Risk Assessment Tool (Use this tool to analyze potential risks in your work area.

)
Principle Investigator/Area Supervisor: Brief Description of Laboratory Activities/Project: Date of Assessment:

Department:
Assessor(s)/Team:
Building: Positions affected by area (lab personnel/students/faculty/staff/visitors):

Room Number: Lab Operation Hours (if operational hours impact the Risk Assessment):

Consequences (Outcome)
How could you be Given the exposure, what is Probability Risk
Existing Control
Hazard/Exposure Category exposed to this hazard? negative outcome? (briefly What is the Value Value 0 Rating
Measure In Place
(briefly describe) describe) expected harm? 0 to 5 to 5 Number

Chemical Exposure - Toxic /

Highly Toxic

Chemical Exposure - Corrosive

0

Chemical Exposure - Reproductive

Toxins (Mutagen/Teratogens)
0

Exposure to
Carcinogens
0

Exposure to Irritants
0

Exposure to Sensitizers
0

Exposure to Nonionizing Radiation

0

Exposure to Ionizing Radiation

0
 Consequences (Outcome)
How could you be Given the exposure, what is Probability Risk
Existing Control
Hazard/Exposure Category exposed to this hazard? negative outcome? (briefly What is the Value Value 0 Rating
Measure In Place
(briefly describe) describe) expected harm? 0 to 5 to 5 Number

Exposure to Organic Peroxide

0

Storage or Use of Explosives

0

Water Reactive Material

0

Unstable (reactive) /
Polymerizable Material
0

Combustible Liquid /
Flammables
0

Exposure to
Biohazards/Bloodborne Pathogens
0

Combustible Dust
0

Oxidizer
0

Pyrophoric Material
0

Exposure to Compressed
Gases (including
cryogenic material)
0

Exposure to heat/cold
0
 Consequences (Outcome)
How could you be Given the exposure, what is Probability Risk
Existing Control
Hazard/Exposure Category exposed to this hazard? negative outcome? (briefly What is the Value Value 0 Rating
Measure In Place
(briefly describe) describe) expected harm? 0 to 5 to 5 Number

Exposure to Noise
0

Walking/Working Surfaces
0

Means of Egress (Emergency)

0

Energy Control (Lock-out/Tag-out)

0

Exposure to Fall Hazards

0

Pressure vessels
0

Material Handling of
Chemicals (Bulk)
0

Physical Hazards - Exposure to

Sharp Objects
0

Physical Hazards -
Exposure to Rotating
Equipment & Points of
Operation
0

Welding/Cutting Hazards
0

Exposure to Electrical Hazards

0

Employee knowledge of the chemical hygiene plan

0
 Consequences (Outcome)
How could you be Given the exposure, what is Probability Risk
Existing Control
Hazard/Exposure Category exposed to this hazard? negative outcome? (briefly What is the Value Value 0 Rating
Measure In Place
(briefly describe) describe) expected harm? 0 to 5 to 5 Number

Eye Hazards
0

Unattended Operations
0

Working Alone
0

Working with Animals or Biological Agents

0
 Risk Hazard Matrix

Consequences Probability
Probably
Will occur Frequent/
Possible will occur
under Regular /
Unlikely to occur under
current Continuous
over time routine
conditions Occurrence
conditions
People
1 2 3 4 5
Fatality(s) / Chronic Illness with no recovery 5

Injury/Illness requiring personnel to be hospitalized/off

work for extended period of time 4

High Risk
Injury/Illness requiring medical treatment by a medical
professional beyond first aid / no time off work required 3 Medium Risk

Injury/Illness requiring first aid treatment by non-

medical personnel 2

Low Risk
Minimal - no medical treatment or assistance
needed. 1