UNIT 3

ACCIDENT INVESTIGATION AND REPORTING:- Concept of an accident, reportable and non reportable
accidents, unsafe act and condition – principles of accident prevention, Supervisory role- Role of safety committee
– Accident causation models - Cost of accident. Overall accident investigation process - Response to accidents, India
reporting requirement, Planning document, Planning matrix, Investigators Kit, functions of investigator, four types
of evidences, Records of accidents, accident reports Class exercise with case study.

An accident, is an unplanned & uncontrolled event which causes or is likely to cause an injury.

An accident, also known as an unintentional injury, is an undesirable, incidental, and an unplanned event that
could have been prevented had circumstances leading up to the accident been recognized, and acted upon, prior to
its occurrence.

According to Factories Act-1948 : “Industrial accident is an occurance in an industry causing physical injury to an
employee which make him unfit to resume his duties in the next 48 hours.”

Reportable Accident:

A reportable accident is an event that results in fatalities, critical injuries, occupational illness that prevent the
worker from working for the period of 48 hours or more or resulting in death. If someone has died or has been
injured because of a work-related accident this may have to be reported.
Reporting of accident in a factory/industry is covered under Section 88 of the Factories Act, 1948 which makes it
mandatory for a Factory Manager to report an accident to the Inspector of Factories (prescribed authority) of such
accident where a worker is unable to discharge duties for 48 hours or more or where an accident results into a
death. Report submitted by the Factory Inspector are further analysed to find out the reason of accident and
further action is taken to strengthen the safety system and initiate penal action against the factory owner under
the rules. Cases of serious accidents causing loss of limbs or livelihood are further processed/taken up under
Employees Compensation Act, 1923.
Here supervisor is responsible to report to the higher management and arrange another worker so that the
production could not be affected.
Types of reportable injury
The death of any person
All deaths to workers and non-workers, with the exception of suicides, must be reported if they arise from a work-
related accident, including an act of physical violence to a worker.
Specified injuries to workers
 fractures, other than to fingers, thumbs and toes
 amputations
 any injury likely to lead to permanent loss of sight or reduction in sight
 any crush injury to the head or torso causing damage to the brain or internal organs
 serious burns (including scalding) which:
o covers more than 10% of the body
o causes significant damage to the eyes, respiratory system or other vital organs
 any scalping requiring hospital treatment
 any loss of consciousness caused by head injury or asphyxia
 any other injury arising from working in an enclosed space which:
o leads to hypothermia or heat-induced illness
o requires resuscitation or admittance to hospital for more than 24 hours
 Occupational diseases
Employers and self-employed people must report diagnoses of certain occupational diseases, where these are likely
to have been caused or made worse by their work: These diseases include
 carpal tunnel syndrome;
 severe cramp of the hand or forearm;
 occupational dermatitis;
 hand-arm vibration syndrome;
 occupational asthma;
 tendonitis or tenosynovitis of the hand or forearm;
 any occupational cancer;
 any disease attributed to an occupational exposure to a biological agent.
Dangerous occurrences
Dangerous occurrences are certain, specified near-miss events. Not all such events require reporting. There are 27
categories of dangerous occurrences that are relevant to most workplaces, for example:
 the collapse, overturning or failure of load-bearing parts of lifts and lifting equipment;
 plant or equipment coming into contact with overhead power lines;
 the accidental release of any substance which could cause injury to any person.

Non Reportable Accident

A non reportable accident is the workplace incident which does not involve death, injury or illness that requires
medical treatment beyond first aid, days away from work, restricted work, transfer to another job, loss of
consciousness, a significant injury or illness diagnosed by a physician or other licensed health care professional.

ACCIDENT INVESTIGATION:
The prime objective of accident investigation is prevention. Finding the causes of an accident and taking steps to
control or eliminate it can help prevent similar accidents from happening in the future. Accidents can rarely be
attributed to a single cause. Work environment, job constraints, and supervisory or worker experience can all play a
part. These factors must be examined to determine what role each had in causing the accident.
Once the causes are established, precautions must be identified and implemented to prevent a recurrence.
Investigators must always keep in mind that effective accident investigation means fact-finding, not fault-finding.
What to Investigate?
● All accidents whether major or minor are caused.
● Serious accidents have the same root causes as minor accidents as do incidents with a potential for
serious loss. It is these root causes that bring about the accident, the severity is often a matter of chance.
● Accident studies have shown that there is a consistently greater
number of less serious accidents than serious accidents and in the
same way a greater number of incidents then accidents.

Primary Focus: PREVENT REOCCURENCE!!!

PREVENT REOCCURENCE!!!
PREVENT REOCCURENCE!!!
Reasons to investigate a workplace incident include:
  most importantly, to find out the cause of incidents and to prevent similar incidents in the future
 to fulfill any legal requirements
 to determine the cost of an incident
 to determine compliance with applicable regulations (e.g., occupational health and safety, criminal, etc.)
 to process workers' compensation claims
The same principles apply to an inquiry of a minor incident and to the more formal investigation of a serious event.
Most importantly, these steps can be used to investigate any situation (e.g., where no incident has occurred ... yet)
as a way to prevent an incident.
Many accident ratio studies have been undertaken and the one shown below is based on studies carried out by the
Health & Safety Executive.
An investigation would be conducted by someone or a group of people who are:

experienced in incident causation models,

experienced in investigative techniques,
knowledgeable of any legal or organizational requirements,
knowledgeable in occupational health and safety fundamentals,
knowledgeable in the work processes, procedures, persons, and industrial relations environment for that
particular situation,
 able to use interview and other person-to-person techniques effectively (such as mediation or conflict
resolution),
 knowledgeable of requirements for documents, records, and data collection; and
 able to analyze the data gathered to determine findings and reach recommendations.
Members of the investigating team can include:

 employees with knowledge of the work

 supervisor of the area or work
 safety officer
 health and safety committee
 union representative, if applicable
 employees with experience in investigations
 "outside" experts
 representative from local government or police
The important point is that even in the most seemingly straightforward incidents, seldom, if ever, is there only a
single cause. For example, an "investigation" which concludes that an incident was due to worker carelessness, and
goes no further, fails to find answers to several important questions such as:

 Was the worker distracted? If yes, why was the worker distracted?
 Was a safe work procedure being followed? If not, why not?
 Were safety devices in order? If not, why not?
 Was the worker trained? If not, why not?

An inquiry that answers these and related questions will probably reveal conditions that are more open to
correction.
The steps involved in investigating an incident?
First:

 Report the incident occurrence to a designated person within the organization.

 Provide first aid and medical care to injured person(s) and prevent further injuries or damage.
The incident investigation team would perform the following general steps:

 Scene management and scene assessment (secure the scene, make sure it is safe for investigators to do
their job).
 Witness management (provide support, limit interaction with other witnesses, interview).
 Investigate the incident, collect data.
 Analyze the data, identify the root causes.
 Report the findings and recommendations.
The organization would then:

 Develop a plan for corrective action.

 Implement the plan.
 Evaluate the effectiveness of the corrective action.
 Make changes for continual improvement.
As little time as possible should be lost between the moment of an incident and the beginning of the investigation.
In this way, one is most likely to be able to observe the conditions as they were at the time, prevent disturbance of
evidence, and identify witnesses. The tools that members of the investigating team may need (pencil, paper,
camera or recording device, tape measure, etc.) should be immediately available so that no time is wasted.

Accident Study Ratio (Safety Triangle)

The Safety Triangle has many other names – Bird’s Triangle, Heinrich’s Triangle or the Loss Control Triangle. The
Safety Triangle refers to a ratio which has come to define many safety practices and policy developments to date –
1-10-30.

The safety triangle was devised by Frank

E. Bird, Jr based on the findings of
H.W.Heinrich in his book, Industrial
Accident Prevention. Heinrich established
that based on his findings an accident
ratio of 1 major injury to 29 minor
injuries, and 29 minor injuries to 300 no-
injury accidents existed.

Bird – using the findings of Heinrich – commissioned his own study to evaluate how true this mathematical ratio
was. Bird analysed close to two million accidents in almost 300 companies wherein he found a similar ratio existed
– this materialised in the one we have come to know and love today – 1-10-30.

Based on his findings, Bird found that for every major injury (resulting in death, disability, medical complications or
lost time) there were likely to be 10 report minor injuries which required only first aid. This gives us our first two
numbers, 1 & 10.
The meaning of 30 lies in property damage accidents – with approximately thirty of these occurring per major
injury.
some individuals and further studies have sought to add lower levels onto the triangle to give the concept more
depth. Bird initially eludes to another number 600 – which refers to the number of total incidents which were near
miss, meaning they may have resulted in injury or property damage. Industry experts argue that this number is in
fact lower (closer to 300) and also argue over adding another level to reflect at risk behaviours with a number
closer to 200,000 – 300,000 per major injury.

Essentially there are three things we can learn from this

powerful concept.

The first is that there is a distinct mathematical relationship

between incidents of similar type and how severe there
are. You can use technology like Safesite to keep track of
where your company is in relation to industry standards and
even calculate this ratio for yourself anytime at your
command or receive an automated report each week.

Secondly – it is not plant, equipment or location which accounts for the majority of safety incidents but employee
behaviour – especially if we expert more modern interpretations of the theory which incorporate another level in
the triangle for at risk behaviours. Usage of Safesite encourages all employees, not just safety managers to log
hazards, record observations, maintain equipment and support safety officers in their inspections – reducing poor
behaviour and increasing productivity by up to 38%.

Thirdly – by reducing overall frequency of workplace injuries the number of severe or fatal injuries will
consequently reduce. Safesite allows you to combine the best of technology with the best people in your workforce
to get on the front foot when it comes to safety management, safety culture improvement and risk reduction.

Accident Causation Model

An accident causation model is a systematic method of ascertaining the causes of an accident. An accident is a
complex coincidence of activities or phenomena in a single time and space. Therefore, determining the causes
leading to an accident can be quite difficult, as there are so many variables to consider.

Systematic examination of causes of accidents began in the early 20th century. The development started with the
simple linear "domino model," explaining the individual’s behavior and circumstances surrounding an accident. It
gradually advanced to complex linear models, and further to complex non-linear models considering the time
sequences. Varying models contunue to be developed still.
There are three basic types of accident causation models:

 Simple linear models (Heinrich, 1931) - Presumes that an accident is the end result of a series of sequential
events playing out like dominos. The sequence begins with the social environmental factor, individual
factor, unsafe acts, mechanical and physical hazards, accident, injury, etc.. It is expected that, the
elimination of one of the dominos may prevent the accident. The first sequential accident model was the
‘Domino effect’ or ‘Domino theory’.
 Heinrich’s five factors were:

 Social environment/ancestry
 Fault of the person
 Unsafe acts, mechanical and
physical hazards
 Accident
 Injury.

The sequential domino

representation was continued by Bird and Germain (1985)

 Complex linear models - Presumes that an accident is a combination of a number of unsafe conditions and
factors where an individual interacting close to the system is at the risk of an accident. It is expected that
an accident could be prevented by setting appropriate controls. Some varieties of this type of model are
time sequence models, generic epidemiological models, systemic models, Reason’s "Swiss Cheese" model
and models of systems safety
 Complex non-linear models (Hollnagel, 2010) - Expresses that the accidents are caused by mutually
interacting variables in real time environments. Accidents could be prevented through understanding these
multiple interacting factors. Examples of such models are
 Systems-theoretic accident model and process (STAMP)
 Functional resonance accident model (FRAM)

How are the facts collected?

The steps in the investigation are simple: the investigators gather data, analyze it, determine their findings, and
make recommendations. Although the procedures are seemingly straightforward, each step can have its pitfalls. As
mentioned above, an open mind is necessary in an investigation: preconceived notions may result in some wrong
paths being followed while leaving some significant facts uncovered. All possible causes should be considered.
Making notes of ideas as they occur is a good practice but conclusions should not be made until all the data is
gathered.
Physical Evidence

Before attempting to gather information, examine the site for a quick overview, take steps to preserve evidence,
and identify all witnesses. In some jurisdictions, an incident site must not be disturbed without approval from
appropriate government officials such as the coroner, inspector, or police. Physical evidence is probably the most
non-controversial information available. It is also subject to rapid change or obliteration; therefore, it should be the
first to be recorded. Based on your knowledge of the work process, you may want to check items such as:

 positions of injured workers

 equipment being used
 products being used
 safety devices in use
 position of appropriate guards
 position of controls of machinery
 damage to equipment
 housekeeping of area
 weather conditions
 lighting levels
 noise levels
 time of day

You may want to take photographs before anything is moved, both of the general area and specific items. A later
study of the pictures may reveal conditions or observations that were missed initially. Sketches of the scene based
on measurements taken may also help in later analysis and will clarify any written reports. Broken equipment,
debris, and samples of materials involved may be removed for further analysis by appropriate experts. Even if
photographs are taken, written notes about the location of these items at the scene should be prepared.

Witness Accounts

Although there may be occasions when you are unable to do so, every effort should be made to interview
witnesses. In some situations witnesses may be your primary source of information because you may be called
upon to investigate an incident without being able to examine the scene immediately after the event. Because
witnesses may be under severe emotional stress or afraid to be completely open for fear of recrimination,
interviewing witnesses is probably the hardest task facing an investigator.

Witnesses should be kept apart and interviewed as soon as possible after the incident. If witnesses have an
opportunity to discuss the event among themselves, individual perceptions may be lost in the normal process of
accepting a consensus view where doubt exists about the facts.

Witnesses should be interviewed alone, rather than in a group. You may decide to interview a witness at the scene
where it is easier to establish the positions of each person involved and to obtain a description of the events. On
the other hand, it may be preferable to carry out interviews in a quiet office where there will be fewer distractions.
The decision may depend in part on the nature of the incident and the mental state of the witnesses.

Interviewing

The purpose of the interview is to establish an understanding with the witness and to obtain his or her own words
describing the event:
DO...

 put the witness, who is probably upset, at ease

 emphasize the real reason for the investigation, to determine what happened and why
 let the witness talk, listen
 confirm that you have the statement correct
 try to sense any underlying feelings of the witness
 make short notes or ask someone else on the team to take them during the interview
 ask if it is okay to record the interview, if you are doing so
 close on a positive note

DO NOT...

 intimidate the witness

 interrupt
 prompt
 ask leading questions
 show your own emotions
 jump to conclusions

Ask open-ended questions that cannot be answered by simply "yes" or "no". The actual questions you ask the
witness will naturally vary with each incident, but there are some general questions that should be asked each
time:

 Where were you at the time of the incident?

 What were you doing at the time?
 What did you see, hear?
 What were the work environment conditions (weather, light, noise, etc.) at the time?
 What was (were) the injured worker(s) doing at the time?
 In your opinion, what caused the incident?
 How might similar incidents be prevented in the future?

Asking questions is a straightforward approach to establishing what happened. But, care must be taken to assess
the accuracy of any statements made in the interviews.

Another technique sometimes used to determine the sequence of events is to re-enact or replay them as they
happened. Care must be taken so that further injury or damage does not occur. A witness (usually the injured
worker) is asked to reenact in slow motion the actions that happened before the incident.

Analysis & Recommendations :

At this stage of the investigation most of the facts about what happened and how it happened should be known.
This data gathering has taken considerable effort to accomplish but it represents only the first half of the objective.
Now comes the key question - why did it happen?

Keep an open mind to all possibilities and look for all pertinent facts. There may still be gaps in your understanding
of the sequence of events that resulted in the incident. You may need to re-interview some witnesses or look for
other data to fill these gaps in your knowledge.
When your analysis is complete, write down a step-by-step account of what happened (the team’s conclusions)
working back from the moment of the incident, listing all possible causes at each step. This is not extra work: it is a
draft for part of the final report. Each conclusion should be checked to see if:

 it is supported by evidence
 the evidence is direct (physical or documentary) or based on eyewitness accounts, or
 the evidence is based on assumption.

This list serves as a final check on discrepancies that should be explained.

The most important final step is to come up with a set of well-considered recommendations designed to prevent
recurrences of similar incidents. Recommendations should:

 be specific
 be constructive
 identify root causes
 identify contributing factors

Resist the temptation to make only general recommendations to save time and effort.

For example, you have determined that a blind corner contributed to an incident. Rather than just recommending
"eliminate blind corners" it would be better to suggest:

 install mirrors at the northwest corner of building X (specific to this incident)

 install mirrors at blind corners where required throughout the worksite (general)

Accident Causes

Unsafe Acts

 An unsafe act occurs in approx 85%- 95% of all analyzed accidents with injuries
 An unsafe act is usually the last of a series of events before the accident occurs (it could occur at any step
of the event)
 By stopping or eliminating the unsafe act, we can stop the accident from occurring
 an act by the injured person or another person (or both) which caused the accident, and/or
 More difficult to recognize and correct because they involve human factors. For example, snow creates an
unsafe condition to drive in, but that hazard is magnified by driving in the snow without slowing down or by
not maintaining safe distances. The act of driving too fast and not leaving safe stopping distances makes an
unsafe condition even worse.
- Operating equipment without qualification or authorization
- Lack of/or improper use of PPE
- Operation equipment at unsafe speeds
- Failure to warn
- Bypass or removal of safety devices
- Using defective equipment

Unsafe Condition

 Some environmental or hazardous situation which caused the accident independent of the employee.
 A condition in the work place that is likely to cause property damage or injury.
  Defective tools, equipment or supplies
 Inadequate supports or guards
 Congestion in the workplace
 Inadequate warning systems
 Fire and explosion hazards
 Poor housekeeping
 Hazardous atmospheric conditions

Principles Of Accident Prevention

It is apparent that questions of accident prevention cannot be solved in isolation, but only in the context of their
relationship with production/work output and the working environment, the following principles for accident
prevention can be derived: For example, in the production setting:

 Accident prevention must be built into production planning with the goal of avoiding disruptions;
 The ultimate goal is to achieve a production flow that is as unhindered as possible. This results not only in
reliability and the elimination of defects, but also in the workers’ wellbeing, labour-saving methods and work
safety.
Some of the practices commonly used to achieve accident prevention in the workplace[1]:

 Workers and supervisors must be informed and be aware of the dangers and potential hazards (e.g., through
education).
 Workers must be motivated to function safely (behaviour modification).
 Workers must be able to function safely. This is accomplished through certification procedures, training and
education.
 The personal working environment should be safe and healthy through the use of administrative or
engineering controls, substitution of less hazardous materials or conditions, or by the use of personal
protective equipment.
 Equipment, machinery and objects must function safely for their intended use, with operating controls
designed to human capabilities.
 Provisions should be made for appropriate emergency response in order to limit the consequences of
accidents, incidents and injuries.
The employer has to pay attention not only to risk assessment, work organisation, employee consultation,
information and training but also to health surveillance. Health surveillance is an important part of accident
prevention. It can reveal workers’ health problems that can lead to accidents at work.
But this is not enough. To prevent accidents in the workplace and improve occupational safety and health as a
whole employers should establish a safety management system. Improving safety management systems in large
enterprises requires a careful analysis of the environmental, organisational and job factors, and human and
individual characteristics that influence behaviour at work

Safety Committee

A Safety Committee is an organizational structure where members represent a group. This gives everyone a voice
but keeps the meeting size to an effective number of participants. Safety committees should not have any
regulatory enforcement powers and therefore should never be assigned such responsibilities; they are advisory
only. All enforcement of safety and health rules and policies within the company is the responsibility of designated
employer representatives, such as supervisors.
Committee Responsibilities and Functions
The safety committee will:

 Help management evaluate the effectiveness of control measures used to protect employees from safety and
health hazards in the workplace.
 Help management review and update the workplace safety and health program by evaluating employee injury
and accident records, identifying trends and patterns, accident investigation findings, inspection findings, and
employee reports of unsafe conditions or work practices.
 Accept and address anonymous complaints and suggestions from employees.
 Help management formulate corrective measures to prevent recurrence of injuries, near-misses, accidents, and
property damage.
 Promote safety and health awareness and co-worker participation through continuous improvements to the
workplace safety program.
 Assist management in monitoring workplace safety education and training to ensure that it is in place, that it is
effective, and that it is documented.
 Identify unsafe work practices and conditions and provide safety recommendations to [name(s), job title(s), or
department(s)] regarding health and safety issues.
 Review the safety and health program established by [Company XYZ].
 Review incidents involving work-related fatalities, injuries and illnesses, and complaints by employees
regarding safety or health hazards.
 Review the employer’s work injury and illness records, other than personally identifiable medical information,
and other reports or documents related to occupational safety and health.
 Conduct inspections of the worksite at least [time interval] and in response to complaints by employees or
committee members regarding safety or health hazards.
 Conduct interviews with employees in conjunction with inspections of the worksite.
 Observe the measurement of employee exposure to toxic materials and harmful physical agents.
 Establish procedures for exercising the rights and responsibilities of the committee.
 Make recommendations on behalf of the committee, and in making recommendations, permit any members of
the committee to submit separate views to the employer for improvements in the employer’s safety and health
program and for the correction of hazards to employee safety or health. The recommendations are advisory
only and the employer will retain full authority to manage the worksite.
 Accompany, upon request, the regulatory agency representative during any physical inspection of the worksite.

Few other are:

- For better cooperation and involvement of employees in safety activity
- Employees like to participate in decision making concerning their safety and health.
- contributes to the safety promotional activities through group efforts
- Recognition to employees who contribute in safety activities
- Encourages closer relation between management and employees
- Statutory requirements(section 41G and factory rules)
- For implementation of various safety programs, it will be necessary to have standing committees which
form the policies and indicate the course of action to be taken.
- These committees will advise the safety engineering department for achieving a better performance in
safeguarding the men, machines and materials
- The employees representatives must also be included as members in these committees so that they can
present the view of workers and come with their ideas and suggestions.
Notification of Accidents under Labour Laws in India

Following are theprovisionsrelating to notification of accidents under the relevant labour and industrial laws in
India –

EXTRACT FROM THE FACTORIES ACT, 1948

(Section 88)(1.)Where in any factory an accident occurs which causes death or which causes any bodily injury by
reason of which the person injured is prevented from working for a period of forty-eight hours or more
immediately following the accident, or which is of such nature as may be prescribed in this behalf, the manager of
the factory shall send notice thereof to such authorities, and in such form and within such time, as may be
prescribed.

(2) Where a notice given under sub-section (1) relates to an accident causing death, the authority to whom the
notice is sent shall make an inquiry into the occurrence within one month of the receipt of the notice or, if such
authority is not the Inspector, cause the Inspector to make an inquiry within the said period.(3) The State
Government may make rules for regulating the procedure at inquiries under this section.]

XTRACT FROM THE MAHARASHTRA FACTORIES RULES, 1963

(Rule 115)
(1) Where any accident specified in sub-clause (a) of clause 1 of the Schedule hereto appended or any dangerous
occurrence specified in clause 2 of the Schedule takes place in a factory, the manager of the factory shall, within 24
hours of the happening of such accident or occurrence, send notice thereof by telephone, special messenger or
telegram, to the Inspector and the Administrative Medical Officer, Employees State Insurance Scheme, Bombay,
appointed as Additional Inspector under the Act; and where the accident is fatal or of such serious nature that it is
likely to prove fatal, notice as aforesaid shall be sent to:-
(a) the District Magistrate or Sub-Divisional Magistrate,
(b) the Officer-in-charge of the nearest Police Station, and
(c) the nearest relatives of the injured or dead person.
(2) The notice so given shall be confirmed by the Manager of the factory of the authorities mentioned in sub-rule
(1) by sending to them a written report in the case of an accident in Form 24 or in Form No.16 appended to
Employees’ State Insurance (General) Regulations, 1950, and in the case of a dangerous occurrence, in Form 24A
within twelve hours of the taking place of any such accident or occurrence referred to in that sub-rule.
(3) Where any accident of a minor character specified in sub-clause (b) of the said clause 1 takes place in a factory,
the manager shall, within 24 hours after the expiry of the period specified in the said sub-clause (b), send notice
thereof to the Inspector in Form 24.
(4) If in case of an accident, the injured person subsequently dies due to such accident, information of his death
wherever known shall be sent by the manager by telephone, special messenger or telegram within 24 hours of the
occurrence to:-
(a) The Inspector;
(b) The Administrative Medical Officer, Employees’ State Insurance Scheme, Bombay;
(c) The District Magistrate or Sub-Divisional Magistrate; and
(d) The Officer-in-charge of the nearest Police Station.
Explanation. – For the purpose of this rule, “accident of a serious nature” means an accident which results in-
(i) immediate loss of any part of the body or any limb or part thereof;
(ii) crushed or serious injury to any part of the body due to which loss of the same is obvious or any injury which is
likely to prove fatal.
(iii) Unconsciousness; or
(iv) Severe burns or scalds due to chemicals, steam or any other cause.
 Accident Investigation Kit May Include:
● Digital Camera
● Report forms, clipboard, pens
● Barricade tape
● Flashlight
● Tape measure
● Tape recorder
● Personal Protective Equipment (as appropriate)

Types of Evidences

An incident investigator’s task is to collect and organize evidence to uncover the truth behind the incident. However,
information gathered can be misleading. Witnesses may tell conflicting stories about the same incident. Environmental
conditions can change before the investigator arrives at the scene. Paperwork, such as a procedure, may be lost or
altered. How can an investigator get to the facts of the incident? By remembering to collect four types of evidence.

There are four types (or categories) of evidence to be evaluated. Investigators call these categories 3 Ps and an R. This
stands for:
 People evidence
 Paper evidence
 Physical evidence
 Recording evidence
People Evidence

Often, evidence collection starts with people evidence (a witness statement), and that evidence guides the investigator to
collect paper, physical and recording evidence.

Examples of people evidence include:

 Interviews
 Fatigue-related information
 Evidence of injuries, including cuts and scrapes, bruises, fractures, or sprains
 Information about medical conditions that may have influenced performance (refer to HR or corporate counsel for
guidance on HIPPA)
Where do you begin? First determine who was involved. This includes those who planned the work, supervised the work
and performed the work. Other considerations include a worker’s capability, capacity, training, and qualification to
perform his or her role.

Inquire into the background of those involved. Determine if they have been involved in any previous incidents or if they
have any related performance or conduct issues. Find out if those involved had any work restrictions such as an
impairment, physical capability, or lapsed accreditation.

Understand how the employees worked together. What were the dynamics of the team including supervision and team
performance. Determine the context (such as environmental conditions, distractions or perspectives).

Paper Evidence

Paper evidence may include all sorts of things including:

 Regulatory paperwork
 Activity-specific paperwork
 Personnel paperwork
 Policy and procedure paperwork
 Equipment manuals
What do you think the biggest mistake is when it comes to collecting paper evidence… given all of the paper that we have
in our workplaces? Collecting too much paper not relevant to the investigation!
You don’t need to collect every piece of paper at your facility. How do you know what you don’t need? By looking at the
timeline of events that led to the incident. You need all the paper that supports your timeline of events and supports the
facts. If you use TapRooT®, you can easily upload digital copies of this paperwork, and highlight relevant pages in your
report to management.
Don’t make the mistake of collecting so much paper that what you need for evidence is somewhere at the bottom of the
stack.

Physical Evidence

Physical evidence can range from a very large piece of machinery to a very small tool. It includes hardware and solid
material related to the incident. You will gather physical evidence in one of two ways. You will collect it or you will
record/document evidence that can’t be collected (for example, it is too large to collect, or it is still in use).

Types of physical evidence to collect:

 Broken equipment / parts

 Residue / debris
 Fluid samples
 Paint samples
 Fiber
 Hair, bloodstains, tissue or other DNA
Types of physical evidence to record/document
Evidence is recorded when it is impossible to collect or when it is still in use by the workforce. Following is a list of possible
evidence to collect by recordings:

 Burn marks and flame patterns

 Tracks
 Indentations
 Fingerprints
 Tools
 Equipment
 Products in use
 Equipment status (fixed, portable or temporary?)
 Lights, noise and temperature
 Confined space
 Obstructions
 Surface hazards
 Housekeeping
 Clarity of signs and labels
 Instructions
Following are additional pieces of information you may want to collect:

 Failure history
 Modification / change of use
 Operator interface
 Maintenance records
 Installing / commissioning
 Storage / transportation
 Procurement
 Design / fabrication
Recording Evidence

Recording evidence, such as photography and video, should be captured as soon as possible after an incident to preserve
the scene in images before it is altered in any way. It provides a documented overview of the entire scene. This may occur
as soon as you or a qualified team member can obtain access to the scene.

In addition to video and photography recorded by the investigator, recordings include:

 Video footage (examples: site security cameras, control room cameras)

 Audio recordings (examples: an audio of the noise level, voicemail recordings)
 Photos (examples: cell phone photos captured by bystanders to the incident, photos taken before the incident
occurred)
 Computer data (example: magnetic swipe card system security data for entry doors, computerized data from process
equipment)
 Sketches of an incident scene
Accident Investigation Planning Documents

1. Accident reporting policy

2. Accident investigator/analyst team organization

3. Accident investigator/analyst training requirements

4. Inventory listing of tools/equipment needed for accident investigation

5. Accident reporting forms

6. Distribution lists for accident reports

7. Procedures for report

8. Procedures for recommendation review, implementation and follow-up

 Planning Matrix
Super-big Warehouse Store - Customer Injury Accident

Store Mgr. Assistant Respective Store

Store
Activity & Dept. Store Dept. Security
Mgr.
Heads Manager Head Chief

1. Take injured to hospital X

2. Secure area X

3. Do preliminary survey X

4. Identify witnesses X

5. Identify items for

X
photography

6. Interview witnesses X

7. Tag items for photography X

8. Photograph scene X

9. Interview medical
X
personnel

10. Collect pertinent records X

11. Review evidence X

12. Determine if special

X
investigators are needed

13. Complete accident report X

14. Review report X

Investigator’s Kit

TOOLS
• Flashlight, 3 cell explosion
• Protractor
proof, or lantern
• Spare batteries and bulbs for
• Pliers
flashlight
• Steel tape measure—100 ft. • Wrenches, small adjustable or box end
• Scale—12 inch ruler or NU
Wire cutting pliers
Traffic Template
SPECIAL EQUIPMENT
• Camera with flashgun
• Flashbulbs and film
• Cassette tape recorder and
cassettes
• Sound level meter
MEDICAL EQUIPMENT
• Water
• Hand cleaner, waterless
• Eye drops and ointment
ADMINISTRATIVE SUPPLIES
• Investigators field work book
• Clipboard
• Note pads, lined, 8 ½ x 11
• Plastic bag to cover clipboard
• Envelopes, manila 9 x 12
• Aluminum foil roll
• Paper towel roll
• Adhesive labels– 2 x 3 inch
• Black grease pencils
• Orange spray paint--small
• Eraser—art gum
SPECIAL DEVICES
• Engineer’s scale
• Wire rope/hemp rope size
calculators
PERSONAL PROTECTION
• Hard hat
• Gloves, leather or canvas
• Ear plus
Overall Accident Investigation Process
• Evidence collection
• Analysis and reconstruction
• Develop findings and recommendations
• Write accident investigation report
• Follow up
• Gas vapor analyzer
• Electrical receptacle tension
tester
• Calipers, inside and outside
diameter
• Triangular bandages
• Adhesive tape—1 inch
Peroxide
• Graph paper—¼ inch squares
• Accident report form
• Witness interview statement
• Pocket portfolio
• Felt tip markers
• Ballpoint pens
• Soft, Nr 3 pencils
• Yellow lumber crayon
• Scotch tape
• Masking tape—2 inch
• Cardboard tags, string
• Metric conversions
• Fluid sample containers
• Glasses, protective
• Gloves, lineman’s
• Vest, orange flagman’s
Functions of Investigator:

• To locate and identify evidence which may relate to a loss incident

• To examine the evidence

• To ascertain its relationship to the loss incident

• To reconstruct the events leading up to the loss incident

• To develop conclusions about measures needed to prevent a reoccurrence

Records of accidents

Recording incidents as soon as they occur is a crucial part of a proper incident investigation. Having a written
record is the primary source of information about the people involved and the sources of hazards. OSHA requires
companies to have a written record of any work related incidents for a minimum of 3 years. Keeping incident
records provide a broad-spectrum of information about the circumstance as well as help establish a better course
of action for future incident prevention.

Obtaining the Correct Information

There are many ways of organizing the information but all processes should rely as much as possible on factual data
rather than inference. Examples of most to least reliable are:

 Quantitative, i.e. date and worker’s occupation

 Qualitative, i.e. weather records, time, light level, task, equipment and procedures
 Inferential, i.e. workers knowledge, function, motive, if the surface is slippery and visible

It is important to include information that is both relevant and factual to the case at hand, when the quality of the
information decreases so does its credibility. The reports are most useful when they summarize the individual
events; presenting the incidents by task, causative agent and industry sector. Maintaining these reports are
essential for possible future investigations and looking into questions that may not have been previously answered.