Please indicate how much you agree with each statement (past 30 days).
Rows Strongly disagree Disagree Neither agree nor disagree Agree Strongly agree I felt comfortable speaking up about hazards. • • • • • My team stops work when conditions feel unsafe. • • • • • Supervisors address reported safety issues promptly. • • • • • Safety rules were not overridden by production pressure. • • • • • Safety rules were enforced consistently. • • • • • I received useful feedback after raising a concern. • • • • •
Over the past 30 days, safety was prioritized over production on my crew.
Scale: 11 (star)
Min: Strongly disagree Max: Strongly agree
How do you usually report hazards, near misses, or incidents on this site? Select all that apply.
Tell supervisor in person Paper or card Radio/phone call Mobile app Computer kiosk/terminal Safety hotline Toolbox talk/team meeting
When a hazard or near miss occurs, how often do you personally report it? (past 30 days)
Every time Most times About half the time Occasionally Never Not applicable (no issues observed)
How many near-miss events did you personally observe in the past 30 days? Enter 0 if none.
Accepts a numeric value
Whole numbers only
On average, how many minutes does it take you to complete a typical safety report?
Accepts a numeric value
Whole numbers only
Which of the following have you reported in the past 90 days? Select all that apply.
Near miss Minor injury (first aid) Recordable injury Unsafe condition/housekeeping Equipment damage/failure Environmental spill/release Vehicle incident
What makes reporting harder on your site? Select all that apply.
Unclear what should be reported Takes too much time to complete Fear of blame or negative consequences Little or no feedback after reporting Reporting system is difficult to use Belief that minor issues don’t matter Lack of supervisor support Language or communication barriers
Please rank what most motivates you to report, from most to least motivating.
Drag to order (top = most important)
Protect coworkers and myself Fix hazards quickly Company expects it Regulatory compliance Recognition for reporting Option to report anonymously
In the past 90 days, I could report issues without fear of blame or punishment.
Range: 1 – 10
Min: Strongly disagree Mid: Neutral Max: Strongly agree
I clearly know what should be reported and how to do it (past 30 days).
Range: 1 – 10
Min: Strongly disagree Mid: Neutral Max: Strongly agree
Attention check: To confirm you are paying attention, please select "Agree" for this item.
Range: 1 – 10
Min: Strongly disagree Mid: Neutral Max: Strongly agree
What is your primary job role on this site?
Operator/Production Maintenance/Trades Supervisor/Foreman Safety/Health Engineer/Planner Contractor Other
What is your employment status?
Employee Contractor Visitor/Temporary Other
What shift do you typically work?
How long have you worked in mining?
Less than 1 year 1–3 years 4–9 years 10–19 years 20 or more years
How long have you worked at this site?
Less than 1 month 1–6 months 7–12 months 1–3 years More than 3 years
What is your primary work environment?
Surface Underground Both Other
Which region do you primarily work in?
North America South America Europe Africa Asia Australia/New Zealand Other
What would make reporting easier or faster at this site? Be specific if possible.
Max 600 chars
Welcome! This short survey takes about 5–7 minutes. Please answer based on your recent experience (past 30–90 days). Your responses are confidential and used to improve safety.
AI Interview: 2 Follow-up Questions on Site Safety Reporting
Length: 2 Personality: [Object Object] Mode: Fast
Thank you for completing the survey. Your input helps strengthen safety and reporting on site.