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Title of Job/Operation:  Title of Person who Does Job: Date:
Company: Location: Supervisor: Analysis By:

Required and/or Recommended Personal Protective Equipment:

 
Department: Reviewed By:
Sequence of Basic Job Steps
Potential Accidents or Hazards
Recommended Safe Job Procedures
     
     
     
     
     
     
     
     
     
     
     

Instructions for Completing Job Safety Analysis Worksheet

Job Safety Analysis (JSA) is an important accident prevention tool that works by finding hazards and eliminating or minimizing them before the job is performed, and before they have a chance to become accidents. Use your JSA for clarification and hazard awareness, as a guide in new employee training, for periodic contacts and for retraining of senior employees, as a refresher on jobs which run infrequently, as an accident investigation tool and for informing employees of specific job hazards and protective measures. Set priorities for doing JSAs: jobs that have a history of many accidents, jobs that have produced disabling injuries, jobs with high potential for disabling injury or death, and new jobs with no accident history.

Here's how to do each of the three parts of a Job Safety Analysis:

Sequence of Basic Job Steps
Potential Accidents or Hazards
Recommended Safe Job Procedures
Break down the job into steps. Each of the steps of a job should accomplish some major task. The task will consist of a set of movements. Look at the first set of movements used to perform a task and then determine the next logical set of movements. For example, the job might be to move a box from a conveyor in the receiving area to a shelf in the storage area. How does that break down into job steps? Picking up the box from the conveyor and putting it on a handtruck is one logical step of movements, so it is one job step. Everything related to that one logical step of movements is part of that job step.

The next logical set of movements might be pushing the loaded handtruck to the storeroom. Removing the boxes from the truck and placing them on the shelf is another logical set of movements. And finally, returning the handtruck to the receiving area might be the final step in this job.

Be sure to list all the steps in a job. Some steps might not be done each time -- checking the casters on the handtruck, for example. However, that task is part of the job as a whole, and should be listed and analyzed.

Identify the hazards associated in each step. Examine each step to find and identify hazards -- actions, conditions, and possibilities that could lead to an accident.

It's not enough to look at the obvious hazards. It's also important to look at the entire environment and discover every conceivable hazard that might exist.

Be sure to list health hazards as well, even though the harmful effect may not be immediate. A good example is the harmful effect of inhaling a solvent or dust over a long period of time.

It's important to list all hazards. Hazards contribute to accidents, injuries and occupational illnesses.

In order to the part 3 of the JSA effectively, you must identify potential and existing hazards. That's why it's important to distinguish between a hazard, an accident and an injury. Each of these has a specific meaning:

HAZARD -- a potential danger. Oil on the floor is a hazard
ACCIDENT -- an unintended happening that may result in injury, loss or damage. Slipping on the oil is an accident
INJURY -- The result of an accident. A sprained wrist from the fall would be an injury.

Some people find it easier to identify possible accidents and illnesses and work back from them to the hazards. If you do that, you can list the accidents and illnesses in parentheses following the hazard. But be sure you focus on the hazard for developing recommended actions and safe work procedures.

Using the first two columns as a guide, decide what actions are necessary to eliminate or minimize the hazards that could lead to an accident, injury, or occupational illness.

Among the actions that can be taken are:

  1. engineering the hazard out
  2. providing personal protective equipment
  3. job instruction and training
  4. good housekeeping
  5. good ergonomics (positioning the person in relation to the machine and other elements in the environment in such a way as to eliminate stresses and strains)

List recommended safe procedures on the form and also list required or recommended personal protective equipment for each step of the job,

Be specific. Say exactly what needs to be done to correct the hazard, such as, "lift using your leg muscles." Avoid general statements like, "Be careful."

Give a recommended action or procedure for every hazard.

If the hazard is a serious one, it should be corrected immediately. The JSA should then be changed to reflect the new conditions.

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