ࡱ>  "bjbjΚΚ Yll<<<<<4ppphpR4@BBBBBB, vn<n<<<<@@:o?Uzr ,0 C!C!<(nnC!l :   Please retain this form within the department/section when completed. To be completed by staff \ Dept availing of Manual Handling Risk Assessment Support Service or by staff trained in manual handling techniques on return to their workplace or where Manual Handling Risks are obviously low. This form may be used as an alternative or prelim to the checklist in Section 19.3.3.1. Room/Location: ______________________________Name of Person: _______________________________________ Position: ___________________________________ Date: _______________________________________________ Nature of Work: ______________________________________________________________________________________ REF.TASK DESCRIPTION:FACTORSASSESSMENTCOMMENTS BASED ON REFERENCE FACTORS IN THE REGULATIONS (SeeOverleaf) AWEIGHT OF LOAD123HeavyLOADManageableLightBSIZE/SHAPE123AwkwardLOADManageableCompactCLIFT LEVEL123High or LowEFFORTManageable HeightIdeal HeightDDEGREE OF TWISTING123SignificantEFFORTModerateLittle or NoneEWORK RATE123HighFREQUENCYModerateLowFCARRYING DISTANCE123LongACTIVITYModerateShortGBODY SIZE NEEDED123LargeINDIVIDUALAverageAnyHENVIRONMENT 123SignificantENVIRONMENTManageableLittle or None Note: If Column '3' if ticked for any factor further review or work reorganisation should be considered. If more than three factors are ticked in Column '2', further review or work reorganisation should be considered. REFERENCE FACTORS 1. CHARACTERISTICS OF THE LOAD [See also Section 3.3.3.1.2 Characteristics of the Load] The manual handling of a load may present a risk particularly of back injury if it is: too heavy or too large; unwieldy or difficult to grasp; unstable or has contents likely to shift; positioned in a manner requiring to be held or manipulated at a distance from the trunk, or with a bending or twisting of the trunk; likely, because of its contours and/or consistency, to result in injury to workers, particularly in the event of a collision. 2. PHYSICAL EFFORT REQUIRED A physical effort may present a risk particularly of back injury if it is: too strenuous; only achieved by a twisting movement of the body; likely to result in a sudden movement of the load; made with the body in an unstable position. 3. CHARACTERISTICS OF THE WORKING ENVIRONMENT [See also Section 3.3.3.1.4 Characteristics of the Working Environment] The characteristics of the work environment may increase a risk particularly of back injury if: there is not enough room, particularly vertically, to carry out the task; the floor is uneven, slippery, thus presenting slip and trip hazards; the place of work or work environment prevents the handling of loads at a safe height or with good posture by the worker; there are variations in the floor level or the working surface requiring the load to be handled at different levels; the floor or the foot rest is unstable; the temperature, humidity, lighting or ventilation in unsuitable. 4. REQUIREMENTS OF THE ACTIVITY [See also Section 3.3.3.1.3 Characteristics of the Activity] The activity may present a risk particularly of back injury if it entails one or more of the following requirements: over- frequent or over-prolonged effort involving, in particular, the spine; an insufficient bodily rest or recovery period; excessive lifting, lowering or carrying distances; a rate of work imposed by the process which cannot be altered by the worker. 5. INDIVIDUAL RISK FACTORS [See also Section 3.3.3.1.5 Individual Characteristics] The worker may be at risk if he/she: is physically unsuited to carry out the task in question; is wearing unsuitable clothing, footwear or other personal effects; has not received adequate or appropriate manual handling training. Assessment Conclusion Page Location: ____________________________________________________________ Task: ____________________________________________________________ Solutions: _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ Procedure: _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ Note: The Risks as assessed will be reduced to the following level LOW \ MEDIUM. (Please delete as appropriate) on application of the above Solutions \ Procedures. Correct Manual Handling techniques must be applied to all Manual Handling tasks. 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