SEM1 2018/2019
Group Information
Group Leader : QUEK AI XIAN AE180095
Group Secretary : KOW FANG JIUN CE180025
Group Member No. Name Matrix No.

2. OOI GUO LUN AE180091
VERIFIED BY (SIGNATURE & STAMP) : …………………………………..


DATE : ………………………………
The industries are looking to their production systems in the different direction to get the competitive advantages. But the most important is to find out the problem of the production system to make improvements. In this paper, a part of the production system of companies is studied to find the problems of the safety system of the company to make the improvements and to recommend some points to the companies for the achievements of its goals and avoid accidents. Increasing number of accidents involving workers has drawn our attention towards safety measures in the factories.

Malaysia recorded an average of 4 workers injured hourly in 2013 (SOCSO 2014). This shows that ensuring safety at the workplace is to avoid incidents or accidents from happening—more commonly known as incident prevention.

Incident prevention looks into developing a safe workplace which minimizes the possibility (and if possible, zero possibility) of being injured at the workplace.

Basic Principle to create zero injuries
No incident means no accident; and when no accident happens, it means zero injuries.

Figure 1:
Why implement incident prevention?
Incident prevention is required by trade acts and regulations to avoid mistreated and misused of workers.

As for businesses, incidents or accidents happenings creates extra costs such as increased insurance premiums, damage to equipment, loss of production time during investigation and fines.

Incident prevention implemented to avoid these costs along with avoiding interruption to the business due to accidents.

When worker safety is assured and no injury occurs, workers will work safely and happily
resulting in high productivity and no interruption on business output.

Therefore, incident prevention should be listed as priority and compulsory for employers to beimplemented.

Concept of Incident
An incident is the description of an individual or combined series of causal events and the effect of an action or actions that creates unwanted situation (usually situations causes injuries and death) towards human beings, objects or substance.

It is a condition that starts with unexpected and unplanned events due to a single cause or combination of causes. These causes are mostly identified as occurring by itself and imply no blame or responsibilities
Unfortunately, most of the occurrences are identified as human error or unsafe act and unsafe condition of the environment (Henrich, 1959).

When the combined occurrences cause reactions, it could cause physical harm to workers or loss of property, known as an accident.

The chains of events can also create near misses—an event happens, but does not create any harm to workers or property.

Block Diagram for Concept of Incident

Figure 2: Concept of Incident
Defination of Incidents
The definition for accident, near miss and incident at work varies depending on the context and the purpose.

–For incident prevention,
•accident is a part of incidents
–For accident investigation and workers compensation,
•occupational accidents such as from SOCSO, non- injuries incidents and near misses are identified as different entities from accidents.

Defination of Incident for Incident Prevention

Figure 3: The relationship between incident, accident and near miss, based on MS1722:2001 and OHSAS 18001:2007
Defination of Incident for HSE Investigation

Figure 4: The relationship between incident, accident and near miss, for HSE Investigation
Principle of Incident and Prevention
The purpose of incident prevention is to avoid workers from being injured and those who are likely to suffer financial loss, disability, extreme pain and even death.

Damages of property should also be avoided because of the direct and indirect costs associated with incidents.

It has become common practice for clients to request safety records as part of a tender process.

–When a company has successfully secured a contract, the client would request continual reports on safety as part of performance indicator and assessment.

An effective incident prevention is shown by the success of reported rates or the lowest number of incidents. Principles are used as guidance and ensure acceptance of rules and methods used. There are three fundamental principles for applying science to accident prevention (Heinrich, 1931):
–Through the creation and maintenance of an active interest in safety
–Be fact finding
–Leads to corrective action based on facts
The HSE (2014) emphasizes more on safety management system compared to Heinrich’s methods. In order to ensure an effective implementation of an incident prevention programs, the following principles of incident prevention should be practiced:
i)Good leadership and management
ii)Legal compliance
iii)Competent organization and resources
iv)Co-operation between management and workers
v)Best available information and technology
Accident Causation Theory or Model
Accident causation models were developed to assist safety officers or safety committees models to investigate and identify the causes of the occupational accidents effectively.

Early proactive procedures could be taken before any incident could happen.

By understanding accident causation theories, the understanding and the identification of the types of failures or errors that cause accidents could be done.

Heinrich Domino Theory
In his analysis, Heinrich concludes:
–88 per cent of industrial accidents are caused by unsafe acts of workers
–10 per cent of industrial accidents happen due to unsafe conditions
–2 per cent are unavoidable (act of God)
Domino Theory- five-element singular sequential linear causation
Social environment and ancestry
Recklessness, stubbornness and other undesirable character traits may be passed along through inheritance or blood lines.

The fault of the person
Inherited or acquired traits such as violent temper, lack of consideration, ignorance of safe practice etc. are responsible for the person committing unsafe acts or allowing the existence of mechanical or physical hazards.

Unsafe acts and/or mechanical or physical hazard
Unsafe acts include going into a construction site without a safety helmet, standing under suspended loads, failure to adhere to lock-out/tag-out policy for electrical equipment used, horseplay at work, removal or not wearing safeguards or personal protection equipment provided.

Examples of mechanical or physical hazards are unguarded machinery, unguarded pinch points, and insufficient light.

Events such as slips and trips, being struck by moving or flying objects, being caught in machinery, or coming into contact with high energy sources or radiation.

Sprains, fractures, lacerations, cuts, etc. that result from accidents

Figure 5: Heinrich’s Domino Theory
Curb Accident Using Domino Theory
Heinrich suggested that removing the domino nearest to the ‘Accident’ domino could stop the happenings of accident events and eliminate injury.

The suggested domino is the third domino (third element). With this action taken, even if ‘Social Environment and Ancestry’ and ‘Fault of the person’ happens, ‘Accident’ still can be avoided.

Figure 6: Suggested Domino Theory Application
Bird’s Loss Causation Model or International Loss Control Institute (ILCI) Model
–The influence of management and managerial error found happening of near misses or accidents are caused by lack of management control towards their workers.

–Loss is as the result of an accident—which not only represent injuries, but also represents damages due to production losses, property damage or wastage of other assets.

Bird’s Loss Causation Model in five sequential orders

Figure 7: Loss Causation Model
Bird’s Loss Causation Model in five sequential orders are:
Step 1) Lack of control
–There are 2 common reasons for lack of control:
–Inadequate safety program
–Inadequate compliance with standards
Step 2: Basic causes
-Personal factors: lack of knowledge, skill, or inability to handle pressures of the job
-Job factors: inadequate training, inappropriate and inadequate equipment and tools, worn equipment and tools
Step 3 Immediate/ direct causes
Substandard practices
•Operating equipment without authority
•Improper loading
•Under influence of alcohol and/or other drugs
Substandard conditions
•Inadequate guards or barriers
•Defective tools, equipment or materials
•Poor housekeeping; disorderly workplace
•Inadequate ventilation
Step 4 Incident/Contact
Incidents that may or may not result in injury to a person or damages to property.

when the amount of energy received by the person, property or equipment exceeds the amount of safety values, injury or damage is a result of the exceeded absorption.

Step 5 :Loss (injury or damage to property)Direct loss includes some or all of the following: harm to people, damage to property, or a reduction/halt in productivity.

Indirect costs may include, but are not limited to, increased training costs to replace injured employees, legal expenses, investigation time, and loss of business due to unfavorable press
Loss is the result of an accident. Loss can be direct or indirect, both of which must be considered to fully appreciate the impact to a company
Multi-causation Accident Model
The Multi-causation Accident model outgrew the Domino Theory.

The contribution factors can be divided into two groups:
–behavioral group or unsafe acts;and
–environmental group or unsafe conditions.

Figure 8: Multi-Causation Accident Model
Example : Multi-causation Accident Model

Figure 9: Example of Multi-Cause Accident
The successes of implementing an accident prevention program depends on
–management commitment in accident prevention,
–procedures in developing an incident prevention plan and ;
–implementation of the incident prevention program.

Management Commitment
Commitment from supervisors or middle management officers is vital for accident prevention.

Accident causation models and multiple research on accident prevention programs show all incidents can be prevented if commitment from management at all levels, and worker co-operation is obtained.

Moreover, in supporting the policy, accident prevention plans and safety procedures should be developed.

Appropriate information, instruction, training and supervision are required to complement the documentation.

Accident Prevention Planning
An effective accident prevention planning usually contains eight elements:
Management commitment : Management is committed to ensure workplace is safe and support incident prevention planning and programs by allocating time and resources.

Employee involvement : Employees should be the ‘eyes’ to report hazards, unsafe conditions and behaviors..

Safe work practices : Procedure of implementing work.

Workplace hazard assessment : Hazard assessment and identification from HIRARC is used to identify unsafe acts and conditions at the workplace.

Hazard control : Based on HIRARC data , hierarchry of control is used to determine the best solution to prevent control and based on the recommendation given, incident prevention planning are implemented based on the need analysis of the highest risk as priority then the lowest risk as when needed only basis.

Accident investigation : Accident investigation reports are used to determine the weakness of incident prevention measures already in place.

–Newly employed workers should undergo orientation and induction training to learn processes and basic safety procedures.

–New equipment and processes will require knowledge and competency training.

–Senior workers should also have regular awareness or refresher training sessions.

Record keeping : A legal requirement and should be kept for seven years.

–All safety activities, such as training, auditing, accident investigation, safety committee meeting, medical surveillance, implemented accident prevention programs and so on must be documented for reference and records.

–Data for any unsafe acts can be obtained and analyzed to develop better incident prevention programs.

Accident Prevention Training
The rational for accident prevention training is to ensure all workers are knowledgeable to follow instructions and to understand the importance of accident prevention procedures.

The reasons workers fail to follow safety procedures are due to
–Specific instructions for operating equipment were not given
–Workers misunderstood instructions
–Workers do not listen to instructions
–Workers felt instructions given is unimportant and unnecessary
–Workers disregarded instructions
4 steps of implementing Accident Prevention Training
Step 1: Determine the importance and list according to priority of which training program should be implemented. Due to limited allocation and resources given for safety purposes, only high impact and compulsory training are allowed to be conducted.

The training is based on the following recorded references:
–Review accident reports/records
–Review industry information
–Request from workers, supervisors
–Legal aspect needs
–Complete job safety analysis
Step 2: Determine the scope of training, which refers to the focus group. The level of training is either general or specific as different aspects have different preparation and levels of competency.

Step 3: Identify the goals and objectives based on scope of training. If the number of objectives and goals is too large, training can be divided into a couple of sessions to ensure achievable results.

Step 4: Conduct training and collect documentation. There are four basic steps of conducting training:
a. Preparation
–Planning instruction consists of course outline, lesson plan, preparing facilities and preparing the learners.

b. Presentation
–The type of presentation depends on the goals, objectives and the nature of the training.

–For example, new policy information is linked to normal lectures or forum- based methods.

–Practical on-site and demonstration suits firefighting or fire
drills training best.

c. Application
–After basic theories and concepts are introduced, practical application should be conducted to determine competency.

d. Evaluation
–Feedback from trainees about effectiveness and understanding should be obtained. Competency tests should be conducted to ensure input is understood and can be applied on-site. Evaluation can be used as record keeping as required by legal and also for effectiveness of the training. From this, improvements can be made to correct weaknesses of the program.

Example to show the Difference Between Incidents, Accidents and Near Misses
Incident Events Combination of Events Results
Human Injury Property Loss
Slip and fall causing injury on the arms and elbow.

(Accident) Wet and slippery surface
Ridor lighting Due to the dim lights, pedestrian unable to see wet and slippery surface Injured arms and back Slip while walking up stairs
(Near Miss) Worn out shoes soles
Hold stair railing Due to worn out shoes soles, worker slips and misses one of the steps but manages to hold to stair railing to avoid falling. None None
Chemical spills
(Accident) Slippery bottle surface due to residue
Wrong side of the bottle (covering label) Due to the slippery surface of the bottle, bottle slips and fell on the floor
Inhale fumes and hard to breathe Floor surface and a table
Incident Events Combination of Events Results
Human Injury Property Loss
Operating equipment without utilizing the required guards or personal protective equiment Drilling holes for wood work
Not wearing safety goggles While drilling a hole, wood chip spreads upwards but misses handler None None
Incident prevention is an important tool used as intervention for eliminating accidents, in terms of injuries, death and damages of property.

Principles of incident prevention and accident causation theories or models explain the capability of sciences and management to be integrated to form a better prevention system.

Accident causation models and theories show the methods of identifying cause and effect and the changes of such models due to technology and human needs.

Identification, planning and implementation of incident prevention needs good understanding of the costs involved due to accidents, versus the prevention costs and the benefits of implementing incident prevention.

Overall, the theoretical part of developing and planning is systematic: implementing the plan and dealing with human behavior never is. Practically, incidents can be prevented with resources and co-operation from both workers and management.