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Struck by Object Report

A struck by object report records an event where a person was hit by a falling, flying, moving or swinging object — for example dropped tools, falling materials, moving loads or ejected parts. This page explains in general educational terms what the form is for and what it typically contains. It is a simplified template example, not an official document and not legal advice.

An educational library of workplace documents — purpose, who completes them, when they are used, typical fields, common mistakes and how they connect. Linked to workplace safety, workplace training, occupations, industries and employment documents. Informational only — template examples, not legal advice or official documents; employers remain responsible and using a document does not guarantee compliance.

What a struck by object report is

A struck by object report captures events where energy is transferred by an object hitting a person — something dropped from height, a load that swung, material that toppled or a part that was ejected. Recording the source and path of the object is key to preventing a repeat.

This is an educational overview with a simplified example. It is not an official template, and recording it does not by itself remove the hazard or guarantee compliance — the source of the object must be controlled.

Purpose

  • Record events where a person is struck by an object.
  • Capture the source, path and energy of the object.
  • Identify exclusion zones and securing measures that failed.
  • Trigger control of dropped, falling and moving objects.

Who completes it

  • A supervisor or manager, with input from those present.
  • Witnesses help establish the path of the object.
  • The employer decides the process and who is responsible.
  • A review may cover lifting, stacking or overhead work.

When it is used

  • As soon as practicable after a person is struck by an object.
  • For falling, flying, moving or swinging objects.
  • For near misses where an object narrowly missed someone.
  • When stacked, stored or lifted material is involved.

Typical fields

  • Date, time, location and the object involved.
  • The source and path of the object.
  • The task and any exclusion zone or securing in place.
  • Any injury, and the immediate response.
  • Cause, follow-up and the control to prevent a repeat.
  • Example fields only — adapt to your process and the applicable law.

Common mistakes

  • Recording the injury but not where the object came from.
  • Ignoring near misses where an object just missed someone.
  • Overlooking exclusion zones, securing and overhead work.
  • Failing to address stacking, storage or lifting causes.

Document workflow

A struck by object report follows the accident report or near miss process and can trigger a dangerous occurrence report for serious events such as load failures. It drives an incident investigation and corrective actions, and a review of the relevant risk assessment for lifting, stacking and overhead work.

See the related documents below for what is commonly used with and completed after a struck by object report.

Retention (high level)

These records are usually kept with the accident records for a period set by the applicable law and the employer’s duties. This page does not state a period — confirm with the applicable law and the official authority.

Completing and sharing as a PDF

Struck by object reports are commonly completed and stored as PDFs, often with a sketch or photo of the object’s path. Exporting to PDF supports the record; it does not control the hazard or guarantee compliance.

Employer checklist

  • Record where the object came from and how it reached the person.
  • Treat near misses where an object just missed as serious.
  • Review exclusion zones, securing and overhead work.
  • Control the stacking, storage or lifting cause.

Worker notes

  • Report being struck, and near misses where an object just missed.
  • Respect exclusion zones below lifting and overhead work.
  • Secure tools and materials so they cannot fall or be knocked.

Country considerations

Expectations around controlling falling and moving objects vary by country, and the official authority differs. This page is general and high-level — not a statement of any country’s law and not legal advice.

Confirm requirements with the official authority for your country and a qualified professional.

Who is responsible

The employer is responsible for controlling the risk of struck-by events, recording and investigating incidents and compliance. This page is an educational overview with a template example; it does not control any hazard and does not transfer responsibility.

Export, edit and share documents

The documents, policies and templates this involves can be exported, edited, signed, stored and shared as PDFs with the HELPERG PDF Editor.

Free, printable HR & employment resources

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For general informational and educational purposes only. This is documentation guidance — not legal advice and not a substitute for professional or legal guidance. Any fields, sections or checklists shown are simplified template examples only — not official, approved or jurisdiction-specific documents. Employers remain responsible for determining which documents are required, adapting them to their organisation and the applicable law, and for compliance; using a document does not guarantee legal or regulatory compliance and reading this page does not satisfy any legal obligation. Requirements vary by role, site and country and change over time — always follow the applicable law and the official authority, and confirm specifics with a qualified professional.
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FAQ

Frequently asked questions

Is this an official struck by object report?

No. It is a simplified template example for educational purposes — not an official, approved or jurisdiction-specific document and not legal advice. Adapt it to your process and the applicable law.

Does completing it control the hazard?

No. The form records the event; the hazard is only controlled when its source — stacking, securing, lifting or overhead work — is addressed. It does not by itself guarantee compliance.

Should near misses where an object just missed be reported?

Yes. An object that narrowly missed someone is a clear warning. Recording and investigating it can prevent an injury next time.

Who is responsible for the risk?

The employer, who must control falling and moving objects and investigate incidents. These resources support understanding; they do not transfer that responsibility.