How to use the Machinery Risk Assessment Template:

IMPORTANT: Familiarise yourself with the contents of the Machinery Safety Risk Assessment
Implementation Guide.

Step 1:
Complete the details in the first table used to identify the machine(s) being assessed and dating the
assessment.

Step 2:
Identify the phases of the machine’s life cycle that are relevant for you to assess. Available phases
are Transport, Assembly & Installation, Commissioning, Setting Up, teaching/Programming, Process
changeover, Operation, maintenance, Cleaning, Troubleshooting and Dismatleing.

Not all phases will be relevant. These can be left to be assessed at a later date. Phases that have not
been assessed will be clearly tagged “Not Assessed” by the template. When these phases become
relevant (eg dismantling) then they should be assessed before proceeding.

Step 3:
Identify all the reasonably foreseeable interactions (including misuse) people may have with the
machine(s) in each relevant phase and assess them using the template.

The template is prepopulated with default values taken from ISO12100 to help speed up its
completion. Two fields (Task/interaction and Accident Scenario) allow the user to overwrite this
information with more precise real information from the assessment.

HOW TO COMPLETE THE ASSESSMENT:

To illustrate how to complete the template for each interaction we will work through an example.
We will look at an interaction from the OPERATION phase:

Click on the + to the left of the word OPERATION. This opens up 10 lines to assess this phase. If more
lines are needed they can be inserted in the usual way.

NOTE: The numbers (1 & 2) above row 1 can be clicked on to either expand or collapse all phases at
the same time

Add a Task/Interaction to the OPERATION phase by clicking in the column and opening a drop down
list. Select the most relevant description from the list or simply type your own. We select “Feeding,
filling, loading of raw materials” .

Next select the hazards that are present during this interaction/task. Once again select from the drop
down list for hazard group then Hazard Origin. The drop down selection cannot be modified for these
fields.

If there is more than one hazard for a particular interaction list each one in a separate line.

Once each hazard has been defined using hazard Group and Origin select an accident scenario from
the next column. A default list is provided but it is recommended to type a more precise description
down list for hazard group then Hazard Origin. The drop down selection cannot be modified for these
fields.

If there is more than one hazard for a particular interaction list each one in a separate line.

Once each hazard has been defined using hazard Group and Origin select an accident scenario from
the next column. A default list is provided but it is recommended to type a more precise description
of what type of event could actually occur.
 Assessment

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Date of Assessment
Workshop:
Exact Location:
Machine ID:
Date of Next Review

Engineering controls Engineering

AND
Task/Interaction Hazard Group Hazard Origin Accident Scenario Severity Probability Risk Score Risk Rating preventing access to controls stopping WITH
OR
hazard the hazard

TRANSPORT CRITICAL MANDATORY MANDATORY

ASSEMBLY & INSTALLATION NOT ASSESSED
COMMISSIONING NOT ASSESSED
SETTING UP NOT ASSESSED
TEACHING/PROGRAMMING NOT ASSESSED
PROCESS CHANGEOVER NOT ASSESSED
OPERATION NOT ASSESSED
MAINTENANCE NOT ASSESSED
CLEANING CRITICAL MANDATORY MANDATORY
TROUBLESHOOTING NOT ASSESSED
DISMANTLING NOT ASSESSED
 Re-Asssessment
Designated
Safety Circuit Performance Architecture & Actions & Comments Severity Probability Risk Score Risk Rating
Performance Level

NOT RE-ASSESSED
NOT RE-ASSESSED
NOT RE-ASSESSED
NOT RE-ASSESSED
NOT RE-ASSESSED
NOT RE-ASSESSED
NOT RE-ASSESSED
NOT RE-ASSESSED
NOT RE-ASSESSED
NOT RE-ASSESSED
NOT RE-ASSESSED
Phase of Machine Life Cycle
Transport TRANSPORT
Assembly and installation TRANSPORT
Commissioning TRANSPORT
Setting TRANSPORT
Teaching/programming TRANSPORT
Process changeover TRANSPORT
Operation INTALL
Maintenance INTALL
Cleaning INTALL
Troubleshooting INTALL
Disabling INTALL
Dismantling INTALL
INTALL
INTALL
INTALL
INTALL
INTALL
SETTING
SETTING
SETTING
SETTING
SETTING
SETTING
SETTING
SETTING
OPERATION
OPERATION
OPERATION
OPERATION
OPERATION
OPERATION
OPERATION
OPERATION
OPERATION
OPERATION
OPERATION
SERVICING
SERVICING
SERVICING
SERVICING
SERVICING
SERVICING
SERVICING
SERVICING
SERVICING
SERVICING
SERVICING
TROUBLESHOOTING
TROUBLESHOOTING
TROUBLESHOOTING
TROUBLESHOOTING
TROUBLESHOOTING
TROUBLESHOOTING
TROUBLESHOOTING
TROUBLESHOOTING
TROUBLESHOOTING
TROUBLESHOOTING
TROUBLESHOOTING
DISMANTLING
DISMANTLING
DISMANTLING
DISMANTLING
DISMANTLING
DISMANTLING
DISMANTLING
Task Hazard_Group
Lifting Mechanical
Loading Electrical
Packing Thermal
Transportation Acoustic
Unloading Vibration
Unpacking Radiation
Adjustment of machine/components Chemical
Assembly of Machine Ergonomic
Connecting of supply Environmental
Connecting disposal systems Combination
Demonstration
Feeding, filling loading of ancillary fluids
Fixing, achoring, fencing
Preparation for installation
Running the machine without load
Testing
Trials with load or maximum load
Adjustment and setting of protective devices
Adjustment and setting of functional parameters of the machine
Clamping/fastening of workpiece
Feeding, filling, loading of raw materials
Functional tests, trials
Mounting or changing tools
Programming verification
Verification of final product
Clamping/fastening of workpiece
Control/Inspection
Driving the machine
Feeding, filling, loading of raw materials
Manual loading/unloading
Minor adjustments and setting of functional parameters of the machine
Minor interventions during operation
Operating manual controls
Restarting the machine after stopping/interruption
Supervision
Verification of final product
Adjustments
Cleaning, disinfection
Dismantling, removal of parts, components, devices of the machine
Housekeeping
Isolation and energy dissipation
Lubrication
Replacement of tools
Replacement of worn parts
Resetting
Restoring fluid levels
Verification or parts, components, devices of the machine
Adjustments
Dismantling, removal of parts, components, devices of the machine
Fault-finding
Isolation and energy dissipation
Recovering from control and protective devices failure
Recovering from jamming
Repairing
Replacement of parts, components, devices of the machine
Rescue of trapped persons
Resetting
Verification of parts, components, devices of the machine
Disconnection and energy dissipation
Dismantling
Lifting
Loading
Packing
Transporting
Unloading
Mechanical Electrical
Acceleration Arc
Deceleration Electromagnetic phenomena
Angular parts Electrostatic phenomena
Approach of a moving element to a fixed part Live parts
Cutting parts Not enough distance to live parts under high voltage
Elastic elements Overload
Falling objects Parts which have become live under fault conditions
Gravity Short-circuit
Height from the ground Thermal radiation
High pressure
Instability
Kinetic energy
Machinery mobility
Moving elements
Rotating elements
Rough, slippery surface
Sharp edges
Stored energy
Vacuum
Thermal Acoustic
Explosion Cavitation phenomena
Flame Exhausting system
Objects or materials with a high or low temperature Gas leaking at high speed
Radiation from heat sources Manufacturing process (stamping, cutting, etc.)
Moving parts
Scraping surfaces
Unbalanced rotating parts
Whistling pneumatics
Worn parts
Vibration
Cavitation phenomena
Misalignment of moving parts
Mobile equipment
Scraping surfaces
Unbalanced rotating parts
Vibrating equipment
Worn parts
Radiation
Ionizing radiation source
Low frequency electromagnetic radiation
Optical radiation (infrared, visible and ultraviolet), including laser
Radio frequency electromagnetic radiation
Chemical Ergonomic
Aerosol Access
Biological and microbiological (viral or bacterial) agent Design or location of indicators and visual displays units
Combustible Design, location or identification of control devices
Dust Effort
Explosive Flicker, dazzling, shadow, stroboscopic effect
Fibre Local lighting
Flammable Mental overload/underload
Fluid Posture
Fume Repetitive activity
Gas Visibility
Mist
Oxidizer
Environmental Combination MechanicalCon ElectricalCon
Dust and fog Being run over Burn
Electromagnetic disturbance Being thrown Chemical effects
Lightning Crushing Effects on medical implants
Moisture Cutting or severing Electrocution
Pollution Drawing-in or trapping Falling, being thrown
Snow Entanglement Fire
Temperature Friction or abrasion Projection of molten particles
Water Impact Shock
Wind Injection
Lack of oxygen Shearing
Slipping, tripping and falling
Stabbing or puncture
Suffocation
ThermalCon AcousticCon VibrationCon
Burn Discomfort Discomfort
Dehydration Loss of awareness Low-back morbidity
Discomfort Loss of balance Neurological disorder
Frostbite Permanent hearing loss Osteo-articular disorder
Injuries by the radiation of heat sources Stress Trauma of the spine
Scald Tinnitus Vascular disorder
Tiredness
Any other (for example, meMutation
RadiationCon ChemicalCon ErgonomicCon EnvironmentalCon
Burn Breathing difficulties, suffocation Discomfort Burn
Damage to eyes and skin Cancer Fatigue Slight disease
Effects on reproductive capability Corrosion Musculoskeletal disorder Slipping, falling
Mutation Effects on reproductive capability Stress Suffocation
Headache, insomnia, etc Explosion Any other (for example, mechAny other as a consequence of the e
Fire
Infection
Poisoning
Sensitization
 CombinationCon Hazard Origin
Shape and/or superficial finishing of accessible machine parts
Moving parts of the machine
Kinetic energy and/or potential energy of the machine, parts, tools and materials
Stability of the machine and/or parts of the machine
er as a consequence of the effect c Mechanical strength of parts of the machine, tools, etc.
Pneumatic, hydraulic equipment
Electrical equipment
Control system
Chemical factors
Physical factors
Workstation and/or work process design
Potential Consequences Severity Severity Score Probability
Contact with rough surfaces Very High 100 Very High
Contact with sharp edges or protruding parts High 40 High
Contact with moving parts Medium 21 Medium
Contact with rotating open ends Low 8 Low
Falling or ejection of objects Very Low 2 Very Low
Loss of stability
Break-up diring operation
Displacement of moving elements
Projection of high pressure fluids
Uncontrolled movement
Direct contact with energized equipment
Disruptive discharge
Electric arc
Fire
Indirect contact
Short-circuit
Dropping or ejection of a moving part of the machine
Dropping or ejection of a workpiece clamped by the machine
Failure to stop moving parts
Machine action resulting in inhibition of protective devices
Uncontrolled movement, including speed change
Unintended/unexpected start-up
Contact with object with high/low temperature
Emission of hazardous substance
Emission of hazardous level of noise
Emission of vibration that can be hazardous
Emission of radiation field that can be hazardous
Harsh environmental conditions
Excessive force/effort
Human errors/violations (unintentional and deliberate)
Loss of direct visibility of the work area
Awkward posture
Repetitve handling at high frequency
Probability Score Risk Score Min Risk Score Max Risk Rating Action Rating Safety Circuit Score
10 2 19 LOW OPTIONAL 2
8 20 209 MEDIUM RECOMMENDED 30
6 210 599 CRITICAL MANDATORY 210
4 600 1000 VERY CRITICAL MANDATORY
1
Performance Design
Simple Cat 1, PL-b
Single Channel w/Monitoring Cat 2, PL-c
Control Reliable Cat 3, PL-d