Although OSHA’s new reporting rule has been in effect for almost seven months now, it has caused some major changes in the way that OSHA operates. Since the new reporting rule went into effect on January 1, 2015, OSHA has received more than 5,000 reports of work-related deaths, inpatient hospitalizations, amputations, and losses of an eye. As OSHA anticipated, compliance with the rule has focused the agency’s attention on industries and hazards that it had not focused on before. For example, because of the unexpectedly high number of reports of amputations from supermarkets, OSHA issued a safety Fact Sheet last month focused on preventing cuts and amputations from food slicers and meat grinders.
Around 40 percent of the newly filed reports have prompted OSHA investigations. Another 46 percent have resulted in what the agency refers to as a “rapid response investigation.” In a rapid response investigation, OSHA contacts the reporting employer to learn more about the incident. The agency often expects the employer to conduct its own investigation into the root cause of the incident, determine how to prevent similar incidents from happening in the future, and report these findings back to OSHA in about a week.
In cases where OSHA is dissatisfied with an employer’s response, such as reports that merely blame the victim, the agency may proceed to conduct its own inspection of the incident. An important related issue has not yet been resolved by the agency—that is, whether statements made in the investigation report that will result from the employer’s root cause analysis will be used as admissions by OSHA in the event of an enforcement action. Accordingly, now more than ever, it is vital for employers to understand how to conduct an effective root cause analysis and produce an effective investigation report that will help them prevent similar incidents from taking place in the future.
Root cause investigations are often conducted by an employee’s supervisor, but a more effective approach involves managers and employees working together, bringing a variety of perspectives to the investigation. As noted above, employers should be wary of merely blaming the victim and should instead investigate the incident thoroughly, interviewing the injured employee and all witnesses and assuring them that they will not be retaliated against for speaking truthfully about the incident. The scene of the incident should also be temporarily cordoned off to enable the investigation team to document the location and any objects that were involved in the incident. When searching for the root cause of an incident, the investigator should always be asking “why?” For example, if a safety procedure was not followed, why was it not followed? If inadequate training was involved, why had the problem not been identified before? By asking enough whys, the root cause of the incident will eventually be revealed, enabling the employer to respond to the situation and minimize or eliminate the possibility of a similar incident occurring in the future.
When recording the findings of the root cause analysis, employers must be mindful to exclude hearsay or conjecture—the content of the report should be completely factual and should include as much of the following information as possible:
- Background information, such as where and when the incident took place, who and what were involved, the victim’s role and actions, and everything learned from witness interviews
- A full description of the incident, such as the sequence of events, the type of incident, any objects or machinery that were involved, and any unusual circumstances, such as adverse weather or equipment failure
- An analysis of why the incident took place, based on everything that the employer discovered during the investigation
- Recommended corrective actions that will prevent recurrences
By following these guidelines and ensuring that the recommended corrective actions are implemented, employers can improve employee safety and morale while reducing the risk that their investigation reports will result in an OSHA citation.