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Dust Risk Assessment Template

Inspection

Overview

Description of procedure, task or worksite being assessed

Risk Matrix and Hierarchy of Controls

Risk Matrix Reference:

Hierarchy of Controls Reference:

Hazard Register

Hazard

Description of hazard

Photo of hazard (optional)

Type of Dust

Risk Rating

Consequences

Likelihood

Risk Rating (refer risk matrix above)

Controls

Select control measures

Elimination
Substitution
Engineering Controls
Administrative Controls
PPE
Other

Description of support measures

Completion

Recommendations

Name and Signature of Safety Officer

Dust Risk Assessment Template Checklist

Created by: SafetyCulture Staff | Industry: General | Downloads: 25

A dust risk assessment checklist helps to monitor employees’ exposure to construction dust and implement control measures to prevent acquisition of respiratory related diseases.

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