To root out ergonomic injuries you must be proactive. The first step is to do a record review and create a “snapshot” of worker injuries, so you can analyze causes and identify trends. HOW TO USE THIS TOOL Use and adapt this form to use at your workplace to perform an effective records review or ergonomic injuries.  

A. REVIEWER IDENTIFICATION

Team Leader: __________________________________________________ Tel. No.: ______________________________________________________ Record Reviewer: _______________________________________________ Tel. No.: ______________________________________________________ Department: ____________________________________________________ Review Date: ___________________________________________________

B. RECORD IDENTIFICATION

Employee Name (or Record ID number if confidential): ______________________ Employee Job Title: ___________________________________________________ Record Reviewed: _____________________________________________________ 

[  ] OSHA or OHS form (specify) ________________________________ [  ] Incident […]