HSE Performance Report 01

HSE PERFORMANCE REPORT(MONTHLY)
*Month of: Year: 2021

Operation

Management Representative:

HS&E Officer:

MONTHLY HS&E PERFORMANCE
LAGGING INDICATORS Monthly Year to
By Business Area Total Date LEADING INDICATORS Monthly Year to
By Business Area Total Date
*Near Misses (#)
*First Aids (#) Toolbox Talks
*Medical Treatments (#) Safety Meetings
*Lost Time (#) Orientations
*Other Recordable (#) Inspections / Observations
*Lost Work Days Corrective Actions completed

*Restricted / Modified Work Days Trainings

*Reportable Environmental Incidents (#) Other:
*Hours Worked (Regular)
*Hours Worked (Overtime)
*Total Exposure Hours
Total Recordable Injury Frequency
REGULATORY ACTIONS OR INSPECTIONS
Yes No
If yes, provide regulatory agency and description of action taken
Injury Statistic Definitions

Near Miss – An incident that could have, but did not, result in unintended harm or damage.
First Aid Injury – An Occupational Injury/Illness that requires first aid treatment only and does not result in loss of time from work or
Restricted Work. First Aid Injuries include:
a) Use of non-prescription medications at a non-prescription strength, including antiseptics;
b) Administration of tetanus or diphtheria shot(s) or booster(s). Other immunizations such as Hepatitis B vaccine
or rabies vaccine related to an injury are considered medical treatment;
c) Cleaning, flushing or soaking wounds on skin surface;
d) Use of wound coverings such as bandages including liquid bandages, gauze pads, steristrips or butterfly bandages,
etc. Wound closing devices such as staples, sutures and skin glue are considered medical treatment;
e) Use of any hot/cold therapy (e.g., compresses, soaking, whirlpools, non-prescription skin creams / lotions for local
relief, etc.);
f) Use of any totally non-rigid, non-immobilization means of support (e.g., elastic bandages, wraps);
g) Use of temporary immobilization devices while transporting an accident victim;
h) Drilling of a nail to relieve pressure or to drain fluid from a blister;
i) Use of eye patches;
Doc. Ref: PAC/PMM/FM/03 Rev: 0 Page |1

j) Removal of foreign bodies not embedded in the eye if only irrigation or removal with a cotton swab is
required;
k) Removal of splinters or foreign material from areas other than eyes by irrigation, tweezers, cotton swabs or other
simple means;
l) Use of finger guards;
m) Use of massages; and,
n) Drinking of fluids for relief of heat stress.
Medical Treatment – A classification of Occupational Injury/Illness for Medical Treatment beyond First Aid Injury where there has
been no Lost Days. The following are not considered Medical Treatment Injuries:
a) Visit(s) to a health care provider limited to observation or counseling or prescribed Restricted Work;
b) Diagnostic procedures (e.g., X-rays, blood tests), including the use of prescription medications solely for diagnostic
purposes (e.g., eye drops to dilate pupils).
Lost-Time Injury – An injury/illness resulting in Lost Days beyond the date of injury as a direct result of an Occupational Injury/Illness
incident.
Other Recordable Injury/Illness

Restricted Work – When an employee, due to a work-related injury/illness, is medically determined to be unable to perform
one or more routine functions or unable to work the normal time period of their pre-injury/illness work day, they are working in
a “restricted” capacity. Routine functions are the work activities that employee regularly performs at least once a week.
Significant Occupational Injury/Illness – Any injury/illness, that is not recorded as a Fatality, Lost-Time Injury, Medical
Treatment Injury or Restricted Work case, but has been medically diagnosed and determined to be work-related and the cause
is a verified trauma or workplace exposure that has extended to be within the current reporting period. Injury examples
include: punctured eardrums and fractured or cracked bones. Illness examples might be hearing loss, or respiratory disease.
Loss of Consciousness – Is a work-related, altered state of consciousness that can vary from disorientation to time, place or
person, to coma. For reporting purposes, the Loss of Consciousness must be witnessed or medically substantiated as related to
a work activity or exposure.
Recordable Injury – Any Occupational Injury/Illness that results in an employee experiencing:

a) Fatality;
b) Lost-Time Injury;
c) Medical Treatment Injury; or
d) Other Recordable injury/illness (not captured above), which has:
i) Restricted Work; or
ii) Significant Occupational Injury./Illness; or
iii) Loss of Consciousness.
Lost Days – The number of calendar days that the employee is unable to work beyond the day of injury/illness recommended by a
physician or other health care professional. Lost time ends as of the date that the employee is deemed fit to work either full or
Restricted Work or to a maximum of 180 calendar days for any individual case. For cases where the disability will continue beyond
the closing date, Lost Days and Restricted Days shall be estimated on the basis of medical opinion as to probable ultimate disability
and included in the data submission. Lost Days are only recorded for the period that the injured person is in the employ of the
company.
Restricted Days – The number of calendar days to a maximum of 180 days during which the employee is subject to Restricted Work,
based on the recommendation of a physician or licensed health care professional, for an individual case. For cases where the
disability will continue beyond the closing date, Lost Days and Restricted Days shall be estimated on the basis of medical opinion as
to probable ultimate disability and included in the data submission. Restricted Days are only recorded for the period that the injured
person is in the employ of the company.
Exposure Hours – Exposure to injuries shall be measured by the total number of hours of employment (i.e., the actual worked hours)
of all employees for each contractor and sub-contractor companies for the reporting period.
Total Recordable Injury = Number of Recordable Injuries X 200,000

Frequency Rate Total Exposure Hours
Doc. Ref: PAC/PMM/FM/03 Rev: 0 Page |2

HSE Performance Report 01

Uploaded by

Copyright:

Available Formats

HSE Performance Report 01

Uploaded by

Document Information

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

HSE Performance Report 01

Uploaded by

Copyright:

Available Formats

HSE PERFORMANCE REPORT(MONTHLY)

*Month of: Year: 2021

*First Aids (#) Toolbox Talks

*Medical Treatments (#) Safety Meetings

*Lost Time (#) Orientations

*Other Recordable (#) Inspections / Observations

*Lost Work Days Corrective Actions completed

*Hours Worked (Regular)

*Hours Worked (Overtime)

*Total Exposure Hours

Total Recordable Injury Frequency

REGULATORY ACTIONS OR INSPECTIONS

Injury Statistic Definitions

Doc. Ref: PAC/PMM/FM/03 Rev: 0 Page |1

Other Recordable Injury/Illness

Recordable Injury – Any Occupational Injury/Illness that results in an employee experiencing:

Total Recordable Injury = Number of Recordable Injuries X 200,000

Doc. Ref: PAC/PMM/FM/03 Rev: 0 Page |2

You might also like