Title Page
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Conducted on
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Area/Department
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Prepared by
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plant risk assessed
Can the following items become ENTANGLED with moving parts of the plant, or materials in motion:
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Hair, Jewellery, Rags, Gloves, clothing
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Other materials – specify:
EMERGENCY STOP BUTTONS - can injury from interaction with the plant be caused by:
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Lack of prominence of emergency stop Emergency stop not being fail safe
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Emergency stop not red in colour
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Stored energy being released slowly or at a sequent time
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Lack of clarity of emergency stop markings
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Restarting plant by resetting the emergency stop button
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Other factors – specify:
Can anyone be CRUSHED due to:
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Falling, uncontrolled or unexpected movement of plant
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Lack of capacity to slow, stop or immobilize the plant
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Falling, uncontrolled or unexpected movement of plant’s load
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Under or trapped between plant and materials or fixed structure
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Contact with moving parts during testing, inspection, maintenance, cleaning or repair
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Tipping or rolling over Parts of plant collapsing
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Being thrown off
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Other factors – specify:
Can anyone be CUT, STABBED or PUNCTURED by coming in contact with:
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Moving plant or parts
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Sharp or flying objects
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Work pieces disintegrated
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Work pieces ejected
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Other factors – specify: <br> <br>
SHEARING – Can anyone’s body parts be cut off between:
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Two parts of the plant
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A part of the plan and a work piece or structure
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Other factors – specify:
Can anyone be injured by ELECTRICAL shock or burnt due to:
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Damaged/poorly maintained leads or switch
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Working near or contact with live electrical conductors
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Water near electrical equipment Lack of isolation procedures
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Other factors – specify:
Can anyone be injured by an EXPLOSION of the following items triggered by plant operation
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Gas Dust
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Vapours Liquids
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Other factors – specify:
FRICTION - Can anyone be burnt due to:
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Contact with moving parts or surfaces of the plant
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Material handled by the plant
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Other factors – specify:
Can anyone be STRUCK by moving objects due to:
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Plant or work pieces being ejected or disintegrated Mobility
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Uncontrolled or unexpected plant movement
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Other factors – specify:
Can anyone using the plant or in the vicinity of the plant, SLIP, TRIP or FALL due to:
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The working environment Uneven work surfaces Lack of guardrails
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Uneven work surfaces Lack of guardrails
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Slippery work surfaces
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Poor housekeeping
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Other factors – specify:
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Lack of oxygen
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Atmospheric contamination
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Other factors – specify:
HIGH TEMPERATURE OR FIRE – Can anyone:
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Come into contact with objects at high temperature
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Be injured by fire
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Other factors – specify:
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Exposure to high temperatures
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Exposure to low temperatures
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Other factors – specify:
Can anyone come into contact with FLUIDS or GASES under HIGH PRESSURE due to:
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Failure of the plant? Misuse of the plant?
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Other factors – specify:
ERGONOMIC (incl Manual Handling) –
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Seating design
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Excessive effort
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Poor lighting
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Controls layout and design
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Repetitive body movement or posture
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Poor workplace or plant design
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Lack of consideration for human behaviour causing mental or physical stress
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Other factors – specify:
Can anyone be injured or suffer ill health from exposure to OTHER HAZARDS:
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Chemicals Fumes Dusts
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Vibration Noise Biologicals
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Toxic gases or vapours
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Ionising Radiation Non-Ionising Radiation
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Other factors – specify:
Does the plant generate significant environmental aspects due to:
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Energy consumption Hazardous emissions Water consumption
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Nuisance noise Hazardous waste Dust
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Other factors – specify:
