ISO 45001 and the Waste Sorting Line Incident

In March 2023, at the waste and recycling facility of Stonegrave Aggregates Limited in Aycliffe Quarry, County Durham, a serious incident occurred that illustrates exactly why robust health & safety management is critical.

A worker was cleaning a waste picking line when a supervisor mistakenly restarted the machinery, believing a colleague in similar clothing was operating nearby. The result: the employee became trapped in the moving machine, suffering a fractured shoulder, torn ligaments and a broken finger.

The investigating body, Health and Safety Executive (HSE), found that the company failed to ensure a proper isolation procedure was in place while employees were cleaning the picking line. Further, it emerged that the site had a previous fatal incident in December 2015 involving similar equipment and failures.

Stonegrave Aggregates was fined £270,000 and ordered to pay £15,637 in costs after pleading guilty to breaching Section 2(1) of the Health & Safety at Work etc. Act 1974.

The ISO 45001 Angle: Where the System Could Have Made a Difference

ISO 45001 provides a structured framework for managing occupational health & safety risks. In this case the standard could have intervened in multiple areas:

Leadership & Commitment (Clause 5)

Top management would set the tone: safety of workers is non‑negotiable. A company aligned with ISO 45001 would embed a culture of strong supervision and safety accountability, ensuring that cleaning operations are treated with the same rigour as full production operations.

Planning (Clause 6)

The standard requires identification of hazards and assessment of risks. Stonegrave’s operation should have identified “machine cleaning while power available” as a hazard, with risk assessments covering the likelihood of incorrect start‑up and consequences to staff. Planned control measures would include safe isolation procedures, lock‑out/tag‑out protocols and supervised cleaning operations.

Support & Operation (Clauses 7 & 8)

ISO 45001 demands the resources, competence, awareness, and documented processes needed to safely carry out work. For the waste picking line:

• Cleaning should only occur when the machine is fully isolated, with locked off power and verified by a supervisor.

• The roles of staff must be clear: who is operating, who is cleaning, who verifies isolation, who gives restart permission.

• Procedures must be documented and communicated, change control managed (e.g., who authorises machine restart).

• Supervisory safeguards: the mistaken identity of the worker suggests inadequate supervision and inadequate control of safe work zones.

Performance Evaluation & Improvement (Clauses 9 & 10)

The standard requires monitoring of safety performance (e.g., incidents, near‑misses, machine starts during cleaning) and investigation when things go wrong. Stonegrave had a prior fatal incident on the same line in 2015, yet despite this historical data the control systems failed again. Under ISO 45001, management review would recognise the pattern, investigate root causes, update controls, and verify effectiveness. The fact that a second incident happened suggests lack of effective corrective action.

What a Different Outcome Might Have Looked Like

If Stonegrave had an ISO 45001‑mature system:

• Before cleaning starts, the machine is locked, isolated, and a tag placed; an authorised person verifies and signs the permit to work.

• The supervisor confirms identity of the worker, verifies no restart until cleaning complete, and posts a watch or barrier - preventing confusion of personnel.

• Machine controls are interlocked in such a way that if the isolation is removed, the machine won’t start until a reset sequence is followed.

• Performance data - e.g. number of cleaning‑phase starts, near misses, previous injuries - is reviewed monthly; trends show risk remains high; corrective action (redesign, additional lock‑out equipment, training refresh) is taken.

• As a result, the incident is prevented, the £270k fine doesn’t occur, worker remains safe, and the business avoids reputational and financial damage.

Why This Matters Now

• According to HSE data, 124 workers were killed in work‑related accidents in Great Britain during 2024‑25.

• High‑risk operations like machine cleaning, maintenance, and isolation of equipment remain persistent danger zones in manufacturing, waste, recycling and processing industries.

• Fines for health & safety failures are rising. Some of the largest in 2025 already exceed millions.

• Embedding ISO 45001 is not just about ticking a box - it’s about systematically managing risk, protecting workers, and preventing repeat incidents.

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