UNIVERSITY OF BATH: DEPT. OF CHEMISTRY
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 completing the forms are available from the Safety Coordinator. The form is available in electronic format.
Academic/ PI:
Researcher/s:
Laboratory:
Start date:
Experiment:
Proposed reaction (e.g., reaction scheme), including process (e.g., heat at reflux), work-up and
approximate quantities of reagents and solvents:
Reaction Volume
<5 mL/ NMR
< 25 mL
<100 mL
<500 mL
>500 mL
Are any of the reagents used listed on the Dept. of Chemistry dangerous chemicals list? Yes/ No
Chemicals: Use label and (M)SDS for information - note hazards, workplace exposure limits and stock bottle quantities
Hazardous Substances (list)
All substances which have a hazard code, WEL or are
radioactive. Include reagents, solvents and products.
Stock
Quantity
(g, mg, ml,
MBq, etc.)
Hazard
WEL
Toxic, Health Hazard, Corrosive, Flammable, Harmful to
Environment, carcinogenic, mutagenic, reacts violently with
water, α, β, γ-emitter etc.
TWA/ STEL
ppm or
mg.m3
Treat any unknown or novel compound as Toxic, unless you know otherwise.
Containment and Protection
Containment of the chemicals to minimise exposure; personal protection from
contact with hazardous substances.
Containment for substances
Fume cupboard/ Glovebox/ Class 2 tissue culture cabinet/ lab bench
Circle containment facility required.
Other (specify):
Gloves. Disposables (EN374): latex/ thin nitrile/ purple nitrile
Other (specify):
Eye Protection. Safety glasses/ goggles/ face visor
Additional e.g., apron, toe-capped shoes (specify):
Personal protection
Circle level of personal protection required.
Minimum PPE in a chemistry lab is
safety glasses (BSEN 166 F) and
fastened lab coat.
Waste Disposal:
How the waste from the experiment will be disposed of safely, avoiding
contamination or injury to persons or to the environment. State method of disposal,
e.g., Flammable solvent waste bottle, laboratory bin, special waste, etc.
Do any of the compounds used or produced require special disposal methods?
Emergency Procedures:
Any special procedures and precautions necessary in the event of exposure, spillage
or failure of services. Give realistic spill clean-up procedures which will be applied in
the laboratory. Report all incidents.
What should happen in case of exposure (skin/ eye contact, inhalation, ingestion), spillage or if equipment fails?
Making the Reaction Safe:
Provide details on how to make your experiment safe in case of emergency.
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.
Any special training, supervision and monitoring (exposure or health) necessary for
use of the hazardous substances, including requirements of local rules.
Risk Assessor
Print name:
PDRO, academic staff, technical staff, etc.
Supervisors must sign for undergraduate and postgraduate students.
Signature:
Date:
Names and Signatures of PG/ UG students and other workers
All others who will be using the hazardous substances must signify that they understand the hazards and risks
Print name:
Signature:
Date: