Mechanism 11.0 - Incident Notification, Investigation and Reporting

Article-level navigation isn't available for this document — showing the full text as extracted.

Abu Dhabi Occupational Safety and
Health System Framework
(ADOSH-SF)
Mechanisms
Mechanism 11.0 – Incident Notification,
Investigation and Reporting
Version 4.0
July 2024

ADOSH-SF – Mechanisms
Mechanism 11.0 – Incident Notification, Investigation and Reporting
Version 4.0 –15 th July 2024
Page 2 of 30
Table of Contents
1. Introduction .................................................................................................................................... 4
2. Key Definitions ................................................................................................................................ 5
3. Classification of OSH Incidents........................................................................................................ 6
3.1 Incident Types ......................................................................................................................... 6
3.2 Recordable vs. Reportable Incidents ...................................................................................... 6
3.3 Establishing Work Relationship............................................................................................... 7
3.4 Pre-existing Medical / Health Conditions ............................................................................... 7
3.5 Penetration (SHARPS) injuries................................................................................................. 7
3.6 Other Persons ......................................................................................................................... 8
4. Entity OSH Incident Notification and Reporting Procedure(s)........................................................ 9
4.1 Serious OSH Incident Notification and Reporting Requirements ........................................... 9
4.2 OSH Incidents with Multiple Consequences ......................................................................... 10
4.3 Medium & Low Risk Entities Notification and Reporting ..................................................... 10
4.4 Principal Contractor OSH Incident Notification and Reporting Process ............................... 10
5. Entity Internal OSH Incident Investigation.................................................................................... 12
5.1 Internal Investigation team................................................................................................... 12
5.2 Preserving Incident Site and Evidence .................................................................................. 12
5.3 Process of investigating and analyzing OSH incidents .......................................................... 13
5.4 OSH Investigation Reports .................................................................................................... 13
5.5 Completing and Reporting Serious OSH Incident Investigations .......................................... 14
6. SRA Requirements for Notification, Investigation and Reporting of Incidents ............................ 15
6.1 OSH Incident Notification ..................................................................................................... 15
6.2 OSH Incident Investigation.................................................................................................... 16
6.3 Submission and Review of OSH Investigations ..................................................................... 16
6.4 Monitoring Corrective Actions. ............................................................................................. 17
6.5 Incident Analysis ................................................................................................................... 17
7. Role of ADPHC in an OSH Investigation ........................................................................................ 18
7.1 Role of ADPHC in Incident Monitoring, Coordination and Investigation .............................. 18
7.2 Media Activities..................................................................................................................... 18

ADOSH-SF – Mechanisms
Mechanism 11.0 – Incident Notification, Investigation and Reporting
Version 4.0 –15 th July 2024
Page 3 of 30
8. ADOSH-SF - Standard Forms ......................................................................................................... 19
9. Document Amendment Record .................................................................................................... 20
Appendix 1: Incident Notification, Investigation and Reporting Process ............................................. 21
Appendix 2: OSH Incidents with Multiple Consequences ..................................................................... 22
Schedule A: Serious Dangerous Occurrences ....................................................................................... 24
Schedule B: Serious Injuries .................................................................................................................. 26
Schedule C: Serious Occupational Illnesses / Diseases ......................................................................... 27

ADOSH-SF – Mechanisms
Mechanism 11.0 – Incident Notification, Investigation and Reporting
Version 4.0 –15 th July 2024
Page 4 of 30
1. Introduction
This mechanism is designed to define the procedures to be utilized by Abu Dhabi Public Health
Center (ADPHC), Sector Regulatory Authorities (SRAs) and Entities to manage OSH Incident
Notification, Investigation and Reporting.
This mechanism has been designed to ensure fair, transparent and consistent implementation
of the ADOSH-SF.

ADOSH-SF – Mechanisms
Mechanism 11.0 – Incident Notification, Investigation and Reporting
Version 4.0 –15 th July 2024
Page 5 of 30
2. Key Definitions
(a) All definitions relevant to the ADOSH-SF are held within ADOSH-SF – Glossary of terms,
however key definitions relevant to this Mechanism are listed below:
(i) Lost Time Injury (LTI): Any absence from work resulting from work-related
Fatalities, Permanent Total Disabilities, Permanent Partial Disabilities and Lost
Workday Cases.
(ii) Lost WorkDay Case (LWDC): A work-related injury or illness that results in an
injured person temporarily unable to perform any regular job or restricted work
activity on a subsequent scheduled workday or shift, supported by a medical
report from an approved medical practitioner.
Note: Lost Time Injury (LTI) vs. Lost Work Day Case (LWDC): A lost time injury is a
reporting requirement and is a collection of a number of different consequences that
can occur following an incident, such as a fatality, permanent disability etc. A lost Work
Day Case is a single injury or illness which has resulted in a work day being lost,
excluding fatalities.
(iii) Serious OSH Incident: A work related incident that requires notification to SRA
and consisting of or resulting in:
1. Fatality;
2. Serious Injuries;
3. Serious Occupational Illness;
4. Serious Dangerous Occurrence
(iv) Restricted Workday Case (RWDC): is a work-related injury or illness that results
in limitations on work activity that prevent an individual from doing any task of
his/her normal job or from doing all of the job for any part of the day.
(b) Notification: Under ADOSH-SF, this term includes notifying the Serious Incidents to
concerned SRA using the ADOSH-SF - Form G – Serious OSH Incident Notification
within:
(i) 24 hrs. for fatalities; or
(ii) 3 working days for other serious incidents.
(c) Reporting: Under ADOSH-SF, this term includes:
(i) reporting of incident investigation findings (using ADOSH-SF - Form G1 – Serious
OSH Incident Investigation); and
(ii) reporting incidents in Quarterly Performance Report (ADOSH-SF - Form E – Entity
Quarterly OSH Performance Report to the relevant SRA, or ADOSH-SF - Form E2
– Government Entity Quarterly OSH Performance Report to ADPHC).
(d) OSH Investigation: Under ADOSH-SF, this term refers to the internal investigation
undertaken by the entity and/or the SRA investigation for the purpose of identifying
the root causes of OSH incidents and identifying appropriate corrective actions to
prevent reoccurrence.
Note: OSH incident investigations for judicial purposes, including required control of the
incident location and the collection of evidence, can only be undertaken by an investigator
assigned by the Abu Dhabi Police, the Public Prosecutor’s Office or the Court.

ADOSH-SF – Mechanisms
Mechanism 11.0 – Incident Notification, Investigation and Reporting
Version 4.0 –15 th July 2024
Page 6 of 30
3. Classification of OSH Incidents
3.1 Incident Types
(a) The types of OSH incidents recognized under ADOSH-SF are listed below:
(i) Lost Time Injury;
1. Fatality;
2. Permanent Total Disability;
3. Permanent Partial Disability; and
4. Lost Workday Case;
(ii) Serious Injury;
(iii) Serious Occupational Illness / Disease;
(iv) Serious Dangerous Occurrence;
(v) Restricted Work Case;
(vi) Medical Treatment Case;
(vii) First Aid Injury;
(viii) Equipment / Property Damage; and
(ix) Near Miss
Schedule A specifies the List of Serious Dangerous Occurrences.
Schedule B specifies the List of Serious Injuries.
Schedule C specifies the List of Serious Occupational Illnesses / Diseases.
3.2 Recordable vs. Reportable Incidents
(a) High- and medium-risk entities shall ensure that all incidents are recorded, whether
reportable (refer to 3.2(b)) or not, to ensure effective collection of OSH incident and
performance data.
(b) The term “Reportable” as used in this Mechanism refers to Notification & Reporting
requirements as per clauses 2(c) & 2(d) of this mechanism.
(c) Refer to Schedule No. 1 of Cabinet Resolution No. 33 OF 2022 Concerning Work
Injuries and Occupational Diseases, and Schedule A (Serious Dangerous Occurrences),
Schedule B (Serious Injuries) & Schedule C (Serious Occupational Illnesses / Diseases)
of this mechanism.

ADOSH-SF – Mechanisms
Mechanism 11.0 – Incident Notification, Investigation and Reporting
Version 4.0 –15 th July 2024
Page 7 of 30
3.3 Establishing Work Relationship
(a) An illness or injury to an employee shall be considered as work-related if:
(i) it occurred on the way to or back from work provided that the trip to or from the
place of work is made without interruption or deviation from the normal route
(as given under the definition of work injury within Federal Law No. 33 of 2021
Regarding the Regulation of Employment Relationship); or
(ii) it arises from a work practice; or
(iii) it arises from the conditions in a workplace; or
(iv) it is caused by an employee during and by reason of carrying out their duties.
(b) This includes, but is not limited to, illnesses, injuries or incidents at an entity-controlled
site.
(c) Work related Injuries / illnesses include the recurrence, aggravation or exacerbation of
previous work-related injuries.
(d) Whether a case involves a work-related injury or Illness is determined by the nature
of the original event or exposure that caused the case, not by the resulting condition
of the affected employee.
3.4 Pre-existing Medical / Health Conditions
(a) When reporting work related incidents that involve occupational illness and injury the
entity shall take into consideration pre-existing medical / health conditions and
aggravation of an existing illness or injury. Refer to definition of work-related injury /
illness in Sections 3.1 & 3.3 of this mechanism for more details.
3.5 Penetration (SHARPS) injuries
(a) A penetration injury is an injury with a risk of infectious disease transmission (such as
needle-stick injury):
(i) All penetration injuries are to be recordable;
(ii) When a person is injured by a sharp KNOWN to be contaminated with a blood
borne virus (BBV) e.g. Hepatitis B or C or HIV, this will be reported as a serious
dangerous occurrence (refer to schedule A);
(iii) When a person receives a sharps injury and a BBV acquired by this route sero
converts (escalates), this shall be reported a Serious Occupational Illness /
Disease (refer to schedule C); and
(iv) If the injury itself is so severe that it must be reported, this will be reported as
a serious injury (refer to schedule B)

ADOSH-SF – Mechanisms
Mechanism 11.0 – Incident Notification, Investigation and Reporting
Version 4.0 –15 th July 2024
Page 8 of 30
3.6 Other Persons
(a) Entities, except as stipulated in 3.6(c), shall record, investigate and report any serious
work-related incidents that occur to other persons (non-employees) as a result of the
entity’s work practices, work conditions, entity undertakings or presence at an entity
controlled workplace or site.
(b) Other persons or non-employees shall include but not limited to:
(i) non-nominated contractors / sub-contractors ;
(ii) customers;
(iii) students;
(iv) members of the public;
(v) visitors; and
(vi) any other person(s) at the workplace / site.
(c) If an incident occurs to a non-employee / other person who is employed by a
nominated entity:
(i) The nominated entity who is in control of the workplace or work practice where
the incident occurred shall be responsible for the internal investigation of the
incident.
(ii) The entity undertaking the internal incident investigation shall invite a member
of the other person’s employer to participate as a member of the investigation
team.
(iii) the entity who is the other persons employer shall be responsible for official
notification and reporting of the incident.
(iv) Refer to section 4.4 for requirements on notification and reporting of incidents
at construction sites managed by a “Principal Contractor”.
Note: As per international practice, incidents involving aircraft passengers, international sea
passengers, aircraft or sea craft crew whilst on board the craft are not to be reported under
ADOSH-SF.
Incidents that occur to passengers or crew whilst accessing the craft within the Emirate of
Abu Dhabi shall be reported as per the requirements of this document.
Note: LWDC are not applicable to other persons.

ADOSH-SF – Mechanisms
Mechanism 11.0 – Incident Notification, Investigation and Reporting
Version 4.0 –15 th July 2024
Page 9 of 30
4. Entity OSH Incident Notification and Reporting Procedure(s)
(a) The entity OSH Incident Notification and Reporting Procedure(s) shall address, at a
minimum (refer to Appendix 1 for Incident Notification, Investigation and Reporting
Process):
(i) Process for identification and notification, both internally and externally;
(ii) hierarchies, timetables and responsibilities for incident notification and
reporting;
(iii) internal OSH incident reporting requirements; and
(iv) external OSH incident reporting requirements (in line with the requirements of
section 4.1 of this mechanism);
4.1 Serious OSH Incident Notification and Reporting Requirements
(a) The entity shall officially notify the concerned SRA as follows:
(i) Within 24 hours of an incident occurring at a workplace which results in Fatality;
(ii) Within maximum of 3 working days from the date of an incident occurring at a
workplace which results in the following incident types (serious incidents):
1. Serious Dangerous Occurrence (Schedule A);
2. Serious Injury (Schedule B); and
3. Receipt of a written diagnosis or other knowledge of the occurrence of a
Serious Occupational Illness or Disease arising out of and in the course of
work (Schedule C).
(b) OSH injuries / illnesses shall be notified to SRA’s based on immediate judgment of their
severity, where a medical report is not available at the time of notification.
(c) The entity shall notify the concerned SRA of relevant OSH incidents by completing
and submitting ADOSH-SF Form G – Serious OSH Incident Notification (mandatory for
entities with an approved OSH MS and for Medium Risk Entities complying with
minimum requirements stipulated in ADOSH-SF – Mechanism 5.0).
(d) Incidents may not only require notification to the concerned SRA, but also to Abu
Dhabi Police and other relevant authorities as per their stipulated reporting
requirements (such as Ministry of Human Resources and Emiratization, etc.).
(e) The actual severity and consequences of the notified injury / illness once established
based on investigation and diagnosis by licensed health care professional and
supported by medical report shall be reported in the Serious OSH Incident
Investigation report to the SRA (Form G1) as well as in the entity performance report
to the SRA (Form E/E2).
(f) Incident recording and reporting shall be based on actual severity of consequence as
established by the investigation process and/or medical report. Incident escalation
where applicable is important for necessary update in records and initiating the
reporting process.

ADOSH-SF – Mechanisms
Mechanism 11.0 – Incident Notification, Investigation and Reporting
Version 4.0 –15 th July 2024
Page 10 of 30
Note: If a LWDC transforms into Fatality or Permanent Total / Partial Disability, it will no longer
be considered as LWDC. Incident Severity, Statistics and KPIs shall be updated accordingly for
severity of injury and number of lost workdays. Such escalation applies to all types of incident
/ injury.
(g) Although contractual or other obligations may require entities to notify and report
OSH Incidents to other relevant stakeholders (such as. Client, Relevant Authority),
“ADOSH-SF Notification and Reporting” shall only be to the concerned SRA that the
entity is nominated by.
4.2 OSH Incidents with Multiple Consequences
(a) A single OSH incident may result in multiple consequences.
(b) In case the consequences are multiple injuries, injury details for each person should
be completed as part of the incident notification.
(c) ADOSH-SF – Form E, E1 and E2 have been designed to collate multiple consequences
of single incidents. This is to correctly account for the number of injuries and incidents
while calculating injury rates / frequencies.
Note: refer to Appendix 2 for an example.
4.3 Medium & Low Risk Entities Notification and Reporting
(a) Entities officially notified to comply with
ADOSH-SF – Mechanism 5.0 – OSH
Requirements for Medium Risk Entities shall follow these requirements for Serious
OSH Incident Notification & Reporting:
(i) Notification of all “Serious OSH Incidents” as soon as practicable (as per the
requirements of section 4.1), by submitting ADOSH-SF – Form G – Serious OSH
Incident Notification;
(ii) Submitting internal investigation Reports for all “Serious OSH Incidents” as
stipulated in section 5 of this mechanism, by completing and submitting ADOSH-
SF – Form G1 – Serious OSH Incident Investigation.
(b) For notified Low Risk Entities, the concerned SRA shall undertake the internal OSH
investigation when notified of fatalities.
4.4 Principal Contractor OSH Incident Notification and Reporting Process
(a) Principal contractors of construction work shall notify, investigate and report relevant
OSH Serious incidents to the Building and Construction SRA (as per ADOSH-SF – CoP
53.0 – OSH Management during “Construction Work”) for their operations and all
construction subcontractors that are not nominated.
(b) At a workplace where “Construction Work” is being undertaken and there is a principal
contractor assigned the following OSH performance and incident reporting hierarchies
apply:
(i) all OSH Serious incidents at the workplace shall be notified to the principal
contractor;
(ii) if a sub-contractor or project manager / client representative / supervising
consultant is involved in an OSH Serious incident and they do have an approved

ADOSH-SF – Mechanisms
Mechanism 11.0 – Incident Notification, Investigation and Reporting
Version 4.0 –15 th July 2024
Page 11 of 30
OSH MS, they are responsible for notifying, investigating and reporting the
incident to the concerned SRA; and
(iii) if a sub-contractor or project manager / client representative / supervising
consultant is involved in an OSH Serious incident and they are not nominated,
the principal contractor is responsible for notifying, investigating and reporting
the incident to the concerned SRA.

ADOSH-SF – Mechanisms
Mechanism 11.0 – Incident Notification, Investigation and Reporting
Version 4.0 –15 th July 2024
Page 12 of 30
5. Entity Internal OSH Incident Investigation
(a) The entity internal OSH Incident Investigation Procedure(s) shall address, at a
minimum (refer to Appendix 1 for Incident Notification, Investigation and Reporting
Process):
(i) process for classification of incidents and incident types;
(ii) process of recording, investigating and analyzing OSH incidents;
(iii) roles and responsibilities of all stakeholders involved in incident investigations;
(iv) that investigations are performed by competent person(s), as required by
ADPHC and in consultation and coordination with relevant stakeholders;
(v) terms of reference for investigations;
(vi) contents of an investigation report;
(vii) that investigations are performed in a timely manner;
(viii) process to determine the root causes of OSH incidents;
(ix) opportunities for corrective and preventative control measures; and
(x) effective communication of the outcomes of the investigation to relevant
stakeholders.
5.1 Internal Investigation team
(a) The entity shall ensure that the person(s) designated to undertake the internal OSH
investigation are competent in the application of techniques employed in the
investigation.
(b) The entity shall ensure that persons designated to undertake internal OSH
investigations are sufficiently independent from the process or procedure being
investigated.
(c) The entity shall provide additional technical expertise where required due to the
complexity of the internal OSH investigation or the technical nature of the
investigation.
(d) Depending on the severity of OSH incidents, it may be deemed appropriate and/or
necessary to utilize the services of professional investigators to assist in the internal
OSH investigation of the root causes of the incident.
5.2 Preserving Incident Site and Evidence
(a) If an incident notified is deemed to require the intervention of the Abu Dhabi Police
or other judicial authority:
(i) The entity shall, as far as reasonably practicable, preserve and not disturb the
site where an incident has occurred until the relevant authorities (Police, Civil
Defense) arrive on site or direct the employer to take other action.
(ii) The entity shall preserve all evidence associated with the incident until such
time as the relevant authorities (Police, Civil Defense) deem necessary to ensure
that all relevant evidence is collected.

ADOSH-SF – Mechanisms
Mechanism 11.0 – Incident Notification, Investigation and Reporting
Version 4.0 –15 th July 2024
Page 13 of 30
(iii) Notwithstanding these requirements, the entity may take such steps as
reasonably necessary to preserve the life or safety of any person, or prevent
further damage to property.
(b) For incidents that do not require the intervention of Abu Dhabi Police or other judicial
authorities, the entity shall preserve the incident location and collect and preserve all
relevant evidence as far as reasonably practicable to ensure an effective OSH internal
investigation.
5.3 Process of investigating and analyzing OSH incidents
(a) The entity shall ensure that all work related incidents, including near misses and
dangerous occurrences, are investigated. The focus of investigation shall be to
identify root causes, prevent future incidents and injuries and not to assign blame for
the incident.
(b) The entity shall initiate an internal investigation of all incidents as soon as practicable,
in which:
(i) the level of investigation shall be proportional to the magnitude of the
occurrence;
(ii) the entity shall use methods, processes and techniques sufficient to identify the
root cause(s) of the occurrence;
(c) The internal investigation shall consider available outcomes from any Abu Dhabi Police
or other judicial investigation and the results of any relevant medical reports.
(d) The entity shall utilize the findings of investigations to improve the control of hazards
or significant impacts on other operations within the entity.
(e) On completion of the internal investigation, or sooner where warranted, the findings
of the investigation, along with corrective actions or other necessary steps identified
by the employer, shall be communicated to relevant members of the workforce.
(f) The entity shall ensure that the findings of all investigations are reviewed and
analyzed to identify the following as a minimum:
(i) Reoccurring incident(s);
(ii) Common incident contributors; and
(iii) Common trends.
5.4 OSH Investigation Reports
(a) An internal OSH incident investigation report shall include information such as, but not
limited to:
(i) type of OSH incident;
(ii) details of the injured person (e.g. gender, occupation, experience, training, etc);
(iii) details of the location;
(iv) details of the event;

ADOSH-SF – Mechanisms
Mechanism 11.0 – Incident Notification, Investigation and Reporting
Version 4.0 –15 th July 2024
Page 14 of 30
(v) evidence collected (e.g. arrangements and location for witness interviews, the
statements of the interviewees, photographs of the scene, OSHMS documents,
maintenance registers);
(vi) actual consequences (e.g. people, assets, reputation) and potential
consequences of the incident;
(vii) details of the investigation outcome (e.g. equipment maintenance records; risk
assessments / registers; the status of the implementation of the emergency
plan and procedures, where appropriate);
(viii) recommendations (corrective action plan) on preventing the recurrence of a
similar incident (the recommendations shall prioritise the actions with target
completion dates and stipulate the action parties and responsibilities);
(ix) the person(s) responsible for the investigation, their authority and competency
requirements; and
(x) the direct and indirect causes of the incident.
(b) The entity shall ensure that all completed internal OSH investigation reports are
reviewed and accepted by the ‘management representative’ or a person with formal
delegated authority.
(c) Corrective actions identified as part of the investigation shall be managed in
accordance with
ADOSH-SF – Element 8 – Audit and Inspection.
5.5 Completing and Reporting Serious OSH Incident Investigations
(a) These requirements are applicable to all Serious OSH Incidents notified to the
concerned SRA using Form G (refer to section 4) by entities with an approved OSH MS
as well as for Medium Risk Entities complying with minimum requirements stipulated
in
ADOSH-SF – Mechanism 5.0.
(i) The internal incident investigation report, as per the requirements of section
5.4, shall be completed and submitted to the concerned SRA within 30 calendar
days of the date of the incident as an attachment to the completed ADOSH-SF –
Form G1.
(ii) The completed ADOSH-SF - Form G1 shall identify OSH injuries / illnesses in
terms of their actual severity and consequences based on diagnosis by licensed
health care professional and supported by medical report.
(iii) Entities shall submit the corrective action plan, as defined in section 5.4 to the
relevant SRA as part of the completed investigation report. The entity shall
update the relevant SRA on the progress of the corrective actions.
(iv) Where applicable, entities are required to update incident investigation reports
as soon as relevant information becomes available.
(v) ADPHC acknowledges that specific components of the final report may not be
available within 30 calendar days of the incident – such as outcomes of official
Abu Dhabi Police investigation or the results of specific scientific/medical
investigations or tests. This should not delay the submission of the entity’s
investigation report.

ADOSH-SF – Mechanisms
Mechanism 11.0 – Incident Notification, Investigation and Reporting
Version 4.0 –15 th July 2024
Page 15 of 30
6. SRA Requirements for Notification, Investigation and Reporting of
Incidents
(a) The concerned SRA shall develop, document, implement and maintain a systematic
process for the recording, notifying, investigating, monitoring, analyzing and closure
of all serious incidents that are notified and reported to them by entities within the
concerned sector.
(b) The SRA shall ensure that the person(s) designated to undertake the OSH
investigation and/or review of the investigation are competent in the application
of techniques employed in the investigation.
6.1 OSH Incident Notification
(a) The SRA shall develop, document, implement and maintain a system to allow entities
to notify and report incidents to them as per the requirements of this mechanism.
(b) The SRA shall ensure that the system developed, as per section 6.1(a) is
communicated to all entities within the concerned sector.
(c) The concerned SRA shall officially notify ADPHC of below listed serious incidents
(classified based on injury severity known at the time of the incident) as soon as
practicable but maximum within one working day after receiving the notification:
(i) Fatality;
(ii) Serious Dangerous Occurrence (Schedule A);
(iii) Serious Injury (Schedule B); and
(iv) Serious Occupational Illness (Schedule C).
(d) The concerned SRA shall notify ADPHC, through appropriate means, of other Serious
Incidents that the concerned SRA believes ADPHC should be aware of. Examples
include:
(i) an incident that may affect members of the general community (e.g. release
of a hazardous material); and
(ii) an incident that may be of public interest and may be reported in the media.

ADOSH-SF – Mechanisms
Mechanism 11.0 – Incident Notification, Investigation and Reporting
Version 4.0 –15 th July 2024
Page 16 of 30
6.2 OSH Incident Investigation
(a) The SRA shall ensure that all incidents notified to them by entities are investigated in
line with the requirements of section 5 of this document.
(b) The SRA shall monitor the progress and quality of all internal incident investigations
notified to them. The SRA shall take appropriate action if it considers the entity
internal OSH investigation being undertaken to be inadequate or inappropriate.
(c) The SRA shall ensure that the type and level of internal investigation undertaken by
an entity shall be proportionate to the actual or potential consequences of the event.
(d) The SRA shall undertake an independent OSH investigation for all fatal incidents
reported to them. The purpose of the SRA investigation will be to identify the root
causes of the incident and identify areas of improvement/corrective action for all
stakeholders involved in the incidents.
(e) The concerned SRA may conduct an investigation for any other serious incidents it
deems necessary to identify the root causes of the incident and identify areas of
improvement/corrective action for all stakeholders involved in the incidents.
(f) All SRA investigations shall be done in accordance with the requirements of this
mechanism and any ADPHC OSH investigation policies notified to the SRA.
(g) ADPHC may, at any time, request the SRA to undertake an independent investigation
to meet the objectives of this mechanism for an incident that has been notified.
6.3 Submission and Review of OSH Investigations
(a) The SRA shall ensure that all completed internal OSH incident investigations by
entities are submitted within 30 calendar days. Where this is not possible due to
information not being fully available or the investigation incomplete, the SRA shall
ensure that an ongoing record of communication is kept and all stakeholders, including
ADPHC, are aware of the timescales for completion.
(b) The SRA shall ensure that the completed OSH internal incident investigation report
includes all information as required by Section 5.4 of this document. Reports
submitted not containing all required information shall be officially rejected and
returned to the entity for corrective action.
(c) The SRA shall review all submitted investigations for completeness and to ensure the
root cause of the incident has been identified, within 5 working days of receipt of the
completed investigation.
(d) The SRA shall review the corrective action plan submitted, as part of the internal OSH
incident investigation, to ensure it is reasonable and appropriate. The SRA may
request additional corrective action where required.
(e) The SRA shall ensure that all completed investigations, including ADOSH-SF - Form
G1, are submitted to ADPHC within 3 working days of review by the SRA.

ADOSH-SF – Mechanisms
Mechanism 11.0 – Incident Notification, Investigation and Reporting
Version 4.0 –15 th July 2024
Page 17 of 30
(f) ADPHC may request, at any time, additional investigation or action on a submitted
internal investigation.
6.4 Monitoring Corrective Actions.
(a) The SRA shall ensure that entities regularly update the status of corrective actions
identified within the internal investigation report.
(b) Where timescales have not been met, the SRA shall seek official clarification from the
entity as to the status of the corrective action. The SRA shall ensure that ADPHC is
regularly updated with regards to the status.
(c) The SRA shall monitor the effective implementation of all corrective actions and
confirmation of the implementation shall be done through audits and inspections.
6.5 Incident Analysis
(a) The SRA shall develop, document, implement and maintain a systematic process to
review and analyze the notified incidents and completed incident investigations.
(b) As a minimum this review shall identify:
(i) Repeating entities;
(ii) Incident causation;
(iii) Reoccurring trends;
(iv) Root Cause(s); and
(v) Statistical data as required.
(c) The SRA shall publish safety alerts or notices in line with the requirements of
ADOSH-
SF – Mechanism 12.0 – Notification Requirements for OSH Awareness Activities.

ADOSH-SF – Mechanisms
Mechanism 11.0 – Incident Notification, Investigation and Reporting
Version 4.0 –15 th July 2024
Page 18 of 30
7. Role of ADPHC in an OSH Investigation
7.1 Role of ADPHC in Incident Monitoring, Coordination and Investigation
(a) ADPHC shall monitor the concerned entities and SRA’s to ensure appropriate OSH
investigations are undertaken on Serious Incidents as per the requirements of section
4 of this mechanism.
(b) SRA’s and/or other Competent Authorities can request ADPHC to lead / assist /
participate in the required OSH incident investigation.
(c) For investigations required as per section 6 of this mechanism, ADPHC can at any time:
(i) lead and/or coordinate investigations for incidents that require notification to
ADPHC within 24hrs;
(ii) directly lead investigations of Serious OSH incidents, as deemed appropriate by
the ADPHC Director General; and
(iii) undertake an independent investigation of any incident notified under the
requirements of this mechanism.
7.2 Media Activities
(a) All media reporting or contact with the media shall be managed in accordance with the
requirements of ADOSH-SF – Mechanism 12.0 – Notification Requirements for OSH
Awareness Activities.

ADOSH-SF – Mechanisms
Mechanism 11.0 – Incident Notification, Investigation and Reporting
Version 4.0 –15 th July 2024
Page 19 of 30
8. ADOSH-SF - Standard Forms
Form G
– Serious OSH Incident Notification
This form is to be submitted by entities to the concerned SRA to notify a Serious Incident. It
requires details of the incident and shall be submitted as per the reporting requirements: a) for
fatalities within 24 hrs. of incident and b) for other Serious Incidents within maximum of 3 working
days from the date of incident. The concerned SRA to notify ADPHC about the Serious Incident
using Form G within one working day form receipt of the notification.
Form G1
– Serious OSH Incident Investigation
This form is to be submitted by entities to the concerned SRA to summarize Serious Incident
Internal Investigation findings. The full OSH Incident investigation shall be attached to the
completed ADOSH-SF – Form G1. It requires details of the incident investigation and shall be
submitted as per the reporting requirements: as soon as practicable – Maximum 30 Calendar Days
from Date of Incident - For all Serious Incidents notified to SRA by Form G.
Form G2
– Non-Serious OSH Incident Investigation
This form shall be used internally by high- and medium-risk entities for recording and investigating
non-serious Incidents not requiring notification to the SRA.

ADOSH-SF – Mechanisms
Mechanism 11.0 – Incident Notification, Investigation and Reporting
Version 4.0 –15 th July 2024
Page 20 of 30
9. Document Amendment Record
Version Revision Date Description of Amendment
Page/s
Affected
4.0 15 th July 2024
System acronym updated from OSHAD-SF to
ADOSH-SF to accurately reflect document title
Throughout
Change from OSHAD to ADPHC
Change of Logo
Requirements for internal recording of non-
serious incidents further clarified (Clause
3.2(a) and Section 8)
Section 3.1 reduced to only identify the types
of OSH incidents recognized under ADOSH-SF.
6
Update Clauses 3,2(c) and 3.3(a)(1) to refer to
federal law No 33 of 2021 and Cabinet
Resolution No 33 of 2022.
6, 7
Requirements for incidents involving other
persons (Clause 3.6(a)) limited to serious OSH
incidents
8
From clause 4.3(a), delete reference to low-
risk entities
10
Amended clause 6.1(c) (now put in two
successive clauses) to clarify SRA role in
notifying ADPHC of incidents
15
Deleted previous Section 7.1 and Form K
(regarding role of ADPHC in monitoring and
coordination of internal OSH investigations),
and amended titles within Section 7.0
18, 19
From schedule B, delete leading paragraphs
repeating requirements stated in body of the
document
26
Schedule C (Occupational Diseases) updated to
reflect contents of schedule 1 in Cabinet
Resolution No 33 of 2022.
27, 28
Schedule D (Emergency Contact Numbers)
deleted
NA
Other (minor) editorial changes throughout the
document without changing requirements.
Throughout

ADOSH-SF – Mechanisms
Mechanism 11.0 – Incident Notification, Investigation and Reporting
Version 4.0 –15 th July 2024
Page 21 of 30
Appendix 1: Incident Notification, Investigation and Reporting Process
Incident Notification, Investigation and
Reporting
OSH Incident Occurs
Is the incident serious
– as per section 5
Entity undertakes an
internal investgation
Incident notified to
the relevant SRA
using Form G
SRA to
Review content of
notified incident,
provide feedback /
amend notification
Entity to undertake
an Internal
Investigation
Compile internal
investigation report
Report of completed
internal
investigation to
relevant SRA using
ADOSH-SF – Form
G1
Incident notified to
ADPHC
Independent OSH
Investigation
Required?
SRA / Entity
Informed
Yes
Incident
Investigation
undertaken
Facility / site /
project owner
informed of
completion and
outcomes of the
investigaiton
SRA to review
completed
investigation and
provide feedback to
entity if required
ADPHC / SRA to
monitor
implementation of
identified corrective
action(s)
Incident Coordination
by ADPHC Required? No
ADPHC to
coordinate the
incident
investigaiton
Yes
ADPHC to review
completed
investigation and
provide feedback
No
Report Approved
by SRA
Incident
Investigation
report
approved?
No
Yes
Yes
No
Completed Internal
Investigation
recorded using
ADOSH-SF – Form
G2

ADOSH-SF – Mechanisms
Mechanism 11.0 – Incident Notification, Investigation and Reporting
Version 4.0 –15 th July 2024
Page 22 of 30
Appendix 2: OSH Incidents with Multiple Consequences
Incident description: A tanker truck while delivering petrol to a construction site rolled over and
an ambulance was called to the site. The driver (employee of the entity) received minor cuts and
bruises. A passenger (employee of the entity) got an arm injury. The truck received substantial
damage however with no flammable release. The passenger (employee of the entity) was treated
at hospital, diagnosed with arm fracture and advised 6 days sick leave.
Notification of Serious Incident and Non-Serious Consequences in Form G:
While notifying the “Serious Incidents”, “Other Consequences” section shall be filled in Section 3
of Form G for “Non-Serious” Consequences resulting from the same Incident.
While notifying the “Incident” and “Consequences” for above mentioned Incident in Incident
Notification Form (Form G) below shall be considered:
• Serious Injury (1) – Lost Workdays Injury to Passenger (entity’s employee);
• Medical Treatment Case (1) – for Driver (entity’s employee); and
• Equipment/Property Damage (1) - Damage to the truck
Fig 1: below shows how section 3 of Form G shall be completed for above mentioned tanker
incident.
3. Incident Information
Date of Incident DD/MM/YYYY Time (24 hr):
Type of Incident: ☐ Fatality
☐ Serious Dangerous
Occurrence ☒ Serious Injury ☐ Serious Occupational Illness
Mechanism 11
Schedule A
Mechanism 11
Schedule B Mechanism 11 Schedule C
Other
Consequences:
(equipment/property
damage or non-
serious injuries
resulting from the
same incident but
excluding the
serious injured
person (s) reported
above)
Restricted
Workday
Case
Medical Treatment
Case First Aid Case Equipment / Property
Damage Near Miss
1 1
Fig 1: Notification of Serious Incidents with Multiple Consequences
Important: Only the injury with highest severity shall be notified for an individual injured person
(i.e. for each person in an incident, one injury must be included irrespective of escalation level of
the injury severity, and multiple injuries shall not be reported for same person). For example, if an
injured person (passenger in this incident) received first aid or medical treatment immediately at
an incident site and later diagnosed for Lost Workday Injury (fracture) by Registered Medical
Practitioner, Section 3 shall be filled only for “Serious Injury” for this employee (passenger).

ADOSH-SF – Mechanisms
Mechanism 11.0 – Incident Notification, Investigation and Reporting
Version 4.0 –15 th July 2024
Page 23 of 30
Reporting of Incident and Consequences in Performance Reports (Form E)
While reporting the “Incident” and “Consequences” for above mentioned Tanker Incident in
Performance Report (Form E) the below shall be considered:
• Number of Incidents to be reported: 1
• Number of consequences to be reported: 3 (as listed below)
• Medical Treatment Case (1) – Driver (entity’s employee) receiving medical treatment from
a medical professional;
• Equipment / Property Damage (1) – Damage to the truck; and
• Lost Workdays Injury (1) – Passenger (entity’s employee) was diagnosed with arm
fracture and advised 1 week (6 days) rest.
Fig 2 below shows how the incident and the consequences would be reported in Form E.
KPI 2-02 Total Incidents (From my Entity)
(Total No. of incidents that occurred during the reporting quarter) 1
Entity (s) Employees Injuries & Illness Consequences No. Lost Workdays Other Consequences No.
Lost Time Injuries
Fatality Serious Dangerous Occurrence
Permanent Total Disability Equipment / Property Damage 1
Permanent Partial Disability
Lost Workdays Cases
a) Lost Workdays Injuries 1 6
b) Lost Workdays Occupational Illness
Restricted Workday Case
Medical Treatment Case 1
Total Injuries & Illness for calculating KPI 2-03 (TRCF) 2
Total Lost Workdays for calculating KPI 2-04 (LTISR) 6
Total Consequences (Summation of Injuries, illnesses and other Consequences) 3
Fig 2: Reporting Incident with Multiple Consequences in Occupational Health & Safety Performance Summary for Entity

ADOSH-SF – Mechanisms
Mechanism 11.0 – Incident Notification, Investigation and Reporting
Version 4.0 –15 th July 2024
Page 24 of 30
Schedule A: Serious Dangerous Occurrences
Explosion or Fire
(a) Explosion or fire in a room or place in which persons are at work, and which results in
substantial damage to the structure of the site, or to any machinery or plant there, and the
explosion or fire is a result of the ignition of dust, gas or vapor. The incident shall have also
resulted in the complete suspension of ordinary work at the site or stoppage of machinery or
workplace for at least 5 hours.
(b) Electrical short circuit or failure of electrical machinery, plant or apparatus, which results in an
explosion, fire or structural damage and involves its stoppage or disuse for at least 5 hours.
(c) Explosion or fire affecting any site in which persons are at work and causing complete
suspension of ordinary work in the site for at least 24 hours.
Failure and/or Collapse of Equipment
(a) Failure or collapse of false-work / formwork or its supports.
(b) Collapse, partial collapse, overturning or failure of load-bearing parts of scaffold, lifts and
lifting plant, equipment and/or accessories.
(c) Failure of a breathing apparatus / equipment while in use or during testing immediately
before use.
(d) Failure or endangering of diving equipment, the trapping of a diver, an explosion near a diver,
or an uncontrolled ascent.
(e) The collapse, overturning, failure or malfunction of, or damage to, any plant/equipment that
the employee is in contact with that had the potential to cause injury / illness.
Machinery Damage
(a) Bursting of a revolving vessel, wheel, grindstone or grinding wheel moved by mechanical
power.
(b) Explosion or failure of the structure of a steam boiler, receiver or any container used for the
storage at a pressure greater than atmospheric pressure of any gas or gases (including air) or
any liquid or solid resulting from the compression of gas.
Collapse of Building / Structure or Excavation
(a) Any unintended collapse or partial collapse of:
(i) any building or structure (whether above or below ground) under construction,
reconstruction, alteration or demolition; and / or
(ii) any floor or wall of any building (whether above or below ground) used as a place of
work; and / or
(iii) of an excavation or any shoring supporting an excavation.

ADOSH-SF – Mechanisms
Mechanism 11.0 – Incident Notification, Investigation and Reporting
Version 4.0 –15 th July 2024
Page 25 of 30
Electric Lines, Cables and Pipelines
(a) Any unintentional incident in which plant or equipment either:
(i) comes into contact with overhead or underground electric lines, cables or pipeline; or
(ii) causes an electrical discharge from such an electric line by coming into close proximity
to it; and/or
(iii) causes an overhead line be at an height less than that required by regulation.
Malfunction of Radiation Generating Equipment
(a) Any incident in which:
(i) the malfunction of a radiation generator or its ancillary equipment causes it to fail to
de-energize at the end of the intended exposure period; or
(ii) the malfunction of equipment causes a radioactive source to fail to return to its safe
position by the normal means at the end of the intended exposure period.
Escape of Flammable Liquids and Gases
(a) The sudden, unintentional, uncontrolled release inside a building:
(i) of 100 kilograms or more of a flammable liquid; and / or
(ii) of 10 kilograms or more of a flammable liquid at a temperature above its normal
boiling point; and / or
(iii) of 10 kilograms or more of a flammable gas.
(b) The sudden, uncontrolled release In the open air of 500 kilograms or more of any of the
material referred to in sections (i), (ii) and (iii) above.
Escape of Hazardous Materials
(a) The accidental release or escape of any materials in any quantity sufficient to cause the
death, major injury or any other damage to the health of any person.
Biological Agent
(a) Any incident which resulted in or could have resulted in the release or escape of a biological
agent likely to cause severe human infection or illness.
Penetration (SHARPS) Injury
(a) when a person is injured by a sharp KNOWN to be contaminated with a blood borne virus (BBV)
e.g. Hepatitis B or C or HIV.

ADOSH-SF – Mechanisms
Mechanism 11.0 – Incident Notification, Investigation and Reporting
Version 4.0 –15 th July 2024
Page 26 of 30
Schedule B: Serious Injuries
Serious Injuries requiring notification to SRA include the below-listed work-related injuries:
(a) An injured person temporarily unable to perform any regular job or restricted work activity on
a subsequent scheduled workday or shift, supported by a medical report from an approved
medical practitioner.
(b) immediate medical treatment of the injured person(s) as an in-patient in a hospital;
(c) medical treatment of the injured person(s) within 48 hours of exposure to a substance;
(d) immediate medical treatment of the injured person(s) for:
(i) fracture (not including fingers or toes);
(ii) the loss of a distinct part or organ of the body, including the amputation of any part
of body;
(iii) loss of consciousness and/or requiring resuscitation;
(iv) a serious head injury;
(v) a serious eye injury, including loss of sight (temporary or permanent);
(vi) exposure to a hazardous material;
(vii) the separation of skin from any underlying tissue (such as scalping or de-gloving);
(viii) electric shock or electrical burn;
(ix) serious burns due to thermal and chemical agents;
(x) entrapment of a body part in machinery/equipment/plant;
(xi) a spinal injury;
(xii) dislocation of joint;
(xiii) the loss of bodily function; and
(xiv) Serious laceration

ADOSH-SF – Mechanisms
Mechanism 11.0 – Incident Notification, Investigation and Reporting
Version 4.0 –15 th July 2024
Page 27 of 30
Schedule C: Serious Occupational Illnesses / Diseases
List reproduced from Cabinet Resolution No. (33) of 2022 Concerning Work injuries and
Occupational Diseases – Schedule 1:
No. Disease Occupation Causing the Disease
1 Poisoning by Lead and
lead components
Any occupation that requires use or handling of lead or its
compounds containing lead
2 Poisoning by mercury
and its components
Any occupation that requires the production, use or disposal
of mercury and its components, in addition to any work
involving exposure to dust or gases of mercury or its
components or materials containing mercury.
3 Poisoning by arsenic and
its components
Any work that requires the production, use or disposal of
arsenic and its components, in addition to any work involving
exposure to dust or gases of arsenic or its components or
materials containing arsenic.
4 Poisoning by antimony
and its components
Any occupation that requires use or handling of antimony or
its components or exposure to the dust or gases of antimony
or its components or items containing antimony
5 Poisoning by
phosphorous and its
components
Any occupation requiring use or handling of phosphorus or its
components or exposure to the dust or gases of phosphorus
or its components or items containing phosphorus
6 Poisoning by petroleum,
its gases, derivatives or
components
Any occupation that requires use or handling of benzene
(petroleum) and its derivatives or its compounds or exposure
to the dust or vapors of benzene (petroleum) whether in
solid, liquid or gaseous form
7 Poisoning by Manganese
and its components
Any work that requires the production, use or disposal of
Manganese and its components, in addition to any work
involving exposure to dust or gases of manganese or its
components or materials containing Manganese.
8 Poisoning by sulfur metal
and its components
Any occupation that requires use or handling of sulfuric
metal or its components or any items having sulfuric content
or exposure to the dust and gases of sulfuric metal and its
components or any items having sulfuric content.
9 Poisoning by chloroform
or carbon tetrachloride.
Any occupation that requires use or handling of chloroform
or carbon tetrachloride or exposure to the gases containing
them
10 Diseases resulting from
Radium or radioactive
substance or (X-rays)
Any occupation that requires exposure to radium or any
other radio-active substance or X=rays.
11 Chronic skin disease and
burns of the skin and the
eye
Any occupation that requires use or handling of tar or coal tar
equipment, mineral oil or kerosene or cement, flour or similar
dust or any of their compounds, products or residues

ADOSH-SF – Mechanisms
Mechanism 11.0 – Incident Notification, Investigation and Reporting
Version 4.0 –15 th July 2024
Page 28 of 30
No. Disease Occupation Causing the Disease
12 Eye affections from the
heat and light, and the
consequences of such
affections
Any occupation that requires recurrent or continuous
exposure to reflection of light, heat or radiation emitted by
molten glass, hot or molten metals or exposure to powerful
light and high temperature that could cause harm to eye or
sight
13 Pneumoconiosis
resulting from:
1. Silicosis (Silicon dust)
2. Asbestosis (Asbestos
dust)
3. Byssinosis (cotton
dust)
4. Any other dust
Any occupation that requires exposure to silicon dust or any
items with silicon content in a concentration of more than
5%, such as work in rock cement factories, sandblasting of
metals or any other occupation requiring a similar exposure,
as well as any work requiring exposure to asbestos or cotton
dust to such an extent as to result in such a disease.
14 Anthrax Any occupation that requires contact with animals affected
by such a disease or with their skins, horns and hair
15 Ascites Any occupation that requires contact with animals affected
by this disease
16 Pulmonary Tuberculosis Any occupation in hospitals providing treatment to patients
affected by this disease
17 Enteric Fever Any work in hospitals specialized in the treatment of this
disease

ADOSH-SF – Mechanisms
Mechanism 11.0 – Incident Notification, Investigation and Reporting
Version 4.0 –15 th July 2024
Page 29 of 30
Additional Reportable Occupational Illness / Diseases:
No. Disease Occupation Causing the Disease
1 Legionella Any work requiring contact with water storage,
distribution, and treatment systems that are
contaminated with Legionella bacteria. This
includes swimming pools, hot tubs, showers, cooling
towers, and similar types of equipment
2 Cumulative Trauma
Disorder
Any work requiring repetition of a task that results
in a muscular skeletal disorder
3 Vibration white finger Any work with equipment that continually vibrates
the hands and causes reduced blood flow to the
fingers
4 Whole body vibration
syndrome
Any work with equipment that exposes the body to
whole body vibration and shocks and results in pain
and injury
5 Hand arm vibration
syndrome
Any work with equipment that continually vibrates
the hands and causes reduced blood flow to the
fingers
6 Cancer Any occupational exposure to chemicals that
results in cancer
7 Tenosynovitis Any work exposure that results in the inflammation
of the fluid-filled sheath that surrounds a tendon
8 Pleural Disease Any work exposure that causes an accumulation or
reduction of pleural fluid