A brief description of the coding used on the form follows. Mechanisms, which are specific events, include motor vehicle accidents. The mechanism selected should be that which directly caused the most serious injury or disease. The agency classification is used to identify the object, substance or circumstance that directly caused the most serious injury or disease. Only the box that is most closely associated with the injury should be ticked.
Environmental agency includes noise, heat, cold ,dust, dirt, etc.
Part of body injured Identify the part of the body affected by the most serious injury or disease. Expand briefly if appropriate by writing in such detail as finger, toe, wrist etc. If more than one part of the body is affected, the multiple locations box should be ticked. Secondary conditions which may affect other parts of the body should be ignored when completing this part of the question. Nature of accident or injury or disease Tick the boxes which represent the most serious initial injury or disease being reported.