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| Inspection Nr | 108054933 |
| Investigation Nr | 913459 |
| Line Nr | 1 |
| Age | |
| Sex | |
| Nature of Injury | Poisoning(Systemic) |
| Part of Body | Othbodysys |
| Source of Injury | Chem Liquids/Vapors |
| Event Type | Inhalation |
| Environmental Factor | Gas/Vapor/Mist/Fume/Smoke/Dust |
| Human Factor | Insuff/Lack/Writn Wrk Prac Prog. |
| Occupation | Occupation not reported |
| Degree of Injury | Fatality |
| Task Assigned | Task not regularly assigned |
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