Instructions for customizing this document

1.This document is intended to illustrate the basic framework or outline of an effective program. It is your responsibility to use this document as a guideline or template for creating a program which accurately portrays your organization’s operations and health and safety.

2.Throughout the body of this document you will find general instructions for customizing the document. These instructions are in red fontand should be self-explanatory. Always be sure to delete the instructions after you’ve complied with them.

3.Throughout the body of this document, you will also find places where you are asked for some organization-specific fact. For example, the title of a person who has a specific responsibility, or the location of some piece of equipment or document. These questions are in green font. After you’ve answered the question, be sure to delete it, and convert the font color to black.

4.Most importantly, as you customize this document, always be sure that the document paints an accurate picture of your organization’s actual health and safety practices. Don’t lie or misrepresent the truth. Don’t state that your organization does things that they don’t, and vice versa. For instance, don’t state, or imply that there is a new employee training program if there isn’t one. If the document points out requirements that you aren’t currently in compliance with, it’s best to contact us to discuss.

5.For cosmetic purposes, the following fonts and colors should be used:

  • The body of all text is 12 pt. Twentieth Century Modern (Tw Cen MT) in black
  • The section titles are same as above, but bold
  • The headers are same as above, but bold caps
  • Line spacing throughout the document is single spacing, 0 pt. “before” and “after”

6.If you have questions or problems, be sure to call Sotera Consulting, LLC at (612)597-6463 or through our website at

DELETE THIS PAGE WHEN DONE!

[Name of company]

A Workplace Accident and Injury Reduction (AWAIR) Program

Issued [Issue date]

[Company address]

[Company phone]

A Workplace Accident and Injury Reduction (AWAIR) Program

HEALTH AND SAFETY POLICY

[In this section, enter your organization’s safety and health policy statement, or use the one below. Feel free to edit as you see fit. Delete this instruction when done]

The management of [Name of company]values the health, safety, and welfare of our employees, and understands that the prevention of occupational injuries and illnesses is critical to meeting our organization’s goals and fulfilling our responsibilities as a good corporate citizen.

Furthermore, the avoidance of occupational injuries and illnesses is critical to the quality of life, and financial viability of our employees.

To that end, it is our policy to take reasonable measures to provide our employees with a workplace which is free of recognized, serious safety and health hazards.

GOALS AND OBJECTIVES

[In this section, enter your organization’s safety and health goals and objectives. A “goal” is what you want to accomplish. An “objective” is what you plan to do to accomplish it. Aim for 3-5 high-quality goals, with 3-5 objectives for each goal. All goals should be SMART (Specific, Measurable, Actionable, Realistic, Time oriented. Remember to assign responsibilities and timelines/milestones. Delete this instruction when done]

RESPONSIBILITIES

[In this section, describe the health and safety responsibilities of various levels of ownership/management, supervision, employees, etc. You can use the sample responsibilities below, or edit them, or replace them altogether. Delete this instruction when done]

[Title of highest-ranking member of management i.e. “president”, “owner”, etc.]

  • Issues the [name of company] Health and Safety policy and sets the example for the health and safety culture.
  • Assumes overall responsibility for the implementation of the [name of company] AWAIR program at all facilities and worksites.
  • Assesses information provided during management review, and directs actions to continually improve the AWAIR program and reduce risk in the workplace.
  • Provides visible guidance and operational leadership for implementing the AWAIR program consistently with the organization’s policy in all facilities and operations.

[Title of first line supervisors (i.e. “Foremen”, “supervisors”, “leads”, etc.]

  • Implements the AWAIR and all other organizational safety practices and programs under their supervision or control.
  • Requires all staff members under their direction to successfully complete required training.
  • Collects, recommends, and implements health and safety improvements.
  • Collects appropriate data to support the AWAIR program.
  • Ensures there is a process in place to maintain workplaces and equipment under their direction that are safe, well kept, and in compliance with applicable policies and regulations.
  • Ensures adequate procedures are developed for the safe use of hazardous chemicals, machines, equipment, tools, etc.
  • Conducts or arranges for risk assessments.
  • Conducts incident investigations.
  • Meets all health and safety needs for units/departments.

[Title of operations employees (i.e. “employee”, “staff members”, “partners”, “production”)]

  • Complies with the organization’s health and safety policies, and procedures.
  • Successfully completes required OHS and IIPP training.
  • Participates in the IIPP by reporting incidents or near misses, attending health and safety meetings and training, reporting problems and recommending improvements, and other related activities.
  • Informs a supervisor or instructor of any safety hazards or system deficiencies in the workplace.
  • Reports all work-related injuries and illnesses at the earliest practicable time and cooperates with any follow up activities such as accident investigation, testing, etc.

[Title of the person responsible for safety and health (if there is one)]

  • Advises management and employees about responsibilities regarding the AWAIR program and health and safety in general.
  • Develops processes that prepare documents and guidelines for programs to ensure individual and organizational compliance with relevant health and safety laws, regulations, policies, and guidelines.
  • Recommends programs and actions for compliance.
  • Develops effective health and safety programs and procedures.
  • Provides guidance and technical assistance to supervisors and managers in departments and other work units in identifying, evaluating, and correcting health and safety hazards.
  • Provides guidance and assistance in performing risk assessments.
  • Provides training and materials assistance to ensure safe and healthful work practices.
  • Conducts analyses of occupational incidents and injuries.
  • Analyzes injury and illness and monitoring data for trends.
  • Monitors compliance with the IIPP including health and safety statutes and regulations and organizational health and safety policies, programs, and guidelines.
  • Notes instances of noncompliance, and recommend improvements of the program.

HAZARD IDENTIFICATION

[In this section, describe how the organization methodically identifies the hazards that may be faced by its employees. You can use the methods below, or edit them, or replace them altogether. Delete this instruction when done]

Job Safety Analysis (JSA)/Job Hazard Analysis (JHA). JSA/JHA (these terms are interchangeable) may be used to evaluate the hazards of any job, but especially jobs with higher than average injury or illness rates.

Inspections/audits of the worksite. Worksites will be inspected, in an effort to identify unsafe conditions or work practices. Inspections may be conducted by trained and knowledgeable internal staff, insurance carriers, safety consultants, or other qualified parties. Written reports of inspections will be made and maintained.

Hazard reports. All employees are required to report any hazards that they observe to management. Hazard reports should be reported to [title of person who receives hazard reports].

Safety suggestions. All employees are encourage to make safety suggestions to management. Safety suggestions should be made to [title of person who receives safety suggestions].

Historical data. Records such as workers’ compensation loss runs, OSHA logs, first reports of injury, etc. will be reviewed periodically to identify trends that represent ongoing hazards.

Industrial hygiene assessments. When necessary, industrial hygiene monitoring will be carried out to identify hazards related to noise, radiation, air quality, etc.

Metrics programs. When appropriate, we will identify and track key metrics which not only measure performance and progress towards safety goals, but which also look forward to help us identify and analyze upcoming trends and occurrences.

HAZARD CONTROL/MITIGATION

When/if serious, recognized hazards are identified, they shall be controlled, to the extent feasible, using the following hierarchy of controls:

Preference / Type of control / Description / Example
1 / Elimination / A hazard is completely removed or eliminated. /
  • A broken ladder or damaged extension cord is discarded or removed from a worksite.

2 / Substitution / A hazardous machine, chemical, etc. is substituted with one which is less hazardous. /
  • A flammable cleaning chemical is replaced with a non-flammable product.
  • An ungrounded tool is replaced with a grounded one.

3 / Isolation / Employees are physically separated from hazards, either by distance or some type of barrier, enclosure or confinement. /
  • A noise or radiation source is relocated further from employees.
  • A locking door is used to restrict access to high voltage circuits.
  • A fence is constructed around dangerous equipment.
  • Hazardous machines are installed on a platform, 20 feet off the floor.

4 / Engineering controls / A machine, chemical, piece of equipment, etc. is modified to reduce its hazards. /
  • Guardrails or machine guards are installed.

5 / Administrative controls / Hazards are controlled through some type of policy, procedure or rule. /
  • A Standard Operating Procedure (SOP) is written and implemented
  • Employees work shorter shifts to minimize their exposure to noise or airborne chemicals.
  • Additional safety training is provided to employees.
  • “Danger” signs are installed to warn employees of a hot surface.

6 / Personal Protective Equipment (PPE) / Employees are issued and required to wear protective equipment. /
  • Employees wear safety glasses or goggles to protect them from particles or chemicals.
  • Employees wear body harnesses to protect them from falling.

SAFETY TRAINING AND COMMUNICATION

[In this section, describe how the AWAIR program, and other key safety programs and policies will be communicated to employees. You can use the methods below, or edit them, or replace them altogether. Delete this instruction when done]

New employee training. All new employees will receive training related to the health and safety issues related to their jobs at their time of hire.[You may describe the new employee health and safety training program here.]

Periodic employee health and safety training.Employees will receive training at various times throughout their employment. Training content, frequency, etc. will be dictated by the employees’ job responsibilities, the associated hazard exposures, as well as regulatory requirements. All training will emphasize recognition of hazards they may face, and how to avoid, eliminate, prevent and mitigate the hazards.[You may describe the ongoing/annual employee health and safety training program here. For example, what topics are covered, when is the training conducted?.]

“Toolbox Talks”. Toolbox talks are brief, informal reminders or summaries of material which has been covered through some more formal and comprehensive means. Toolbox talks may be conducted periodically as the need arises.

Informal and/or “On-the-job training”. At times, employees may receive informal or “on-the-job” training from senior employees.

Types of training.Training may be provided in a variety of formats, such as large group classroom training, small, informal “tool box talks”, or one-on-one coaching.

Understandability of training.Training will always be provided in a language and a level of complexity which is understandable to the employees participating in it.

Documentation of training.All training will be adequately documented. At a minimum, training documentation will always include:

  • Name/title of employees who successfully completed the training
  • Date of training
  • Beginning and end time, or duration of training
  • Name of trainer
  • A brief description or outline of the material presented.

Other communication. Safety messages may also be communicated through means such as postings, announcements, periodic newsletters/reminders, hazard alerts, etc.

REPORTING AND INVESTIGATING INCIDENTS

[In this section, describe how employees are to report work-related injuries and illnesses to management. Describe the process for investigating those incidents to identify root causes, so they can be eliminated and reoccurences can be prevented. You can use the methods below, or edit them, or replace them altogether. Delete this instruction when done]

For the purposes of this program, an “incident” is defined as any unexpected, undesirable event which creates the potential for an undesirable consequence, regardless of whether or not that consequence actually occurs. These consequences include, but are not limited to injuries, illnesses, property damage, monetary loss, regulatory fine or citation, etc.

Near misses are considered incidents. A near miss is an incident that does not result in injury, illness or damage – but had the potential to do so.

Employees must report all incidents to [Title of person to whom incidents are report (i.e. “the immediate supervisor)]immediately.

In the case of injuries and illnesses, the incident must be reported as soon as the employee becomes aware that they have been injured, or made ill from a work-related incident. The supervisor will work with the employee to complete a First Report of Injury (“FROI”). Additionally, it may be necessary to record the incident on the OSHA 300 log, depending on whether or not the case meets the definition of a “recordable case”, as defined on the 300 form itself. [Title of person who maintains OSHA logs]is responsible for maintaining the OSHA 300, 300A and 301 forms.

In all cases, some degree of incident investigation or analysis will occur. The degree to which cases are investigated will be based on the severity (either actual or potential) of the case at hand and whether or not a comprehensive investigation would provide any value in preventing reoccurrences. The primary purpose of an accident investigation is to identify causal factors, so that they can be eliminated and reoccurrences can be prevented. [Title of person to whom incidents are report (i.e. “the immediate supervisor)] and the employee will work together to identify causal factors, and more importantly, to provide suggestions for correcting any hazards and prevent reoccurrences. When necessary, [Title of person who may assist with incident investigation, as needed]will assist in completing required documentation.

SAFETY RULES AND ENFORCEMENT

[In this section, describe how your organization establishes, communicates, and enforces safety and health rules. If your organization has an established disciplinary procedure, be sure to refer to it here, rather than copying and pasting it into the program. You can use the methods below, or edit them, or replace them altogether. Delete this instruction when done]

Safety rules will be developed and communicated through a variety of means, including individual health and safety programs/manual. Safety rules may also be communicated through training, written SOP’s, signs and postings, training, handbooks, etc.

In all cases, safety rules will be stated clearly and in a manner which is understood by all employees.

Compliance with all safety rules, guidelines, SOPs, etc. is expected of all employees as a condition of employment. Safety procedures will be enforced fairly and consistently. All disciplinary action will comply with applicable organization policies.

Primary responsibility for monitoring compliance with safety rules belongs to [Title of employee who monitors day-today compliance, such as immediate supervisor, foreman, supervisor].

[Title of person who applies the disciplinary policy when needed, such as Human Resources]is responsible for administering any disciplinary procedure, as necessary.