Federal Register of Legislation - Australian Government

Primary content

SR 1995 No 17 Regulations as amended, taking into account amendments up to SR 2001 No. 326
Administered by: Education, Employment and Workplace Relations
Start Date 15 Dec 2001
End Date 27 Nov 2009

OCCUPATIONAL HEALTH AND SAFETY (MARITIME INDUSTRY) REGULATIONS 1995



Compilation Information

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Occupational Health and Safety (Maritime Industry) Regulations 1995

Statutory Rules 1995 No. 17 as amended
made under the
Occupational Health and Safety (Maritime Industry) Act 1993
This compilation was prepared on 15 December 2001
taking into account amendments up to SR 2001 No. 326
Prepared by the Office of Legislative Drafting,
Attorney-General's Department, Canberra

OCCUPATIONAL HEALTH AND SAFETY (MARITIME INDUSTRY) REGULATIONS 1995
Part 1 Preliminary

OCCUPATIONAL HEALTH AND SAFETY (MARITIME INDUSTRY) REGULATIONS 1995
- REG 1
Name of regulations [see Note 1]

These regulations are the Occupational Health and Safety (Maritime Industry) Regulations 1995.

OCCUPATIONAL HEALTH AND SAFETY (MARITIME INDUSTRY) REGULATIONS 1995
- REG 2
Interpretation

(1)
In these Regulations, unless the contrary intention appears:

Act means the Occupational Health and Safety (Maritime Industry) Act 1993.

serious personal injury means an injury to, or disease in, a person:

(a)
that is caused by an accident at a workplace; and

(b)
for which the person is:

(i)
given emergency treatment on the prescribed ship or prescribed unit on which the accident occurred; or
(ii)
given emergency treatment in another place by a registered medical practitioner; or
(iii)
admitted to a hospital; or
(iv)
treated in a hospital as a casualty, without being admitted to the hospital.
(2)
A reference in these Regulations to a form by number is a reference to the form so numbered in the Schedule.

OCCUPATIONAL HEALTH AND SAFETY (MARITIME INDUSTRY) REGULATIONS 1995
- REG 3
Forms, notices and reports

(1)
A form containing a direction in, or at the foot of, the form must be completed in accordance with the direction.

(2)
A form, notice or report must be completed in sufficient detail to allow proper consideration of the form, notice or report.

(3)
A form, notice or report must be produced clearly and legibly in handwriting or by means of a machine in order to enable clear and legible reproduction of the contents of the form, notice or report.


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OCCUPATIONAL HEALTH AND SAFETY (MARITIME INDUSTRY) REGULATIONS 1995
- REG 4
What is a dangerous occurrence?

An occurrence is a dangerous occurrence for the purpose of the definition of dangerous occurrence in section 4 of the Act if it occurs at a workplace, and:

(a)
resulted from operations that arose from an undertaking conducted by or for the operator of the workplace; and

(b)
could have caused:

(i)
the death of, or serious personal injury to, any person; or
(ii)
the incapacity of an employee for a duration of 5 or more successive working days;
but as a result of which death, serious personal injury or incapacity did not occur.

OCCUPATIONAL HEALTH AND SAFETY (MARITIME INDUSTRY) REGULATIONS 1995
Part 2 Elections

OCCUPATIONAL HEALTH AND SAFETY (MARITIME INDUSTRY) REGULATIONS 1995
- REG 5
Involved union to authorise returning officer

(1)
An involved union that intends to conduct an election for a health and safety representative must appoint a returning officer to conduct the election for the union.

(2)
The returning officer must conduct the election in accordance with the rules of the union.

OCCUPATIONAL HEALTH AND SAFETY (MARITIME INDUSTRY) REGULATIONS 1995
Part 3 Advice, investigations and inquiries

OCCUPATIONAL HEALTH AND SAFETY (MARITIME INDUSTRY) REGULATIONS 1995
- REG 6
Form of provisional improvement notices

A provisional improvement notice issued by a health and safety representative to the person in command under subsection 58 (1) of the Act must be in accordance with Form 1.

OCCUPATIONAL HEALTH AND SAFETY (MARITIME INDUSTRY) REGULATIONS 1995
- REG 7
Taking samples for testing etc

(1)
If a sample of a substance or thing taken at a workplace under subsection 91 (1) of the Act is practicably divisible, the inspector who has taken the sample must:

(a)
divide the sample into 3 parts; and

(b)
put each part into a container and seal and label the container appropriately; and

(c)
give one part to the operator of the workplace; and

(d)
arrange for another part to be inspected, examined, measured or tested; and

(e)
retain the remaining part for any further inspection, examination, measuring or testing that is required.

(2)
If the sample of a substance or thing is not practicably divisible, the inspector must arrange for the whole sample to be inspected, examined, measured or tested.

(3)
An inspector who removes plant, a substance or a thing, or a sample of a substance or thing, from a workplace under subsection 91 (1) of the Act must take all reasonable steps to ensure that, while it is in his or her possession or control:


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(a)
the plant, substance or thing is not damaged; or

(b)
the sample is not contaminated.

OCCUPATIONAL HEALTH AND SAFETY (MARITIME INDUSTRY) REGULATIONS 1995
- REG 8
Form of certain notices

A notice issued by an investigator under a provision of the Act referred to in one of the following paragraphs must be in accordance with the form specified in the paragraph:

(a)
subsection 91 (2) (notice of taking possession of plant, taking samples of substances etc) — Form 2;

(b)
subsection 92 (1) (direction not to disturb workplace etc) — Form 3;

(c)
subsection 93 (1) (issue of prohibition notices) — Form 4;

(d)
subsection 98 (1) (issue of improvement notices) — Form 5.

OCCUPATIONAL HEALTH AND SAFETY (MARITIME INDUSTRY) REGULATIONS 1995
- REG 9
Alteration or disturbance of site of accident or dangerous
occurrence

(1) A person in command of a prescribed ship or prescribed unit commits an offence if:

(a)
the person in command engages in conduct, or allows another person to engage in conduct, that results in the alteration or disturbance of the site of an accident or a dangerous occurrence on the ship or unit; and

(b) at the time of the conduct:

(i)
an inspector had not inspected the site; and
(ii)
the inspector had not given permission in writing for the alteration or disturbance of the site.

Penalty:   10 penalty units.

(2)
It is a defence to a prosecution for an offence against subregulation (1) if the person in command had a reasonable excuse.

Note   A defendant bears an evidential burden in relation to the matter mentioned in subregulation (2) (see section 13.3 of the Criminal Code).

(3) It is a defence to a prosecution for an offence against subregulation (1) if, at the time of the conduct, the person in command had given a notice of the accident or dangerous occurrence, and:

(a)
the Inspectorate had notified the person in command in writing that an inspection of the site of the accident or dangerous occurrence by an inspector was not required; or

(b)
the ship or unit was in an Australian port when notice was given of the accident or dangerous occurrence and an inspector did not visit the site within 24 hours of notice being given;

(c)
the ship or unit was at sea and proceeding to an Australian port when notice was given of the accident or dangerous occurrence, and an inspector did not visit the site within 24 hours of the arrival of the ship or unit at the port; or

(d)
the ship or unit was at sea and not proceeding to an Australian port when notice of the accident or dangerous occurrence was given.

Note   A defendant bears an evidential burden in relation to the matters mentioned in subregulation (3) (see section 13.3 of the Criminal Code).

(4) Without limiting subregulation (2), a person in command had a reasonable excuse if either:

(a)
the alteration or disturbance was unavoidable; or

(b)
the person engaged in, or allowed another person to engage in, the conduct that resulted in the alteration or disturbance of the site of an accident or dangerous occurrence as a result of:


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(i)
the rescue, or attempted rescue, of an injured person; or
(ii)
the retrieval, or attempted retrieval, of the body of a deceased person; or
(iii)
the protection, or attempted protection, of the health or safety of a person; or
(iv)
the prevention, or attempted prevention, of damage being done to a substance or thing; or
(v)
the restoration, or attempted restoration, of a workplace to safe working conditions; or
(vi)
the performance, or attempted performance, of a task necessary for the proper operation of the ship or unit.

OCCUPATIONAL HEALTH AND SAFETY (MARITIME INDUSTRY) REGULATIONS 1995
Part 4 Notices and reports

OCCUPATIONAL HEALTH AND SAFETY (MARITIME INDUSTRY) REGULATIONS 1995
- REG 10
Definition for Part 4

In this Part:

incident means:
(a)
an accident of a kind described in paragraph 107 (1) (a) or (b) of the Act; or

(b)
a dangerous occurrence.

OCCUPATIONAL HEALTH AND SAFETY (MARITIME INDUSTRY) REGULATIONS 1995
- REG 11
Period of incapacity requiring notice and report

For paragraph 107 (1) (b) of the Act, a period of 5 successive days or more is prescribed.

OCCUPATIONAL HEALTH AND SAFETY (MARITIME INDUSTRY) REGULATIONS 1995
- REG 12
Notifying incidents

(1)
The requirements in this regulation are prescribed for paragraph 107 (2) (a) of the Act.

(2)
The operator must give notice of an incident to the Inspectorate within 4 hours of becoming aware of the incident.

Penalty:   10 penalty units.

(3)
However, if it is not reasonably practicable for the operator to give notice to the Inspectorate within 4 hours, the operator must give notice to the Inspectorate as soon as practicable after the end of that time.

(4)
The notice:

(a)
must be in accordance with Form 6 (Incident alert); and

(b)
may be given to the Inspectorate by any practicable means.

OCCUPATIONAL HEALTH AND SAFETY (MARITIME INDUSTRY) REGULATIONS 1995
- REG 13
Reporting incidents

(1)
The requirements in this regulation are prescribed for paragraph 107 (2) (b) of the Act.

(2)
The operator must give a report about an incident to the Inspectorate within 72 hours of becoming aware of the incident.


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Penalty:   10 penalty units.

(3)
However, if it is not reasonably practicable for the operator to give the report to the Inspectorate within 72 hours, the operator must give the report to the Inspectorate as soon as practicable after the end of that time.

(4)
The report must be:

(a)
in accordance with the relevant parts of Form 7 (Incident report); and

(b)
given to the Inspectorate by sending it to the postal address, facsimile number, or electronic mail address stated in the form.

OCCUPATIONAL HEALTH AND SAFETY (MARITIME INDUSTRY) REGULATIONS 1995
- REG 15
Records of accidents and dangerous occurrences

For the purposes of section 108 of the Act, an operator must retain a record of a report about an incident for 5 years after the day on which the report was made.

OCCUPATIONAL HEALTH AND SAFETY (MARITIME INDUSTRY) REGULATIONS 1995
- REG 16
Statistical reports

(1)
An operator must report in writing to the Authority within the period of 30 days after the end of a financial year:

(a)
the average number of full-time equivalent employees of the operator in that financial year; and

(b)
the total number of hours worked by employees of the operator in the financial year.

Penalty:   1 penalty unit.

(1A)
An offence against subregulation (1) is an offence of strict liability.

Note   For strict liability, see section 6.1 of the Criminal Code.

(1B)
It is a defence to a prosecution for an offence against subregulation (1) if it is not reasonably practicable for the operator to report within the period required by subregulation (1).

Note   A defendant bears an evidential burden in relation to the matter mentioned in subregulation (1B) (see section 13.3 of the Criminal Code).

(2)
In subregulation (1), average number of full-time equivalent employees means the number calculated in accordance with Australian Standard AS1885.1—1990, as in force at the commencement of this regulation.

OCCUPATIONAL HEALTH AND SAFETY (MARITIME INDUSTRY) REGULATIONS 1995
Schedule Forms

(subregulation 2 (2))

Form 1 Provisional improvement notice

(regulation 6)
OCCUPATIONAL HEALTH AND SAFETY (MARITIME INDUSTRY) REGULATIONS
Provisional improvement notice
To the person in command of (insert name of prescribed ship or prescribed unit)
I, (insert name of the health and safety representative issuing the notice), selected as the health and safety representative under section 41 of the Occupational Health and Safety (Maritime Industry) Act 1993 for (insert name of the prescribed ship or prescribed unit), after

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consultation in accordance with subsection 57 (1) of the Act, believe that the following contravention of the Act or Regulations is occurring, or has occurred and is likely to occur again:
The contravention is (give a brief description)
The contravention is occurring at (specify location)
The reasons for my opinion are as follows:
(give reasons briefly)
In accordance with paragraph 58 (2) (c) of the Act, action necessary to prevent the contravention, or the likely contravention, of the provision or provisions referred to above must be taken before (insert the date of a day that is:
(a) not less than 7 days after the day when the notice is issued; and
(b) reasonable in the opinion of the health and safety representative).

(page 2 of Form 1)

In the meantime, the following action should be taken in accordance with subsection 58 (3) of the Act:
(give a brief description)
Dated
(signature)
Health and safety representative
Notes:
1. Under subsection 59 (1) of the Act, a person to whom a provisional improvement notice is given may, within 7 days, request the Inspectorate or an inspector to conduct an investigation into the subject matter of the notice.
2. Under subsection 59 (2) of the Act, the operation of a provisional improvement notice is suspended if a request is made for an investigation into the subject matter of the notice. The suspension remains in effect until an inspector makes a determination that confirms, varies or cancels the notice.
3. Subsection 60 (1) of the Act requires the person in command to whom a provisional improvement notice is given:

* to notify each employee who is affected by the notice of the fact that the notice has been issued; and

* to display a copy of the notice at or near each workplace at which work that is the subject of the notice is being performed.
4. Under subsection 60 (2) of the Act, a provisional improvement notice ceases to have effect if:

* it is cancelled by the health and safety representative or an inspector; or

* the person in command, or a person who is given a copy of the notice under subsection 58 (5), takes the action specified in the notice or, if no action is specified, takes the action that is necessary to prevent the contravention, or likely contravention, with which the notice is concerned.
5. Section 61 of the Act requires the person in command:

* to ensure, as far as practicable, that a provisional improvement notice is complied with; and

* to inform the health and safety representative who issued the notice of the action taken to comply with the notice.
6. Under subsection 100 (2) of the Act, if an inspector has confirmed, varied or cancelled a provisional improvement notice the following persons may request the Australian Industrial Relations Commission in writing to review the decision of the inspector:

* the operator affected by the inspector's decision;

* the person in command;

* the person to whom the notice was given by the person in command under subsection 58 (5) of the Act;

* the health and safety representative for the designated work group that includes an employee who is affected by the decision or an involved union for the designated work group;

* if there is no designated work group of that kind — an involved union in relation to the affected employee;

* the owner of any plant, substance or thing to which the decision relates.

Form 2 Notice of removal of plant or sample

(paragraph 8 (a))
OCCUPATIONAL HEALTH AND SAFETY (MARITIME INDUSTRY) REGULATIONS
Notice of removal of plant or sample
To the person in command of (insert name of prescribed ship or prescribed unit)
and (insert name of health and safety representative for the prescribed ship or prescribed unit)
I, (insert name of inspector), an inspector appointed under section 84 of the Occupational Health and Safety (Maritime Industry) Act 1993, in the course of conducting an investigation under section 87 of the Act, have taken possession of:
(insert description of item removed)
from (insert name of the prescribed ship or prescribed unit) located at

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(insert location of ship or unit)
The reason for this action is:
(give explanation of why removal of item was necessary)
Signed: (signature of inspector)
Dated: (insert date)

(page 2 of Form 2)

Notes:

1. Subsection 91 (3) of the Act requires the person in command of the prescribed ship or prescribed unit to display this notice in a prominent place on the ship or unit from which the item was removed.
2. Under subsection 100 (2) of the Act, any of the following persons may request the Australian Industrial Relations Commission in writing to review the inspector's decision:

* the operator affected by the inspector's decision;

* the health and safety representative for a designated work group that includes an employee affected by the decision or the involved union for the designated work group;

* if there is no designated work group — an involved union in relation to the employee;

* the owner of any plant, substance or thing to which the inspector's decision relates.

Form 3 Do not disturb notice

(paragraph 8 (b))
OCCUPATIONAL HEALTH AND SAFETY (MARITIME INDUSTRY) REGULATIONS
Do not disturb notice
To the person in command of (insert name of the prescribed ship or prescribed unit)
I, (insert name of inspector), an inspector appointed under section 84 of the Occupational Health and Safety (Maritime Industry) Act 1993, direct that:
(insert name of the prescribed ship or prescribed unit, or part of the ship or unit, or of the plant, substance or thing, that is affected)
is not to be disturbed during the period from hours
to hours on (date).
The reasons for issuing this notice are:
(give reasons briefly)
Signed: (signature of inspector)
Dated: (insert date)

(see notes over)

(page 2 of Form 3)

Notes:
1. Subsection 92 (4) of the Act requires the person in command of the prescribed ship or prescribed unit to display this notice in a prominent place on the ship or unit.
2. Under subsection 92 (6) of the Act, if the operator of the prescribed ship or prescribed unit does not ensure that the notice is complied with, the operator may be liable for a fine not exceeding $25,000 (if the operator is an individual), or not exceeding $125,000 (if the operator is a body corporate).
3. Under subsection 100 (2) of the Act, any of the following persons may request the Australian Industrial Relations Commission in writing to review the inspector's decision to issue a prohibition notice:

* the operator affected by the inspector's decision;

* the health and safety representative for a designated work group that includes an employee affected by the decision or the involved union for the designated work group;

* if there is no designated work group — an involved union in relation to the employee;

* the owner of any plant, substance or thing to which the inspector's decision relates.

Form 4 Prohibition notice

(paragraph 8 (c))
OCCUPATIONAL HEALTH AND SAFETY (MARITIME INDUSTRY) REGULATIONS
Prohibition notice
To the person in charge of (insert name of prescribed ship or prescribed unit)
I, (insert name of inspector), an inspector appointed under section 84 of the Occupational Health and Safety (Maritime Industry) Act 1993, am of the opinion that activity being undertaken on (insert name of prescribed ship or prescribed unit) is of a kind that immediately threatens the health and safety of a person.
I THEREFORE PROHIBIT the following activity or activities:
(specify prohibited activity or activities)
*Action that may be taken that will be adequate to remove the threat to health and safety of the person is:
(if insufficient space, use additional page or pages)
Signed: (signature of inspector)

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Date: (insert date)
[*  Omit if inapplicable]
(see notes over)


(page 2 of Form 4)

Notes:
1. Section 96 of the Act requires the person in command of the prescribed ship or prescribed unit to give a copy of this notice to the health and safety representative on the ship or unit and to display a copy of this notice in a prominent place on the ship or unit.
2. Under subsection 93 (5) of the Act, if the operator of the prescribed ship or prescribed unit does not ensure that the notice is complied with, the operator may be liable to a fine not exceeding $25,000 (if the operator is an individual), or not exceeding $125,000 (if the operator is a body corporate).
3. This notice ceases to have effect when the inspector notifies the person in command that the inspector is satisfied that the operator has taken adequate action to remove the threat to health and safety.
4. Under subsection 100 (2) of the Act, any of the following persons may request the Australian Industrial Relations Commission to review the inspector's decision to issue a prohibition notice:

* the operator affected by the inspector's decision;

* the health and safety representative for a designated work group that includes an employee affected by the decision or the involved union for the designated work group;

* if there is no designated work group — an involved union in relation to the employee;

* the owner of any plant, substance or thing to which the inspector's decision relates.
5. Under subsection 100 (3) of the Act, any of the following persons may request the Australian Industrial Relations Commission to review the inspector's decision that adequate action has been taken to remove the threat to health and safety:

* the health and safety representative for a designated workgroup that includes an employee affected by the decision or the involved union for the work group;

* if there is not a designated work group — an involved union in relation to the affected employee.

Form 5 Improvement notice

(paragraph 8 (d))
OCCUPATIONAL HEALTH AND SAFETY (MARITIME INDUSTRY) REGULATIONS
Improvement notice

To the person in command of (insert name of prescribed ship or prescribed unit)
I, (insert name of inspector), an inspector appointed under section 84 of the Occupational Health and Safety (Maritime Industry) Act 1993, am satisfied that (insert name of person responsible for the contravention) is contravening, or has contravened, or is likely to contravene, section of the Act or regulation of the Occupational Health and Safety (Maritime Industry) Regulations on (insert name of prescribed ship or prescribed unit).

The reasons for my opinion are:
(give a brief description of contravention)

You are required to take action within (insert number) days of the date of this notice to prevent any further contravention or likely contravention of that section or regulation.
*The following action must be taken by the person in command within the period specified above:
(if insufficient space, use additional page or pages)
Signed: (signature of inspector)
Date: (insert date)
[*  Omit if inapplicable]

(page 2 of Form 5)

Return this portion of the notice (when the required improvement has been completed) to:
Name:
Position:
Address:
Telephone:

Improvement Notice No. has been complied with.
Signed:


This notice was delivered to: (insert name)
in the office/position of: (insert office/position)
at: (insert time) hours on: (insert date)

(See notes over)


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(page 3 of Form 5)

Notes:
1. Subsection 99 (1) of the Act requires the person in command of the prescribed ship or prescribed unit to give a copy of this notice to the health and safety representative on the ship or unit and to display a copy of this notice in a prominent place on the ship or unit.
2. If this notice relates to any plant, substance or thing that is owned by a person other than the operator, subsection 99 (2) of the Act requires the inspector to give a copy of this notice to the owner.
3. Under subsection 98 (5) of the Act, if the person in command of the prescribed ship or prescribed unit does not ensure that this notice is complied with, the person in command may be liable to a fine not exceeding $10,000.
4. Under subsection 100 (2) of the Act, any of the following persons may request the Australian Industrial Relations Commission to review the inspector's decision:

* the health and safety representative for a designated work group that includes an employee affected by the decision or the involved union for the designated work group;

* if there is no designated work group — an involved union in relation to the employee.

Form 6 Incident alert

(subregulation 12 (4))

INCIDENT ALERT
SHIP DETAILS
Ship's name
IMO number
Flag
Call sign
Satcom number
Master
Gross tonnage
No. of persons on board
Class society
Propulsion
IOPP certificate date of issue
o Container o Tanker o Bulk Carrier o Tug o OSV o Other
Operator's name and address
Responsible Officer (ISM designated person)
Contact number
Agents and P&I Club


INCIDENT DETAILS

Voyage
From

To
Ship's Location
(eg port, at sea, lat, long)

Location on ship where
incident occurred

Date & time
of incident / / am/pm
No. of persons
involved
Nature of Incident

o Collision
o MARPOL ship defects
o Grounding
o Serious personal injury
o Fire
o Death
o Structural failure
o Disappearance
o Flooding
o Loss
o Machinery failure
o Presumed lost
o Cargo gear
o Close quarters situation
o Pilotage
o Births
o Dangerous goods
o Other (specify)

DESCRIPTION OF INCIDENT/DAMAGE
Note: If incident occurred under Pilotage, include name of pilot







OTHER RELEVANT INFORMATION











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Form 7 Incident report

(subregulation 13 (4))


Incident report
Note: This form must be forwarded within 72 hours of the incident by the ISM Code Designated Person or equivalent to:
General Manager, Ship & Personnel Safety Services, AMSA
GPO Box 2181 Canberra ACT 2601 Australia
Fax: +61 2 6279 5966
E-mail: Reports @amsa.gov.au
For further information please call 1800 021 098
Ship's name

IMO number
Flag
Call sign
Satcom number
Master

Gross tonnage
Propulsion
Class society

Operator's name and address

Agents and P&I Club

Date & time of incident
Ship's location (eg port, at sea, lat, long)

PART 1 - To be completed if reporting under Marine Orders Part 32
Person-in-charge

Employer of person-in-charge

Incident

?   Injury
If injury, complete parts 4 - 8
?   Gear failure
If gear failure, complete parts 5 - 8
?   Dangerous Goods
If dangerous goods, complete parts 5 - 8
PART 2 - To be completed if reporting under sections 268, 269 and 417 of the Navigation Act 1912 (other than births) and regulation 4 of the Navigation (Marine Casualty) Regulations
Voyage
To

From

Incident description


?  Grounding
?  Foundering
?  Stranding
?  Collision
?  Capsize
?  Flooding
?  Fire
?  Explosion
?  Machinery failure
?  Structural failure
?  Close quarters
?  Disappearance
?  Loss
?  Presumed lost
?  Injury
?  Death
?  Dangerous
occurrence

?  Other (specify)


Place of incident


?  Machinery spaces
?  Accommodation block
?  Galley
?  Deck/cargo spaces
?  Gangway/pilot ladder
?  Wharf
?  Other (specify)


Crew numbers
Passenger numbers
Cargo

PART 3 - To be completed if reporting under section 417 of the
Navigation Act 1912 - Births
Child's name

Gender
M / F
Date of birth
Place

Mother's full name


Town & country of birth

Australian resident Yes/ No
Father's full name


Town & country of birth

Australian resident Yes/ No
Note: Part 4 relates to personal injury. If more than one person is affected complete Part 4 on a separate form for each person.

PART 4 - To be completed if reporting under section 107 of the Occupational Health and Safety (Maritime Industry) Act 1993
Name of affected person



Date of birth

Gender M / F
PIN
Home address



Australian resident
Yes / No
Town & country of birth


Capacity



?  Crew
?  Contractor
? Waterside worker
?  Supplier
?  Watchkeeper
?  Other (specify) ..........................................


show watch period: from ............... to .................Time since last rest period: ............
Logbook entry date

Rank

Hours of duty
     Time on:


Time off:
Hours before duty
Affected area



?  Head (1)
?  Eyes (1)
?  Trunk (3)
?  Arms (4)
?  Hands (4)
?  Legs (5)
?  Internal (7)
?  Back (3)
?  Neck (2)
?  Fingers (4)
?  Feet (5)
?  Toes (5)
?  Other (specify)



Type of injury



?  Drowning (150)
?  Crushing (100)
?  Laceration (060/080)

?  Burns & scalds (120)
?  Hernia (450)
?  Fracture (020/010)

?  Electric shock (150)
?  Amputation (070)
?  Foreign Body (110/090)
?  Abrasion (090)
?  Bruising (100)
?  Asphyxia (110/150/140)
?  Strain & sprain (040)
?  None


?  Other (specify)



Result of incident



?  Death
?  Serious Injury
?  Minor Injury

?  Near miss
?  Temporary disability
?  Partial disability

?  Permanent disability
?  Disappearance
?  Time off work

?  None
?  Other (specify)




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Incident factors

?  Machinery and (mainly) fixed plant (1)

?  Mobile plant and transport (2)

?  Powered equipment, tools and appliances (3)

?  Non-powered hand tools, appliances and equipment (4)

?  Chemicals and chemical products (5)

?  Materials and substances (6)

?  Environmental agencies (7)

?  Animal, human and biological agencies (8)

?  Other and unspecified agencies (9)

Cause of injury/illness

Date left ship
Expected period
of incapacity
Treatment given on board ship


PART 5 - Explanation and Description
State cause and give names and addresses of any witnesses
Attach additional pages if necessary




PART 6 - Incident Narrative
Attach additional pages if necessary




PART 7 - Action taken to prevent similar occurrences




PART 8 - Details of person completing report

Name

Position
Contact number
Signature
/      /


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OCCUPATIONAL HEALTH AND SAFETY (MARITIME INDUSTRY) REGULATIONS 1995
Notes to the Occupational Health and Safety (Maritime Industry) Regulations 1995

Note 1

The Occupational Health and Safety (Maritime Industry) Regulations 1995 (in force under the Occupational Health and Safety (Maritime Industry) Act 1993) as shown in this compilation comprise Statutory Rules 1995 No. 17 amended as indicated in the Tables below.

Table of Statutory Rules

Year and
number
Date of notification
in Gazette
Date of
commencement
Application, saving or
transitional provisions
1995 No. 17
14 Feb 1995
14 Feb 1995

1999 No. 101
17 June 1999
1 July 1999

2001 No. 326
13 Dec 2001
15 Dec 2001

Table of Amendments

ad. = added or inserted am. = amended rep. = repealed rs. = repealed and substituted
Provision affected
How affected
R. 1
rs. 1999 No. 101
R. 2
am. 1999 No. 101
R. 9
rs. 2001 No. 326
Rr. 10-13
rs. 1999 No. 101
R. 14
rep. 1999 No. 101
R. 15
am. 1999 No. 101
R. 16
am. 2001 No. 326
Schedule
am. 1999 No. 101
Forms 1-5
1995 No. 17
Form 6
1995 No. 17

rs. 1999 No. 101
Form 7
1995 No. 17

ad. 1999 No. 101