Activity / Process / Operation where this substance/chemical will be used and/or made: /
What are the hazards from using this substance/chemical? 1
Who might be harmed and how2 / Estimate Risk Level (High/Medium/Low) 3
What measures are already in place to reduce the risk? 4 5 6 7 8 9 10 11 / Estimate Risk Level (High/Medium/Low) 12
What further action is needed to reduce the risk? 4 5 6 7 8 9 / Who / When / Check
1 Has all health and safety information been obtained including policies, procedures etc.?
2 Consider the number of people exposed and any special circumstances, e.g. asthma, pregnancy, etc.
3 Estimate initial risk High, Medium or Low
4 Can the substance be eliminated or a safer substitution made?
5 Consider all necessary control measures including storage, procedural and technical controls and disposal.
6 Are controls to the required standard and regularly maintained?
7 Have emergency action plans, including first aid, and dealing with spillages been considered?
8 Is training and instruction and adequate information available?
9 Is supervision adequate?
10 Is Personal Protective Equipment (PPE) required?
11 Is health surveillance required?
12 Estimate risk level achieved – High, Medium or Low
13 Monitoring
Name / Signature / Date / Name / Signature / Date
1 / 2
3 / 4
5 / 6
7 / 8
9 / 10
11 / 12
13 / 14
Monitoring Arrangements13 (e.g. Before each use/occasion, during handover/staff meeting, weekly, monthly, quarterly, annually during site inspections etc.) By whom? State frequency?
Review Date/Frequency: Any significant change in the work?
Risk Assessment Completed by (Name): / Job Title: / Date: /
Authorised by Line Manager (Name): / Job Title: / Date: /
COSHH ASSESSMENT RECORD – INVENTORY OF SUBSTANCES / Review Date
Risk Controls needed
Hazard / Risks
Where is it stored and used?
Substance and Activity
Title: COSHH Risk Assessment
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