The Health Hazard Evaluation Form is a critical workplace safety document required under New Zealand's health and safety regulatory framework. This document is essential when organizations need to assess and document potential health risks in their workplace, particularly when introducing new processes, substances, or equipment, or when reviewing existing hazards. The form incorporates requirements from the Health and Safety at Work Act 2015 and associated regulations, providing a structured approach to hazard identification, risk assessment, and control measure implementation. It should be completed by qualified personnel and updated regularly to maintain current risk assessments and control measures, serving as evidence of due diligence in managing workplace health risks.
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1. Site and Assessment Details: Basic information including facility name, location, date of assessment, and assessor details
2. Purpose of Evaluation: Clear statement of why the evaluation is being conducted and its scope
3. Hazard Identification: Comprehensive list of potential health hazards present in the workplace or situation
4. Exposure Assessment: Evaluation of potential exposure routes and levels for identified hazards
5. Risk Assessment Matrix: Systematic evaluation of likelihood and consequence for each identified hazard
6. Control Measures: Existing and recommended control measures following the hierarchy of controls
7. Monitoring Requirements: Specified requirements for ongoing monitoring and exposure measurement
8. Emergency Procedures: Specific emergency response procedures related to identified health hazards
9. Review and Approval: Sign-off section for relevant parties and review date scheduling
1. Specific Chemical Assessment: Detailed assessment section for workplaces dealing with hazardous chemicals
2. Biological Hazard Assessment: Additional section for workplaces with potential biological hazards
3. Noise Exposure Assessment: Specific section for workplaces where noise is a significant hazard
4. Radiation Safety Assessment: Additional section for workplaces with radiation sources
5. Personal Protective Equipment Requirements: Detailed PPE specifications when complex PPE requirements exist
6. Worker Consultation Record: Documentation of worker consultation process where significant hazards exist
1. Appendix A: Hazard Monitoring Results: Records of any monitoring or testing results
2. Appendix B: Safety Data Sheets: Relevant safety data sheets for hazardous substances
3. Appendix C: Control Measure Specifications: Detailed specifications for control measures
4. Appendix D: Risk Assessment Guidelines: Guidelines used for risk assessment and scoring
5. Appendix E: Referenced Standards: List of relevant standards and guidelines referenced
6. Appendix F: Review History: Record of previous assessments and reviews
Relevant legal definitions
Hazard
Risk
PCBU (Person Conducting a Business
Reasonably Practicable
Control Measure
Exposure Standard
Health Monitoring
Hierarchy of Controls
Notifiable Incident
Worker
Workplace
Safety Data Sheet (SDS)
Acute Effect
Chronic Effect
Critical Control
Exposure Monitoring
Hazardous Substance
PPE (Personal Protective Equipment)
Risk Assessment
Safe Work Procedure
Competent Person
Administrative Control
Engineering Control
Occupational Exposure Limit (OEL)
Time Weighted Average (TWA)
Action Level
Biological Monitoring
Health Surveillance
Safety Critical Equipment
Workplace Exposure Standard (WES)
Risk
PCBU (Person Conducting a Business
Reasonably Practicable
Control Measure
Exposure Standard
Health Monitoring
Hierarchy of Controls
Notifiable Incident
Worker
Workplace
Safety Data Sheet (SDS)
Acute Effect
Chronic Effect
Critical Control
Exposure Monitoring
Hazardous Substance
PPE (Personal Protective Equipment)
Risk Assessment
Safe Work Procedure
Competent Person
Administrative Control
Engineering Control
Occupational Exposure Limit (OEL)
Time Weighted Average (TWA)
Action Level
Biological Monitoring
Health Surveillance
Safety Critical Equipment
Workplace Exposure Standard (WES)
Clauses
Site Information
Assessment Scope
Hazard Identification
Risk Assessment
Control Measures
Exposure Monitoring
Health Surveillance
Emergency Response
Documentation Requirements
Training Requirements
Review and Updates
Responsibilities
Consultation
Compliance
Reporting Requirements
Record Keeping
Equipment Specifications
Personal Protective Equipment
Incident Response
Confidentiality
Assessment Scope
Hazard Identification
Risk Assessment
Control Measures
Exposure Monitoring
Health Surveillance
Emergency Response
Documentation Requirements
Training Requirements
Review and Updates
Responsibilities
Consultation
Compliance
Reporting Requirements
Record Keeping
Equipment Specifications
Personal Protective Equipment
Incident Response
Confidentiality
Relevant Industries
Manufacturing
Construction
Healthcare
Chemical Processing
Mining
Agriculture
Pharmaceuticals
Research and Laboratory
Food Processing
Waste Management
Industrial Services
Transportation and Logistics
Relevant Teams
Health and Safety
Operations
Quality Assurance
Risk Management
Compliance
Environmental
Production
Facilities Management
Laboratory Services
Project Management
Relevant Roles
Health and Safety Manager
Occupational Hygienist
Risk Assessment Specialist
Environmental Health Officer
Operations Manager
Site Supervisor
Quality Assurance Manager
Compliance Officer
Industrial Hygienist
Safety Coordinator
Production Manager
Facility Manager
Laboratory Manager
Project Manager
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