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1 Introduction C oal mining is a major industry in the United States with 26 states producing coal for energy uses. There are an estimated 50,000 un- derground mine workers, about one-fifth of these are contractors, in 549 coal mines of varying size. The size of a mine is determined by the number of employees. There are 172 small mines employing less than 20 underground miners each, 366 larger mines employing 20 to 500 under- ground miners each, and 11 mines employing 500 or more underground miners (Mine Safety and Health Administration, 2011). There are inherent hazards in the coal mine environment, including noise, respirable dust, electrical accidents, diesel exhaust, rock falls, fires, and explosives. If not managed safely, these hazards can lead to situations that require evacuation from the mine such as gas and coal dust explosions and inundations of gas or water. Although recent advances in mining re- search and practice have improved the safety (and health) of mineworkers, there remains a need for additional analysis and research aimed at targeted concerns, particularly those in regard to miners’ ability to self-escape in the event of emergencies. Scrutiny of U.S. mine safety practices has increased in recent years due to highly publicized accidents, such as the Sago mine disaster of January 2, 2006, which resulted in 12 fatalities, and the Upper Big Branch mine disas- ter of April 5, 2010, which resulted in 29 fatalities.1 Subsequent investiga- 1  he T term “mine disaster” historically has been applied to mine accidents claiming five or more lives. Available: http://www.msha.gov/MSHAINFO/FactSheets/MSHAFCT8.HTM [May 2013]. We use the term “emergency” more broadly to indicate accidents or events that have the potential to result in any serious injuries and/or deaths. 11

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12 IMPROVING SELF-ESCAPE FROM UNDERGROUND COAL MINES tions into these accidents suggest that both could have been prevented or mitigated through better human-systems integration practices (Mine Safety and Health Administration, 2007; McAteer et al., 2011). In the wake of the Sago disaster, Congress passed the Mine Improve- ment and New Emergency Response Act of 2006 (MINER Act), which strengthened existing mine safety regulations and introduced new mea- sures aimed at improving accident preparedness and emergency response in underground coal mines. However, there exists relatively little research indicating how mine operators have complied with the new regulations or whether they have been effective, particularly as they relate to self-escape. In an effort to inform and develop a proactive approach to mine safety, the National Institute for Occupational Safety and Health (NIOSH) con- ducted a study in 2007. The study included interviews with staff at both small and large mines across the country, not just miners but also rescue team members, safety officers, and corporate-level managers. NIOSH also commissioned research papers to obtain additional information. The initial results indicated that some concerns were universal, such as efficient and accurate surface-to-mine communications and the variation in the physical capabilities of individual miners. However, the study also revealed a diver- sity of practices across the United States that dictates the need for tailor- made assessments. One overall message that emerged from the NIOSH study is that escaping very early in the stages of a mine emergency makes the difference between life and death. But how do mining personnel make decisions under stressful and dan- gerous conditions? How can they become better equipped to make those decisions? What technology improvements would add to effective self- escape? Specifically, what communications and respiratory escape appara- tus advances are possible? And where can improvements in infrastructure and work organization increase effectiveness of self-escape? To help answer these questions, NIOSH asked the National Research Council to appoint a committee to consider the behavioral, environmental, and human-systems factors and the tools and technologies that could con- tribute to effective decision making and the potential for self-escape from mine emergencies. The committee was asked to identify competencies that are essential for mine workers and to suggest the most effective training methods for the mining industry. The committee was also asked to identify any gaps in the scientific literature. See Box 1-1 for the committee’s full statement of task. The Committee on Mine Safety: Essential Components of Self-Escape was set up to carry out the study. In essence, we were asked to understand the system in which miners work and then to characterize appropriate training for mining personnel and identify knowledge gaps where further research is needed. Although our study is on underground coal mining

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INTRODUCTION 13 practices, it is likely that at least some of our findings, conclusions, and recommendations are applicable for underground metal and nonmetal min- ing, as well as related industries. SELF-ESCAPE: DEFINITIONS AND CONTEXT Self-escape from adverse events in underground mines is inherently not a solo effort, even in the case of a single individual escaping alone. It involves a broader effort of multiple teams and personnel acting in concert to affect a successful escape. However, it is still necessary to begin with a definition of self-escape that must embrace the concept of individual escape in order to focus on identifying the needs of individuals in any effort to resolve the emergency, or, if it cannot be resolved, remove themselves from harm. In general, however, the circumstances that require self-escape occur in a setting where a group, or team, of coal miners is together. Being part of a group having leaders can be helpful in an emergency, but it cannot replace attention to the needs of each individual. Self-Escape We define self-escape in the event of a mine emergency as the ability of an individual miner or a group of miners to remove themselves from the mine using available resources. The committee’s definition of self-escape requires miners to move out- side the mine (to the surface), but we recognize that there are some circum- stances when certain individuals may be required to stay in the mine (e.g., to extinguish a fire). For our purposes, the committee considers self-escape to be uniquely separate from rescue, which is a specialized response of trained rescue teams to assist miners who have become trapped or injured underground and can no longer remove themselves from the mine on their own. “Aided escape” falls under self-escape: it refers to conditions in which miners cannot walk out easily on their own and must rely on aids or re- sources, such as information from the surface, technologies, and assistance from other miners. Although the committee’s definition of self-escape references only ac- tions taken after an emergency is under way, safety management issues before, during, and after an event are also important. Miners must be maximally prepared to react when an emergency happens, either to resolve it if possible or to take effective actions to escape. An underlying principle of this preparation is recognition that self-escape begins well before an emergency occurs. Successful self-escape requires creating the conditions and competencies that promote the best chance for success. First and

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14 IMPROVING SELF-ESCAPE FROM UNDERGROUND COAL MINES BOX 1-1 Statement of Task An ad hoc committee will be appointed to identify and synthesize the literature relevant to understanding “self-escape” in the context of mine safety. The commit- tee will review literature in areas such as judgment and decision making under conditions of uncertainty and stress, training of personnel in high-risk professions, technological advancements that may facilitate self-escape (e.g., signaling), physi- ological and biomechanical effects of stress, and systems approaches to improve the likelihood of success self-escape. This study will focus on underground coal mining but with the understanding that findings and recommendations for that industry will likely be informative to the underground metal/nonmetal mining in- dustry. Basically, the stated purpose of this study is: What in the context of mine operations does it take to give mine workers self-escape capabilities during an emergency? Based on a careful review and collation of a variety of data, the committee will 1.  define “self-escape” in the context of mining emergencies; 2.  consider environmental and human-systems factors as well as technolo- gies that contribute to the potential for self-escape from mine emergencies. Among the factors the committee may consider are escapeway condi- tions, availability of refuge alternatives, communication systems, improved decision-making capabilities, the availability of information, and/or provid- ing physical conditions that would make it easier to escape under adverse conditions; foremost, mine operators need to be compliant with mine safety laws and ensure that everything to support escape is in place and available. There should be no impediments to escape that are within the control of planning and preparation. Mine Emergencies We define a mine emergency as an unplanned event that has the poten- tial to cause serious injuries or loss of life and requires the disruption of mining operations and removal of miners from the mine. Given the nature of past disasters and known hazards in the underground coal mine environ- ment (see Chapter 3), we focus on emergencies that are likely caused by explosion, fire, inundation by water or toxic gases, or collapse of portions of a mine.

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INTRODUCTION 15 3.  suggest the most effective training methods for the mining industry to adopt in order to impart those skills to miners and to validate individual compe- tency levels of same; 4.  identify competencies that are essential for mine workers to have in order to allow them to execute self-escape methods, which will include cognitive competencies as in hazard recognition and decision making, as well as physical abilities; and 5.  identify any “gaps” in scientific findings and the science of human error applied to mining that could inform this issue, thus help to set a possible research agenda for future funding strategies for NIOSH [National Institute for Occupational Safety and Health]. In addition to a careful review and discussion of written literature, the com- mittee will engage a variety of stakeholders who are invested in the issue of mine safety such as mining unions (e.g., United Mine Workers Association), industry (e.g., through the National Mining Association), other government agen- cies (e.g., MSHA [Mine Safety and Health Administration], Navy, NASA [National Aeronautics and Space Administration]), and explore accounts of miners who have self-escaped. Also, the committee will be asked to consider any safeguards planned or in place for analogously dangerous situations in which workers could be faced with a life-threatening situation in which they have to self-escape from the hazardous environment to a place of safety. Examples might include civilian or military firefighting, working in certain industrial facilities, undersea construction or exploration, and the setting up of space stations—i.e., situations where individuals may become “trapped” in a life-threatening environment. Self-Escape Timeline Self-escape in the context of mine safety can be viewed as consisting of eight interconnected stages organized into four phases: (1) prevention/ planning; (2) detection; (3) assessment; and (4) escape phase (see Figure 1-1). The prevention/preparation phase is a critically important stage that includes comprehensive and coordinated efforts to minimize hazard occur- rences and maximize preparation for adverse events. Workers’ pre-event experiences (prior events, false alarms, training, etc.) can have marked ef- fects on subsequent escape performance. The “time window” for successful escape opens with the initiation of the hazardous event. During the detection and assessment phases, miners have to recognize and confirm available cues and then make decisions about the severity of the event and the need to escape and through which routes. The active escape phase (organized movement of personnel) does not actu- ally begin until the hazardous situation has been detected, confirmed, and determined to be severe enough to warrant escape or evacuation. In many, if not most, situations timely completion of the detection and assessment

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16 IMPROVING SELF-ESCAPE FROM UNDERGROUND COAL MINES Assessment of severity (evaluate alternatives) Confirmation of cues Recognition of cues Occurrence of cues Complete escape hazardous event Decision making Initiate escape Initiation of Time Prevention/ Detection Preparation phase phase Assessment phase Escape phase FIGURE 1-1  Timeline for underground coal mine escape phases. SOURCE: Adapted from Australian Building Codes Board (2005). Figure 1-1 phases will lead to better escape performance. Time delay at any stage can complicate a successful escape. Training, communication, and technology are important for each stage and phase. HUMAN-SYSTEMS INTEGRATION APPROACH Self-escape is a task that directly and indirectly involves multiple teams, acting before and during the escape itself, in a dynamic environment. Suc- cessful escape depends on available resources, actions of the organization and the miners, and the interactions between them. Human-systems integra- tion examines the interaction of people, tasks, and equipment/technology in the pursuit of some goal (Booher, 2003; Czaja and Nair, 2006), in this case self-escape. This interaction occurs within, and is influenced by, the broader organizational and environmental context (Henriksen et al., 2008). A key premise of human-systems integration is that much important information is lost when the various components of the system are considered individu- ally or in isolation. A human-systems integration approach acknowledges that people differ in terms of their cognitive, perceptual, and physical capabilities and that these capabilities influence how they engage in different tasks and how they interact with equipment and technology. Tasks, equipment, and technology also have certain characteristics and therefore place varying demands on

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INTRODUCTION 17 External Factors (community/social-cultural/regulatory/economic, etc.) Equipment/ Technology Miners Tasks involved in self-escape Organizational – Environmental Context of Mines and Operations FIGURE 1-2  Human-systems integration model of self-escape. Figure 1-2 users or operators. Most broadly, these interactions take place in an organi- zation and are influenced by contextual and environmental factors that can facilitate or impede the successful use of equipment and technology and the completion of tasks. Human capabilities and limitations are considered in the context of a dynamic system that may change based on both external and internal factors (see Figure 1-2). STUDY APPROACH AND REPORT STRUCTURE Study Methods The committee met five times over the course of a year to gather in- formation and deliberate over available research and current practices. The meetings included a workshop and other public sessions in order to hear from a variety of stakeholders, including mine operators, technology developers, representatives from NIOSH and the Mine Safety and Health Administration, and experts in self-escape from other industrial sectors. To become better acquainted with the coal mine environments and current practices and equipment, the committee visited one mine and one mine training site: the Consol Energy Bailey Mine, an underground coal mine in southwestern Pennsylvania, and the Academy for Mine Training

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18 IMPROVING SELF-ESCAPE FROM UNDERGROUND COAL MINES and Energy Technologies at West Virginia University. The Bailey Mine has nearly 500 employees and uses longwall and continuous mining machines to produce about 10 million tons of coal a year. The Academy for Mine Training and Energy Technologies provides emergency response training to hourly and management employees; the training includes hands-on don- ning and transfer of self-contained self-rescuers in a smoke-filled environ- ment and wayfinding with lifelines with tactile indicators. This facility can conduct classroom activities integrated with environmental simulations of mine emergencies. The committee reviewed multiple sources of information as background for the study, such as relevant government and stakeholder reports and re- search, federal legislation (i.e., the MINER Act), relevant code of federal regulations, and investigation reports from recent mine emergencies that included testimony from miners as well as academic literature, particularly that in regard to emergency response in mine emergencies, decision making, safety management, and training. Report Organization The next two chapters provide the context for understanding current mine safety and the conditions of mine emergencies: Chapter 2 reviews cur- rent efforts in mine safety relevant to the committee’s charge, including the regulation of emergency preparedness and the adoption of needed technolo- gies, and Chapter 3 describes the challenging conditions of mine emergen- cies and examines the task of self-escape and the people and technologies currently involved in it. Chapter 4 considers the relevant decision-science research that can inform self-escape preparations. Chapter 5 looks at the role of a positive safety culture. Chapter 6 looks at both current training for self-escape and lays the groundwork for designing and delivering more effective training. Appendix A reproduces parts of the Code of Federal Regulations that are relevant to self-escape; and Appendix B reproduces the federal form for reporting all mine accidents, injuries, and illnesses.