A man had to be cut free after his leg was trapped in a machine for an hour.
Firefighters were called to the incident at DS Smith Packaging's plant at the Houston industrial estate, Livingston, at 0448 BST.
The 30-year-old was freed at about 0550 and taken to Edinburgh Royal Infirmary with severe leg injuries.
The company, which was fined in 2006 after an employee in Lincolnshire died after being crushed in a machine, said it took staff safety very seriously.
The Health and Safety Executive is investigating the Livingston incident and said an inspector was visiting the site.
Previous accident
In a statement, a spokesman from the company said: "Our immediate concern is for the welfare of the employee and the company wishes to state that it takes the safety of its employees very seriously.
"At this stage, the incident is still being investigated and we cannot comment further until that investigation has been completed. Further details will be released as soon as more information becomes available."
The packaging company was ordered to pay £75,000 in February 2006 after a worker was dragged into a machine and crushed to death.
Colin Blades, 34, of Louth, had reached inside a press to free a blockage when he inadvertently started it up again.
A preventative measure would have cost DS Smith Packaging less than £100, Lincoln Crown Court heard.
The firm admitted breaching the Health and Safety at Work Act by failing to ensure the worker's safety.
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