Display Screen Equipment (DSE) Self Assessment

DSE User Name: / Line Manager Name:
Department: / Date of initial assessment:
Location: / Review frequency1:

Under the Health & Safety (Display Screen Equipment) Regulations 1992, as amended, the company is required to perform a suitable and sufficient assessment of workstations used by regular computer users.

For Regulatory purposes, these are users who use computers continuously for an hour or more / day.

Please read each question fully and answer by ticking the Yes, No or N/A box. If the answers do not appear in the shaded box, your Line Manager must complete the Actions Required section and take appropriate action to resolve any issues.

Theself assessment is retained by the Line Manager and could form part of an evidence file used in support of any action taken in the future with regard to your health and safety.

The DSE Guidance Noteswhich accompany the assessment should be read before completing theassessment.

1. / Training and Information / Yes / No / N/A
a. / Have you read and understood the Guidance Notes on Personal Computers?
b. / Do you know how to adjust your workstation?
c. / Have you received adequate training in how to use the software?
2. / Posture / Yes / No / N/A
a. / Can you sit comfortably and easily change your posture?
b. / Can you adjust your keyboard and screen to a comfortable viewing position?
c. / Can you place your feet firmly on the floor?
d. / When seated are your eyes approximately level with the top of the screen?
e. / Can you comfortably use the mouse?
3. / Workstation/Work surface / Yes / No / N/A
a. / Have you arranged your workstation to meet your specific needs?
b. / Is there space in front of the keyboard to support your hands and forearms?
c. / Do you have sufficient legroom?
d. / Is your workstation and surrounding area free from obstructions and hazards?
e. / Does most of your work require reading from hard copy documents?
f. / If so, do you require a document holder?
4. / Display Screen / Yes / No / N/A
a. / Is the information displayed on your screen clear and easy to read?
b. / Can the brightness and contrast be adjusted easily?
c. / Is the image on the screen stable and free from flicker?
d. / Is your workstation free from reflected glare?
e. / Doses the monitor swivel adequately in each direction?
5. / Keyboard / Yes / No / N/A
a. / Is the keyboard separate from the screen?
b. / Can the tilt of the keyboard be altered/adjusted?
c. / Are the key symbols easy to read?
d. / Does the keyboard have a matt surface to avoid reflected glare?
6. / Work Chair / Yes / No / N/A
a. / Is the chair comfortable and can the height and backrest be adjusted?
b. / Can all adjustments be made easily and safely?
7. / Lighting / Yes / No / N/A
a. / Has your equipment been situated to avoid direct glare?
b. / Does the lighting allow you to work comfortably?
8. / Other Comments / Yes / No / N/A
a. / Do you know who to contact if you experience problems with your workstation, i.e. line manager or H&S dept?
b. / Are there any other issues you wish to raise about your workstation?
c. / If Yes provide further details:
9. / Eyesight* / Yes / No / N/A
a. / Do you require an eyesight test?

* Refer to the:

TUI Eye Care Policy TUI Eye Test Request Form

NOTE: To access embedded documents, double click on the paper clip

Signed / Name / Date
DSE User
Line Manager

Line Manager Actions

On completion of the self assessment, the line manager will need to list any issues identified below, and complete the actions required and date any actions completed.

Staff Member and Line Manager must sign at the end to agree all actions are satisfactorily resolved.

If the Line Manager cannot resolve any issue, they must refer to H&S in Coventry on 02476 283659.

ACTIONS REQUIRED - To be completed by Line Manager in consultation with the DSE User

Item / Issue / Action Required / Date Action Complete

All issues have now been resolved

Signed / Name / Date
DSE User
Line Manager

DSE Self Assessment Review History

Date / Reviewers / Purpose of review1 / Findings

1 Risk assessment review may be initiated by the following: Periodic (e.g. annual) review, following an accident, incident or ill-health, changes in legislation, other significant change e.g. working practices, training, procedure, personnel, location, work equipment.

Document / Display Screen Equipment (DSE) Self Assessment / Issue / 2
Department / Risk Safety and Quality / Page / 1 of 2
Authority / Occupational Risk Manager / Date / October 2010