ABC-IMS-HSE-020 Monthly HSE Statistics

Download as docx, pdf, or txt
Download as docx, pdf, or txt
You are on page 1of 1

Document Ref.

ABC-IMS-HSE-020
INTEGRATED MANAGEMENT SYSTEM Rev. No Rev. Date
0 Dec 2019
Page
Monthly HSE Statistics Form 1 of 1

Project Name: Contract No.:


Month: Dates From/To:
Start of the Project: Project to
Current Previous
Year to Date Date
Expected Completion: Month Month
(Cumulative)
1 Total man hours worked (Including sub-contractors)
2 Fatality (work related death)
3 Serious Injurious Accident (4 days or more lost time)
4 Moderate Injurious Incident (3 days or less lost time)
5 Number of Lost Time Days (work related)
Injury Frequency Rate (serious and moderate)
6 Formula: No. of Injury x 100,000
Total man hours worked
Injury Severity Rate (serious and moderate)
7 Formula: Total Lost Time Days x 100,000
Total man hours worked
8 Minor injurious events (no day lost / first aid & check-up)
9 Serious damage accident (estimated over 10,000 SR)
10 Moderate damage incident (>< 1,000 &10,000 SR)
11 Minor Damage Event (estimated below 1,000 SR)
12 Road accident (outside project or facility locations)
13 Total vehicle/ plant events (09, 10, 11 & 12 combined)
14 Fire (any size)
15 Near miss reports
16 Environmental incident
17 No. of Safety Improvement Notice issued
18 No. of HSE Violation issued
19 No. of HSE Induction given
20 No. of HSE Meeting conducted
21 No. of Site HSE Inspection
22 No. of HSE Training given
23 No. of Toolbox Talk conducted
Note:
Prepared by: Signature: Date:
Project Manager: Signature: Date:
CC: Sr. HSE Manager/ Project Manager/ Construction Manager/ Project File

You might also like