HIRAC FORM PEJABAT KESIHATAN BAHAGIAN MUKAH

HIRARC FORM

Company: Health Environmental Department Conducted By: Nur Shazwani Othman

(Water Quality Control Unit) (Name, Designation)
Process / Location: Water Sampling Process at Palm Oil 15 October 2017
Plantation (On Field) Date:
Approved by:
(Name, designation)
Date: Review Date: Next Review Date:

1. Hazard Identification 2. Risk Analysis 3. Risk Control

No. Work Activity Hazard Which Can Existing Risk Likelihoo Severity Risk Recommended Risk
Cause / Control (If d Control
Effect Any) Measures
1 Lifting up Health Hazard Can Cause Don’t lifting up 4 1 4 No Action Low
Weighted Cool Back pain and weighted cool Required
box for muscle injury box alone or use
sampling when the cool box with
repeatedly wheels
doing it
2 Don’t have PPE Safety Hazard Fall down, Have been 3 4 12 Requires a Medium
while taking slippery, careful while planned to
water sample fatality/trauma taking water control the
especially on sample hazard and seek
the high-level for temporary
area measures. Check
repeatedly and
observe results
by using Risk
Assesment
Form.
3 Dispatch water Safety Hazard Potential to Drive slowly and 4 2 8 Requires a Medium
samples while have road take interval planned to
raining (using accident, break when control the
self-car) cause heavily rain hazard and seek
Fatality/Trauma occur for temporary
measures. Check
repeatedly and
observe results
by using Risk
Assesment
Form.
 HIRAC FORM (HEALTH HAZARDS)

HIRARC FORM

Company: Health Environmental Department Conducted By: Nur Shazwani Othman

(Food Safety and Quality Unit) (Name, Designation)
Process / Location: Food Premis Inspection 22 October 2017
Approved by: Date:
(Name,
designation)
Date: Review Date: Next Review Date:

1. Hazard Identification 2. Risk Analysis 3. Risk Control

No. Work Activity Hazard Which Can Existing Risk Likelihoo Severity Risk Recommended Risk
Cause / Effect Control (If d Control
Any) Measures
1 Inspection food Health Depression/Anxiety Carefully 4 2 8 No Action low
premises Hazard /Exhausted planning an Required
without enough activities so
manpower/team can speed up
members time and
makes work
done orderly
even working
alone
2 Standing for a Health Backpain injury, Using suitable 4 1 4 No action Low
long time Hazard muscle pain and required.
comfortable
shoes that can
absorb
pressure
3 Working without Safety Can get struck by Use Safety 4 1 4 No action Low
using PPE Hazard any sharp object shoe required.
example like knife
and brings harm
 HIRARC FORM

Company: Health Environmental Department Conducted By: Nur Shazwani Othman

(Inspectorate and Legal Unit) (Name, Designation)
Process / Location: Inspectorate and Legal Unit 24 October 2017
Approved by: Preparing Investigation Paper for Date:
(Name, Summons Applicant
designation)
Date: Review Date: Next Review Date:

1. Hazard Identification 2. Risk Analysis 3. Risk Control

No. Work Activity Hazard Which Can Existing Risk Likelihoo Severity Risk Recommended Risk
Cause / Effect Control (If d Control
Any) Measures
1. Computer Health Which give Take interval 4 3 12 Requires a
Monitor for a Hazard radiation from break time planned to
long time computer screen before control the
and can cause continuing hazard and seek
myopia work for temporary
measures.
Check
repeatedly and
observe results
by using Risk
Assessment
Form
2. Travel to Safety Potential to have Drive slow and 3 4 12
dispatch Hazard road accident, focus
Investigation cause
File using a car Fatality/Trauma

HIRARC FORM
Company: Health Environmental Department Conducted By: Nur Shazwani Othman
(Name, Designation)
Process / Location: Office Environment 24 October 2017
Approved by: Preparing Investigation Paper for Date:
(Name, Summons Applicant
designation)
Date: Review Date: Next Review Date:

1. Hazard Identification 2. Risk Analysis 3. Risk Control

No. Work Activity Hazard Which Can Existing Risk Likelihood Severity Risk Recommended Risk
Cause / Control (If Control
Effect Any) Measures
1 Uncomfortable Ergonomic Can Cause Take a walk 5 2 10 Acceptable but
Chairs Hazard/Health Back pain and when sitting for further reduction is
Hazard muscle injury too long necessary,mif the
risk can be
resolved quickly,
control measure
should be
implement
immediately.
2 Office Health Hazard Dryness, Air conditioner 5 1 5 No Action Required
Temperature Dehydration change to the
and lowest
Sleepiness temperature 16
°c
3 Work Equipment High contact with Electrocution - 5 4 20 Need immediate
(Printer, Computer, electric energy (cause fatal and
action to control
wiring, extansion trauma)
switch) the hazard, by
All units following the
hierarchy of
control. Monitoring
and actions taken
using risk
assessment
documentation
4 Fire Extinguisher Environmental Can cause - 4 1 4
metal holder on the Hazard/Safety bruises if they
No action required
walls along the Hazard collides/bring
hallway harms to
employee