0 1 Hot/cold/humid conditions? 0 2 Windy weather? 0 1 Poor lighting conditions? SUB TOTAL (carry forward to page 2) SUB TOTAL (brought forward from page 1) NO INDIVIDUAL CAPABILITY does the job YES SCORE – 0 2 Require unusual strength/height? 0 2 Call for additional information/training? OTHER FACTORS can movement or – possible posture be hindered by 0 1 Clothing? 0 1 Personal protective equipment? FINAL SUB TOTAL IF THE TASK INVOLVES TIME PRESSURES ADD 10 RISK FACTOR Does the activity involve: Risk TOTAL RISK RATING (select one of the below) Factor Frequent handling (several X 4 = times a day) Regular handling (several X 3 = times a week) Occasional handling (several X 2 = a month) Infrequent handling (several X 1 = times a year) Total Risk Rating: Risk Rating 0-10 10-40 40-70 70-100 Very Low Risk; Low Risk; Significant Risk; High 100-200 200-300 Risk; Very High Risk; Unacceptable risk. Remedial action to take in order of priority Date to be Date completed by completed
Hot/cold/humid conditions? 0 1 Windy weather? 0 2 Poor lighting conditions? 0 1 SUB TOTAL (carry forward to page 2) SUB TOTAL (brought forward from page 1) INDIVIDUAL CAPABILITY – does the job NO YES SCORE Require unusual strength/height? 0 2 Call for additional information/training? 0 2 OTHER FACTORS – can movement or possible posture be hindered by Clothing? 0 1 Personal protective equipment? 0 1 FINAL SUB TOTAL IF THE TASK INVOLVES TIME PRESSURES ADD 10 RISK FACTOR Does the activity involve: (select one of the below) Risk Factor TOTAL RISK RATING Frequent handling (several times a day) X 4 = Regular handling (several times a week) X 3 = Occasional handling (several a month) X 2 = Infrequent handling (several times a year) X 1 = Total Risk Rating: Risk Rating 0-10 Very Low Risk; 10-40 Low Risk; 40-70 Significant Risk; 70-100 High Risk; 100-200 Very High Risk; 200-300 Unacceptable risk. Remedial action to take in order of priority Date to be completed by Date completed