Class 6.1 Toxic Risk Assessment Form

HEALTH & SAFETY CHEMICAL RISK ASSESSMENT FORM

Ra No.: Date: Versi Review Date: Authorised by: on No.:

STEP 1 – ENTER INFORMATION ABOUT THE ACTIVITY/TASK, ITS LOCATION AND THE PEOPLE COMPLETING THE RISK ASSESSMENT Location name: Buildin Room No.: Date: Assessed by: HSR/Employee representative: g No.:

Chemical (Manufacturer’s name and product name): If “yes” list the hazard statement: Class 6.1 toxic H290, H300, H310, H330, H315, H318, H372, H410 (example for cyanide) Is the chemical a dangerous good? If “yes” list the Is the chemical a scheduled poison? If “yes” list the poison schedule: Yes No dangerous Yes No goods class:

Description of work/activities/use: Substances that are liableto cause death or serious injury or harm to health . Examples include cyanide and arsenic. Are there any licencing/permit requirements? If “yes” provide Health surveillance requirements (list “nil” if not required): A current MSDS/SDS is available Yes No details: Yes

Exposure route of chemical: Inhalation Skin (absorption) Eye Ingestion Injection Other – Specify: Workplace conditions (Describe layout and physical conditions - including access and egress):

What are the storage requirements? What are the waste/disposal requirements?

List systems of work for the activity/task: ● Training ● Inspections ● SOPs ● Existing controls ● Emergency situations

safety.unimelb.edu.au HEALTH & SAFETY: CHEMICAL RISK ASSESSMENT FORM – CLASS 6.1 TOXIC SUBSTANCES 1

Template date: June 2015 Version: 1.0 Authorised by: Associate Director, Health & Safety Next Review: June 2018 © The University of Melbourne – Uncontrolled when printed. Is there past experience with the chemical that may assist in the assessment? ● Existing controls ● SOPs ● Standards ● Industry standards ● Incidents & near-hits ● Legislation & Codes ● Training ● Incident Investigation ● Guidance material

First aid and emergency requirements ● Additional first aid kit contents ● Special first aid requirements (eg oxygen) ● Emergency eyewash ● Emergency shower ● Spill kit ● Neutralising agent ● Restrict access

Template date: June 2015 Version: 1.0 Authorised by: Associate Director, Health & Safety Next Review: June 2018 © The University of Melbourne – Uncontrolled when printed. STEP 2: SELECT A RISK RATING METHOD TWO VARIABLE RISK MATRIX THREE VARIABLE RISK CALCULATOR

(1) Definitions of likelihood labels (1) Definitions of exposure variables Likelihood (Probability) Exposure E Level Descriptor Description Expected to occur Continuously or many times daily 10 A Almost certain The event will occur on an annual basis Once a year or more Frequently: Approximately once daily 6 B Likely The event has occurred several times or Once every three years Occasionally: Once a week to once a month 3 more in your career Infrequently: Once a month to once a year 2 C Possible The event might occur once in your career Once every 10 years Rarely: Has been known to occur 1 D Unlikely The event does occur somewhere from time Once every 30 years Very rarely: Not known to have occurred 0.5 to time E Rare Heard of something like the event occurring Once every 100 years (2) Definitions of likelihood variables elsewhere Likelihood L

(2) Definitions of consequence labels Almost certain: The most likely outcome if the event occurs 10 Likely: Not unusual, perhaps 50-50 chance 6 Severity level Consequences Unusual but possible: (e.g. 1 in 10) 3 V Catastrophe One or more fatalities and/or severe irreversible disability to one or more people Remotely possible: A possible coincidence (e.g. 1 in 100) 1 IV Major Extensive injury or impairment to one or more persons Conceivable: Has never happened in years of exposure, but possible (eg 1 in 1,000) 0.5 III Moderate Short term disability to one or more persons Practically impossible: Not to knowledge ever happened anywhere (e.g. 1 in 0. 1 10,000) II Insignificant Medical treatment and/or lost injury time <2 weeks I Negligible First aid treatment or no treatment required (3) Definitions of consequence variables Consequences C (3) Risk rating matrix Catastrophe: Multiple fatalities 100 Likelihood Consequence label Disaster: Fatality 50 label I II III IV V Very serious: Permanent disability/ill health 25 A Medium High High Very high Very high Serious: Non-permanent injury or ill health 15 B Medium Medium High High Very high Important: Medical attention needed 5 C Low Medium High High High Noticeable: Minor cuts and bruises or sickness 1 D Low Low Medium Medium High E Low Low Medium Medium High

Template date: June 2015 Version: 1.0 Authorised by: Associate Director, Health & Safety Next Review: June 2018 © The University of Melbourne – Uncontrolled when printed. (4) Risk score calculator Risk Score = E x L x C Risk score Risk rating > 600 Very high 300 - 599 High 90 - 299 Medium < 90 Low

Template date: June 2015 Version: 1.0 Authorised by: Associate Director, Health & Safety Next Review: June 2018 © The University of Melbourne – Uncontrolled when printed. STEP 3 – REVIEW CHEMICAL PROCESS For each stage of the chemical risk assessment: Hierarchy of Control (Control Type)  Review the prompts/examples for each route of exposure for each category; El – Elimination  Determine and record a raw risk score by referencing the two variable risk matrix or the three S – Substitution variable risk calculator; En – Engineering Is – Isolation G – Guarding  In the comments box, describe the route of exposure and any other information (if applicable); Sh – Shielding  Specify the risk control type for each current or proposed risk control; A – Administrative T – Training In – Inspection  Provide a control description for each current or proposed risk control; M – Monitoring H – Health Monitoring  Where proposed risk control(s) have been identified complete a Health & Safety Action Plan; P – PPE  Determine the residual risk score referencing the same two variable risk matrix or three variable For information devising appropriate controls, refer to: Guide to Chemical Risk Hierarchy of Control. risk calculator used to determine the raw risk score.

Category Raw Comments (when/where the Control Type Control Description Residual Risk Score exposure is present) (Current and Proposed) Risk Score Storage Inhalation associated with poor Low ● Inhalation ● Skin (absorption ventilation ● Eye ● Ingestion Corrosive to skin and eyes ● Injection ● Other

Handling Inhalation En Chemical management training. Low ● Inhalation ● Skin (absorption Corrosive to skin and eyes A Secure to appropriate trolley in original shipping packages when moving. ● Eye ● Ingestion T Limit quantities in laboratories to as low as reasonably ● Injection ● Other P practicable. Wear appropriate eye and face protection, protective clothing and gloves as per MSDS/SDS. Other PPE as determined by activity/use and MSDS/SDS (see last page for details of commonly used/required PPE). Decanting/Mixing Inhalation En Decant in a designated decanting area – ventilation, Medium earthing, no ignition sources. ● Inhalation ● Skin (absorption Corrosive to skin and eyes Is Decanting SOP. ● Eye ● Ingestion A Manual handling training. ● Injection ● Other T P Chemical management training. Wear appropriate eye and face protection, protective clothing and gloves. Other PPE as determined by activity/use and MSDS/SDS (see last page for details of commonly used/required PPE). Signage. safety.unimelb.edu.au HEALTH & SAFETY: CHEMICAL RISK ASSESSMENT FORM – CLASS 6.1 TOXIC SUBSTANCES 5

Template date: June 2015 Version: 1.0 Authorised by: Associate Director, Health & Safety Next Review: June 2018 © The University of Melbourne – Uncontrolled when printed. Category Raw Comments (when/where the Control Type Control Description Residual Risk Score exposure is present) (Current and Proposed) Risk Score Applying/Using Inhalation En Reactions to be contained in a sealed reaction vessel in Medium a fume hood. ● Inhalation ● Skin (absorption Corrosive to skin and eyes A Chemical management training. ● Eye ● Ingestion T Read MSDS/SDS before using for the first time. ● Injection ● Other In P Wear appropriate eye and face protection, protective clothing and gloves. Other PPE as determined by activity/use and MSDS/SDS (see last page for details of commonly used/required PPE). Workplace inspections. Spill/Leak Inhalation Have appropriate spill kit and cleanup equipment Low available. ● Inhalation ● Skin (absorption Corrosive to skin and eyes Know local emergency procedures and evacuation ● Eye ● Ingestion routes. ● Injection ● Other P Other PPE as determined by emergency procedures (see last page for details of commonly used/required PPE). Know the location of eye wash/emergency showers. Know the location of first aid kits and the local first aid providers. Use undamaged original container or containers appropriate to hold chemical. Disposal Inhalation Low ● Inhalation ● Skin (absorption Corrosive to skin and eyes ● Eye ● Ingestion ● Injection ● Other

Template date: June 2015 Version: 1.0 Authorised by: Associate Director, Health & Safety Next Review: June 2018 © The University of Melbourne – Uncontrolled when printed. STEP 4 – IMPLEMENTATION AND CONSULTATION PROCESS Determine the person responsible for reviewing and implementing the risk assessment including the identified controls. Ensure a Health & Safety Action Plan has been completed, reviewed and signed off where proposed controls have been identified. Obtain the authorisation of the management representative. Ensure the HSR (if applicable) has been consulted. Ensure the employees undertaking the activity have been consulted. Record below the names of the persons consulted. Management representative HSR/Employee representative Employee(s) Employee(s) Employee(s) Employee(s) Person Responsible for implementation or escalation

Extra writing room - use this page to enter extended comments or descriptions

Review Review risk assessment every 3 years. Review employee chemical procedures during workplace inspections. Review risk assessment where there is an incident with the chemical or new information becomes available. Review risk assessment when the MSDS/SDS is updated/reissued.

Emergency and First Aid procedures Ensure that general first aid procedures and resources are in place and available. Additional specialist first aid equipment may be required. eg oxygen for cyanide poisoning. Consideration must also be taken that first aiders are not overcome by poisonous gases. First aid risk assessment and procedures that take into account the risks associated with the chemical and possible adverse outcomes. University of Melbourne and local area emergency procedures. Spill kits – vermiculite or attapulgite

PPE Respiratory protection: AS/NZS 1715 Selection, use and maintenance of respiratory protective equipment Safety Glasses: AS/NZS 1337.1 Personal eye protection. Eye and face protectors for occupational applications Gloves: AS/NZS 2161.1 Occupational protective glove. Selection, use and maintenance Boots: AS/NZS 2210.1-9 (series) Occupational protective footwear or sturdy footwear as per local area requirements

To eliminate injuries always use the chemical in accordance with the manufacturer’s instructions and for its intended purpose only. All chemical users must have demonstrated competency and be familiar with the risk assessment and any SOPs prior to use of the chemical.

Template date: June 2015 Version: 1.0 Authorised by: Associate Director, Health & Safety Next Review: June 2018 © The University of Melbourne – Uncontrolled when printed.