of the hopper mechanism on the Biffa lorry as the viewing aperture window is too high for this to be achieved by an average height driver.
Secondly, on the six-year-old vehicle in question the Perspex had become opaque.
A Detective Constable who had watched the lifting process to provide evidence of its operation for the court, described the driver as standing on tiptoes to try a check the vehicle hopper, whilst peering around the wing of the lifting mechanism. When asked specifically about the viewing window the officer said it was too high to see through and opaque. The officer told the court the viewing aperture was ‘totally useless’ as a means of checking what was being loaded into the hopper.
Whilst viewing the hopper is impossible on the current vehicle, it renders the instruction for drivers to view the hopper prior to compaction (contained in the Biffa Operating Instructions for Trade Waste Vehicles) impossible to achieve.
In addition, the automatic nature of the compaction process, also makes adherence to the Operating Instructions impossible on some vehicles , as compaction starts immediately the bin is tipped .
” Source location Corrie McKeague · Prevention of Future Deaths report
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How this respondent action was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Continue discussions with other report recipients about bin design, locking, lifting and weighing systems.
Verbatim wording from the response “Since your Report was issued, we have engaged with some of the other recipients of the Report to discuss bin design and locking, bin lifting and weighing systems. These discussions are ongoing.” Source location Response from Biffa
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PFD Monitor interpretation Remind customers to secure bins and, where feasible, store them in secure locations.
Verbatim wording from the response “The effective use of any locking mechanism is reliant upon customers using the locks and not overfilling the bin so that the bin lid can be closed and the locks used effectively. We will be reminding our customers of the importance of bins being secured and, where feasible, being stored in a secure location.” Source location Response from Biffa
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How this respondent action was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Review operating instructions to clarify viewing-window use and acknowledge when hopper checks may not be possible on some vehicle configurations.
Verbatim wording from the response “On the vehicle involved, the side windows fitted are to allow operator vision of the discharge of the container contents relative to the compaction mechanism i.e. the point at which container/mechanism physically approach one another. The windows have therefore been positioned to facilitate viewing of this operation, i.e. at eye line and/or above, rather than to check the contents of the vehicle hopper. We note the comments in your report, and we are reviewing our operating instructions to ensure there is clarity on how and when the viewing window is to be used, if one is present.” Source location Response from Biffa
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PFD Monitor interpretation Refuse collection containers are governed by EN840 and are considered fit for purpose, rejecting the premise that their design requires further safety work.
Verbatim wording from the response “The design & build of Refuse Collection 1100L containers/bins are not covered under CHEM Technical Standards, we understand these are catered for under EN840. The number of these containers in use the UK run into the millions and CHEM believe they are fit for purpose and serve our industry needs well.” Source location Response from Container Handling Equipment Manufacturers
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PFD Monitor interpretation Existing locking mechanisms are considered effective when used and sufficient to secure waste and prevent unauthorised access.
Verbatim wording from the response “We believe the existing locking mechanisms are effective when used and fulfil their purpose of securing waste inside the bin and preventing unauthorised access. However, we have engaged with bin manufacturers on the locking options available and our understanding is that they are considering alternative design options available to secure containers. Whilst there are snap lock options available (being locks that ‘lock’ on closure of the bin lid and then require unlocking), as you heard during the Inquest, these do present an entombing risk for any person entering the bin. Options to overcome this risk are being explored by the manufacturers.” Source location Response from Biffa
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PFD Monitor interpretation Experts do not accept that stronger locks would reduce deaths because containers may remain unlocked and the lock may not determine entry.
Verbatim wording from the response “32. Clearly this is not an isolated case. It is however not accepted by the experts that the number of deaths could be reduced if stronger locks are fitted. Bin crews and/or end users might leave the container unlocked. If a refuse vehicle broke down and therefore did not empty that container when scheduled, and the bin then became overfilled, an individual could easily empty a few bags onto the floor and enter the container. The lock would have served no bearing in that scenario.” Source location Response from BSI
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How this respondent position was interpreted
PFD Monitor created a concise, searchable interpretation from the published response wording shown below.
PFD Monitor interpretation Checking the vehicle hopper before compaction may not be possible on some collection vehicle configurations.
Verbatim wording from the response “Our operating instructions will be reviewed to reflect that checking the vehicle hopper prior to compaction may not be possible on some configurations of collection vehicle such as the one involved in this case.” Source location Response from Biffa
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4 Oct 2018 James Ryan McLaren · Prevention of Future Deaths report Sunderland
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Concerns raised 1
Failure to ensure that locked bins can be opened from the inside View source
This report raised 3 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concerns
Each statement is shown once, even when linked to more than one concern.
No linked response statements No respondent-stated action or position is linked to these concerns in the published data.
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AI-generated summary
James Ryan McLaren · Prevention of Future Deaths report
This summary was generated using AI from the published report. Please read the original report for the complete account.
Report summary
James Ryan McLaren was found deceased at a recycling site on 24 December 2017 after he was last seen leaving a nightclub and CCTV showed him walking towards an area containing large commercial waste bins. The report raises concerns about unsecured or inadequately lit bins, the risk of people sheltering inside them, and whether bins can be opened from the inside when locked.
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How this individual concern was interpreted PFD Monitor created a concise, searchable interpretation from the report wording shown below.
PFD Monitor interpretation Failure to ensure that locked bins can be opened from the inside
Wider context from the report “The WISH WASTE 25 – Managing access to large waste and recycling bins – contains formal guidance to prevent death or serious injury when people shelter in large commercial or communal domestic bins. This guidance was provided to the Inquest. Factors increasing the foreseeability of people gaining access and getting into the bins include, but are not limited to:
▪ the bin storage area:
• being quiet and isolated;
• being dark and unlit, especially at collection times;
▪ the bins:
• having lids that are not secured and easy to open.
I heard evidence that not all bins had lids, and that those, that did, had not been locked on 23rd December 2017. I heard that where there were locks to the bins and their lids, some had a generic lock that could be opened using a generic key, and that to unlock the bins would only take a matter of seconds, and that this would not be an onerous task for an operator to unlock the bin. I also heard that, although not in the location where James climbed into the bin, some customers fitted combination locks to bins with a code shared on a manifest for the collection vehicle. It is not known whether, once a bin is locked, it can be opened from the inside, and this is also a concern. This is particularly relevant with the nights becoming colder and darker, and the potential for people to seek refuge in bins due to the elements or for any other reason.
” Source location James Ryan McLaren · Prevention of Future Deaths report
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Includes safety deficiencies in waste-collection bins, refuse-collection vehicles and their immediate operating areas that are specifically intended to prevent people from entering bins or danger zones, detect people before lifting or compaction, warn exposed people, enable emergency stopping or otherwise prevent or mitigate fatal entrapment and lifting hazards. Includes automatic bin-lift person detection and bin-lock controls when they directly address these risks.
