Transcription of Risk Assessment Form for Individual Computer Work Station
1 40 Guidance on the prevention and management of musculoskeletal disorders(MSDs) in the workplaceAppendix 6: Display Screen Equipment (DSE) Risk Assessment Worksheet (Blank)Name of the Employee DateEmployee Job Description (Key work Tasks)Name of the AssessorNoRisk Assessment Form for Individual Computer work StationAssessment (Tick as Appropriate ) and clearly formed (adequate size/spacing)YesNoSeparate base for screen or an adjustable table providedYesNoSpace in front of the keyboard YesNoScreen can swivel and tilt easily and freelyYesNoKeyboard tiltable and separate from the screenYesNoDocument holder stable, adjustable and positioned appropriatelyYesNoinstability, contrast and brightness adjustableYesNoKeyboard with matt surface.
2 Keyboard arrangements and characteristics of the keys suitable symbols on keys are legible and contrastedYesNoarrangementsYesGuidance on the prevention and management of musculoskeletal disorders(MSDs) in the workplace 41 Appendix 6: Display Screen Equipment (DSE) Risk Assessment Worksheet (Blank)Assessor s Signature DateFindings:Corrective Actions:Sign-off:Employee s Signature DateNo-fortable positionYesNoSeat back adjustable in both height and tiltYesNoSatisfactory lighting conditions/contrast between screen and back-ground/prevention of disturbing glare through correct position of light sourceYesNoSeat adjustable in heightYesNoWorkstation provides space for user to change position and vary movementsYesNoAdequate level of humidity/no excess heat at work stationYesNoWork chair stable and allows freedom of movementYesNoFootrest should be made available where requiredYesNoSources of light at workstation man-aged to
3 Reduce direct glare/distracting windowsYes
