PPE Assessment Form Instructions

Personal Protective Equipment (PPE)
Hazard Assessment Instructions
This document provides guidance on completing a PPE hazard assessment. It
includes the process for identifying hazards and PPE for the eyes, face, head,
hands, feet, torso, respiratory system, and hearing. Personal protective equipment
is the least effective hazard control. If possible PPE should be used in conjunction with
other controls such as substitution to a lesser hazardous substance, engineering
controls, warnings, and administrative controls. Based on the hierarchy of controls,
PPE is a last resort.
The Occupational Safety and Health Administration (OSHA) requires that a hazard
assessment be conducted of workplaces (laboratories) to identify hazards and how
to control those hazards. Potential hazards may be physical or health-related. A
comprehensive hazard assessment should identify hazards in both categories.
Examples of physical hazards include moving objects, fluctuating temperatures, high
intensity lighting, rolling or pinching objects, electrical connections, sharp edges, etc.
Examples of health hazards include overexposure to harmful dusts, chemicals,
radiation, etc.
There are two pages to the University of Notre Dame’s PPE Hazard Assessment,
which is available on the RMS web site at this link. The first page documents the
hazards while the second provides the PPE requirements. Once completed, the
second form must be signed by the individual completing the PPE hazard
assessment. This is to satisfy the OSHA Standard, 29 CFR 1910.132 Subpart I‐
Personal Protective Equipment.
When completing the assessment, if necessary contact Risk Management and Safety
(RMS) at 631-5037 if you have any questions regarding the process, identifying
hazards or the proper PPE. Completed assessments must be accessible to
employees and inspectors (RMS or regulatory agency).
General Guidelines
The PPE hazard assessment can be conducted for an area, a specific task, or specific
hazard. The assessment must be updated when changes occur that may affect the PPE
requirements.
In addition to completing the PPE hazard assessment, it is also a requirement to:
• Identify and provide appropriate PPE for workers
• Train workers in the use and care of the PPE
• Maintain PPE, including replacing worn or damaged PPE
• Periodically review, update and evaluate the effectiveness of the PPE
program
Page 1 of 6
The first page of the PPE hazard assessment identifies the types of hazards and what
body part could potentially be affected by those hazards.
When reviewing the remainder of these instructions, you will note circles with numbers.
These will be used as reference guides in this document and are not on the working
forms.
Figure 1
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PPE HAZARD ASSESSMENT INSTRUCTIONS
STEP 1: Inform Affected Employees of the Process
Affected personnel from the work area/lab that is being assessed should be involved
in the process. Discuss the reasons for the survey and how the assessment will be
conducted. Inform them that the review will include applicable procedures, a
walkthrough of the area/lab to identify potential hazards and a discussion on the
PPE currently in use, to determine if it is appropriate.
Step 2: Review Relevant Safety Alerts for Information
Reports of work‐related injuries or illnesses, near‐miss events and reported
safety concerns are sources of data that can provide helpful information for
assessing hazards. A number of safety alerts are available on the Risk
Management and Safety web site at this link.
Step 3: Conduct a Walkthrough Survey
The purpose of the walkthrough is to identify sources of hazards to employees.
Observe the workplace for the:
• Layout of the workplace
• Location of the employees
• Work operations
• Hazards
• Places where PPE is currently used including the device and reason for use
Using the PPE Hazard Assessment form on page 1, identify the type of hazard(s) present
and associate the hazard by body part. Consideration should be given to the following
basic hazard categories:
•
•
•
•
Physical Hazards – Mechanical, Thermal, Radiation, Electrical
Chemical Hazards – Particulate, Liquids, Gases
Biological – Bacteria, Viruses, Fungi, Parasites, Human Tissues or Body Fluids
Other – Hazards Not Identified on the Worksheet
Complete the first page of the form by entering:
• The laboratory by Building and room number
• The PI responsible for the lab
• Providing a description of the task, hazard or area as appropriate
• The name of the person completing the assessment
Place a checkmark (√) in the column with the identified hazard and the row identifying
which body part(s) could be affected by the hazard. Each body part has been
identified with a number 1 in this training document (See Figure 1 and 2). The circled
number corresponds to a section on page 2 of the PPE Hazard Assessment to assist
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in the use of this training information (See Figure 3). If there is a hazard affecting the
eyes 1 identify PPE for the eyes 1 on page 2. Identify all the body parts that could
credibly be affected by the hazard.
Example
During the walkthrough it is noted that liquid nitrogen must be transferred from a large
container to a smaller one. There is a potential splash hazard from the nitrogen during
transfer resulting in a thermal cold contact hazard.
On the first page of the PPE Hazard Assessment:
1. Identify the appropriate hazard in the columns. For this example it would be:
• PhysicalThermalCold
• Chemical LiquidSplashes, Sprays
2. Place a check mark in the column for the hazards corresponding to the body
part that the Chemical LiquidSplashes, Sprays and the
PhysicalThermalCold could credibly impact. For this example the liquid
nitrogen could splash and have a thermal impact on the following body parts:
• Eyes
• Face
• Hands/Fingers
• Whole Body / Torso
• Legs and feet
Figure 2
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Step 4: Select PPE
After considering and planning for other controls from the list of the hierarchy of
controls select the PPE which provides at least the minimum level of protection
required to protect employees from the hazards. Engineering Controls may alleviate
some PPE requirements.
Using page 2 of the PPE Hazard Assessment form (Figure 3), place a checkmark (√) in
the appropriate body part section identifying the appropriate PPE. For help with proper
PPE selection, consult the CHP, the glove compatibility chart on the RMS web site or
other internet resources, contact Unit/Department Safety Coordinator, or contact RMS
at 1-5037.
Example – Refer to Figure 3
Continuing with the example of transferring liquid nitrogen, we noted that there are
hazards affecting four (4) body parts. PPE should be identified for these body parts as
noted below:
• Eyes – Chemical googles should be selected and used because safety
glasses do not provide adequate protection from chemical splashes.
• Face – A face shield should also be selected due to the hazard being to the
entire face. Please note that face shields are considered secondary
protection and chemical googles must be used with the face shield when
there is a chemical splash hazard.
• Hands/Fingers – Thermal cold contact is the concern in this example so a
thermal cryogenic glove should be used.
• Whole Body/Torso – The splash could credibly impact the torso so a
standard lab coat is required.
• A splash could credibly impact the foot or leg, additional protection is not
necessary if the minimum PPE as describe in the CHP is worn. This
includes: closed-toed / heeled shoes with a substantial sole as well as ankle
length pants or with fabric similar to denim or twill.
Finally the bottom of page 2 requires a signature and date of the person completing the
PPE Hazard Assessment. This is a regulatory requirement.
Step 5: Document Accessibility and Communication
Once the PPE hazard assessment(s) are completed and signed/dated, store them either
electronically or as a hard copy in a location easily accessible to students, lab workers,
and inspectors.
Ensure that affected laboratory personnel are made aware of the required PPE and sign
a PPE certification form. This form is available on the RMS web site this link.
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Step 6: Revise Protocols
If the PPE hazard assessment identifies different PPE requirements, update the
appropriate lab protocols with this information.
Step 7: Reassess the workplace as necessary.
The PPE Hazard Assessment is required to be updated when the hazards change
through new/modified experiments or processes or where there were injuries with
inadequate PPE noted.
The PPE hazard assessment should be periodically reviewed to ensure accuracy.
Figure 3
Signature and Date
Required by OSHA
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