OCCUPATIONAL HEALTH & SAFETY INCIDENT REPORT
Project: SPETCO Informed By: ANOJ SHAH
Department: MECHANICAL Location: WORKSHOP
Name of the Injured VANDEESH C.
Designation: FITTER
Person: K
Date of the Incident: 11/12/2024 Time: 02:30PM
Department Supervisor MANOJ KUMAR Ref No XPO – OHSIR- 003
Accident Category : (Tick)
First Aid Medical Treatment Near Miss Fatality
Others:
Description of the Incident: Mr. Vansheesh was unloading a hammer after completing his work when it
suddenly slipped from his shoulder and fell, striking his nose. The impact caused bleeding, swelling, and
a minor fracture to his nasal bone. The unexpected drop of the hammer highlights the risk associated with
improper handling or positioning of heavy tools during unloading. The injury required immediate medical
.attention to treat the nasal fracture and manage the swelling caused by the accidental fall of the hammer
Part of body effected:
Head Trunk Internal Arm Hand Leg Foot
□ Eye □ Neck □ Heart □ Left □ Left □ Left □ Left
□ Ear □ Hip □ Lungs □ right □ Right □ Right □ Right
Nose Chest Systemi Shoulder Thumb Knee Great toe
□ □ □ □ □ □ □
c
Mouth Stomac Upper Fingers Lower Other
□ □ □ □ □ □
h arm leg toes
□ Teeth □ Groin □ Elbow □ palm □ Ankle
□ Face □ back □ Forearm □ Thigh
skull Multiple Wrist Upper
□ □ □ □
leg
:Others □
Up to 1 Up to 2 Up to 4 Resulting in
Possible length of 1- 3 Up to 6 Weeks
Week Weeks Weeks Death
Incapacity to work (Tick):
□ □ □ □ □ □
Was hospitalization necessary: □ Yes □ No
Root Cause:
The root cause of the incident was improper handling and positioning of the hammer during
unloading. Carrying the hammer on the shoulder created an unstable balance, increasing the risk of
it slipping and falling. Additionally, a lack of proper unloading techniques or safe storage practices
.contributed to the incident
Action to be taken to avoid recurrence of the Incident: (Corrective Action)
The corrective action involves implementing proper unloading and handling techniques for heavy tools,
ensuring they are carried and stored securely. Provide training to workers on safe manual handling
practices to prevent such incidents. Additionally, designate specific procedures for unloading and storing
tools to minimize the risk of accidents. Conduct regular reviews of work practices to ensure compliance
with safe handling guidelines.
.XPO TECHNOLOGY GENERAL TRADING & CONTRACTING CO. W.L.L
XPO-HSE-F-03 Issue No.: 01 Revision No.: 00 Effective Date: 07.06.2023 4 Page 1 of
OCCUPATIONAL HEALTH & SAFETY INCIDENT REPORT
Preventive Action/ Recommendation (if any): Use proper handling techniques, avoid carrying
tools on shoulders, provide training, and implement safe unloading and storage procedures.
conduct periodic safety briefings to reinforce proper practices.
Target Date of Completion: Immediate Responsible Person: Supervisor
Name of Witness (If applicable): ANOJ SHAH,MANOJ KUMAR,
Safety Officer Project Manager MR
Name:
Sign:
Date:
.XPO TECHNOLOGY GENERAL TRADING & CONTRACTING CO. W.L.L
XPO-HSE-F-03 Issue No.: 01 Revision No.: 00 Effective Date: 07.06.2023 4 Page 2 of
OCCUPATIONAL HEALTH & SAFETY INCIDENT REPORT
EVIDENCES & TREATMENT
.XPO TECHNOLOGY GENERAL TRADING & CONTRACTING CO. W.L.L
XPO-HSE-F-03 Issue No.: 01 Revision No.: 00 Effective Date: 07.06.2023 4 Page 3 of
OCCUPATIONAL HEALTH & SAFETY INCIDENT REPORT
.XPO TECHNOLOGY GENERAL TRADING & CONTRACTING CO. W.L.L
XPO-HSE-F-03 Issue No.: 01 Revision No.: 00 Effective Date: 07.06.2023 4 Page 4 of
