Risk Assessment of: Insert task and location Assessor(s): Date: Insert name and role Insert date of assessment Overview of activity / location / equipment / conditions being assessed: Insert description Identification and Rating of Risk Factor Yes The Individuals Does the Yes / Yes / The Environment Are Yes / – – The Load Is it: The Task - Does it involve: – / No job: No No there: No heavy? require unusual strength, holding or manipulating space constraints height etc? loads at distance from preventing ergonomic trunk? posture? bulky or unwieldy? create a hazard to those unsatisfactory bodily uneven, slippery or who might reasonably be movement or posture, unstable floors? considered to be especially: pregnant or to have a twisting the trunk? health problem or other Stooping? vulnerability? Reaching upwards? Difficult to grasp? Require special excessive movement of Variations in level of information or training for loads, especially: floors or work surfaces? its safe performance? Excessive lifting or lowering distances? Excessive carrying distances? Excessive pushing or pulling of loads? Y Unstable, or with Is movement or posture Frequent or prolonged Extremes of contents likely to shift? hindered by personal physical effort? temperature or protective equipment or humidity? by clothing?
Risk Assessment of: Insert task and location Assessor(s): Insert name and role Date: Insert date of assessment Overview of activity / location / equipment / conditions being assessed: Insert description Identification and Rating of Risk Factor The Load – Is it: Yes / No The Individuals – Does the job: Yes / No The Task - Does it involve: Yes / No The Environment – Are there: Yes / No heavy? require unusual strength, height etc? holding or manipulating loads at distance from trunk? space constraints preventing ergonomic posture? bulky or unwieldy? create a hazard to those who might reasonably be considered to be pregnant or to have a health problem or other vulnerability? unsatisfactory bodily movement or posture, especially: uneven, slippery or unstable floors? twisting the trunk? Stooping? Reaching upwards? Difficult to grasp? Require special information or training for its safe performance? excessive movement of loads, especially: Excessive lifting or lowering distances? Excessive carrying distances? Excessive pushing or pulling of loads? Variations in level of floors or work surfaces? Unstable, or with contents likely to shift? Is movement or posture hindered by personal protective equipment or by clothing? Frequent or prolonged physical effort? Y Extremes of temperature or humidity?