SAMRASS 2 FORM SECTION F: DETAILS OF INJURY This Section need not be completed for a Dangerous Occurrence – refer to example below: SECTION F: INJURY DETAILS – THIS SECTION NEED NOT BE COMPLETED FOR A DANGEROUS OCCURRENCE 1. Task: (person injured or killed while performing) 2. Activity: (injured or killed while…) 3. Nature of injury 4. Part of body injured 5. Type of accident of individual Fatal (F), Totally disabling (T), In jury (I) F 6. Allocated days lost (to be completed by DME) T I ITEM 1. TASK: PERSON INJURED OR KILLED WHILE PERFORMING This refers to the task/assignment being carried out or performed at the time of the accident i.e. a piece of work being done, a job or a duty. Make use of the full 6 digit code. 1A MINING/BREAKING ROCK/CUTTING/EXCAVATING Digging, drilling, dredging 1A0101 1A0102 1A0103 Coal cutters/shearers Continuous miner Diamond dredges/drilling machines Drilling 1A0201 1A0202 Hydraulic Pneumatic Preparing the face 1A0301 Treating misfires Charging 1A0401 Loading explosives Blasting 1A0501 Initiation Cleaning (broken rock) 1A0601 1A0602 1A0603 1A0604 1A0605 Scraping (scraper winch) Mechanical loading Hand loading (lashing) Waterjet Sweeping Make safe (includes barring) 1A0701 1A0702 Visually examining Barring Installing 1A0801 1A0802 1A0803 1A0804 1A0805 1A0806 1A0807 1A0808 1A0809 Timber packs Timber elongates Hydraulic support Backfill Rockbolting Meshing/lacing Concrete packs Sandwich/composite packs Sticks, timberpoles Removing support 1A0901 1A0902 1A0903 1A0904 1A0905 1A0906 1A0907 1A0908 1A0909 Timber packs Timber elongates Hydraulic support Backfill Rockbolting Meshing/lacing Concrete packs Sandwich/composite packs Sticks, timberpoles 1B TRANSPORTING Transporting of mineral/rock/ore by 1B0101 1B0102 Rail transport Free-steered vehicle 1B0103 1B0104 1B0105 1B0106 1B0107 Conveyors Ore pass Boxfront/chute Dragline Skips Transporting of people by 1B0201 1B0202 1B0203 1B0204 1B0205 1B0206 1B0207 Rail transport Trackless mobile vehicle Shaft transport Self transport (person walking, running, ascending/descending etc) Conveyors Chairlift Magic carpet Transporting of materials/equipment by 1B0301 1B0302 1B0303 1B0304 1B0305 1B0306 1B0307 Rail transport Shaft transport Free-steered vehicle Winches Mono-rope Mono-rail Moving trackless mobile equipment, e.g. moving a rockbolter or roadheader between working places 1B0308 Moving trackbound equipment Material handling (loading, unloading, stacking) 1B0401 1B0402 1B0403 1B0404 Loading Unloading Stacking Lifting 1C ENGINEERING TASKS 1C0101 1C0201 1C0301 1C0401 1C0501 Maintenance of equipment Repairing equipment Assembling equipment Installation and erection of equipment e.g. pipe winches Construction/building permanent structu re e.g. concrete, steelwork 1C0601 1C0701 Manufacturing e.g.sheet metal, carpentry Lifting e.g. cranes, block and tackle, chainblock 1D TREATING ROCK/BENEFICIATION Mechanical or chemical processes 1D0101 1D0102 1D0103 1D0104 1D0105 1D0201 1D0301 1D0401 Crushing Grinding Sizing (screening) Washing Flotation Chemical treatment Pyrometallurgy Construction of waste dumps or slime dams 1E ANCILLARY TASKS Mine infrastructure and services 1E0101 1E0102 1E0103 1E0104 1E0105 Survey Geology Rock engineering/mechanics Training Stores Environmental control services 1E0201 1E0202 1E0203 1E0204 1E0205 1E0206 Ventilation Dust control Water management Illumination Gas monitoring/control Radiation 1E0207 1E0208 Noise Heat General maintenance/housekeeping 1E0301 1E0302 1E0303 1E0304 Gardening services Cleaning Road maintenance Property maintenance Catering/hostel services 1E0401 1E0402 Cooking/serving Cleaning 1E0501 1E0601 1E0701 1E0801 1E0901 Recreation Admin/office/clerical work Security Industrial action Rescue operations ITEM 2. ACTIVITY (INJURED OR KILLED WHILE...) This is the activity (verb) i.e. when the injured is the doer of an action at the time of the accident. 2001 2002 2003 2004 2005 2001 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2002 Adjusting/assembling/stripping equipment or machinery Adjusting/changing (not equipment) Aligning Analysing Annealing Assembling/stripping/adjusting equipment or machinery Assembling (not equipment) Attaching Backfilling Ballasting Barring Bending/throwing/reaching Bleeding lines Blocking Blowing over Boiling Bolting Breaking (not rock/slag/concrete) Breaking (rock/slag/concrete) Burning explosives Burning material Carrying Casting/tapping/skimming Cementation Changing/adjusting (excluding equipment) 2025 2027 2028 2029 2030 2031 2032 2033 2034 2035 2036 2037 2038 2039 2040 2041 2042 2043 2044 2045 2046 2047 2048 2049 2050 2051 2052 2053 2054 2055 2044 2056 2057 2058 2059 2060 2061 2062 2063 2064 2062 2065 2065 2046 2067 2068 2069 2070 2071 2072 2073 2065 2075 2076 3077 2078 Changing clothes Changing equipment/material Charging batter ies Charging up Checking/inspecting machinery, vehicles or equipment Checking/inspecting (excluding machinery/vehicles/equipment) Clamping Cleaning other than equipment, machinery and footwall Cleaning footwall task Cleaning machinery/equipment Clearing Clearing obstructions Clerical work Climbing Closing/opening (excluding doors/valves) Closing/opening doors Closing/opening valves Collaring hole Connect/disconnect electricity Connecting equipment/machinery/hoses Construct/erect structures Cooking/making tea Covering Coupling/uncoupling electricity/equipment Coupling/uncoupling (excluding electricity, equipment, machinery, hos es and valves) Crawling Crushing Cutting with gas torch Cutting with tools Digging Disconnect/connect electricity Dislodging Dismantling Diving Draining Drawing rock Drilling (electric al) Drinking/eating Dumping Driving Eating/drinking Empty/fill containers or hoppers Entering/leaving conveyance Erect/construct structures Equipping Examining Exercising/sport Extending Extracting Falling Fastening Fill/ empty containers or hoppers Filling Firing furnace/bricks etc. Fitting Flushing 2079 2080 2081 2082 2083 2084 2085 2086 2087 2088 2089 2090 2091 2092 2093 2094 2095 2096 2097 2098 2099 2100 2101 2102 2103 2104 2105 2106 2107 2108 2109 2110 2111 2112 2113 2114 2115 2110 2111 2081 2116 2117 2118 2119 2120 2121 2122 2123 2124 2125 2126 2127 2128 2129 2130 2131 Forging Grading Greasing/lubricating Grinding Grouting Guarding Guiding Hammering Handling Handling cable Hanging Hoisting men/material Hoisting rock Heating Hitting/striking Holding Hooking Inflating Inserting Inspecting/checking of machinery, vehicles or equipment Inspecting/checking (excluding machinery/vehicles or equipment) Installing equipment/machinery Installing (excluding support/barr/wall/machinery) Joining Jumping Kicking Kneeling Lashing Laying Leaving/entering conveyance Levelling Lifting/lowering by hand Lifting/lowering/raising with machinery Lighting Lining/relining Loading/offloading Loosening Lowering/lifting by hand Lowering/lifting/raising with machinery Lubricating/greasing Machining Making tea/cooking Marking off Marking off drill holes Measuring Mixing (excluding concrete) Mixing concrete Moving objects Nailing Offloading/loading Opening/closing (excluding doors/valves) Opening/closing doors Opening/closing valves Opening equipment/tools Operating track bound vehicles Packing 2132 2133 2134 2135 2136 2137 2138 2139 2140 2141 2142 2143 2144 2145 2146 2147 2148 2149 2150 2151 2152 2153 2154 2155 2156 2157 2158 2159 2160 2161 2162 2163 2164 2165 2166 2167 2168 2169 2170 2171 2172 2173 2174 2175 2176 2177 2178 2179 2180 2181 2182 2183 2184 2185 2186 2187 Painting Parking Patrolling Pegging Picking Placing Plastering Plugging Positioning Pouring Preparing Preparing face (task) Profile cutting Projecting Pulling Pumping Pushing Raising/lowering/lifting with machinery Reaching/throwing/bending Reaming Reclaiming material Reclaimimg/sweeping/vamping Reconditioning Refueling Relining/lining Removing (excluding support, equipment and machines) Removing equipment/machinery Removing support Repairing Replacing Rerailing Resetting Reversing Riding (track bound vehicles) Riding (trackless vehicles) Rolling (not self) Rotating (not self) Routing Running Sampling Sandblasting Sanding Sawing Scraping Setting Sharpening Shoveling Showering Shunting Signaling Sitting/standing/waiting (person in stationery position) Skimming/casting/tapping Sliding Slinging Soldering Sorting 2188 2189 2190 2191 2192 2193 2194 2195 2196 2197 2198 2199 2200 2201 2202 2203 2204 2205 2206 2207 2208 2209 2210 2211 2212 2213 2214 2215 2216 2217 2218 2219 2220 2221 2222 2223 2224 2225 2226 2227 2228 2229 2230 2231 2232 2233 2234 2235 2236 2237 Sounding/testing Spacing Spinning Splicing Sport/exercising Spotting Spragging Standing/sitting/waiting (person in stationery position) Starting Steering Stemming/tamping Stopping (not self) Straightening (not self) Striking/hitting Stripping/assembling/adjusting equipment or machinery Supervising Sumping Surveying Sweeping/brushing Sweeping/reclaiming/vamping Swimming Switching (rail) Switching (reference) Tamping/stemming Tapping/casting/skimming Tempering Tensioning Testing Testing (excluding equipment) Testing/sounding Throwing/reaching/bending Tightening Timbering Tipping Training (conveyor belt) Tramming Trimming Turning on/off Twisting (person) Uncoupling/coupling electricity etc. Uncoupling/coupling (other than electricity, equipment, machinery, hoses and valves) Vamping/sweeping/reclaiming Waiting/standing/sitting (person in stationery position) Walking Warning Washing Watering Wedging Welding (electric) Welding (gas) ITEM 3. NATURE OF INJURY In some cases the injured person suffers different types of injuries to different body parts. In such cases the injury resulting in the most days lost must be used, unless it can be classified as multiple to the whole body. A B C D E F G H I J K L M N P Q R S T U V W X Z Y AB Amputation Abrasion Burn (flame) Burn (chemical) Burn (steam/hot substance) Concussion Crushing (injury) Contusion bruise Dislocation Drowning Dermatitis Burn (electric) Fracture Foreign body/splinter Gassing Heat exhaustion Heat stroke Hernia Laceration Multiple injury Poisoning Puncture Asphyxiation Other Sprain/strain Blindness ITEM 4. PART OF BODY INJURED Head/face and neck 01 02 03 Skull and scalp (occipital, frontal, maxilla) Ear (malleus, otitis, barotrauma) Eyes and orbit (eye socket) Note: where blindness results, use code AB in Nature of Injury (ITEM 3) i.e. AB03 = 6000 days lost Nose and sinuses Face (upper jaw, zygoma (cheekbone)) Lower jaw (teeth, mandible(lower jaw), ramus) Neck (throat) Multiple injuries to head, face and neck Brain 04 05 06 07 09 60 Trunk 10 11 12 Thorax (chest - excluding spinal region) Thoracic (chest, spinal region, lungs, sternum, ribs) Abdomen (including lumbar spine, back, vertebrae) 13 14 15 18 19 20 21 22 Anterior abdominal wall Pelvic girdle (sacrum, coccyx, buttocks, hip) External genital area (scrotum) Other (specify) Multiple injuries to trunk Scapula (shoulder blade) Collar bone (clavicle) Shoulder (acromion) Arms and hands 23 24 25 26 29 30 31 32 33 34 35 36 37 39 Forearm (ulna, radius, extensor (muscle), indicis) Elbow Arm Both arms Multiple injuries to one arm only Wrist (scaphoid, flexor, carpus (muscle), colles) Palm (thenar) Back of hand (including metacarpal bones, dorsum) Thumb Single finger Thumb plus one or more fingers Two or more fingers (excluding thumb) Both hands injured Multiple injuries to one hand (hand general) Legs and feet 40 41 42 43 44 45 46 47 48 49 Thigh (femur) Knee joint (including patella) Leg injured below the knee (fibula, tibia, shin) Ankle (cuneiform, calcaneus, talus, cuboid, heel) Foot (including toes) Foot (excluding toes), metatarsal Toes (one or more) Whole of lower limb (whole leg) Both feet Both lower limbs (legs) Multiple 50 51 52 53 54 55 56 99 Multiple injuries to head, face, neck and trunk Multiple injuries to head, face, neck and limbs Multiple injuries to the entire body Multiple injuries to the trunk and upper limb(s) Multiple injuries to the trunk and lower limb(s) Multiple injuries to the upper and lower limb(s) Multiple injuries to the trunk, lower limbs and upper limbs UNSPECIFIED ITEM 5. F I T TYPE OF ACCIDENT OF INDIVIDUAL One person killed (allocate 6000 days lost.) One person reportably injured One person totally disabled for own occupation, e.g. paraplegic/quadriplegic/deaf/blind/permanently bedridden/permanently totally disabled. ITEM 6. ALLOCATED DAYS LOST The allocated days lost must be completed according to the nature of injury and body part injured, as reflected in the table in Appendix 11, e.g. a fracture (M) to the leg (42) is attributed 160 days lost.
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