What Does an Incident Report Need to Include?

An incident report is a formal recording of the facts related to a workplace accident,

injury, or near miss. Its primary purpose is to uncover the circumstances and conditions
that led to the event in order to prevent future incidents.

Every incident report you file should contain a minimum of the following:

 Type of incident (injury, near miss, property damage, or theft)

 Address
 Date of incident
 Time of incident
 Name of affected individual
 A narrative description of the incident, including the sequence of events and
results of the incident
 Injuries, if any
 Treatments required, if any
 Witness name(s)
 Witness statements
 Other workers involved
 Video and/or 360-degree photographs of the scene

Include quantifiable measurements where possible. For example, the ladder capacity is
250 lbs and the victim was hoisting 300 lbs.

Finally, where more than one person is injured in an incident, create a unique report for
each affected employee. While it’s fine to duplicate general details between reports of
this nature, you’ll need to include details specific to that person, such as the event from
their point of view or medical records.

When Does an Incident Report Need to Be Completed?

Create an incident report as soon as your employees are safe. By recording details
immediately, you improve the accuracy of your report and the effects of your corrective
actions. While it may take a few days to complete your report, it should take you only
hours (or less) to start it.

After an incident, secure the worksite for all crews and make sure injured employees are
receiving medical care if needed. Start your fact gathering for your report immediately
after this.

Depending on your company policies and regulatory body, you may be legally bound to
complete an incident report within a given amount of time. In addition, you may need to
send your report to the organization providing oversight, US Federal or State OSHA, for
example, within a given period of time.

Incident Reporting Mistakes to Avoid

Blame-casting and just “getting it done” are two common incident-reporting mistakes you
should avoid.

Incident reports aren’t created for the purpose of finding out who’s to blame. It is easy to
go on a witch-hunt when accidents happen. While staff should be held responsible (as
stipulated by company policy) when they knowingly endanger themselves or others, the
report should focus on improving workplace safety.

If you make it clear you’ll abide by company policy but are not out to cast blame, you
increase the likelihood that employees will participate in your incident investigation and
provide honest witness statements.

In addition, if you’re rushing through the report to “just get it done,” you may miss out on
important details or lack clarity in wording. Irresponsible reporting can lead your team
into even more danger, while detailed, clear reporting can lead to improved work
conditions and better training.

Three Incident Report Samples

Below are some sample incident report formats for three common types of workplace
accidents. Use them as guides to effectively describe events.

Injury and Lost Time Incident Report Sample

If an injury requiring medical treatment, lost time/altered responsibilities happens in your

workplace, it’s important to document it ASAP while the details are still fresh in memory.

Here are some of the vital elements to include in your description of the incident:

 Type of incident (injury, near miss, property damage, or theft)

 Location (Address)
 Date/time of incident
 Name
 Name of supervisor
 Description of the incident, including specific job site location, the sequence of
events, and the results of the event
 Whether or not proper PPE was being used
 The root cause(s) of the incident
  Associated hazards raised and resolved following the event
 The affected individual’s version of the events
 Actions taken by concerned individuals after the incident
 Description of injuries
 How the decision was made to call (or not to call) emergency services
 Treatment required
 Witness name(s)
 Witness statements
 Photographs of the scene

Though the details above seem like a lot, mentioning them in the incident report paints a
more accurate picture than glossing over the incident. It’s important to include the above
information in as detailed and concise a manner as possible.
To write an incident report, use a narrative format. Simply tell the story. Here’s an
incident report sample description of a slip or fall resulting in a fracture, written as a
narrative:
“On Friday afternoon, February 3, 2019, at 2 p.m. in ABC Shipping Co. located in 13th
Avenue, Applewood, one of the warehouse workers (John Keegan) slipped and fell while
carrying heavy (85 lbs) inventory. The root cause is believed to be the unavailability of a
hand truck or pallet jack. Instead of waiting, John attempted carrying the load himself. A
second possible cause is the condition of John’s PPE, specifically his boots, which are very
worn in certain places.

When John fell, his colleagues rushed to his assistance. Suspecting a fracture, the
supervisor on the floor (Kathy Pickens) decided to call 911.
John said he felt a bit dizzy when he lost his balance and that he just ‘tripped over his feet.’
He tried to minimize damage to the load itself while falling, which may have led to a more
awkward fall.

Two of his co-workers said that they noticed he was struggling a bit before the fall but
were busy with their own tasks and felt it would be rude to ‘call him out.’ See the attached
witness statements for more info.

John was taken to a nearby hospital and a fracture to his wrist was confirmed. John will be
out of work for a number of weeks.

The supervisor is currently working with the safety officer (Chris Darnell) to assess the
condition of the floor, the number and condition of hand trucks and pallet jacks on the
floor, as well as the condition of company-provided boots over two years old.”

As you can see, including the full story, complete with small details and witness
statements will help you investigate and recall the incident with greater clarity.

After documenting the incident, you may have legal reporting requirements. Report and
store the files according to your regulator’s requirements. It’s generally best practice to
preserve the files for the duration of employment.

Exposure Incident Report Example

When exposure to dangerous chemicals or pathogens occurs, it’s important to document

the event carefully in an incident report.

Including the following details will make your exposure incident report more effective:

 Type of incident (injury, near miss, property damage, or theft)

 Address
 Date/time of incident
 Name of affected individual
 Name of Supervisor
 Description of the incident, including specific job site location, sequence of events,
and results of the event
 Name of the chemical/pathogen/carcinogen, amount, concentration, and
description of hazard labels/safety data sheets (SDS)
 Exposure monitoring data, if available
 Whether or not a contaminated sharp was involved
 Whether or not proper PPE was being used
 The root cause(s) of the incident
 Associated hazards raised and resolved following the event
 The affected individual’s version of the events
 Actions taken by concerned individuals after the incident
 Description of injuries, including body part(s) exposed, length of exposure, and size
of area exposed
 Signs and symptoms displayed
 How the decision was made to call (or not to call) emergency services
 Treatment required
 Witness name(s)
 Witness statements
 Photographs of the scene and hazard labels involved
 A

Here’s an incident report sample description for overexposure via inhalation:

“Josh Lee, a freight handler in XYZ Shipping Lines, was exposed to carbon monoxide fumes
on December 2, 2017, Tuesday, from (estimated) 7:30 AM to 11:30 AM. He was at the
unloading bay B, helping unload some freight from various containers with the help of two
forklift operators: Kit Stevens and Donald Summers, neither of which complained of
symptoms.

During unloading, Lee suddenly experienced lightheadedness and nausea. He informed his
supervisor (Donna Martin) that he thought he was ill.

Martin noticed his symptoms were consistent with CO exposure, so she walked over to the
area and felt the air quality seemed off. She ran a sensor (Portable Direct Reading
Monitor) and discovered that CO levels were on the high end but within the acceptable
limit: 30 PPM.

Stevens and Summers were ordered to turn off powered vehicles and sit in fresh air for an
hour while the ventilation system could be examined (see attached report).

Lee was driven to the hospital by Martin to receive treatment. On the way, he complained
of blurred vision briefly but said that it had cleared up upon walking into the ER. A full
report will be attached once received.

Lee’s colleagues, Stevens, and Summers didn’t notice anything out of the norm with the air
quality, but Summers acknowledged that at 11:00 AM, his vehicle had been left running
near the open end of a container for thirty minutes while Lee was adjusting two
improperly arranged pallets just inside. There is no air quality data from that time.”

Be sure to attach medical reports and lost-time from work, if any, to your initial report.
Keep the report on hand for the duration of the employee’s tenure with the company, at a
minimum.

First Aid Incident Report Sample

Some workplace mishaps result in an injury that requires on-site or walk-in medical first
aid treatment. Often, workers can return and finish their shift. Recording an incident
report is still vitally important, even where it’s not expressly required by regulatory
bodies.
Here is an incident report sample description for incidents resulting in the need for first
aid.
“On May 12, 2019, at around 9:34 AM. at King Street job site, Michael Williams was hit by
an air nail gun that had been dropped by Carl Simone near the top of a staircase and
gained momentum as it tumbled down.

Williams, who was nailing drywall at the bottom of the staircase and wearing noise
protective headphones, eye protection, and a short-sleeved shirt, was hit in the arm,
causing a bruise and abrasion. He was treated with antiseptic, antibiotic ointment, a
bandage, and an ice pack on site. Williams returned to work within a half hour.

Simone had shouted a warning after he dropped the gun, but Williams said he did not hear
it. Simone said that he simply lost his grip, but Williams said he felt that the tool may have
been ‘swung’ before dropping. There were no other witnesses to report on the
circumstances of the accident.

Simone was wearing gloves when he dropped the nail gun. There are no outstanding
hazards related to this incident and all workers will be reminded about glove selection and
tool handling at the next safety meeting.”