UNIVERSITY OF BATH - DEPT. OF PHARMACY & PHARMACOLOGY
CHEMICAL RISK ASSESSMENT (COSHH FORM)
A COSHH form must be completed for all work involving hazardous substances before the work starts. Attach extra sheets of paper if necessary. Advice and
assistance with completing the forms are available from the Chemical Safety Adviser. This form is also available in electronic format.
The Researchers and the Laboratory
Staff member
Students
Laboratory
Start date
Title:
Proposed reaction/process:
The Chemicals
Hazardous substances
Quantity
Hazard
All substances which have a hazard phrase (harmful,
toxic, etc.) , a Maximum Exposure Limit or an
Occupational Exposure Limit or are radioactive. Put all
hazardous substances for an experiment or procedure on
one form.
Quantity (g, mg, ml,
MBq, etc.) to be used
in each experiment or
procedure.
Harmful, toxic, highly toxic, irritant, mutagenic, carcinogenic,
flammable, highly flammable, harmful to the environment,
corrosive, explosive, reacts violently with water, //-emitter etc.
Containment and Protection
Containment of the chemicals to minimise exposure; personal protection from contact with hazardous
substances.
Containment for substances
Personal protection
Delete inappropriate containment facilities.
Delete inappropriate personal protection.
Fume cupboard
Safety spectacles
Laboratory coat
Glove-box
Disposable gloves
Other
Class 2 tissue culture cabinet
Rubber gloves (nitrile - blue)
Other
Rubber gloves (ordinary pink/black/yellow)
Specify
Waste Disposal1
Waste materials
Specify
How the waste from the experiment will be disposed of safely, avoiding contamination or
injury to persons or the to environment.
Disposal
Sink, waste solvent bottle, laboratory bin, special waste disposal, etc.
Emergency Procedures
Any special procedures and precautions necessary in the event of spillage or of failure of
services. Give realistic spill clean-up procedures which will be applied in the laboratory.
All significant spills should be reported immediately to the Chemical Safety Adviser.
Training, Supervision and
Monitoring
Any special training, supervision and monitoring (exposure or health) necessary for use of the
hazardous substances, including requirements of local rules. Note here if lone working is not
permitted for this procedure or process.
Other Information
Any other information relevant to this use of hazardous substances, e.g. unusual experimental
procedures. Note here any controls on access to the laboratory area.
Signatures2
Signature of person making this Risk Assessment:
PRINT name of Risk Assessor:
Signature of Supervisor :
Signatures of others who will use this RA:
Date
Initialled by Chemical
Safety Adviser
Notes:
1
Please detail any special disposal methods that will be employed, e.g. destruction of excess sodium metal
prior to disposal of wastes.
2
The person making the risk assessment should ensure that their supervisor has signed the assessment and
that the Department Chemical Safety Adviser has initialled it BEFORE any practical work is started.