sample COSHH assessment - North Somerset Council

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Control of Substances Hazardous to Health: COSHH Assessment Form
Substance Name
Kilrock-K
Specific use
Task(s) substance used for
Descaling appliances
How substance is used
Solution mixed with water and added to
appliance
Location and description of storage
Stored in locked cleaner’s cupboard
Where is the substance
used?
Outside
Inside well
ventilated
Inside poorly
ventilated
Confined space
Hazard classification
Harmful
Irritant
Toxic /
Very
Toxic
Corrosive
Environment
Explosive
Highly /
Extremely
Flammable
Oxidising
Biological
Other:
Hazardous by
Eye contact
Skin absorption
Skin Contact
Ingestion
Injection
Inhalation
Contractors
Cleaners
Student / Young People
Other *Specify
Persons Exposed
Employees
Visitors/ public
Risk Phrases (hazard)
R34 Causes Burns
North Somerset Council COSHH Assessment May 2013
Safety Phrases (precautionary)
S1/2 Keep locked up and out of reach of
children.
S23 Do not breathe gas/fumes/vapour/spray.
S26 in case of contact with eyes rinse
immediately with plenty of water and seek
medical advice.
S45 in case of accident or if you feel unwell
seek medical advice immediately (show the
label where possible)
Storage and Usage Instructions
Storage requirements
Storage area should be cool, under cover, well
ventilated and out of direct sunlight.
Store away from sources of heat or ignition.
Use original container.
Storage area should be away from
incompatible materials.
Handling instructions
Care should be taken to allow internal pressure
to escape before releasing closures. Empty
container may contain hazardous residues.
Avoid contact with eyes, skin and clothing.
Wear suitable protective clothing. Emergency
shower and eye wash facilities should be
readily available. Adequate ventilation should
be provided if there is a risk of vapour build-up.
Workplace Exposure Limits (WELs) (delete as appropriate)
Long-term (8hrTWA):
Short-term (15 mins):
No
Personal Protective Equipment / Clothing (PPE / PPC) (delete / highlight as appropriate)
Hand protection
Eye protection
Skin protection
Foot protection
Dust mask
Respirator
Other
Type:
Impervious gloves Face shield
Protective overalls
When ventilation =
inadequate
Fire Precautions
Use water spray, foam or CO2. Select extinguishing medium appropriate to other materials
involved.
Spill Management
Small spillages (up to 10 litres) may be flushed
with large quantities (1000 litres) of water.
Disposal
Empty container to normal waste.
First Aid Information
Inhalation: Remove from exposure. If
breathing stops or shows signs of failing apply
artificial respiration. Obtain medical attention
urgently. Keep warm and at rest. If there is
difficulty in breathing give oxygen. Do not use
mouth to mouth ventilation.
Eye contact: Wash out eye for at least 15
minutes with plenty of water. Seek medical
attention.
Skin contact: Immediately flood the skin with
large quantities of water, preferably under a
shower. Remove contaminated clothing as
washing proceeds. Contaminated clothing
should be washed or dry-cleaned before reuse. Obtain medical attention if blistering
occurs or redness persists.
Ingestion: Wash out mouth with water. Give
sips of cold water or milk to soothe the affected
parts. Ingested acid must be diluted by
approximately x 100 to render harmless to
tissues. Do not induce vomiting. Obtain medical
attention.
Existing Control Measures
Only small quantities used and stored, storage as per manufacturer’s guidance (stored away from bleach
North Somerset Council COSHH Assessment May 2013
2
and other alkalis), manufacturer’s original storage container, PPE available and used. Staff familiar with
COSHH assessment.
Is exposure adequately controlled? (delete as appropriate)
Additional control measures required? (delete as appropriate)
Yes
Yes
No
No
Is this assessment shared with other groups as necessary? For
example, contractors. (delete as appropriate)
Yes
No
Risk Rating Following Control Measures (delete as appropriate)
High
Medium
Assessor
Insert name
Date
North Somerset Council COSHH Assessment May 2013
7 July 2012
Low
Review date
July 2014
3
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