Unit IA2: Loss Causation and Incident Investigation: GO GO GO GO

Unit IA2 : Loss Causation and Incident
Investigation
Theories of Loss Quantitative External and Loss and near-
Part 1
Part 2
Part 3
Part 4
Causation Analysis of Internal miss
Accident and Ill- Reporting and investigations;
Health Data, Recording requirements
Limitations of System and benefits,
Applications and procedures and
Presentation documentation
and involvement
of
communication
with relevant
staff and
representatives.
GO GO GO GO
Pass Your NEBOSH

Investigation
Accident / Incident Ratio Studies
Domino / Multi-Causality Theories

• Single Causal Theories
• Multi Causal Theories
Immediate, Underlying and Root Causes

• Reason’s Model of Accident Causation
Pass Your NEBOSH

Investigation
Accident / Incident Ratio Studies
Serious or disabling injury Major or lost time
Minor injuries (first aid)
Minor
Damage accidents
Near-miss accidents No injury accident
Basic Principles:
1. Although actual figures may vary, the basic principle to note is that for every
major incident, there are many more minor or near miss incidents.
2. Minors or near miss incidents has the potential to become a major incident.
3. All events are due to failure to control – even near-misses or minor incidents.
Precautions and action plans are required to prevent reoccurrences.
Pass Your NEBOSH

Investigation
Ancestry and
Fault of Unsafe Act or
Social Accident Injury
Person Condition
Environment
Heinrich’s Accident Sequence

“A preventable accident is one of five factors in a sequence that results in injury. The injury is invariable caused by an
accident and the accident in turn is always the result of the factor that immediately precedes it.”
Lack of
Immediate
Control by Basic Causes Incident Loss
Causes
Management
Updated Domino Sequence (Bird and Loftus)
Pass Your NEBOSH

Investigation
Unsafe Act Unsafe Condition

• Human Performance • Any other condition,
that leads to such as physical
accident, such as condition of the
negligence in machinery, poor safe
working with a system of work
machinery
Credits :
http://image.slidesharecdn.com/a-part21accidentinvestigation-
090312192809-phpapp02/95/a-part-21-accident-investigation-
8-728.jpg?cb=1236886129
Pass Your NEBOSH

Investigation
Immediate Causes Underlying Causes Root Causes
• Direct Cause of • Less obvious • Ultimate failings

Accident reason which all other
• E.g. Sharp blade • E.g. Removal of failings arrive
of a machine guard of a sharp • E.g. Failure in
cutting a finger blade of a safe system of
machine work to provide
training of
workers, or
failure to assess
risk of the
organization
Pass Your NEBOSH

Investigation
Reason’s Model of Accident Causation

(Swiss Cheese Model)
First Page Credits: http://www.dangreller.com/accidents-errors-and-swiss-cheese/ Next Chapter
Pass Your NEBOSH

Investigation
Credits:
RRC NEBOSH International Diploma Study Materials Unit IA2 (Part 1)
Pass Your NEBOSH
Investigation
Loss Event Data can be presented in the form

of:
1. Histogram
2. Pie Charts
3. Line Graphs
First Page Next Chapter
Pass Your NEBOSH

Investigation
• Requirement of reporting
and recording loss
Reporting incidents are set out in ILO
Requirements Occupational Safety and
Health Convention (C155)
and Procedures and Protocol (P155)
• Sample form Annex A
• Employers should also

record and maintain
Internal reports of minor injuries
Reporting and • Form should be simple to
use and able to record all
Recording important information
• Sample form Annex B
Pass Your NEBOSH

Investigation
Protocol P155 outlines that an employer should:
1. Record and notify occupational accidents, suspected
cases of occupational diseases, dangerous
occurrences and commuting accidents.
2. Inform employees about recording system and
notification
3. Maintain records and use them to prevent
reoccurrence
Pass Your NEBOSH

Annex A
Source: UK HSE Form F2508
Pass Your NEBOSH

Investigation
Format Use
• Name of affected worker • To help control accidents that

• Date, day and time of accident cause damage and injuries
• Location of accident • Helps to identify:
• Occupation of the person and job • Relative importance of various
being done at the time damage or injuries
• Extent of damage / injury • Conditions that caused the
• What happened damage or injury
• How it happened / control failure • How often similar type of injury
has happened
• What caused the accidents
• Accident repeaters
• Immediate remedial action
• How to prevent reoccurrences in
• Recommendations to prevent
the future
reoccurrence in the future
Pass Your NEBOSH

Annex B
Near Miss / Minor Injury Report
Pass Your NEBOSH

Annex B
Credits:
BRC Accident / Incident Report Form
Pass Your NEBOSH
Annex B
Credits:
First Page BRC Accident / Incident Report Form Next Chapter
Pass Your NEBOSH
Investigation
• Identify immediate causes and underlying / root causes of an accident (Understand domino effect)
• Prevent reoccurrence
• Legal Liability
• Data Gathering
Purpose • Identification of Trends
Procedures • 4 Steps Approach
and
Methodologies
• Using Failure Tracing Methods as Investigative Tools
Lessons Learnt
Pass Your NEBOSH

Investigation
4 step accident investigation methodology by

UK HSE Guide Investigating Accidents and Incidents (HSG245)
Plan and Implement

Identify Control Measures
Analysis of Information
Gather of Relevant Information
Via Incident Report Cause and Effect See Unit IA5 Involvement of
Form Identifying Gaps Managers,
Interview Process Supervisors,
Employees’
Representatives and
Others in the
Investigation Process
Managers,
Supervisors
Employees’
Representatives and
Others
Pass Your NEBOSH

Investigation
Timing Location
Equipments Who to talk

to?
Pass Your NEBOSH

Investigation
Pointers on Interview Process
• Prompt inspection of the • Interviewing Witness
scene  Types of Witness
• Equipments • Primary (victim)
 Recording Tools; Cameras, • Secondary (eyewitness)
Voice Recorder • Tertiary (people working
 Writing Tools; Pen and Paper around the accident)
 Detectors  Interview Location (Scene of

Incident)
 Portable Lighting
• Question Phrasing
 Who, What, Where, Why,
How
First Page
Pass Your NEBOSH

Unit IA2: Loss Causation and Incident Investigation: GO GO GO GO

Uploaded by

Copyright:

Available Formats

Unit IA2: Loss Causation and Incident Investigation: GO GO GO GO

Uploaded by

Document Information

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Unit IA2: Loss Causation and Incident Investigation: GO GO GO GO

Uploaded by

Copyright:

Available Formats

Unit IA2 : Loss Causation and Incident

Pass Your NEBOSH

Accident / Incident Ratio Studies

Domino / Multi-Causality Theories

Immediate, Underlying and Root Causes

Pass Your NEBOSH

Pass Your NEBOSH

Heinrich’s Accident Sequence

Updated Domino Sequence (Bird and Loftus)

Pass Your NEBOSH

Unsafe Act Unsafe Condition

Pass Your NEBOSH

• Direct Cause of • Less obvious • Ultimate failings

Pass Your NEBOSH

Reason’s Model of Accident Causation

Pass Your NEBOSH

Loss Event Data can be presented in the form

First Page Next Chapter

Pass Your NEBOSH

• Employers should also

Pass Your NEBOSH

Pass Your NEBOSH

Pass Your NEBOSH

• Name of affected worker • To help control accidents that

Pass Your NEBOSH

Pass Your NEBOSH

Procedures • 4 Steps Approach

• Using Failure Tracing Methods as Investigative Tools

Pass Your NEBOSH

4 step accident investigation methodology by

Plan and Implement

Pass Your NEBOSH

Equipments Who to talk

Pass Your NEBOSH

 Detectors  Interview Location (Scene of

You might also like