Accident Causation;

Risky Workplace and Risky workers

Session objectives
At the end of this module, participants will be able to:
• Discuss the accident causation theory
• Discuss the importance of accident investigation
• Identify the difference dangerous occurrence and imminent danger
• Explain the basic procedure in the conduct of accident investigation,
document and make recommendations based on the investigation
• Practice the Frequency Rate and Severity Rate
computation
Introduction
Accident is unplanned, uncontrolled and undesirable.
▪Disrupts normal function of the organization due to injuries/
fatality of workers or damage to property.
▪ Accident can be prevented from recurring through
an
efficient root cause investigation.
An accident is an unplanned event that sometimes has
inconvenient or undesirable consequences, other times being
inconsequential. The occurrence of such an event may or may not have
unrecognized or unaddressed risks contributing to its cause.
https://en.wikipedia.org/wiki/Accident
 Accident causation
PEOPLE
Workforce Work Theory
Management of the workforce MAN
Policies
Behavior

ENVIRONMENT Environment Equipment

Physical surroundings
Natural environment
Community, social & legal influences
MATERIALS
Used, worked or made Materials

EQUIPMENT
Tools and Machinery
 Work Theory
MAN

Environment Equipment

Materials

Accident causation refers to the factors that are the primary reasons
behind an accident.
For occupational health and safety professionals, determining causation
factors in any workplace injury or accident is the key.
ACCIDENT THEORY

X
People

Environment Equipment

Method

Materials

You can buy a person’s time, presence at workplace, and measured number of
physical activities. But you can not buy perseverance, loyalty, enthusiasm, and
heartfelt commitment. You must earn them.
George L. Germaine
 H. W. Heinrich, Domino Theory
▪ Study of Accidents
• 98 % – Preventable
» 88% - Unsafe Acts
» 10% - Unsafe Conditions
• 2% - Non-Preventable

▪Domino Theory, “Accident” is one factor in a sequence that may lead

to injury.
Scientific Approach to Accident/Prevention
Heinrich’s Triangle
 Primary Causes of Accidents

• Unsafe Act

• Unsafe Condition

https://www.google.com/url?sa=i&url=https%3A%2F%2Fwww.miningsafety.co.za%2Fdynamiccontent%2F140%2FReporting-Unsafe-Conditions-at-Mines-and-Quarries&psig=AOvVaw30r-hMRQmfTvoX3bPc2nbO&ust=1591429387969000&source=images&cd=vfe&ved=0CEYQr4kDahcKEwiIuLP kl-
rpAhUAAAAAHQAAAAAQAg
 Primary Causes of Accidents
Unsafe Act
• A human action that departs from a standard or written job procedure or
common practice, safety rules, regulations, or instructions.
• A violation of a commonly-accepted safe procedures and or
processes.

https://www.google.com/url?sa=i&url=https%3A%2F%2Fwww.alamy.com%2Fstock-photo%2Funsafe-conditions.html&psig=AOvVaw30r-hMRQmfTvoX3bPc2nbO&ust=1591429387969000&source=image
s&cd=vfe&ved=2ahUKEwjij47MlurpAhUGHKYKHeQzC3wQr4kDegUIARCJAg
 Primary Causes of Accidents
Unsafe Condition
•The physical or chemical property of a material, machine or the
environment that may result in injury to a person, damage or
destruction to property and other losses; these could have been
guarded or prevented.

https://www.google.com/url?sa=i&url=https%3A%2F%2Fwww.miningsafety.co.za%2Fdynamiccontent%2F140%2FReporting-Unsafe-Conditions-at-Mines-and-Quarries&psig=AOvVaw30r-hMRQmfTvoX3bPc2nb
O&ust=1591429387969000&source=images&cd=vfe&ved=0CEYQr4kDahcKEwiIuLPkl-rpAhUAAAAAHQAAAAAQAg
 ACCIDENTS / ILLNESSES

US / UH US / UH
Acts Conditions

•Unaware
•Unnoticed
•Unable
•Uncorrected
•Unmotivated
Cost of Accidents
Accident Investigation
▪A methodical effort to collect and interpret the facts of accident.

▪An inquiry as to how and why the accident occurred in order to explore
actions that should be taken to prevent or minimize recurrence of the
accident.
 Accident Investigation
Purpose of accident investigation
▪ To establish all facts
▪ To draw conclusion
▪ To make recommendations
▪ To prevent recurrence

https://www.google.com/url?sa=i&url=https%3A%2F%2Fwww.proveiance.com%2Fen%2Faccident-and-incident-investigation%2F&psig=AOvVaw0PLazJi37pmHO5dYHh9hCx&ust=1591430899213000&source=images&cd=vfe&ved= 0CJkBEK-
JA2oXChMI-Nnn0J3q6QIVAAAAAB0AAAAAEAQ
Important Feature of an Accident Investigation

● Formal Policy requiring the proper and consistent reporting of all

accidents is one of the most important principles of any accident
investigation program.
PRINCIPLE OF ACCIDENT INVESTIGATION
The investigation of any accident event will never progress unless
that event is first properly reported to the appropriate
management element within an organization.
 REASONS WHY ACCIDENTS ARE NOT
REPORTED
• Natural fear may people have of being associated with an
accident event.
• Idea of investigating a situation that has resulted in
some degree of loss
• reflect unfavorably on their own performance that of their
or department.
• Simply do not wish to interrupt work
production
REPORT REQUIREMENTS – Rule 1050 OSHS/ DO 13
• Disabling work accidents and illnesses
• must be reported to DOLE Regional Office on or

before the 20th of the month (WAIR)

• Accident or illness resulting to death or permanent

total disability
• Must be reported to DOLE Regional office within
24 hours;
• DOLE will conduct investigation within 24 hours
upon receipt of report
Types of accident to be reported
• Fatal accidents
• Accident causing injury or illness
• Diseases
• Dangerous occurrences
•Near miss – is a circumstance where injuries
or property damage did not occur, but the
potential exists for those undesirable events.
A Dangerous Occurrence, often called a 'near miss',
is an incident where no person is injured, but which had
the potential to cause serious injury, incapacity or
death. ... This suggests a correlation exists between the
circumstances of Dangerous Occurrences and those
http://www.fsc.gov.au/sites/fsc/news/pages/fsc-highlights-importance-of-reporting-dangerous-occurrences

incidents where injuries actually occurred

REPORT REQUIREMENTS – Rule 1050 OSHS
The following are dangerous occurrences which
shall be investigated and reported.
a. Explosion of boilers used for heating or
power
b. Explosion of a receiver or storage container
c.Bursting of a revolving wheel, grinding stone
or grinding wheel
d.Collapse of a crane, hoist and other
equipment used in raising or lowering persons or
goods
e.Explosion or fire causing damage to the structure
of any room or place
f.Electrical short circuit or failure of
electrical machinery, machinery, plant or apparatus
An IMMINENT DANGER is a workplace hazard that puts you at
immediate serious risk of death or serious physical harm.

It may be a safety hazard such as an unstable trench or exposed

electrical wire that could cause a serious or fatal accident immediately
under present conditions.
The following are examples of grounds
of work stoppage due to condition or
stage of being in imminent danger:
 STAGE OF IMMINENT DANGER
1. Damaged Pressure Relief Valve
2. Increase temperature of tank due to hot work & absence of inert
gas inside tank.
3. No proper enclosure of the workplace & absence of machine guard
4. Outriggers of crane are not placed on stable ground
5. Oxygen acetylene gas cylinders exposed to excessive heat
6. Defective overcurrent protective device
WHO SHOULD INVESTIGATE?
• DEPENDENT ON SEVERITY OF THE ACCIDENT
INVESTIGATION TEAM
• Manager
• Supervisor
• Safety Officer
• Safety and Health Committee
• Company OH Physician and Nurse
• Security Officer
• Union Members
• Involved Workers
 Size of Investigating Team
• The extent of injury

• The potential for injury or damage

• The potential of repetitions

• The department involved

• Requirement for specialized knowledge

• Legal requirement
Investigation is a 4 Step Process

1. Control the Scene

Accident

3. Analyze the data 2. Gather the data

4. Write Report
The Investigation Process
1. Control the Scene
Eliminate the hazards:
• Control chemicals
• De-energize
• De-pressurize
• Light it up
• Shore it up
• Ventilate
Provide Care to the Injured
• Ensure that medical care is provided to the
injured people before proceeding with the
investigation.
Isolate the
• Barricade the area of the accident, and
Scene keep
everyone out!
• The only persons allowed inside the barricade should
be rescuers, law enforcement, and investigators
• Preserve the evidence until investigation is complete
2. Gather the data
Ask “What Happened”
• Get a brief overview of the situation from
witnesses and victims.
• Not a detailed report yet, just enough to
understand the basics of what happened.
Interview Victims &
Witnesses • Interview as soon as possible after the incident
• Do not interrupt medical care to interview
• Interview each person separately
• Do not allow witnesses to confer prior
to interview
 • Examine the accident scene. Look for things that will help
Gather you understand what happened:
Evidence • Dents, cracks, scrapes, splits, etc. in equipment
• Tire tracks, footprints, etc.
• Spills or leaks
• Scattered or broken parts
• Etc.
Gather Evidence
• Diagram the scene
• Use blank paper or graph paper. Mark the location of all
pertinent items; equipment, parts, spills, persons, etc.
• Note distances and sizes, pressures and temperatures
• Note direction (mark north on the map)
Gather Evidence

• Take photographs
• Photograph any items or scenes which may provide an understanding of
what happened to anyone who was not there.
• Photograph any items which will not remain, or which will be cleaned
up (spills, tire tracks, footprints, etc.)
Gather Data
• Photos of accident scene
• Drawings & sketches & measurements
• Data
▪ Persons involved
▪ Date, time, location
▪ Activities at time of accident
▪ Equipment involved
▪ List of witnesses
The
Interview
• When? Where?
• In group or individually?
• Put the person at ease.
• People may be reluctant to discuss the
incident, particularly if they think someone will get in
trouble

• Reassure them that this is a fact-finding process

only.
• Remind them that these facts will be used to prevent a
recurrence of the incident
The Interview
• Take Notes!
• Ask open-ended questions
• “What did you see?”
• “What happened?”
• Do not make suggestions
• If the person is stumbling over a word or concept,
do not help them out
The Interview
• Use closed-ended questions later to gain more detail.
• After the person has provided their explanation,
these type of questions can be used to clarify
• “Where were you standing?”
• “What time did it happen?”
The Interview
• Don’t ask leading questions
• Bad: “Why was the forklift operator driving recklessly?”
• Good: “How was the forklift operator driving?”
The Interview
• If the witness begins to offer reasons, excuses, or explanations,
politely decline that knowledge and remind them to stick with
the facts
The Interview
• Summarize what you have been told.
• Correct misunderstandings of the events between you
and the witness
The Interview
• Ask the witness/victim for recommendations to
prevent recurrence
• These people will often have the best solutions to
the problem
The Interview
• Get a written, signed statement from the witness
• It is best if the witness writes their own statement;
interview notes signed by the witness may be used if the
witness refuses to write a statement
4. Analyze the data
Determine causes
• Employee actions
• Environmental conditions
• Equipment condition)
• Procedures
• Training
Effective Accident Investigations

Policies/Procedures Equipment Materials

Environment Tas People/Operators

k
Note :Accidents generally have more than one cause
DETERMINE
CAUSES • Employee actions
• Safe behavior, at-risk behavior
 DETERMINE CAUSES
• Environmental conditions
• Lighting, heat/cold, moisture/humidity, dust, vapors, etc.
DETERMINE CAUSES
• Equipment condition
• Defective/operational, guards, leaks, broken parts, etc.
 DETERMINE CAUSES
• Procedures
• Existing (or not), followed (or
not), appropriate (or not)
DETERMINE CAUSES
• Training
• Was employee trained - when, by whom, documentation
DETERMINE CAUSES
• DESIGN
• Workplace layout
• Design of tools & equipment
• Maintenance
DETERMINE CAUSES
• Systems & Procedures
• Lack of systems & procedures
• Inappropriate systems &
procedures
• Training in procedures
• Housekeeping
FIND ROOT CAUSES
• Root Cause Analysis, finding the
real cause of the problem and
dealing with it rather than simply
continuing to deal with the
symptoms.
FIND ROOT CAUSES
• When you have determined the contributing
factors, dig deeper!
• If employee error, what caused that
behavior?
• If defective machine, why wasn’t it

fixed?
• If poor lighting, why not corrected?
• If no training, why not?
Analyze the data
Review Records:
• Check training records
– Was appropriate training provided?
– When was training provided?

• Check equipment maintenance records

– Is regular PM or service provided?
– Is there a recurring type of failure?

• Check accident records

– Has there been similar incidents or injuries involving other employees?
Prepare investigation report
• Background Information
– Where and when the accident occurred
– Who and what were involved
– Operating personnel and other witnesses

• Account of the Accident (What happened?)

– Sequence of events
– Extent of damage
– Accident type
– Agency or source (of energy or hazardous Material)
 Prepare investigation report
•Discussion (Analysis of the Accident - HOW; WHY)

• Direct causes (unsafe acts, energy sources; hazardous materials)

• Contributing causes (personal or environmental causes)

•Root causes (management policies; system procedures; inadequate

trainings)
• Recommendations (to prevent recurrence)
Rule 1050 – Notification and Keeping of Records of Accident
and/ or Occupational Illness

1053.01 Notification
🙧All work accidents or occupational illnesses resulting in
disabling conditions or dangerous occurrence shall be reported
by the employer to the Regional Labor Office
Rule 1050 – Notification and Keeping
of Records of Accident and/ or
Occupational Illness
Prescribed form: DOLE/BWC/OHSD-IP-6
(Employers Work Accident/Illness Report)

The formal report (2 copies) shall be

submitted by the employer on or before
the 20th day of the month following
the date of the occurrence of the
accident.
Rule 1050 – Notification and
Keeping of Records of Accident
and/ or Occupational Illness
Prescribed Form :
DOLE/BWC/OHSD-IP6B
Annual Work Accident/Illness
Exposure Data Report
(AEDR)
Submitted on or before January
20th of the following year with or
without accident
A disabling injury is a work injury which results in a
death or fatality; permanent total disability (PTD);
permanent partial disability (PPD) or temporary total
disability (TTD).
PTD is any injury or sickness which permanently and totally
incapacitates a worker from gainful occupation or which results in the
loss of or the complete loss of any of the following:
• Both eyes, both legs or feet, both arms

• Any two of the above not in the same limb;

• Permanent complete paralysis of two limbs; and

• Brain injury resulting in incurable imbecility or insanity

 • PPD on the other hand, is an injury or sickness which results in the loss or loss
of use of any member or part of the member of the body regardless of any
pre-existing disability of the injured member of impaired body function.

• TTD is an injury or illness which does not result in PPD or PTD but which result
in disability from work for a day or more

TIP: Count the number of accidents which result in death, PTD, PPD and TTD to
determine the disabling injuries. Do NOT
Include medical treatment injuries
Key Definitions

Days Lost or Charged

- For TTD- refers to the actual days that the worker has been unable to work
Ex.: medical staff determined that a worker must rest for 2 days to recover from
an injury. This 2 days is the days lost for that injury

- For Death, PTD and PPD- refer to Table 6: Tabulation of the Scheduled Charges
of the OSHS, p. 192
(1) Actual Exposure Hours - Employee hours of
exposure shall be, if
possible, taken from the payroll or time clock records and shall include only the actual straight
time hours worked and actual overtime hours worked.
(2) Estimated Exposure Hours – When actual employee – hours of
exposure are not available estimated hours may be used. Such estimated hours should be
obtained by multiplying the total employee days worked for the period by the average number of
hours worked per day. If the hours worked per day vary among departments, a separate estimate
should be made for each department, and these estimates added to obtain the total hours.
Estimates for overtime hours shall be included
Frequency
Rate
Frequency Rate (FR) = No. of disabling injury X 1,000,000
Total Employee-Hour Exposure

Frequency Rate (FR) = 10 X 1,000,000

200,000

Frequency Rate (FR) = 50

Assuming:
# of Disabling Injuries = 10
Total Emp-Hr Exp = 200,000
Severity Rate

Severity Rate (SR) = Total days lost X 1,000,000

Total Employee-Hour Exposure

Severity Rate (SR) = (300) X 1,000,000

200,000
Severity Rate (SR) = 1,500
● Accidents disrupt normal function of the organization due to injuries/
fatality of workers or damage to property.

● Accident can be prevented from recurring through an efficient root

cause investigation.

● Primary causes of accidents are unsafe/unhealthy acts &

conditions
•Basic procedures in the conduct of accident investigation must
be followed
•Results of accident investigation must be documented properly
and thoroughly.

• Make recommendations based on the investigation.

• Dangerous occurrences in the workplace must be addressed.