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Regulation Of The Minister Of Labour And Social Policy Dated 7 January 2009 On The Statistical Card Of An Accident At Work

Original Language Title: ROZPORZĄDZENIE MINISTRA PRACY I POLITYKI SPOŁECZNEJ z dnia 7 stycznia 2009 r. w sprawie statystycznej karty wypadku przy pracy

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REGULATION OF THE MINISTER OF LABOUR AND SOCIAL POLICY 1)

of 7 January 2009

on the statistical card of an accident at work

On the basis of art. 237 § 3 of the Act of 26 June 1974. -Labour Code (Dz. U. 1998 r. No 21, pos. 94, z późn. 1. 2) ) The following shall be managed:

§ 1. The Regulation sets out a model for the statistical accident card for work, the manner and time limits for its preparation and transmission to the competent statistical office.

§ 2. A model of statistical accident at work, with the symbol Z-KW, hereinafter referred to as 'the statistical card', shall be defined; Annex 1 [ 1] to the Regulation.

§ 3. The statistical card shall be drawn up on the basis of an approved memorandum of determination of the circumstances and causes of the accident at work, hereinafter referred to as the 'post-accident protocol', or on the basis of an accident card where it is found that the accident is an accident at the work or accident on a par with an accident at work.

§ 4. 1. The statistical card shall be drawn up in accordance with the explanatory notes, the classification and the code markings to be completed on this card, which are set out in Annex 2 to the Regulation.

2. Part I of the statistical charter shall be drawn up no later than 14 working days from the date on which the post-accident protocol has been approved or in which the accident card has been drawn up.

3. Part II, the supplementary statistical card shall be drawn up within a period which allows the time limit for the transmission referred to in paragraph 5 (1) to be retained. 2.

§ 5. 1. A statistical card, with the exception of its part II, supplementary, the employer shall transfer within a period of up to 15. on the working day of the month following the month in which the post-accident protocol was approved or in which the accident card was drawn up.

2. A completed part of the II, supplementary, statistical card of the employer shall be transmitted no later than 6 months after the date of approval of the post-accident protocol or from the date on which the accident card was drawn up.

3. The statistical card shall be submitted in electronic form to the reporting portal of the Central Statistical Office.

4. Employer employing no more than 5 employees may transfer the original statistical card drawn up in paper form to the Statistical Office in Gdańsk after the submission of the reasoned information about the selection of this form.

§ 6. Repealed Regulation of the Minister for Economic Affairs and Labour of 8 December 2004. on the statistical card of an accident at work (Dz. U. No 269, item. 2672).

§ 7. The Regulation shall enter into force after 7 days from the date of the announcement.

1) The Minister of Labour and Social Policy heads the government administration-work, pursuant to § 1 paragraph. 2 point 1 of the Regulation of the Prime Minister of 16 November 2007. on the detailed scope of the action of the Minister of Labour and Social Policy (Dz. U. No 216, item. 1598).

2) Amendments to the text of the single law have been announced in the Dz. U. 1998 r. No. 106, pos. 668 i Nr 113, poz. 717, 1999 Nr 99, pos. 1152, of 2000 No 19, pos. 239, Nr 43, pos. 489, No. 107, pos. 1127 and No. 120, pos. 1268, 2001 No 11, pos. 84, Nr 28, pos. 301, Nr 52, pos. 538, Nr 99, pos. 1075, Nr 111, poz. 1194, No 123, pos. 1354, Nr 128, poz. 1405 and No. 154, pos. 1805, of 2002. No. 74, item. 676, No. 135, pos. 1146, No. 196, item. 1660, Nr 199, pos. 1673 and No. 200, pos. 1679, 2003 Nr 166, pos. 1608 i Nr 213, poz. 2081, 2004 Nr 96, pos. 959, Nr 99, pos. 1001, Nr 120, poz. 1252 and No. 240, pos. 2407, of 2005 Nr 10, pos. 71, Nr 68, poz. 610, Nr 86, pos. 732 and No 167, pos. 1398, of 2006. Nr 104, pos. 708 and 711, No. 133, pos. 935, Nr 217, poz. 1587 and No. 221, pos. 1615, 2007 No. 64, pos. 426, Nr. 89, pos. 589, Nr 176, pos. 1239, Nr 181, pos. 1288 and No. 225, pos. 1672 and 2008 Nr 93, pos. 586, Nr 116, pos. 740, No. 223, pos. 1460 and No. 237, pos. 1654.

Annex 1. [ STATISTICAL ACCIDENT CARD]

Annexes to the Regulation of the Minister of Labour
and the Social Policy of 7 January 2009. (pos. 80)

Annex No 1

STATISTICAL ACCIDENT CARD

infoRgrafika

infoRgrafika

Annex 2. [ EXPLANATORY NOTES, CLASSIFICATIONS AND CODE MARKINGS TO COMPLETE THE STATISTICAL ACCIDENT CARD (Z-KW)]

Annex No 2

EXPLANATORY NOTES, CLASSIFICATIONS AND CODE MARKINGS TO COMPLETE THE STATISTICAL ACCIDENT CARD (Z-KW)

A. Clarifications of basic concepts

According to Article 3 of the Act of 30 October 2002. o social insurance in the field of accidents at work and occupational diseases (Dz. U. Nr. 199, pos. 1673, of late. zm.):

1) for accidents at work a sudden event caused by an external cause causing injury or death which has occurred in connection with the work shall be considered:

(a) during or in connection with the performance by the worker of normal operations or orders of superiors,

(b) during or in connection with the performance of an employee's activity in favour of the employer, even without a request,

(c) at the time of the stay of the employee at the employer's disposal on the way between the employer's head office and the place of performance of the employment obligation

2) On a par with an accident at work, in the field of entitlement to the benefits referred to in the Act, the accident to which the worker has been granted shall be treated:

(a) during a business trip in circumstances other than those referred to in point 1, unless the accident is caused by the conduct of a worker which is not in connection with the performance of the tasks assigned to him,

(b) during training in the field of universal self-defence,

(c) in the performance of tasks outsourced by the employer's working organisations;

3) for the accident at work is also considered to be a sudden event caused by an external cause, causing injury or death, which occurred during an accident insurance period in respect of a given title during:

(a) practising sport during competitions and training by a person receiving a sporting scholarship,

(b) the performance of the work to be carried out on the basis of a referral to work at the time of imprisonment or temporary arrest,

(c) the appointment of a Member or a senator who takes the emoluments,

(d) the appointment of a Member of the European Parliament elected in the Republic of Poland

(e) training, internship, or professional preparation at the place of work by a person receiving a scholarship during the period of such training, internship, or professional preparation in the workplace on the basis of a referral issued by a county office work or by any other operator,

(f) the execution, by a member of an agricultural cooperative, of a production cooperative, of agricultural cooperatives, and by another person treated as a member of a cooperative within the meaning of the provisions on social security schemes, working for the benefit of such cooperatives,

g) to perform work on the basis of a agency contract, contract contract or service contract, to which, in accordance with the Civil Code, the provisions relating to the order shall apply,

(h) cooperation in the performance of the work on the basis of a contract agency contract or a service contract, to which, in accordance with the Civil Code, the provisions relating to the order shall apply,

(i) the pursuit of normal activities relating to the conduct of non-agricultural activities within the meaning of the provisions on social security schemes,

(j) the pursuit of normal activities relating to cooperation in the conduct of non-agricultural activities within the meaning of the provisions on social security schemes,

(k) the exercise by a spiritual person of religious activities or activities relating to the pastoral or religious functions entrusted to it,

(i) to serve as a replacement service,

(m) teaching at the National School of Public Administration by the earners receiving the scholarship,

(n) the performance of work under an agency contract, contract contract or service contract, to which, according to the Civil Code, the provisions relating to the order shall apply, or the contract of work, if such contract has been concluded with the employer, with whom the person remains in employment, or if, in the framework of such an agreement, he performs work for the benefit of the employer, with whom he remains in employment,

(o) a customs officer shall carry out his duties;

4) for a fatal accident at work there is an accident in the event of death within a period not exceeding six months from the date of the accident;

5) for a severe accident at work there is an accident which results in severe damage to the body, such as loss of vision, hearing, speech, reproductive performance or other bodily injury or a body of health, which violates the essential functions of the body, as well as a disease that is not treatable or life-threatening, persistent mental illness, total or partial inability to work in the profession or permanent, significant ankylosing or disfigurement of the body;

6) for the collective accident at work an accident which has resulted in at least two persons in the event of the same event shall be considered.

B. Explanatory notes for the statistical fulfilment of the accident card

Number of working (without full-time conversion)-code markings (position B of the form address part)

Operating they are the persons performing work bringing them the earnings or income. For the working part of the accident investigation (position A), all persons working on the date of the occurrence of the event, whether or not they are also working in other reporting units (excluding persons), shall be included in the working part of the accident investigation (heading A). working on the basis of the contract contract), namely:

1) persons employed on the basis of employment relationship (i.e. contracts for employment, appointment, selection or appointment), including seasonal and casual employment;

2) employers and self-employed;

(a) owners and co-owners (including the assisting members of their families) of business entities (excluding shareholders of companies who do not work in the company),

(b) self-employed persons, e.g. persons performing free occupations;

3) agents working on the basis of agency contracts and contracts on the terms of the order (including the assisting members of their families and the persons employed by agents);

4) persons performing work overlays;

5) members of agricultural production cooperatives and members of cooperatives of agricultural cooperatives;

6) clerics performing pastoral duties.

Number of Workers

Code

1 working (self-employed, without employees)

0

2-9 working (no full-time conversion)

1

10-49 working (no full-time conversion)

2

50-249 working (no full-time conversion)

3

250-499 working (no full-time conversion)

4

500 or more working (no full-time conversion)

5

Unknown number of work

9

Locality (municipality) in which the unit is located (question X1).

The name of the village (the municipality) is to be given in this field, while the code (7-digit) for this village will be supplemented by the statistical office (as in question 15).

Type of activity by Polish Classification of Activities (PKD) (question X2).

The name of the type of activity performed by the entity which is the actual place of work of the injured person should be given in this field (e.g. branch, branch, shop, warehouse), Whereas the code (5-digit) for this activity will be supplemented by the statistical office.

Form of ownership (FW)-classification and code markings (question X3)

Ownership

Code

PUBLIC SECTOR

Property of the State Treasury

111

Ownership of State legal persons

112

Self-government

113

Mixed ownership in the public sector

Mixed ownership in the public sector with the advantage of the Treasury

121

Mixed ownership in the public sector with the advantage of the state of the legal persons

122

Mixed ownership in the public sector with the advantage of self-government

123

Mixed ownership in the public sector with a lack of advantage of any kind of public property

127

1

2

Mixed ownership between sectors with public sector ownership advantage

Mixed ownership between sectors with public sector ownership, including the ownership of the State Treasury

131

Mixed ownership between sectors with the advantage of public sector ownership, including the advantage of public ownership of legal persons

132

Mixed ownership between sectors with the advantage of public sector ownership, including ownership of local government ownership

133

Mixed ownership between sectors with public sector ownership outweighs with a lack of advantage of any kind of public property

137

PRIVATE SECTOR

Ownership of national natural persons

214

Domestic private property remained

215

Foreign ownership

216

Residential property in the private sector

Mixed-ownership in the private sector with the advantage of domestic natural persons

224

Mixed ownership in the private sector with the advantage of the domestic private property remaining

225

Mixed ownership in the private sector with a foreign ownership advantage

226

Mixed property in the private sector with a lack of advantage of any type of private property

227

Mixed ownership between sectors with private sector ownership

Mixed-ownership ownership of the private sector, including the ownership of national natural persons

234

Mixed ownership between sectors with private ownership, including private ownership of the rest of the private sector

235

Mixed ownership between sectors with ownership of the private sector, including the foreign ownership

236

Mixed ownership between private sector ownership sectors with a lack of advantage of any type of private property

237

ABSENCE OF A SECTORAL ADVANTAGE

Mixed ownership between sectors with the same share of public and private sector ownership with the highest ownership of the State Treasury in total capital

331

Mixed ownership between sectors with the same share of ownership of the public and private sector with the highest share of the state ownership of legal persons in capital

332

Mixed ownership between sectors with the same share of ownership of the public and private sector with the highest share of self-government ownership in capital

333

Mixed ownership between sectors with the same share of public and private sector ownership with the highest share of national ownership of natural persons in total capital

334

Mixed ownership between sectors with the same share of ownership of the public and private sector with the highest ownership of other national private units in total capital

335

Mixed ownership between sectors with the same share of ownership of the public and private sector with the highest share of foreign ownership in total capital

336

Mixed ownership between sectors with the same share of ownership of the public and private sector with a lack of advantage of any type of ownership in the capital

338

Nationality-classification and code designation

(question 03)

Nationality

Code

Citizenship unknown

0

National of the country in which the accident took place

1

A citizen from an EU country other than the one in which the accident took place

2

A citizen from outside EU countries

3

Employment status-classification and code markings

(question 04)

Hiring Status

Code

Unknown status

000

Self-employing

100

Full-time employee, full

work time dimension

311

Part-time employee, part-time

work time dimension

312

Temporary staff member, full

work time dimension

321

Part-time employee, part-time

work time dimension

322

Cooperating person

400

Apprentice/apprentice

500

Other Status

900

Occupation (Question 05)

By the end of 2010 the aggrieved profession is to be provided using the classification of professions and specialties for labour market needs introduced by the Minister for Economic Affairs and Labour Minister of 8 December 2004. on the classification of professions and specialties for the needs of the labour market and the scope of its application (Dz. U. No 265, pos. 2644, as late. zm.). From 1 January 2011 The classification of professions and specialties introduced by the Regulation of the Minister of Labour and Social Policy of 27 April 2010 should be used. on the classification of professions and specialties for the labour market and the scope of its application (Dz. U. Nr 82, pos. 537). The information on the profession (specialty) performed by the injured persons in accidents at work is described by the full code of this profession (specialties), i.e. 6 ciphers and assigned to this code A word term.

Type of injury-classification and code markings

(question 08)

Type of injury

Code

Type of injury unknown or unspecified

000

Wounds and superficial injuries

010

Fractures

020

Displacements, retractors, twisting and overturning

030

Traumatic amputations (loss of body part)

040

Internal injuries

050

Burns by fire or chemical agents, burns

water or steam, frostbite

060

Infection poisoning

070

Toning, strangulation due to lack of oxygen

080

Effects of sounds, vibrations and pressure

090

Effects of extreme temperatures, lighting and

radiation (different from frostbite)

100

Shocks (acute stress, trauma shock)

110

Multiple injuries

120

Other injury

999

Location of the injury-classification and code markings

(Question 09)

The location of the injury

Code

Location of the injury unknown or unspecified

00

Head

Skull, brain, with blood vessels

11

Face

12

Eye, eyes

13

Ear, ears

14

Tooth, teeth

15

Head, multiple seats

18

Head, places not specified or unknown

19

Neck with spine

20

Back, including spine

30

Torso and internal organs

Ribs, shoulders

41

Thoracic internal organs

42

Pelvic area and abdomen, together with internal organs

43

Torso and internal organs, numerous places of injury

48

Torso and internal organs, places not specified or unknown

49

Upper limb

Shoulder with shoulder joint

51

Arm with elbow

52

Hand

53

Finger, fingers

54

Wrist

55

Upper limb, numerous places of injury

58

Upper limb, not specified or unknown

59

Limb

Hip with biodrome

61

Leg with knee joint

62

Ankle joint

63

Rate

64

Finger, fingers

65

Lower limbs, numerous places of injury

68

Lower limbs, places not specified or unknown

69

Whole body and its various parts

Whole body

71

Multiple injury parts of the body

78

Other part of body

99

Estimated material losses due to accidents (question 14) is the sum of the values of damaged machinery, equipment, tools, raw materials, finished goods, buildings and their equipment, etc.

Geographical location of the accident site (question 15). The name of the locality in which the accident occurred should be provided.

In the case of a locality located in the country code (7-digit) for this village, will be supplemented by the Statistical Office in accordance with the identifiers and names of the territorial division units of the country, specified in the Annex No. 1 to the Regulation of the Council of Ministers of 15 December 1998. on the detailed rules for the conduct, use and making available of the national official register of the territorial division of the country and the related duties of the authorities of government administration and local government units (Dz. U. Nr. 157, pos. 1031, with late. (m), which is in force since 1 January 1999. For a locality situated outside the country, the statistical office will enter the code place 7 times "z" (symbol: zzzzzzz).

Where the accident occurred (question 18) is the place where the victim was staying at the time of the accident (it could be both a work room and a different place).

Place of accident-classification and code markings

Where the accident occurred

Code

No Data

000

Industrial production sites

Place of production

011

Maintenance and Repair Location

012

Place of storage

013

Other, not specified or unknown locations in this group

019

Construction site, quarry, excavations mine

Construction site-site under construction

021

Construction site-undated, tumultuous, refurbished

022

Excavations, quarry, etc.

023

Construction site-underground

024

Construction site-on water, above water

025

Construction site-in high pressure environment

026

Other, not specified or unknown in this group

029

Places of cultivation, breeding, fishing, forests and green areas

Place of breeding

031

Site of crop fields

032

Place of growing trees and shrubs

033

Forest area

034

Place of farming and/or fishing, water crops, etc.

035

Garden, park, botanical garden, zoo

036

Other, not specified or unknown locations in this group

039

Offices, scientific establishments and schools, service facilities

Office, library, conference room, etc.

041

Scientific centre, school, kindergarten

042

Place of trade

043

Service facility

044

Other, not specified or unknown locations in this group

049

Health care facilities

050

Places and means of public communication

Areas of public communication (e.g. roads, car parks, waiting rooms, etc.)

061

Land transport measures

062

Public transport related areas intended for the sole purpose of authorised personnel (e.g. Railway tracks, airport plate, etc.)

063

Other, not specified or unknown locations and measures in this group

069

Households

Apartment, single-family house

071

Other, not specified or unknown locations in this group

079

Sports facilities

Indoor sports facilities

081

Sports Facilities Discovered

082

Other, not specified or unknown objects in this group

089

In the air, at the height, excluding the construction sites

At the height-on a fixed level (roof, terrace etc.)

091

On the height-pylon, mast, suspended platform etc.

092

Airborne-on board aircraft

093

Other, not specified or unknown locations in this group

099

Underground, excluding construction sites

Underground-tunnel

101

Underground-mine

102

Underground-Wells, Sewer

103

Other, not specified or unknown locations in this group

109

On water, above water, excluding construction sites

Sea or ocean-on board all kinds

ships, platforms, etc.

111

Lake, river, port-on board of all kinds

112

ships, platforms, etc.

Other, not specified or unknown locations in this group

119

In a high pressure environment, excluding construction sites

In a high-pressure environment-underwater (eg. scuba diving)

121

In a high pressure-chamber environment

122

Other, not specified or unknown locations in this group

129

Other Location

999

Work Process (question 19) is the basic type of work done by the aggrieved party at the time when the accident took place.

Process of work-classification and code markings

Work Process

Code

No Information

00

Production, processing, warehousing

Production, processing

11

Storage

12

Other, not specified or unspecified works in this group

19

Excavation and earthworks, construction work

Excavation and earthworks

21

Building new buildings

22

Building infrastructure, e.g. roads, bridges, there, ports, etc.

23

Rebuilding, repair, expansion, maintenance of construction works and infrastructure

24

Demolition and demolition work

25

Other, not specified or unspecified works in this group

29

Agricultural crops, vegetables, horticulture, orchards, forestry, animal husbandry, fish

Cultivation of cereals and other agricultural crops

31

Vegetable, Gardening, Gardening

32

Breeding and rearing of animals

33

Forestry work

34

Fish farming, fisheries

35

Other, not specified or unspecified works in this group

39

Services, mental work

Services, care, assistance to the public

41

Mental work-teaching, training, office work, organizing, managing

42

Commercial activities-buying, selling and accompanying services

43

Other, not specified or unspecified works in this group

49

Other works

Preparing, installing, assembling,

demounting, stripping, etc.

51

Maintenance, repair, adjustment, etc.

52

Cleaning, cleaning-machine or hand-cleaning

53

Waste management, waste disposal, etc.

54

Monitoring, inspection-with or without monitoring equipment

55

Other, not specified or unspecified works in this group

59

Movement, sports, artistic activities

Movement, including means of transport

61

Sport, artistic activities

62

Other, not specified or unspecified works in this group

69

Other Work Process

99

Type of accident site (question 20) specifies the location of the event due to the location of the workplace at or outside the work station.

Company Local Unit of Work it is an organised whole (establishment, branch, branch, etc.) located at the site identified by a separate address under which or from which the activity is carried out by at least one working person, with:

1. Self-balancing plants located at one address shall be separate local units;

2) covered by a separate legal registration of the organizational parts of entities are local units;

3. units operating in the field of transport are local units by the places from which the orders are issued or the work is organized;

4) entities operating in the field of construction are local units according to the places where the orders for the execution of works and auxiliary works are accepted, or the works of the management are carried out, or the organization of work is carried out construction and ancillary services; place of construction sites (construction sites of individual buildings) are not local units;

5) the sale of a doorstep, obsivant and retail outlet without a fixed location, as well as conducting services exclusively at the customer is one local unit in the place of residence of the natural person, the place of the seat of the legal person or the entity an organisational without legal personality.

Type of accident site-classification and code markings

The general characteristics of the accident site

Code

Unspecified accident site

0

Location in the unit of the local work plant

1

Location outside the local unit of the establishment

2

Other site of the accident

9

The action performed by the victim at the time of the accident (question 21) is the act carried out by the aggrieved intentionally, immediately before the accident.

Action Performed By The Affected Person in moment of accident-classification and code markings

The action performed by the victim at the time of the accident

Code

No Information

00

Machine handling

Start/Stop Machines

11

Administration/receiving of materials, semi-finished products, articles, etc.

12

Overseeing and other work activities and moving machinery

13

Other, not specified or unknown actions in this group

19

Manual tools work

Non-mechanised tools

21

Mechanised Tool Work

22

Other, not specified or unknown work in this group

29

Driving/driving means of transport/handling of mobile machinery and other equipment

Routing of means of transport or operation of machinery and other mobile devices, self-propelled

31

Routing of means of transport or operation of machinery and other mobile devices, without own propulsion

32

Driving by means of transport in the role of a passenger

33

Other, not specified or unknown actions in this group

39

Object operations

Hand-to-hand, grabbing, holding, placing-horizontally

41

Bonding, wrapping/wrapping, ripping, spindling/solving, compression, twisting/twisting of screw connections, bending, etc.

42

Fixation, suspension, lifting, etc.

43

Throwing, Rejecting

44

Opening or closing boxes, parcels, etc.

45

Pouring into, filling in, spilling, spraying, spilling, selecting liquid, etc.

46

Opening or closing a drawer, a door, etc.

47

Other, not specified or unknown actions in this group

49

Manual transport

Transport in vertical-lifting, lowering

51

Horizontal transport-pull, push, rolling

52

Move

53

Other, not specified or unknown actions in this group

59

Navigating

Walking, running, getting on, coming down with, etc.

61

Entering/exiting with

62

Jumping, jumping, etc.

63

Crawling, climbing, etc.

64

Get up, sit down

65

Swimming, Diving

66

Movements in place, e.g. During washing, dressing/undamination, etc.

67

Other, not specified or unknown actions in this group

69

Attendance

70

Other Action

99

Deviation of the event from the normal state (question 23) this event does not comply with the proper course of the work process that caused the accident.

If the accident occurred as a result of a series of consecutive events, the last of these events should be recorded.

Deviation from the normal state-classification and code markings

Deviation of the event from the normal state

Code

No Information

00

Explosions related to electricity, explosion, fire

Electrical-related deviation, e.g. damage to equipment-leading to indirect contact

11

Electrical-related deviation, e.g. damage to equipment-leading to direct contact

12

Explosion

13

Fire, ignition

14

Other, not specified or unspecified variance in this group

19

Leakage, leakage, emission of harmful substances

Falling out, drying out, outcast of substances in solid state

21

Transfer, leaking, judging, flow, spattering, fluids spraying

22

Vapour and gas emissions

23

Emissions of dusts, smoke, particles

24

Other, not specified or unspecified variance in this group

29

Damage, rupture, rupture, slipping, fall, collapse of material

Material damage-on connection, seams

31

Debris, tear-forming debris (wood, glass, metal, stone, plastic, other)

32

Slip, fall, collapse of material factor-fall factor in advance (impact of the aggrieved by the falling material factor)

33

Slip, fall, collapse of the material factor-to the bottom (winding the aggrieved party down)

34

Slipping, falling, melting of the material factor-at the same level

35

Other, not specified or unspecified variance in this group

39

Loss of control of: machine, means of transport, transported cargo, tool, object, animal

Loss of control of the machine (including unintentional launch) or machined material

41

Loss of control of means of transport or of supported mobile equipment (mechanised or not)

42

Loss of control of the tool (mechanised or not) or the material being machined by this tool

43

Loss of control over an object

44

Loss of control of the animal

45

Other, not specified or unspecified variance in this group

49

Slipping, stumping, falling person

The fall of a person from the height-to a lower level

51

Slipping, stumping, falling person-at the same level

52

Other, not specified or unspecified variance in this group

59

Body movements without physical exercise (generally leading to external injuries)

Entry into sharp object

61

Kneeling, sitting on, basing on

62

Applause or rejection of a person

63

Uncoordinated, improper movements

64

Other, not specified or unspecified variance in this group

69

An event that is a deviation from the normal state (dok).

Code

Associated body movement of Physical effort (lead to internal trauma)

Lifting

71

Push, pull

72

Capillating

73

Rotating, twisting

74

Wrong tresps

75

Other, not specified or unspecified variance in this group

79

Shocks, fear, violence, attack, threat, presence

Shocks, fear

81

Violence, attack, threat-from the employees of the work plant (including the injured party)

82

Violence, attack, threat-from people outside the workplace

83

Aggression, offsetting-by animal

84

Presence of an injured person or a third party in the danger zone

85

Other, not specified or unspecified variance in this group

89

Other Variance

99

Event causing injury (question 25) describes how the injured person suffered an injury (physical or mental) caused by a material factor.

Event Causing Injury-Classification and code markings

Event causing injury

Code

No Information

00

Contact with electric current, temperature, hazardous substances and chemical preparations

Intermediate contact with the welding arc, spark and lightning

11

Contact with electricity through direct contact

12

Contact with flame or hot/flammable object/environment

13

Contact with cold/frozen object/environment

14

Contact with hazardous substances and chemical preparations by inhalation

15

Contact with hazardous substances and chemical preparations by peel/eyes

16

Contact with hazardous substances and chemical preparations by the digestive system

17

Other, unlisted or unspecified contact in this group

19

Toning, burying, closing

Liquid Toning

21

Zakopane, falling asleep

22

Closure in something, the environment through gas, dust, etc.

23

Other, unlisted or unspecified contact in this group

29

Collision with/impact in a stationary object

Vertical

31

Horizontal

32

Other, unlisted or unspecified contact in this group

39

Strike by object in motion

Hit by an ejected object

41

Hit by a falling object

42

Hit by the deaf object

43

Impact by rotating, moving, transported object, including vehicles

44

Collision with moving object, including vehicles (affected person moving), collision with a person

45

Other, unlisted or unspecified contact in this group

49

Event causing injury (docks)

Code

Contact with the subject of a sharp, rough, rougher

Contact with the subject of the sharp (knife, blade, etc.)

51

Contact with the subject matter of the spikes (nail, sharp tool, etc.)

52

Contact with the subject of roughness, roughness

53

lnny, unlisted or unspecified contact in this group

59

Incarceration, crushing

Incarceration, crushing-in

61

Imprisonment, crushing-under

62

Imprisonment, crushing-between

63

Contact causing detachment or cut off of body parts

64

Other, unlisted or unspecified contact in this group

69

Physical or mental stress

Musculoskeletal load

71

Effects of radiation, noise, light, pressure

72

Mental stress (e. g. sudden stress, shock)

73

Other, unlisted or unspecified type of charge

79

Manifestation of aggression on the part of man or animal

Bite

81

Sting

82

Impact or strangulation

83

Other, unlisted or undetermined manifestation of aggression

89

Other Event

99

The material factor related to the act performed by the victim at the time of the accident (question 22) is a machine, tool, or other object that is used by the affected person at the time it has been affected by the accident.

The material factor associated with the variation (question 24) is a machine, tool, other object, or a factor of the environment that has a direct relationship of The event that is a deviation from the normal state. If of deviations are related to several material factors, then the last of these material factors must be indicated.

Injury source material factor (question 26) is a machine, tool, other object or a factor of the environment with which contact has become the cause of trauma (physical or mental).

Material Factor-Classification and Coding

Material factor

Code

Material factor not is missing or missing information

Material factor does not occur

00.01

No information available and

00.02

Buildings, structures and their components, surfaces-on a ground level (inside or outdoors, fixed or moving, temporary)

Buildings, constructions and their elements-doors, walls, windows. and gingerbread, etc.

01.01

Ground level horizontal surfaces-fixed (e.g. Floor, indoor and outdoor floors, agricultural area, sports areas, etc.)

01.02

Horizontal surfaces at ground level-movable or temporary (e.g. Footbridge, moving sidewalk, etc.)

01.03

Other, unlisted or unspecified factor in this group

01.99

Buildings, constructions and their components, surfaces-above ground level (indoor or outdoor, stationary or mobile, temporary)

Buildings and their elements at the height-constants (e.g. roofs, terraces, doors and windows, stairs, platforms, etc.)

02.01

Structures, surfaces above ground level-stationary (e.g. transitions, bridges, fixed ladders, pylons, scaffolds, etc.)

02.02

Structures, surfaces above ground level-movable (e.g. Scaffolding, mobile ladders, mobile ladders and bridges, platform-lifting, etc.)

02.03

Constructions, surfaces above ground-temporary (scaffolding, work baskets, etc.)

02.04

Objects, constructions over water (eg. drilling rigs, and scaffolding on the shoulders, etc.)

02.05

Other, unlisted or unspecified factor in this group

02.99

Material factor (cd.)

Code

Buildings, structures and components thereof, surfaces-below ground level (indoor or outdoor, stationary or mobile, temporary)

Excavations, excavations, wells, etc.

03.01

Underground objects, tunnels, etc.

03.02

Objects, constructions underwater

03.03

Other, unlisted or unspecified factor in this group

03.99

Supply, distribution and discharge systems of gases, liquids and solids, pipe networks, installations

Supply and distribution systems, pipe networks, installations-stationary

04.01

Supply and distribution systems, pipe networks, installations-mobile

04.02

Drainage systems, sewerage, drains, etc.

04.03

Other, non-vexitive or unspecified factor in this group

04.99

Equipment for the manufacture, processing, storage, transmission and distribution of energy

Energy-generating and processing equipment-motors, generators (heat, electrical, etc.)

05.01

Energy transmission and storage systems (mechanical, pneumatic, hydraulic, electric, including batteries and accumulators, etc.)

05.02

Other, unlisted or unspecified factor in this group

05.99

Manual tools without drive

Handtools without drive-for piling

06.01

Non-drive hand tools-for cutting, cutting (including scissors, secateurs)

06.02

Hand-held tools without drive-for carving, damping, engraving, cutting, cutting, mowing, etc.

06.03

Hand tools without drive-for scrubbing, grinding, polishing, etc.

06.04

Hand tools without drive-for drilling, twisting, tightening, etc.

06.05

Manual tools without drive-for connecting parts (depressing, riveting, connecting with staples, etc.)

06.06

Hand tools without drive-for sewing, embroider, etc.

06.07

Hand-held tools without drive-for welding (welding, brazing, welding, gluing, etc.)

06.08

Unpowered hand tools-for the extraction of materials and earthworks (including agricultural tools)

06.09

Manual tools without drive-for washing and cleaning, waking, lubrication

06.10

Hand tools without drive-paint

06.11

Hand-held tools without drive-for grabbing, holding in place

06.12

Hand-held tools without drive-for kitchen work (excluding knives)

06.13

Manual tools without drive-surgical and other medical-sharp, cutting

06.14

Manual tools without propulsion-surgical and other medical-non-stirrers, other for medical work

06.15

Other, unlisted or unspecified factor in this group

06.99

Mechanised or hand-held tools

Mechanised Hand Tools-for sawing

07.01

Mechanised hand tools-for cutting, cutting (including scissors, secateurs, etc.)

07.02

Mechanized hand tools-for sculpting, churning, engraving, cutting, cutting, mowing, etc.

07.03

Mechanized hand tools-for scrubbing, grinding, polishing, etc. (including saw-cutters)

07.04

Mechanized hand tools-for drilling, screwing, tightening, etc.

07.05

Mechanized hand tools-for connecting parts (tripping, riveting, connecting with staples, etc.)

07.06

Mechanised hand tools-for sewing, embroider, etc.

07.07

Mechanized hand tools-for welding (welding, brazing, welding, gluing, etc.)

07.08

Mechanised hand tools-for the extraction of materials and groundwork (including agricultural tools, air-braided)

07.09

Mechanized hand tools-for washing and cleaning, waking, lubrication, etc. (including high-pressure cleaning tools, vacuum cleaners)

07.10

Material factor (cd.)

Code

Mechanised Hand Tools-Paint

07.11

Mechanized hand tools-for grabbing, holding in place

07.12

Mechanised hand tools-for kitchen work (excluding knives)

07.13

Mechanized hand tools-generating heat (dryers, burners, irons, etc.)

07.14

Mechanized hand tools-surgical and other medical-sharp, cutting

07.15

Mechanised hand tools-surgical and other medical-without cutting

07.16

Pneumatic tools (without specific purpose)

07.17

Other unlisted or unspecified factor in this group

07.99

Machinery and equipment-portable or mobile

Portable or mobile mining machinery, earthworks, drilling equipment, etc.

09.01

Portable or mobile agricultural machinery

09.02

Portable or mobile construction machinery (excluding earthmoving machinery)

09.03

Mobile cleaning machines

09.04

Other, unlisted or unspecified factor in this group

09.99

Machinery, equipment and fixtures

Stationary mining machinery and equipment or for earthmoving

10.01

Machines and equipment for the pre-treatment of materials-for milling, powering, filtering, separating, mixing, mixing, etc.

10.02

Machines and equipment for the processing of materials in chemical processes (e.g. fermentation processes, reactions, etc.)

10.03

Machines and equipment for the processing of materials at elevated temperatures (e.g. furnaces, dryers, ovens, etc.)

10.04

Machines and equipment for the processing of materials at low temperatures (e.g. refrigerators, freezers, etc.)

10.05

Machinery and equipment for processing materials-other processes

10.06

Machinery and equipment for moulding-by compression, compaction

10.07

Machines and equipment for moulding-by rolling, calendering, etc. (including paper machines)

10.08

Machines and equipment for moulding-by injection, blowing, spinning, resuscitation, melting, casting, pressing, etc.

10.09

Machining machines

10.10

Saws

10.11

Cutting and cutting machines and apparatus (including scissors, slicers, guillotines)

10.12

Machines and appliances for cleaning, washing, drying, painting, printing

10.13

Machines and devices for coating applications-for galvanizing, electrolytic surface treatment, heat spraying, etc.

10.14

Machines and apparatus for connecting (welding, gluing, nailing, tightening, riveting, spinning, wrapping, bulking, stitching, etc.)

10.15

Wrapping, wrapping machines and appliances (sealing, labelling, closing, etc.)

10.16

Other machines and equipment for specific applications (e.g. control, measurement, weighing, testing, monitoring)

10.17

Specialist machinery and equipment for crops

10.18

Other unlisted or unspecified factor in this group

10.99

Machinery, equipment and equipment for lifting, handling and storage

Belt conveyors, screw conveyors, bulbs, etc.

11.01

Lifts, lifts, elevators, lifting equipment

11.02

Stationary lifts, movable cranes, cranes for vehicles, bridging cranes, suspended load devices

11.03

Mobile moving equipment, transport trolleys (powered or un-powered)

11.04

Material factor (cd.)

Code

Auxiliaries for transport, gripping elements (hooks, ropes, etc.), protective equipment, inspection equipment and various portability (including child-carrying equipment)

11.05

Storage systems, packaging, containers (silos, tanks)-stationary

11.06

Storage systems, packaging, containers-moving containers

11.07

Storage accessories shelving, pallets, pallet racks

11.08

A variety of small and medium sized non-stationary packaging (containers, various containers, bottles, boxes, etc.)

11.09

Other, unlisted or unspecified factor in this group

11.99

Road vehicles

Heavy transport vehicles

12.01

Light transport vehicles

12.02

Two-or three-wheel vehicles, driven or not

12.03

Other, unlisted or unspecified vehicle in this group

12.99

Other transport vehicles

Rail vehicles (including one-new vehicles) for the transport of cargo

13.01

Rail vehicles (including one-new) for the transport of persons

13.02

Vehicles for the carriage of cargo

13.03

Vehicles for the transport of persons

13.04

Fishing vehicles for fishing

13.05

Vehicles for the transport of goods

13.06

Air vehicles for the transport of persons

13.07

Other, unlisted or unspecified vehicle in this group

13.99

Materials, objects, products, parts of machinery

Building materials

14.01

Non-mechanised components or assemblies of machinery or vehicles

14.02

Components or assemblies, mechanised (including parts and components of these material factors)

14.03

Mounting elements (rivets, pins, bolts, nails, etc.)

14.04

Dust particles, shards, chips, etc.

14.05

Farm products

14.06

Products used in cultivation and breeding (including fertilizer, animal feed)

14.07

Stored products-including items and packages in storage areas

14.08

Stored products-in rolls, coils

14.09

Loads-moved by mechanized conveyors, conveyors

14.10

Loads-suspended on lifting equipment, cranes

14.11

Loads-manually staged

14.12

Other, unlisted or unspecified factor in this group

14.99

Chemicals, radioactivity, explosive, biological

Corrosive substances which cause corrosion (solid, liquid or gaseous)

15.01

Harmful substances, toxic (solid, liquid or gaseous)

15.02

Flammable substances (continuously, liquid or gaseous)

15.03

Exploding substances which are easily interacting (solid, liquid or gaseous)

15.04

Gases, biologically inert vapour, suffocating

15.05

Radioactive substances

15.06

Biological material

15.07

Inert, solids or liquid substances

15.08

Other, unlisted or unspecified factor in this group

15.99

Safety-related equipment and equipment

Protective and protective devices for machinery

16.01

Personal protective equipment

16.02

Equipment and equipment used in the event of a failure

16.03

Other, unlisted or unspecified factor in this group

16.99

Material Factor (Dock.)

Code

Office equipment, personal, sports, weapons

Furniture

17.01

Computer hardware, office equipment-to communicate

17.02

Equipment-for learning, writing, drawing, etc.

17.03

Sports equipment (including games)

17.04

Weapons

17.05

Personal items, clothing

17.06

Musical instruments

17.07

Appliances and household items, but

used professionally

17.08

Other, unlisted or unspecified factor in this group

17.99

Humans and other living organisms

Plants

18.01

Animals-domestic animals, breeding animals

18.02

Animals-other

18.03

Micro-organisms

18.04

Viruses

18.05

People

18.06

Other, unlisted or unspecified factor in this group

18.99

Waste

Waste-from the raw materials of products, materials, objects

19.01

Waste-of chemicals

19.02

Waste-of biological substances, plants, animals

19.03

Other, unlisted or unspecified factor in this group

19.99

Physical phenomena and elements of the natural environment

Physical phenomena-noise, radiation, pressure

20.01

Elements of the natural environment and atmospheric phenomena

(including water reservoir, earth, rain, hail, snow, ice, etc.)

20.02

Factors arising from the action of the forces of nature (e.g. lava, floodwave, fire)

20.03

Other, unlisted or unspecified factor in this group

20.99

Other material factor

99.00

Reasons (question 27) they are any deficiencies and irregularity which directly or indirectly contributed to the accident, related to material (technical) factors, with the general organisation of work in the establishment or organisation of the workplace, and related to the labor.

Reasons for the accident-classification and code markings

Reasons

Code

Incompetent State of the material factor

Design defects or improper solutions

technical and ergonomic material factor

Structural defects of the material agent, which is the source of the hazard

001

The wrong spatial structure of the material factor

002

Inadequate strength of the material factor

003

Inadequate stability of the material factor

004

Absence or improper protective devices

005

Absence or improper measures of collective protection

006

Malfunction controls

007

Absence or inadequate indication of hazards

008

Underuse of the material factor for transport,

maintenance or repair

009

Other, not specified or unspecified design and construction abnormalities

019

Improper performance of a material factor

Use of surrogate materials

021

Failure to meet the required technical parameters

022

Other, not specified or unspecified execution abnormalities

039

Material defects of material factor

Hidden Material Defects of Material Factor

041

Other, not specified or unspecified material defects

059

Causes of the accident (cd.)

Code

Inaccurate operation of the material factor

Over-operation of the material factor

061

Insufficient maintenance of the material factor

062

Improper repairs and repairs of a material factor

063

Other operations not specified or unspecified related to exploitation

079

Invalid General Work Organization

Invalid work breakdown or contour of tasks

101

Wrong superiors

102

No oversight

103

Failure to coordinate collective work

104

Execution of supervision, work not falling within the scope of the staff member's duties

105

No instructions for use of material factor

106

Admission to the work of a material factor without the required controls, reviews

107

Tolerability by persons supervising, derogations from the rules and rules on health and safety at work

108

Insufficient professional preparation of the staff member

109

Absence or improper training in occupational safety and health

110

Tolerability by persons exercising supervision, misuse of technology

111

Admission to the work of an employee with or without medical examination

112

Performing a work in a small cast

113

Carrying out work despite poor supply of tools, raw materials

114

Other, not specified or unspecified abnormalities associated with the general organisation of work

119

Wrong job organization

Improper positioning of equipment at the workplace

121

Inappropriate transitions and advent

122

Unsuitable placement and storage of work items (raw materials, semi-finished products, products, etc.)

123

Non-discarded unnecessary objects, substances or energy (e.g. waste, packaging, remnants of the substance, non-power supply, etc.)

124

No personal protective equipment

125

Inappropriate selection of personal protective equipment

126

Other, non-specified or unspecified irregularities in the organisation of the workplace

139

Absence or improper use of a material factor by an employee

Using inappropriate for a given material factor

141

Manual work instead of using a material factor

142

Use of the material factor when staying in the danger zone

143

Improper security of the material factor (e.g. unacidification of the brake at standstill)

144

Provision by an employee of a material factor to an unauthorised person

145

Use of a material factor not in accordance with its intended purpose

146

Improper capturing, keeping the material factor

147

Faulty installation, fixation, suspension of material factor by employee

148

Other, not specified or unspecified abnormalities in the use of the material factor

159

Cause of the accident (docs)

Code

Failure to use protective equipment by an employee

Non-use by an employee of personal protective equipment

161

Failure by the staff member to use

security

162

Non-use by an employee of collective protection measures

164

Other

179

An employee's unsuitable self-behaviour

Performing work that does not fall within the employee's responsibilities

181

Moving, passing, or staying in places

not allowed

182

Entrance into the surveillance zone without making sure there is no danger.

183

Perform an action without removing a hazard (e.g. Nonpower off a voltage-off machine)

184

Drive too fast

185

Improper operation of limbs in the danger zone

186

Jokes, brawls

187

Other misconduct of the employee

199

Worker's psychophysical condition, not ensuring safe work performed due to

Abrupt illness, physical indisposition

201

Conductive, or acute psychiatric illness

202

Fatigue

203

Nervous

204

Consumption of alcohol, narcotic drugs or psychotropic substances

205

Other reasons

219

Abnormal behaviour of the worker caused by

Hazard failure

221

No knowledge, regulations and security rules

and health at work

222

Disregard of threat (bravado, risk)

223

Disregard for superiors

224

Insufficient attention to be focused on the

actions

225

The surprise of the unexpected event

226

Wrong pace of work

227

No experience

228

Other reasons

239

Other Reason

999

Notes:

Statistical accident card with Z-KW must be completed on the basis of the approved post-accident protocol drawn up in accordance with the formula set out in the Regulation of the Minister for Economic Affairs and Labour of 16 September 2004. on the model of the protocol to determine the circumstances and causes of the accident at work (Dz. U. Nr. 227, pos. 2298), in which it was found that the accident is an accident at work or an accident treated on an equal basis with an accident at work or on the basis of an accident card, drawn up according to the formula specified in the Regulation of the Minister of Labour and Social Policy of the day 19 December 2002 on the mode of recognition of an event arising during the period of accident insurance for the accident at work, the legal qualification of the event, the model of the accident card and the time limit for drawing up the accident (Dz. U. No 236, pos. 1992).

Copy In the case of an accident at work, the employer shall keep a record of the accident at work for 10 years, in accordance with the provisions of Article 4 234 § 3 1 the Act of 26 June 1974. -Labour Code (Dz. U. 1998 r. No 21, pos. 94, z późn. zm.).

[ 1] Annex No 1 as set out in § 1 item 2 of the Regulation of the Minister of Labour and Social Policy of 8 November 2010. amending the Regulation on the statistical accident card at work (Journal of Laws No. 218, item. 1440; ost. zm.: Dz.U. z 2010 r. No. 240, pos. 1612). The amendment entered into force on 21 December 2010.