HEALTH & SAFETY CHEMICAL RISK ASSESSMENT FORM Ra No.: Date: Version No.: Review Date: Authorised by: STEP 1 – ENTER INFORMATION ABOUT THE ACTIVITY/TASK, ITS LOCATION AND THE PEOPLE COMPLETING THE RISK ASSESSMENT Location name: Building No.: Room No.: Chemical (Manufacturer’s name and product name): Date: Is the chemical a hazardous substance? Yes Class 4.1 flammable solids Is the chemical a dangerous good? Yes If “yes” list the dangerous goods class: No Assessed by: No Yes If “yes” list the hazard statement: H228, H412 (example for red phosphorous) Is the chemical a scheduled poison? 4.1 HSR/Employee representative: If “yes” list the poison schedule: No Description of work/activities/use: Solids that under certain conditions are readily combustible or may cause or contribute to a fire. Examples include magnesium and red phosphorous. Are there any licencing/permit requirements? Yes If “yes” provide details: Health surveillance requirements (list “nil” if not required): No Nil A current MSDS/SDS is available Yes Exposure route of chemical: Inhalation Skin (absorption) Eye Ingestion Injection Other – Specify: Workplace conditions (Describe layout and physical conditions - including access and egress): A purpose built laboratory fitted with fume hoods and restricted access. What are the storage requirements? What are the waste/disposal requirements? Store in a Class 4 storage cabinet that complies with AS 5026. The storage of class 4 dangerous goods segregated from incompatible materials ie. Sub risk 5 chemicals Use the University waste procedure and the preferred hazardous waste contractor List systems of work for the activity/task: Chemical management training ● Training ● Inspections Chemical handling SOPs ● SOPs ● Existing controls Scheduled bi-monthly lab inspections ● Emergency situations Is there past experience with the chemical that may assist in the assessment? Chemical management training. ● Existing controls ● SOPs ● Standards AS 5026: The storage of class 4 dangerous goods. AS 2243.1-10: Safety in laboratories ● Industry standards ● Incidents & near-hits ● Legislation & Codes Dangerous Goods (Storage and Handling) Regulations 2012. ● Training ● Incident Investigation ● Guidance material University of Melbourne chemical management guidance material. Chemical Risk Management Procedure safety.unimelb.edu.au Chemical handling SOPs OHS Act 2004. OHS Regulations 2007. HEALTH & SAFETY: CHEMICAL RISK ASSESSMENT FORM – CLASS 4 .1 FLAMMABLE SOLIDS 1 Template date: June 2015 Version: 1.0 Authorised by: Associate Director, Health & Safety Next Review: June 2018 © The University of Melbourne – Uncontrolled when printed. First aid and emergency requirements University of Melbourne and local area emergency procedures (see last page). ● Additional first aid kit contents ● Special first aid requirements (eg oxygen) Local area first aid procedures (see last page). ● Emergency eyewash ● Emergency shower Vermiculite or attapulgite spill kit. ● Spill kit safety.unimelb.edu.au ● Neutralising agent ● Restrict access Eye and burn modules HEALTH & SAFETY: CHEMICAL RISK ASSESSMENT FORM – CLASS 4 .1 FLAMMABLE SOLIDS 2 Template date: June 2015 Version: 1.0 Authorised by: Associate Director, Health & Safety Next Review: June 2018 © The University of Melbourne – Uncontrolled when printed. STEP 2: SELECT A RISK RATING METHOD TWO VARIABLE RISK MATRIX THREE VARIABLE RISK CALCULATOR (1) Definitions of likelihood labels (1) Definitions of exposure variables Likelihood (Probability) Exposure E Level Descriptor Description Expected to occur Continuously or many times daily 10 A Almost certain The event will occur on an annual basis Once a year or more Frequently: Approximately once daily 6 Occasionally: Once a week to once a month 3 Infrequently: Once a month to once a year 2 B Likely The event has occurred several times or more in your career Once every three years C Possible The event might occur once in your career Once every 10 years Rarely: Has been known to occur 1 D Unlikely The event does occur somewhere from time Once every 30 years to time Very rarely: Not known to have occurred 0.5 E Rare Heard of something like the event occurring elsewhere (2) Definitions of likelihood variables Once every 100 years (2) Definitions of consequence labels Severity level Consequences V Catastrophe One or more fatalities and/or severe irreversible disability to one or more people IV Major Extensive injury or impairment to one or more persons III Moderate Short term disability to one or more persons II Insignificant Medical treatment and/or lost injury time <2 weeks I Negligible First aid treatment or no treatment required Likelihood L Almost certain: The most likely outcome if the event occurs 10 Likely: Not unusual, perhaps 50-50 chance 6 Unusual but possible: (e.g. 1 in 10) 3 Remotely possible: A possible coincidence (e.g. 1 in 100) 1 Conceivable: Has never happened in years of exposure, but possible (eg 1 in 1,000) 0.5 Practically impossible: Not to knowledge ever happened anywhere (e.g. 1 in 10,000) 0. 1 (3) Definitions of consequence variables (3) Risk rating matrix Likelihood Consequence label label I II III IV V A Medium High High Very high Very high B Medium Medium High High Very high C Low Medium High High High D Low Low Medium Medium High E Low Low Medium Medium High Consequences C Catastrophe: Multiple fatalities 100 Disaster: Fatality 50 Very serious: Permanent disability/ill health 25 Serious: Non-permanent injury or ill health 15 Important: Medical attention needed 5 Noticeable: Minor cuts and bruises or sickness 1 (4) Risk score calculator Risk Score = E x L x C Risk score Risk rating > 600 Very high 300 - 599 High 90 - 299 Medium < 90 safety.unimelb.edu.au Low HEALTH & SAFETY: CHEMICAL RISK ASSESSMENT FORM – CLASS 4 .1 FLAMMABLE SOLIDS 3 Template date: June 2015 Version: 1.0 Authorised by: Associate Director, Health & Safety Next Review: June 2018 © The University of Melbourne – Uncontrolled when printed. STEP 3 – REVIEW CHEMICAL PROCESS For each stage of the chemical risk assessment: Hierarchy of Control (Control Type) Review the prompts/examples for each route of exposure for each category; El – Elimination Determine and record a raw risk score by referencing the two variable risk matrix or the three variable risk calculator; S – Substitution In the comments box, describe the route of exposure and any other information (if applicable); En – Engineering Specify the risk control type for each current or proposed risk control; Sh – Shielding Provide a control description for each current or proposed risk control; A – Administrative T – Training Where proposed risk control(s) have been identified complete a Health & Safety Action Plan; M – Monitoring Determine the residual risk score referencing the same two variable risk matrix or three variable risk calculator used to determine the raw risk score. P – PPE Category Raw Risk Score Storage Is – Isolation G – Guarding In – Inspection H – Health Monitoring For information devising appropriate controls, refer to: Guide to Chemical Risk Hierarchy of Control. Comments (when/where the exposure is present) Control Type Control Description (Current and Proposed) Residual Risk Score Low 1 x 3 x 50 Inhation associated with poor ventilation En ● Inhalation ● Skin (absorption = 150 Corrosive to the skin and eyes Is Limit quantities in storage to as low as reasonably practicable ● Eye ● Ingestion Medium Unplanned fire In Store in a cabinet that complies with AS 5026 ● Injection ● Other A Restricted access Regular scheduled inspections Handling 2 x 3 x 50 Inhation associated with poor ventilation En Chemical management training ● Inhalation ● Skin (absorption = 300 Corrosive to the skin and eyes A Secure to appropriate troleey for moving around. ● Eye ● Ingestion High Unplanned fire T Limit quantities in laboratories to as low as reasonably practicable ● Injection P ● Other Low Wear appropriate eye and face protection, protective clothing and gloves as per MSDS/SDS Other PPE as determined by activity/use and MSDS/SDS (see last page for details of commonly used/required PPE) Decanting/Mixing safety.unimelb.edu.au 2 x 3 x 50 Inhation associated with poor ventilation En Decant in a designated decanting area – ventilation, Low HEALTH & SAFETY: CHEMICAL RISK ASSESSMENT FORM – CLASS 4 .1 FLAMMABLE SOLIDS 4 Template date: June 2015 Version: 1.0 Authorised by: Associate Director, Health & Safety Next Review: June 2018 © The University of Melbourne – Uncontrolled when printed. Category Raw Risk Score Comments (when/where the exposure is present) Control Type ● Inhalation ● Skin (absorption = 300 Corrosive to the skin and eyes Is Control Description (Current and Proposed) earthing, no ignition sources ● Eye ● Ingestion High Unplanned fire A Decanting SOP ● Injection ● Other T Manual handling training P Chemical management training Residual Risk Score Wear appropriate eye and face protection, protective clothing and gloves Other PPE as determined by activity/use and MSDS/SDS (see last page for details of commonly used/required PPE) Signage Applying/Using 2 x 3 x 50 Inhation associated with poor ventilation En Use only in a fume hood ● Skin (absorption = 300 Corrosive to the skin and eyes A Chemical management training ● Eye ● Ingestion High Unplanned fire T Read MSDS/SDS before using for the first time ● Injection ● Other In Wear appropriate eye and face protection, protective clothing and gloves ● Inhalation P Low Other PPE as determined by activity/use and MSDS/SDS (see last page for details of commonly used/required PPE) Workplace inspections Spill/Leak 1 x 3 x 50 Inhation associated with poor ventilation Is ● Skin (absorption = 150 Corrosive to the skin and eyes A ● Eye ● Ingestion Low Unplanned fire T ● Injection ● Other ● Inhalation P Have appropriate spill kit and cleanup equipment available Low Know local emergency procedures and evacuation routes PPE as determined by emergency procedures (see last page for details of commonly used/required PPE) Know the location of eye wash/emergency showers Know the location of first aid kits and the local first aid providers Store in bunded area Use undamaged original container or containers appropriate to hold chemical Disposal safety.unimelb.edu.au 1 x 3 x 50 Inhation associated with poor ventilation El Ourches in required quantities only to eliminate waste Low HEALTH & SAFETY: CHEMICAL RISK ASSESSMENT FORM – CLASS 4 .1 FLAMMABLE SOLIDS 5 Template date: June 2015 Version: 1.0 Authorised by: Associate Director, Health & Safety Next Review: June 2018 © The University of Melbourne – Uncontrolled when printed. Category Raw Risk Score Comments (when/where the exposure is present) Control Type Control Description (Current and Proposed) ● Inhalation ● Skin (absorption = 150 Corrosive to the skin and eyes A ● Eye ● Ingestion Low Unplanned fire Is Use the University of Melbourne preferred hazardous waste contractor ● Injection ● Other T Store in dedicated area prior to disposal Residual Risk Score Local area emergency procedures Restricted access safety.unimelb.edu.au HEALTH & SAFETY: CHEMICAL RISK ASSESSMENT FORM – CLASS 4 .1 FLAMMABLE SOLIDS 6 Template date: June 2015 Version: 1.0 Authorised by: Associate Director, Health & Safety Next Review: June 2018 © The University of Melbourne – Uncontrolled when printed. STEP 4 – IMPLEMENTATION AND CONSULTATION PROCESS Determine the person responsible for reviewing and implementing the risk assessment including the identified controls. Ensure a Health & Safety Action Plan has been completed, reviewed and signed off where proposed controls have been identified. Obtain the authorisation of the management representative. Ensure the HSR (if applicable) has been consulted. Ensure the employees undertaking the activity have been consulted. Record below the names of the persons consulted. Management representative HSR/Employee representative Employee(s) Employee(s) Employee(s) Employee(s) Person Responsible for implementation or escalation Extra writing room - use this page to enter extended comments or descriptions Review Review risk assessment every 3 years. Review employee chemical procedures during workplace inspections. Review risk assessment where there is an incident with the chemical or new information becomes available. Review risk assessment when the MSDS/SDS is updated/reissued. Emergency and First Aid procedures Ensure that general first aid procedures and resources are in place and available. First aid risk assessment and procedures that take into account the risks associated with the chemical and possible adverse outcomes. University of Melbourne and local area emergency procedures. Spill kits – vermiculite or attapulgite PPE Respiratory protection: AS/NZS 1715 Selection, use and maintenance of respiratory protective equipment Safety Glasses: AS/NZS 1337.1 Personal eye protection. Eye and face protectors for occupational applications Gloves: AS/NZS 2161.1 Occupational protective glove. Selection, use and maintenance Boots: AS/NZS 2210.1-9 (series) Occupational protective footwear or sturdy footwear as per local area requirements To eliminate injuries always use the chemical in accordance with the manufacturer’s instructions and for its intended purpose only. All chemical users must have demonstrated competency and be familiar with the risk assessment and any SOPs prior to use of the chemical. For use in conjunction with the OHS risk management procedure and the Chemical risk management procedure. For further information, refer to http://safety.unimelb.edu.au/tools/risk/ or contact your Local Health & Safety contact. safety.unimelb.edu.au HEALTH & SAFETY: CHEMICAL RISK ASSESSMENT FORM – CLASS 4 .1 FLAMMABLE SOLIDS 7 Template date: June 2015 Version: 1.0 Authorised by: Associate Director, Health & Safety Next Review: June 2018 © The University of Melbourne – Uncontrolled when printed. safety.unimelb.edu.au HEALTH & SAFETY: CHEMICAL RISK ASSESSMENT FORM – CLASS 4 .1 FLAMMABLE SOLIDS 8 Template date: June 2015 Version: 1.0 Authorised by: Associate Director, Health & Safety Next Review: June 2018 © The University of Melbourne – Uncontrolled when printed.