Health & Safety
chemical risk assessment Form
Ra No.: / Date: / Version No.: / Review Date: / Authorised by: /
STEP 1 – ENTER INFORMATION ABOUT THE ACTIVITY/TASK, ITS LOCATION AND THE PEOPLE COMPLETING THE RISK ASSESSMENT /
Location name: / Building No.: / Room No.: / Date: / Assessed by: / HSR/Employee representative:
Chemical (Manufacturer’s name and product name):
Ethanol / Is the chemical a hazardous substance?
Yes No / If “yes” list the hazard statement:
H225, H315,H320, H335, H401
Is the chemical a dangerous good?
Yes No / If “yes” list the dangerous goods class:
3.1 / Is the chemical a scheduled poison?
Yes No / If “yes” list the poison schedule:
Description of work/activities/use:
Used for qualitative analysis research
Are there any licencing/permit requirements?
Yes No / If “yes” provide details:
There a no mandatory licencsing requirements however there may be ATO licensing requirements, associated with revenue, dependant on the local area arrangements. / Health surveillance requirements (list “nil” if not required):
Nil / A current MSDS/SDS is available
Yes
Exposure route of chemical:
Inhalation Skin (absorption) Eye Ingestion Injection Other – Specify:
Workplace conditions (Describe layout and physical conditions - including access and egress):
Purpose built PC2 laboratory with fumes hoods and restricted access.
What are the storage requirements?
Store in a flammable liquids cabinet that meet the requirements of AS 1940 The storage and handling of flammable and combustible liquids. Cumulative amount of all flammable liquids in the laboroatory to be < 150 ml. Segregate from Class 5 dangerous goods. / What are the waste/disposal requirements?
Use the University waste procedure and the preferred hazardous waste contractor
List systems of work for the activity/task:
● Training ● Inspections
● SOPs ● Existing controls
● Emergency situations / Chemical management training
Equipment use SOP
Bimonthly workplace inspections – include chemical storage and use
Is there past experience with the chemical that may assist in the assessment?
● Existing controls ● SOPs ● Standards
● Industry standards ● Incidents & near-hits ● Legislation & Codes
● Training ● Incident Investigation ● Guidance material / Chemical management training
AS 1940: The storage and handling of flammable and combustible liquids
Dangerous Goods (Storage and Handling) Regulations 2012 OHS Act 2004. OHS Regulations 2007
University of Melbourne chemical management guidance material. Chemical Risk Management Procedure
First aid and emergency requirements
● Additional first aid kit contents ● Special first aid requirements (eg oxygen)
● Emergency eyewash ● Emergency shower
● Spill kit ● Neutralising agent ● Restrict access / Burns and eye module for first aid kit
Vermiculite or Attapulgite absorbent material
University of Melbourne local area emergency procedures (see last page)
Local area first aid procedures (see last page)

safety.unimelb.edu.au HEALTH & SAFETY: chemical Risk Assessment Form – Ethanol 1

Template date: June 2015 Version: 1.0 Authorised by: Associate Director, Health & Safety Next Review: June 2018

© The University of Melbourne – Uncontrolled when printed.

Step 2: Select a Risk Rating Method

safety.unimelb.edu.au HEALTH & SAFETY: chemical Risk Assessment Form – Ethanol 1

Template date: June 2015 Version: 1.0 Authorised by: Associate Director, Health & Safety Next Review: June 2018

© The University of Melbourne – Uncontrolled when printed.

Two Variable Risk Matrix

(1) Definitions of likelihood labels
Level / Likelihood (Probability)
Descriptor / Description / Expected to occur
A / Almost certain / The event will occur on an annual basis / Once a year or more
B / Likely / The event has occurred several times or more in your career / Once every three years
C / Possible / The event might occur once in your career / Once every 10 years
D / Unlikely / The event does occur somewhere from time to time / Once every 30 years
E / Rare / Heard of something like the event occurring elsewhere / Once every 100 years
(2) Definitions of consequence labels
Severity level / Consequences
V Catastrophe / One or more fatalities and/or severe irreversible disability to one or more people
IV Major / Extensive injury or impairment to one or more persons
III Moderate / Short term disability to one or more persons
II Insignificant / Medical treatment and/or lost injury time <2 weeks
I Negligible / First aid treatment or no treatment required
(3) Risk rating matrix
Likelihood
label / Consequence label
I / II / III / IV / V
A / Medium / High / High / Very high / Very high
B / Medium / Medium / High / High / Very high
C / Low / Medium / High / High / High
D / Low / Low / Medium / Medium / High
E / Low / Low / Medium / Medium / High


Three Variable Risk Calculator

(1) Definitions of exposure variables
Exposure / E
Continuously or many times daily / 10
Frequently: Approximately once daily / 6
Occasionally: Once a week to once a month / 3
Infrequently: Once a month to once a year / 2
Rarely: Has been known to occur / 1
Very rarely: Not known to have occurred / 0.5
(2) Definitions of likelihood variables
Likelihood / L
Almost certain: The most likely outcome if the event occurs / 10
Likely: Not unusual, perhaps 50-50 chance / 6
Unusual but possible: (e.g. 1 in 10) / 3
Remotely possible: A possible coincidence (e.g. 1 in 100) / 1
Conceivable: Has never happened in years of exposure, but possible (eg 1 in 1,000) / 0.5
Practically impossible: Not to knowledge ever happened anywhere (e.g. 1 in 10,000) / 0. 1
(3) Definitions of consequence variables
Consequences / C
Catastrophe: Multiple fatalities / 100
Disaster: Fatality / 50
Very serious: Permanent disability/ill health / 25
Serious: Non-permanent injury or ill health / 15
Important: Medical attention needed / 5
Noticeable: Minor cuts and bruises or sickness / 1
(4) Risk score calculator
Risk Score = E x L x C
Risk score / Risk rating
> 600 / Very high
300 - 599 / High
90 - 299 / Medium
< 90 / Low

safety.unimelb.edu.au HEALTH & SAFETY: chemical Risk Assessment Form – Ethanol 1

Template date: June 2015 Version: 1.0 Authorised by: Associate Director, Health & Safety Next Review: June 2018

© The University of Melbourne – Uncontrolled when printed.

safety.unimelb.edu.au HEALTH & SAFETY: chemical Risk Assessment Form – Ethanol 1

Template date: June 2015 Version: 1.0 Authorised by: Associate Director, Health & Safety Next Review: June 2018

© The University of Melbourne – Uncontrolled when printed.

STEP 3 – review chemical process
For each stage of the chemical risk assessment:
·  Review the prompts/examples for each route of exposure for each category;
·  Determine and record a raw risk score by referencing the two variable risk matrix or the three variable risk calculator;
·  In the comments box, describe the route of exposure and any other information (if applicable);
·  Specify the risk control type for each current or proposed risk control;
·  Provide a control description for each current or proposed risk control;
·  Where proposed risk control(s) have been identified complete a Health & Safety Action Plan;
·  Determine the residual risk score referencing the same two variable risk matrix or three variable risk calculator used to determine the raw risk score. / Hierarchy of Control (Control Type)
El – Elimination
S – Substitution
En – Engineering Is – Isolation G – Guarding
Sh – Shielding
A – Administrative T – Training In – Inspection
M – Monitoring H – Health Monitoring
P – PPE
For information devising appropriate controls, refer to: Guide to Chemical Risk Hierarchy of Control.
Category / Raw
Risk Score / Comments (when/where the exposure is present) / Control Type / Control Description
(Current and Proposed) / Residual Risk Score /
Storage / 1 x 1 x 25
= 25
Low / Inhalation in poorly ventilated location
Eye irritant / En
Is
In
A / Keep container tightly closed.
Store in original container
Store in a cabinet that meets the requirements of AS 1940
Regular scheduled inspections / Low
● Inhalation ● Skin (absorption
● Eye ● Ingestion
● Injection ● Other
Handling / 1 x 3 x 25
= 75
Low / Inhalation
Eye irritant / En
A
T
P / Chemical management training
Wear appropriate eye and face protection, protective clothing and gloves as per MSDS/SDS
Other PPE as determined by activity/use and MSDS/SDS (see last page for details of commonly used PPE) / Low
● Inhalation ● Skin (absorption
● Eye ● Ingestion
● Injection ● Other
Decanting/Mixing / 1 x 3 x 50
= 150
Medium / Inhalation
Eye irritant
Manaula handling associated with decanting from large containers / En
Is
A
T
P / Decant in a designated decanting area – ventilation, earthing, no ignition sources Decanting SOP
Manual handling training Chemical management training
Wear appropriate eye and face protection, protective clothing and gloves
Other PPE as determined by activity/use and MSDS/SDS(see last page for details of commonly used/required PPE)
Signage / Low
● Inhalation ● Skin (absorption
● Eye ● Ingestion
● Injection ● Other
Applying/Using / 1 x 3 x 50
= 150
Medium / Inhalation
Eye irritant / En
A
T
P / Use as per standard operating procedures
Use in a fume hood
Chemical management training
Wear appropriate eye and face protection, protective clothing and gloves as per MSDS/SDS
Other PPE as determined by activity/use and MSDS/SDS (see last page for details of commonly used PPE) / Low
● Inhalation ● Skin (absorption
● Eye ● Ingestion
● Injection ● Other
Spill/Leak / 1 x 3 x 25
= 75
Low / Inhalation
Eye irritant / Is
A
T
P / Have appropriate spill kit and cleanup equipment available
Know local emergency procedures and evacuation routes
Other PPE as determined by emergency procedures (see last page for details of commonly used PPE)
Know the location of first aid kits and the local first aid providers
Use undamaged original container or containers appropriate to hold chemical / Low
● Inhalation ● Skin (absorption
● Eye ● Ingestion
● Injection ● Other
Disposal / 1 x 1 x 25
= 25
Low / Inhalation
Eye irritant / Is
T / Store in dedicated area prior to disposal
Local area emergency procedures
Restricted access / Low
● Inhalation ● Skin (absorption
● Eye ● Ingestion
● Injection ● Other
STEP 4 – ImpleMEntation and consultation process /
Determine the person responsible for reviewing and implementing the risk assessment including the identified controls. Ensure a Health & Safety Action Plan has been completed, reviewed and signed off where proposed controls have been identified.
Obtain the authorisation of the management representative.
Ensure the HSR (if applicable) has been consulted. Ensure the employees undertaking the activity have been consulted.
Record below the names of the persons consulted.
Management representative / HSR/Employee representative
Employee(s) / Employee(s)
Employee(s) / Employee(s)
Person Responsible for implementation or escalation
Extra writing room - use this page to enter extended comments or descriptions
Review
Review risk assessment every 3 years.
Review employee chemical procedures during workplace inspections.
Review risk assessment where there is an incident with the chemical or new information becomes available.
Review risk assessment when the MSDS/SDS is updated/reissued.
Emergency and First Aid procedures
Ensure that general first aid procedures and resources are in place and available.
First aid risk assessment and procedures that take into account the risks associated with the chemical and possible adverse outcomes.
University of Melbourne and local area emergency procedures.
Spill kits – vermiculite or attapulgite
PPE
Respiratory protection: AS/NZS 1715 Selection, use and maintenance of respiratory protective equipment
Safety Glasses: AS/NZS 1337.1 Personal eye protection. Eye and face protectors for occupational applications
Gloves: AS/NZS 2161.1 Occupational protective glove. Selection, use and maintenance
Boots: AS/NZS 2210.1-9 (series) Occupational protective footwear or sturdy footwear as per local area requirements
To eliminate injuries always use the chemical in accordance with the manufacturer’s instructions and for its intended purpose only.
All chemical users must have demonstrated competency and be familiar with the risk assessment and any SOPs prior to use of the chemical.

safety.unimelb.edu.au HEALTH & SAFETY: chemical Risk Assessment Form – Ethanol 1

Template date: June 2015 Version: 1.0 Authorised by: Associate Director, Health & Safety Next Review: June 2018

© The University of Melbourne – Uncontrolled when printed.