ANALISE DE ACIDENTE

Empresa:___________________________________________________________
Nome dos Participantes:
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Data:__/__/__ Local/Maquina/Serviço:______________________________

Tipo de Acidente: Queda ( ) Desmaio/Mal Subto ( ) Intoxicação ( ) Espaço ( )

Qual?____________________

1) Relato ou ordem cronológica da atividade até o acidente.

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2) Causas Imediatas
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3) Causas Básicas
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Aplique a investigação com diagrama de ISHIKAWA

Mão de obra Meio ambiente Materiais

Efeito

Máquinas Medição Métodos

 1- Mão de Obra
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2- Meio Ambiente
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3- Materiais
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4- Maquinas
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5- Medição
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6- Métodos
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4) Recomendações de Segurança

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