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| Inspection Nr | 314316845 |
| Investigation Nr | 201863107 |
| Line Nr | 4 |
| Age | |
| Sex | |
| Nature of Injury | Poisoning(Systemic) |
| Part of Body | Blood |
| Source of Injury | Gases |
| Event Type | Ingestion |
| Environmental Factor | Gas/Vapor/Mist/Fume/Smoke/Dust |
| Human Factor | Equip. Inappropr For Operation |
| Occupation | Occupation not reported |
| Degree of Injury | Hospitalized injury |
| Task Assigned | Task regularly assigned |