HAZARD ASSESSMENT FORM For University of Virginia Departments
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1 HAZARD ASSESSMENT FORM For University of Virginia Departments Required by the Occupational Safety & Health Administration (OSHA) Personal Protective Equipment Standard (29 CFR ) Prepared by: Michelle Whitlock, UVa-Environmental Health & Safety Page 1 of 6
2 2006 Work Area: Facility: Hazard Assessment Form Assessment by: Reference 29 CFR Date: EYES abrasive blasting chopping cutting drilling soldering torch brazing computer work punch press operations sanding grinding hammering chipping airborne dust dirt UV flying particles/objects blood splashes hazardous liquid chemicals mists chemical splashes molten metal splashes glare/high intensity lights laser operations intense light hot sparks Safety glasses Safety goggles Dust-tight goggles Impact goggles Welding helmet/shield Chemical goggles Chemical splash goggles Laser goggles Shading/Filter (# ) Welding shield With: Side shields Face shield Shaded Prescription FACE cleaning cooking siphoning painting dip tank operations pouring foundry work mixing pouring molten metal hazardous liquid chemicals extreme heat extreme cold potential irritants: Face shield Shading/Filter (# ) Welding shield Page 2 of 6
3 HEAD building maintenance confined space operations construction electrical wiring walking/working under catwalks walking/working on catwalks walking/working under conveyor belts working with/around conveyor belts walking/working under crane loads utility work beams pipes exposed electrical wiring or components falling objects fixed object machine parts Protective Helmet Type A (low voltage) Type B (high voltage) Type C Bump cap (not ANSI-approved) Hair net or soft cap HANDS/ARMS baking cooking grinding working with glass using computers using knives dental and health care services garbage disposal computer work material handling sanding hammering using power tools blood irritating chemicals tools or materials that could scrape, bruise, or cut extreme heat extreme cold animal bites electric shock vibration musculoskeletal disorders sharps injury Gloves Chemical resistance Liquid/leak resistance Temperature resistance Abrasion/cut resistance Slip resistance Latex or nitrile Anti-vibration Protective sleeves Ergonomic equipment Page 3 of 6
4 FEET/LEGS building maintenance construction demolition food processing foundry work logging plumbing trenching use of highly flammable materials explosive atmospheres explosives exposed electrical wiring heavy equipment slippery surfaces impact from objects pinch points crushing slippery/wet surface sharps injury blood chemical splash chemical penetration extreme heat/cold fall Safety shoes or boots Toe protection Electrical protection Puncture resistance Anti-slip soles Leggings or chaps Foot-Leg guards Metatarsal protection Heat/cold protection Chemical resistance BODY/SKIN baking or frying battery charging dip tank operations fiberglass installation chemical splashes extreme heat extreme cold sharp or rough edges irritating chemicals Vest, Jacket Coveralls, Body suit Raingear Apron Welding leathers Abrasion/cut resistance With: Long sleeves Page 4 of 6
5 BODY/WHOLE building maintenance construction logging computer work utility work working from heights of 10 feet or more impact from flying objects impact from moving vehicles sharps injury blood electrical/static discharge hot metal musculoskeletal disorders sparks chemicals extreme heat/cold elevated walking/working surface working near water injury from slip/trip/fall With: Fall Arrest/Restraint Hood Traffic vest Full sleeves Static coats/overalls Flame resistant jacket/pants Insulated jacket Cut resistant sleeves/wristlets hoists/lifts ergonomic equipment: LUNGS/RESPIRATORY cleaning mixing painting fiberglass installation compressed air or gas operations confined space work floor installation ceiling repair pouring dust or particulate toxic gas/vapor chemical irritants (acids) fume asbestos pesticides organic vapors oxygen deficient environment paint spray extreme heat/cold Dust mask Disposable particulate respirator Replaceable filter particulate w/cartridge PAPR (Air recycle) PPSA (Air supply) With/Type: face shield acid/gas crtdg organic crtdg pesticide crtdg spray paint crtdg half faced full faced hooded Page 5 of 6
6 EARS/HEARING generator ventilation fans motors sanding pneumatic equipment punch or brake presses use of conveyors grinding machining routers sparks loud noises loud work environment noisy machines/tools punch or brake presses ear muffs ear plugs leather hood Page 6 of 6
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