Machinery Risk Assessment Form

Machine Assessed Assessors Name Dave West Date of Assessment

Area: Operator: MANAGER: ASSESSOR: DAVE WEST ORIGINAL ASSESSMENT DATE: REVIEWED MACHINE DESCRIPTION AND USE Signature

The risk rating is the HAZARD RATING (1 to 5) x PROBABILITY RATING (0 to 5) giving a risk rating on a scale of 0 to 25. (0ZERO--->LOW6 7LOW--->SIGNIFICANT12 15 HIGH--->CERTAIN 25) Where the risk rating is 7 or higher additional safety measures are required to eliminate or reduce the risk to an acceptable level ie. 0 to 6. EEF form ref: MACH/RA summarises the risk assessments for the identified hazards. The risk evaluation includes the list of required additional safety measures. NOTE: This machine has been assessed with guidance from EN ISO 14121-1:2007. The flow chart indicates the process used to adequately assess the Safety of this machine. The risk assessments are quantative assessments, with ratings assigned, to identify potential risks to exposed persons and any additional safety measures required to eliminate or control the risks to an acceptable level, taking into account the relevant requirements of MHSWR* and PUWER*, and the practical considerations allowed by these regulations. * * MHSWR = Management of Health and Safety at Work Regulations 1999. PUWER = Provision and Use of Work Equipment Regulations

Risk Reduction

MACHINE ASSESSED:

Determination of the limits of the Machine What is the intended primary function of the machine? What are the different operating modes of the machine? What procedures can the operative perform using the machine? What are the space requirements for operation of the machine? What are the space requirements for maintenance of the machine? Has training been received and documented for the operator. What is the energy supply for the machine? What is the predicted life limit of the machine? If there is an energy surge, how are the components likely to react and what will the significant hazards be? Are there any reasonably foreseeable misuses of the machine?

Comments

SEVERITY/INJURY POTENTIAL/RATING Multiple / certain fatal / high numbers at serious risk Extremely severe, possible fatal, highly toxic Severe injuries/chronic health damage Reportable but not severe (eg. acute, fume, small burns, cuts) Slight injury (eg. small cuts, bruise, discomfort)

5 4 3 2 1

SEVERITY/INJURY POTENTIAL/RATING Very likely/certain 5 Probable 4 Possible 3 Unlikely 2 Virtually impossible 1 impossible / no exposure 0 Form MACH/RA

MACHINE ASSESSED:
Highest Rating Probability Persons Exposed
(Operator, setters, maintenance, temp, trainee)

Risk Rating

Numbers

Existing Safety Measures

Description of Hazards

Additional Safety Required Yes/No

Parts fail during the operation of the machine, what are the significant hazards? Misuse of Machinery

Entanglement

Stabbing Puncture:

SEVERITY/INJURY POTENTIAL/RATING Multiple / certain fatal / high numbers at serious risk Extremely severe, possible fatal, highly toxic Severe injuries/chronic health damage Reportable but not severe (eg. acute, fume, small burns, cuts) Slight injury (eg. small cuts, bruise, discomfort)

5 4 3 2 1

SEVERITY/INJURY POTENTIAL/RATING Very likely/certain 5 Probable 4 Possible 3 Unlikely 2 Virtually impossible 1 impossible / no exposure 0 Form MACH/RA

MACHINE ASSESSED:
Crushing Hazards:

Shearing Hazards:

Drawing in or Trapping:

Cutting or Severing:

high pressure fluid injection hazards:

SEVERITY/INJURY POTENTIAL/RATING Multiple / certain fatal / high numbers at serious risk Extremely severe, possible fatal, highly toxic Severe injuries/chronic health damage Reportable but not severe (eg. acute, fume, small burns, cuts) Slight injury (eg. small cuts, bruise, discomfort)

5 4 3 2 1

SEVERITY/INJURY POTENTIAL/RATING Very likely/certain 5 Probable 4 Possible 3 Unlikely 2 Virtually impossible 1 impossible / no exposure 0 Form MACH/RA

MACHINE ASSESSED:
Friction or Abrasion

Ejection: .

SEVERITY/INJURY POTENTIAL/RATING Multiple / certain fatal / high numbers at serious risk Extremely severe, possible fatal, highly toxic Severe injuries/chronic health damage Reportable but not severe (eg. acute, fume, small burns, cuts) Slight injury (eg. small cuts, bruise, discomfort)

5 4 3 2 1

SEVERITY/INJURY POTENTIAL/RATING Very likely/certain 5 Probable 4 Possible 3 Unlikely 2 Virtually impossible 1 impossible / no exposure 0 Form MACH/RA

MACHINE ASSESSED:
Numbers Highest Rating Probability Persons Exposed
(Operator, setters, maintenance, temp, trainee)

Risk Rating

Existing Safety Measures

Description of Hazards

Additional Safety Required Yes/No

Electrical Hazards Approach to live parts under high voltage: Electrostatic Discharge: Thermal Hazards Burns/scalds from contact

SEVERITY/INJURY POTENTIAL/RATING Multiple / certain fatal / high numbers at serious risk Extremely severe, possible fatal, highly toxic Severe injuries/chronic health damage Reportable but not severe (eg. acute, fume, small burns, cuts) Slight injury (eg. small cuts, bruise, discomfort)

5 4 3 2 1

SEVERITY/INJURY POTENTIAL/RATING Very likely/certain 5 Probable 4 Possible 3 Unlikely 2 Virtually impossible 1 impossible / no exposure 0 Form MACH/RA

MACHINE ASSESSED:
Numbers Highest Rating Probability Persons Exposed (Operator, setters, maintenance, temp, trainee) Risk Rating Additional Safety Required Yes/No

Existing Safety Measures

Description of Hazards

Noise Hazards

Vibration Hazards

Ergonomic Hazards:

SEVERITY/INJURY POTENTIAL/RATING Multiple / certain fatal / high numbers at serious risk Extremely severe, possible fatal, highly toxic Severe injuries/chronic health damage Reportable but not severe (eg. acute, fume, small burns, cuts) Slight injury (eg. small cuts, bruise, discomfort)

5 4 3 2 1

SEVERITY/INJURY POTENTIAL/RATING Very likely/certain 5 Probable 4 Possible 3 Unlikely 2 Virtually impossible 1 impossible / no exposure 0 Form MACH/RA

MACHINE ASSESSED:
Environmental Hazards:

Radiation Hazards

SEVERITY/INJURY POTENTIAL/RATING Multiple / certain fatal / high numbers at serious risk Extremely severe, possible fatal, highly toxic Severe injuries/chronic health damage Reportable but not severe (eg. acute, fume, small burns, cuts) Slight injury (eg. small cuts, bruise, discomfort)

5 4 3 2 1

SEVERITY/INJURY POTENTIAL/RATING Very likely/certain 5 Probable 4 Possible 3 Unlikely 2 Virtually impossible 1 impossible / no exposure 0 Form MACH/RA

MACHINE ASSESSED:

Highest Rating

Numbers

Probability

Persons Exposed
(Operator, setters, maintenance, temp, trainee)

Risk Rating

Existing Safety Measures

Description of Hazards

Additional Safety Required Yes/No

Materials and Substances Fire or explosion hazard

Neglected use of PPE (Personal protective equipment) Combined Hazards

SEVERITY/INJURY POTENTIAL/RATING Multiple / certain fatal / high numbers at serious risk Extremely severe, possible fatal, highly toxic Severe injuries/chronic health damage Reportable but not severe (eg. acute, fume, small burns, cuts) Slight injury (eg. small cuts, bruise, discomfort)

5 4 3 2 1

SEVERITY/INJURY POTENTIAL/RATING Very likely/certain 5 Probable 4 Possible 3 Unlikely 2 Virtually impossible 1 impossible / no exposure 0 Form MACH/RA

MACHINE ASSESSED:
Numbers Highest Rating Probability Persons Exposed
(Operator, setters, maintenance, temp, trainee)

Risk Rating

Existing Safety Measures

Description of Hazards

Additional Safety Required Yes/No

Unexpected Starts, Overruns

Unstoppable/ out of control

Machine
Hazards caused by variations in speed

SEVERITY/INJURY POTENTIAL/RATING Multiple / certain fatal / high numbers at serious risk Extremely severe, possible fatal, highly toxic Severe injuries/chronic health damage Reportable but not severe (eg. acute, fume, small burns, cuts) Slight injury (eg. small cuts, bruise, discomfort)

5 4 3 2 1

SEVERITY/INJURY POTENTIAL/RATING Very likely/certain 5 Probable 4 Possible 3 Unlikely 2 Virtually impossible 1 impossible / no exposure 0 Form MACH/RA

MACHINE ASSESSED:
Numbers Highest Rating Probability Persons Exposed
(Operator, setters, maintenance, temp, trainee)

Risk Rating

Existing Safety Measures

Description of Hazards

Additional Safety Required Yes/No

Failures of Power Supply

Failures in control circuit

SEVERITY/INJURY POTENTIAL/RATING Multiple / certain fatal / high numbers at serious risk Extremely severe, possible fatal, highly toxic Severe injuries/chronic health damage Reportable but not severe (eg. acute, fume, small burns, cuts) Slight injury (eg. small cuts, bruise, discomfort)

5 4 3 2 1

SEVERITY/INJURY POTENTIAL/RATING Very likely/certain 5 Probable 4 Possible 3 Unlikely 2 Virtually impossible 1 impossible / no exposure 0 Form MACH/RA

MACHINE ASSESSED:
Numbers Highest Rating Probability Persons Exposed
(Operator, setters, maintenance, temp, trainee)

Risk Rating

Existing Safety Measures

Description of Hazards

Additional Safety Required Yes/No

Other hazards as listed I.e. errors of fitting, machine break up, falling or ejected objects, loss of stability.

SEVERITY/INJURY POTENTIAL/RATING Multiple / certain fatal / high numbers at serious risk Extremely severe, possible fatal, highly toxic Severe injuries/chronic health damage Reportable but not severe (eg. acute, fume, small burns, cuts) Slight injury (eg. small cuts, bruise, discomfort)

5 4 3 2 1

SEVERITY/INJURY POTENTIAL/RATING Very likely/certain 5 Probable 4 Possible 3 Unlikely 2 Virtually impossible 1 impossible / no exposure 0 Form MACH/RA

MACHINE ASSESSED:
Numbers Highest Rating Probability Persons Exposed
(Operator, setters, maintenance, temp, trainee)

Risk Rating

Existing Safety Measures

Description of Hazards

Additional Safety Required Yes/No

Slips, trips and falls

Other e.g. manual handing, whiplash from hydraulic hoses.

SEVERITY/INJURY POTENTIAL/RATING Multiple / certain fatal / high numbers at serious risk Extremely severe, possible fatal, highly toxic Severe injuries/chronic health damage Reportable but not severe (eg. acute, fume, small burns, cuts) Slight injury (eg. small cuts, bruise, discomfort)

5 4 3 2 1

SEVERITY/INJURY POTENTIAL/RATING Very likely/certain 5 Probable 4 Possible 3 Unlikely 2 Virtually impossible 1 impossible / no exposure 0 Form MACH/RA

ADDITIONAL SAFETY MEASURES/ACTIONS AREA: ASSESSED BY: DAVE WEST MACHINE/ITEM: DATE:
Additional Safety Measures: Priority Company Action Record/ Date

P1

P3

P1

P1 = Immediate P2 = Short Term P3 = Non urgent/Longer Term Form:..