INSERT LOGO AND COMPANY NAME HERE
OCCUPATIONAL SAFETY AND HEALTH
MANAGEMENT MANUAL
WESTERN AUSTRALIA
FEBRUARY, 2016
Occupational Safety and Health Management Manual
COMPANY NAME
Western Australia
CONTENTS
COMPANY NAME – OCCUPATIONAL SAFETY AND HEALTH POLICY............ 1
1.
2.
3.
4.
5.
6.
MANAGEMENT, SUPERVISORS AND EMPLOYEE RESPONSIBILITIES ........... 2
1.1
Introduction .................................................................... 2
1.2
Management Responsibilities ................................................ 2
1.3
Supervisor Responsibilities ................................................... 3
1.4
Responsibilities of Employees ............................................... 4
RESOLUTION OF ISSUES / HAZARDS ............................................... 5
2.1
Introduction .................................................................... 5
2.2
Definition of Issue ............................................................. 5
2.3
Definition of a Hazard ........................................................ 5
2.4
Procedure ....................................................................... 5
INDUCTION ............................................................................ 8
3.1
Introduction .................................................................... 8
3.2
SITE INDUCTIONS............................................................... 8
CHEMICALS ........................................................................... 11
4.1
Introduction .................................................................. 11
4.2
Chemical Assessment and Control ........................................ 11
4.3
Material Safety Data Sheets (MSDS) ....................................... 11
4.4
Storage, Transportation and Disposal .................................... 12
4.5
Training ....................................................................... 12
4.6
Record Keeping .............................................................. 12
EMERGENCY EVACUATION ......................................................... 13
5.1
Introduction .................................................................. 13
5.2
Exits ........................................................................... 13
5.3
Emergency Evacuation Policy .............................................. 13
FIRST AID ............................................................................. 14
6.1
Introduction .................................................................. 14
Occupational Safety and Health Management Manual
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Western Australia
6.2
Consultation .................................................................. 14
6.3
Communication .............................................................. 14
6.4
Training ....................................................................... 14
6.5
Notification ................................................................... 14
6.6
Contents of First Aid Kits ................................................... 15
6.7
Maintenance of First Aid Boxes ............................................ 16
6.8
Treatment .................................................................... 16
7.
GENERAL SAFETY AND HEALTH RULES .......................................... 17
8.
HAZARDS .............................................................................. 18
9.
10.
11.
8.1
Introduction .................................................................. 18
8.2
Electrical Safety ............................................................. 18
8.3
Manual Handling ............................................................. 18
INCIDENT / ACCIDENT INVESTIGATION .......................................... 19
9.1
Introduction .................................................................. 19
9.2
Definition of AN Accident .................................................. 19
9.3
Definition of an Incident.................................................... 19
9.4
Process ........................................................................ 19
9.5
The Investigation ............................................................ 19
INCIDENT / ACCIDENT REPORTING ............................................... 21
10.1
Introduction .................................................................. 21
10.2
Incident / Accident Reporting Procedure ................................ 21
10.3
Reporting to Outside Authorities .......................................... 22
MANAGEMENT AND REHABILITATION OF INJURED EMPLOYEES............. 27
11.1
12.
13.
Process Guidelines........................................................... 27
PERSONAL PROTECTIVE EQUIPMENT ............................................ 28
12.1
Introduction .................................................................. 28
12.2
Risk Assessment .............................................................. 28
12.3
Promotion and Maintenance of Equipment .............................. 28
12.4
Employee Training ........................................................... 28
PURCHASING POLICY ............................................................... 30
13.1
Introduction .................................................................. 30
13.2
Items of Plant and Equipment ............................................. 30
Occupational Safety and Health Management Manual
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Western Australia
13.3
14.
Substances .................................................................... 30
WORKING AT HEIGHTS ............................................................. 31
14.1
Introduction .................................................................. 31
14.2
Risk Assessment .............................................................. 31
14.3
Ladders ........................................................................ 31
14.4
Security ....................................................................... 32
14.5
Workplace Inspections and Audits......................................... 32
Occupational Safety and Health Management Manual
COMPANY NAME
Western Australia
INSERT NAME AND LOGO HERE
OCCUPATIONAL HEALTH AND SAFETY POLICY
COMPANY NAME is committed to achieving a Safe and Healthy work
environment for its employees. COMPANY NAME will achieve this goal by:

Establishing programmes and procedures for managing workplace risk.

Involving all employees in the development and implementation of the
programmes and procedures.

Committing adequate and appropriate resources necessary to achieve
these goals.
The Directors accepts ultimate responsibility for the policy and its monitoring
and implementation. It is the responsibility of Directors to ensure the
development, implementation and review of the programmes and
procedures, and ensuring all staff are engaged in the process.
All staff have a responsibility to take care of their own wellbeing and that of
their fellow employees, and to take remedial action where workplace hazards
are identified.
_____________________
NAME
Date:.....................................
___________________
NAME
Date:...............................
To be reviewed Annually
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Western Australia
1.
1.1
MANAGEMENT, SUPERVISORS AND EMPLOYEE
RESPONSIBILITIES
INTRODUCTION
The provision of a safe and healthy workplace is a management responsibility. No
Company Occupational Health and Safety Programme can be successful without the
full visible and audible support of management. Management have to show
commitment to the programme through their own personal involvement with safety
and health issues in their area of responsibility.
The following lists of responsibilities in essence reflect Western Australia statutory
responsibilities.
1.2
MANAGEMENT RESPONSIBILITIES

To set occupational health and safety objectives and develop plans to
implement programmes and procedures to ensure compliance with Western
Australian safety and health legislation and standards.

To encourage the involvement of all people in achieving a safe and healthy
workplace by establishing and supporting occupational safety and health
committees.

To provide and maintain plant, equipment and mobile machinery to ensure a
high standard of safety and health.

To provide documented systems of work and safe working procedures to
ensure that people are able to work safely and without risk to health.

To provide training and instruction for all employees to ensure that they
understand their responsibilities to work without risk to themselves and
others and maintain a safe and healthy working environment.

To ensure safe handling, use, labelling and storage of chemical substances,
and to obtain material safety data sheets for all relevant materials used.

To ensure that contractors and site visitors understand and observe COMPANY
NAME’s safety and health practices and procedures.

To ensure that all workplace incidents, accidents and injuries are fully
reported, recorded and investigated and relevant people notified.
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
To ensure that adequate first aid provisions and trained first aid personnel
are available at each work location.

To ensure employees who require health surveillance attend for examination
when required.

To support COMPANY NAME’s rehabilitation programme so as to encourage the
early return to work of employees suffering from a work based injury or
illness.
1.3
SUPERVISOR RESPONSIBILITIES

To ensure that safe working practices and procedures are implemented and
adhered to.

To ensure that plant and equipment is maintained in a safe condition, and a
regular programme of maintenance established.

Through regular inspections, identify potential problems and hazards. When
necessary, arrange assessment of possible hazards and institute control
measures.

To encourage reporting of all incidents and hazards as well as accidents and
injuries. Ensure the appropriate forms are completed and investigate all
reported events.

To ensure that all new employees and contractors receive induction and
arrange other safety, health and on the job training when required.

To ensure that personal protective equipment is available and that employees
are instructed in its use, maintenance and limitations.

To encourage the involvement of all employees in achieving a safe and
healthy workplace, by personally being involved with occupational health and
safety, arranging tool box meetings and inviting input from people on matters
relating to work process as well as to safety and health.

To ensure the contractors in the supervisor’s area of responsibility, observe
COMPANY NAME’s safety procedures and use the appropriate personal
protective equipment where necessary.

To oversee the provision of first aid facilities on site and to ensure that
qualified first aid personnel are available when required.

To ensure safe handling, use, labelling and storage of chemical substances.

Keep management informed as to all matters relating to safety and health.
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
To support and assist with the rehabilitation of employees who have been
injured at work, by encouraging their early return to normality through work
based rehabilitation programmes.
1.4
RESPONSIBILITIES OF EMPLOYEES

To work with due care and consideration to safeguard their own safety and
health and the safety and health of others.

To comply with all safe working practices and procedures set in place by
management.

To report any potential hazards identified in the workplace or any accidents,
incidents or injuries that may occur during the course of work.

To observe all instruction issued to protect their safety and health or the safety
and health of others.

To attend, when directed, any course of training or instruction related to health
and safety.

To use any equipment that is issued for personal protection, and to ensure that
it is maintained in proper order.

To co-operate with any rehabilitation programme that is arranged for the
purpose of assisting recovery from injury for themselves or for fellow employees.

Not to interfere with, remove, misuse or damage anything that is provided in
the interests of safety and health.
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2.
RESOLUTION OF ISSUES / HAZARDS
2.1
INTRODUCTION
COMPANY NAME recognises that from time to time, problems, whether hazardous,
or not, relating to safety will arise. Accordingly the following process has been
devised in order to meet legal obligations as well as allowing participating
consultation in order to resolve those problems.
2.2
DEFINITION OF ISSUE
The term ‘issue’ is not defined in the Occupational Safety and Health Act, so it must
be interpreted by using the normal meaning of the word. This means that an ‘issue’
exists where there is a difference of opinion between the employer and one or more
employees relating to health, safety or welfare at the workplace. It does not mean
that there has to be a ‘dispute’. It is enough that a question has arisen as to what
should or should not be done or has been done, in a particular situation.
A health and safety issue may include any item in the general duty section of the
Act, any hazard or potential hazard, or any procedural issue relating to health,
safety and welfare.
2.3
DEFINITION OF A HAZARD
The definition of hazard is anything that has the potential to cause injury or harm
to health.
2.4
PROCEDURE
1.
All hazards will be noted on the appropriate hazard report form (copy
attached) which will go to the immediate supervisor for resolution.
2.
Action taken by the supervisor will be noted on the form including completion
date:
(a)
a copy will be returned within 3 working days to the instigator of the
hazard report;
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(b)
a copy will be filed under “completed hazard reports” when actions
addressing problem are complete.
3.
If work is encountered that an employee considers hazardous to him/herself
or to fellow co-workers then they must immediately remove themselves from
the immediate area and report their situation to their immediate supervisor
as a matter of urgency.
4.
The supervisor must immediately ensure all work in the affected area ceases
until the problem is resolved. Where agreement cannot be reached on a
solution to the issue either party may be entitled to obtain outside assistance
in the form of advice from WorkSafe Western Australia, other Government
departments or professional OSH bodies.
5.
In the event that resolution of the problem may take some time, the
employee involved may be offered reasonable alternative work without loss
of any moneys he/she would normally have earned had they continued to
perform their normal duties
6.
If a resolution of the problem cannot be found between the employee,
supervisor and safety and health representative (SHR), then either COMPANY
NAME or the SHR or the employee may call in a WorkSafe Western Australia
Workplace Inspector to address the issue.
If any party is unhappy with the Inspectors actions (or lack of), the matter can be
referred to an Occupational Safety and Health Magistrate.
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HAZARD REPORT FORM
(To be completed by person reporting hazard.
Please use one form per hazard)
Hazard No ....................
Date ....................
Description of Hazard:
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
Suggested Solution:
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
Reported by:
Name:(please print) ................................
Signature: ......................................
Thank you for completing this form, now forward it to your supervisor
--------------------------------------------------------------------------------------------------------------(To be completed by Supervisor)
Corrective Action Taken:
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
Actioned By: ...............................
Date: .....................................
Signed: ..................................
Action Completed:
Date: .....................................
Signed: ..................................
(Date) ..................
(Copy of above form stating action taken
returned to person reporting hazard.)
Date: .....................................
Signed: ..................................
(Note: this must occur within 3 working days of report occurring)
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3.
INDUCTION
3.1
INTRODUCTION
In order for COMPANY NAME to meet its legal obligations for employees and
contractors all personnel will undergo a relevant company induction.
3.2
SITE INDUCTIONS
All employees and contractors receive an induction at each site attended. These are
run by the head contractor, builder or building management.
The induction checklist below is a generic representation of those that would be
filled out at site and may have more or less and different categories that would be
explained.
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INDUCTION CHECK LIST
Surname: .................................
Given Names: ..................................
Date: .............................................
After the induction has been completed it is then the responsibility of the supervisor
(or his/her delegate) to organise a site familiarisation, with the following
shown/explained/introduced. As each is explained to the inductee’s satisfaction,
they should be ticked to acknowledge coverage.
AMENITIES
Time Recording Duties
Crib room / change room
Toilets
Site Layout
Fire extinguishers
First Aid Facilities
Phones
Emergency Muster Areas








SITE PERSONNEL
Supervisor
Safety Representative
Safety Committee Members
First Aider/s




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SYSTEMS EXPLAINED AND SHOWN
Responsibility of Employers & Employees under OSH legislation.
Emergency procedure
Danger / Out of Service Tags
Accident / incident report forms
General Safety rules
Safety committees and their functions
Safety Representative and his / her functions
General Hazards
Hazard report forms
Housekeeping
Personal Protective Clothing / equipment Issued
Workers Compensation and rehabilitation












I acknowledge that I have received an explanation of all the items ticked above with
special reference made to safety procedures and safety equipment.
Employee Name:
Employee Signature:
Date Signed:
Inductor’s Name:
Inductor’s Signature:
Date Signed:
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4.
CHEMICALS
4.1
INTRODUCTION
COMPANY NAME believes that all chemicals have the ability to cause harm therefore
will take all steps necessary to ensure all employees and contractors to the
workplace are not adversely exposed to potentially hazardous substances.
4.2
CHEMICAL ASSESSMENT AND CONTROL
(Refer also to purchasing policy.)
All substances used on site will be assessed to establish:

the nature of hazard associated with substance;

the degree of risk associated with hazard;

measures needed to control hazard if substances cannot be eliminated or
substituted for a less toxic substance;

what monitoring is necessary including health

what training required.
4.3
MATERIAL SAFETY DATA SHEETS (MSDS)
1.
No chemical will be purchased unless COMPANY NAME has received a current
MSDS and has satisfied itself that the product is the least toxic available for
the task required.
2.
No employee will handle or use any chemical unless they are aware of:
(a)
the proper means, and precautions required, for use;
(b)
the potential health effects;
(c)
the required first aid treatments;
(d)
any necessary emergency procedures.
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3.
All MSDSs will conform with the information requirement provisions of the
National Occupational Health and Safety Commission Code of Practice
NOHSC:2011 (1994).
4.4
STORAGE, TRANSPORTATION AND DISPOSAL
All substances will be stored and transported in accordance with manufacturers
instructions, the Western Australian Dangerous Goods Regulations 1992 and the
Australian Code for the Transport of Dangerous Goods by Road and Rail.
Disposal of empty containers shall be in accordance with manufacturer’s instructions
and by prior arrangement with the local shire.
4.5
TRAINING
All employees with potential to be exposed to any hazardous substance will be
provided with information, instruction and training relevant to that substance and
records will be kept of training provided.
4.6
RECORD KEEPING
The central register records must currently be kept for a minimum of 5 years and
health surveillance records for 30 years.
Records of assessments made that may not necessarily give rise to monitoring or
health surveillance must also be kept as well as monitoring results and training
given. These records must also be kept for a minimum of 5 years.
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5.
EMERGENCY EVACUATION
5.1
INTRODUCTION
The office and workshop premises is not a general work area, as the vast majority
of the work is performed on site. However this section will deal with procedures,
should an incident take place here. COMPANY NAME acknowledge that there is
always the possibility that a situation may arise that will require the office/workshop
to be evacuated, ie. fire, bomb threat, earthquake or chemical spill.
5.2
EXITS
All persons that may be present will leave the building in an orderly manner and
assemble in Zeta Crescent
5.3
EMERGENCY EVACUATION POLICY

All personnel will be taken through the Emergency Evacuation Plan on
commencement of employment as part of the induction process.
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6.
FIRST AID
6.1
INTRODUCTION
As part of supplying a safe system of work, COMPANY NAME will provide sufficient
first aid facilities to address any worst case scenarios and ensure sufficient persons
are trained to administer first aid treatment.
All Company motor vehicles will have the workplace first aid kit supplied by St John
Ambulance. These kits will be checked and an order for resupply of necessary
contents will be done each month, unless required sooner.
6.2
CONSULTATION
Ongoing discussion with the workforce will be conducted in order to establish at
what level first aid facilities need to be provided and to monitor whether what is
provided is sufficient for ongoing needs.
6.3
COMMUNICATION
In the event of an emergency (refer incident accident reporting policy) the
designated site controller will be contacted who, in turn, will alert the appropriate
authorities.
6.4
TRAINING
COMPANY NAME will ensure that sufficient employees will be trained to senior first
aid level. First aid skills will be updated as prescribed by St John Ambulance.
6.5
NOTIFICATION
All employees will be notified as to whom the current first aiders are.
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6.6
CONTENTS OF FIRST AID KITS
The following is a list to assist in determining the requirements and quantities for a
basic first aid box. Individual items and quantities may vary according to identified
hazards.
Basic First Aid Box For Use At Workplace

Adhesive dressing strips individually
wrapped

Torch (small pencil type)

Gauze squares 75 millimetre x 75
millimetre sterile packs

Paracetamol or similar analgesics

Eye pads sterile

Burn cream

Triangular bandage

Saline disposable 30 millilitre bottle
for eye wash and wound dressing

Safety pins

Wound dressing 13, 14, 15

Scissors (blunt or universal)

Dressing sterile, non adherent, small

Splinter probe

Dressing sterile, non adherent, large

Iodine 15 millilitres (swabs or
sachets)

Cotton tipped applicators, sterile
packs of 3

Gauze bandages 5 centimetres

Conforming bandages (crepe or
cotton)

Non-stretch adhesive tape hypoallergenic 1.25 centimetres wide

Disposable gloves

Cold packs (ice chemicals)

Note pad and pencil

Instruction booklet for emergency
treatment

Expire air resuscitation (EAR) and
cardio-pulmonary resuscitation
(CPR) guides

Face shields
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6.7
MAINTENANCE OF FIRST AID BOXES

All first aid boxes are to be dustproof and kept clean and tidy.

An appointed person to be responsible for maintaining required First Aid
supplies.

All boxes are to be readily accessible during working hours.

Boxes are to contain only First Aid items in accordance with the list of
contents.

First Aid instructions should be included in all boxes.
6.8
TREATMENT
All treatment including bandaids and Panadol shall be recorded on the Site Medical
Form attached. All incidents / accidents shall be reported on the incident/accident
form (see Incident/Accident Procedure).
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7.
GENERAL SAFETY AND HEALTH RULES
COMPANY NAME has a few basic rules that it asks all employees to follow:

Anticipate what you will need to do in an emergency situation. Familiarise
yourself with the various emergency plans and obey your supervisors
instructions.

Report any hazardous situation, equipment or tools to your supervisor. Ensure
the appropriate form, where appropriate, is filled out and handed to your
supervisor.

Ensure all accidents and near misses are reported immediately and the
appropriate form filled out.

If you are unsure of any task given to you, ask for information and instruction.

When you finish a job, always ensure the area is cleaned up and left tidy.

Wear all necessary personal protective equipment. Minimum requirements
safety boots and safety glasses. Hard hat, hearing protection, dust masks,
gloves or respirators may be required for some tasks.

Obey all safety directive signs.

No firearms are to be brought on site.

No drugs or alcohol is permitted on site.

Do not handle or use any chemical unless you are aware of the potential
health hazards, any necessary emergency procedures including first aid
treatment, and the proper means and precautions required for use.
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8.
HAZARDS
8.1
INTRODUCTION
COMPANY NAMEError! Reference source not found. recognises that various hazards
exist and will endeavour to address them within statutory guidelines. Accordingly
there are a few hazards which persist, to which the following rules apply.
8.2
ELECTRICAL SAFETY

All electrical power tools, leads, site-lighting and power supply on site will
comply with the relevant regulations, standards and codes of practice.

All unnecessary electrical wiring should be disconnected and rendered safe
by a competent person or where necessary the local electrical supply
authority before renovation work commences.
8.3
MANUAL HANDLING

Manual handling tasks will be assessed and controlled using the hierarchy of
control measures, ie. wherever possible mechanical aids should be used to
move materials, equipment and debris.
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9.
INCIDENT / ACCIDENT INVESTIGATION
9.1
INTRODUCTION
COMPANY NAME recognises that despite best intentions, preventative policies and
procedures, incidences/accidents can and will happen from time to time. Therefore
COMPANY NAME believes that an effective accident prevention plan must also
include the investigation, analysing of incidents/accidents and the implementation
of resulting recommendations in order to prevent recurrence of those
incidents/accidents.
9.2
DEFINITION OF AN ACCIDENT
An unplanned event that results in personal injury or damage to equipment or
property.
9.3
DEFINITION OF AN INCIDENT
An unplanned event that does not result in injury, or damage to equipment or
property but had the potential to do so.
9.4
PROCESS
(Refer also to incident/accident reporting policy).
Any and all incidents/accidents that occur, including to or by contractors or
subcontractors must be investigated.
Upon receipt of an incident/accident form, the Supervisor will initiate an
investigation based on the perceived seriousness of the event.
An incident/accident is deemed to be serious when it results in (or could have
resulted in) a fatality, amputation or hospitalisation of an individual or individuals.
9.5
THE INVESTIGATION
The following are steps that should be followed:
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
Ensure the area is safe.

Take photographs, make sketches of the scene, any damage that has occurred
and any other relevant evidence.

Interview witnesses and involved parties as soon as reasonable possible after
the incident. Bearing in mind that parties involved in incidents are often
shaken and suffering shock, these interviews should be conducted with
sensitivity and consideration. All statements should be written in ink, dated
and signed by the investigators and where possible the interviewee.

If serious, do not interfere with the scene of an accident unless WorkSafe
Western Australia or, in the case of a fatality, the coroner has given
permission.
All information gathered will be analysed along with training records and existing
systems of work (job procedures) in order to establish basic causes which in turn will
lead to more effective recommendations. It is not COMPANY NAME’s intention for
this to be a blaming exercise but rather a prevention exercise.
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10.
INCIDENT / ACCIDENT REPORTING
10.1 INTRODUCTION
All incidents must be reported whether or not they result in a personal injury,
property or equipment damage, or pollution of the environment.
All incidences will be reviewed or investigated so that appropriate action can be
taken to prevent a recurrence.
10.2 INCIDENT / ACCIDENT REPORTING PROCEDURE
In the event of an accident, dependent on its seriousness, the first person on the
scene must ensure that if necessary:

the site controller is notified;

the area is made safe;

the person(s) are assisted and assessed.
The site controller must where appropriate:

notify internal and external emergency services;

act as a focal point to coordinate procedures.
(Refer also incident/accident investigation policy)
The person in immediate authority must ensure that the safety and health
representative, where one exists, is notified and an appropriate investigation
conducted.
Regardless of whether the event was an incident or an actual accident the
appropriate form must be filled in as soon as possible and given to the person in
immediate authority over that work area. For the purposes of this procedure, an
accident is defined as an unplanned event that results in personal injury or damage
to equipment or property.
An incidence is defined as an unplanned event that does not result in injury, or
damage to equipment or property but had the potential to do so.
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All recommendations resulting from an investigation must be implemented as soon
as reasonably practical. The safety and health committee or, if one does not exist,
the Site Manager and Safety Coordinator for Error! Reference source not found.
will review on a monthly basis all accidents that have occurred and the actions
taken.
10.3 REPORTING TO OUTSIDE AUTHORITIES
The Supervisor is to ensure that accidents specified by WorkSafe Western Australia
are reported by telephone and via the form at the rear of this section as soon as
possible or as soon as COMPANY NAME becomes aware the injured party will be off
work for 10 days or more.
The type of accidents that must be reported are:

fracture of skull, spine or pelvis;

fracture of any bone other than in the hand, wrist, ankle or foot;

amputation of any part of the body;

loss of sight;

10 or more days from the date of injury - non availability to work.
The last point refers to actual days of being unable to work not working days.
Certain diseases such as Tuberculosis, Viral Hepatitis, Legionnaires Disease and HIV
must also be reported on the appropriate attached form.
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SCHEDULE 2 - FORMS RELATING TO GENERAL PROVISIONS
FORM 1 - NOTIFICATION OF INJURY
[Regulation 2.4(2)]
Occupational Safety and Health Act 1984
WorkSafe Western Australia Commissioner
PO Box 294
WEST PERTH WA 6872
Phone (08) 9237 8777 Fax: (08) 9321 8973
INJURY REPORTING TELEPHONES:
(08) 9327 8800
1 800 198 118
Section 1: Employer Details
Employer Name
Date of Injury:
Workplace Name:
__ / __ / __
Address:
Suburb/Town:
Postcode:
Phone Number:
Time of Injury:
Fax Number:
__ __ : __ __ am
WorkCover Number:
__ __ : __ __ pm
Address of Workplace
where the injury
occurred:
Suburb/Town:
Postcode
Phone Number:
Fax Number:
Type of workplace
Where injury occurred:
(eg. Construction site,
panel
beating shop, etc)
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Section 2: Details of injured person
Surname:
Estimated
person is
Given Names:
unable to work:
Occupation:
__ __ __ days
Date of Birth: __ / __ / __
__
Sex:
Male 
time
Age: __
Female 
Section 3: Injury details
Nature of injury
Brief description
occurred:
of
how
injury
Place injured person removed to:
Name of person reporting accident:
Position:
Phone Number:
Person for liaison:
Phone Number:
OFFICE USE ONLY:
 Nat.
Person receiving report: ___________________________
 Loc.
 Ag.
Date: __ / __ / __
Time ____________
 Type
Page 24
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SCHEDULE 2 - FORMS RELATING TO GENERAL PROVISIONS
FORM 2 - NOTIFICATION OF DISEASE
[Regulation 2.5(2)]
Occupational Safety and Health Act 1984
WorkSafe Western Australia Commissioner
PO Box 294
WEST PERTH WA 6872
Phone (08) 9237 8777 Fax: (08) 9321 8973
DISEASE REPORTING TELEPHONES:
(08) 9327 8800
1 800 198 118
Section 1: Employer Details
Employer Name
Workplace Name:
Address:
Suburb/Town:
Phone Number:
Postcode:
WorkCover Number
Fax Number:
Section 2: Details of person affected
Surname:
Given Names:
Occupation:
Sex:
Date of Birth: __ / __ / __
Age: __ __
Male: 
Female: 
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Section 3: Diagnosis details
Name of disease:
Date of diagnosis:
Name
of
Practitioner:
Medical
Address:
Suburb/Town:
Postcode:
Phone Number
Fax Number:
Section 4: Description of work done by affected person
Section 5:
Name of
disease:
Person
reporting
Position:
Phone Number:
Person for liaison:
Phone Number:
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Occupational Safety and Health Management Manual
COMPANY NAME
Western Australia
11.
MANAGEMENT AND REHABILITATION OF INJURED EMPLOYEES
Introduction rehabilitation for all employees who suffer a work related injury or
illness in order to enable those employees to return to normal work functions as
soon as reasonably practical.
The rehabilitation process can involve any or all of the following:
1.
Medical: prompt medical diagnosis and treatment.
2.
Vocational: dependent on the type of injury may include vocational
assessment, guidance, training/retraining or counselling.
3.
Social: dependant on the type of injury, may include assisting in restoring
self image, reducing stress associated with the disability not only in the work
environment, but within the community socially.
4.
Work environment: providing as far as practical an ergonomically sound
work environment. Dependent on the type of injury, providing alternative or
modified duties.
11.1 PROCESS GUIDELINES
Initial Response: Where possible all injuries to be treated by site first aiders and
documented; alternatively referred directly to a preferred medical practitioner. It
is imperative that all injuries are documented.
WorkCover WA Notification: Where it becomes apparent that the injury will result
in a workers compensation claim the appropriate notification using the attached
forms will be made by the person responsible for site OSH coordination within a 3
day time frame.
Follow Up: Regular follow up of the injured employee should be made by
Supervisors via personal visits to the employee and his/her family, supplemented by
telephone contact.
Treating Doctor: Contact should be made regularly with the treating doctor to
advise them of COMPANY NAME's rehabilitation program and alternative duties
available.
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Occupational Safety and Health Management Manual
COMPANY NAME
Western Australia
12.
PERSONAL PROTECTIVE EQUIPMENT
12.1 INTRODUCTION
COMPANY NAME will provide employees with personal protective equipment free of
charge to minimise the risk involved when work hazards cannot be adequately
controlled by other means. Statutory law requires approved types of personal
protective equipment to be used in specific circumstances.
12.2 RISK ASSESSMENT
A survey of jobs and working conditions will be carried out to determine what risks
employees and contractors face and which type of protective equipment is suitable.
Equipment should also comply with legislative requirements and the
recommendations of suppliers such as provided on material safety data sheets.
Based on the risk assessment, employees, contractors and subcontractors will be
required to provide and wear the appropriate personal protective equipment
including fall arrest devices.
12.3 PROMOTION AND MAINTENANCE OF EQUIPMENT
COMPANY NAME will take measures to ensure the proper use of personal protective
equipment, including education, instruction and supervision.
There will be regular maintenance and inspection of safety equipment to ensure that
it is kept in good order.
12.4 EMPLOYEE TRAINING
All COMPANY NAME Western Australia employees who may be required to wear
personal protective equipment will be instructed and trained to ensure that they
understand when it should be used, how it should be maintained and its limitations.
Safety Equipment must comply with the appropriate Australian Standards i.e.
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Occupational Safety and Health Management Manual
COMPANY NAME
Western Australia
AS 1800, 1801 (1981)
-
Safety helmets
AS 1336 (1997)
-
Safety glasses
AS 1270 (1988)
-
Hearing protection
AS 2210 (1994)
-
Foot protection
AS 1716 (1994)
-
Respiratory Protection
(Refer ‘Code of Practice for First Aid, Workplace Amenities and Personal Protective
Equipment’ issued by WorkSafe Western Australia Commission November 1996)
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Occupational Safety and Health Management Manual
COMPANY NAME
Western Australia
13.
PURCHASING POLICY
13.1 INTRODUCTION
Prior to purchasing any item likely to affect the safety and health of any COMPANY
NAME employee, consultation will be held with employees.
13.2 ITEMS OF PLANT AND EQUIPMENT
Each item to be purchased will be assessed on its compliance to Australian standards,
ergonomic friendliness, and suitability for the task.
13.3 SUBSTANCES
Prior to any substance being purchased a Material Safety Data Sheet will be obtained
and the substance will be assessed on:

the nature of the hazards associated with that substance;

the risk of that hazard eventuating;

whether or not a substitute substance is available that is less toxic /
hazardous;

what monitoring both atmospheric and health is required.
In all cases, levels of appropriate training will be determined prior to purchase.
Documented records of the consultation and assessment process will be made and
retained for seven years.
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Occupational Safety and Health Management Manual
COMPANY NAME
Western Australia
14.WORKING AT HEIGHTS
14.1 INTRODUCTION
COMPANY NAME will ensure that safe work processes are used where work cannot be
performed safely from the ground or from solid construction.
14.2 RISK ASSESSMENT
Persons working at height where such work is not being carried out safely from solid
construction may be exposed to a risk of falling.
Accordingly, a risk assessment process will be carried out for all persons who are
either performing work or gaining access to or from a work station where they may
fall to a lower level.

Unless the outcome of the risk assessment establishes an alternative safe
work practice, fall protection will be provided for all persons exposed to a
fall of 2.0 metres or greater.

Having regard to the hierarchy of control, COMPANY NAME will implement the
higher order controls of elimination and isolation to ensure all persons work
from solid construction.
14.3 LADDERS

Ladders will only be used for works of a minor nature. Ladders will not be
used on elevated floor levels near the perimeter of the building where there
is a danger of a person falling.
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COMPANY NAME
Western Australia
WORKPLACE ACCESS AND SECURITY
Access To and From the Work Area

Where practicable a minimum of two access ways will be maintained to the
work area to provide an alternative escape route in the event of an emergency
cutting off the primary access.
14.4 SECURITY
Prevention of Unauthorised Entry

Sufficient hoarding and barricades will be erected at all entrances to prevent
accidental or unauthorised entry to the site.

Safety warning signs stating that unauthorised persons are not to enter the
site should be fixed in positions where they will be readily visible to persons
approaching the site.
14.5 WORKPLACE INSPECTIONS AND AUDITS

Inspection of all plant, equipment and the workplace and work practices shall
be carried out by the Supervisor on a regular basis. Any corrective action
taken, or to be taken, will be noted on the report form.
Inspections will be carried out as necessary eg all electrical equipment should
be inspected prior to commencing work and must be inspected and tagged
every 3 months
The inspection forms are at the end of this Section.
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Occupational Safety and Health Management Manual
COMPANY NAME
Western Australia
HAZARD INSPECTION CHECKLIST
AREA & DATE INSPECTED: ________________________________________________
INSPECTED BY: __________________________________________________________
INSPECTED BY: __________________________________________________________
AREA OR
ITEMS TO
INSPECT
Floors
SPECIFIC ELEMENTS TO
INSPECT
RISK RATING
ACTION REQUIRED
ACTION TAKEN
Even surfaces/no holes
Loose/broken boards or
steps
Water/Oil/Grease spills
Swept & tidy including
around machinery etc.
Enough rubbish bins,
need to be emptied
Any electrical cables
airlines on floor
or
Trip hazards removed
Material correctly placed in
laydown areas
Aisles
Adequately marked
Clear of obstructions,
equipment, rubbish, etc.
Adequately illuminated
Fire Safety
Fire extinguishers - correct
type for risk
Access unobstructed
Fully charged and serviced
Fire hoses - coiled up
Access unobstructed
Last equipment service
date ..........................
Equipment signposted
Emergency evacuation
procedure displayed
Emergency evacuation last
practice date ...............
Audible fire alarm last
check date ...................
Flammables minimised,
stored in correct place
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COMPANY NAME
Western Australia
AREA OR
ITEMS TO
INSPECT
SPECIFIC ELEMENTS TO
INSPECT
RISK RATING
ACTION REQUIRED
ACTION TAKEN
Obvious fire hazards
Entry/Exit
Doors not obstructed
Handles/locks operate
correctly
Fire doors self closing and
latching
Fire exits signposted
Roller doors easily opened
- no binding
Lighting
Is natural lighting used to
best advantage
Windows clean and free of
dust
Open smoothly - minimum
effort locks operate
All areas adequately
illuminated
Fittings clean and lamps
same colour
Maintenance required i.e.
lamps out or flickering
Electrical
Light switches/power
points broken or cracked
Access obstructed (incl.
switchboards)
Extension cords/plugs and
sockets
Portable tools in good
condition
Service tags current
Warning light/system
when current in use
"Danger" and “Out of
Service" Tags available and
used
Switchboards/fuse boxes
and major cut off switches
marked
Earth leakage protection
fitted/tested
Flex protection when
crossing traffic ways
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