Document XzdYyRrw77MQBJ21Q0On8k2jy

RETURN THIS REPCUT TO STATISTICAL DIVISION, NATIONAL SAFETY COUNCIL 425 NORTH MICHIGAN AVENUE, CHICAGO 11, ILLINOIS NATIONAL SAFETY COUNCIL CONTEST REPORT M nthly Summary of Industrial Injuries for 1%$_ (Month) This report should be returned on or before the 15th of the following month by all contestants except those in the Marine and Food Sections', reports from these sections should be returned by the 25th of the following month. The Contest Bulletins greatly increase in interest and value when the record of every contestant is completely up-to-date. rrtMPAMv Columbia-Southem Chemical Corporation AnnF^ P 0* Box 900 Lake Charles, LouisianaCONTEST Chemical NAME OF UNIT Lake Charles -forkskey number 769 Use a separate form for each unit. (Pipw, Rublw, Cbeatiol, Etc.) 1. CUMULATIVE TOTALS FROM JANUARY 1 TO BEGINNING OF THIS MONTH (Except on the January report, these totals must agree with the totals on the last line of the previous month's report. Leave this line blank on the January report) Average Number Employees H Man-hours El 7sm7 Total Reportable Injuries 151 . 25 Injury Frequency Rate 1 2. REVISIONS OR CHANGES IN PREVIOUSLY RE PORTED FIGURES (Show here any revisions in man hours or injuries which you have made since submitting your last report, and add or subtract them from the totals on Line 1. Explain the changes under "Comments" and state the months affected) 3. TOTALS AND RATE FOR THIS MONTH 454 12______ _0 78037 25_____ ___0 4. CUMULATIVE TOTALS AND RATE FROM JAN UARY 1 TO END OF THIS MONTH (Sum of items 1, 2 and 3 in columns A and B. .Carry these totals for ward to the first line of next month's report) -73037_______5_______ 0 COMMENTS______ Report for aonth of January 3.955 I certify that all accident records are compiled in accordance with the American Standard Method of Compiling Industrial Injury Rates, code Z16.1-1945. Safety & Training Director Approved byTitle_________________________ _______________________ ________ DEFINITIONS AND INSTRUCTIONS The following injury definitions conform to the American Standard Method of Compiling Industrial Injury Rates [S This report shall cover employees and supervisors on all shifts, including operating, production, maintenance, clerical, office, sales, transportation, and all other departments. Enter on Line 3 all man hours worked by these employees during this month only. (j A reportable injury is any injury or occupational disease arising out of and in the course of employment, resulting in death, perma nent total disability, permanent partial disability, or temporary total disability. 1. Permanent total disability is any injury which permanently and totally incapacitates an employee for following a gainful occupation. manent disability, but which, in the opinion of the attending physician, renders the injured person unable to return to a regularly established job is the plant where he was injured at any time within bis regular working hours on the calendar day following the day on which the injury occurred, or because of his injury is unable to work on some later day. A regularly established job is one which has not been set up especially to accommodate the injured person, either for therapeutic reasons or to avoid counting the case as a temporary total disability. When in doubt as to whether or not to count a case, the case should be described under "Comments" or in an attached letter, and an opinion requested from the National Safety Council. 2. Permanent partial disability is any injury (other than death and permanent total disability) which involves (a) the loss of, or (b) the permanent impairment of any function of any mem ber of the body or part thereof. Every permanent disability shall be counted even though the injured does not lose time. 3. Temporary total disability is an injury not involving per* Printed in U.S.A. [3 Injury frequency rate = Total Reportable Injuries X i,qoo,oqo Man-hours Compute frequency rate to two decimal places; for example; 15.24, not 15 or 15.2. Compute the rate separately for Line 3 and Line 4. ISC-3-150M-5-54-09