Controls and Personal Protective Equipment - Accident/Incident Prevention Techniques - page 372

Personal Protective Equipment Program

hazard Assessment certiication Form
Date:

Location:

Assessment.Conducted.By:
Speciic.Tasks.Performed.at.This.Location:

hazard Assessment and selection of Personal Protective equipment
I. Overhead Hazards
•. Hazards.to.consider.include:
•. Suspended.loads.that.could.fall
•. Overhead.beams.or.loads.that.could.be.hit.against
•. Energized.wires.or.equipment.that.could.be.hit.against
•. Employees.work.at.elevated.site.who.could.drop.objects.on.others.below
•. Sharp.objects.or.corners.at.head.level

Hazards.Identiied:

head Protection
Hard.Hat: Yes No

If.yes,.type:
□ Type A .(impact.and.penetration.resistance,.plus.low-voltage.electrical.insulation)
□ Type B .(impact.and.penetration.resistance,.plus.high-voltage.electrical.insulation)
□ Type C .(impact.and.penetration.resistance)

II. Eye and Face Hazards
•. Hazards.to.consider.include:
•. Chemical.splashes
•. Dust
•. Smoke.and.fames
•. Welding.operations
•. Lasers/optical.radiation
•. Projectiles

Hazards.Identiied:

eye Protection
Safety.glasses.or.goggles Yes No

Face.shield Yes No

III. Hand Hazards
•. Hazards.to.consider.include:
•. Chemicals
•. Sharp.edges,.splinters,.etc.

FIgure 24.3 PPE. hazard. analysis. checklist.. ( Source: . Courtesy. of. the. Occupational.
Safety.and.Health.Administration.)