"Field Activity Risk Assessment Template - University of Wollongong"

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Field Activity Title: _______________________________________________________________________
Subject Name
: ___________________________________
Subject No. _________________
(if applicable)
Date(s) of Activity:
From: ______/______/______
To: ______/______/_____
Supervisor/Leader:
______________________________________________________________________________
Location Assessed By: ______________________________________
Date Assessed:_____/____/____
Outline of Field Activity:
Step 1: IDENTIFY POTENTIAL AND EXISTING INDIVIDUAL HAZARDS
Using Table 1, assess each
(
hazard as high, medium or low. Blank or no rating indicates the hazard is not applicable to this particular field
activity)
Risk Rating
Risk Rating
Risk Rating
Camp/Bush Fires
Cold Environment/Hypothermia/Frost Bite
Working in/near water (boats,
swimming, diving)
Noise
Hot Environment/Dehydration/UV
Contaminated Waters
Concealed Holes
River, Stream or Lake Crossing
Fatigue (eg. driving long hours)
Slippery Surfaces
Hail/Severe Storm/Lightening
Manual Handling/Lifting
Rainfall/Flood
Moving/Falling objects
Use of Hazardous Chemicals
Heavy Traffic Area
Falls from heights/Cliffs
Unstable/Uneven/Soft ground
Violent Persons
Bites/Stings (wasps, jellyfish, leeches)
Hazardous Equipment (hammers,
augers, drills)
Harassment
Animal Attacks (snakes, dingos)
Fencing (wire, electric, high)
Dry Environment
Strong currents/wave action/tides
Other(s) (please specify)
TABLE 1
Step 1 – Consider the Consequences
Step 2 – Consider the Likelihood
Step 3 – Calculate the Risk
What are the consequences of this incident
What is the likelihood of the consequence identified in
1.Take step 1 rating and select the correct column
occurring? Consider what could reasonably have
step 1 happening? Consider this without new or interim
2.Take Step 2 rating and select the correct line
happened as well as what actually happened. Look at
controls in place. Look at the descriptions and choose
3.Circle the risk score where the two ratings
the descriptions and choose the most suitable
the most suitable Likelihood.
cross on the matrix below.
Consequence.
E = Extreme, = High, M = Medium, L = Low
N = Negligible
CONSEQUENCES
LIKELIHOOD
Risk Score = ……………….
Consequence
Description
Likelihood
Description
CONSEQUENCES
Major
Death and extensive injuries
The event is expected to occur in
A
Maj
Mod
Min
Ins
most circumstances
Moderate
Medical treatment
B
The event could occur at some time
A
E
E
H
M
Minor
First aid treatment
C
The event could occur, but only rarely
B
E
H
M
M
Insignificant
No treatment
D
The event may occur, but probably
C
H
M
M
L
never will.
D
M
M
L
N
BR 0100
Custodian: Officer, Legal & Compliance
Page 1
of 2
Created: March 2003
Last Review: May 2005
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Field Activity Title: _______________________________________________________________________
Subject Name
: ___________________________________
Subject No. _________________
(if applicable)
Date(s) of Activity:
From: ______/______/______
To: ______/______/_____
Supervisor/Leader:
______________________________________________________________________________
Location Assessed By: ______________________________________
Date Assessed:_____/____/____
Outline of Field Activity:
Step 1: IDENTIFY POTENTIAL AND EXISTING INDIVIDUAL HAZARDS
Using Table 1, assess each
(
hazard as high, medium or low. Blank or no rating indicates the hazard is not applicable to this particular field
activity)
Risk Rating
Risk Rating
Risk Rating
Camp/Bush Fires
Cold Environment/Hypothermia/Frost Bite
Working in/near water (boats,
swimming, diving)
Noise
Hot Environment/Dehydration/UV
Contaminated Waters
Concealed Holes
River, Stream or Lake Crossing
Fatigue (eg. driving long hours)
Slippery Surfaces
Hail/Severe Storm/Lightening
Manual Handling/Lifting
Rainfall/Flood
Moving/Falling objects
Use of Hazardous Chemicals
Heavy Traffic Area
Falls from heights/Cliffs
Unstable/Uneven/Soft ground
Violent Persons
Bites/Stings (wasps, jellyfish, leeches)
Hazardous Equipment (hammers,
augers, drills)
Harassment
Animal Attacks (snakes, dingos)
Fencing (wire, electric, high)
Dry Environment
Strong currents/wave action/tides
Other(s) (please specify)
TABLE 1
Step 1 – Consider the Consequences
Step 2 – Consider the Likelihood
Step 3 – Calculate the Risk
What are the consequences of this incident
What is the likelihood of the consequence identified in
1.Take step 1 rating and select the correct column
occurring? Consider what could reasonably have
step 1 happening? Consider this without new or interim
2.Take Step 2 rating and select the correct line
happened as well as what actually happened. Look at
controls in place. Look at the descriptions and choose
3.Circle the risk score where the two ratings
the descriptions and choose the most suitable
the most suitable Likelihood.
cross on the matrix below.
Consequence.
E = Extreme, = High, M = Medium, L = Low
N = Negligible
CONSEQUENCES
LIKELIHOOD
Risk Score = ……………….
Consequence
Description
Likelihood
Description
CONSEQUENCES
Major
Death and extensive injuries
The event is expected to occur in
A
Maj
Mod
Min
Ins
most circumstances
Moderate
Medical treatment
B
The event could occur at some time
A
E
E
H
M
Minor
First aid treatment
C
The event could occur, but only rarely
B
E
H
M
M
Insignificant
No treatment
D
The event may occur, but probably
C
H
M
M
L
never will.
D
M
M
L
N
BR 0100
Custodian: Officer, Legal & Compliance
Page 1
of 2
Created: March 2003
Last Review: May 2005
Step 2: OVERALL RISK ASSESSMENT
(Taking into account the hazards identified in Step 1 and the likelihood and consequences of hazards occurring during
the activity, assess the overall risk of the activity as a whole by circling the appropriate risk rating on Table 1, above)
U A SSESSMENT SUMMARY (
)
please tick
Low Risk (routine assessment)
-
Make note of risks and file in relevant department.
Medium Risk (readily controlled/minimised)
-
Provide participants with a copy and file in department.
High Risk (not readily controlled/minimised)
-
Do not proceed with activity until risks have been adequately
controlled and appropriate insurance arrangements confirmed.
Once risks are controlled, provide participants with a copy and
file in relevant department.
Step 3: RISK CONTROL AND ACTIONS
(please tick)
Please note: First Aid Kit and appropriate clothing, footwear and hat are always required, regardless of real or perceived risks.
Priority
Control
Example
1.
Eliminate
Removing the hazard.
2.
Substitute
Replacing a hazardous process with a less hazardous one.
3.
Isolation
Isolating the hazard from the person at risk, eg using a guard or barrier.
4.
Engineering
Redesign a process or piece of equipment to make it less hazardous.
5.
Administrative
Adopting safe work practices or providing appropriate training, instruction or
information. eg. Following the Field Activity Guidelines.
Example
Hazard
Problem
Remediation
Working in/near water
Pools of water, drowning
Wear PPE, work in pairs, report back to
in a peat swamp
Supervisor/Leader when task is completed.
Actions taken:
Completed By:
________________________________________________________________________________
Signed:
_______________________________________________________
Date: _____/_____/_____
Signed (Supervisor): ___________________________________________________
Date: _____/_____/_____
Signed (H.O.D):
_______________________________________________________
Date: _____/_____/_____
BR 0100
Custodian: Officer, Legal & Compliance
Page 2
of 2
Created: March 2003
Last Review: May 2005
Page of 2