OSHA表格300 Word版

更新时间:2023-06-18 04:26:48 阅读: 评论:0

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OSHA's Form 300
Year年
Attention:  This form contains information relating to employee health and must be ud in a manner that protects the confidentiality of employees to the extent possible while the information is being ud for occupational safety and health purpos.本表包含与员工健康有关的信息,必须采用合适的方式最大程度地保护员工的隐私,本信息仅用于职业健康与安全场合;
LOGO
Log of Work-Related Injuries and Illness
与工作有关的伤害和疾病记录
You must record information about every work-related injury or illness that involves loss of consciousness, restricted work activity or job transfer, days away from work, or medical treatment beyond first aid.  You must also record significant work-related injuries and illness that are diagnod by a physician or licend health care professional.  You must also record work-related injuries and illness that meet any of the specific recording criteria listed in 29 CFR 1904.8 through 1904.12.  Feel free to u two lines for a single ca if you need to.  You must complete an injury and illness incident report (OSHA Form 301) or equivalent form for each injury or illness recorded on this form.  If you're not sure whether a ca is recordable, call your local OSHA office for help.必须记录每一个与工作有关的伤害和疾病的信息,包括意识丧失,工作限制和调换,未工作天数,急救之外的医疗处理;必须记录医师和有资格健康保健专业人员诊断出的重要的与工作有关的伤害和疾病;还必须记录标准中所列的与工作有关的伤害和疾病的专项记录;需要的话,单个事件可以填写2行;对本表所亡的每一个伤害和疾病必须完成一个伤害和疾病报告(OSHA 表301)或等效表格;如果不确定是否需要记录,打电话给当地OSHA的办公室寻求帮助。
Establishment name
公司名称 
                                                         
City
城市
                     
State
国家
               
Identify the person人员识别
Describe the ca事件描述
Classify the ca事件分类
(A)
(B)
(C)
(D)
(E)
(F)
CHECK ONLY ONE box for each ca bad on the most rious outcome for that ca:
基于事件中最严重的结果,每个事件勾选一个
Enter the number of days the injured or ill worker was:
Check the "injury" column or choo one type of illness:                                                                                 
勾选伤害列或选择一种疾病
Ca No.
事件序号
Employee's Name                                  员工姓名
Job Title  (e.g., Welder)
工种
Date of injury or ont of illness
日期(mo./day)/
Where the event occurred (e.g. Loading dock north end)                                  发生地点
Describe injury or illness, parts of body affected, and object/substance that directly injured or made person ill (e.g. Second degree burns on right forearm from acetylene torch)伤害和疾病描述,受影响的身体部位,直接受伤或使人生病的对象/物质(如氧乙炔炬导致的右前臂二级烧伤)梦得
Death                           
死亡
Days away from work
不能工作
Remained at work 继续工作
伤害或生病的天数
Injury
伤害
Skin Disorder
皮肤病
Respiratory                                            Condition                                      呼吸道病
Poisoning
中毒
Hearing Loss                                  听力损失
All other                                        illness                              所有其它疾病
Job transfer or restriction工作转换或受限
Other record- able cas其它可记录的事件
Away From Work (days)未工作
On job transfer or restriction (days)工作转换或受限
(G)
犹豫读音(H)
(I)
(J)
(K)
(L)
(1)
(2)
(3)
(4)
(5)
(6)
熟食配送
Page totals 本页汇总
Be sure to transfer the totals to the Summary page (Form 300A) before you post it.在发布汇总表(表300)之前, 确认与本表的总数一致;
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