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| Inspection Nr | 300813870 |
| Investigation Nr | 201096112 |
| Line Nr | 1 |
| Age | |
| Sex | |
| Nature of Injury | Asphyxia |
| Part of Body | Blood |
| Source of Injury | Chem Liquids/Vapors |
| Event Type | Inhalation |
| Environmental Factor | Gas/Vapor/Mist/Fume/Smoke/Dust |
| Human Factor | Safety Devices Removed/Inoper. |
| Occupation | Laborers, except construction |
| Degree of Injury | Fatality |
| Task Assigned | Task regularly assigned |
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