Osha Form 301 - Injury And Illness Incident Report Page 2

Public reporting burden for this collection of information is estimated to average 22 minutes per response, including time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed and completing and reviewing the collection of information. Persons

are not required to respond to the collection of information unless it displays a valid OMB control number. If you have any comments about these estimates or any other aspects ofof this data collection, contact: US Department of Labor, OSHA Office of Statistics, Room N-3644, 200

Constitution Ave, NW, Washington, DC 20210. Do not send the completed forms to this office.

How to Investigate an Accident or Job-Related Illness

When an accident occurs or an employee becomes ill from something related to their job, the leadership has an obligation

Notes:

to investigate the circumstances. The investigation starts with collecting the relevant details as soon as possible. OSHA

Form 301 or a similar “accident report” form (like the one used to file for workers’ compensation benefits as long as it

contains the same information) should be used to document the details while they are fresh in everyone’s memory. Any

incident that results in one of the following situations is considered work-related and must be investigated using an

accident report:

•

the death of an employee on the job;

•

the loss of consciousness of an employee while on the job;

•

the employee loses at least one day of work because of the

What is First Aid?

incident;

•

the employee’s duties or abilities are restricted or he/she is

If the incident required only the following types of

transferred to another job because of the incident (this generally

treatment, consider it first aid; DO NOT record it on

includes animal-inflicted injuries such as bites and severe

the log.

scratches);

the use of non-prescription medications at non-

•

the employee receives medical treatment other than first aid (see

prescription strengths;

box for definitions) because of the incident;

administration of tetanus immunizations;

cleaning, flushing or soaking wounds on the skin

•

the employee suffers a fractured or cracked bone, a punctured

surface;

ear drum or any chronic, irreversible disease as a result of their

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using wound coverings such as BandAids , gauze

job;

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pads, etc. or using SteriStrips

or butterfly

•

the employee develops cancer, tuberculosis or is removed from

bandages;

their job for medical reasons under an OSHA health standard; or

using hot or cold therapy;

•

the employee is stuck with a needle or cut from a sharp object

using any totally non-rigid means of support, such

that is contaminated with HUMAN blood or HUMAN infectious

as elastic bandages, wraps, non-rigid back belts,

material during performance of their duties.

etc;

drilling a fingernail to toenail to relieve pressure, or

draining fluids from blisters;

Note: Incidents involving non-employees (visitors, clients)

using eye patches;

should be reported to the insurance company but are not

using simple irrigation or a cotton swab to remove

considered workplace accidents according to OSHA standards

foreign bodies not embedded in or adhered to the

and therefore should not be included in this process.

eye;

using irrigation, tweezers, cotton swabs or other

simple means to remove splinters or foreign

material from areas other than the eye;

The leadership or Safety Committee should review the accident report

using finger guards;

after completion of the investigation to determine if any changes to the

using massages;

hospital operations are necessary.

drinking fluids to relieve heat stress.

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