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| Inspection Nr | 300005055 |
| Investigation Nr | 200000321 |
| Line Nr | 1 |
| Age | |
| Sex | |
| Nature of Injury | Poisoning(Systemic) |
| Part of Body | Lung |
| Source of Injury | Chem Liquids/Vapors |
| Event Type | Inhalation |
| Environmental Factor | Gas/Vapor/Mist/Fume/Smoke/Dust |
| Human Factor | Misjudgment, Haz. Situation |
| Occupation | Painting and paint spraying machine operators |
| Degree of Injury | Fatality |
| Task Assigned | Task regularly assigned |
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