Accident Investigation

Industrial accidents occur everyday. Some are major, with injuries to workers and damage to property, but most are minor and don't involve time lost, medical care or repairs to property. So why should every accident be investigated, regardless of the size or severity of the accident?
Why not just investigate major accidents and save time? That's what this program is all about. We want to explain the basics of accident investigation and the benefits of investigating every accident, regardless of its size or severity and why this policy is an essential part of your overall safety program.
Let's begin by explaining the misnomer "accident". It's misnamed because most dictionaries define the word accident as an uncontrolled event. If the way we use this word to describe work incidences, then there is nothing we can do about "accidents" because they can't be controlled.
Accidents can be controlled and prevented, so keep in mind that when we say accident, it's not the same meaning as in the dictionary. It's a term that's been around for so many years in industry, that we understand what an accident is, in the work environment. Accidents are described as occurrences and their causes that may lead to property damage or work injuries and fall into two categories.
Non-injury accidents and injury accidents.
Certainly every worker has the right to expect a safe and healthy environment in which to work and most companies provide a safe and healthful work environment for their employees. There is a big difference, however, to want to keep your environment safe and making accident prevention a policy and priority. To this end, companies and supervisors must take an active role in accident prevention and accident investigation is an integral part of the program.
Let's take a look at how accident investigation is an important part of accident prevention. First of all, the purpose of an investigation is to determine facts, not place blame. The focus is always on preventing future accidents. Accident investigation and the data gathered become a vital part of the program.
Accident statistics and specific categories of the data gathered are not usable, unless they make sense... therefore when investigating accidents, it's important to assign codes for specific categories of the data. Investigation forms normally provide the codes, but it's up to the supervisor or investigator to assign the proper code or grouping so later analysis can be made of the information.
The minimum data elements that should be included in any accident investigation report include: Employer characteristics, such as the type of industry, the size of the establishment and number of employees. Employee characteristics, or the victim's age, sex, department, occupation, whether full or part time, or seasonal, length of service and how often the employee repeats the activity involved in the accident.
A narrative description of the accident itself, including what the person was doing, what objects or substances were involved, actions which led to the accident and a brief history of any preceding events that might have contributed to the accident. Any other conditions, such as temperature, light, noise or weather that related to the accident should also be noted in the narrative. Characteristics of the equipment associated with the accident, such as the type, brand, size, distinguishing features of the equipment, its condition, age and the specific part or parts involved. Characteristics of the task performed at the time of the accident, both the general category of the task, such as repairing a motor and the specific activity such as using a torque wrench on an automobile wheel.
Time factors, or the time of day the accident occurred, such as the first hour of the swing shift. meal time or overtime. The use and nature of preventative measures, which should include the following questions: Was personal protective equipment required and worn at the time of the accident? Did the employee's clothing affect the accident sequence? What was the level of the employee's training? Did standards or procedures exist for the task and were they followed?
If not, what happened? Were all safety guards in place and in use? Was the supervisor on the job? What immediate action was taken to prevent other accidents? The severity of the injury and the part or parts of the body affected should be discussed.
It's important to obtain statements from eye witnesses, as well as taking photographs or video of the accident's location. Equipment involved and other pertinent information to verify the information in the report.
As reports are collected, classifications for organizing accident data for analysis can be created. Generally, in most case, some basic form is used to begin your data base. Some companies use computer data bases for analyzing accidents and injuries, however, the most important part of analysis is to determine patterns of accidents in similar areas, at similar times and under similar circumstances from trends that will justify corrective action.
If you're finding that many injuries are occurring within 30 minutes of returning from meals or breaks, that tells you the attention span of employees may be distracted during this period. Corrective action could be to hold short meetings immediately upon returning from meals or breaks, to improve awareness and reduce these exposures during this time.
Remember, the purpose of accident investigation is to determine the facts and take corrective action to prevent similar accidents in the future.
Let's investigate a simple accident and see what corrective action could be learned from the investigation.
An employee was using a ladder to replace a burned out light bulb and was using a step ladder. He slipped and fell off the ladder, knocking him unconscious when he hit the floor. Using the basics of what we discussed earlier, the first section you complete is the description of the company and related information. You describe the person injured, who is 31 years old, a full time maintenance employee who has been with the company 7 years and who has no record of previous accidents. He has probably performed this same task many times in the course of his employment and has a reputation for being a conscientious worker.
As you investigate the accident, two of the injured person's co-workers who witnessed the accident explained that, as the victim was coming down the ladder, he slipped off one rung of the step ladder and fell. They know he was wearing tennis shoes at the time of the incident. That's all they could remember of the incident. Upon investigation of the actual ladder used, there was some grease on the side rails and top of the step ladder. The ladder was basically in good condition and did not have any defects, other than grease on the rails and top. This is a fairly simple accident, with obvious results, but what could you do to help prevent similar incidents?
You discussed the accident with the injured person and all he could remember is that his foot slipped off one rung of the bottom of the stepladder and he tried to catch himself by grabbing the ladder, but still fell to the floor.
Upon reviewing other ladder injuries, approximately 4 months ago, another employee, using a straight ladder to repair a broken fixture on the outside of the building. The employee fell approximately 10 feet, injuring his spine when he hit the ground. The investigation revealed that he was wearing tennis shoes at the time of the incident, but the ladder was determined to have been in good condition, except there was some grease or slippery substance on the ladder at the time of the incident. Photographs were taken of the ladder and the surrounding area and also of the grease on the rungs of the ladder. Going back further into accident analysis and statistics over the years, there have been several ladder accidents. Four out of seven accidents involved persons wearing tennis shoes, 5 out of seven revealed grease or slippery substance on ladders, one ladder was damaged and one ladder incident involved use of the wrong type of ladder for the job being performed.
By analyzing past similar accidents, you can begin to see what needs to be changed to prevent future accidents. In this company, it appears that ladders are not being inspected prior to use, therefore, procedures and more training is required to make sure anyone using ladders must first inspect ladders to make sure they are not damaged and that there is no grease or slippery substances on the ladder.
One specific area, near the location where ladders are stored had a history of being somewhat greasy and poor housekeeping conditions occur frequently. Tennis shoes were involved in four occurrences, although there is no evidence that tennis shoes were the cause of the accident. However, it is well known that tennis shoes and grease make a very slippery surface, whereas, other work shoes are not as slippery in the same environment.
Basically, the accident investigation information in these incidences can be used to prevent future, similar accidents. The company has identified one area where grease and poor housekeeping may have contributed to the accident, so this area must be cleaned and maintained in good, clean conditions. All employees must be trained and supervised that anytime they use ladders, they must first inspect the ladder for any defects, damage or to make sure all rungs and side rails are free of grease or slippery substances.
Proper footing for ladders is a requirement, and when using straight ladders, the ladder must be tall enough to extend at least 36 inches beyond the top of the building or landing, so a person getting on or off the ladder at the top will have a hand hold. The ladder should also be secured at the top to prevent it from falling.
Employees using ladders must be restricted from wearing tennis shoes and use only leather topped shoes with good, serviceable soles, which must also be inspected for grease or slippery substances. All employees using ladders should be properly trained and provided information relating to ladder procedures and rules that would or could have prevented these accidents.
The employees involved in ladder accidents can also be a valuable source of information about preventing ladder injuries. They can be used to provide their experiences with others, or help draft accident prevention standards for the use of ladders.
Overall, you have a lot of information, you have made recommendations, based upon facts gathered during the investigation, you have a written report that can be reviewed by others in the accident prevention process, you have photographs of the accidents and equipment involved. All this information is vital in the accident prevention process.
Adequate written documentation of the accidents in the files provides information and documentation in the event of future litigation or other legal action. In other words, the more information you have, the better accident analysis and prevention will be to help prevent accidents in the future. It's very cost effective to investigate all accidents, even if there is no injury or property damage. If you investigate a near miss, you have the probability of preventing a injury.

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