1a. 1b 1c. 1d. 2a. 2b. 2c. 2d.

3a 3b 3c 3d 3e
S/N Work activity Hazard Possible Accident/ Ill
health to persons, fire or
property loss
Existing Risk
Control
Severity Likelihood RPN* Additional Risk
Control Measures
Severity Likelihood RPN* Follow up by (name) &
date
Hazard Identification Risk Evaluation Risk Control
*RPN - Risk Prioritization Number
RISK ASSESSMENT FORM
School / Department & Exact Location Of The Work Performed:

Project / Work Description:
Risk Assessment Team (Name/s): Approved By Supervisor / Reporting Officer:
(Name, Date & Signature)
Date Conducted: Next Review Date:
3f
Remarks
Risk Control
*RPN - Risk Prioritization Number
RISK ASSESSMENT FORM
Project / Work Description:
Approved By Supervisor / Reporting Officer:
(Name, Date & Signature)
Instructions for using the Risk Assessment form
Header
Column 1b
Column 1c
Column 1d
Column 2a
Fill up all sections in the header of the RA form. Note 1: Discuss
with your supervisor/reporting officer on the next review date for the RA. Normally the next review date is up to
one year ahead. The RA is also reviewed:
(1) When there are changes in work processes/activities (2) After any
accidents/incidents Note 2: Check your Division
rules about team or individual submission for RA
Describe the work activity to be carried out. Note: Please do
not fill in names of machines/equipment to be used. Therefore, a computer is not an
activity, but working on a computer is
Identify hazard(s) associated with the activity to be carried out. Examples of
hazards include chemical, biological, electrical, mechanical, physical, ergonomics, psychosocial, slip & fall etc.
Identify possible accidents/ill health associated with each identified hazard. Examples of
possible accidents/ill health include fires, explosions, cuts, burns, frost bites, fractures etc.
Indicate risk control measures that are already in place to eliminate or minimise risks. Methods to
control risks may be analysed according to the Hierarchy of Controls: Elimination, Substitution, Engineering Controls,
Administrative Controls and Personal Protective Equipment (PPE). Elimination of the hazard should take first
priority while PPE should be the last line of defence.
Elimination
Example: Use water based solvents instead of organic based solvents Substitution
Example: Use a less toxic solvent
Engineering Controls
Example: Use of fume cupboard or gloves boxes Administrative
Controls Example: Work
instructions. Good laboratory practices. Training on proper use of chemicals PPE
Example: Use of safety eyewear plus respiratory protection, use of gloves
Column 2b
Column 2c
Column 2d
Column 3a
Column 3b
Column 3c
Column 3d
Column 3e
Column 3f
S=Severity Severity is the degree
or extent of injury or harm caused by the hazards, or as a result of an accident. Choose the most likely severity
from a value between 1 and 5, rather than the most extreme. Refer to the Risk Matrix tab for the severity
table
Enter the name of the person appointed to oversee the implementation of the additional control measures. Enter the follow-
up date.
Enter any remarks
L=Likelihood Likelihood of occurance
of an accident, incident or ill health is defined as the probability that the said accident, incident or ill health will
happen. Choose the likelihood from a value between 1 and 5. Consider the records of such events happening in
the past when deciding on the likelihood. Refer to the Risk Matrix tab for the likelihood table
RPN=Risk Prioritisation Number RPN=Severity X
Likelihood All RPNs should not be more
than 6
Additional risk control measures are required when the RPN indicated in column 2d exceeds 6. If the RPN is 6 or
less, enter "NA" in the column
S=Severity S may reduce
upon introduction of additional control measures
L=Likelihood
L may reduce upon introduction of additional control measures
RPN=Risk Prioritisation Number
RPN will reduce upon introduction of additional control measures
Fill up all sections in the header of the RA form. Note 1: Discuss
with your supervisor/reporting officer on the next review date for the RA. Normally the next review date is up to
one year ahead. The RA is also reviewed:
(1) When there are changes in work processes/activities (2) After any
accidents/incidents Note 2: Check your Division
rules about team or individual submission for RA
Describe the work activity to be carried out. Note: Please do
not fill in names of machines/equipment to be used. Therefore, a computer is not an
activity, but working on a computer is
Identify hazard(s) associated with the activity to be carried out. Examples of
hazards include chemical, biological, electrical, mechanical, physical, ergonomics, psychosocial, slip & fall etc.
Identify possible accidents/ill health associated with each identified hazard. Examples of
possible accidents/ill health include fires, explosions, cuts, burns, frost bites, fractures etc.
Indicate risk control measures that are already in place to eliminate or minimise risks. Methods to
control risks may be analysed according to the Hierarchy of Controls: Elimination, Substitution, Engineering Controls,
Administrative Controls and Personal Protective Equipment (PPE). Elimination of the hazard should take first
priority while PPE should be the last line of defence.
Elimination
Example: Use water based solvents instead of organic based solvents Substitution
Example: Use a less toxic solvent
Engineering Controls
Example: Use of fume cupboard or gloves boxes Administrative
Controls Example: Work
instructions. Good laboratory practices. Training on proper use of chemicals PPE
Example: Use of safety eyewear plus respiratory protection, use of gloves
S=Severity Severity is the degree
or extent of injury or harm caused by the hazards, or as a result of an accident. Choose the most likely severity
from a value between 1 and 5, rather than the most extreme. Refer to the Risk Matrix tab for the severity
table
Enter the name of the person appointed to oversee the implementation of the additional control measures. Enter the follow-
up date.
Enter any remarks
L=Likelihood Likelihood of occurance
of an accident, incident or ill health is defined as the probability that the said accident, incident or ill health will
happen. Choose the likelihood from a value between 1 and 5. Consider the records of such events happening in
the past when deciding on the likelihood. Refer to the Risk Matrix tab for the likelihood table
RPN=Risk Prioritisation Number RPN=Severity X
Likelihood All RPNs should not be more
than 6
Additional risk control measures are required when the RPN indicated in column 2d exceeds 6. If the RPN is 6 or
less, enter "NA" in the column
S=Severity S may reduce
upon introduction of additional control measures
L=Likelihood
L may reduce upon introduction of additional control measures
RPN=Risk Prioritisation Number
RPN will reduce upon introduction of additional control measures
Risk Assessment Matrix
Risk Prioritisation Number = Severity x Likelihood
Severity Table
Pt Severity level Workplace Safety Workplace Health Environment Fire Damage Downtime Incurred
Fatality, single
or multiple
Acute Poisoning,
Failure of Major
Bodily Functions
Spills to Outside Campus
More Than $10
million damages
More than 1 year for full
re-instatement
Permanent Body
Injury or Loss of Use for
more than 30 days
Infection with No
Known Cure
Infection - outside
Campus area
Injury requiring 30 days
of hospitalisation
and/or medical leave
Moderate exposure,
Reversible injury to
Bodily Functions on
prolong recovery
Spills to Outside Building
More Than $1 million
damages
More than 3 months for
full re-instatement
Temporary Body Injury
or Loss of Use for more
than 10 days but not
exceeding 30 days
Infection with Known
Cure but extensive
treatment
Infection - outside
Building area but within
Campus
Injury requiring 10 days
of hospitalisation
and/or medical leave
Mild exposure,
Reversible injury to
Bodily Functions with
less than 30 days
recovery
Spills to Outside
Laboratory/Room
More Than $100k
damages
More than 1 month for
full re-instatement
Temporary Body
Injury or Loss of Use for
up to 10 days
Infection with Known
Cure but extensive
treatment
Infection - outside
Laboratory area but
within building
Injury requiring
maximum of 3 days of
medical leave only
Very Mild exposure,
Reversible injury to
Bodily Functions with
less than 3 days
recovery
Spills to Outside
Workplace but within
laboratory
More Than $10k
damages
More than 5 days for
full re-instatement
Temporary Body
Injury or Loss of Use for
3 days or less
Infection with Known
Cure but treatment
needed
Infection - outside
workplace but within
Laboratory
First aid treatment only
Very Mild exposure,
Reversible injury to
Bodily Functions with
less than 3 days
recovery
Spills within Workplace
only
Less than $5k
damages
No significant downtime
No or superficial injury No Exposure
No Infection or infection
with no effects within
workplace
Likelihood Table
Pt Likelihood level
5
Frequent
4
Moderate
3
Occasional
2
Remote
1
Unlikely
Likelihood of Occurrence / Exposure Criteria
Likely to occur many times per year
5 Critical
4 Very Serious
3 Serious
Might occur once in five years
Might occur once in ten years
2 Marginal
1 Negligible
Likely to occur once per year
Might occur once in three years
Risk level Determination - 5 x 5 Matrix
Critical
(5)
Very Serious
(4)
Serious
(3)
Marginal
(2)
Negligible
(1)
Frequent
(5)
25
Operation not
permissible
20
Operation not
permissible
15
High priority
10
Review at
appropriate time
5
Risk acceptable
Moderate
(4)
20
Operation not
permissible
16
Operation not
permissible
12
High priority
8
Review at
appropriate time
4
Risk acceptable
Occasional
(3)
15
High priority
12
High priority
9
Review at appropriate
time
6
Risk acceptable
3
Risk acceptable
Remote
(2)
10
Review at appropriate
time
8
Review at
appropriate time
6
Risk acceptable
4
Risk acceptable
2
Risk acceptable
Unlikely
(1)
5
Risk acceptable
4
Risk acceptable
3
Risk acceptable
2
Risk acceptable
1
Risk acceptable
Action Table
Colour Score Risks
16 - 25 High
12 - 15 Warning
8 -10 Medium
Operation not Permissible
Stop operation & review controls. If necessary abort
experimentation.
High priority remedial action
Proceed with extreme caution with PI present at all times.
Implement additional (secondary) controls immediately. Review
within 7 days. Emergency control measures shall be in place.
SEVERITY
L
I
K
E
L
I
H
O
O
D
Take remedial action at appropriate time
Proceed with care. Additional control is advised. Review shall be
implemented within 30 days.
Action
Review the risk assessment records every year or whenever there are changes in processes, work activities or upon
any incident occurrence, whichever is earlier.
1 - 6 Warning
Risk acceptable: Residual risk
If possible, risk reduction should be further considered, particularly
severity.
There are no imminent dangers. Frequent review shall be in place
especially changes in procedures, materials or environment.
1a. 1b 1c. 1d. 2a. 2b. 2c. 2d. 3a 3b 3c 3d
S/N Work activity Hazard Possible Accident/ Ill
health to persons, fire or
property loss
Existing Risk
Control
Severity Likelihood RPN* Additional Risk
Control Measures
Severity Likelihood RPN*
Physical Hazard Severe Eye Injuries Beam blocks and
beam dumps used
to blocked off
laser beams.
Only authorised
users are allowed
to operate the
system.
Users are
equipped with
laser goggles
3 2 6 NA NA NA NA
Electrical Hazard Electrocution due to high
voltage
Warning signs are
displayed beside
system to warn
users of high
voltage
4 3 12 Regular servicing
and maintenance
of laser system by
vendor
Only authorised
users are allow to
operate the
system
4 1 4
Operation of Femtosecond Laser
Systems
1
RISK ASSESSMENT FORM
School / Department & Exact Location Of The Work Performed:
(Example: SPMS -PAP - Lab A)

Project / Work Description: Working with Femtosecond Laser Systems
Risk Assessment Team (Name/s): Johnny (Team Leader), Alice, Roland, Kenny Approved By Supervisor / Reporting Officer:
(Name, Date & Signature)
Prof Tan (Project Supervisor), 16th March 2012
Date Conducted: 11th March 2012 Next Review Date: 10th March 2013
Hazard Identification Risk Evaluation Risk Control
*RPN - Risk Prioritization Number
3e 3f
Follow up by (name) &
date
Remarks
NA
NA
(Johnny) 13th March 2012
NA
RISK ASSESSMENT FORM
Project / Work Description: Working with Femtosecond Laser Systems
Approved By Supervisor / Reporting Officer:
(Name, Date & Signature)
Prof Tan (Project Supervisor), 16th March 2012
Risk Control
*RPN - Risk Prioritization Number
1a. 1b 1c. 1d. 2a. 2b.
S/N Work activity Hazard Possible Accident/ Ill
health to persons, fire or
property loss
Existing Risk
Control
Severity
1 Weighing chemicals for the synthesis
work
Irritant Chemicals Irritation when come in
contact with skin and
eyes
Handle under
fumehood.
Put on required
PPE - safety
glasses, lab coat,
long pants, gloves,
covered shoes.
1
2 Prepare glassware and add
chemical into chemical reactor
Glass breakage due
to overpressure
(chemical reaction)
Cuts on skin/eye due to
flying particles
Inspect glassware
before use.
Put on required
PPE - safety
glasses, lab coat,
long pants, gloves,
covered shoes.
3
Hazard Identification Risk Evaluation
RISK ASSESSMENT FORM
School / Department & Exact Location Of The Work Performed:
(Example: SPMS -CBC - Lab K)

Risk Assessment Team (Name/s): Benny
Date Conducted: 11th March 2012 Next Review Date: 10th March 2013
*RPN - Risk Prioritization Number
2c. 2d. 3a 3b 3c 3d 3e 3f
Likelihood RPN* Additional Risk
Control Measures
Severity Likelihood RPN* Follow up by (name) &
date
Remarks
3 3 NA NA NA NA NA
NA
3 9 Install pressure
control / relief
valves
Supervisor to brief
group to pull
down fumehood
sash
3 1 3 (Benny) Ongoing
NA
Risk Evaluation Risk Control
RISK ASSESSMENT FORM
Project / Work Description: Chemical works
Approved By Supervisor / Reporting Officer:
(Name, Date & Signature)
Prof Xiao (Project Supervisor), 16th March 2012
*RPN - Risk Prioritization Number
1a. 1b 1c. 1d. 2a. 2b.
S/N Work activity Hazard Possible Accident/ Ill
health to persons, fire or
property loss
Existing Risk
Control
Severity
1 Sorting of documents / Use of paper Contact with sharp
edges (from paper
edges and bent
plaster dividers
Cuts and lacerations to
hand and fingers
Handle files and
documents with
care, avoiding
fingers running
along the edge of
papers.
Discard bend
plastic folders.
1
Strike by moving
parts or caught
between moving
parts
Fingers may get injured
(crush) during punching
Proper usage of
hole punch
Do not overload
paper for
punching
Maintenance of
hole puncher
1
RISK ASSESSMENT FORM
School / Department & Exact Location Of The Work Performed:
(Example: Office)

Risk Assessment Team (Name/s): Joey
Date Conducted: 11th March 2012 Next Review Date: 10th March 2013
Punching holes for document to
be filed
Hazard Identification Risk Evaluation
Ergonomic hazard
(repetive similar
action)
Muscular starins Staff to adopt
good ergonomice
practice e.g. table
height. Job
rotations; avoid
prolong repetitive
punching
operation.
Brief staff on
proper usage of
hole punch.
3
*RPN - Risk Prioritization Number
Punching holes for document to
be filed
2c. 2d. 3a 3b 3c 3d 3e 3f
Likelihood RPN* Additional Risk
Control Measures
Severity Likelihood RPN* Follow up by (name) &
date
Remarks
4 4 Provide finger cots
to staff to lift
paper
1 3 3 Office Staff (April 2012)
NA
3 3 NA NA NA NA NA
NA
RISK ASSESSMENT FORM
Project / Work Description: General Office Activities
Approved By Supervisor / Reporting Officer:
(Name, Date & Signature)
Mr Lim (Manager), 16th March 2012
Risk Evaluation Risk Control
1 3 NA NA NA NA NA
NA
*RPN - Risk Prioritization Number