Job Safety Analysis

• Site conducted

  Select

• Activity / Task being performed

• Approved by

• Date

  Date

• Training required to complete this task

JSA Risk Asseement Matrix

Heirarchy of Controls

• 

• Note: All Workers undertaking this task will read and sign the last page of this JSA

Falls / Objects falling

• Working from or Using a ladder to access the work area?

• Does the task require work on an elevated workplace?

• Falling trees or objects?

• Working in the vicinity of an edge over which a person could fall?

• Working on a surface through which a person could fall?

• Working or near an excavation or pit?

• Working in the vicinity of an opening through which a person could fall?

Manual Handling

• Does the task involve repetitive or sustained postures, movements or forces? E.g. bending or twisting the back, neck, arms or wrists / reaching, lifting, pushing, pulling.
  If so, is the task completed for more than 2 hours over a day or for more than 30 minutes continuously?
  

• Does the task involve high force? E.g. Lifting, lowering or carrying heavy loads; pushing, pulling objects that are hard to move.

• Does the task involve exposure to sustained vibration for more than 30 minutes continuously or for more than 2 hours over a whole shift?

Plant & Equipment

• Entanglement
  Crushing
  Cutting / Stabbing or Puncturing
  Shearing / Striking
  Noise:
  Are you exposed to more than, for example:
  85db for 8 hrs
  88db for 4 hrs
  91db for 2 hrs
  94db for 1 hrs
  97db for 30 min
  100db for 15 min
  (Decibels increase by 3 and exposure time halves)
  
  Electrical
  Pressurised Water / Air
  Other:

Hazardous Chemicals / Materials

• Chemical exposure - eyes
  Chemical exposure - general public
  Chemical exposure - inhalation
  Chemical exposure - ingestion
  Chemical exposure - injection
  Chemical exposure - skin / body contact
  Exposed to Asbestos
  Exposed to Lead
  Fire or explosion
  Ignition sources
  Inappropriate Storage
  Lack of ventilation
  Spills
  Unlabelled containers
  Unsecure chemicals
  Other:

Environmental / People Factors

• Bites – Insects / Snakes
  Dust
  Contractors use
  Electrical – Overhead Power lines
  General Public
  Fatigue
  Heat Stress
  Lighting - poor
  New Starter / Inexperienced
  Other person’s working in the vicinity
  Sharps - Syringes
  Slips and Trips
  Traffic Exposure
  UV Exposure
  Underground Services
  Violence / Aggression
  Weather – Hot / Cold / Wind / Lighting
  Stress

• Controls are required for all these risks above

Activity

• List the tasks required to perform the activity in the sequence they are carried out

Potential Hazards / Risks

• Against each task list the hazards that could cause injury when the task is performed

• Risk Rating

  High

  Medium

  Low

Risk Control Measures

• List the control measures required to eliminate or minimise the risk of injury arising from the identified hazard. Follow the hierarchy of control

• Residual Risk Rating

  High

  Medium

  Low

Who is Responsible?

• Write the name of the person responsible for implementing the control measures

• Name

• Signature (by signing below you are acknowledging that you have read and understood this JSA)

  Sign