The Accident Reporting Form

When beginning to analyze the causes of accidents or incidents, use the Accident Report Form found in Table 7.5. It will act as a guide in identifying the various causes in each category and provides space for making recommendations, which will help prevent the recurrence of this type of causal factor or accident. 

A study of the accident reporting forms used by 25 offshore companies in the United Kingdom reported that there were a large number of immediate causes for the occurrence of accidents [8]. Most of these immediate causes were as follows [3,8] ... 

Thus, accidents have many causes. Basic (root) causes lead to unsafe acts and unsafe conditions (indirect causes). Indirect causes may result in a release of energy or hazardous material (direct causes). The direct cause may allow for contact, resulting in personal injury or property damage or equipment failure (accident). You can use the accident report form found in Figure 8.2 to identify and analyze these three causes. 

As part of the comprehensive plan for the collection and use of gas and hazardous liquid data, revise the cause categories on the accident report forms to eliminate overlapping and confusing categories and to clearly list excavation damage as one of the data elements, and consider developing categories that address the purpose of the excavation. (P-97-21)... 

This form is the basic tool in an accident investigation.The accident reporting form identifies vital information necessary to analyze the accident. There are several types of accident reporting forms. The best type is one that provides accurate information and is easy to complete. Any form can be modified to fit the needs of any organization. Once the report is complete, the person reading it should be able to visualize exactly what has happened. ... 

For a coalmine accident causing less than three deaths, the accident investigation is organized by the chief of regional inspectorate. Immediately upon receipt of the accident report, the chief shall select appropriate members to form a capable accident investigation team, and appoint a team. The team shall as soon as practical collect and fill out a brief initial report of the accident, and within 72 hours report to the head of Coalmine Safety and Health Department [PENG Cheng 2001]. 

The hazard analysis process was inadequate, and no control was exercised over the potential hazard of manually entering incorrect constants, a very common human error. If system safety engineers had identified the constants as critical, then a process would have existed for monitoring the generation of these critical variables. In fact, neither the existence of a system safety program or any form of hazard analysis is mentioned in the accident report. If such a program had existed, one would think it would be mentioned. 

An accident at work resulting in an over-three-day injury (that is, an employee being absent from work for over three days as a result of an accident at work) requires that accident report form F2508 be sent to the Local Authority within 10 days. 

Who are the reports sent to They are sent to the Environmental Health Department of the Local Authority or the area HSE offices (see Appendix B for area office addresses). Accident report forms F2508 can also be obtained from them or by ringing the HSE Infoline, or by ringing the incident contact centre on 0845 300 9923. 

For most businesses, a reportable accident, dangerous occurrence or disease is a very rare event. However, if a report is made, the company must keep a record of the occurrence for three years after the date on which the incident happened. The easiest way to do this would probably be to file a photocopy of the completed accident report form F2508, but a record may be kept in any form which is convenient. 

The producer or shipper should supply drivers with standard accident report forms. For each journey, a route should be chosen that reduces the risks and in particular avoids areas of high population density when that is possible. Weather is another important factor, and chlorine should not be transported when weather conditions are unsuitable. 

Descriptive statistics are techniques used to describe a population or sample. One cannot draw conclusions using descriptive statistics. For example, suppose a safety manager collects information from accident report forms about the age of workers that suffered a back injury. The average age for the sample was found to be 45 years old. The only conclusion the safety manager can make is that the average age of those persons from which the sample was selected is 45 years old. He or she cannot conclude that the average age for all people ever suffering from a back injury is 45 years... 

Upon notification of an occupational injury or illness, the supervisor should complete a formal incident/accideut report aud, if possible, seud it with the injured employee to the medical professioual involved. The incident/accident report form must be completed and forwarded to the company medical department even if the employee receives medical treatment at the hospital and/or from a private physician. 

All near-miss incidents also must be reported on the Incident/Accident Report Form within 24 hours of occurrence. In place of indicating the result of the incident (i.e., actual personal or property damage), the reporting person should indicate the avoided injury or damage. 

The majority of staff had become involved in the event of an accident. This was especially so for supervisors who were the most likely to be informed immediately an accident occurred. They may have been called upon to administer first aid and would have been expected to fill out accident report forms. Managers tended to be directly involved if they were called upon to lead an inquiry following a serious accident. Other than this their involvement was... 

The responsible person must notify the enforcing authority without delay by the quickest practicable means, for example, telephone. They will need to give brief details about the organization, the injured person(s) and the circumstances of the accident and, within ten days, the responsible person must also send a completed accident report form, F2508. 

Over three-day lost time injury If there is an accident connected with work (including physical violence) and an employee, or self-employed person working on the premises, suffers an injury and is away from work or not doing their normal duties for more than three days (including weekends, rest days or holidays) but not counting the day of the accident, the responsible person must send a completed accident report form, F2508, to the enforcing authority within ten days. 

A completed accident report form, F2508, must be sent to the enforcing authorities within ten days but see information concerning the Incident Report Centre which follows. 

Appendix 15.2 provides a checklist of headings, which may assist in the collection of information. It is not expected that all accidents and incidents will be investigated in depth and a dossier with full information prepared. Judgement has to be applied as to which incidents might give rise to a claim and when a full record of information is required. All accident report forms should include the names of all witnesses as a minimum. Where the injury is likely to give rise to lost time, a photograph(s) of the situation should be taken. 

Because accidents must be reported to supervisors immediately, all laboratories must post a list of emergency telephone numbers. Although generic accident report forms are available (Fig. 19.2), it is recommended that the winery develop its own forms to document accidents as well as those used by supervisors conducting accident investigations. Required information includes names and telephone numbers of the injured and witnesses, the date, time, and location of the incident, a description of the incident, the involved department(s), and the contract person and telephone number. 

The person to whom the accident is reported, makes a written record of the salient points, usually on an accident report form or accident record form. 

There are various ways of meeting the requirements listed above but they all depend on well-designed forms and well-thought out systems for reporting and recording. A suitably designed accident report form may also be accepted by insurers as notification of a claim. 

Other information has to be recorded as a narrative and space for this should be included on the accident record form. However, it is often necessary for this brief summary to be supplemented by a more detailed investigation report. 

If there is an immediate threat to human life, employees should immediately call emergency responders (911 or an equivalent number) if the plant has trained emergency response personnel. An accident report form must be filled out within 24 h of the incident. It is critical to capture as much information as possible about events leading up to the accident. Prompt and factual reporting of accidents facilitates accident investigation and acquisition of necessary information that will eventually go into the system safety analyses and be incorporated into the company SMS. If the accident is serious, an investigation board should be set up immediately. All accidents should be investigated. 

The laboratory supervisor should see that all serious injuries that require medical attention be reported by calling emergency response. All incidents that result in an injury or property damage are to be reported using an accident report form. 

The Team files an Accident Report (form attached) within 12 hours of the accident with the Director, the Director of Security and the Controller. 

Accident investigation reports are likely to be disclosed to a wide audience, and for this reason should be purely factual in content. Speculation as to causation and outcome should be avoided, as should the allocation of blame where possible. Whether the accident report is made on a standard form, or specially written, it should contain the following ... 

What are the items on which offshore industry accident reporting forms usually contain information ... 

A study of accident reporting forms of 25 offshore oil companies in the United Kingdom reported that the causes of accidents were grouped under two categories as shown in Figure 7.1 [3]. 

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