Questionnaire: Physical-Ergonomic Workplace Evaluation The University of Aarhus 2008 1 of 22. Please fill in this workplace evaluation questionnaire for all your work functions e.g. office, computer room, classroom, lecture rooms, laboratories, workshops etc. and fieldwork. The questionnaire should be filled in individually. It is important that you state the locality you can state more localities under each question. As a help to fill in the questionnaire you can take a look at the subject list in the bottom of this document. 2 of 22. Do you have any problems with PHYSICAL? No --- go to question no. 12 3 of 22. Are your problems with physical conditions concerned with your workplace environment? No --- go to question no. 5 4 of 22. Are your workplace environment problems concerned with your Workplace layout? Space (e.g. cramped conditions)?
5 of 22. Are your problems with physical conditions concerned with noise? No --- go to question no. 7 6 of 22. Are your noise problems caused by People/animals? Equipment? Ventilation? 7 of 22. Are your problems with physical conditions concerned with vibrations? No If yes, state the building number and room number 8 of 22. Are your problems with physical conditions concerned with lighting? No --- go to question no. 10 9 of 22. Are your lighting problems caused by
Letting in daylight? Equipment lighting? Room lighting? 10 of 22. Are your problems with physical conditions concerned with the indoor climate? No --- go to question no. 12 11 of 22. Are your indoor climate problems caused by Heat? Cold? Draughts? Smell/odour? Cleaning? 12 of 22. Do you have any problems with ERGONOMIC? No --- go to question no. 14 13 of 22. Are your ergonomic problems caused by
Working posture? Repetitive work? Lifting? 14 of 22. Do you have any problems with CHEMICAL? No --- go to question no. 16 Not relevant 15 of 22. Are your problems with chemical conditions caused by Substances and materials hazardous to health? Safety precautions? Waste? Fire? 16 of 22. Do you have any problems with BIOLOGICAL? No --- go to question no. 18 Not relevant
17 of 22. Are your problems with biological conditions caused by Infectious material? GMO? Safety precautions? Handling animals? Waste? 18 of 22. Are there conditions in your job or at your workplace which can cause workplace determined RISK OF ACCIDENTS? No --- go to question no. 20 19 of 22. Where are the conditions which can cause RISK OF ACCIDENTS? In the laboratory? At the workshop? During fieldwork on land? During fieldwork at sea? During fieldwork in the air? Other places? State the locality with RISK OF ACCIDENTS
20 of 22. Are there conditions in your physical work environment that can contribute to ABSENCE DUE TO ILLNESS? E.g. heavy lifting, allergy, eczema or other? No 21 of 22. Do you have access to the necessary LEGISLATIVE DOCUMENTATION regarding your job? For example: have measures been introduced to ensure that your work can be carried out in a responsible way as regards safety before you actually start working? Are you confident about the responsibility conditions? Are applicable arrangements for providing help incorporated in connection with pregnancy, handicap, flex job, etc. Supplier and workplace instruction manuals, special regulations for carcinogenic substances, risk evaluations, etc. No Do not know 22 of 22. Thank you for your response!
Subject List for the Physical-Ergonomic APV Questionnaire AREAS WHAT SHOULD BE TAKEN INTO SPECIAL ACCOUNT - ARE THERE SHORTCOMINGS AT: PHYSICAL WORKPLACE ENVIRONMENT WORKPLACE LAYOUT SPACE (E.G. CRAMPED ) Furniture, location of equipment Room to "manoeuvre", space for putting down objects, note taking space etc., fire and emergency routes, shared office Flooring, covering, fire extinguishers and the like NOISE PEOPLE / ANIMALS Available protective equipment, shared office EQUIPMENT VENTILATION Machinery, office equipment, protective equipment available Ventilation, protective equipment available NOISE VIBRATIONS Hand and whole-body vibration, etc. LIGHTING LETTING IN DAYLIGHT EQUIPMENT LIGHTING ROOM LIGHTING Daylight, glare, reflections, mirroring Glare, reflections, mirroring, point lighting, lighting by equipment Daylight, glare, reflections, mirroring INDOOR CLIMATE LIGHTING PROBLEMS HEAT COLD Temperature, heat generating equipment, heat radiation, humidity, heavy air, regulation of heat Temperature, cold storage DRAUGHTS Exhausting, leakage SMELL/ODOUR CLEANING From the drainage, from the ventilation system Insufficient cleaning, dust Static electricity
PHYSICAL Static electricity, X-rays, laser etc., magnetic field, radioactive sources, dust ERGONOMIC WORKING POSTURE Seated, walking, standing, stooping posture, twisting the back, high and low work. Instruction in postures REPETITIVE WORK LIFTING Frequent repetition of the work operation, lack of variety of work Heavy lifting, push and pull, with and without aid CHEMICAL ERGONOMIC SUBSTANCES AND MATERIAL HAZARDOUS TO HEALTH SAFETY PRECAUTIONS WASTE FIRE Shape of tools, operating grip Conduct of weighing, packaging, storage of substances, materials and medicine / drugs, dust, allergenic substances, enzymes, chromium, nickel Fume cupboards, point exhaust, laughing gas exhaust, personal protective equipment, grinding, milling and polishing of metals, acrylic, plaster, etc., instruction Storage, neutralization, labelling, handling Working with chemicals which can ignite spontaneously or chemicals which are flammable or explosive BIOLOGICAL CHEMICAL INFECTIOUS MATERIAL GMO SAFETY PRECAUTIONS HANDLING ANIMALS WASTE BIOLOGICAL E.g. Nanotechnology, isotopes Infection risk, work which involves or releases bacteria, viruses, fungi, parasites, etc., instructions in dealing with infectious persons / materials, soil, sludge, dust, allergenic material Plants, animals To prevent contamination of others, the product and / or you, instructions Protection against bites, kicks, twisting by e.g. feeding and moving Storage, neutralization, labelling, handling E.g. by classified laboratories
RISK OF ACCIDENT ABSENCE DUE TO ILLNESS IN THE LABORATORY AT THE WORKSHOP Location of materials, safeguarding equipment/machinery, floors, eye rinse bottles, protective equipment, special tools, syringes, scalpel blades, gas cylinders, risk of fire Machines with emergency stop, placement and handling of machinery, eye rinse bottles, gas cylinders, risk of fire FIELDWORK LAND Formulate risk assessments RISKS OF ACCIDENT SEA AIR Formulate risk assessments for sailing Formulate risk assessments for aviation Maintenance, shielding, transport equipment, cranes, lifts, electrical installation, electrical equipment, scaffolding, ladders, stairs, surface, lighting, storage of explosives and flammable substances, escape routes Are there circumstances in your work that contribute to absence due to illness, e.g. heavy lifting, allergies, eczema etc? LEGISLATIVE DOCUMENTATION Are any initiatives made to ensure that you can perform your work safely before you start working? Are you sure about the liability conditions? Are any relief measures incorporated in the event of pregnancy, disability, flexible job? Supplier and workplace manuals, special rules for carcinogens, risk assessments, etc.