RISK ASSESSMENT FORM Risk Assessment No GENERIC RA019

List identified hazards and detail measures taken to address the hazards: Reference to SOP No GENERIC SOP019

Cost Centre
University Wide / Department
University Wide / Location
University Wide / Area Supervisor
OH&S Unit
Plant/equipment/procedure
Laminator “Generic” / Assessed by
OH&S Unit / Date
28/01/2009 / Review Date
28/01/2011
Probability - Risk Factors → / Consequence - Risk Factors →
Very Likely / Probably occur immediately or within a short period of time / Fatality / May cause death or loss of facility
Likely / Probably occur in time / Major / Severe injury or illness or major property damage
Possible / Could happen occasionally / Minor / Minor (usually reversible) injury or illness resulting in days off work or minor property damage
Unlikely / Could eventually happen / First Aid / First aid level treatment
Highly Unlikely / Has potential to occur, but probably never will / Negligible / No medical treatment
Forms of Hazard
Physical / Mechanical action, impact, electrical exposure, heat/cold, noise, vibration, explosion etc.
Chemical / Corrosive liquid, toxic gases, noxious fumes etc.
Ergonomic / Height of workbench, design of chair, set-up of a work station etc.
Radiation / x-ray machine, infrared beams etc.
Psychological / Stress from using equipment without proper training or instruction, interpersonal conflict
Biological / Sharps, specimen containers carrying infected material, viruses from A/C system
Sources / Environment Substances Equipment/plant Work systems
Plant/equipment/procedure
Laminator “Generic”
Risk Matrix / Consequence / Probability / Control Hierarchy
Very likely / Likely / Possible / Unlikely / Highly unlikely / Elimination / Is it necessary
Fatality / Extreme / High / High / High / Medium / Substitution / Is there a less hazardous alternative
Major injury / High / High / High / Medium / Medium / Isolation / Eg Restrict access, use in a closed container, fume cabinet
Minor injury / High / Medium / Medium / Medium / Medium / Engineering / Eg Trolleys to move loads, guards on machinery, Fume cupboard
First aid / Medium / Medium / Medium / Low / Low / Administration / Eg: Training, Safe Work Procedure, signage
Negligible / Medium / Medium / Low / Low / Low / PPE - Personal
Protective Equipment / Eg: Gloves, respirator, safety glasses
Identified Hazards / Risk Assessment / Risk
Measure
(see matrix) / Required Controls / Controls
implemented
Number / Description / Consequences ? Fatality-may cause death or loss of facilityMajor injury-Severe injury or illnessMinor injury-injury or illness- days off workFirst aid level medical treatmentNegligible - no medical treatment / Probability
? Very likely-expected to occur now or soonLikely-will probably occur in timePossible-might occur in the next few monthsUnlikely-Could eventually happen ~a yearHighly unlikely-potential to occur, probably won't / Yes / No
1 / Electrical hazards / -Select-FatalityMajor injuryMinor injuryFirst aidNegligible / -Select-Very likelyLikelyPossibleUnlikelyHighly unlikely / -Select-ExtremeHighMediumLow / All electrical items are tested and tagged as required by Legislation
2 / Burns from hot surfaces / -Select-FatalityMajor injuryMinor injuryFirst aidNegligible / -Select-Very likelyLikelyPossibleUnlikelyHighly unlikely / -Select-ExtremeHighMediumLow / Follow instructions as per operators manual
-Select-FatalityMajor injuryMinor injuryFirst aidNegligible / -Select-Very likelyLikelyPossibleUnlikelyHighly unlikely / -Select-ExtremeHighMediumLow
-Select-FatalityMajor injuryMinor injuryFirst aidNegligible / -Select-Very likelyLikelyPossibleUnlikelyHighly unlikely / -Select-ExtremeHighMediumLow
-Select-FatalityMajor injuryMinor injuryFirst aidNegligible / -Select-Very likelyLikelyPossibleUnlikelyHighly unlikely / -Select-ExtremeHighMediumLow
SUMMARY OF RISK Review the risk measured, and the controls, then please select the relevant risk summary statement:
A / The assessment reveals that the potential risk to health from the use of the plant/equipment/procedure is not currently significant
B / The assessment reveals that the potential risk to health from the use of the plant/equipment/procedure is significant, however controls are in place that reduce risk to acceptable levels
C / The assessment reveals that the potential risk to health from the use of the plant/equipment/procedure is significant. Interim controls are in place to reduce risk to acceptable levels.

Approved by Supervisor……………………………………….. Date…………………………

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