Risk Assessment Form

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Risk Assessment Form
This risk assessment form should be completed electronically and approved and signed by the appropriate responsible person: principal
investigator (PI), module leader, tutor, or dissertation mentor. Guidance on completing this form is provided on the University Safety Office
website and in the HSE guidance Five Steps to Risk Assessment, which can be downloaded from the HSE website or USO website. It is the
responsibility of the person in charge of the fieldwork that this risk assessment is made available to all participants of the fieldwork.
Title of project and/or module:
Person conducting
Other people involved
fieldwork (PI or student):
in this fieldwork:
(If needed attach
separate sheet)
Supervisor/Module Leader
(for student fieldwork):
Date(s) of fieldwork
Location(s) of fieldwork
Field activity outline: (brief synopsis)
Hazards, Risks and Controls
It is important to understand the difference between hazard and risk. The hazard of a substance/activity/condition is the intrinsic
property of the substance/activity/condition to cause harm. The risk in relation to exposure to a hazard means the likelihood that the
potential for harm will be expressed under the conditions of use and the severity of that harm. The main purpose of your risk assessment
is to identify the hazards, decide who is at risk (Bear in mind that as a result of your activities, members of the public might be at risk),
assess the level of risks to people, and decide on suitable controls to ensure that the work can be done safely.
List the potential Hazards. Assess the level of risk (E = Extreme: needs immediate action, H = High, M = Moderate, L = Low, N =
Negligible). Outline the control measures put in place (‘so far as is reasonably practicable’) to reduce the risk. Then assess the level of risk
with the control measures in place.
Reduced
Level of
Potential Hazard
Level
Control measures to reduce the Risk
Risk
of Risk
Travel
How are you getting to your field work?
Think of vehicles, roads, flights, visas, FCO advice
Dealing with other people
Think of home/office environment, safety in public
places, culture, landowners, authorities, interviewees,
lone working etc.
Risk Assessment Form
This risk assessment form should be completed electronically and approved and signed by the appropriate responsible person: principal
investigator (PI), module leader, tutor, or dissertation mentor. Guidance on completing this form is provided on the University Safety Office
website and in the HSE guidance Five Steps to Risk Assessment, which can be downloaded from the HSE website or USO website. It is the
responsibility of the person in charge of the fieldwork that this risk assessment is made available to all participants of the fieldwork.
Title of project and/or module:
Person conducting
Other people involved
fieldwork (PI or student):
in this fieldwork:
(If needed attach
separate sheet)
Supervisor/Module Leader
(for student fieldwork):
Date(s) of fieldwork
Location(s) of fieldwork
Field activity outline: (brief synopsis)
Hazards, Risks and Controls
It is important to understand the difference between hazard and risk. The hazard of a substance/activity/condition is the intrinsic
property of the substance/activity/condition to cause harm. The risk in relation to exposure to a hazard means the likelihood that the
potential for harm will be expressed under the conditions of use and the severity of that harm. The main purpose of your risk assessment
is to identify the hazards, decide who is at risk (Bear in mind that as a result of your activities, members of the public might be at risk),
assess the level of risks to people, and decide on suitable controls to ensure that the work can be done safely.
List the potential Hazards. Assess the level of risk (E = Extreme: needs immediate action, H = High, M = Moderate, L = Low, N =
Negligible). Outline the control measures put in place (‘so far as is reasonably practicable’) to reduce the risk. Then assess the level of risk
with the control measures in place.
Reduced
Level of
Potential Hazard
Level
Control measures to reduce the Risk
Risk
of Risk
Travel
How are you getting to your field work?
Think of vehicles, roads, flights, visas, FCO advice
Dealing with other people
Think of home/office environment, safety in public
places, culture, landowners, authorities, interviewees,
lone working etc.
Reduced
Level of
Potential Hazard
Level
Control measures to reduce the Risk
Risk
of Risk
Health
Think of food, drink (incl. clean water), environment,
immunizations, allergies, etc.
Location Specific
Think of urban hazards, FCO safety & security advice,
cold/hot environment, weather, animals, insect bites,
cliffs/crevices, slopes, deep water, tides, soft sediments
Activity Specific
Think of river crossing, instream sampling, entering
caves, coring, conducting interviews & observations
Equipment Specific
Thinks of heavy/hazardous equipment, sharp tools,
electrical equipment, fragile equipment, etc.
Other Hazards
Personal Protective Equipment (PPE)
Risk Control Measures
Indicate on the list below which PPE is required for this fieldwork
Indicate the standard risk control measures needed.
Hi Viz jacket(s)
Walkie talkies
Adequate drinking water
First aid kit
Rope
Sunscreen / insect repellent
Hard hat(s)
Climbing gear
Notify authorities
Hiking boots
Dry suit(s)
Notify land owners
Wellington boots
Goggles
Obtain permissions
Waders
Ear protectors
Obtain local weather information
Emergency blanket
Face shield(s)
Work in pairs/groups
Survival bag
Protective gloves
Emergency details/medical form of participants
GPS
Satellite phone
Mobile phone
Other______________
Other_____________
Insurance cover & documents
Other Control Measures: (List any other PPE or control measures that will be used)
Training: (Outline any specialist training needs to successfully carry out field tasks)
Emergency Plan
Despite all preparations and no matter how careful you are, accidents can happen. Indicate procedures to follow in an
emergency (who do you contact, where do you go).
Contacts
Contact
Address/Telephone Number
Accommodation
Emergency Services
Nearest Hospital
Police
British Embassy/Consulate
Insurance contact & policy no.
Other
University Emergency
+44 (0)191 222 6666
Telephone Number
Comments and additional information:
Name
Signature
Date
Assessor:
Risk Assessment Completed by:
Name
Signature
Date
Approval:
PI/Module Leader/ Tutor/
Dissertation Mentor
Submit:
Review:
When multiple field visits are planned, please review this risk assessment after each visit
and revise where necessary.

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