Iowa Summary of Work-Related Injuries and Illnesses Poster

OSHA	Forms for Recording	Work-Related Injuries and Illnesses	
What’s Inside…	In this package, you’ll find everything you need to complete
OSHA’s and the
for the next several years. On the following pages, you’ll find:General instructions for filling out the forms in this package
and definitions of terms you should use when you classify
your cases as injuries or illnesses. An example to guide you in filling
out the properly.
Several pages of the
(but you may make as many copies of
the as you need.) Notice that the is separate from the
Removable pages
for easy posting at the end of the year.
Note that you post the only,
not the
A worksheet for
figuring the average number of employees who worked for
your establishment and the total number of hours worked.
A copy of the OSHA 301 to
provide details about the incident. You
may make as many copies as you need or
use an equivalent form.
Take a few minutes to review this package. If you have any
questions,
We’ll be happy to help you. Log Summary of Work-Related Injuries and Illnesses
Log Log
Log
Log Summary.
Summary
Summary
Log.











	
An Overview: Recording Work-Related Injuries and Illnesses
How to Fill Out the LogLog of Work-Related Injuries andIllnesses
Summary of Work-Related Injuries andIllnesses
Worksheet to Help You Fill Out the SummaryOSHA’s 301: Injury and Illness IncidentReport
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visit us online at www.osha. gov call your local OSHA office	
U.S. Department of Labor
Occupational Safety and Health Administration	
Dear Employer:	
This booklet includes the forms needed for maintaining
occupational injury and illness records for 2004. These new forms have
changed in several important ways from the 2003 recordkeeping forms.
In the ,
OSHA announced its decision to add an occupational hearing loss
column to OSHA’s Form 300, Log of Work-Related Injuries and
Illnesses. This forms package contains modified Forms 300 and
300A which incorporate the additional column M(5) Hearing Loss.
Employers required to complete the injury and illness forms must begin
to use these forms on January 1, 2004.
In response to public suggestions, OSHA also has made several
changes to the forms package to make the recordkeeping materials
clearer and easier to use:
 On Form 300, we’ve switched the positions of the day countcolumns. The days “away from work” column now comes before
the days “on job transfer or restriction.”
 We’ve clarified the formulas for calculating incidence rates.
 We’ve added new recording criteria for occupational hearing loss to the “Overview” section.
 On Form 300, we’ve made the column heading “Classify the Case” more prominent to make it clear that employers should
mark only one selection among the four columns offered.
The Occupational Safety and Health Administration shares with you
the goal of preventing injuries and illnesses in our nation’s workplaces.
Accurate injury and illness records will help us achieve that goal. December 17, 2002 Federal Register (67 FR 77165-77170)
Occupational Safety and Health Administration
U.S. Department of Labor

Have questions?	If you need help in filling out the or or if you
have questions about whether a case is recordable, contact
us. We’ll be happy to help you. You can:Visit us online at:
Call your regional or state plan office. You’ll find the
phone number listed inside this cover. Log Summary,



	
www.osha.gov	
U.S. Depar tment of Labor
Occupational Safety and Health Administration