EOSMS- 108 Last Updated: 02/14/2014 Page 1 of 6



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Environmental Health & Safety Incident Reporting & Investigations Department EOSMS- 108 Last Updated: 02/14/2014 Page 1 of 6 1. Purpose This procedure describes how Kennesaw State University (KSU or the University) handles reporting, investigating and monitoring of environmental and occupational safety (EOS) incidents. 2. Scope This procedure covers all faculty, staff, students, contractors and other personnel at KSU or under the management or control of KSU. The procedure applies to work- related incidents and hazards, including: injuries or illnesses incident, near misses or hazards environmental damage 3. Responsibilities A. KSU Employees i. Promptly report an actual or potential incident or accident to his or her immediate supervisor and complete the necessary form(s). Participate in incident investigation as requested. B. Contractors i. Take all steps necessary to protect the safety and health of KSU s students, employees, and visitors during the performance of their work. Ensure that all incidents or injuries relating to the job are promptly investigated. C. Manager/Supervisor/Principal Investigator i. Receive, review and sign Employee s Injury or Illness Report and forward the report to Human Resources (HR) as soon as possible and no later than 24 hrs. i Ensure investigation is conducted to determine the cause(s) of the accident or incident, and communicate the findings to the Environmental Health and Safety Department (EHS). Ensure appropriate corrective measures have been implemented to address identified hazards to eliminate or reduce the risk of a similar incident occurring in the future. EOSMS - 108 Incident Reporting and Investigations Page 1

D. Human Resources Department (HR) i. Ensure that an injury or illness report is properly communicated to the EHS and the Department of Strategic Security & Safety and Enterprise/ Risk Management (SSS/RM). Ensure that insurance claims are filed when there is medical treatment and communicate with the employee as needed. E. Environmental Health & Safety Department (EHS) i. Provide support and assistance to departments in the investigation of incidents. i Ensure the investigation of accidents or incidents involving significant human harm, fatality, release of hazardous material or significant damage to the environment. Review all incident investigation reports and ensure that appropriate hazard control measures have been identified. Track and document corrective actions to ensure timely follow- up and completion. v. Escalate issues when necessary. vi. v In conjunction with Risk Management Department, review and analyze incident investigation reports to assess for trends and monitor effectiveness of control measures. Review and revise procedures and forms as necessary. F. Strategic Security and Safety /Risk Management (SSS/RM) i. Participate in investigation of incidents and assist in the control and mitigation of hazards. i Participate in the review and analyze incident investigation reports to assess for trends and monitor effectiveness of control measures. Oversee the Kennesaw State Preparedness and Response System (KSPARS) Manages the Crisis Coordinator First Responder Program. G. Legal Affairs i. Provide legal guidance on handling of EOS related incidents. H. Department of Public Safety Respond to emergency situations. i Provide assistance in the control and mitigation of hazards. Page 2

4. Procedure A. Initial General Response i. For incidents involving a fire, medical emergency, hazardous material spill or other types of emergencies, call KSU s emergency number 770-423- 6666 or extension 6666 or 9-1- 1 immediately. i For hazardous material spills or fire within a building, cease all operations in the affected area, alert area and building occupants and evacuate the area if necessary. Whenever safe and necessary to do so, take immediate appropriate actions to safeguard the site to prevent further incidents and if possible, provide aid to any injured people. Avoid further disturbance of the site until it is confirmed that the incident does not require further investigation and a Public Safety or EHS officer has authorized the disturbance. B. Incident Reporting i. All KSU employees and contracts should report, as soon as possible, any of the following that occurs on campus, at a University controlled workplace, or while engaged in any University sanctioned activity: a. Incidents resulting in injury or illness. b. Incidents or near misses with no injuries. c. Incidents resulting in environmental damage. Serious incidents or incidents requiring immediate medical attention are reported immediately by calling the campus emergency number 770-423- 6666 or extension 6666 or 9-1- 1. All other incidents are reported in writing within 24 hours of becoming aware of the incident, injury or illness. 1. Incidents with Injury or illness i. Incidents resulting in an injury or illness are reported in accordance with the University s procedure for Employee Work- Related Injury or Illness. i An employee is required to report all injuries or illnesses to his or her supervisor or the supervisor s designee immediately (but no later than 24 hours). This notification is made by the employee by completing the Employee Report of Injury or Illness Form and by returning the completed form to his or her supervisor within 24 hours of the injury or illness. 1) Upon receipt of an incident report, the supervisor: a. Immediately contacts the HR Department at 770-423- 6030 or extension 6030 to inform them of the injury or illness. b. Documents immediate actions taken to assist any persons injured during the incident. c. Takes any immediate actions necessary to prevent further injuries or illnesses (e.g. clean up spills, isolate the area) Page 3

2. Incidents or near misses with no injuries i. Incidents or near misses which do not result in an injury or illness are reported in accordance to this procedure. i An employee reports the incident to his or her supervisor or the supervisor s designee immediately as soon as possible but no later than 72 hours. Employee makes notification by completing the Employee Report of Incident or Near- miss Form and by returning the completed form to his or her supervisor within 72 hours of the incident or near- miss event. 3. Environmental Incidents i. Incidents involving a hazardous material or chemical spill are to be reported in accordance with chemical or hazardous substance spill response procedure. Incidents involving an oil spill are reported in accordance with the KSU Spill Prevention, Control and Countermeasure Plan (SPCC). C. Incident Investigation i. After the supervisor receives a report of an incident, near miss, illness or injury the supervisor ensures that a formal incident investigation is carried out. i Incident investigations commences within a reasonable time after the supervisor is informed of the incident, near miss, illness or injury and within 72 hours. If necessary, the supervisor establishes an incident investigation team, which may include: a. The supervisor or manager as the team leader. b. Persons involved in the incident and witnesses. c. Representative from the EHS Department and/or the Office of Strategic Security and Safety/Risk Management. d. Other knowledgeable persons. For accidents or incidents involving significant human harm, fatality, release of hazardous material or significant damage to the environment, the EHS Department in collaboration with SSS/RM department establishes a team to investigate the incident and determine the root cause(s). 1. Conducting Investigations i. Investigations are conducted to identify: a) Unsafe working conditions (environment) including any unsafe work practices (behaviors) that contributed to the occurrence of the incident or accident. Page 4

i b) Management system deficiencies (absence or failure of the process to adequately control unsafe practices or conditions) that led to behavioral or environmental causes. The incident investigation establishes the facts, including circumstances leading up to the incident, what happened during and after the incident, and gathers, considers and documents information including: a. Exact time and date of the incident and other time factors. b. Person(s) involved. c. Identifies associated hazards. d. Identifies existing hazard controls and their effectiveness. e. Identifies materials, equipment, chemicals and substances involved. f. Exact location and environmental conditions e.g. lighting, weather, ventilation and floor conditions. g. Discussions with persons involved, and recording statements from witnesses. h. Considers sequence of events including before, during and after the incident. The investigation is documented on the University s Incident Investigation Report form. Statements from witnesses should be recorded on the Incident Witness Statement Form. The investigation recommends corrective actions to eliminate or reduce the risk of a similar incident occurring in the future. v. The supervisor or investigation team leader provides a copy of the completed incident investigation report to the EHS Department and the Risk Management Department. D. Corrective Action Items i. The supervisor ensures that appropriate corrective actions are implemented, or that the recommended corrective actions are escalated to a person with the responsibility for its implementation. The supervisor also monitors progress on implementing corrective actions and documents when implementation is finalized. E. Review of Investigation Reports i. The EHS Department: a. Review and analyze incident investigation reports submitted to the Department to assess for trends and monitor the effectiveness of the implementation of control measures. b. Present a summary of incident investigations to the University Safety Council during the annual review. 5. Record Keeping A. The EHS Department maintains record of all reports: accident, incident and investigation, in accordance with record retention period specified by the Board of Regents (BOR). Page 5

Definitions of Terms Incident Any unplanned event resulting in, or having a potential for injury, ill health, damage or other loss. Illness Hazard Environmental damage Near miss Serious Incident or Accident Any work-related illness. A source or a situation with a potential for harm in terms of human injury or illhealth, damage to property, damage to the environment, or a combination of these. An event that causes harm to the environment through the generation and release of environmental contaminants. An event that could have resulted in human injury or damage to property, process or the environment, but did not. Incidents that involve significant human harm or fatality, results in release of hazardous substances which causes harm to the environment or require notification to a regulator. Page 6