Student Risk Assessment to Accompanying Taught Programmes Ethics Applications

Research Programmes should not complete this form

Student’s surname

Student’s forename(s)

School

Degree

Title of Project

Brief description of the project

Supervisor’s nameReserve supervisor in case of absenceLocations where work will be carried out

It is the responsibility of the PI / Supervisor to ensure the risk assessment is suitable and sufficient and that risk assessments are reviewed should any significant changes to the project / research be made.

Risk assessment (RA) tracking

Hazard RA required

RA complete

Risk level as identified in RA

Authorised as suitable and sufficient by supervisor

Initial Risk Assessment Physical / Mechanical / Electrical / Animal

Biological Microorganisms

Chemical

Radiation

Travel / Fieldwork

1

Risk Assessment Forms for Research and Projects

Host Organisation

I shall be working in the establishment named below (where applicable):

Name:

Address:

Tel:

Emergency Contact DetailsRole Name Telephone & email

Student

Academic Supervisor

Host organisation Supervisor (where applicable)

Please complete the following risk assessment forms as dictated by the proposed project.

Guidance on how to complete the assessments can be found in the Project RA handbook.

Please delete the sections that are irrelevant to your project.

Contents

Initial Risk Assessment...................................................................................................................3

Physical / Mechanical / Electrical / Aminal Risk Assessment................................................5

Biological Risk Assessment – Microorganisms (Bacteria / Fungi) ......................................7

Genetically Modified Organism (GMO) Risk Assessment.....................................................10

Biological Risk Assessment (Animals)......................................................................................11

Chemical Risk Assessment (COSHH)........................................................................................12

DSEAR Risk Assessment..............................................................................................................15

Radiation / Laser Risk Assessment............................................................................................18

Travel / Fieldwork Risk Assessment...........................................................................................20

2

Risk Assessment Forms for Research and Projects Initial Risk Assessment

Location: Task/Activity/Environment: Date of Assessment:

Identify Hazards which could cause harm:

Identify risks, i.e. what could go wrong if hazards cause harm:

No. Hazard No. Risk

Physical / mechanical / electrical / animalBiological

Chemical

Radiation / Lasers

Lone working

Travel / Fieldwork

Disposal of waste material

List groups of people who could be

affected:

What numbers of people

are involved?

What existing precautions are in place to reduce risks? Risk level with existing precautions

What additional actions are required to ensure precautions are implemented/effective or to reduce the risk further?

Risk level with additional precautions

Is health surveillance required? YES/NO If YES, please detail:

Who will be responsible for implementing the By When:

3

Risk Assessment Forms for Research and Projects precautions:

Completed by: Signed:

Record of annual review:

Risk Rating:

Incr

easin

g Co

nseq

uenc

e 5 10 15 20 25

4 8 12 16 20

3 6 9 12 15

2 4 6 8 10

1 2 3 4 5

Increasing Likelihood

17-25 Unacceptable – Stop activity and make immediate improvements/seek further advice10-16 Tolerable – look to improve within specified timescale

5-9 Adequate – Look to improve at next review

1-4 Acceptable - No further action, but ensure controls are maintained

Guide to using the risk rating table:

Consequences Likelihood1 Insignificant – no injury 1 Very unlikely – 1 in a million chance of it

happening2 Minor – minor injuries 2 Unlikely – 1 in 100,000 chance of it happening3 Moderate – up to three days absence 3 Fairly likely – 1 in 10,000 chance of it happening4 Major – more than three days absence

4 Likely – 1 in 1,000 chance of it happening

5 Catastrophic – death or disabling 5 Very likely – 1 in 100 chance of it happening

4

Risk Assessment Forms for Research and Projects Physical / Mechanical / Electrical / Biological (Animals) Risk Assessment

Location: Task/Activity/Environment: Date of Assessment:

Identify hazards which could cause harm:

Identify risks = what could go wrong if hazards cause harm:

No. Hazard No. Risk

List groups of people who could be affected: What numbers of people

are involved?

What existing precautions are in place to reduce risks? Risk level with

existing precautions

No.

What additional actions are required to ensure precautions are

implemented/effective or to reduce the risk further?

Risk level with

additional

precautions

No.

Is health surveillance required? YES/NO If YES, please detail:

Who will be responsible for implementing

precautions:

By When:

Completed by: Signed:

5

Risk Assessment Forms for Research and Projects

Record of annual review:

Risk Rating:

Incr

easin

g Co

nseq

uenc

e 5 10 15 20 25

4 8 12 16 20

3 6 9 12 15

2 4 6 8 10

1 2 3 4 5

Increasing Likelihood

17-25 Unacceptable – Stop activity and make immediate improvements/seek further advice10-16 Tolerable – look to improve within specified timescale

5-9 Adequate – Look to improve at next review

1-4 Acceptable - No further action, but ensure controls are maintained

Guide to using the risk rating table:

Consequences Likelihood1 Insignificant – no injury 1 Very unlikely – 1 in a million chance of it

happening2 Minor – minor injuries 2 Unlikely – 1 in 100,000 chance of it happening3 Moderate – up to three days absence 3 Fairly likely – 1 in 10,000 chance of it happening4 Major – more than three days absence

4 Likely – 1 in 1,000 chance of it happening

5 Catastrophic – death or disabling 5 Very likely – 1 in 100 chance of it happening

6

Risk Assessment Forms for Research and Projects Biological Risk Assessment – Microorganisms

Step 1 – Obtain the Information

Microorganism Biological Hazard Classification

Locations Possible Route of Entry(Inhalation, Ingestion, Absorption,

Vector, Sharps)

GMO Status Disposal route Risk level

1 N/A 1 2 3 Yes / No

2 N/A 1 2 3 Yes / No

3 N/A 1 2 3 Yes / No

4 N/A 1 2 3 Yes / No

5 N/A 1 2 3 Yes / No

6 N/A 1 2 3 Yes / No

7 N/A 1 2 3 Yes / No

8 N/A 1 2 3 Yes / No

If any or the organisms hold a GMO status then your project / research must be referred to the GMO Committee for their approval.

7

Risk Assessment Forms for Research and Projects Step 2 – Assess the Risk

Identify hazards which could cause harm: Identify risks = what could go wrong if hazards cause harm:

No. No.

List groups of people who could be

affected:

What numbers of people are involved?

What existing precautions are in place to reduce risks? Risk level with existing

precautionsNo.

What additional actions are required to ensure precautions are implemented/effective or to reduce the risk further? Risk level with additional

precautions

No.

Is health surveillance required?

YES/NOIf YES, please detail: Is immunisation required?

YES/NOIf YES, please detail:

Who will be responsible for implementing

precautions:

By When:

8

Risk Assessment Forms for Research and Projects

Completed by: Signed:

Record of annual review:

Risk Rating:

Incr

easin

g Co

nseq

uenc

e 5 10 15 20 25

4 8 12 16 20

3 6 9 12 15

2 4 6 8 10

1 2 3 4 5

Increasing Likelihood

17-25 Unacceptable – Stop activity and make immediate improvements/seek further advice

10-16 Tolerable – look to improve within specified timescale

5-9 Adequate – Look to improve at next review

1-4 Acceptable - No further action, but ensure controls are maintained

Guide to using the risk rating table:

Consequences Likelihood1 Insignificant – no injury 1 Very unlikely – 1 in a million chance of it happening2 Minor – minor injuries 2 Unlikely – 1 in 100,000 chance of it happening3 Moderate – up to three days absence 3 Fairly likely – 1 in 10,000 chance of it happening4 Major – more than three days absence 4 Likely – 1 in 1,000 chance of it happening5 Catastrophic – death or disabling 5 Very likely – 1 in 100 chance of it happening

9

Risk Assessment Forms for Research and Projects Genetically Modified Organism (GMO) Risk Assessment.

Brief description of the activity and the reason for carrying it out.As briefly as possible, your description must answer the following: What do you wish to do? To what? How? Why do you want to do it? What is the importance of the outcomes? Most of the answers may be self-evident to you but, legally, they are now required to be understandable by anyone.

Hazard identification in respect of human health and environmental safety

Host(s):If the host organism(s) are not listed in the SACGM compendium (http://www.hse.gov.uk/biosafety/gmo/acgm/acgmcomp/) as disabled, or especially disabled, and you claim it is/they are, you must provide evidence from either the literature or supplier to support your claim.

Vector(s):If the vector is not listed in the SACGM compendium as mobilisation defective, or non-mobilisable, and you claim it is you must provide evidence from either the literature or supplier to support your claim.

Inserted sequence(s):What do the sequences determine? Will a biologically active protein such as an enzyme, hormone, receptor etc. be expressed? If so could it/they be transferred to an unintended host (human or wild type organism) in the event of an accident? If this were to occur could harm be realised? If not, you must say why not.

Final GMO(s):If you claim the final GMO to be less harmful, or no more harmful than the unmodified host, you must justify.

Escape from containment

(a) Consider the possible severity of harm to humans(b) Consider the possible severity of harm to animals, plants or ecosystems

Provisional assignment of the class of containment.

The provisional class [and containment level] for this organism is:

Requirement for a disaster plan?

The risk assessment indicates that no disaster plan is required.

The disaster plan [attached] has been complied and the following authorities [have been/will be] notified accordingly.

(Delete the statement that is not applicable)

10

Risk Assessment Forms for Research and Projects Assignment of the final activity class.

Are additional control measures required?

Describe in detail any deviation from the above and state why it is necessary

Training and authorisation:The final classification of the organism is:

Signature of the applicant: Date:

Accepted

The Genetically Modified Organisms Sub-Committee of the School of Environmental Life Sciences at The University of Salford agrees that the above is an accurate assessment of the risks associated with this activity.

Signatures: Date:

Safety Committee Chair _____________________________ __________

Local GMO Safety Advisor _____________________________ __________Rejected

The committee does not agree with the risk assessment and asks you to consider re-application after further consideration of the following points:

Registration and notification,To be completed in collaboration with the local GMO Safety Advisor and (where necessary) with the University Safety Advisor.

A copy of the notification and risk assessment has been sent to the:

Biological Safety Officer [date] __________________________

University Safety Advisor [date] _________________________

11

Risk Assessment Forms for Research and Projects

The GMO Safety Advisor is required to inspect containment facilities for new applications and their first use within any Class 1 laboratory.

Date of visit: __________________________

12

Risk Assessment Forms for Research and Projects Chemical Risk Assessment (COSHH).

No Product / Chemical MSDS presentRisk Phrases (R…)

Safety Phrases (S…)

Flammable/ highly flammable / explosive / oxidising?

What precautions are required? What PPE is required? Risk level

1

2

3

4

5

6

7

8

9

10

Enter the product brand name or chemical name.

Make sure the MSDS is available in the area in which you are working.

These should be on the MSDS

These should be on the MSDS

Please state which if applicable.

E.g. Fume cabinet / specialised storage cabinets / segregation of chemicals.

E.g. gloves / goggles / lab coats.

Use the table below to calculate this.

13

Risk Assessment Forms for Research and Projects If any medium, high or critical risks are identified you will need to implement additional control measures to lower the risk.

No Product / Chemical Risk level

in 1st table What additional precautions are required? Risk level

1

2

3

4

5

6

7

8

9

10

Use the corresponding number and product name from the first table

Eg. use and alternative chemical / process, reduce the quantities and exposure levels

Use the table below to calculate this after the additional precautions have been implemented.

14

Risk Assessment Forms for Research and Projects Completed by: Signed:

Record of annual review:

Risk Rating:

Incr

easin

g Co

nseq

uenc

e 5 10 15 20 25

4 8 12 16 20

3 6 9 12 15

2 4 6 8 10

1 2 3 4 5

Increasing Likelihood

17-25 Unacceptable – Stop activity and make immediate improvements/seek further advice

10-16 Tolerable – look to improve within specified timescale

5-9 Adequate – Look to improve at next review

1-4 Acceptable - No further action, but ensure controls are maintained

Guide to using the risk rating table:

Consequences Likelihood1 Insignificant – no injury 1 Very unlikely – 1 in a million chance of it happening2 Minor – minor injuries 2 Unlikely – 1 in 100,000 chance of it happening3 Moderate – up to three days absence 3 Fairly likely – 1 in 10,000 chance of it happening4 Major – more than three days absence 4 Likely – 1 in 1,000 chance of it happening5 Catastrophic – death or disabling 5 Very likely – 1 in 100 chance of it happening

15

Risk Assessment Forms for Research and Projects DSEAR Risk Assessment.

Please put an ‘x’ in those that apply.

Explosive Chemicals that explode

Explosive, self-reactive, organic peroxide

R1 to R19

R1: Explosive when dryR2: Risk of explosion by shock, friction, fire or other sources of ignitionR3: Extreme risk of explosion by shock, friction, fire or other sources of ignitionR4: Forms very sensitive explosive metallic compoundsR5: Heating may cause an explosionR6: Explosive with or without contact with airR7: May cause fireR8: Contact with combustible material may cause fireR9: Explosive when mixed with combustible materialR10: FlammableR11: Highly flammableR12: Extremely flammableR14: Reacts violently with waterR15: Contact with water liberates extremely flammable gasesR16: Explosive when mixed with oxidising substancesR17: Spontaneously flammable in airR18: In use, may form flammable/explosive vapour-air mixtureR19: May form explosive peroxides

Oxidising Chemicals that react exothermically with other chemicals

Oxidising gases, oxidising liquids, oxidising solids

Extremely flammable Chemicals that have an extremely low flash point and boiling point, and gases that catch fire in contact with air or highly flammable Chemicals that may catch fire in contact with air, only need brief contact with an ignition source, have a very low flash point or evolve highly flammable gases in contact with water

Flammable gasses, flammable liquids, flammable solids, flammable aerosols, organic peroxides, self-reactive, pyrophoric, self-heating, contact with water emits flammable gas

R30Can become highly flammable in use

R44 Risk of explosion if heated under confinement

R14/15Reacts violently with water, liberating extremely flammable gases

R15/29 Contact with water liberates toxic, extremely flammable gases

16

Risk Assessment Forms for Research and Projects

DSEAR (2002) RISK ASSESSMENTSubstance(s) / Process:

Manufacturers Safety Data Sheet(s) available?

Yes No

MSDS stored: Electronically Paper copy

Does the substance / process match any of the Risk Phrases mentioned above

Yes No

Is the substance: Flammable Highly flammable

Liquid Extremely flammable Gas ExplosiveSolid OxidisingPowder Flashpoint below 32ocIf any of the risk phrases / symbols, or boxes in the red section apply to the substance(s) you are using then please fill in the next section. If not, no further action is required under DSEAR.Approximate quantity to be used?Storage and handling arrangements (including any waste storage).Measures in place to stop explosive atmosphere forming.

Ignition sources.

Measures in place to stop ignition of substances / atmospheres.Likelihood of fire or explosion (A).

(see column A below)

Anticipated scale of accidental fire or explosion after control measures have been implemented (B).

(see column B below)

Risk level (A x B) If greater than 7, identify additional actions to reduce risk further

17

Risk Assessment Forms for Research and Projects Additional control measures required

Likelihood and scale after additional controls are in place (A x B)

Completed by: Signed:

Record of annual review:

Risk Rating:

Incr

easin

g Co

nseq

uenc

e 5 10 15 20 25

4 8 12 16 20

3 6 9 12 15

2 4 6 8 10

1 2 3 4 5

Increasing Likelihood

17-25 Unacceptable – Stop activity and make immediate improvements/seek further advice10-16 Tolerable – look to improve within specified timescale

5-9 Adequate – Look to improve at next review

1-4 Acceptable - No further action, but ensure controls are maintained

Guide to using the risk rating table:

Consequences Likelihood1 Insignificant – no injury 1 Very unlikely – 1 in a million chance of it

happening2 Minor – minor injuries 2 Unlikely – 1 in 100,000 chance of it happening3 Moderate – up to three days absence

3 Fairly likely – 1 in 10,000 chance of it happening

4 Major – more than three days absence

4 Likely – 1 in 1,000 chance of it happening

5 Catastrophic – death or disabling 5 Very likely – 1 in 100 chance of it happening

18

Risk Assessment Forms for Research and Projects Radiation / Laser Risk Assessment

Location: Task/Activity/Environment:

Date of Assessment:

Identify Hazards which could

cause harm:

Identify risks = what could go wrong if hazards cause harm:

No. Hazard No. Risk

List groups of people who could be affected: What numbers of people

are involved?

What existing precautions are in place to reduce risks? Risk level with

existing precautions

No.

What additional actions are required to ensure precautions are

implemented/effective or to reduce the risk further?

Risk level with

additional

precautions

No.

Is health surveillance required? YES/NO If YES, please detail:

Who will be responsible for implementing By When:

19

Risk Assessment Forms for Research and Projects precautions:

Laser Inspection Form Date:

Building & room number: Type:   

Make:   Mode:  

Model:   1   

Serial No.:    Max Power:   

Precautions Class 1

Class 1M

Class 2

Class 2M

Class 3R

Class 3B Class 4

Remote Interlock              Key Control              Emission indicator              Beam Shutter              Beam Stop              Beam Level              Beam Enclosure              Eye Protection              Protective Clothing              Eye Examinations              Training              Laser Labels              Door Signs              *Shaded boxes do not apply to that class of laser.

Authorised Users (please list):  

Completed by: Signed:

Record of annual review:

20

Risk Assessment Forms for Research and Projects Risk Rating:

Incr

easin

g Co

nseq

uenc

e 5 10 15 20 25

4 8 12 16 20

3 6 9 12 15

2 4 6 8 10

1 2 3 4 5

Increasing Likelihood

17-25 Unacceptable – Stop activity and make immediate improvements/seek further advice10-16 Tolerable – look to improve within specified timescale

5-9 Adequate – Look to improve at next review

1-4 Acceptable - No further action, but ensure controls are maintained

Guide to using the risk rating table:

Consequences Likelihood1 Insignificant – no injury 1 Very unlikely – 1 in a million chance of it

happening2 Minor – minor injuries 2 Unlikely – 1 in 100,000 chance of it happening3 Moderate – up to three days absence

3 Fairly likely – 1 in 10,000 chance of it happening

4 Major – more than three days absence

4 Likely – 1 in 1,000 chance of it happening

5 Catastrophic – death or disabling 5 Very likely – 1 in 100 chance of it happening

21

Risk Assessment Forms for Research and Projects Travel / Fieldwork Risk Assessment

This form should be completed in conjunction with the University Travel and Fieldwork Policy and Code of PracticeDestination(s)

Date of trip From: _ _ : _ _ hrs on _ _ / _ _ / _ _

To: _ _ : _ _ hrs on _ _ / _ _ / _ _

Number of participantsFirst Aider(where required)

Emergency Contact in School Or Maxwell Control (Security) +44 (0)161 29 5 33 33

out of hours.

Potential Hazard

Existing Controls Risk Level

Additional Controls (if existing risk level is med or above)

Risk Level

Weather conditions

Terrain

Water (tides / deep water / currents etc.)Harmful substances (chem. or bio.)Animals

Danger from traffic / site vehiclesIndustrial processes / plant etc.Transport to and from site

Transport on

22

Risk Assessment Forms for Research and Projects site

Crime

Other(please state)

NOTE: please use the table on the next page to determine risk levels

For destinations with medium (or above) risk ratings from Control Risks website (http://www.hr.salford.ac.uk/safety/controlrisk/index) please attach a copy of their advice and complete the additional assessment as per the Travel and Fireldwork Policy / Code of Practice.

Completed by: Signed:

Record of annual review:

Risk Rating:

Incr

easin

g Co

nseq

uenc

e 5 10 15 20 25

4 8 12 16 20

3 6 9 12 15

2 4 6 8 10

1 2 3 4 5

Increasing Likelihood

17-25 Unacceptable – Stop activity and make immediate improvements/seek further advice10-16 Tolerable – look to improve within specified timescale

5-9 Adequate – Look to improve at next review

1-4 Acceptable - No further action, but ensure controls are maintained

Guide to using the risk rating table:

Consequences Likelihood1 Insignificant – no injury 1 Very unlikely – 1 in a million chance of it

happening2 Minor – minor injuries 2 Unlikely – 1 in 100,000 chance of it happening3 Moderate – up to three days absence

3 Fairly likely – 1 in 10,000 chance of it happening

23

Risk Assessment Forms for Research and Projects 4 Major – more than three days absence

4 Likely – 1 in 1,000 chance of it happening

5 Catastrophic – death or disabling 5 Very likely – 1 in 100 chance of it happening

24