RISK ASSESSMENT - NOISE

Workplace/Work Activity/Process

Assessment Ref:

Date

Summary of Noise Survey

What was the highest daily / weekly * exposure (LEP,d)?

* Delete as necessary

Below the first action level (80 dBA LEP,d ) (Peak 135dBA)
Between the first and second action levels (80 85 dBA LEP,d)
Above the second action level (85 dBA LEP,d) (Peak 137dBA)
Above the limit value (87 dBA LEP,d) (Peak 140 dBA)
Were the peak action levels exceeded at any time?

Yes

No

Who could be harmed?

Employees

Students

Contractors

Visitors

Public

Identify any other individuals or groups of individuals especially at risk:

Young persons

Trainees/Inexperienced persons

Disabled Persons

New Employees

Other

New/Expectant Mothers
Lone Workers

(please specify).

Existing Precautions (complete where appropriate)

Below the First Action Level
Has the noise level been reduced to the lowest level reasonably practicable?

Yes

No

If yes, please specify steps taken below

Between the First and Second Action Levels

Has a noise risk assessment been undertaken?

Yes

No

Has information and instruction been provided to employees?

Yes

No

Yes

No

Please specify

Has noise protection been made available to employees?

Please specify

Above the Second Action Level

Has a noise risk assessment been undertaken?

Yes

No

Have noise levels been reduced by methods other than

Personal Protective Equipment?

Yes

No

Please specify

Have ear protection zones been identified?

Yes

No

Yes

No

Yes

No

Please specify

Has information and instruction been provided to employees?

Please specify

Has noise protection been provided to employees and enforced?

Please specify

Does the hearing protection have these features?

List the features that hearing protection must have to be

effective against the risks

Yes

No

Audio-metric Testing
Are exposed workers subject to periodic audio-metric tests?

Yes

No

Please specify

Do the existing precautions reduce the risk

Yes
to the lowest level that is reasonably practicable? (refer to Safe Working Guidelines).

No

If a NO answer is entered, a Remedial Action Plan must be developed and a re-assessment carried out when the
Remedial Actions have been completed.
Assessment review date:
Assessment completed by:
Signed:

Title:

Name: (print)

Date: