PPE Hazard Assessment

Personal Protective Equipment Hazard Assessment
Laboratory Work Activities (although this could be used for other work as well)

WEB-SUBMIT
FORM

Hazard assessment and its written record, "certification," are required by OSHA for all work activities that require personal protective equipment. Use this utility if it helps you satisfy this requirement for your work area(s). It is not fast, nor simple, but it might be quite a bit faster and simpler than performing the process another way.

The supervisor makes the rules for workplace PPE, and must make reasonable and responsible rules. The posted, written Hazard Assessment Certification constitutes those rules, which are to be understood and obeyed by all workers, and which are to be enforced whenever necessary by the supervisor or by a designee to whom the supervisor has given the authority and power to enforce them.

Modify anything in these columns so that it fits your needs	You may copy and paste from "minimum PPE recommended" cells below into the "required by supervisor" field at right. Modify if needed. (But don't copy/paste the text in italics.)	Insert your requirements here
Task description	Description of hazards	minimum PPE recommended by REM	PPE required by supervisor
Work with < 50mL corrosive liquids pH < 4 or pH >10, or any volume < 50mL organic liquids.	Skin irritation or damage, eye irritation or damage.	Safety glasses, disposable nitrile gloves, skin cover to knees, elbows, throat, closed shoe, socks.
Work with 50mL < volume < 1L of corrosive liquids (pH < 4 or pH > 10), or any 50mL < volume < 1L organic liquids.	Severe skin irritation or damage, severe eye irritation or damage.	Splash goggles, disposable nitrile gloves, skin cover to ankles, wrists, throat, closed shoe, socks.
Work with volume > 1L of corrosive liquids (pH < 4 or pH > 10), or any volume > 1L organic liquids.	Severe permanent skin or eye damage or scarring, loss of function, and/or loss or vision.	Face shield (to chin) with splash goggles under, disposable nitrile gloves, lab coat and other skin cover to ankles, wrists, throat, closed shoe, socks.
Work with infrared emitting equipment, e.g., glassblowing, welding, brazing, IR emitting instrument or exposed diodes.	Corneal burns, cataracts, conjunctivitis, erythema.	Shaded (IR filter) glasses, googles, or visor appropriate to the wavelength(s) and to potential for exposure. Specify shade rating as per PPE Policy Appendix.
Spark-producing operations, e.g., metals grinind, welding,.	Burns to hands, skins, eyes, hair, clothing.	Fire retardant apparel, gloves, and impact goggles *(shaded if also appripriate)*. Keep hair short, covered, or tied away from sparks.
Machine operation activities likely to catch clothing, hair, or jewelry.	Skin/limb injury.	Bind vulnerable clothing/hair, remove jewelry
Metal working/grinding, woodworking/grinding, other operations likely to throw particles.	Eye impact injuries.	Safety glasses. No loose clothing, no jewelry.
Handling, moving, pouring, or any use of cryogenic liquids, including simple close proximity to an open container of cryogen..	Skin or eye tissue damage.	Safety glasses, disp gloves, skin cover to elbows, knees, throat, full shoes/socks for < 50mL. For > 50mL splash goggles, cryogloves, skin cover to ankles, wrists, throat.
Working with or around sources of ultraviolet radiation.	Eye irritation or damage, erythema (sunburn).	UV blocking goggles, skin cover on all potentially exposed areas. When face sunburn potential exists, a filtering face shield is required.
Working with or around Class 3b or 4 lasers.	Skin irritation and/or damage, eye injury, vision loss.	Goggles appropriate to beam parameters, closed shoe, no jewelry/reflective items.
Human blood, cells, tissue, body fluids or materials derived from these.	Infectious disease, e.g. human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV).	Safety glasses, "exam" gloves, skin cover on all potentially exposed areas, shoes/socks, work at Biosafety Level II.
Work with or around hazardous solid (toxin, reproductive toxin, mutagen, carcinogen, irritant).	Systemic poinsoning, reproductive effects, skin or mucous membrane irritation.	Safety glasses, disposable nitrile gloves, skin cover to elbows/knees/throat, closed shoes/socks, lab coat.
Work with or around > 100g hazardous solid, or > 1g when a high potential exists for airborne concentration, or if operations involve "chemical requiring designated area."	Systemic poinsoning, reproductive effects, skin or mucous membrane irritation.	Safety glasses, gloves chosen for substance, skin cover to wrists/ankles/throat, closed shoes/socks.

Modify anything in these columns
so that it fits your needs

You may copy and paste from "minimum PPE recommended" cells below into the "required by supervisor" field at right. Modify if needed.
(But don't copy/paste the text in italics.)

Insert your requirements here

Task description

Description of hazards

minimum PPE
recommended by REM

PPE required by
supervisor

Work with < 50mL corrosive liquids pH < 4 or pH >10, or any volume < 50mL organic liquids.

Skin irritation or damage, eye irritation or damage.

Safety glasses, disposable nitrile gloves, skin cover to knees, elbows, throat, closed shoe, socks.

Work with 50mL < volume < 1L of corrosive liquids (pH < 4 or pH > 10), or any 50mL < volume < 1L organic liquids.

Severe skin irritation or damage, severe eye irritation or damage.

Splash goggles, disposable nitrile gloves, skin cover to ankles, wrists, throat, closed shoe, socks.

Work with volume > 1L of corrosive liquids (pH < 4 or pH > 10), or any volume > 1L organic liquids.

Severe permanent skin or eye damage or scarring, loss of function, and/or loss or vision.

Face shield (to chin) with splash goggles under, disposable nitrile gloves, lab coat and other skin cover to ankles, wrists, throat, closed shoe, socks.

Work with infrared emitting equipment, e.g., glassblowing, welding, brazing, IR emitting instrument or exposed diodes.

Corneal burns, cataracts, conjunctivitis, erythema.

Shaded (IR filter) glasses, googles, or visor appropriate to the wavelength(s) and to potential for exposure. Specify shade rating as per PPE Policy Appendix.

Spark-producing operations, e.g., metals grinind, welding,.

Fire retardant apparel, gloves, and impact goggles (shaded if also appripriate). Keep hair short, covered, or tied away from sparks.

Machine operation activities likely to catch clothing, hair, or jewelry.

Skin/limb injury.

Bind vulnerable clothing/hair, remove jewelry

Metal working/grinding, woodworking/grinding, other operations likely to throw particles.

Safety glasses. No loose clothing, no jewelry.

Handling, moving, pouring, or any use of cryogenic liquids, including simple close proximity to an open container of cryogen..

Skin or eye tissue damage.

Safety glasses, disp gloves, skin cover to elbows, knees, throat, full shoes/socks for < 50mL. For > 50mL splash goggles, cryogloves, skin cover to ankles, wrists, throat.

Working with or around sources of ultraviolet radiation.

Eye irritation or damage, erythema (sunburn).

UV blocking goggles, skin cover on all potentially exposed areas. When face sunburn potential exists, a filtering face shield is required.

Working with or around Class 3b or 4 lasers.

Skin irritation and/or damage, eye injury, vision loss.

Goggles appropriate to beam parameters, closed shoe, no jewelry/reflective items.

Human blood, cells, tissue, body fluids or materials derived from these.

Infectious disease, e.g. human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV).

Safety glasses, "exam" gloves, skin cover on all potentially exposed areas, shoes/socks, work at Biosafety Level II.

Safety glasses, disposable nitrile gloves, skin cover to elbows/knees/throat, closed shoes/socks, lab coat.

Safety glasses, gloves chosen for substance, skin cover to wrists/ankles/throat, closed shoes/socks.

Date:	Dept:	Bldg:	Room(s):
Supervisor:		name of preparer:
Supervisor email:		email of preparer: