Title Page

  • Document No.

  • Conducted on

  • Department.
  • Personnel

  • Task being assessed.

  • Does the task involve lifting?

  • 1
  • Which coloured area of the chart does the load weight/frequency of the lifting operation fall into?

  • 2
  • Hand distance from the lower back

  • 3
  • Vertical lift region

  • 4
  • Torso twisting and sideways bending

  • Postural constraints<br>I.e narrow gap between pallet and table.

  • 6
  • Grip on the load

  • Floor surface

  • Other environmental factors <br>Observe the work environment and score if the lifting operation takes place in extremes of temperature; with strong air movements; or in extreme lighting dark or bright.

  • Does the task involve carrying?

  • 7
  • Which coloured area of the chart does the load/weight frequency of the carry operation fall into?

  • 2
  • Hand distance from the lower back

  • 8
  • Asymmetrical torso/load

  • Postural constraints<br>I.e narrow gap between pallet and table.

  • 6
  • Grip on the load

  • Floor surface

  • Other environmental factors <br>Observe the work environment and score if the lifting operation takes place in extremes of temperature; with strong air movements; or in extreme lighting dark or bright.

  • Carry distance<br>Observe the task and estimate the total distance that the load is carried.

  • Obstacles on route<br>

  • Does the task involve team handling

  • Load weight

  • 9
  • Hand distance from the lower back

  • Torso twisting and sideways bending

  • 10
  • Vertical lift region.

  • Postural constraints<br>I.e narrow gap between pallet and table.

  • 6
  • Grip on the load

  • Floor surface

  • Other environmental factors <br>Observe the work environment and score if the lifting operation takes place in extremes of temperature; with strong air movements; or in extreme lighting dark or bright.

  • Communication between the operatives is essential when lifting as a team. E.g. Counting to three before lifting. Look to see if the team have control of the load, that it is lifted smoothly and that all members lift together.

  • Take a photo (or multiple photos) of the task.

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