Information
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Document No.
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Portfolio
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Building & Room #
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Workstation Ergonomic Assessment for:
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Conducted on
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Prepared by
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Location
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Employee name:
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Employee concerns/symptoms:
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Date & Time of audit.
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Photograph of the workstation #1
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Photograph of workstation #2
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Photograph of workstation #3
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Photograph of workstation #4
Chair
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Feet cannot rest flat on the floor.
- Yes
- No
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Raise / lower chair to allow feet to rest comfortably on th floor
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Use footrest if keyboard/ desk height requires an elevated chair.
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Unable to sit with thighs parallel to the floor, or with a slight downwards angle.
- Yes
- No
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Adjust chair heights so that feet remain flat on floor or footrest.
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Front edge of seatpan presses into back of knee.
- Yes
- No
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Choose a chair with 2-3 fingers width between front edge of chair and back of knee.
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Attach removable back support cushion.
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Choose a chair with curved front edge.
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Replace seatpan
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Space exists between spine and back rest.
- Yes
- No
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Arrange workstation to allow proper back support.
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Remove or lower arm rests.
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Replace seatpan.
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Armrest provide inadequate forearm support when keying or mousing
- Yes
- No
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Armrest are too low or too high
- Yes
- No
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Add padding
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Only use armrest for short period
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Replce with adjustable armrest.
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Armrest are too wide
- Yes
- No
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Adjust closer
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Replace with narrow seatpan
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Replace with width adjustable armrest.
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Notes:
Keyboard and mouse
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Wrist is not flat , forearm not parallel with floor.
- Yes
- No
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Place on keyboard tray
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Support arms on armrest.
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Adjust seat height
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Retract keyboard feet
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Adjust work surface
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Wrist is deviated when using keyboard, mouse or input device.
- Yes
- No
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Ensure adequate space for input device.
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Use appropriately sized keyboard.
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Reaching to side or front when using mouse or other devices.
- Yes
- No
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Place mouse appropriatly
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Use mouse on left side
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Use keyboard with numeric pad
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Ensure adequate space available for devices.
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Notes:
Monitor and Workstation
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Head titlted up and down
- Yes
- No
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Raise or lower monitor
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Place document holder
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Head turn side to side
- Yes
- No
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Position monitor in front
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Place document holder between worker and monitor.
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Neck tilted to the side
- Yes
- No
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Maintain one hand on phone
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Use hand free system
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Head not directly over spine
- Yes
- No
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Arrange workstation for proper posture.
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Hard / sharp objects press into skin.
- Yes
- No
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Move devices
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Use palm rest
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Raise chair so devices are below elbow height
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Pad sharp edge with foam
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Replace with rounded edge devices
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Install keyboard tray
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Twisting of torso
- Yes
- No
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Arranges accessories on the strong hand side
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Locate phone on the opposite side
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Determine mostly used devices
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Encourage standing up for retreiving items
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Inadequate space under desk for legs.
- Yes
- No
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Raise desktop surface
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Remove marerials under the desk.
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Install keyboard tray.
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Repeated or prolonged trunk bending
- Yes
- No
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Adjust to get neutral back posture.
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Notes:
Environemental
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Adequate lighting
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No Glare on monitor
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Room temperature is adequate?
Recommendations
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Recommendations:
Audit required signatures.
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Employee
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Supervisor
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Health and Safety Representative Signature