HFE Checklist (Jan 2023) - 020331

HUMAN FACTOR AND ERGONOMICS (HFE) ASSESSMENT CHECKLIST FOR WORKPLACES
HUMAN FACTORS AND ERGONOMCIS (HFE) CHECKLIST FOR WORKPLACES
A. WORKPLACE AND ASSESSMENT PARTICULARS
A1. WORKPLACE DETAILS

COMPANY NAME :_______________________________________________________________________________________________
ADDRESS :_______________________________________________________________________________________________
PERSON IN CHARGE :_______________________________________________________________________________________________
DESIGNATION :_______________________________________________________________________________________________
PHONE NUMBER :_______________________________________________________________________________________________
E-MAIL ADDRESS :_______________________________________________________________________________________________
COMMENCEMENT OF :_______________________________________________________________________________________________
OPERATION
DOSH REGISTRATION NUMBER :_______________________________________________________________________________________________
TYPE OF INDUSTRY :_______________________________________________________________________________________________
For manufacturing industry, state type: _________________________________________________
NUMBER OF WORKERS :______________ (MALE:__________ , FEMALE: ___________)
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SECTION A – WORKPLACE AND ASSESSMENT PARTICULARS
A2. ASSESSMENT PARTICULARS

DATE OF ASSESSMENT: _____________________________________
ASSESSMENT TEAM
NAME CONTACT NO
1.
2.
3.
4.
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SECTION B- - SCREENING
B. SCREENING
B1 What is the nature of process/ work activities being carried out at this location?
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B2 For each process/work activities, carry out screening to identify medium- and high-risk activities that require assessment
using this checklist. Low-risk activities do not require assessment.
1. List out all work activities carried out at the workplace. The work activities should be similar to those listed in
existing risk assessments such as HIRARC.
2. For each activity, answer the following questions to fill up the screening matrix below.
a. Based on the Guidelines on Ergonomic Risk Assessment at Workplace 2017, was an initial ERA required?
b. Based on Guidelines for Hazard Identification, Risk Assessment and Risk Control (HIRARC) 2008, is the
HIRARC score medium risk or above (≥5)?
c. Does the task require confined space entry?
d. Based on the Identification of Excessive Noise Checklist in the Industry Code of Practice for Management of
Occupational Noise Exposure and Hearing Conservation 2019, was the possibility of excessive noise
identified?
e. Based on the Guideline on Heat Stress Management at Workplace 2016, did the Heat Stress Screening
checklist resulted in 3 or more parameters scoring >1 OR a total score of ≥ 5?
f. Has there been any health and safety incidents related to this activity involving injury and/or fatality within
the past 5 years?
3. Answer “Yes” if the specified screening criteria has been met or “No” if it has not been met.
Answer “Not done” if the assessment specified in the screening questions has not been carried out before.
Answer “NA” if the assessment specified in the screening questions is not applicable to the workplace.
4. If “Yes” or “Not done” is answered for any of the questions, this CEIHE checklist is required for that work activity.
If “No” is answered for all questions, this CEIHE assessment checklist is optional.
5. The work activity should be re-assessed when there have been changes to the work area, machinery and tools or the
work method.
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Screening Matrix:
Answer “Yes”, “No”, “Not done” or “NA”
(a) (b) (c) (d) (e) (f)
Ergonomics HIRARC Confined Identification Heat Stress Incidents
Screening criteria
Risk Factors Space Entry of Excessive Screening
(Screening) Noise HFE
Incident Checklist
involving (Required/
3 or more
Task involves Possibility of injury and/or Not
Initial ERA is parameters
Threshold level Score is ≥5 confined excessive fatality has required)
required scored >1 OR
space entry noise occurred
total score ≥ 5
within the
past 5 years
Work Activity
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C. TASK SPECIFIC ASSESSMENT
For each work activity identified for assessment, conduct a Hierarchical Task Analysis to describe all necessary steps in the task. For
examples of HTA, please refer to the HFE Checklist Guide.
Fill in the Summary for Task Specific Assessment table below to identify the relevant sections of the checklist that is applicable to each
task. Refer to the guide for additional information.
SUMMARY FOR TASK SPECIFIC ASSESSMENT
C1 C2 C3 C4 C5
Task Design
Ergonomics
Interaction
Machinery
Work Activity Task
Computer
Human-
Tool
Y Y
Y Y
Y Y
Y Y
Y Y
Y Y
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SECTION C1 – TASKS INVOLVING HUMAN-COMPUTER INTERACTION
C1 – TASKS INVOLVING HUMAN-COMPUTER INTERACTION
A human-computer interaction is when a user interacts with a machine, system, or device via a user interface. This includes
but is not limited to control panels, machine dashboards, personal computers, and laptops. Section C1 is applicable if:
i) The machine, system or device must have a visual display but may or may not have controls
ii) The worker interacts with the machine system or device by looking at the display and/or using the controls
C1 Tasks involving human-computer interaction
Task being assessed
Name
Designation
Years of service
Brief description of
task
Device type
Description of worker
interaction with HCI
device
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Displays/ Signals Yes No NA Evidence (s) Action items

C1.1 The displayed information is easily understood.
C1.2 The most important elements within the visual display (e.g.,
process parameters, status indicator, etc) are placed where
they can be quickly and easily seen.
C1.3 Frequently used displays are located within the central line of
vision.
C1.4 The display font (i.e., font type, colour, size) clear and does not
cause confusion or reading errors.
C1.5 The display components are distinguished adequately (e.g.,
using form, position, colour or tone) so as to not cause
confusion or error.
C1.6 There is sufficient visual distance for reading precision.
C1.7 For numerical displays, the display is able to give a reading with
sufficient accuracy for the task being carried out.
C1.8 There is sufficient time for action to be taken before the
displayed information changes.
C1.9 The visual displays and auditory signals conform to the work
process.
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Displays/ Signals Yes No NA Evidence (s) Action items

C1.10 Auditory signals are audible over the background noise of the
area.
C1.11 Emergency signals (visual and/or auditory) easily recognizable.
C1.12 Warning flashing signals are located within the field of vision of
the worker.
C1.13 The cognitive aspects (mental demand) of the task has been
evaluated.
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If there is only a display with no attached controls, answer NA for questions C1.14 to C1.24. Examples of controls include push buttons,
flip buttons, dials, levers, gears, wheels, touch screens, proximity sensors, voice-activated controls, etc.
Controls Yes No NA Evidence (s) Action Items

C1.14 The controls are labelled/ colour-coded/symbol-coded
for clear identification.
C1.15 The dimension and shape of the controls are designed to
match the physical characteristics of the workers so that
it
i) Can be used with either hand
ii) Provides a good grip
iii) Avoids awkward postures
C1.16 The controls are comfortable to operate (e.g., optimal
temperature, minimal vibration, electrostatic charge,
etc.).
C1.17 The placement of the display and control are sufficiently
close to each other.
C1.18 The movement direction of the display and the control
are harmonised (e.g., left control movement gives
leftward unit movement, etc.).
C1.19 The controls are sequentially arranged for function
and/or frequency of use.
C1.20 The controls are protected against accidental operation.
C1.21 The force required to operate the control is minimal
(light force).
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C1.22 The precision required to operate the control is

acceptable (low to moderate precision).
C1.23 Emergency stop buttons are placed where they are easily
accessible but with appropriate guards to protect against
accidental use.
C1.24 For touch screens, the layout of the display matches with
the screen-based controls.
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SECTION C2 – TASKS INVOLVING MACHINERY
C2 – TASKS INVOLVING MACHINERY
Machinery is defined as any stationary or mobile machine or group of machines. It is any physical system that uses power to
apply forcers and/or control movement to perform specific task or action. This includes, but is not limited to, includes steam
boilers, unfired pressure vessels, fired pressure vessels, pipelines, prime movers, gas cylinders, gas holders, hoisting machines
and tackle, transmission machinery, driven machinery, materials handling equipment, amusement device or any other similar
machinery and any equipment for the casting, cutting, welding or electro-deposition of materials and for the spraying by
means of compressed gas or air of materials or other materials.
A stationary machine is defined as any machinery that is stationary or is fixed within a stationary frame when being operated.
A mobile machinery is defined as any machinery or vehicle that moves from one location to another when in operation. This
includes, but is not limited to, vehicles such as lorries, vans, trucks, cars, and forklifts as well as machinery such as conveyor
belts.
It does not include non-powered tools such as bicycles, push carts or manual trolleys.
C2 Tasks involving machinery

Task being assessed
Name
Designation
Years of service
Brief description of task
Machinery type
interaction with the
machinery
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SECTION C2 – TASKS INVOLVING MACHINERY
Yes No NA Evidence (s) Action items
C2.1 For stationary machines, the placement physically

stable.
C2.2 For mobile machines, the pathway/route is free of
obstruction, stable and even.
C2.3 The speed of machine/ vehicle can be controlled by
the worker.
C2.4 Workers operating or interacting with machine are not
in an awkward posture.
C2.5 The operating mechanisms of the machine (e.g. wheel,
handles, valve, etc) are designed and placed so that it
does not hamper the movements of workers working
in the vicinity of the machine.
C2.6 Machine guards have been installed and inspected
regularly to reduce the risk of injury.
C2.7 The machinery has been equipped with warning
signals.
C2.8 The machinery is inspected and maintained at regular
intervals.
C2.9 The machine can be accessed for inspection and
maintenance easily and safely.
C2.10 The work instructions for machine operation,
maintenance and safety are available and easily
accessible to workers.
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SECTION C3 – TASKS INVOLVING TOOLS
C3 – TASKS INVOLVING TOOLS
Tools are defined as any hand-held portable item that is operated directly by the worker. It includes handheld machine or
power-driven tools (e.g. drills, grinders, jackhammers, blowers etc,), electrical devices (e.g. flashlights, etc.) and manual tools
(e.g. screwdrivers, hammers, hoses, etc.). It also includes equipment that can be moved or handled manually (e.g. ladders,
trolleys, pushcarts, lifting jacks, bicycles, etc.)
The tools can be portable or be fixed or tethered to the work area.
Any machine- or power-driven tools that are not handheld or portable should be assessed as a machine in Section C2 instead.
C3 Tasks involving tools

Task being assessed
Name
Designation
Years of service
Tool type
interaction with tool
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SECTION C3 – TASKS INVOLVING TOOLS

C3.1 The tool can be easily and safely carried.
C3.2 The tool can be used with either hand.
C3.3 The worker can use the tool without any
awkward wrist posture.
C3.4 The form and position of the handle is designed
for convenient grip.
C3.5 Power-driven tools are designed for two-hand
operation.
C3.6 With the exception of the edge of a bladed
component, the tool is free from sharp edges or
ridges that may cause injury.
C3.7 Anti-vibration gloves regularly used when
operating a vibrating tool.
C3.8 Tools/ equipment are pre-positioned to avoid
mental delay.
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SECTION C4 – TASK ERGONOMICS
C4 – TASK ERGONOMICS
Physical ergonomics deals with the physical load on the human body when performing tasks. The ergonomics risk factors can
be identified an assessed as outlined in the Guidelines on Ergonomics Risk Assessment at the Workplace 2017.
C4 Task Ergonomics
Task being assessed
Name
Designation
Years of service
Yes No NA Evidence(s) Action items

C4.1 Identification of ergonomics issues.  Musculoskeletal self-
assessment by workers
 Inspection
walkthrough
 Inspection of records
 Others:
C4.2 Identification of ergonomic risk factors.
C4.3 Advanced ERA.
C4.4 Implementation of ALL control measures
recommended by the assessment report.
C4.5 Identification of environmental factors
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SECTION C4 – TASK ERGONOMICS
Yes No NA Evidence(s) Action items

i) Inadequate lighting
ii)Extreme temperature
iii)
Inadequate air ventilation
iv)Exposed to excessive noise during working
hours
v) Noise exposure above Noise Exposure
Limit (NEL).
Records
C4.6 The following records are available
i) Ergonomics Risk Assessment Report
ii) Occupational Accident/ Incident/
Complaint/ Illness Report
iii)Workers’ ergonomics training records
iv) Medical records
v) Other records
(e.g. studies, EPF claims, etc).
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SECTION C5 – TASK DESIGN
C5 – TASK DESIGN
Task design refers to the way a task is designed to be carried out.
C5 Task Design
Task being assessed
Name
Designation
Years of service
C5 Task design Yes No NA Evidence (s) Action items

Skill Requirement
C5.1 Training has been identified and carried out for all
workers.
Manpower and Working Hours
C5.2 The manpower (number of people) and manhours
(number of working hours) is sufficient
C5.3 The pace of the machine has considered attentional
demand of the worker.
C5.4 Control measures have been implemented to ensure
safety and health of workers that are working alone or
in remote areas.
Tools, Equipment and Methods
C5.5 The tools and methods of the work are specific to the
purpose of the task and in sufficient quantity.
C5.6 The suitable PPE for this task has been identified.
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SECTION D – CONFINED SPACES
D –CONFINED SPACES
A “confined space” as defined in the Industry Code of Practice for Safe Working in A Confined Space 2010 is an enclosed or
partially enclosed space that is at atmospheric pressure during occupancy and is not intended or designed primarily as a place
of work, and
a) is liable at any time to
(i) have an atmosphere which contains potentially harmful levels of contaminants;
(ii) have an oxygen deficiency or excess; or
(iii) cause engulfment; and
b) could have restricted means for entry and exit.
The following are some examples of confined spaces

a) storage tanks, tankers, boilers, silos and other tank like compartment usually having a manhole for entry;
b) open-topped spaces such as pits or degreasers;
c) pipes, sewers, tunnels, shafts, ducts and similar structures; and
d) any shipboard spaces entered through a small manhole, cargo tanks, cellular double bottom tanks, duct keels,
ballasts and oil tanks
A person whose head or upper body is within a confined space is considered to have entered the confined space
D Confined Spaces
Location
 Tank: ___________________ (state type of tank)

 Open topped confined space:__________________________ (state type of space)
Type of confined space
 Pipes/ sewers/ tunnels
 Shipboard spaces:______________________________________ (state type of space)
 Cleaning  Repair
Activity
 Inspection  Construction
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 Maintenance  Others
 Physical ______________________________________________________(state in detail)
 Chemical _____________________________________________________(state in detail)
Type of hazards  Psychosocial _________________________________________________(state in detail)
 Biological ____________________________________________________(state in detail)
 Ergonomics __________________________________________________(state in detail)
Yes No
Permitted entrant   _____________(State number of persons)
Standby person   _____________(State number of persons)
Authorise Gas Tester   ________________________________________(State name and registration number)
  ________________________________________(State name and registration number)
Entry Supervisor   ________________________________________(State name and registration number)
*If more space is required, attach an additional sheet

D.1 Hazard Identification
D.1.1 Identification of hazards.
Risk Assessment (JHA/HIRARC)
D.1.2a Risk assessment has been carried out prior to
entry into the confined space.
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D.1.2b CHRA has been carried out by a competent
assessor.
D.1.2c The risk has been re-assessed when no longer
valid, every 5 years or when directed by DOSH.
Risk Control
D.1.3 Establish and implement procedures and
practices of hazard control.
Entry into safe atmosphere
D.1.4a Initial cleaning.
D.1.4b Purging.
D.1.4c Testing and evaluation of the CS atmosphere by
a competent AGT.
D.1.4d Continuous testing /monitoring of CS
atmosphere by AGT/ AE.
D.1.4e Continuous ventilation.
Entry into hazardous atmosphere
D.1.5a Use of suitable breathing apparatus.
D.1.5b Can only be carried out by authorised entrant
who has been trained and competent.
D.1.5c Continuous gas monitoring for LEL.
D.1.5d Hot work must not be undertaken if the
explosimeter reading exceeds 1% LEL.
D.1.5e Entry is prohibited if the readings exceed 10%
LEL unless positive pressure respirators are
used.
D.1.5f Special consideration:
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- Management of compressed air-line systems
- Compressed air-line systems handled by
trained workers.
D.1.5g Condition of the compressed air line system is
monitored by trained workers.
D.1.5h Special safety considerations when working
under inert atmosphere.
Standby Person (SP)
D.1.6 At least one SP available throughout the
duration of the CS entry operations.
Monitoring of multiple confined spaces
D.1.7 Programme includes means and procedures to
enable SP to respond to an emergency without
distracting from the SP’s responsibilities.
Permit to Work (PTW) System

D.1.8a Written procedure for
- Preparation
- Issuance
- Implementation
- Cancellation.
D.1.8b Duration of the PTW shall not exceed the time
required to complete the assigned task or job in
accordance with the purpose of entry or eight
hours, which ever is shorter.
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D.1.8c PTW may be extended only once for a maximum
of four hours, provided all the terms and
conditions remain the same.
D.1.8d The PTW contains all information as stated in
the iCOP.
D.1.8e Implementation of the PTW system.
D.1.8f A copy of all PTWs that have been cancelled or
closed is kept for at least 1 year or until the next
entry (whichever is later).
Signage
D.1.9a Placed at easily visible areas.
D.1.9b In both Bahasa Malaysia and English.
Training
D.1.10a Training is provided to every affected worker.
D.1.10b Workers attended training approved by the DG
and pass the examination.
D.1.10c AGT and ES are registered with DOSH.
D.1.10d Employee undergoes a refresher course every
two years using modules approved by the DG.
D.1.10e Training records are kept.
D.1.10f Training records contain elements stated in the
iCOP.
Equipment
D.1.11a Employer shall provide appropriate equipment
as per iCOP.
D.1.11b All equipment shall be inspected prior to use.
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D.1.11c The equipment used for the purposes of
confined space entry or emergency services
shall be maintained and thoroughly examined
by a qualified person appointed by the employer
at least once a month..
D.1.11d All other equipment used for entry shall be
maintained and thoroughly examined by a
qualified person appointed by the employer.
D.1.11e Inspection/ maintenance records are kept.
Communication
D.1.12a Has a means of communication.
D.1.12b Communication procedure between
- Site manager
- ES
- AE
- ERT
- Other rescue/ emergency agencies.
External hazard protection (pedestrians and vehicles)
D.1.13 External hazard protection.
Identification of the duties
D.1.14a Designation and identification of the duties of
AE, SP, AGT, ES, PI or other related personnel.
D.1.14b Ensured that the personnel mentioned above
carried out their duties as specified in Part IV of
the iCOP.
Information to the contractor
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D.1.15 Provide and brief contractors with information
about the confined space hazards, safety rules
and emergency procedures.
Coordination of entry operations involving employees of more than one contractor working simultaneously
D.1.16 Procedures are developed and implemented.
Conclusion of entry
D.1.17a Procedures for concluding the entry are
developed and implemented.
D.1.17b A debriefing is held after the PTW is closed.
D.2 Reviewing of confined space entry programme
D.2 The CS program is reviewed.
D.3 Emergency procedures
D.3.1 Emergency procedures have been developed.
Alarm
D.3.2 Suitable alarm system is used.
Emergency Action
D.3.3 An emergency action plan is prepared.
Evacuation, rescue and first aid
D.3.4 Evacuation, rescue and first aid procedures are
available.
Rescue procedures
D.3.5 Emergency procedures, including provision for
rescue equipment.
D.3.6 Emergency preparation for hazardous
atmospheres,
D.4 Record keeping
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D.4.1 All relevant documents are maintained for
inspection by DOSH.
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SECTION E - JOB DESIGN
E – JOB DESIGN ASSESSMENT
Job design refers to how a set of tasks or an entire job is organized. For this assessment, the job design for each job position
will be assessed to address problems such as work overload or underload, isolation, excessive working hours, etc.
Status
Evidence (s) (s) (s)
(Y/N)
Have the job positions involved for each work process
List of job positions/ job description
been identified and documented?
For each job position identified, carry out assessment if it includes any tasks that has been assessed in Section C.
Note
1. One job position may have multiple tasks.
2. One task may be carried out by multiple people in different job positions.
SUMMARY FOR JOB DESIGN
Work Activity Task Job Position
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NAME OF JOB POSITION:
TASKS REQUIRED TO BE COMPLETED BY PERSONNEL IN THIS POSITION:
i. …………………………………………..
ii. ………………………………………….
iii. …………………………………………..
ESTIMATED NUMBER OF PERSONNEL:
E Job design Yes No NA Evidence (s) Action items

Work Time Schedule
E.1 The work schedule (i.e., work hours/day/week/year, including
seasonal work and shift system) for this position been
identified.
E.2 The limit for overtime/ extra work has been prescribed.
E.3 The cognitive, emotional and health impacts on the worker
have been assessed.
E.4 If the worker is away from his job (e.g., on annual leave,
medical leave or attending training), there is another worker
that can take over his duties.
E.5 Sufficient breaks/ rest periods are provided throughout the
shift.
E.6 The worker has the discretion to take breaks when necessary.
Training Requirements
E.7 A training needs analysis has identified the knowledge and
skills required for this job.
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E.8 The training(s) required for workers to acquire necessary
skills has been identified.
E.9 Regular training or up-skilling is provided to workers in this
job.
Job Variety
A worker’s job should include a variety of tasks or skillsets to avoid boredom as well as promote emotional and mental wellness.
However, the number of tasks should not be to the point where a worker becomes overburdened physically or mentally.
E.10 This job includes job rotation among people within the same
team/ group.
E.11 There is variation to the level of stimulation (e.g., visual and
auditory environment) experienced by the worker to avoid
boredom or monotony.
E.12 There are opportunities for job enlargement or additional
tasks to avoid boredom.
Job Clarity
E.13 Job roles and goals are clearly defined.
E.14 The worker is assigned a supervisor with clear reporting lines.
Task Significance
E.15 The worker can easily understand how his/her tasks make a
significant contribution to the total work system.
Mental Workload
E.16 The mental burden of handling information, decision making
and managing risks has been considered in all situations
including high pressure situations (e.g. during emergencies,
etc.).
Overall workload
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E.17 The additional workload to a worker appointed into positions
such as the HCA, NRA, HT2, AGTS, OSH Coordinator, etc. has
been assessed.
Personal Protection Equipment (PPE)
E.18 The worker has been provided the suitable type of PPE to cater
for the risks involved in all tasks and work areas.
E.19 Fit-testing has been carried out to ensure that the PPE
provided is a good fit to the worker.
E.20 Workers have been trained on the use and maintenance of the
PPE before the PPE is issued to them.
E.21 Refresher trainings have been conducted regularly.
E.22 The workers’ PPE have been inspected and maintained
regularly.
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SECTION F– ENVIRONMENTAL ASSESSMENT OF WORK AREA
F – ENVIRONMENTAL ASSESSMENT OF WORK AREA
For each task being assessed, list the work area(s) where the task takes place. For each work area, identify which Sections of the HFE
checklist must be filled for that work area:
 Sections F1 and F2 must be filled for all tasks

 Section F3 is applicable for all tasks except for tasks that only relies on natural lighting
 Section F4 must be filled if the task involves use of local exhaust ventilation (LEV)
SUMMARY OF ENVIRONMENTAL ASSESSMENT OF WORK AREAS
F1 F2 F3 F4
Local Exhaust
Ventilation
Work Activity Task Work Area
Lighting
(LEV)
Noise
Heat
Y Y
Y Y
Y Y
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WORK LOCATION/ AREA:
TASKS REQUIRED TO BE COMPLETED BY PERSONNEL IN THIS WORK AREA:
i. …………………………………………..
ii. ………………………………………….
iii. …………………………………………..
ESTIMATED NUMBER OF PERSONNEL:
F1 - NOISE
Ye Action
F1 No NA Evidence (s)
s items
Identification of Excessive Noise
F1.1 Has identified excessive noise exposures for ALL work areas.
Re-identification of Excessive Noise
F1.2 Has re-identified excessive noise.
Noise Risk Assessment
F1.3 Has carried out noise risk assessment.
Audiometric Testing
F1.4 Audiometric testing is carried out each year by an approved
testing centre.
Employer Commitment
F1.5 Employer commitment towards noise management.
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Ye Action
F1 No NA Evidence (s)
s items
F1.6 The employer has made an assessment before implementation
whether the control measure is practicable to reduce excessive
noise by way of engineering control or administrative control.
Implementation of Planned Control Measures
F1.7 Effectiveness of the implemented control measures.
Personal Hearing Protectors
F1.8 Personal Hearing Protectors, are table to reduce the noise
exposure to below the NEL.
Worker Training
F1.9 Workers exposed to excessive noise are given appropriate
training.
Hearing Protection Zones
F1.10 "Hearing Protection Zones" are clearly marked and easily
understood by workers.
Effectiveness of control measures
F1.11 The employer has assessed the effectiveness of control measures.
F1.12 The employer has made improvements to the control measures, if
required.
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F2 – HEAT
This section must be filled for all work areas being assessed. Refer to Guidelines on Heat Stress Management at workplace 2016 for
detailed information.
F2 Yes No NA Evidence (s) Action items

F2.1 The heat stress load to the worker has been assessed.
F2.2 The methods used to measure heat stress are suitable.
F2.3 The action items and recommendations from the heat
stress assessment have been implemented.
F3 – LIGHTING
This section must be filled for all work areas being assessed that is done using artificial lighting. It is not required for work areas using
natural lighting (e.g. outdoors).

General Lighting
F3.1 The amount of lighting is adequate for the task.
F3.2 The work area is free of glare.
F3.3 The work area is free of light flickers.
F3.4 The light installations are designed for the work
environment in which it has to operate.
F3.5 The light fitting are easy to access for maintenance.
F3.6 The lights maintained regularly.
F3.7 When measuring illuminance, the lux meter used
conforms to internationally recognised specifications.
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F3.8 The lux meter used to measure illuminance has been
calibrated at least once a year.
Emergency Lighting
F3.9 The illuminance for escape lighting reaches the required
level 5 seconds after the failure of the main lighting
system.
F3.10 For battery powered escape lighting, the battery lasts
long enough to ensure evacuation of the building.
F3.11 Emergency exit lights are easily visible and
recognisable.
F4 – LOCAL EXHAUST VENTILATION
This section must be filled if the LEVs are being used in the work area.
F4 Local Exhaust Ventilation Yes No NA Evidence (s) Action items

F4.1 The LEV is designed, installed and tested following a
standard that has been endorsed by a registered
professional engineer.
F4.2 The LEV system is inspected by the employer at least
once a month
F4.3 The LEV system is checked and its effectiveness is
assessed by an Industrial Hygiene Technician at least
once every 12 months.
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F4 Local Exhaust Ventilation Yes No NA Evidence (s) Action items

F4.4 The records of the design, construction, testing,
inspection and examination and the maintenance of the
LEV system are available.
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SECTION G – ORGANISATIONAL ELEMENTS ASSESSMENT
G – ORGANISATIONAL ELEMENTS ASSESSMENT
Fill in Section G once for the entire organisation.

G Organisation Yes No NA Evidence (s) Action items
Organizational culture
G.1 The corporate goals and values have been communicated to
the employees.
G.2 Safety and health culture is promoted among employees.
G.3 Safety and health procedures implemented by the
organization has been assessed for its effectiveness.
G.4 The organization has taken follow up action on accidents.
Communication
G.5 Workers can communicate with one another regardless of
position or hierarchy.
G.6 The organization highlights the significance of the job by
providing acknowledgement and recognition.
G.7 The worker receives feedback on their job performance.
Incentives
G.8 The worker has an opportunity for advancement to a
higher-level position.
G.9 The worker receives financial incentive in line with his/her
job performance.
G.10 The organization provides support to workers to resolve
conflicts or ambiguities in his/her individual job scope and
responsibilities.
Employee autonomy and participation
G.11 The worker is involved in decision making (participatory).
37

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HUMAN FACTOR AND ERGONOMICS (HFE) ASSESSMENT CHECKLIST FOR WORKPLACES

HUMAN FACTORS AND ERGONOMCIS (HFE) CHECKLIST FOR WORKPLACES

A. WORKPLACE AND ASSESSMENT PARTICULARS

A1. WORKPLACE DETAILS

A2. ASSESSMENT PARTICULARS

SUMMARY FOR TASK SPECIFIC ASSESSMENT

C1 – TASKS INVOLVING HUMAN-COMPUTER INTERACTION

C1 Tasks involving human-computer interaction

Task being assessed

Displays/ Signals Yes No NA Evidence (s) Action items

C1.6 There is sufficient visual distance for reading precision.

Displays/ Signals Yes No NA Evidence (s) Action items

Controls Yes No NA Evidence (s) Action Items

C1.22 The precision required to operate the control is

C2 – TASKS INVOLVING MACHINERY

C2 Tasks involving machinery

Yes No NA Evidence (s) Action items

C2.1 For stationary machines, the placement physically

C3 – TASKS INVOLVING TOOLS

The tools can be portable or be fixed or tethered to the work area.

C3 Tasks involving tools

Yes No NA Evidence (s) Action items

Yes No NA Evidence(s) Action items

Yes No NA Evidence(s) Action items

Task design refers to the way a task is designed to be carried out.

C5 Task design Yes No NA Evidence (s) Action items

The following are some examples of confined spaces

 Tank: ___________________ (state type of tank)

Yes No NA Evidence (s) Action items

Yes No NA Evidence (s) Action items

Yes No NA Evidence (s) Action items

Permit to Work (PTW) System

Yes No NA Evidence (s) Action items

Yes No NA Evidence (s) Action items

Yes No NA Evidence (s) Action items

Yes No NA Evidence (s) Action items

E – JOB DESIGN ASSESSMENT

SUMMARY FOR JOB DESIGN

Work Activity Task Job Position

NAME OF JOB POSITION:

TASKS REQUIRED TO BE COMPLETED BY PERSONNEL IN THIS POSITION:

E Job design Yes No NA Evidence (s) Action items

E Job design Yes No NA Evidence (s) Action items

E Job design Yes No NA Evidence (s) Action items

F – ENVIRONMENTAL ASSESSMENT OF WORK AREA

 Sections F1 and F2 must be filled for all tasks

SUMMARY OF ENVIRONMENTAL ASSESSMENT OF WORK AREAS

WORK LOCATION/ AREA:

TASKS REQUIRED TO BE COMPLETED BY PERSONNEL IN THIS WORK AREA:

F2 Yes No NA Evidence (s) Action items

F3 Yes No NA Evidence (s) Action items

F3 Yes No NA Evidence (s) Action items

F4 – LOCAL EXHAUST VENTILATION

F4 Local Exhaust Ventilation Yes No NA Evidence (s) Action items

F4 Local Exhaust Ventilation Yes No NA Evidence (s) Action items

G – ORGANISATIONAL ELEMENTS ASSESSMENT

Fill in Section G once for the entire organisation.

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