ST073 – Eye Damage Prevention

Safety Talk

Written Assessment Questionnaire

Employee Details
(Employee to complete)

Last Name

Given Names

Occupation Division

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Assessment Details
(Instructor to complete)

Assessment
checked by:

Position Date

Result Signature

Instructions to Employee

Print your details clearly and legibly.

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ST073 – Eye Damage Prevention

Question 1

Name two ways you can be responsible for looking after your eyes at work.

1.

2.

Question 2

Name four different causes of eye injury at work.

1.

2.

3.

4.

Question 3

What are two methods could you use to prevent work mates from being
injured when you are working with a welder or drill?

1.

2,

Question 4

If you were working with chemicals that gave off fumes or there was a risk of
splashing, would you wear goggle or glasses?

1.

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