Form Latihan Hira
Form Latihan Hira
Form Latihan Hira
Form : FM-TR-IH-
06
Revisi : 0
Department & Exact Location Of The Work Performed: Project / Work Description:
;
Risk Assessment Team (Name/s): Approved By Supervisor / Reporting Officer:
(Name, Date & Signature)
S/N Work activity Hazard Possible Accident/ Ill Existing Risk Severity Likeli RPN* Additional Risk Severity Likeli RPN* Follow up by Remarks
health to persons, fire or Control hood Control Measures hood (name) & date
property loss
1 Pengisian Tabung O2 Portable Ledakan Cidera-fatality, kerusakan SPO, PG, FM, TRN 5 2 10 Alarm, OS, RTRN 5 1 5 Eng 20,000,000
bangunan, kerusakan
alat
2 Pemasangan Infus Virus, Benda tajam Cidera, Terinfeksi SPO, TRN, ATB 4 2 8 R-TR, SPV, MENT, 4 1 4 Ka. Ruangan 1,000,000
*RPN - Risk Prioritization Number
Risk Assessment Matrix
Risk Prioritisation Number = Severity x Likelihood
Severity Table
Pt Severity level Workplace Safety Workplace Health Environment Fire Damage Downtime Incurred
Fatality, Acute Poisoning, More Than $10 More than 1 year for
Failure of Major Spills to Outside Campus
single or multiple million damages full re-instatement
Bodily Functions
5 Critical
Permanent Body
Injury or Loss of Use Infection with No Infection - outside
Known Cure Campus area
for more than 30 days
Mild exposure,
Injury requiring 10 days Reversible injury to Spills to Outside More Than $100k More than 1 month for
of hospitalisation Bodily Functions with Laboratory/Room damages full re-instatement
and/or medical leave less than 30 days
recovery
3 Serious
No Infection or infection
No or superficial injury No Exposure with no effects within
workplace
Likelihood Table
Pt Likelihood level Likelihood of Occurrence / Exposure Criteria
SEVERITY
Critical Very Serious Serious Marginal Negligible
(5) (4) (3) (2) (1)
Frequent 25 20 15 10 5
(5) Operation not Operation not High priority Review at Risk acceptable
permissible permissible appropriate time
Moderate 20 16 12 8 4
(4) Operation not Operation not High priority Review at Risk acceptable
permissible permissible appropriate time
LIKELIHOOD
Occasional 15 12 9 6 3
Review at appropriate
(3) High priority High priority time Risk acceptable Risk acceptable
Remote 10 8 6 4 2
(2) Review at Review at Risk acceptable Risk acceptable Risk acceptable
appropriate time appropriate time
Unlikely 5 4 3 2 1
(1) Risk acceptable Risk acceptable Risk acceptable Risk acceptable Risk acceptable
Review the risk assessment records every year or whenever there are changes in processes, work activities or upon
any incident occurrence, whichever is earlier.
Action Table
Colour Score Risks Action
Column 1d Identify possible accidents/ill health associated with each identified hazard. Ex
possible accidents/ill health include fires, explosions, cuts, burns, frost bites, fractures etc.
Column 2a Indicate risk control measures that are already in place to eliminate or minimise risks. Me
control risks may be analysed according to the Hierarchy of Controls: Elimination, Substitution, Engineering Con
Administrative Controls and Personal Protective Equipment (PPE). Elimination of the hazard sho
priority while PPE should be the last line of defence.
Elimination
Example: Use water based solvents instead of organic based solvents
Substitution
Example: Use a less toxic solvent
Engineering Controls
Example: Use of fume cupboard or gloves boxes Ad
Controls Example:
instructions. Good laboratory practices. Training on proper use of chemicals PPE
Example: Use o
eyewear plus respiratory protection, use of gloves
Column 2b S=Severity Severity i
or extent of injury or harm caused by the hazards, or as a result of an accident. Choose the most likely
from a value between 1 and 5, rather than the most extreme. Refer to the Risk Matrix tab fo
severity table
Column 3a Additional risk control measures are required when the RPN indicated in column 2d exceeds 6. If the R
less, enter "NA" in the column
Column 3b S=Severity Sm
upon introduction of additional control measures
Column 3c L=Likelihood
L may reduce upon introduction of additional control measures
Column 3e Enter the name of the person appointed to oversee the implementation of the additional control measures. En
follow-up date.
Note: Please do
Therefore, a computer is not an
Examples of
cs, psychosocial, slip & fall etc.
Examples of
actures etc.
e risks. Methods to
n, Substitution, Engineering Controls,
Elimination of the hazard should take first
vents
Administrative
Example: Work
PPE
Example: Use of safety
Severity is the degree
ident. Choose the most likely severity
efer to the Risk Matrix tab for the
Likelihood of occurance
said accident, incident or ill health will
he records of such events happening in
Risk Matrix tab for the likelihood table
RPN=Severity X
All RPNs should not be more
S may reduce
Risk Assessment Team (Name/s): Johnny (Team Leader), Alice, Roland, Kenny Approved By Supervisor / Reporting Officer:
(Name, Date & Signature)
Prof Tan (Project Supervisor), 16th March 2012
Date Conducted: 11th March 2012 Next Review Date: 10th March 2013
S/N Work activity Hazard Possible Accident/ Ill Existing Risk Severity Likelihood RPN* Additional Risk Severity Likelihood RPN*
health to persons, fire or Control Control Measures
property loss
1 Operation of Femtosecond Laser Physical Hazard Severe Eye Injuries Beam blocks and 3 2 6 NA NA NA NA
Systems beam dumps used
to blocked off
laser beams.
Only authorised
users are allowed
to operate the
system.
Users are
equipped with
laser goggles
Electrical Hazard Electrocution due to high Warning signs are 4 3 12 Regular servicing 4 1 4
voltage displayed beside and maintenance
system to warn of laser system by
users of high vendor
voltage Only authorised
users are allow to
operate the
system
*RPN - Risk Prioritization Number
Systems
Control
3e 3f
NA NA
Date Conducted: 11th March 2012 Next Review Date: 10th March 2013
S/N Work activity Hazard Possible Accident/ Ill Existing Risk Severity
health to persons, fire or Control
property loss
1 Weighing chemicals for the synthesis Irritant Chemicals Irritation when come in Handle under 1
work contact with skin and fumehood.
eyes Put on required
PPE - safety
glasses, lab coat,
long pants, gloves,
covered shoes.
2 Prepare glassware and add Glass breakage due Cuts on skin/eye due to Inspect glassware 3
chemical into chemical reactor to overpressure flying particles before use.
(chemical reaction) Put on required
PPE - safety
glasses, lab coat,
long pants, gloves,
covered shoes.
*RPN - Risk Prioritization Number
K ASSESSMENT FORM
Project / Work Description: Chemical works
Likelihood RPN* Additional Risk Severity Likelihood RPN* Follow up by (name) & Remarks
Control Measures date
3 3 NA NA NA NA NA NA
Date Conducted: 11th March 2012 Next Review Date: 10th March 2013
S/N Work activity Hazard Possible Accident/ Ill Existing Risk Severity
health to persons, fire or Control
property loss
1 Sorting of documents / Use of paper Contact with sharp Cuts and lacerations to Handle files and 1
edges (from paper hand and fingers documents with
edges and bent care, avoiding
plaster dividers fingers running
along the edge of
papers.
Discard bend
plastic folders.
Punching holes for document Strike by moving Fingers may get injured Proper usage of 1
to be filed parts or caught (crush) during punching hole punch
between moving Do not overload
parts paper for
punching
Maintenance of
hole puncher
Ergonomic hazard Muscular starins Staff to adopt 3
(repetive similar good ergonomice
action) practice e.g. table
height. Job
rotations; avoid
prolong repetitive
punching
operation.
Brief staff on
proper usage of
hole punch.
Likelihood RPN* Additional Risk Severity Likelihood RPN* Follow up by (name) & Remarks
Control Measures date
3 3 NA NA NA NA NA NA
1 3 NA NA NA NA NA NA