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Risk Assessment Tool (Use this tool to analyze potential risks in your work area.

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Principle Investigator/Area Supervisor: Brief Description of Laboratory Activities/Project: Date of Assessment:

Department:
Assessor(s)/Team:
Building: Positions affected by area (lab personnel/students/faculty/staff/visitors):

Room Number: Lab Operation Hours (if operational hours impact the Risk Assessment):

How could you be Given the exposure, what is Consequences (Outcome)


Existing Control
Hazard/Exposure Category exposed to this hazard? negative outcome? (briefly What is the Value Measure In Place
(briefly describe) describe) expected harm? 0 to 5

Chemical Exposure - Toxic /


Highly Toxic

Chemical Exposure - Corrosive

Chemical Exposure - Reproductive


Toxins (Mutagen/Teratogens)

Exposure to
Carcinogens

Exposure to Irritants

Exposure to Sensitizers
How could you be Given the exposure, what is Consequences (Outcome)
Existing Control
Hazard/Exposure Category exposed to this hazard? negative outcome? (briefly What is the Value Measure In Place
(briefly describe) describe) expected harm? 0 to 5

Exposure to Nonionizing Radiation

Exposure to Ionizing Radiation

Exposure to Organic Peroxide

Storage or Use of Explosives

Water Reactive Material

Unstable (reactive) /
Polymerizable Material

Combustible Liquid /
Flammables

Exposure to
Biohazards/Bloodborne Pathogens

Combustible Dust
How could you be Given the exposure, what is Consequences (Outcome)
Existing Control
Hazard/Exposure Category exposed to this hazard? negative outcome? (briefly What is the Value Measure In Place
(briefly describe) describe) expected harm? 0 to 5

Oxidizer

Pyrophoric Material

Exposure to Compressed
Gases
(including cryogenic
material)

Exposure to heat/cold

Exposure to Noise

Walking/Working Surfaces

Means of Egress (Emergency)

Energy Control (Lock-out/Tag-out)

Exposure to Fall Hazards


How could you be Given the exposure, what is Consequences (Outcome)
Existing Control
Hazard/Exposure Category exposed to this hazard? negative outcome? (briefly What is the Value Measure In Place
(briefly describe) describe) expected harm? 0 to 5

Pressure vessels

Material Handling of
Chemicals (Bulk)

Physical Hazards - Exposure to


Sharp Objects

Physical Hazards -
Exposure to Rotating
Equipment & Points of
Operation

Welding/Cutting Hazards

Exposure to Electrical Hazards

Employee knowledge of the chemical hygiene plan

Eye Hazards

Unattended Operations

Working Alone
How could you be Given the exposure, what is Consequences (Outcome)
Existing Control
Hazard/Exposure Category exposed to this hazard? negative outcome? (briefly What is the Value Measure In Place
(briefly describe) describe) expected harm? 0 to 5

Working with Animals or Biological Agents


Probability Risk
Value 0 to Rating
5 Number

0
Probability Risk
Value 0 to Rating
5 Number

0
Probability Risk
Value 0 to Rating
5 Number

0
Probability Risk
Value 0 to Rating
5 Number

0
Probability Risk
Value 0 to Rating
5 Number

0
Risk Hazard Matrix

Consequences Probability
Probably
Will occur
will occur Frequent/
Possible under
under Regular /
Unlikely to occur current
routine Continuous
over time condition
condition Occurrence
s
People s

1 2 3 4 5
Fatality(s) / Chronic Illness with no recovery 5

Injury/Illness requiring personnel to be hospitalized/off


work for extended period of time 4

High Risk
Injury/Illness requiring medical treatment by a medical
professional beyond first aid / no time off work required 3 Medium Risk

Injury/Illness requiring first aid treatment by non-


medical personnel 2

Low Risk
Minimal - no medical treatment or assistance
needed. 1

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