Title Page
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Site conducted
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Conducted on
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Prepared by
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Location
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Task being performed
LIFTING.
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Load Dimension
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Frequency (No. of lifts)
- 1 Lift Every 5 Seconds
- 1 Lift Every 9 Seconds
- 1 Lift Every 14 Seconds
- 1 Lift Every Minute
- 1 Lift Every 2 Minutes
- 1 Lift Every 5 Minutes
- 1 Lift Every 30 Minutes
- 1 Lift Every per day
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Weight of item being lifted
- <10kg
- >10kg
- >20kg
- >30kg
- >40kg
- >50kg
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Obtain image of the item being lifted
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Hand distance from lower back
- 1. Close, Upper arms aligned vertically and upright torso
- 2. Moderate, Upper arms angled away from body.
- 3. Moderate, Torso bent forward
- 4. Far, upper arms angled away from body and torso bent forward.
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1. Close: Upper arms aligned vertically and upright torso
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2. Moderate: Upper arms angled away from body.
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3. Moderate: Torso bent forward
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4. Far: Upper arms angled away from body and torso bent forward.
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Vertical lift position.
- 1. Above knee and /or below elbow height.
- 2. Below knee and / or above elbow height.
- 3. Floor level or below or Above head height.
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1. Above knee and/or below elbow height.
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2. Below knee and/or above elbow height.
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3. Floor level or below / Above head height
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Torso twisting and sideways bending.
- 1. Little or no torso twisting or sideways bending.
- 2. Torso twisting or sideways bending.
- 3. Torso twisting and sideways bending.
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1. Little or no torso twisting or sideways bending
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2. Torso twisting or sideways bending
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3. Torso twisting and sideways bending
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Postural Constraints
- No postural Constraints
- Limited space with restricted posture
- Severely limited space and severely restricted posture
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Grip
- Good grip, Item with well designed handles, fit for purpose, Loose parts enabling good grip
- Item with poor handles or handholds, fingers to be clamped at 90 degrees under the item.
- Item with poor design, loose parts, irregular objects, bulky or difficult to handle. Non-regid sacks or unprediccated loads
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Floor surface
- Dry/clean floor in good condition
- Dry floor but in poor condition, worn or uneven
- Contaminated/wet or steep sloping floor or unstable surface or unsuitable footwear
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Other environmental factors: Extremes of temperature (Hot/Cold), strong air movements, extreme lighting (Bright/Dark)
- No factors
- One factor present
- Two or more factors present
CARRYING
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Carrying Frequency
- No postural constraints
- Limited space with restricted posture
- Severely limited space and severely restricted posture.
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Carrying Weight
- <10kg
- >10kg
- >20kg
- >30kg
- >40kg
- >50kg
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Hand distance from lower back.
- Close: Upper arms aligned vertically and upright torso.
- Moderate: Upper arms angled away from body.
- Moderate: Torso bent forward.
- Far: Upper arms angled away from body and torso bent forward
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Close: Upper arms aligned vertically and upright torso.
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Moderate: Upper arms angled away form body.
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Moderate: Torso bent forward
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Far: upper arms angled away form body and torso bent forward
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Asymmetrical torso/load
- Load and hands symmetrical in front of item.
- Load and hand asymmetrical, upright body position.
- One handed carrying to the side
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Load and hands symmetrical in front of item.
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Load and hands asymmetrical, upright body position.
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One handed carrying to the side.
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Postural Constraints
- No postural constraints
- Limited space with restricted posture
- Severely limited space and severely restricted posture.
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Grip
- Good grip, Item with well designed handles, fit for purpose, Loose parts enabling good grip
- Item with poor handles or handholds, fingers to be clamped at 90 degrees under the item.
- Item with poor design, loose parts, irregular objects, bulky or difficult to handle. Non-regid sacks or unprediccated loads
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Floor surface
- Dry/clean floor in good condition
- Dry floor but in poor condition, worn or uneven
- Contaminated/wet or steep sloping floor or unstable surface or unsuitable footwear
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Other environmental factors: Extremes of temperature (Hot/Cold), strong air movements, extreme lighting (Bright/Dark)
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Carrying distance
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Obstacles on route
- No obstacles on route and the carry route is flat
- Steep slope or up steps or throught closed doors or trip hazards.
- Using ladders
COMPLETION
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Name and signature of inspector