Title Page

  • Assessment date

  • Assessor

  • Task

Factors, do they involve:

  • 1. Holding or manipulating loads at distance from trunk?

  • Actions to reduce risk?

  • 2. Unsatisfactory bodily movement or posture, especially:

  • a) Twisting the trunk?

  • Actions to reduce risk?

  • b) Stooping?

  • Actions to reduce risk?

  • c) Reaching upwards?

  • Actions to reduce risk?

  • 3. Excessive movement of loads, especially:

  • a) Excessive lifting or lowering distances?

  • Actions to reduce risk?

  • b) Excessive carrying distances?

  • Actions to reduce risk?

  • c) Excessive pushing or pulling of loads?

  • Actions to reduce risk?

  • 4. Risk of sudden movement of loads?

  • Actions to reduce risk?

  • 5. Frequent or prolonged physical effort?

  • Actions to reduce risk?

  • 6. Insufficient rest or recovery periods?

  • Actions to reduce risk?

  • 7. A rate of work imposed by a process?

  • Actions to reduce risk?

Are they:

  • 8. Heavy?

  • Actions to reduce risk?

  • 9. Bulky or unwieldy?

  • Actions to reduce risk?

  • 10 .Difficult to grasp?

  • Actions to reduce risk?

  • 11. Unstable, or with contents likely to shift?

  • Actions to reduce risk?

  • 12. Sharp, hot or otherwise potentially damaging?

  • Actions to reduce risk?

Are there:

  • 13. Space constraints preventing good posture?

  • Actions to reduce risk?

  • 14. Uneven, slippery or unstable floors?

  • Actions to reduce risk?

  • 15. Variations in level of floors or work surfaces?

  • Actions to reduce risk?

  • 16. Extremes of temperature or humidity?

  • Actions to reduce risk?

  • 17. Conditions causing ventilation problems or gusts of wind?

  • Actions to reduce risk?

  • 18. Poor lighting conditions?

  • Actions to reduce risk?

Does the job:

  • 19. Require unusual strength, height, etc?

  • Actions to reduce risk?

  • 20. Create a hazard to those who might reasonably be considered to be pregnant or to have a health problem?

  • Actions to reduce risk?

  • 21. Require special information or training for its safe performance?

  • Actions to reduce risk?

Untitled Page

  • Risk Ranking Number of YES answers
    Low Less than 2
    Medium Between 2 and 4
    High Greater than 4

    Tasks which have a medium or high risk ranking must have control measures developed to reduce the risk to an acceptable level.

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