Corporate Safety Manual Chapter 14 Near Miss Reporting Last updated: April 2015
Near Miss Reporting Chapter 14: Near Miss Reporting Index Page Introduction...14-3 Process...14-4 Near Miss Events to be reported to the Provincial OH&S Branch...14-4 Provincial OH&S Regulations that apply to Near Miss...14-4 Accidents Causing Serious Bodily Harm...14-4 Dangerous Occurrences...14-4 Near Miss Reporting Form...14-6 Completing the Near Miss Form...14-7 Workplace Health and Safety Branch 14-1
City of Regina Safety Manual 14-2 Workplace Health and Safety Branch
Near Miss Reporting Introduction The identification and reporting of a near miss event is a critical component of a Safety Management System, hazard identification, reporting and taking measures to eliminate or mitigate hazards in the workplace before injury or loss occurs is a principle of accident prevention. Completion of the Near Miss Report Form is a preventive measure for the identification of hazards within the workplace that has not but may have caused property damage, injury or death of a worker. Once the report has been submitted it will be the responsibility of the workplace s management to determine the cause for the near miss and then take measures to prevent future occurrences. Management can ask for assistance to determine the cause of the event from their employees, OH&S Co-chairs, members of their OH&S Committee or may consult with their Workplace Health and Safety Representative. The following are examples of a near miss event that would have to be reported to management. In all examples there was no injury or death of a worker: A jack stand fails and a vehicle falls to the garage floor A citizen removes a traffic barricade and proceeds to drive through a construction site While removing a sidewalk a live electrical cable is exposed. The underground locate did not identify the presence of the electrical utility. An office worker slips on a wet floor An operator exits the cab of a grader while the tip of the wing is in contact with an overhead high voltage power line While lifting an object with a crane the sling fails dropping the load to the ground A facilities cleaner mixes two cleaning chemicals together that react with each other creating noxious fumes and the need to evacuate the area Workplace Health and Safety Branch 14-3
City of Regina Safety Manual Process The Near Miss Report Form is to be completed by the Employee witnessing the event or the Supervisor who is responsible for the workplace. Copies of the completed report are to be submitted to the: Manager of the workplace to determine cause and measures needed to be taken to prevent a reoccurrence Occupational Health and Safety Committee to review at the next scheduled committee meeting and when required provide recommendations to improve safety in the workplace Workplace Health and Safety Representative to review and determine if trends are developing which could contribute to an unsafe workplace and to provide consultation services to the workplace experiencing near miss events. When required, liaison with outside service providers or agencies to reduce potential hazards in City of Regina workplaces. Near Miss Events to be reported to the Provincial OH&S Branch Not all near miss events have to be reported to the Provincial OH&S Branch. Only near miss events that meet the criteria as defined in the Provincial OH&S Regulations, Section 8 in which the event may have caused bodily harm, or Section 9 (1) which could be considered a Dangerous Occurrences must be reported. Before submitting a Near Miss Report Form to the Provincial OH&S Branch have your Workplace Health and Safety Representative review the form before submission. Provincial OH&S Regulations that apply to Near Miss Accidents Causing Serious Bodily Injury 8(1) An employer or contractor shall give notice to the division as soon as is reasonably possible of every accident at a place of employment that causes or may cause the death of a worker Dangerous Occurrences 9(1) In this section, dangerous occurrence means any occurrence that does not result in but could have resulted in a condition or circumstance set out in subsection 8(1) includes: The structural failure or collapse of: A structure, scaffold, temporary false work or concrete formwork All or any part of an excavated shaft, tunnel, caisson, coffer dam, trench or excavation 14-4 Workplace Health and Safety Branch
Near Miss Reporting The failure of a crane or hoist or the overturning of a crane or unit of powered mobile equipment An accidental contact with an energized electrical conductor The bursting of a grinding wheel An uncontrolled spill or escape of a toxic, corrosive or explosive substance A premature detonation or accidental detonation of explosives The failure of an elevated or suspended platform The failure of an atmosphere-supplying respirator Note: In the event of an injury to a worker, a Workplace Injury Report Form (WIR) is to be completed. This is not a near miss. In the event of vehicle or property damage an Incident/Collision Report is to be completed. The Risk Manager, Legal Department is to be notified of all collisions and property damage. Workplace Health and Safety Branch 14-5
City of Regina Safety Manual Near Miss Report Form Employee Name: Incident Date: / / DD MM YY Witness: Incident Time: HH MM a.m. / p.m. Department: Branch: Position: Location of Incident: Description of Incident: Employee s Signature: Was the immediate Supervisor notified? YES NO Name of Supervisor: (Print Name) Immediate Action Taken: 14-6 Workplace Health and Safety Branch
Near Miss Reporting Completing the Near Miss Report Form 1) Employee Name: The employee reporting the near miss prints their name in this area. 2) Incident Date: The date of the near miss is entered into this area. 3) Witness: The name of the witness is printed in this area. If there are multiple witnesses include their names in the Description of Incident section. 4) Incident Time: Enter the time of the near miss in this area. Ensure the a.m./p.m. is indicated. 5) Department: Enter the Department of the work group that experienced the near miss. 6) Branch: Enter the Branch of the work group that experienced the near miss. 7) Position: Enter the position of the employee reporting the near miss. 8) Location of Incident: Street address or physical description of where the incident took place. 9) Description of Incident: Provide detailed information for the reader to understand: Who was involved? Include their name and position title. What happened? Describe the work being performed and what tools and equipment were involved in the near miss. What was the result? Describe what could have happened. 10) Employee Signature: Employee signs the form. 11) Was the immediate supervisor notified? Yes / No? Print the name of the Supervisor. 12) Immediate action taken: Provide detailed information for the reader to understand what actions were taken immediately after the near miss was identified: Was the work stopped? What actions were taken to improve safety on the worksite? Was a Tailgate Meeting held with all of the workers? Were the OH&S Co-chairs called due to a Dangerous Occurrence? Workplace Health and Safety Branch 14-7