Incident and near-miss report: the fields three regulators name
The fields named on OSHA Form 301, in WorkSafeBC's four employer incident investigation reports and on HSE's adverse event form, each credited to the form or page that names it.
Checked against the sources at the bottom of this page on October 9, 2026. Rules, fees and pay change: the source has the last word.
This page reports what the named codes, regulators and makers say. It is not training and does not teach the work. This page reports what the official source says. It is not legal advice: ask the office named here. It lists the fields that three regulators name for a report on an injury, an incident or a near miss: OSHA in the United States, WorkSafeBC in British Columbia and the Health and Safety Executive in Great Britain. Each field is credited to the form or page that names it. The page does not offer a template, and a record with these fields is not claimed to meet any rule. HSE text is adapted under the Open Government Licence v3.0. All pages were read on October 9, 2026. Where reports go to the regulator is set out in the guide to reporting injuries by country.
United States: OSHA Form 301
The OSHA recordkeeping rule, 29 CFR 1904.29, calls the form the Injury and Illness Incident Report. It says one is completed for each recordable injury or illness entered on the Log, within seven calendar days of receiving information that the case has occurred, and that an equivalent form has the same information, is as readable and is completed with the same instructions. The form itself, in the OSHA recordkeeping forms package, groups its numbered fields in three blocks. OSHA says the form is kept for five years after the year it covers.
| Block | Fields on the form |
|---|---|
| Information about the employee | Full name; street address, city, state and ZIP; date of birth; date hired; sex |
| Information about the physician or other health care professional | Name of the physician or health care professional; where treatment was given if away from the worksite (facility and address); whether treated in an emergency room; whether hospitalized overnight as an in-patient |
| Information about the case | Case number from the Log; date of injury or illness; time the employee began work; time of the event; what the employee was doing just before the incident, including tools, equipment or material; what happened; what the injury or illness was, with the body part; the object or substance that directly harmed the employee; date of death if the employee died |
The form carries a note on four of its case fields (what the employee was doing, what happened, the injury and the object): it says they are to be written without personally identifiable information about the worker, such as names, phone numbers or Social Security numbers. The form also has a line for who completed it, with title, phone and date. The rule at 1904.29 lists privacy concern cases, for which the employee's name is left off the Log.
British Columbia: employer incident investigation reports
The WorkSafeBC page on conducting an employer investigation says employers investigate serious injury or death, injury needing medical treatment, and a minor injury or no injury where the incident had the potential for serious injury, which brings near misses in. It names four reports, each showing the investigation at a point in time, and says the content is set by WorkSafeBC Prevention Policy items P2-71-1 and P2-72-1, with an online tool and a PDF template (Form 52E40) offered as the minimum content. It adds that a customized form may add fields but not delete any.
| Report and timing | Content WorkSafeBC names |
|---|---|
| Preliminary investigation report. Within 48 hours of the incident, unless WorkSafeBC grants an extension. | Facts of the incident including names of injured workers and witnesses; the sequence of events leading up to it and what happened; unsafe conditions or acts that significantly contributed; recommended corrective actions |
| Interim corrective actions report. Between the incident and the full report. | Addresses the findings of the preliminary investigation and the steps taken to prevent a repeat |
| Full investigation report. Within 30 days of the incident, submitted to WorkSafeBC. | The cause or causes found; the unsafe conditions, acts or procedures behind them; recommended corrective actions |
| Full corrective actions report. After the full investigation. | The unsafe conditions, acts or procedures that made action necessary; the action taken; names and job titles of those responsible; the completion date |
WorkSafeBC says copies of each report go to the joint health and safety committee or worker representative, or are posted at the workplace where there is neither, and that only personal information relevant to the investigation is recorded. It says that, on the page read October 9, 2026, WorkSafeBC does not require investigations for psychological injuries.
Great Britain: HSE adverse event report and investigation form
The HSE workbook Investigating accidents and incidents (HSG245) includes a blank adverse event report and investigation form. HSE defines an adverse event to include an accident (injury or ill health) and an incident, and says an incident covers near misses and undesired circumstances. The form has four parts, each filled in by a different person as HSE sets out.
| Part and who completes it | Fields |
|---|---|
| Part 1 Overview. Manager or supervisor for the work activity, immediately. | Reference number; reported by; date and time of the event; category (incident, ill health, minor injury, serious injury, major injury); brief details of what, where, when, who and emergency measures; forwarded to, with date and time |
| Part 2 Initial assessment. The person responsible for health and safety. | Type of event (accident, ill health, near miss, undesired circumstance); actual or potential for harm (fatal or major, serious, minor, damage only); whether reportable under RIDDOR and the date; accident book entry; investigation level; whether further investigation is needed and by whom |
| Part 3 Information gathering. The investigation team, where appropriate. | 21 numbered questions: where and when; who was involved; how it happened; activities under way; unusual conditions; safe working procedures; injuries caused; whether the risk was known; work organization; maintenance; competence; layout; materials; plant and equipment; safety equipment; other conditions; immediate, underlying and root causes; control measures; similar risks elsewhere; similar events before |
| Part 4 Risk control action plan. The investigation team with managers who can decide. | Control measures with completion date and person responsible; risk assessments and procedures to review; whether findings were recorded and analysed for trends, and what the event cost; signature and team members |
The HSE page on the lone working policy and the guide to job briefing record fields cover neighbouring records.
Credit: HSE text adapted under the Open Government Licence v3.0.