Ergonomics Checklist Industrial
Ergonomics Checklist Industrial
Supervisors and workers are to use this checklist to identify risk factors for work activities with ergonomic concerns and risk-reduction solutions (see
Ergonomics: Ergonomic Evaluation Procedures [SLAC-I-730-0A21S-059]). Analyze the task and mark the check boxes for any risk factors. List the
ergonomic control measures that mitigate the identified risk factors. Contact the ergonomics specialist at ext. 4588 for additional assistance. There
are no recordkeeping requirements for this checklist.
Task
Location Department
Evaluated by Date
1. Lifting
Risk Control Measures
Risk (e.g., mechanical assists, making load smaller, additional
Factor help, lifting technique, postural awareness, microbreaks,
Risk Factor Observed work rotation)
Frequent lifts
Low-frequency: < 2 hours/day or > 2
hours/day with < 12 lifts/hour
Moderate-frequency: > 2 hours/day and <
30 lifts/hour
High-frequency: > 2 hours/day and < 360
lifts/hour
Note: if one or more items are checked, efforts should be made to minimize one or more of the following: load weight, load distance, and lifting
frequency. For recommended weight limits, refer to the Oregon Safe Lifting Calculator (http://www.orosha.org/interactive/lifting/lift_safety.html).
2. Awkward Postures
Risk Control Measures
(e.g., mechanical assists, adjustable workstations, tools
Check if with alternate handles, stands, larger grips, postural
Risk Factor Observed awareness, microbreaks)
References
Based on Stanford University, Department of Environmental Health and Safety, Industrial Ergonomics Screening Tool (OHS 14-026)
American Conference of Governmental Industrial Hygienists, Threshold Limit Values for Lifting, in Threshold Limit Values (TLVs) and Biological
Exposure Indices (BEIs)-2005 (ACGIH TLVs and BEIs-2005)
Washington State Department of Labor and Industries, Caution Zone Checklist and Hazard Zone Checklist (available from Evaluation
Tools, http://www.lni.wa.gov/Safety/Topics/Ergonomics/ServicesResources/Tools/default.asp)
Oregon Occupational Safety and Health Division, Safe Lifting Calculator (http://www.orosha.org/interactive/lifting/lift_safety.html)