PPE Checklist Template

Audit

Material from this audit is an interpretation of Fire Safety and Prevention Guidelines per OSHA regulations. The checklist was modeled from industry guidelines laid out on: https://www.osha.gov/dte/library/ppe_assessment/ppe_assessment.html

**INSTRUCTIONS** Review the following audit to identify and evaluate need for Personal Protective Equipment in a given workplace. Answer "SAFE" if employee is not likely to be exposed to work condition listed below. Answer "AT RISK" if employee may be exposed to work condition

EYES

Eye and Protection Criteria * Protect against specific hazard(s) encountered by employees * Comfortable to wear * Must not restrict vision or movement * Durable and easy to clean and disinfect * Must not interfere with the function of other required PPE * Meets requirements of ANSI Z87.1-1989 for devices purchased after July 5, 1992 and ANSI Z87.1-1968for devices purchased before that date

Employees Perform tasks, or work near employees that perform tasks, that might produce airborne dust or flying particles

Employees handle, or work near employees who handle hazardous liquid chemicals or encounter blood splashes

Employees' eyes exposed to other potential physical or chemical irritants

Employee exposed to intense light or lasers

FACE

Eye and Protection Criteria * Protect against specific hazard(s) encountered by employees * Comfortable to wear * Must not restrict vision or movement * Durable and easy to clean and disinfect * Must not interfere with the function of other required PPE * Meets requirements of ANSI Z87.1-1989 for devices purchased after July 5, 1992 and ANSI Z87.1-1968for devices purchased before that date

Employee handles or works near employees who handle hazardous liquid chemicals

Employees' faces are exposed to extreme heat

Employees' faces are exposed to other potential irritants

HEAD

Tools or other objects may potentially fall from above and strike your employee on the head

Employees' heads, when they stand or bend, are near exposed beams, machine parts, pipes, etc.?

Employees work with or are in close proximity to electrical wiring or components of electrical wiring

FEET

Tools, heavy equipment or other objects may potentially roll, fall onto or strike employees' feet

Employees work with or are near exposed electrical wiring or electrical wiring components

Employees handle or work with those who handle molten metal

Employees work with explosives or are in an explosive atmosphere

HANDS

Employees' hands may come into contact with tools or materials that might scrape, bruise or cut

Employees handle chemicals that might irritate skin or come into contact with blood

Employees place their hands and arms near extreme heat

Employees' hands and arms are placed ear exposed electrical wiring or components

BODY

Employees' bodies exposed to irritating dust or chemical splashes

Employees' bodies exposed to sharp or rough surfaces

Employees' bodies exposed to extreme heat

Employees' bodies exposed to acids or other hazardous substances

HEARING

Employees are exposed to loud noise from machines, tools, music systems, etc.