Lab Incidents and Lab Incident Report Form

All laboratory incidents (exposures, injuries, spills, leaks, near misses) should be reported immediately to the faculty member, the department head, and to Environmental Health and Safety (EH&S) by phone at: 413-545-2682.  EH&S will report to the laboratory to investigate upon notification or if called by emergency personnel or University Health Services. Within 48 hours the Lab Incident Report Form must be completed and submitted. If the incident caused an injury, a Notice of Injury (NOI) form must also be filed with the UMass Amherst Department of Human Resources (HR) if the injured party is a UMass employee.

Lab Incident Report Form

Complete the attached Lab Incident Report Form. (The form is also in the Laboratory Health and Safety Manual/Chemical Hygiene Plan Appendix F.) Complete the form within 48 hours of the incident. Please email the completed form to Kristi Ohr EH&S will investigate the incident to find the root cause and recommend corrective actions to prevent such incidents in the future and will send a report to the supervisor, department chair and department lab safety coordinator.

Notice of Injury Report Form

If the incident resulted in an injury and the injured party is a UMass Amherst employee, an Notice of Injury (NOI) Report must also be filed with UMass Amherst Human Resources (HR). Contact the Human Resource Worker's Compensation Specialist at: 413-545-6114 for additional information. The NOI must be completed by the injured employee and signed by their supervisor. Return the NOI to HR within 48 hours of the incident via the fax number indicated on the form.