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16 views6 pagesWorkplace Risk Assessment Questionnaire
The document is a workplace risk assessment questionnaire designed to identify various factors affecting employee safety and comfort in the work environment. It covers aspects such as workplace design, environmental conditions, equipment safety, and psychosocial factors, with sections for respondents to indicate their experiences and observations. The survey aims to gather confidential feedback to implement preventive measures and improve working conditions.
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0% found this document useful (0 votes)
16 views6 pagesWorkplace Risk Assessment Questionnaire
The document is a workplace risk assessment questionnaire designed to identify various factors affecting employee safety and comfort in the work environment. It covers aspects such as workplace design, environmental conditions, equipment safety, and psychosocial factors, with sections for respondents to indicate their experiences and observations. The survey aims to gather confidential feedback to implement preventive measures and improve working conditions.
Translated by
ScribdTranslationsCopyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
Workplace design YES NO N/A OBSERVATIONS
1 Height of the work surface (table,
inadequate for the type of task or
for the dimensions of the worker
2 Workspace (on the surface, below
of her or in the environment) insufficient or
inadequate
3 The design of the position makes it difficult to maintain a posture of
comfortable work
4 The controls and the indicators associated with it
work (controls of the equipment, control panels
instrumentation, etc.) are visualized with
difficulty
5 Work in isolation or
confinement (even if it is sporadic)
6 Work areas and difficult passage places
due to excessive objects
7 Lack of dressing rooms (if needed)
QUESTIONNAIRE FOR THE IDENTIFICATION OF FACTORS OF
RISK IN THE WORKPLACE
The content of this survey is confidential and will be handled
exclusively appropriate personnel, so anonymity is
guaranteed. Your collaboration, which we appreciate, will help us to
implement the preventive measures that can guarantee a
adequate working conditions in our work environment.
ORGANIZATION
…………………………………………………………………...................
PERSONAL DATA: MAN WOMAN
Between 18 and 35 years old Between 35-50 years old More than 50
years
DATOS PROFESIONALES:
Permanent staff or fixed-term employee
Temporary personnel, hired for a specific task or service
Date of completion of the present
questionnaire
The questions that follow refer to your job position.
•Marque la respuesta que considere correcta: SI, NO, N/S, (no sabe), N/P,(no procede)
The column on the right is for making the relevant remarks, if applicable.
Environmental conditions YES NO N/A
8 Inadequate temperature due to the existence
from sources of much heat or cold or to the
non-existence of an air conditioning system
appropriate
9 Inadequate ambient humidity (environment)
dry or too humid
10 Drafts that cause discomfort
11 Annoying ambient noises or that provoke
difficulty in concentration for the
execution of the work
12 Insufficient lighting at your workstation
the work environment
13 There are annoying reflections or glare.
in the workplace or its environment
14 Experiences frequent discomfort in the eyes.
15 Frequent complaints attributable to the quality of
indoor environment (stale air, bad
odors, suspended dust, products of
cleaning, etc.)
16 Problemas atribuibles a la luz solar
(dazzlings, reflections, excessive heat,
etc.)
Work teams YES NO NOT APPLICABLE
17 Work teams or tools are managed
dangerous, defective or in poor condition
18 Lacks work instructions, in language
understandable for the workers in relation
to the use of the equipment or tools
19 The maintenance of the equipment or
tools are nonexistent or inadequate
Fires and explosions YES NO N/A
20 Products are stored or manipulated
flammable or explosive
21 Fire fighting elements (fire extinguishers,
hoses, blankets, ...) insufficient, distant or
in bad condition
22 Unawareness of how to use the elements
of fighting against fire
Pollutants (chemical, physical - YES NO N/A
ionizing and non-ionizing radiation - and
biological) and laboratory working conditions
23 Little information about the risk of the agents
chemicals, physical or biological that it uses (missing
of initial information, non-existence of files of
security, etc.)
24 Non-existence, insufficiency or little habit of
I work in showcases / security booths
suitable
25 Hazardous products improperly
labeled / identified
26 Lack of work procedures in the
that security measures are included in the
I work with this type of agents
27 Non-existence, insufficiency or little habit of
I work with personal protective equipment
(gloves, glasses, respiratory protection, etc.)
28 Habits of using gowns and clothing
incorrect jobs (do not use it in the laboratory
or use it in other areas: office,
dining room, auditorium, etc., take it
unbuttoned, wash it at home, etc.)
29 Non-existence of suitable containers and
correctly marked for waste
30 Eat, smoke, drink, or use cosmetics in.
the laboratories or similar rooms (storage
of chemical products, animal facilities,
greenhouses, etc.)
Jobs with data display screens YES NO N/A
31 Poorly positioned screen and no possibility of
relocation
32 Non-existence of support for the forearm
while using the keyboard
33 Using the mouse is uncomfortable.
The chair is uncomfortable or without device
34 regulation
35 Insufficient space on the table to distribute
the necessary equipment (computer, documents,
printer, keyboard, phone, etc.
36 Insufficient free space under the table for
a comfortable position of the legs
37 Non-existence of a podium and/or footrest in case
if you need any of these accessories
38 Frequent discomfort in vision,
back, wrists, etc.
Physical load and manual handling of loads YES NO N/A
39 Usually handles heavy loads,
large, bulky, difficult to hold or in
unstable equilibrium
40 Make important, sudden physical efforts,
in unstable position (distance, torsion or
trunk inclination
41 The space where this effort takes place is
insufficient, irregular, slippery, uneven, to
an incorrect height or in conditions
inadequate environmental or lighting conditions
42 His activity requires frequent physical effort.
prolonged, with insufficient period of
recovery or at an imposed pace that does not
can modular
43 At the end of the day, one feels 'especially'.
tired
Other ergonomic factors YES NO N/A
44 Forced work postures
habitual or prolonged
45 Repetitive movements of arms / hands /
dolls (pipette,...)
46 Prolonged standing postures
474 Sedentary work
8 Other habitual inappropriate postures
(on knees, squatting, ...)
49 Tasks with high visual demands or of great
meticulousness
50 I work shifts (night or rotating)
Psychosocial factors YES NO N/P
51 His work is based on treatment of
information (administrative jobs, control of
automated processes, computing, etc.
52 The level of attention required for execution
your homework is high
53 His/her work is monotonous and/or lacks content.
54 Performs very repetitive tasks
55 The errors, breakdowns or other incidents that
they can report to their workplace
and frequently and/or may have
severe consequences
56 The rhythm or cadence of his work comes to him
tax
57 The breaks from your work come to you
taxes
58 The information provided to you about your
functions, responsibilities, competencies
working methods, etc. is insufficient
59 It is difficult to do your job due to not having
sufficient resources, based on instructions
incompatible or with which they do not agree
60 His/her employment situation is unstable
61 Lacks opportunities for initial training,
continues or not in accordance with the tasks it performs
62 He/She has difficulty promoting in his/her field of
work
63 The organization of working time
(schedules, shifts, vacations, etc.) causes him/her
discomfort
64 The relationships between colleagues and/or bosses are
unsatisfactory
65 Lacks autonomy to perform their work.
66 Do you feel satisfied with the work you do?
underrated
67 How do you feel about yourself and the work you do?
underrated
68 Situations arise that involve
psychological or physical violence for any reason
Special sensitivities YES NO NOT APPLICABLE
Your physical or biological state (pregnancy, allergy,
minusvalía, enfermedad, patología previa, aptitud
physics, etc.) has problems with the
job conditions
Deficiencies in preventive activity YES NO N/A
70 You have received information about the risks
work-related exposures
71 You can access the training courses at
Occupational Risk Prevention offered by
company
72 Consider this adequate and sufficient.
training
Consider that in your Center / Institute there is
consider their suggestions for improvement of the
73
working conditions
74 Has knowledge of first aid
related to your job position
75 Does your center have a Prevention Delegate?
Institute
76 Learn how prevention is organized.
at OLEOFINOS S.A. INDUSTRIALIZER
S.A. de C.V.
77 Learn how prevention is organized.
in its Center / Institute
78 Prevention regulations are included
risks in the instructions you receive for
develop your work
79 It has been implemented in your Center or Institute the
mandatory Emergency Plan is carried out
periodic drills
80 Studies are being conducted for the surveillance of the
health (specific medical recognitions
initials, periodicals or others