scope:

Abstract:

This mishap involved three office workers in a high-rise office building who lost time from work between January 26 and March 27, 2007. The subsequent investigation identified causes including problems with the performance and operation of the buildings HVAC system, operation of the garage exhaust ventilation system, the lack of maintenance personnel training on the HVAC and energy management systems, the lack of written mishap preparedness and contingency plans, and employees lack of knowledge and understanding of the process to follow when reporting health and safety hazard and concerns. Lessons learned from this mishap are provided to prevent recurrences of similar events.