Chapter 4 - Investigative Techniques

In order to perform an effective accident investigation, you must collect evidence and gather facts. Although the purpose of an accident investigation is not to assess blame and an accident investigation is not a legal proceeding, some legal-sounding terms are used during the first, or investigative phase of an investigation. (Remember that the three parts of an accident investigation are the investigative phase, the analytical phase, and the recommendation phase.) Any technique used to collect evidence and obtain facts or knowledge about the accident is called an investigative technique. The facts discovered and the accident sequence derived from them are used for the analytical phase of the investigation.

Are You Ready for an Accident?

Of course nobody is ever “ready” for an accident, but it is important to be prepared and have the right investigation tools on hand in case an accident happens. The four most important components of an accident investigation program are a formal written accident investigation policy, training in emergency response, training in accident investigation, and an accident investigation kit. Exhibit 4.1 outlines the accident investigation necessities.

Formal Written Accident Investigation Policy

This policy states the purposes of reporting accidents and investigating
accidents. Important parts of the policy are:

  • A statement letting employees know that all accidents must be reported through the proper channels and that the purpose of an accident investigation is not to place blame.
  • A description of the purpose of an accident investigation.
  • An explanation of how causal factors and corrective actions are determined.

Emergency Response Plan and Training

The emergency response plan should emphasize fast care and rescue while minimizing the harm to other employees and the emergency responders. In larger companies, emergency response teams, fire personnel, medical personnel, and other first responders are trained to respond to accidents. Although smaller plants do not usually have dedicated emergency response teams, their employees also need to be prepared for accidents. Preparation can be in the form of training in CPR (cardiopulmonary resuscitation) and first aid as well as in evacuation and shutdown procedures.

Accident Investigation Training

The first part of accident investigation training involves all employees— everyone should understand the purpose of an accident investigation and the importance of reporting all accidents. If accidents are not reported, there is no avenue for finding and correcting problems in the safety program.

The second part involves only the people who will be conducting investigations. The company must ensure that they have the knowledge to perform adequately. Training courses on interviewing techniques, analytical techniques, causal analysis, and other aspects of investigation are available.

Accident Investigation Kit

Accident investigation kits can contain materials ranging from comprehensive—tools, personal protective equipment, cameras, tape measures, gloves, lights, security tape, tweezers, evidence bags, and other equipment—to simple—a pair of gloves, a clipboard, accident forms, and barricade tape. Exhibit 4.2 lists the contents of a typical accident investigation kit (DOE 1999). With a kit ready and waiting, an investigator can react to accidents quickly.

Emergency Response Actions

After an accident is reported, the first part of the accident investigation involves actions taken by the emergency response personnel. These should include:

  • Securing the scene. This could mean turning machines off, cutting power, pulling alarms, etc. The intent is to minimize adverse effects to other employees in the plant.
  • Providing care to the injured. One way to do this is to remove the injured person from the scene and take him or her to a medical facility. This is usually done if the person is still in a hazardous environment. If there is no danger of further injury or if there is any suspicion of back or neck injuries, it is best to leave the person at the scene until medical personnel and equipment arrive to transport him or her properly to a medical facility.

Rendering aid to an injured worker should be done only by properly trained emergency response personnel and medical personnel. Aid given by an untrained (albeit well-intentioned) person could cause additional harm.

Those providing first aid must be aware of the dangers of bloodborne pathogens and take appropriate precautions to avoid coming into contact with blood or body fluids. This means that blood and body fluids must be treated as if they are known to carry infectious pathogens. Controls, including work practice controls and personal protective equipment (gloves, masks, etc.) should be used to not only minimize exposure to emergency workers, but also to prevent other employees from having contact with these substances (U.S. Department of Labor 2003). These controls should be mandated by the company. For instance, if blood at the accident scene is known to be infectious, any worker having contact with the blood should be vaccinated against hepatitis.

Preservation of Evidence

Preserving evidence at an accident scene is an important part of accident investigation, although it must not get in the way of providing care to the injured. Securing the scene and keeping people from contaminating evidence is important in determining both lower-level causes and system failures.

How to Protect the Accident Site from Tampering and Contamination
  • Cordon off the area. Prevent people from stepping into it or moving anything in or out of the scene.
  • Photograph the scene. Take pictures as soon as possible after the accident, as it may be difficult to maintain the scene as it was at the time of the accident. This is especially true with accidents that occur outdoors, where wind, rain or snow can alter evidence.