HAZARD ASSESSMENT For PERSONAL PROTECTIVE EQUIPMENT (PPE) ------- Hazard Assessment For PPE This tool can help you do a hazard assessment to see if your employees need to use personal protective equipment (PPE) by identifying activities that may create hazards for your employees. The activities are grouped according to what part of the body might need PPE. You can make copies, modify and customize it to fit the specific needs of your particular work place, or develop your own form that is appropriate to your work environment. This tool can also serve as written certification that you have done a hazard assessment as required by WAC 296-800-16010 Document your hazard assessment for PPE. Make sure that the blank fields at the beginning of the checklist (indicated by *) are filled out (see below, Instructions #4). Instructions: 1. Do a walk through survey of each work area and job/task. Read through the list of work activities in the first column, putting a check next to the activities performed in that work area or job. 2. Read through the list of hazards in the second column, putting a check next to the hazards to which employees may be exposed while performing the work activities or while present in the work area, (for e.g., work activity: chopping wood; work-related exposure: flying particles). 3. Decide how you are going to control the hazards. Try considering engineering, work place, and/or administrative controls to eliminate or reduce the hazards before resorting to using PPE. If the hazard cannot be eliminated without using PPE, indicate which type(s) of PPE will be required to protect your employee from the hazard. 4. Make sure that you complete the following fields on the form (indicated by *) to certify that a hazard assessment was done: *Name of your work place *Address of the work place where you are doing the hazard assessment *Name of person certifying that a workplace hazard assessment was done *Date the hazard assessment was done ------- PPE Hazard Assessment Certification Form *Name of work place: *Assessment conducted by: *Work place address: *Date of assessment: Workarea(s): Job/Task(s): "Required for certifying the hazard assessment. Use a separate sheet for each job/task or work area EYES Work activities, such as: Work-related exposure to: Can hazard be eliminated without the use of PPE? ~ abrasive blasting ~ sanding ~ chopping ~ sawing ~ cutting ~ grinding ~ drilling ~ hammering ~ welding ~ punch press operations I-! other: ~ airborne dust ~ flying particles ~ blood splashes ~ hazardous liquid chemicals ~ intense light I-! other: Yes ~ No ~ If no, use: ~ Safety glasses ~ Side shields ~ Safety goggles ~ Dust-tight I-! Shadina/Filter (# ) aoaales ~ Welding shield I-! Other: FACE Work activities, such as: Work-related exposure to: Can hazard be eliminated without the use of PPE? ~ cleaning ~ foundry work ~ cooking ~ welding ~ siphoning ~ mixing ~ painting ~ pouring molten ~ dip tank operations metal I-! other ~ hazardous liquid chemicals ~ extreme heat/cold I-! potential irritants: I-! other: Yes ~ No ~ If no, use: ~ Face shield I-! Shadina/Filter (# ) ~ Welding shield I-! Other: HEAD Work activities, such as: Work-related exposure to: Can hazard be eliminated without the use of PPE? ~ building maintenance ~ confined space operations ~ construction ~ electrical wiring ~ walking/working under catwalks ~ walking/working under conveyor belts ~ walking/working under crane loads ~ utility work I-! other: ~ beams ~ pipes ~ exposed electrical wiring or components ~ falling objects ~ machine parts I-! other: Yes ~ No ~ If no, use: ~ Protective Helmet ~ Type A (low voltage) ~ Type B (high voltage) ~ Type C ~ Bump cap (not ANSI-approved) ~ Hair net or soft cap I-! Other: ------- HANDS/ARMS Work activities, such as: Work-related exposure to: Can hazard be eliminated without the use of PPE? ~ baking ~ material handling ~ cooking ~ sanding ~ grinding ~ sawing ~ welding ~ hammering ~ working with glass ~ using computers ~ using knives ~ dental and health care services I-! other: ~ blood ~ irritating chemicals ~ tools or materials that could scrape, bruise, or cut ~ extreme heat/cold I-! other: Yes ~ No ~ If no, use: ~ Gloves ~ Chemical resistance ~ Liquid/leak resistance ~ Temperature resistance ~ Abrasion/cut resistance ~ Slip resistance ~ Protective sleeves I-! Other: FEET/LEGS Work activities, such as: Work-related exposure to: Can hazard be eliminated without the use of PPE? ~ building maintenance ~ construction ~ demolition ~ food processing ~ foundry work ~ logging ~ plumbing ~ trenching ~ use of highly flammable materials ~ welding I-! other: ~ explosive atmospheres ~ explosives ~ exposed electrical wiring or components ~ heavy equipment ~ slippery surfaces ~ tools I-! other: Yes ~ No ~ If no, use: ~ Safety shoes or boots ~ Toe protection ~ Metatarsal protection ~ Electrical protection ~ Heat/cold protection ~ Puncture resistance ~ Chemical resistance ~ Anti-slip soles ~ Leggings or chaps ~ Foot-Leg guards I-! Other: BODY/SKIN Work activities such as: Work-related exposure to: Can hazard be eliminated without the use of PPE? ~ baking or frying ~ battery charging ~ dip tank operations ~ fiberglass installation ~ irritating chemicals ~ sawing I-! other: ~ chemical splashes ~ extreme heat/cold ~ sharp or rough edges I-! other: Yes ~ No ~ If no, use: ~ Vest, Jacket ~ Coveralls, Body suit ~ Raingear ~ Apron ~ Welding leathers ~ Abrasion/cut resistance I-! Other: ------- BODY/WHOLE 1 Work activities such as: Work-related exposure to: Can hazard be eliminated without the use of PPE? ~ building maintenance ~ construction ~ logging ~ utility work I-! other: ~ working from heights of 10 feet or more ~ working near water I-! other: Yes ~ No ~ If no, use: I-! Fall Arrest/Restraint: Tvoe: I-! PFD: Tvoe: I-! Other: *(See Footnote 1) LUNGS/RESPIRATORY 1 Work activities such as: Work-related exposure to: Can hazard be eliminated without the use of PPE? ~ cleaning ~ pouring ~ mixing ~ sawing ~ painting ~ fiberglass installation ~ compressed air or gas operations I-! other: ~ irritating dust or particulate ~ irritating or toxic gas/vapor I-! other: Yes ~ No ~ *(See Footnote 1) EARS/HEARING 1 Work activities such as: Work-related exposure to: Can hazard be eliminated without the use of PPE? ~ generator ~ grinding ~ ventilation fans ~ machining ~ motors ~ routers ~ sanding ~ sawing ~ pneumatic equipment ~ punch or brake presses ~ use of conveyors I-! other: ~ loud noises ~ loud work environment ~ noisy machines/tools ~ punch or brake presses I-! other: Yes ~ No ~ *(See Footnote 1) (1) NOTE: There are other hazards requiring PPE (such as respiratory, noise, fall, etc. hazards), that are not included in this volume of the PPE Guide but will be covered in future volumes (see WAC 296-62 for respiratory and hearing protection and WAC 296-155 for fall protection for further assessment). However, you should consider all hazards when you conduct your hazard assessment. See a list of other WISHA rules (in "How to use this guide" p. 4) for information regarding PPE for specific work places. ------- |