Health, Safety and Wellbeing Handbook

HIGHER DEGREE BY RESEARCH : SAFETY MANAGEMENT PLAN

TO BE COMPLETED BY THE STUDENT & SUPERVISOR IN CONSULTATION
NOTE: ONLY THE FIRST PAGE MUST BE COMPLETED AND SUBMITTED TO THE ADELAIDE GRADUATE CENTRE
If further information related to the Hazard ID Form is required please consult with your local Health and Safety Officer or Manager, HSW
Student Name
Student Number
School
Contact details

Date
Supervisor
Room No
Mobile/Phone

HAZARD IDENTIFICATION FORM

(In discussion with your supervisor identify any foreseeable hazards associated with your project by ticking the appropriate boxes.
Hazards identified will need to be addressed on the Hazard Management Log - see page 2)
Physical/Environmental Hazards

Plant and Equipment

Noise > 85dB(A)

Temperature or weather extremes (e.g. heat, cold, wind, rain)

Radiation

Working on a slippery or uneven surfaces

Hit by flying, moving or falling object (including vehicles)

Fire hazard/naked flame other than controlled lab work

Biological

Remote areas/isolated locations

Confined space (e.g. pit, tank, silo, entry through a hatch)
Fall from a height (e.g. ladder, elevated platform, cliff)

Poor lighting/visibility

Vibrating objects or surface

First Aid/Evacuation

Additional first aid requirements due to the nature of the research

(e.g. field work or specific hazards)

A rescue effort would be difficult in the event of an emergency

(e.g. remote areas, difficult to access to work site)

Communications

Potential for communication problems (e.g. by virtue of location)

Research may disrupt/impact on adjacent areas of the University

Electrical

Electrical risk from portable electrical appliances or tools

Water and electricity in close proximity to each other

Ergonomics/Manual Handling

Working for long periods in a sustained awkward posture

Required to lift, push or pull heavy objects

Stress/Duress

Mobile plant will be introduced (e.g. forklift, mobile platform)

Scaffolding, raised platforms or ladders
Pressurised vessels/systems (e.g. autoclave, boiler)
Hazardous plant (e.g. lathes, lasers, microtomes, cryostats, etc)

Sealed sources
Unsealed sources
Other (e.g. UV)

Contamination (i.e. virus, bacteria, disease)

Human or animal body fluids/tissue

Animals (including fish, birds or insects that may introduce a

hazard e.g. handling, bite, sting, venom)
Needlestick\matrix bands
Surgical instruments
AQIS/OGTR

Chemical

Explosive substances
Flammable gas
Toxic or asphyxiant gas (e.g. CO2 including dry ice, liquid N2,)
Highly flammable liquid (Packing Group1)
Respiratory irritants (e.g. nanotech, asbestos, dust)
Chemical spraying (e.g. agricultural, pest )
Hazardous substances (not included above)

Personal security (e.g. physical harm by others)

Other

Stressful situations

________________________________________________

________________________________________________

Working alone\home visits

Working hours (e.g. long shifts required)

HSW Handbook
Authorised by
Warning

HDR Safety Management Plan Template

Effective Date:
11 February 2010
Vice Chancellor and President
Review Date:
February 2013
This process is uncontrolled when printed. The current version of this document is available on the HSW Website.

Version 1.1
Page 1 of 3

No hazards identified with this research

HSW Handbook
Authorised by
Warning

Students signature

__________________________

Supervisors signature

__________________________

HDR Safety Management Plan Template

Effective Date:
11 February 2010
Vice Chancellor and President
Review Date:
February 2013
This process is uncontrolled when printed. The current version of this document is available on the HSW Website.

Version 1.1
Page 2 of 3

HAZARD MANAGEMENT LOG - To be completed by Student & Supervisor in consultation prior to commencement of the activity involving the specific hazard
Only the hazard identification process page 1 is required for completion of the core structure program, this section should be kept and maintained by the student and supervisor over the course of the
research project and reviewed at regular intervals. (The document should be kept in such a way that it can be found for safety audits as may be required from time to time).
Page No

Should you require additional pages please re-print this page and attach to the checklist.
Should you require any further information in relation to the risk assessments please discuss with your supervisor.

Date hazard
Identified

HSW Handbook
Authorised by
Warning

Description of the
Hazard.

When and/or where is the

hazard likely to occur?

(as identified on
page 1 or during
progress of the project)

(Activity or period when

you or others may be
exposed to this hazard)

Risk assessment ref.

(insert RMSS ref no
or attach a copy of the
assessment if a paper
version as a record)

HDR Safety Management Plan Template

Effective Date:
11 February 2010
Vice Chancellor and President
Review Date:
February 2013
This process is uncontrolled when printed. The current version of this document is available on the HSW Website.

Date that the

assessment
completed or
reference noted

Version 1.1
Page 3 of 3

Signature of Student

Comments if activity has

not been risk assessed
or if activity has been
removed from the project

Supervisors
initials