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Upon opening the OSHA 300 log for CSU Widget Factory, you are to calculate the total recordable incidence rate (TRIR), the DART rate, the lost workday injury and illness rate (LWDII), and the severity rate (SR). Be sure to show your calculations.

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1. Calculating Lagging Indicator Metrics

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Your boss just e-mailed you with a new project. He is requesting you review the information for the CSU Widget Factory which is attached(labeled UnitII_WidgetFactory)

Upon opening the OSHA 300 log for CSU Widget Factory, you are to calculate the total recordable incidence rate (TRIR), the DART rate, the lost workday injury and illness rate (LWDII), and the severity rate (SR). Be sure to show your calculations.

Next, distinguish some of the leading indicators that you would use if examining the CSU Widget Factor Safety Management System.

Finally, summarize your findings back to your boss, including any suggestions for improvement.

Your paper must be a minimum of two pages. All sources, including the textbook, must be cited/referenced in proper APA format.

2. JHA/JSA Assignment

Consider a task in your workplace that has led to issues, injuries, or near injuries. Perform a Job Hazards Analysis (JHA) for this task. (The form is attached and labeled UnitIII_JHA_Form)

Upon completing the JHA, you will need to address the following items surrounding your workplace:

Describe principles of risk assessment and hazard analyses used within your occupation.

Explain how OSHA and other control methods are currently being used to prevent injuries and illnesses.

Critique current strategies in your workplace to combat the hazards surrounding the selected job task.

Your essay is required to be a minimum of two pages and follow APA guidelines. All sources used, including the textbook, must be referenced; paraphrased and quoted material must have accompanying citations.

  • UnitIII_JHA_Form.docx
  • UnitII_WidgetFactory.pdf

JOB HAZARD ANALYSIS FORM – BOS 3001, RISK MANAGEMENT

Job Title: Analyst Name: Date:
Job Description:
# Job Steps Basic description of tasks recorded in sequence Hazards Description and effect of existing and potential hazards based on observation and experience. Controls Describe necessary controls for each hazard using the Hierarchy of Controls method.
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(add/delete rows as needed)

Comments/Discussion (200-word minimum)

2

ALOrange Beach

15

month / day /

daysdays Reset 1 Jane Doe Widget Welder 1 18 Welding Area Burned Retinas – both eyes ● 2 ●

month / day /

daysdays Reset 2 William Smith Warehouse Worker 2 24 Storeroom Lumbar Strain ● 4 ●

month / day /

daysdays Reset 3 Nellie Kershaw Production Line Worker 5 18 Main Production Floor Respiratory Condition ● 2 14 ●

month / day /

daysdays Reset

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U.S. Department of Labor Occupational Safety and Health Administration

OSHA’s Form 300 (Rev. 01/2004) Year 20Log of Work-Related

Injuries and Illnesses You must record information about every work-related death and about every work-related injury or illness that involves loss of consciousness, restricted work activity or job transfer, days away from work, or medical treatment beyond first aid. You must also record significant work-related injuries and illnesses that are diagnosed by a physician or licensed health care professional. You must also record work-related injuries and illnesses that meet any of the specific recording criteria listed in 29 CFR Part 1904.8 through 1904.12. Feel free to use two lines for a single case if you need to. You must complete an Injury and Illness Incident Report (OSHA Form 301) or equivalent form for each injury or illness recorded on this form. If you’re not sure whether a case is recordable, call your local OSHA office for help.

Page

In ju

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Sk in

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R es

pi ra

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co

nd iti

on

Page totals

Establishment name

City

Enter the number of days the injured or ill worker was:

Select the “Injury” column or choose one type of illness:

Public reporting burden for this collection of information is estimated to average 14 minutes per response, including time to review the instructions, search and gather the data needed, and complete and review the collection of information. Persons are not required to respond to the collection of information unless it displays a currently valid OMB control number. If you have any comments about these estimates or any other aspects of this data collection, contact: US Department of Labor, OSHA Office of Statistical Analysis, Room N-3644, 200 Constitution Avenue, NW, Washington, DC 20210. Do not send the completed forms to this office.

(A) (B) (C) (D) (E) (F)

(M)

(K) (L)(G) (H) (I) (J) Death

Days away from work

On job transfer or restriction

Away from work

Attention: This form contains information relating to employee health and must be used in a manner that protects the confidentiality of employees to the extent possible while the information is being used for occupational safety and health purposes.

SELECT ONLY ONE box for each case based on the most serious outcome for that case:

Job transfer or restriction

Other record- able cases

Remained at Work

(1) (2) (3) (4) (5) (6)

(1) (2) (3) (4) (5) (6)

Case no.

Job title (e.g., Welder)

Where the event occurred (e.g., Loading dock north end)

Describe injury or illness, parts of body affected, and object/substance that directly injured or made person ill (e.g., Second degree burns on right forearm from acetylene torch)

Date of injury or onset of illness (e.g., 2/10)

Identify the person Describe the case Classify the case

Employee’s name

Po is

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H ea

rin g

lo ss

A ll

ot he

r ill

ne ss

es A

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he r

ill ne

ss es

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Po is

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Form approved OMB no. 1218-0176

State

CSU Widget Factory

of

Note: You can type input into this form and save it. Because the forms in this recordkeeping package are “fillable/writable” PDF documents, you can type into the input form fields and then save your inputs using the free Adobe PDF Reader. In addition, the forms are programmed to auto-calculate as appropriate.

0 3 0 0 8 14 2 0 1 0 0 0

1 1Save Input Add a Form Page

OSHA’s Form 300A (Rev. 01/2004) Summary of Work-Related Injuries and Illnesses

Form approved OMB no. 1218-0176

Total number of deaths

Total number of cases with days away from work

Number of Cases

Total number of days away from work

Total number of days of job transfer or restriction

Number of Days

Post this Summary page from February 1 to April 30 of the year following the year covered by the form.

All establishments covered by Part 1904 must complete this Summary page, even if no work-related injuries or illnesses occurred during the year. Remember to review the Log to verify that the entries are complete and accurate before completing this summary. Using the Log, count the individual entries you made for each category. Then write the totals below, making sure you’ve added the entries from every page of the Log. If you had no cases, write “0.” Employees, former employees, and their representatives have the right to review the OSHA Form 300 in its entirety. They also have limited access to the OSHA Form 301 or its equivalent. See 29 CFR Part 1904.35, in OSHA’s recordkeeping rule, for further details on the access provisions for these forms.

Establishment information

Your establishment name

Street

City

Industry description (e.g., Manufacture of motor truck trailers)

Standard Industrial Classification (SIC), if known (e.g., 3715)

Public reporting burden for this collection of information is estimated to average 50 minutes per response, including time to review the instructions, search and gather the data needed, and complete and review the collection of information. Persons are not required to respond to the collection of information unless it displays a currently valid OMB control number. If you have any comments about these estimates or any other aspects of this data collection, contact: US Department of Labor, OSHA Office of Statistical Analysis, Room N-3644, 200 Constitution Avenue, NW, Washington, DC 20210. Do not send the completed forms to this office.

Total number of . . .

Skin disorders

Respiratory conditions

Injuries

Injury and Illness Types

Poisonings

Hearing loss

All other illnesses

(G) (H) (I) (J)

(K) (L)

(M)

(1)

(2)

(3)

(4)

(5)

(6)

Total number of cases with job transfer or restriction

Total number of other recordable cases

U.S. Department of Labor Occupational Safety and Health Administration

Year 20

OR

North American Industrial Classification (NAICS), if known (e.g., 336212)

Employment information (If you don’t have these figures, see the Worksheet on the next page to estimate.)

Annual average number of employees

Total hours worked by all employees last year

Sign here

Knowingly falsifying this document may result in a fine.

I certify that I have examined this document and that to the best of my knowledge the entries are true, accurate, and complete.

________________________________ ___________________ Company executive Title

Phone ______ – _______ – ___________ Date _____ / _____ / ______

0

Note: You can type input into this form and save it. Because the forms in this recordkeeping package are “fillable/writable” PDF documents, you can type into the input form fields and then save your inputs using the free Adobe PDF Reader.

State Zip

0

8

0

0

Save Input

0 3 0 0

14

2

1

CSU Widget Factory

21982 University Lane Orange Beach AL 36561

Widget Manufacturing

326199

27 58675

Information about the employee

Full name

Street

City State ZIP

Date of birth

Date hired

Male Female

Information about the physician or other health care professional

Name of physician or other health care professional

If treatment was given away from the worksite, where was it given?

Facility

Street

City State ̀ZIP

Was employee treated in an emergency room? Yes No

Was employee hospitalized overnight as an in-patient? Yes No

OSHA’s Form 301 Injury and Illness Incident Report

Form approved OMB no. 1218-0176

This Injury and Illness Incident Report is one of the first forms you must fill out when a recordable work-related injury or illness has occurred. Together with the Log of Work-Related Injuries and Illnesses and the accompanying Summary, these forms help the employer and OSHA develop a picture of the extent and severity of work-related incidents. Within 7 calendar days after you receive information that a recordable work-related injury or illness has occurred, you must fill out this form or an equivalent. Some state workers’ compensation, insurance, or other reports may be acceptable substitutes. To be considered an equivalent form, any substitute must contain all the information asked for on this form. According to Public Law 91-596 and 29 CFR 1904, OSHA’s recordkeeping rule, you must keep this form on file for 5 years following the year to which it pertains. If you need additional copies of this form, you may photocopy the printout or insert additional form pages in the PDF, and then use as many as you need.

Information about the case

Case number from the Log (Transfer the case number from the Log after you record the case.)

Date of injury or illness

Time employee began work AM PM

Time of event AM PM Check if time cannot be determined

What was the employee doing just before the incident occurred? Describe the activity, as well as the tools, equipment, or material the employee was using. Be specific. Examples: “climbing a ladder while carrying roofing materials”; “spraying chlorine from hand sprayer”; “daily computer key-entry.”

Completed by

Title

Phone

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 current valid OMB control number. If you have any comments about this estimate or any other aspects of this data collection, including suggestions for reducing this burden, contact: US Department of Labor, OSHA Office of Statistical Analysis, Room N-3644, 200 Constitution Avenue, NW, Washington, DC 20210. Do not send the completed forms to this office.

10)

11)

12)

13)

14)

15)

16)

17)

18)

1)

2)

3)

5)

6)

7)

8)

9)

4)

U.S. Department of Labor Occupational Safety and Health Administration

What Happened? Tell us how the injury occurred. Examples: “When ladder slipped on wet floor, worker fell 20 feet”; “Worker was sprayed with chlorine when gasket broke during replacement”; “Worker developed soreness in wrist over time.”

What was the injury or illness? Tell us the part of the body that was affected and how it was affected; be more specific than “hurt,” “pain,” or “sore.” Examples: “strained back”; “chemical burn, hand”; “carpal tunnel syndrome.”

What object or substance directly harmed the employee? Examples: “concrete floor”; “chlorine”; “radial arm saw.” If this question does not apply to the incident, leave it blank.

If the employee died, when did death occur? Date of death Month Day Year

Month Day Year

Month Day Year

Month Day Year

Month Day Year

Date – –

Attention: This form contains information relating to employee health and must be used in a manner that protects the confidentiality of employees to the extent possible while the information is being used for occupational safety and health purposes.

Note: You can type input into this form and save it. Because the forms in this recordkeeping package are “fillable/writable” PDF documents, you can type into the input form fields and then save your inputs using the free Adobe PDF Reader. In addition, the forms are programmed to auto-calculate as appropriate.

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