MANUAL TASK RISK ASSESSMENT

• Manual Task Assessed:

• Employee Name:

• Prepared by: LGIS Injury Prevention Consultant

• Location
  Address

• LGA:

• Department:

• Job Role:

• Conducted on

  Date

• %Time spent Sitting

• %Time spent Standing

• %Time spent Walking

• %Time spent Bending

• %Time spent Lifting

• %Time spent Other

• If other, please list:

Manual Task 1

• Manual Task

• Work location:

• Average hours per day

• Required PPE:

  Select Long pants and sleeves Protective Footwear Hearing protection Eye protection Face shield Reflective wear Falls protection Harness Chaps Gloves Hard hat Waders Disposable protective suit Respiratory protection Sun protection (hat) Other

  • Long pants and sleeves
  • Protective Footwear
  • Hearing protection
  • Eye protection
  • Face shield
  • Reflective wear
  • Falls protection
  • Harness
  • Chaps
  • Gloves
  • Hard hat
  • Waders
  • Disposable protective suit
  • Respiratory protection
  • Sun protection (hat)
  • Other

• If other; please list:

Do the actions and posture involve:

• Holding loads away from trunk (30cm or greater)

  Select N/A Sedentary Light Medium Heavy Very Heavy

  • N/A
  • Sedentary
  • Light
  • Medium
  • Heavy
  • Very Heavy

• Reaching upwards or load handling above shoulder height

  Select N/A Sedentary Light Medium Heavy Very Heavy

  • N/A
  • Sedentary
  • Light
  • Medium
  • Heavy
  • Very Heavy

• Bending forward or handling below mid-thigh height

  Select N/A Sedentary Light Medium Heavy Very Heavy

  • N/A
  • Sedentary
  • Light
  • Medium
  • Heavy
  • Very Heavy

• Twisting

  Select N/A Sedentary Light Medium Heavy Very Heavy

  • N/A
  • Sedentary
  • Light
  • Medium
  • Heavy
  • Very Heavy

• Sideways bending or load handling by one hand

  Select N/A Sedentary Light Medium Heavy Very Heavy

  • N/A
  • Sedentary
  • Light
  • Medium
  • Heavy
  • Very Heavy

• Long carrying distance

  Select N/A Sedentary Light Medium Heavy Very Heavy

  • N/A
  • Sedentary
  • Light
  • Medium
  • Heavy
  • Very Heavy

• Pushing or pulling

  Select N/A Sedentary Light Medium Heavy Very Heavy

  • N/A
  • Sedentary
  • Light
  • Medium
  • Heavy
  • Very Heavy

• Sudden jerky movements

  Select N/A Sedentary Light Medium Heavy Very Heavy

  • N/A
  • Sedentary
  • Light
  • Medium
  • Heavy
  • Very Heavy

• Exposure to whole-body vibration

  Select N/A Sedentary Light Medium Heavy Very Heavy

  • N/A
  • Sedentary
  • Light
  • Medium
  • Heavy
  • Very Heavy

• Exposure to hand-arm vibration

  Select N/A Sedentary Light Medium Heavy Very Heavy

  • N/A
  • Sedentary
  • Light
  • Medium
  • Heavy
  • Very Heavy

Are the loads:

• Difficult to grasp

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Unstable or unpredictable

  Select Yes No N/A

  • Yes
  • No
  • N/A

• A person or animal

  Select Yes No N/A

  • Yes
  • No
  • N/A

Are the movement repetitive or sustained

• Gripping of objects/tools/controls

  Select N/A Sedentary Light Medium Heavy Very Heavy

  • N/A
  • Sedentary
  • Light
  • Medium
  • Heavy
  • Very Heavy

• Wrist movements with objects/tools/controls

  Select N/A Sedentary Light Medium Heavy Very Heavy

  • N/A
  • Sedentary
  • Light
  • Medium
  • Heavy
  • Very Heavy

• Elbow movements with objects/tools/controls

  Select N/A Sedentary Light Medium Heavy Very Heavy

  • N/A
  • Sedentary
  • Light
  • Medium
  • Heavy
  • Very Heavy

• Shoulder movements with objects/tools/controls

  Select N/A Sedentary Light Medium Heavy Very Heavy

  • N/A
  • Sedentary
  • Light
  • Medium
  • Heavy
  • Very Heavy

• Neck movements

  Select N/A Sedentary Light Medium Heavy Very Heavy

  • N/A
  • Sedentary
  • Light
  • Medium
  • Heavy
  • Very Heavy

• Kneeling, squatting or crouching, crawling

  Select N/A Sedentary Light Medium Heavy Very Heavy

  • N/A
  • Sedentary
  • Light
  • Medium
  • Heavy
  • Very Heavy

• Sitting

  Select N/A Sedentary Light Medium Heavy Very Heavy

  • N/A
  • Sedentary
  • Light
  • Medium
  • Heavy
  • Very Heavy

• Standing

  Select N/A Sedentary Light Medium Heavy Very Heavy

  • N/A
  • Sedentary
  • Light
  • Medium
  • Heavy
  • Very Heavy

• Walking or climbing

  Select N/A Sedentary Light Medium Heavy Very Heavy

  • N/A
  • Sedentary
  • Light
  • Medium
  • Heavy
  • Very Heavy

• Lifting

  Select N/A Sedentary Light Medium Heavy Very Heavy

  • N/A
  • Sedentary
  • Light
  • Medium
  • Heavy
  • Very Heavy

• Other

  Select N/A Sedentary Light Medium Heavy Very Heavy

  • N/A
  • Sedentary
  • Light
  • Medium
  • Heavy
  • Very Heavy

• If other, please list

• Additional Comments/Notes

Please details the equipment used and its weight

• Equipment 1

• undefined

  Select 0-4.5kgs 4.5-9kgs 9-22kgs 22-45kgs >45kgs

  • 0-4.5kgs
  • 4.5-9kgs
  • 9-22kgs
  • 22-45kgs
  • >45kgs

• Equipment 2

• undefined

  Select 0-4.5kgs 4.5-9kgs 9-22kgs 22-45kgs >45kgs

  • 0-4.5kgs
  • 4.5-9kgs
  • 9-22kgs
  • 22-45kgs
  • >45kgs

• Equipment 3

• undefined

  Select 0-4.5kgs 4.5-9kgs 9-22kgs 22-45kgs >45kgs

  • 0-4.5kgs
  • 4.5-9kgs
  • 9-22kgs
  • 22-45kgs
  • >45kgs

• Equipment 4

• undefined

  Select 0-4.5kgs 4.5-9kgs 9-22kgs 22-45kgs >45kgs

  • 0-4.5kgs
  • 4.5-9kgs
  • 9-22kgs
  • 22-45kgs
  • >45kgs

• Equipment 5

• undefined

  Select 0-4.5kgs 4.5-9kgs 9-22kgs 22-45kgs >45kgs

  • 0-4.5kgs
  • 4.5-9kgs
  • 9-22kgs
  • 22-45kgs
  • >45kgs

• Equipment 6

• undefined

  Select 0-4.5kgs 4.5-9kgs 9-22kgs 22-45kgs >45kgs

  • 0-4.5kgs
  • 4.5-9kgs
  • 9-22kgs
  • 22-45kgs
  • >45kgs

• Equipment 7

• undefined

  Select 0-4.5kgs 4.5-9kgs 9-22kgs 22-45kgs >45kgs

  • 0-4.5kgs
  • 4.5-9kgs
  • 9-22kgs
  • 22-45kgs
  • >45kgs

• Equipment 8

• undefined

  Select 0-4.5kgs 4.5-9kgs 9-22kgs 22-45kgs >45kgs

  • 0-4.5kgs
  • 4.5-9kgs
  • 9-22kgs
  • 22-45kgs
  • >45kgs

• Equipment 9

• undefined

  Select 0-4.5kgs 4.5-9kgs 9-22kgs 22-45kgs >45kgs

  • 0-4.5kgs
  • 4.5-9kgs
  • 9-22kgs
  • 22-45kgs
  • >45kgs

• Equipment 10

• undefined

  Select 0-4.5kgs 4.5-9kgs 9-22kgs 22-45kgs >45kgs

  • 0-4.5kgs
  • 4.5-9kgs
  • 9-22kgs
  • 22-45kgs
  • >45kgs

• Summary:

• Identified Manual Task Risks:

• Recommendations: