Field Activity Risk Assessment Form
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Field Activity Title: _______________________________________________________________________
Subject Name
: ___________________________________
Subject No. _________________
(if applicable)
Date(s) of Activity:
From: ______/______/______
To: ______/______/_____
Supervisor/Leader:
______________________________________________________________________________
Location Assessed By: ______________________________________
Date Assessed:_____/____/____
Outline of Field Activity:
Step 1: IDENTIFY POTENTIAL AND EXISTING INDIVIDUAL HAZARDS
Using Table 1, assess each
(
hazard as high, medium or low. Blank or no rating indicates the hazard is not applicable to this particular field
activity)
Risk Rating
Risk Rating
Risk Rating
Camp/Bush Fires
Cold Environment/Hypothermia/Frost Bite
Working in/near water (boats,
swimming, diving)
Noise
Hot Environment/Dehydration/UV
Contaminated Waters
Concealed Holes
River, Stream or Lake Crossing
Fatigue (eg. driving long hours)
Slippery Surfaces
Hail/Severe Storm/Lightening
Manual Handling/Lifting
Rainfall/Flood
Moving/Falling objects
Use of Hazardous Chemicals
Heavy Traffic Area
Falls from heights/Cliffs
Unstable/Uneven/Soft ground
Violent Persons
Bites/Stings (wasps, jellyfish, leeches)
Hazardous Equipment (hammers,
augers, drills)
Harassment
Animal Attacks (snakes, dingos)
Fencing (wire, electric, high)
Dry Environment
Strong currents/wave action/tides
Other(s) (please specify)
TABLE 1
Step 1 – Consider the Consequences
Step 2 – Consider the Likelihood
Step 3 – Calculate the Risk
What are the consequences of this incident
What is the likelihood of the consequence identified in
1.Take step 1 rating and select the correct column
occurring? Consider what could reasonably have
step 1 happening? Consider this without new or interim
2.Take Step 2 rating and select the correct line
happened as well as what actually happened. Look at
controls in place. Look at the descriptions and choose
3.Circle the risk score where the two ratings
the descriptions and choose the most suitable
the most suitable Likelihood.
cross on the matrix below.
Consequence.
E = Extreme, = High, M = Medium, L = Low
N = Negligible
CONSEQUENCES
LIKELIHOOD
Risk Score = ……………….
Consequence
Description
Likelihood
Description
CONSEQUENCES
Major
Death and extensive injuries
The event is expected to occur in
A
Maj
Mod
Min
Ins
most circumstances
Moderate
Medical treatment
B
The event could occur at some time
A
E
E
H
M
Minor
First aid treatment
C
The event could occur, but only rarely
B
E
H
M
M
Insignificant
No treatment
D
The event may occur, but probably
C
H
M
M
L
never will.
D
M
M
L
N
BR 0100
Custodian: Officer, Legal & Compliance
Page 1
of 2
Created: March 2003
Last Review: May 2005
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