Job Safety Analysis (JSA)

Ref: Version:
Organisation Details
Business details

Business name:

ABN: Contact person:

Address: Contact position:

Contact email
Contact phone number
address:

Job Safety Analysis details

Work activity: Location:

Who are involved in the This job analysis has been authorised by:
activity:
Name: ...................................................................................................................
Plant and equipment used:
Position:................................................................................................................
Maintenance checks required:
Signature: .............................................................................................................
Tools used:
Date: .....................................................................................................................

Materials used:

Personal protective
equipment:

Certificates, permits
and/approvals required

Relevant legislation, codes,

standard MSDSs etc
applicable to this activity

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Risk assessment
**Use the risk rating table to assess the level of risk for each job step.

Likelihood
1 2 3 4 5
Rare Unlikely Moderate Likely Almost Certain
Consequence The event may occur in The event could occur The event should occur The event will probably occur The event is expected to
exceptional circumstances sometimes sometimes in most circumstances occur in most circumstances
1 Insignificant
No injuries or health LOW LOW LOW LOW MODERATE
issues
2 Minor
First aid treatment LOW LOW MODERATE MODERATE HIGH

3 Moderate
Medical treatment, LOW MODERATE HIGH HIGH CRITICAL
potential LTI
4 Major
Permanent disability or LOW MODERATE HIGH CRITICAL CATASTROPHIC
disease
5 Extreme
Death MODERATE HIGH CRITICAL CATASTROPHIC CATASTROPHIC

Risk rating:
Low risk: Acceptable risk and no further action required as long as risk has been minimised as possible. Risk needs to be reviewed periodically.
Moderate risk: Tolerable with further action required to minimise risk. Risk needs to be reviewed periodically.
High risk: Tolerable with further action required to minimise risk. Risk needs to be reviewed continuously.
Critical risk: Unacceptable risk and further action required immediately to minimise risk.
Catastrophic: Unacceptable risk and urgent action required to minimise risk.

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Risk controls
The hierarchy of control can be used as an effective tool to deal with health and safety issues at work. Use the type of control suggested as measures to deal
with the hazard. Aim to use control measures from as high on the hierarchy of control list as possible. If that is not possible the next option down the list or a
combination of the measures should be implemented. The least effective control measure is the use of personal protective equipment (PPE) and it should be
used as a last resort or a support to other control measures. Information and training should be integrated with all levels of control to explain how controls
work.

1. Eliminate – if it is possible, the hazard should be removed completely.

For example, get rid of dangerous machines.

2. Substitute – replace something that produces the hazard with something

that does not produce a hazard. For example, replacing solvent based
paint with water based paint. Risk assessment on the substitution must be
conducted to ensure that it will not pose another hazard.

3. Engineering control – isolate a person from the hazard by creating

physical barrier or making changes to process, equipment or plant to
reduce the hazard. For example, install ventilation systems.

4. Administrative control – change the way a person works by establishing

policies and procedures to minimise the risks. For example, job
scheduling to limit exposure and posting hazard signs.

5. Use personal protective equipment (PPE) – protect a person from the

hazard by wearing PPE. For example, wearing gloves, safety glasses,
hard hats and high-visibility clothing. PPE must be correctly fitted, used
and maintained to provide protection.

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JSA – Action steps
Risk Name of persons responsible for
Step No Job step details Potential hazards How to control risks***
rating** work

Review number: Version:

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 Risk Name of persons responsible for
Step No Job step details Potential hazards How to control risks***
rating** work

Review number: Version:

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This job safety analysis has been developed through consultation with our employees and has been read, understood and signed by all employees undertaking the works:

Print Names: Signatures: Dates:

Review No 01 02 03 04 05 06 07 08 09

Initial:

Date:

A10592057

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