Risk Identification Checklist

According to the current Victorian regulations, the existence of any ONE of the following key risk factors indicates that the workplace being assessed must undergo a full noise assessment to determine the potential noise hazards, as per regulation 11 (1) (b), part 4 of the Victorian Code of Practice - Occupational Health & Safety Regulations (Noise) 1992.

Read through the following questions & tick the box if your answer is YES. Then if you answered YES to any question fill out your details below & submit. One of our consultants will contact you to discuss your potential risk.

1) Is there any difficulty (or does the speaker need to raise their voice above normal speaking level) in communication between 2 employees at a distance of one meter? Yes:

2) Do employees in the area notice a reduction in hearing ability over the course of the day? (This reduction may not actually be noticed until after work). Yes:

3) Do employees experience any of the following:
Ringing in the ears (Tinnitus)? Yes:
The same sound having a different volume or tone in each ear ? Yes:
Blurred hearing (hearing words but not understanding them clearly)? Yes:

4) Are any long term employees hard of hearing? Yes:

5) Are any hearing protection devices provided to any employees? Yes:

6) Are signs posted anywhere in or near the work area,
indicating that Hearing Protection Devices should be worn? Yes:

7) Does the noise level in any part of the work area exceed 85 decibels? Yes:

8) Do the results of past noise measurements or surveys indicate noise levels
equal to or greater than any of the following:
85 dB(A) slow? Yes:
85 dB(A) LAeq? Yes:
140 dB (Lin) Peak Noise? Yes:
Daily noise dose greater than 0.3 (i.e. LAeq8 85dB(A)? Yes:

9) Have there been any claims for work related hearing loss? Yes:

10) Does any equipment in or around the work area have noise information including
labels that indicate that noise levels equal or greater than any of the following?
80 dB(A)? Yes:
130 dB(lin) Peak noise ? Yes:
80 dB(A) Sound Power? Yes:

11) Do the results of Audiometry indicate that any past or present employees have a hearing loss? Yes:

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