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
Proposed reaction (draw or insert image from e.g. ChemDraw
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
Specify
Waste Disposal
How the waste from the experiment will be disposed of safely, avoiding contamination or
injury to persons or the to environment.
Waste materials
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.
Signatures
Signature of person making this
Risk Assessment
PDRO, academic staff, technical staff., etc. Supervisors
must sign for undergraduate and postgraduate students.
PRINT name of Risk Assessor
Signatures of PG / UG students and
other workers
All others who will be using the hazardous substances
should signify that they understand the hazards and risks
Date
Initialled by Chemical
Safety Adviser