Report an Incident

Incident and Injury Reporting

 

We are currently working remotely and not picking up campus mail daily.  To ensure we receive all reports promptly please submit using the Upload Incident Report tool below, or email to safety@queensu.ca

All types of incidents must be documented and reported to Environmental Health and Safety, using this Incident Report Fillable Form (PDF 779 KB)

Upload Incident Report

Near Miss

Any occurrence that did not result in injury or illness, but had the potential to do so. Only a fortunate break in the chain of events prevented an injury, fatality or damage

First Aid

If any person (employee, student, visitor) only requires first aid as a result of an incident, it should be reported to Environmental Health and Safety. First Aid is a one-time treatment such as cleaning, apply bandage, or apply cold compress.

Spill Report Form

If the near miss resulted in a chemical, radioactive or biological spill please fill out the Spill Report Form and contact the Department of Environmental Health and Safety at 32999.

Major Incidents

An incident must be reported to Environmental Health and Safety immediately, by the Supervisor completing the Incident Form in the following cases:

  • Employee obtaining medical attention, treatment from facilities such as hospital or physician (Not first aid)
  • Lost Time after the day of injury, unable to work due to injury (not including day of incident)
  • Requires modified duties at less than regular pay
  • Employee earning less than regular pay at regular work
  • Requires modified duties at regular pay for more than 7 calendar days after accident

The Incident Report Form must:

  • be submitted to Environmental Health and Safety within 24 hours or next business day of becoming aware of the accident
  • The Incident Report Form must be completed and signed by the supervisor/safety officer (Not the employee)
  • Environmental Health and Safety may investigate the accident
  • Environmental Health and Safety will determine further reporting requirements.  If needed, EHS will complete and submit the WSIB Form 7/ Employer report to the WSIB

WSIB Workers Report of Injury/Disease (Form 6)

In any case that an employee seeks health care for a work related incident or is unable to work after the day of injury, then the employee must complete WSIB reporting. A WSIB Form 6 (PDF 262KB) is the worker's report of injury/disease which is downloadable from WSIB. It must be completed by the employee and returned to the WSIB. 

An employee must provide a copy of their WSIB Form 6 with their Supervisor and EHS.

Additional forms can be found on the WSIB Ontario website

Incident Report Fillable Form (PDF 264 KB)

Critical Injuries 

A critical injury is defined by the Ministry of Labour (MOL) as an injury that: 

  • Places life in jeopardy
  • Produces unconsciousness
  • Results in substantial blood loss
  • Involves the fracture of a leg or arm
  • Involves the amputation of a leg, arm, hand or foot
  • Consists of burns to a major portion of the body
  • Causes the loss of sight in an eye

There are 4 steps in the event of a critical injury:

  • Secure and manage the accident scene
  • Notify the appropriate people
    • Notify Safety at 32999
    • After hours, weekends or holidays contact Security at 36111
    • Environmental Health and Safety will contact the Ministry of Labour
  • Investigate 
    • Assist the Department of Environmental Health and Safety and the Ministry of Labour
  • Report
    • Send a full report to Environmental Health and Safety within one day. EH&S will send a detailed report to the Ministry of Labour

The investigation should begin only after the accident scene is safe and the injured worker(s) has received medical attention. The scene must be secure to ensure no evidence is removed or disturbed. 

Section 52(2) of the Occupational Health and Safety Act states:

Where a person is killed or critically injured at a workplace, no person shall, except for the purposes of, 

  • Saving life or relieving human suffering
  • Maintaining an essential public utility or service or a public transport system
  • Preventing unnecessary damage to equipment or other property

interfere with, disturb, destroy, alter or carry away any wreckage, article or thing at the scene of or connected with the occurence until permission to do so has been given by an inspector. 

Out-of-Country Emergencies

Domestic - Off Campus Activity Emergencies