Hazard Identification and Preliminary Assessment (HIPA) Form

Hazard Identification and Preliminary Assessment (HIPA) Form

Evaluation

This preliminary assessment creates a record of the known hazards and risks associated with a specific process / procedure / activity, and may be used to identify the need (or not) to progress on to the production of a more formal risk assessment form - HSF – 01(a).

Where a risk is considered as ‘significant’ (rating of 8 or more in any one area) on this form, then form HSF – 01(a) as above must also be completed, if the risk is considered as ‘insignificant’ (below a rating of 8), then no further action is required following the completion of this form, other than the identification and communication to all affected, of any mitigating control measures. All files are to be held locally and be available on request, for inspection.

Producers of the formal risk assessment form - HSF - 01(a) should undertake recognised training via the ODTU team before producing / amending / updating these documents.

Process / procedure / activity etc. being assessed:
Location
Campus - Building - Room(s) -
Faculty or support Department
Assessment date / Re-assessment date
Name of Assessor / Assessment ref

The probability and severity rating of any likely injury / damage should be calculated using the following criteria -

Probability (or likelihood) should be assessed and rated as:
Very Unlikely - 1 / Unlikely - 2 / Likely - 3 / Very Likely - 4 / Almost Certain - 5
Freak event – no known history / Unlikely sequence of events / Foreseeable under certain circumstances / Easily foreseeable – has the potential to occur / Common occurrence – aware of incidents
Severity should be assessed and rated as:
Negligible / Delay, minor property damage, no real visible injury or pain / 1
Minor Injury (slightly harmful) / Bruising, minor cuts, light abrasions. Chemical effects, limited to mild irritation of skin or eyes, headaches, ill-health leading to temporary discomfort. Minor property damage. No long term effects. First aid injury / illness / 2
Moderate Injury (harmful) / Heavy bruising, deep flesh wound, loss of consciousness, lacerations, concussion, serious sprains, minor fractures, deafness, asthma, burns, or injury resulting in absence from work for more than three days. Chemical effects: Harmful if inhaled / skin contact or swallowed dermatitis. Ill health leading to permanent minor disability etc. Serious property damage confined to a workroom or area. Oxidising, flammable and highly flammable substances. / 3
Severe Injury (extremely harmful) / Lost time accidents / work related ill-health. Major injuries / diseases which are reportable under RIDDOR, e.g. amputations, major fractures or the following chemical effects: toxic by inhalation, skin contact, swallowed, damage to eyes respiratory system, skin sensitization, fertility effects, prolonged exposure risks, limited evidence carcinogenic effects. Severely life shortening diseases, acute fatal diseases. Major property damage affecting the building. Extremely flammable& explosive substances. / 4
Very Severe / Accidents/work-related ill health that could lead to long term disability or death. Chemical effects: probable carcinogen may cause sensitization by inhalation. Property damage involving the loss of one or more buildings. / 5

Risk rating total = Probability (likelihood) X Severity. A total of eight or more requires the formal risk assessment to be completed.

List of common hazards - mark all applicable types with a cross, and then expand on the detail in the description / controls section.

Hazard code / Hazard type / x / General hazard description
and / or controls to be implemented / Probability / Severity / Risk rating total /
1.0 / Location
1.1 / Lone working within building / Full risk assessment form HSF - 01(a) required / .12345 / .12345
1.2 / Lone working away from base / Full risk assessment required / .12345 / .12345
1.3 / Group working away from base / .12345 / .12345
1.4 / Remote location / .12345 / .12345
1.5 / Party / visit /placement / .12345 / .12345
1.6 / Fieldwork / sports trip / .12345 / .12345
1.7 / Working / Travelling Overseas / Full risk assessment required / .12345 / .12345
1.8 / Other / .12345 / .12345
2.0 / Physical Hazards
2.1 / Poor housekeeping / .12345 / .12345
2.2 / Spillages / wet floor / .12345 / .12345
2.3 / Worn / damaged flooring / .12345 / .12345
2.4 / Uneven surfaces / .12345 / .12345
2.5 / Falls (consider falls from any height) / Full risk assessment required / .12345 / .12345
2.6 / Contact with static object / .12345 / .12345
2.7 / Contact with moving object / .12345 / .12345
2.8 / Needle sticks or sharp objects / .12345 / .12345
2.9 / Extreme cold/low temperature / .12345 / .12345
2.10 / Heat or steam / .12345 / .12345
2.11 / Other physical hazard / .12345 / .12345
3.0 / Mechanical Hazards
3.1 / Crushing / .12345 / .12345
3.2 / Cutting / shearing / .12345 / .12345
3.3 / Entanglement / .12345 / .12345
3.4 / Drawing-in / trapping / .12345 / .12345
3.5 / Impact / Ejection / .12345 / .12345
3.6 / Use of hand tools / .12345 / .12345
3.7 / Contact with dangerous machinery / .12345 / .12345
3.8 / Other mechanical hazards / .12345 / .12345
4.0 / Electrical Hazards
4.1 / Poor isolation of equipment / Full risk assessment required / .12345 / .12345
4.2 / Live working low voltage / Full risk assessment required / .12345 / .12345
4.3 / Live working mains voltage / Full risk assessment required / .12345 / .12345
4.4 / Live working, 3 phase / Full risk assessment required / .12345 / .12345
4.5 / Risk of direct contact / Full risk assessment required / .12345 / .12345
4.6 / Risk of indirect contact / Full risk assessment required / .12345 / .12345
4.7 / Portable equipment not inspected / .12345 / .12345
4.8 / Portable equipment not tested / .12345 / .12345
4.9 / Fixed equipment not tested / .12345 / .12345
4.10 / Building Services not tested / .12345 / .12345
4.11 / Overhead / Underground lines / cables / .12345 / .12345
4.12 / High Voltage / .12345 / .12345
4.13 / Short circuit/overload / .12345 / .12345
4.14 / Source of ignition / .12345 / .12345
4.15 / Lack of compatibility of voltage e.g. (overseas) / .12345 / .12345
4.16 / Other electrical hazards / .12345 / .12345
5.0 / Radiation Hazards etc.
5.1 / Lasers / Full risk assessment required / .12345 / .12345
5.2 / Ionising radiation / Full risk assessment required / .12345 / .12345
5.3 / Electro-magnetic / Microwave / UV emitters / Full risk assessment required / .12345 / .12345
5.4 / Other radiation hazards / .12345 / .12345
6.0 / Work Practices
6.1 / Highly repetitive actions / .12345 / .12345
6.2 / Gripping / Squeezing / .12345 / .12345
6.3 / Twisting / .12345 / .12345
6.4 / Reaching / Stressful postures / .12345 / .12345
6.5 / Finger / hand movement / .12345 / .12345
6.6 / Inadequate ‘warm-up’ / .12345 / .12345
6.7 / Mental strain / stress / .12345 / .12345
6.8 / Visual fatigue / .12345 / .12345
6.9 / Inadequate rest breaks / .12345 / .12345
6.10 / Use of display screens / For regular use - Full HSF - 03 risk assessment required / .12345 / .12345
6.11 / Contact with the public / patients / .12345 / .12345
6.12 / Contact with trespassers etc. / .12345 / .12345
6.13 / Out of hours working (consider lone working, first aid and fire warden cover) / .12345 / .12345
6.14 / Other / .12345 / .12345
7.0 / Lifting/Handling / Consider a manual handling risk assessment – form HSF - 04
7.1 / Weight of object (specify weight) / .12345 / .12345
7.2 / Object not at waist height / .12345 / .12345
7.3 / Unstable object / .12345 / .12345
7.4 / Difficult to hold / .12345 / .12345
7.5 / Outside of own lifting capability / .12345 / .12345
7.6 / Difficult route (doors/steps/people) / .12345 / .12345
7.7 / Poor lighting / .12345 / .12345
7.8 / Poor floor condition / .12345 / .12345
7.9 / Requires more than one person / .12345 / .12345
7.10 / Other / .12345 / .12345
8.0 / Hazardous Substances / Consider a CoSHH risk assessment – form HSF – 05 (a)
8.1 / Harmful / irritant / .12345 / .12345
8.2 / Toxic / corrosive / .12345 / .12345
8.3 / Extremely / Highly Flammable (see also HIPA 9.0) / .12345 / .12345
8.4 / Carcinogen, mutagen or teratogen / .12345 / .12345
8.5 / Explosive / oxidiser (see also HIPA 9.0) / .12345 / .12345
8.6 / Flashpoint below 32C (see also HIPA 9.0) / .12345 / .12345
8.7 / Biological hazard group 1 / .12345 / .12345
8.8 / Biological hazard group 2 / .12345 / .12345
8.9 / Biological hazard group 3 / .12345 / .12345
8.10 / Pre-existing medical condition e.g. dermatitis / asthma/allergy / .12345 / .12345
8.11 / Cryogenic substances / .12345 / .12345
8.12 / Genetically modified organisms / .12345 / .12345
8.13 / Dust / smoke or fume / .12345 / .12345
8.14 / Damaged container / open vessel / .12345 / .12345
8.15 / No bunding / drip tray / .12345 / .12345
8.16 / Inappropriate storage / .12345 / .12345
8.17 / Transport of hazardous substances / .12345 / .12345
8.18 / Poor ventilation (general and LEV) / .12345 / .12345
8.19 / Poor / lack of labelling / .12345 / .12345
8.20 / No material safety data sheet / .12345 / .12345
8.21 / Other hazards / .12345 / .12345
9.0 / Fire Hazards & systems
9.1 / Storage and use of flammables / highly flammables / .12345 / .12345
9.2 / Storage / use of petroleum spirits / Full risk assessment required / .12345 / .12345
9.3 / Storage / use of combustibles / .12345 / .12345
9.4 / `Hot work` activity / Full risk assessment required / .12345 / .12345
9.5 / Work that produces dust / .12345 / .12345
9.6 / Lack of integrity of escape routes / .12345 / .12345
9.7 / Obstructed escape routes / .12345 / .12345
9.8 / Storage of equipment/combustibles under stairs / .12345 / .12345
9.9 / Lack of knowledge regarding fire arrangements / .12345 / .12345
9.10 / Lack of fire wardens / .12345 / .12345
9.11 / Fire door / final exit locked / .12345 / .12345
9.12 / Absence of fire detector / alarm systems / .12345 / .12345
9.13 / a) Small building / .12345 / .12345
9.14 / b) Multi storey building / .12345 / .12345
9.15 / c) Sleeping accommodation / .12345 / .12345
9.16 / Lack of emergency lighting (relevant if working in an area with lack of or no natural light) / .12345 / .12345
9.17 / Fire escape routes / alarms unsuitable for disabled. (Is there a need to carry out a PEEP?) / .12345 / .12345
9.18 / Multi-storey, no refuges / .12345 / .12345
9.19 / Lack / wrong type extinguishers / .12345 / .12345
9.20 / Fire fighting equipment out of test date / .12345 / .12345
9.21 / Other fire hazards / .12345 / .12345
10.0 / Environmental
10.1 / Poor ventilation / draughts / .12345 / .12345
10.2 / Noise (Local) / Consider a risk assessment / .12345 / .12345
10.3 / Noise (Background) / Consider a risk assessment / .12345 / .12345
10.4 / Vibration (whole body/Hand-arm vibration) / .12345 / .12345
10.5 / Poor lighting (internal / external) / .12345 / .12345
10.6 / Lack of facilities to rest and eat meals / .12345 / .12345
10.7 / Lack of available sanitary conveniences / washing facilities / .12345 / .12345
10.8 / Pressure vessels / .12345 / .12345
10.9 / Lack of space / unsuitable position / .12345 / .12345
10.10 / Access / egress unsuitable / .12345 / .12345
10.11 / Area / signage unsuitable for disabled / .12345 / .12345
10.12 / Oxygen deficiency / Full risk assessment required / .12345 / .12345
10.13 / Confined spaces / Full risk assessment required / .12345 / .12345
10.14 / Use of compressed air / gases / Full risk assessment required / .12345 / .12345
10.15 / Localised hot / cold surfaces / .12345 / .12345
10.16 / Insufficient parking spaces / .12345 / .12345
10.17 / Unpredictable environmental condition / .12345 / .12345
10.18 / Activity on or near water / Full risk assessment required / .12345 / .12345
10.19 / Falling objects / .12345 / .12345
10.20 / Rough Terrain / .12345 / .12345
10.21 / Hot / cold ambient temperatures / .12345 / .12345
10.22 / Weather conditions / Climate extremes / .12345 / .12345
10.23 / Exposure to sun / .12345 / .12345
10.24 / Equipment or procedures that would ‘fail to danger’ e.g. ropes / Full risk assessment required / .12345 / .12345
10.25 / Projectiles e.g. bullets / arrows / fireworks etc. / Full risk assessment required / .12345 / .12345
10.26 / Animal / Insect / reptile bites etc. / .12345 / .12345
10.27 / Contaminated water / food / soil / .12345 / .12345
10.28 / Other environmental hazard / .12345 / .12345
11.0 / Organisational
11.1 / Excessive demands on individual e.g. timescales, workload, responsibility / .12345 / .12345
11.2 / Lack of Control over work by individual / .12345 / .12345
11.3 / Lack of Support from colleagues or superiors / .12345 / .12345
11.4 / Poor Relationships & unacceptable behaviour / .12345 / .12345
11.5 / Lack of Understanding of Role / .12345 / .12345
11.6 / Lack of staff engagement in Change / .12345 / .12345
11.7 / Poor maintenance (building/equipment) / .12345 / .12345
11.8 / Unsafe systems / .12345 / .12345
11.9 / Unsuitable equipment / .12345 / .12345
11.10 / Staff / Supervisors lack competence (formal training, qualifications, experience) / .12345 / .12345
11.11 / Ratio supervisors / participants / .12345 / .12345
11.12 / Lack of instruction / information / .12345 / .12345
11.13 / Unattended activity (out of hours / overnight) / .12345 / .12345
11.14 / Prolonged activity without breaks / .12345 / .12345
11.15 / Group newly formed / .12345 / .12345
11.16 / Participants have differing levels of expertise / .12345 / .12345
11.17 / Lack of first aid cover / .12345 / .12345
11.18 / Nursing or Pregnant mothers / Full risk assessment required / .12345 / .12345
11.19 / Participants under 18 years old / Full risk assessment required / .12345 / .12345
11.20 / Hazards associated with overseas travel (see Overseas travel guidance) / Full risk assessment required / .12345 / .12345
11.21 / Frequent organisational change / .12345 / .12345
11.22 / Shift work ‘stressors’ present / .12345 / .12345
11.23 / Other organisational / .12345 / .12345
12.0 / PPE
12.1 / Lack of / inappropriate provision of PPE / .12345 / .12345
12.2 / Lack of maintenance of PPE / .12345 / .12345
12.3 / Lack of training records / .12345 / .12345
12.4 / Inappropriate storage / .12345 / .12345
12.5 / Lack of health surveillance / .12345 / .12345
12.6 / Other / .12345 / .12345
13.0 /

Transport

Hazards associated with: / .12345 / .12345
13.1 / Travelling by road / Full risk assessment required / .12345 / .12345
13.2 / Travelling by rail / .12345 / .12345
13.3 / Travelling by air / .12345 / .12345
13.4 / Off-road travel – remoteness, rough terrain etc / .12345 / .12345
13.5 / Travelling by ferry / boat etc / .12345 / .12345
13.6 / Travelling by other means / .12345 / .12345
Any other hazards not listed above or general comments affecting this assessment;

Action (highlight as appropriate on completion of this form) -