Job Safety Analysis (JSA)

JSA Details

Work activity: Location & Date:

Who are involved in the This JSA has been authorised by:
activity:
Name:...................................................................................................................
Plant and equipment to be used:
Position:................................................................................................................
Maintenance checks required
(e.g. testing and tagging of Signature:.............................................................................................................
electrical equipment, prestart
checks of vehicles etc.):
Date:.....................................................................................................................

Tools to be used:

Materials to be used:

Personal protective
equipment:

Certificates, permits
(e.g. hot works,
confined space, crane
lift, isolation etc.)
and/approvals required

Relevant legislation, codes,

standard SDSs etc.
applicable to this activity

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 Health and Safety Risk Matrix
Determine the Risk Rating (Level of Risk)
For each Consequence Category selected, determine the Risk Rating (Level of Risk) from the relevant Consequence and Likelihood Levels.
Risk Rating (Level of Risk) = Consequence x Likelihood.
Select the Likelihood. Select the appropriate Likelihood or Frequency rating of the Risk Event occurring for the selected Consequence level, given the controls are in place.
Select the Consequence. For the given Risk Event select the relevant Consequence categories and apply a rating. The ratings are determined with the existing controls in place.
Where there are multiple ratings for a risk, the highest combination of Consequence/Likelihood is taken as the final risk rating (do not average out the ratings).
Note: There are 3 types of risk ratings:
Inherent - no controls in place or total control failure; Current - with existing controls in place; Residual - with proposed treatment action plans (TAPs) in place.
Curtin requires the Current risk rating (as a minimum).
LIKELIHOOD DESCRIPTION
The event may occur Not expected but the The event could occur The event will probably The event is expected to
LIKELIHOOD only in exceptional event may occur at at some time. occur in most occur or has occurred
circumstances. some time. circumstances. and is continuing to
impact.
Less than once in 10 At least once between At least once between Once per year. More than once per year.
FREQUENCY years. 5 and 10 years. 1 and 5 years.

PROBABILITY <10% 10% - <35% 35% - <65% 65% - <90% >90%

IMPACTS Likelihood Level

CONSEQUENCE DESCRIPTION

Consequence Level
Environment Rare Unlikely Possible Likely Almost Certain
Health and Safety

Permanent environmental damage to an extensive area Fatality

outside of campus; Sole contributor responsible for
direct GHG emissions AND majority of current practice Permanent Total Disability Critical Extreme
does not meet good practice standards.

Long term environmental damage extending to a large Significant/extensive injury or

area requiring high level of intervention; Significant illness.
contributor responsible for direct GHG emissions AND
Major High
majority of current practice does not meet good Permanent Partial Disability
practice standards.

Short term environmental damage requiring some Serious injury or illness. Lost
intervention; Partial contributor responsible for
direct GHG emissions AND majority of current time injury >10 days Medium
Moderate
practice does not meet good practice standards.

Short term environmental damage affecting a small Injury or illness requiring

area, easily remediated; Partial contributor medical treatment
responsible for indirect GHG emissions AND Minor Low
majority of current practice does not meet good Lost time injury <10 days
practice standards.

Minimal environmental damage affecting a very Injury or illness requiring First

small area, immediately remediated. Aid treatment
Insignificant
No lost time injury days

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 JSA – Action steps

Risk Level Name of person(s) responsible

Step Job step details (list the steps Potential hazards (Consequence x
How to control risks
No involved in the job) for implementing controls
Likelihood)

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 This job safety analysis has been developed through consultation with our employees and has been read, understood and signed by all employees undertaking the works:

Print Names: Signatures: Position: Dates:

Review No 01 02 03 04 05 06 07 08 09

Initial:

Date:

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