A technical reference bulletin by the Risk Control Services
Department of the Glatfelter Insurance Group
A
RISK COMMUNIQUÉ
Personal Protective Equipment Hazard Assessment
Company. Name:
Location:
HAZARD
SELECTION OF PPE
Job Task(s):
HAZARD SEVERITY
MISHAP PROBABILITY.
EYE/FACE
___Flying Objects
___Splash (Metals)
___Splash (Chemicals)
___Dusts
___Mists
___Gas Welding (Shade 4-8)
___Cutting/Torch (Shade 3-6)
___Brazing (Shade 3-4)
___Weld/Electric
(Shade 10-14)
___Spectacle
___Spectacle w/Side Shield
___Face Shield
___Goggles
___Sealed Goggles
___Welding Helmet
___Welding Shield
Other:
Other:
___CAT I: Catastrophic
Hazard may cause death.
___CAT II: Critical
May cause severe injury, severe
illness or disability
___CAT III: Marginal
May cause minor injury or minor
illness.
___A
Likely to occur
immediately or within a
short period of time
___B
Probably will occur in
time
___C
May occur in time
___D
Unlikely to occur
___CAT IV: Negligible
Probably would not cause injury
or minor illness
HEAD
___Falling Objects
___Electrical Shock
FOOT
___Falling Objects
___Rolling Objects
___Piercing Sole
___Electrical Hazard
___Metatarsal Protection
HAND
___Chemical Sorption
___Chemical Burns
___Abrasions
___Punctures
___Thermal Burns
___Temperature Extremes
Certified By:
___Class A (<2,000 volts)
___Class B (>2,000 volts)
___Class C (Conductive)
___CAT I: Catastrophic
___CAT II: Critical
___CAT III: Marginal
___CAT IV: Negligible
___A
___B
___C
___D
___Safety Tip Shoes
___Safety Shoes w/metataursal
protection
___Other
___CAT I: Catastrophic
___CAT II: Critical
___CAT III: Marginal
___CAT IV: Negligible
___A
___B
___C
___D
___CAT I: Catastrophic
___CAT II: Critical
___CAT III: Marginal
___CAT IV: Negligible
___A
___B
___C
___D
___Leather Gloves
___Kevlar Gloves
___Cryogenic Gloves
___Chemical Gloves
Material:_____________
Other: cloth gloves are also
acceptable
Date:
This is a sample guideline furnished to you by Glatfelter Public Practice. Your organization should review it and make the necessary modifications
to meet the needs of your organization. The intent of this guideline is to assist you in reducing risk exposure to the public, personnel and
property. For additional information on this topic, you may contact your GPP Risk Control Representative. www.glatfelterpublicpractice.com
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