High risk machine safety assessment checklist
Template developed for the assessment of high risk machine safety hazards which may result in a fatality or severe, debilitating injuries.
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The purpose of this High Risk Machine Safety Assessment is to determine if uncontrolled hazards exist
Each hazard identified will be assigned a probability and severity ranking which will subsequently be
Mechanical Hazard is a general designation for all physical factors that can give rise to injury resu
Entanglement - Entanglement occurs as a result of bodily contact with one of the following: A single
1.1 Entanglement
- 1.1 Do entanglement hazards exist which could cause or contribute to severe injuries or death?
Friction and Abrasion occurs as the result of bodily contact with relatively smooth parts/equipment m
1.2 Friction and Abrasion
- 1.2 Friction and Abrasion - Do Friction and Abrasion hazards exist which could cause or contribute to severe injuries or death?
Cutting occurs as a result of bodily contact with such items as cutting tools, saws, routers, knives,
1.3 Cutting or Severing
- 1.3 Cutting or Severing - Do Cutting or Severing hazards exist which could cause or contribute to severe injuries or death?
Parts of the body may be sheared between two machine parts or between a a machine part and a workpiec
1.4 Shearing
- 1.4 Shearing - Do Shearing hazards exist which could cause or contribute to severe injuries or death?
The body may be penetrated by flying objects or by rapidly moving parts and/or equipment.
1.5 Stabbing or Puncturing
- 1.5 Stabbing or Puncturing - Do stabbing or Puncturing hazards exist which could cause or contribute to severe injuries or death?
Impact occurs as a result of of bodily contact with objects acting against the inertia of the body no
1.6 Impact
- 1.6 Impact - Do Impact hazards exist which could cause or contribute to severe injuries or death?
Crushing occurs as the result of bodily contact between one part of an object moving against the othe
1.7 Crushing
- 1.7 Crushing - Do Crushing hazards exist which could cause or contribute to severe injuries or death?
Drawing-in occurs as the result of bodily contact with one of the following mechanisms: 1. In-running
1.8 Drawing-in or Trapping
- 1.8 Drawing-in or Trapping - Do Drawn-in or Trapping hazards exist which could cause or contribute to severe injuries or death?
Compressed air or high-pressure fluid injection occurs as a result of skin exposure to high-pressure
1.9 Pressurized Liquids/Gases Injection/Ejection
- 1.9 Pressurized Liquids/Gases Injection/Ejection - Do pressured Liquids/Gases Injection/Ejection hazards exist which could cause or contribute to severe injuries or death?
Because of their mechanical nature, hazards resulting from slipping, tripping and falling in relation
2.0 Slipping, Tripping and Falling
- 2.1 Slipping, Tripping and Falling - Do slip, trip and fall hazards exist which could cause or contribute to severe injuries or death?
Electrical hazards can cause injury or death from explosion, electrical shock or burns. These can be
3.0 Electrical Hazards
- 3.1 Electrical Hazards - Do electrical hazards exist which could cause or contribute to severe injuries or death?
Thermal hazards can result in burns and scalds from contact with objects or materials with an extreme
4.0 Thermal Hazards
- 4.1 Thermal Hazards - Do Thermal hazards exist which could cause or contribute to severe injuries or death?
Noise can result in permanent hearing loss, tinnitus, tireness and stress, other effects such as loss
5.0 Hazards Generated by Noise
- 5.1 Hazards Generated by Noise - Do hazards generated by noise exist which could cause or contribute to severe injuries or death?
Vibration can be transmitted to the whole body and particularly to the hands and arms. The most sever
6.0 Hazards Generated by Vibration
- Vibration - Do hazards generated by vibration exist which could cause or contribute to severe injuries or death?
Hazards generated by radiation can have immediate effects or long term effects. They are produced by
7.0 Hazards Generated by Radiation
- 7.1 Radiation - Do hazards generated by radiation exist which could cause or contribute to severe injuries or death?
Total Machine Risk
- Total Machine Probability
- Total Machine Severity
- Total Machine Risk
Overall all conditions
Auditors Signature
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