QSHE 195a Manual Handling Assessment - Single Person Lift

• Site conducted

  Select

• Conducted on

  Date

• Prepared by

• Location
  Address

• Task being performed

LIFTING.

• Load Dimension

• Frequency (No. of lifts)

  Select 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

  • 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

• Weight of item being lifted

  Select <10kg >10kg >20kg >30kg >40kg >50kg

  • <10kg
  • >10kg
  • >20kg
  • >30kg
  • >40kg
  • >50kg

• Add media

  Media

• Hand distance from lower back

  Select 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.

  • 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.

• 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.

  

• Vertical lift position.

  Select 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.

  • 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.

• 1. Above knee and/or below elbow height.

  

• 2. Below knee and/or above elbow height.

  

• 3. Floor level or below / Above head height

  

• Torso twisting and sideways bending.

  Select 1. Little or no torso twisting or sideways bending. 2. Torso twisting or sideways bending. 3. 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.

• 1. Little or no torso twisting or sideways bending

  

• 2. Torso twisting or sideways bending

  

• 3. Torso twisting and sideways bending

  

• Postural Constraints

  Select No postural Constraints Limited space with restricted posture Severely limited space and severely restricted posture

  • No postural Constraints
  • Limited space with restricted posture
  • Severely limited space and severely restricted posture

• Grip

  Select 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

  • 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

• Floor surface

  Select 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

  • 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

• 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

• Carrying Frequency

  Select Carrying an item every 12 Seconds Carrying an item Once per Minute Carrying an item every2 Minutes Carrying an item every5 Minutes Carrying an item every30 Minutes Carrying an item Once per day

  • Carrying an item every 12 Seconds
  • Carrying an item Once per Minute
  • Carrying an item every2 Minutes
  • Carrying an item every5 Minutes
  • Carrying an item every30 Minutes
  • Carrying an item Once per day

• Carrying Weight

  Select <10kg >10kg >20kg >30kg >40kg >50kg

  • <10kg
  • >10kg
  • >20kg
  • >30kg
  • >40kg
  • >50kg

• Hand distance from lower back.

  Select 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

  • 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

• Close: Upper arms aligned vertically and upright torso.

  

• Moderate: Upper arms angled away form body.

• Moderate: Torso bent forward

  

• Far: upper arms angled away form body and torso bent forward

  

• Asymmetrical torso/load

  Select Load and hands symmetrical in front of item. Load and hand asymmetrical, upright body position. One handed carrying to the side

  • Load and hands symmetrical in front of item.
  • Load and hand asymmetrical, upright body position.
  • One handed carrying to the side

• Load and hands symmetrical in front of item.

  

• Load and hands asymmetrical, upright body position.

  

• One handed carrying to the side.

  

• Postural Constraints

  Select No postural constraints Limited space with restricted posture Severely limited space and severely restricted posture.

  • No postural constraints
  • Limited space with restricted posture
  • Severely limited space and severely restricted posture.

• Grip

  Select 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

  • 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

• Floor surface

  Select 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

  • 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

• 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 distance

  2m-4m

  4m-10m

  10m or more

• Obstacles on route

  Select No obstacles on route and the carry route is flat Steep slope or up steps or throught closed doors or trip hazards. Using ladders

  • 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

• Name and signature of inspector

  Sign