Injury Line: D.O. Dearborn & Son
| Inspection Nr | 119554913 |
| Investigation Nr | 14479760 |
| Line Nr | 1 |
| Age | |
| Sex |   |
| Nature of Injury | Asphyxia |
| Part of Body | Bodysystem |
| Source of Injury | Gases |
| Event Type | Inhalation |
| Environmental Factor | Gas/Vapor/Mist/Fume/Smoke/Dust |
| Human Factor | Equip. Inappropr For Operation |
| Occupation | Construction trades, n.e.c. |
| Degree of Injury | Hospitalized injury |
| Task Assigned | Task regularly assigned |
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