Method of Use

1. Select the appropriate point on the PROABILITY

2. Draw a line from the point on the PROABILITY scale to the
Risk Assessment Worksheet point of EXPOSURE
3. Extend the line to the TIE
4. Draw a line from the intersection of the TIE LINE to the
Site : ………………………………………
appropriate on the POSSIBLE CONSEQUENCES
5. Extend the line to the RISK SCORE
Identify the hazard Assessed by
…………………………………. ………………………………………………………………
…………………………………. ……………………………………………………………….
Occupations & Tasks at Risk ……………………………………………………………….
…………………………………. ……………………………………………………………… RISK CONTROL CHART (hierarchy of control)
…………………………………. Duration of Exposure …………………………………….
Number of People at Risk Frequency of Exposure ………………………………… Control Categories Control Measures

…………………………………. Date ………………………………………………………. Design allows hazards to be designed out,

and control measures to be
designed in
Tie Line
Probability Exposure Possible Consequences Risk Score
Almost Certain Numerous Very High Substitution replacing the material or
Very Rare fatalities Catastrophe Risk process to reduce or eliminate risk
Very Likely
Rare Multiple High Risk Redesign redesigning equipment or work
Unusual Infrequent fatalities Disaster Substantial processes to reduce or eliminate risk
but possible Risk
Occasional Fatality Very Serious Separation isolating the hazard from
Remotely Frequent Serious Moderate persons by enclosing or guarding
possible injury Serious Risk
Continuous Casualty Administration adjusting the time or
Conceivable but treatment Important Risk conditions of risk exposure eg job rotation
very unlikely perhaps
Practicably First Aid Noticeable acceptable
Impossible treatment Personal Protective Equipment
Using appropriately designed &
appropriately fitting equipment where other
controls are not practicable
PROBABILITY EXPOSURE POSSIBLE COINCIDENCE RISK SCORE
Almost Certain Most likely result Very Rare Once per year or less Catastrophe $50,000,00 Very High Risk Consider discontinuing activity
Very Likely 50/50 chance Rare A few times a year Disaster $5,000,000 High Risk Immediate action required
Unusual but possible Coincidence Infrequent Once per month or less Very Serious $500,000 Substantial Risk Correction required
Remotely possible Remote coincidence Occasional Once per week or less Serious $50,000 Moderate Risk Need for attention required
Conceivable but unlikely Has never happened but Frequent Daily Important $5,000 Risk perhaps Improve if possible and
conceivably possible Possible practicable
Practicably Impossible Has never happened Continuous All the time Noticeable $500

AFP (M) Form OHSA 017