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Document code no.

Name of the Region :


Name of the Site :
Name of the Department :

MANGALORE
ESSEL WILLCON
HSE

Name of the document :Format # 02 - For Initial


Occupational Health & Safety Review (IOHSR)

Page no.
OF

12

GUIDELINESFOR FILLING UP OF THE FORMAT


A.1
A.2
A.3
A.4
A.5
A.6

Guidance Criteria for Filling up the Columns


Hazard identification, risk assessment & determining risk control worksheets
Determining risk likelihood guidance criteria
Determining risk severity level guidance criteria
Risk prioritization indicator
Definition of level of risks
A.1 GUIDANCE CRITERIA FOR FILLING UP THE COLUMNS
Column #
Description
1
Write the Serial Number
2
Mention the Name of Activity. Example Excavation, Shuttering
3
Mention Type of Hazard. Example , Fall of Person, Fall of Material , Collapse of Structure
4
Mention Category of Hazard. Accidental/Physical/Chemical/Ergonomical/Biological
5
Mention Type of Risk Example , Injury, cuts Burins
6
Mention The Conditions. Whether Direct Control or Indirect Control
7
Mention The Condition , Whether Regular Activity or Non Regular Activity
8
Refer A.3
9
Refer A.4
10
Refer A.5 and A.6
11
Refer A.5 and A.6
12
Refer A.5 and A.6
13
Mention Input for Control , LC Legal Concern , DC Domino Concern, CC- Chronic Concern
14
Indicate Hierarchy of Controls- : E Elimination, S Substitution, EC Engineering Control; AC Administrative Control; PPE Personal Protective Equipment
15
Mention the Applicable Control Procedure Number

Document code no.


Name of the Region :
Name of the Site :
Name of the Department :

MANGALORE
ESSEL WILLCON
HSE

Name of the document :Format # 02 - For Initial


Occupational Health & Safety Review (IOHSR)

Page no.
OF

12

A.2 HAZARD IDENTIFICATION, RISK ASSESSMENT & CONTROL MEASURES WORKSHEET

Hazard Identification
S
No

Residual Risk Assessment


Conditions

Activity Type of Hazard Category of


Type of Risk
Hazards

Hierarchy of Controls

Risk Priority Number

D/I

R/NR

Likeliho
od
(L)

Severity
(S)

Total =
LxS

Risk
Prioritization

Is Risk level
acceptable
(Yes/No)
(*)

10

11

12

Input for
Controls
(LC/DC/CC)

EC

AC

13

14

15

16

17

Control
PPE Measures

18

19

Emergency
alarm,
Safety
control
equipment
in
machinery,
work
permit,
back horn
of the
machinery,
Safety
shoe,
Display
boards

Construction of Scaffolding

Earth
Stuck against
Excavatio
/stuck in
n

Accidental

Injury ,Major
cuts

12

Substantial

LC

Document code no.


Name of the Region :
Name of the Site :
Name of the Department :

MANGALORE
ESSEL WILLCON
HSE

Name of the document :Format # 02 - For Initial


Occupational Health & Safety Review (IOHSR)
Hazard Identification
S
No

Erection

Page no.
OF

12

Residual Risk Assessment


Conditions

Activity Type of Hazard Category of


Type of Risk
Hazards

Hierarchy of Controls

Risk Priority Number


Total =
LxS

Risk
Prioritization

Is Risk level
acceptable
(Yes/No)
(*)

Input for
Controls
(LC/DC/CC)

EC

AC

Control
PPE Measures

D/I

R/NR

Likeliho
od
(L)

Severity
(S)

10

11

12

13

14

15

16

17

18

Fall of
person/animals
into trenches

Accidental

Injury
,permanent
disability

15

Substantial

LC

Exposure to
high noise

Physical

Hearing
impairment

Moderate

LC

Unstable
Ground

Power
Lines
(electrocutio
n)

Accidental

Accidental

Injury ,Major
cuts,
casualty

Electrical
shock, ill
health

12

Substantial

LC

19
Display
board,
barricade,
safety
shoes &
helmet
display
boards, air
muff
Barricade,
work
permit,
safety shoe
and helmet

insulated
power
supply ,
D

12

Substantial

LC

Proper
Earthing,
Work
permit,
Safety
PPEs

Document code no.


Name of the Region :
Name of the Site :
Name of the Department :

MANGALORE
ESSEL WILLCON
HSE

Name of the document :Format # 02 - For Initial


Occupational Health & Safety Review (IOHSR)
Hazard Identification
S
No

Page no.
OF

12

Residual Risk Assessment


Conditions

Activity Type of Hazard Category of


Type of Risk
Hazards

Hierarchy of Controls

Risk Priority Number


Total =
LxS

Risk
Prioritization

Is Risk level
acceptable
(Yes/No)
(*)

Input for
Controls
(LC/DC/CC)

EC

AC

Control
PPE Measures

D/I

R/NR

Likeliho
od
(L)

Severity
(S)

10

11

12

13

14

15

16

17

18

Fall of objects

Accidental

Injury ,Major
cuts

Moderate

--

Overturning

Accidental

Injury , cuts

12

Substantial

--

Fall from Height

Accidental

Injury ,Major
cuts
,casualty

12

Substantial

LC

Safety belt,
, work
permit

HSE audit,
Safety belt,
hand
gloves,
work
permit,
First aid kit,
Mockdrill

Collapse of
scaffolding

Accidental

Injury ,Major
cuts,
casualty

15

Substantial

--

19
Display
boards,
Scaffolding
Inspection,
safety shoe
& helmet
Display
boards,
safety shoe
& helmet

Document code no.


Name of the Region :
Name of the Site :
Name of the Department :

MANGALORE
ESSEL WILLCON
HSE

Name of the document :Format # 02 - For Initial


Occupational Health & Safety Review (IOHSR)
Hazard Identification
S
No

Fire due to
improper
Hot Work handling of oxy acetylene
cylinder
Fall of molten
metal while
welding

Material Striking against


handling
any object

Fall of objects

Page no.
OF

12

Residual Risk Assessment


Conditions

Activity Type of Hazard Category of


Type of Risk
Hazards

Hierarchy of Controls

Risk Priority Number


Total =
LxS

Risk
Prioritization

Is Risk level
acceptable
(Yes/No)
(*)

Input for
Controls
(LC/DC/CC)

EC

AC

Control
PPE Measures

D/I

R/NR

Likeliho
od
(L)

Severity
(S)

10

11

12

13

14

15

16

17

18

12

Substantial

DC,LC

Moderate

--

Accidental

Injury, major
burns

Accidental

Injury, major
burns

R
Accidental

Injury, cuts

Moderate

LC

Accidental

Injury ,Major
cuts

Moderate

--

19
Fire
extinguishe
r, fire
detectors,
display
boards,
Fire suit
Apron,
Work
permit

Awareness
training,
aprons,
safety shoe
&
handgloves
Display
boards,
safety shoe
& helmet

Document code no.


Name of the Region :
Name of the Site :
Name of the Department :

MANGALORE
ESSEL WILLCON
HSE

Name of the document :Format # 02 - For Initial


Occupational Health & Safety Review (IOHSR)
Hazard Identification
S
No

Whilst
working
on
scaffold

12

Hierarchy of Controls

Risk Priority Number


Total =
LxS

Risk
Prioritization

Is Risk level
acceptable
(Yes/No)
(*)

Input for
Controls
(LC/DC/CC)

EC

AC

Control
PPE Measures

10

11

12

13

14

15

16

17

18

12

Substantial

--

Moderate

--

Overturning

Accidental

Injury , cuts

Slips & trips of


person

Accidental

Bodily harm
ie. eye injury,
head
injury,

Collapse / fall Major Injuries

Page no.
OF

Severity
(S)

Overloading

Likeliho
od
(L)

Body Injury

R/NR

Accidental

D/I

Falling from
scaffold

Residual Risk Assessment


Conditions

Activity Type of Hazard Category of


Type of Risk
Hazards

Moderate

CC

Moderate

19
Display
boards, ,
safety shoe
& helmet
Safety
Shoes,
Safety
helmet
Tool box
talks,
Safety
shoe.
Helmet &
safety belt
Display the
capacity,H
SE audit
Work
permit,
Training

Document code no.


Name of the Region :
Name of the Site :
Name of the Department :

MANGALORE
ESSEL WILLCON
HSE

Name of the document :Format # 02 - For Initial


Occupational Health & Safety Review (IOHSR)
Hazard Identification
S
No

Page no.
OF

12

Residual Risk Assessment


Conditions

Activity Type of Hazard Category of


Type of Risk
Hazards

Hierarchy of Controls

Risk Priority Number


Total =
LxS

Risk
Prioritization

Is Risk level
acceptable
(Yes/No)
(*)

Input for
Controls
(LC/DC/CC)

EC

AC

Control
PPE Measures

D/I

R/NR

Likeliho
od
(L)

Severity
(S)

10

11

12

13

14

15

16

17

18

12

Substantial

LC

10

Substantial

--

Electrocution

Accidental

Electrical
shock, ill
health

Accidental

Injury ,major
cuts,
casualty

People or
objects falling
from height

Accidental

Injury ,Major
cuts

12

Substantial

LC

People or object
exposed to high
noise

Physical

Hearing
impairment

Moderate

--

Erection/al
teration or
Unintentional
dismantle
collapse of a
of scaffold
structure

NR

19
Emergency
plan ,
Proper
Earthling,
Work
permit,
Safety
PPEs
Work
permit,
safety
PPEs
Work
permit,
safety
PPEs
Air muff,
Work
permit,
Acoustic
enclosures
for high
noise
machinerie
s.

Document code no.


Name of the Region :
Name of the Site :
Name of the Department :

MANGALORE
ESSEL WILLCON
HSE

Name of the document :Format # 02 - For Initial


Occupational Health & Safety Review (IOHSR)
Hazard Identification
S
No

3
Striking,
overhead or
underground
services

Unautho
rized
access

Obstruction for
work/ chances
of accidents

Page no.
OF

12

Hierarchy of Controls

Risk Priority Number


Total =
LxS

Risk
Prioritization

Is Risk level
acceptable
(Yes/No)
(*)

Input for
Controls
(LC/DC/CC)

EC

AC

Control
PPE Measures

D/I

R/NR

Likeliho
od
(L)

Severity
(S)

10

11

12

13

14

15

16

17

18

Accidental

Injury major
cuts
,casualty

10

Substantial

--

Body pain

Moderate

--

Injury

Moderate

CC

Display
board

Manual activity
associated with Ergonomically
demolition
6

Residual Risk Assessment


Conditions

Activity Type of Hazard Category of


Type of Risk
Hazards

Accidental

NR

19
Work
permit,
safety
PPEs
Work
permit,
safety
PPEs

Accidental

Injury

ID

NR

Moderate

LC

Awareness
training,
work
permit,
Safety
PPEs

Use of
Falls from
ladder
ladders and step
and step
ladder
ladders

Accidental

Injury

Moderate

LC

LC

HSE
inspection ,
safety belt

Objects dropped
from ladders

Accidental

Injury ,cuts

Moderate

LC

Safety
helmet and
safety shoe

Adverse
weather

High wind

Document code no.


Name of the Region :
Name of the Site :
Name of the Department :

MANGALORE
ESSEL WILLCON
HSE

Name of the document :Format # 02 - For Initial


Occupational Health & Safety Review (IOHSR)
Hazard Identification
S
No

1
9

2
3
Use of
mobile Fall of person or
elevating material from
work
platform
platforms

Page no.
OF

12

Residual Risk Assessment


Conditions

Activity Type of Hazard Category of


Type of Risk
Hazards

Hierarchy of Controls

Risk Priority Number

D/I

R/NR

Likeliho
od
(L)

Severity
(S)

Total =
LxS

Risk
Prioritization

Is Risk level
acceptable
(Yes/No)
(*)

Input for
Controls
(LC/DC/CC)

EC

AC

Control
PPE Measures

10

11

12

13

14

15

16

17

18

Accidental

Injury ,Major
cuts

12

Substantial

LC

Overturning of
platforms

Accidental

Injury , cuts

12

Substantial

LC

Unintentional
lowering of
platform

Accidental

Injury

Moderate

LC

Striking against
overhead
obstructions

Accidental

Injury,
casualty

15

Substantial

LC

19
Work
permit,
safety belt,
safety shoe
& helmet
Safety
stopper,
work
permit,
testing
certificates,
safety
PPEs
Safety
stopper,
work
permit,
testing
certificates,
safety
PPEs
Work
permit,
HSE
inspection,
safety
PPEs

Document code no.


Name of the Region :
Name of the Site :
Name of the Department :

MANGALORE
ESSEL WILLCON
HSE

Name of the document :Format # 02 - For Initial


Occupational Health & Safety Review (IOHSR)
Hazard Identification
S
No

10

Use of
mobile
tower

Page no.
OF

12

10

Residual Risk Assessment


Conditions

Activity Type of Hazard Category of


Type of Risk
Hazards

Hierarchy of Controls

Risk Priority Number

D/I

R/NR

Likeliho
od
(L)

Severity
(S)

Total =
LxS

Risk
Prioritization

Is Risk level
acceptable
(Yes/No)
(*)

10

11

12

Input for
Controls
(LC/DC/CC)

EC

AC

13

14

15

16

17

Control
PPE Measures

18

19
Work
permit,
safety belt

Fall of a person
or material

Accidental

Injury

Moderate

LC

Collapse of
tower

Accidental

Injury, major
cuts,
casualty

15

Substantial

LC

Overturning of
tower

Accidental

Injury , cuts

12

Substantial

LC

Physical injury

Accidental

Injury, cuts

Moderate

--

Note * Acceptable: - If Risk Assessed is Moderate or less (Refer A5)


Number of Low Risks
Number of Medium Risks
Number of High Risks (Potential Emergencies )
A.3

DETERMINING RISK LIKELIHOOD GUIDANCE CRITERIA

HSE
inspection ,
safety
PPEs
HSE
inspection ,
safety
PPEs,
Guide
ropes for
tower
Work
permit,
Safety
PPEs

Document code no.


Name of the Region :
Name of the Site :
Name of the Department :

MANGALORE
ESSEL WILLCON
HSE

Name of the document :Format # 02 - For Initial


Occupational Health & Safety Review (IOHSR)

Page no.
OF

12

11

Likelihood

Weightage

Criteria

Highly Unlikely

It is un heard in the industry

Unlikely

It has rarely occurred in other construction companies

Likely

It has occurred in other construction company

Very Likely

It has occurred in other project sites of the company

Certain

5
It has occurred several times at the site location in a year
DETERMINING RISK SEVERITY LEVEL GUIDANCE CRITERIA

A.4
Level of Harm

Weightage

Human / Community

Insignificant
Slightly Harmful

Momentary Discomfort / inconvenience


Minor injuries (Non reportable) requires first-aid

Harmful

Very harmful

Extremely Harmful

Asset (Infrastructure/Equipment/
Machinery) Damage
No action required
Minor damage

Injuries, absence from the work less or equal to 48


Moderate damage
hrs / temporary disability
Major injuries, absence from the work more than 48
Major damages
hrs / temporary disability
Fatal / Permanent Disability / Chronic diseases. Severe damages/complete destruction
Major incidents involving large number of people
A.5
RISK PRIORITIZATION INDICATORS

Level Of Concerns
Individual
Local or Community
Government Authorities
Industry/Competitor
Global /International

Severity
Likelihood

Insignificant (1)

SLIGHTLY HARMFUL (2)

HARMFUL
(3)

VERY HARMFUL
(4)

EXTREMELY HARMFUL
(5)

HIGHLY UNLIKELY
(1)

TRIVIAL
(1)

TRIVIAL
(2)

TOLERABLE
(3)

TOLERABLE
(4)

MODERATE
(5)

UNLIKELY (2)

TRIVIAL
(2)

TOLERABLE
(4)

MODERATE
(6)

MODERATE
(8)

SUBSTANTIAL
(10)

LIKELY
(3)

TOLERABLE
(3)

MODERATE
(6)

MODERATE
(9)

SUBSTANTIAL
(12)

SUBSTANTIAL (15)

Document code no.


Name of the Region :
Name of the Site :
Name of the Department :

MANGALORE
ESSEL WILLCON
HSE

Name of the document :Format # 02 - For Initial


Occupational Health & Safety Review (IOHSR)

Page no.
OF

12

12

VERY LIKELY
(4)

TOLERABLE
(4)

MODERATE
(8)

SUBSTANTIAL
(12)

SUBSTANTIAL (16)

INTOLERABLE
(20)

CERTAIN (5)

MODERATE
(5)

SUBSTANTIAL (10)

SUBSTANTIAL
(15)

INTOLERABLE
(20)

INTOLERABLE
(25)

A.6
RISK LEVEL

DEFINITION OF LEVEL OF RISKS


ACTION AND TIME SCALE

CATEGORY
Acceptable (Low Risk)

TRIVIAL
TOLERABLE
MODERATE

Continue with the current activity. Monitoring is required to ensure that the controls are effectively maintained.

SUBSTANTIAL

Urgent action is required including engineering / operational controls / administrative controls / PPE / Signages / Training / Behavioral
monitoring

INTOLERABLE

Immediate action should be taken. Work should not be started or continued unitl the impact / risk has been reduced.

* All Intolerable Risks shall be considered as Potential Emergencies and Immediate Action shall be Planned/Taken to Reduce the Risk Levels.

PREPARED By

APPROVED BY

NISANTH.THULASIDAS.MADHAVAN

JOHN VICTOR

Not Acceptable (Medium Risk)

Not Acceptable (High Risk)

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