Pre-Assessment DSE User Questionnaire Assessing risks for computer users

Pre-Assessment Display Screen Equipment (DSE)

User Questionnaire

Please complete this questionnaire and ensure that it is available for your assessment.

Name:
Organisation:
Department:
Workstation number:

General work pattern

Estimate the time spent in the office using computer each day hours

Do you use a laptop for work purposes? Yes No

Do you use other workstations in the workplace? Yes No

Do you work from home on a computer? Yes No

Do you use a computer at home for personal use? Yes No

DSE training

/

Yes

/

N/A

/

No

1.  Have you received information and training in the safe set-up and use of your workstation?

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/
/

Seated posture & support

/

Yes

/

N/A

/

No

2.  Do you know how and why to adjust the back-rest height and tilt angle?

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/

3.  Do you know how and why to adjust the seat height?

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/

Input devices

/

Yes

/

N/A

/

No

4.  Can you position your keyboard directly in front of you and with space to support the hands and arms when not typing?

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/

5.  Is the keyboard sufficiently clean?

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/

6.  Do you have sufficient space to position and use your mouse without stretching?

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/

Screen, reflections & glare

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Yes

/

N/A

/

No

7.  Can you position the monitor at a comfortable viewing distance (approximately arm’s distance)?

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/

8.  When seated at a comfortable keying height is the top of the monitor casing approximately at eye level?

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9.  Is the screen free from glare and/or reflections that make the text difficult to read?

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10. Is the information on the screen easy to read, i.e. text large enough, in focus and flicker-free?

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/

Local environment

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Yes

/

N/A

/

No

11. Does the general office lighting enable you to view the screen, keyboard and your paperwork clearly?

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/

12. Have adequate window blinds been provided where required?

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13. Is the office environment adequate to prevent discomfort from excess heat, cold and draughts?

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14. Is the office environment adequate to avoid discomfort from dry eyes?

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Desk and drawers

/

Yes

/

N/A

/

No

15. Is there adequate legroom clearance under the desktop?

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/

16. Is there adequate space on the desktop?

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/

Document position

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Yes

/

N/A

/

No

17. If you frequently use documents whilst working on your computer do you place them in either a document holder or between keyboard and screen?

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/
/

Equipment position & work area

/

Yes

/

N/A

/

No

18. Are frequently used items of equipment within easy reach on the desk without excess reaching, stretching or twisting?

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/

19. Is the area around your desk free from obstructions, trip hazards, etc?

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Work organisation

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Yes

/

N/A

/

No

20. Do you get off your chair at least once an hour?

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/
/

Vision

/

Yes

/

N/A

/

No

21. Are you aware of the organisation’s DSE eye test guidance?

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/

22. Have you had an eye test within the last 2 years?

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Software

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Yes

/

N/A

/

No

23. Is the software provided suitable for the job you do?

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/

24. Do you know how to use your computer and software sufficiently well to do your job?

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/

Other issues

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Yes

/

N/A

/

No

25. Has this questionnaire covered all of the health and safety issues you wish to raise concerning the use of your workstation or workplace?

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/
/

If the answer to Q25 is “No” please write any extra comments below:

Signature: ______Date: ______

University of Leicester v4 Jan 15 Page 2 of 3