JOB HAZARD ANALYSIS [JHA] WORKSHEET

JHA NO. PTW NO WORK PERMIT TYPE COLD

FACILITY LOCATION SPECIFIC WORKSTATION

EQUIPMENT NO. WORK PERFORM FORWORK, REBAR AND CONCRETE WORK

DESCRIPTION

JOB POTENTIAL
DESCRIPTION OF JOB STEP POTENTIAL CONSEQUENCES CONTROL BARRIERS ACTION PARTY RECOVERY BARRIERS ACTION PARTY
STEP HAZARD

1. Covid 19 briefing ▪ Potential ▪ Difficulty in breathing ▪ Ensure to perform temperature ▪ EBSB Work ▪ Training and supervision ▪
exposure ▪ Acute respiratory distress screening before proceeding to Leader/ ▪ Refer to KKM if there is any
to Covid 19 syndrome workstation (Above 37.5 C Refer to Supervisor suspected case
▪ Respiratory infections nearest clinic) ▪ All worker ▪ Immediately disinfects affected
▪ Ensure to fill in health declaration area
before proceeding to workstation. (If
there is any symptom, such as cough,
fever and breathing difficulty
advisable to refer to nearest clinic)
▪ Practice necessary preventive
measures (e.g. such as wearing mask,
hand sanitizer or regularly washing
hand)
2. Site preparation ▪ Sharp ▪ Hand and finger injury ▪ Correct hand placement ▪ EBSB Work ▪ Apply First Aid ▪ First Aider
object ▪ Always be alert on surroundings Leader/ ▪ Medical Treatment ▪ Medic
(debris) ▪ Eliminate sharp edges (i.e. cover Supervisor ▪ Stop Work
with cotton rag) ▪ Rigger
▪ Wear rubber coated hand glove

▪ Incorrect ▪ Back injury, body injury ▪ Practice correct manual handling ▪ EBSB Work ▪ Apply First Aid ▪ First Aider
manual technique and momentum of the Leader/ ▪ Medical Treatment ▪ Medic
handling body weight to initiate Supervisor ▪ Stop Work
▪ Proper handling technique ▪ Rigger
▪ Use buddy system
▪ Hot ▪ Heat stroke ▪ Ensure adequate breaks (resting ▪ EBSB Work ▪ Apply First Aid ▪ First Aider
weather under shaded area) Leader/ ▪ Medical Treatment ▪ Medic
▪ Drink enough water Supervisor ▪ Stop Work
▪ Reduce the time of manpower ▪ Rigger
exposure to heat.

▪ Uneven ▪ Slip, trip and fall ▪ Ensure proper signage in place ▪ EBSB Work ▪ Apply First Aid ▪ First Aider
surface ▪ Leg and foot injury ▪ Remind all personnel to be careful Leader/ ▪ Medical Treatment ▪ Medic
of stepping position Supervisor ▪ Stop Work
▪ Use handrail when go up/down ▪ Rigger
the stairway
▪ Ensure safe placement of foot
3. Material preparation ▪ Sharp ▪ Hand & finger injury ▪ Correct hand placement ▪ EBSB Work ▪ Apply First Aid ▪ First Aider
edges ▪ Cut injury ▪ Wear rubber coated hand glove Leader/ ▪ Medical Treatment ▪ Medic
▪ Always be alert on surroundings Supervisor ▪ Stop Work

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 JOB
POTENTIAL
STE DESCRIPTION OF JOB STEP POTENTIAL CONSEQUENCES CONTROL BARRIERS ACTION PARTY RECOVERY BARRIERS ACTION PARTY
HAZARD
P
▪ Eliminate sharp edges (i.e. cover ▪ Rigger
with cotton rag)
▪ Pinch point ▪ Hand and finger injury ▪ Correct hand placement ▪ EBSB Work ▪ Apply First Aid ▪ First Aider
▪ Wear rubber coated hand glove Leader/ ▪ Medical Treatment ▪ Medic
▪ Always be alert on surroundings Supervisor ▪ Stop Work
▪ Rigger

▪ Improper ▪ Personnel Injury ▪ Competent personnel / correct ▪ EBSB Work ▪ Apply First Aid ▪ First Aider
manual procedure for rigging and slinging Leader/ ▪ Medical Treatment ▪ Medic
lifting technique Supervisor ▪ Stop Work
▪ Team leader to coordinate with ▪ Rigger
team members
▪ Use Buddy System

4. Formwork fabrication ▪ Sharp ▪ Hand & finger injury ▪ Proper hand placement ▪ EBSB Work ▪ Apply First Aid ▪ First Aider
edges ▪ Cut injury ▪ Wear rubber coated hand glove Leader/ ▪ Medical Treatment ▪ Medic
▪ Always be alert on surroundings Supervisor ▪ Stop Work
▪ Eliminate sharp edges (i.e. cover ▪ Rigger
with cotton rag)

▪ Pinch point ▪ Hand and finger injury ▪ Correct hand placement ▪ EBSB Work ▪ Apply First Aid ▪ First aider
▪ Wear rubber coated hand glove Leader/ ▪ Medical Treatment ▪ Medic
▪ Always be alert on surroundings Supervisor ▪ Stop Work
▪ ▪ Rigger

▪ Improper ▪ Back injury ▪ Competent personnel / correct ▪ EBSB Work ▪ Apply First Aid ▪ First aider
manual ▪ Muscle injury procedure for rigging and slinging Leader/ ▪ Medical Treatment ▪ Medic
lifting technique Supervisor ▪ Stop Work
▪ Team leader to coordinate with ▪ Rigger
team members
▪ Use Buddy System

5. Rebar Fabrication ▪ Improper ▪ Back injury ▪ Competent personnel / correct ▪ EBSB Work ▪ Apply First Aid ▪ First aider
manual ▪ Muscle injury procedure for rigging and slinging Leader/ ▪ Medical Treatment ▪ Medic
lifting technique Supervisor ▪ Stop Work
▪ Team leader to coordinate with ▪ Rigger
team members
▪ Use Buddy System

▪ Sharp ▪ Hand & finger injury ▪ Proper hand placement ▪ EBSB Work ▪ Apply First Aid ▪ First aider
edges ▪ Cut injury ▪ Wear rubber coated hand glove Leader/ ▪ Medical Treatment ▪ Medic
▪ Always be alert on surroundings Supervisor ▪ Stop Work
▪ Eliminate sharp edges (i.e. cover ▪ Rigger
with cotton rag)

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 JOB
POTENTIAL
STE DESCRIPTION OF JOB STEP POTENTIAL CONSEQUENCES CONTROL BARRIERS ACTION PARTY RECOVERY BARRIERS ACTION PARTY
HAZARD
P
▪ Pinch point ▪ Hand and finger injury ▪ Correct hand placement ▪ EBSB Work ▪ Apply First Aid ▪ First aider
▪ Wear rubber coated hand glove Leader/ ▪ Medical Treatment ▪ Medic
▪ Always be alert on surroundings Supervisor ▪ Stop Work
▪ Rigger

6. Formwork and rebar installation ▪ Sharp ▪ Hand & finger injury ▪ Proper hand placement ▪ EBSB Work ▪ Apply First Aid ▪ First aider
edges ▪ Cut injury ▪ Wear rubber coated hand glove Leader/ ▪ Medical Treatment ▪ Medic
▪ Always be alert on surroundings Supervisor ▪ Stop Work
▪ Eliminate sharp edges (i.e. cover ▪ Rigger
with cotton rag)

▪ Incorrect ▪ Back injury ▪ Practice correct manual handling ▪ EBSB Work ▪ Apply First Aid ▪ First aider
manual ▪ Muscle injury technique and momentum of the Leader/ ▪ Medical Treatment ▪ Medic
handling body weight to initiate Supervisor ▪ Stop Work
▪ Proper handling technique ▪ Rigger
▪ Use buddy system
▪ Pinch point ▪ Hand and finger injury ▪ Correct hand placement ▪ EBSB Work ▪ Apply First Aid ▪ First aider
▪ Wear rubber coated hand glove Leader/ ▪ Medical Treatment ▪ Medic
▪ Always be alert on surroundings Supervisor ▪ Stop Work
▪ Rigger

▪ Awkward ▪ Back injury ▪ Correct body posture technique ▪ EBSB Work ▪ Apply First Aid ▪ First aider
body ▪ Limit crew exposure to repetitive Leader/ ▪ Medical Treatment ▪ Medic
posture work Supervisor ▪ Stop Work
▪ Practice correct manual lifting ▪ Rigger
technique and momentum of the
body weight to initiate
▪ Uneven ▪ Slip, trip and fall ▪ Ensure proper signage in place ▪ EBSB Work ▪ Apply First Aid • First aider
surface ▪ Leg and foot injury Leader/ ▪ Medical Treatment ▪ Medic
▪ Remind all personnel to be careful ▪ Stop Work
Supervisor
of stepping position
▪ Ensure safe placement of foot ▪ Rigger

7. Concrete Casting ▪ Sharp ▪ Hand & finger injury ▪ Proper hand placement ▪ EBSB Work ▪ Apply First Aid ▪ First aider
edges ▪ Cut injury ▪ Wear rubber coated hand glove Leader/ ▪ Medical Treatment ▪ Medic
▪ Always be alert on surroundings Supervisor ▪ Stop Work
▪ Eliminate sharp edges (i.e. cover ▪ Rigger
with cotton rag)

▪ Incorrect ▪ Back injury ▪ Practice correct manual lifting ▪ EBSB Work ▪ Apply First Aid ▪ First aider
manual ▪ Muscle injury technique and momentum of the Leader/ ▪ Medical Treatment ▪ Medic
handling body weight to initiate Supervisor ▪ Stop Work
▪ Use buddy system ▪ Rigger

▪ Awkward ▪ Back injury ▪ Correct body posture technique ▪ EBSB Work ▪ Apply First Aid ▪ First aider
body ▪ Limit crew exposure to repetitive Leader/ ▪ Medical Treatment ▪ Medic
posture work Supervisor ▪ Stop Work
▪ Rigger

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 JOB
POTENTIAL
STE DESCRIPTION OF JOB STEP POTENTIAL CONSEQUENCES CONTROL BARRIERS ACTION PARTY RECOVERY BARRIERS ACTION PARTY
HAZARD
P
▪ Practice correct manual lifting
technique and momentum of the
body weight to initiate
▪ Uneven ▪ Slip, trip and fall ▪ Ensure proper signage in place ▪ EBSB Work • Apply First Aid • First aider
surface ▪ Leg and foot injury Leader/ • Medical Treatment ▪ Medic
▪ Remind all personnel to be
Supervisor ▪ Stop Work
careful of stepping position
▪ Ensure safe placement of foot ▪ Rigger

8. Dismantle formwork manually ▪ Sharp ▪ Hand & finger injury ▪ Proper hand placement ▪ EBSB Work ▪ Apply First Aid ▪ First aider
edges ▪ Cut injury ▪ Wear rubber coated hand glove Leader/ ▪ Medical Treatment ▪ Medic
▪ Always be alert on surroundings Supervisor ▪ Stop Work
▪ Eliminate sharp edges (i.e. cover ▪ Rigger
with cotton rag)
▪ Incorrect ▪ Back injury ▪ Practice correct manual handling ▪ EBSB Work ▪ Apply First Aid ▪ First aider
manual ▪ Muscle injury technique and momentum of the Leader/ ▪ Medical Treatment ▪ Medic
handling body weight to initiate Supervisor ▪ Stop Work
▪ Proper handling technique ▪ Rigger
▪ Use buddy system
▪ Pinch point ▪ Hand and finger injury ▪ Correct hand placement ▪ EBSB Work ▪ Apply First Aid ▪ First aider
▪ Wear rubber coated hand glove Leader/ ▪ Medical Treatment ▪ Medic
▪ Always be alert on surroundings Supervisor ▪ Stop Work
▪ Rigger

▪ Drop ▪ Body injury ▪ Correct manual handling ▪ EBSB Work ▪ Apply First Aid ▪ First aider
object ▪ Property damage technique Leader/ ▪ Medical Treatment ▪ Medic
Supervisor ▪ Stop Work
▪ Rigger

▪ Uneven ▪ Slip, trip and fall ▪ Ensure proper signage in place ▪ EBSB Work ▪ Apply First Aid • First aider
surface ▪ Leg and foot injury Leader/ ▪ Medical Treatment ▪ Medic
▪ Remind all personnel to be ▪ Stop Work
Supervisor
careful of stepping position
▪ Ensure safe placement of foot ▪ Rigger

9. Egress from trench ▪ Uneven ▪ Slip, trip and fall ▪ Ensure proper signage in place ▪ EBSB Work • Apply First Aid • First aider
surface ▪ Leg and foot injury Leader/ • Medical Treatment • Medic
▪ Remind all personnel to be
Supervisor • Stop Work
careful of stepping position
▪ Ensure safe placement of foot ▪ Rigger

10. Housekeeping ▪ Heavy load ▪ Musculoskeletal disorder ▪ Assign enough man power ▪ EBSB Work ▪ Apply First Aid ▪ First aider
▪ Utilize mechanical lifting gear for Leader/ ▪ Medical Treatment ▪ Medic
loading and unloading Supervisor ▪ Stop Work
▪ Correct manual handling ▪ Rigger
technique
▪ Sharp ▪ Hand & finger injury ▪ Proper hand placement ▪ EBSB Work ▪ Apply First Aid ▪ First aider
edges ▪ Cut injury ▪ Wear rubber coated hand glove Leader/ ▪ Medical Treatment ▪ Medic
▪ Always be alert on surroundings Supervisor ▪ Stop Work
▪ Eliminate sharp edges (i.e. cover ▪ Rigger
with cotton rag)

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 JOB
POTENTIAL
STE DESCRIPTION OF JOB STEP POTENTIAL CONSEQUENCES CONTROL BARRIERS ACTION PARTY RECOVERY BARRIERS ACTION PARTY
HAZARD
P
▪ Pinch point ▪ Hand and finger injury ▪ Correct hand placement ▪ EBSB Work ▪ Apply First Aid ▪ First aider
▪ Wear hand glove Leader/ ▪ Medical Treatment ▪ Medic
▪ Always be alert on surroundings Supervisor ▪ Stop Work
▪ Rigger

▪ Incorrect ▪ Back injury ▪ Practice correct manual handling ▪ EBSB Work ▪ Apply First Aid ▪ First aider
manual ▪ Muscle injury technique and momentum of the Leader/ ▪ Medical Treatment ▪ Medic
handling body weight to initiate Supervisor ▪ Stop Work
▪ Proper handling technique ▪ Rigger
▪ Use buddy system

Page 5
 JHA NO.

PTW NO

WORK PERMIT TYPE

FACILITY

LOCATION

SPECIFIC WORKSITE

EQUIPMENT NO.

WORK DESCRIPTION

JHA APPROVAL DURING PTW APPLICATION

WORK LEADER APPROVED BY

NAME NAME

DESIGNATION DESIGNATION PRODUCTION Supervisor / MAINTENANCE Supervisor/OIM

SIGNATURE SIGNATURE

DATE DATE

WORK TEAM (CONFIRMATION THAT JHA HAS BEEN COMMUNICATED TO WORK TEAM AS PART OF PREJOB/TOOLBOX MEETING)
Name(s) Designation Signature Name(s) Designation Signature

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