Resourcing/ Occupational Hazard Identification Form (HIF)

Position Title: / Department:
Successful Candidate Details (HR Use only)
Title & Name:
Email Address:
Start Date:
The employee is new / existing (please delete as appropriate)
In order for the Occupational Health Nurse Advisor to determine whether health surveillance is required under legislation we need to have knowledge of the hazards that staff maybe exposed to in their role.
Each department may have hazards unique to that area and the specific role and as such these need to be assessed on an individual or group basis. It is important therefore for the relevant Head to identify the potential hazards of the roles within their area and ensure there is an associated risk assessment held within the department/school.
Please indicate all potential hazards of the role, giving examples of tasks or equipment used and frequency of exposure:
Tick if applicable  / Hazard / Task & Frequency
Noisy working environment (above 80d)
Repetitive limb movements
 / Display Screen Equipment User / Regular use
Working with machinery (please specify any vibration hazards)
Working with chemicals (including requirement to wear latex gloves and including work with CO2 or N2 gasses)
Potential exposure to asbestos or other dusts
Biological Agents/Scientific Hazards (experiments/lasers etc., and waste/sewage)
Working with radiation
Working in confined spaces
Working at heights (see below)
Prolonged physical/manual work/Manual handling (including human beings)
Exposure to animals
Vocational driving on & off campus (includes use of cars, vans, ride-on mowers, buggies)
Night work (at least 3 hours between midnight and 5am) and/or Shift work
Prolonged weather hazard exposure – wind/rain/snow/pollen/UV & sun
Working in isolation (see below)
Conflict resolution (see below)
Contact with Human fluids (blood, saliva etc.)
Pressure to meet important deadlines such as might be inherent in high profile projects

Please Note; Hazards identified should be those implicit with the required duties of the role and not related to potential outcomes from daily working life.

For example:

  • Conflict Resolutionwhere individuals are responsible for resolving conflict using formal University processes or where there is significant risk of physical or psychological injury.
  • A cleaner undertaking general cleaning duties would not constitute potential exposure to asbestos or other dusts. However a maintenance worker removing roofing boards or drilling for prolonged periods may.
  • Working at heights (defined by HSE) as any place where, if there were no precautions in place, a person could fall a distance liable to cause personal injury, e.g. you are working at height if you:
  • are working on a ladder or a flat roof;
  • could fall through a fragile surface;
  • could fall into an opening in a floor or a hole in the ground.
  • Lone Working (defined by the HSE) as those who work by themselves without close or direct supervision. In fixed establishments for example;
  • A person working alone in a small workshop, kiosk or shop for extended periods of time without any form of supervision;
  • People working on their own outside normal hours, e.g. cleaners or maintenance/repair staff (please note; University security staff have continual radio contact with a central resource and have a team and/or supervisor for support purposes and therefore would not constitute lone working under normal circumstances).

v.3.0 – 5 April 2018Page 1 of 2