(1) In case of Emergency:	(2) Fire Fighting medium	Choose an item.
The following services are being used:	Electricity	Water	Gases: (specify)	Other:
☐	☐	Click here to enter text.	Click here to enter text.
Action in case of Fire:	Secure experiment if safe to do so: Turn power off, bring equipment to a safe position, close lab doors. If needed: sound the alarm and evacuate. Call Campus Security on 0161 306 9966 immediately. Report to Supervisor and Safety Advisor	Spillage or release measures:	Remove all sources of ignition. Small spills: Stop leak if without risk and move adjacent containers from spill area. Dilute with water and mop if water-soluble. Clean fluids using gloves and robust lab tissue (inert, clean, dry) and dispose to chemicals waste container. Decontaminate area. Large spills: Stop leak if without risk and move adjacent containers from spill area. Use hazardous spill kit in the lab to absorb liquid. Use appropriate tools to put the spilled content in a convenient container for disposal. Decontaminate area. For significantly large spills: cordon off affected area. Notify colleagues and Supervisor. Evacuate if necessary. Incident Reporting: All incidents must be reported to Safety Advisor and Supervisor. Additional information specific to this task, not covered by the above:
First aid requirements:	Call a First Aider and take provisions from the 1st aid station in the lab. If needed call medical help and show safety data sheet. Protection of First Aider: No action shall be taken involving any personal risk or without suitable training. In cases where it may be dangerous to give mouth-to-mouth resuscitation, carry out chest compressions only. Wash contaminated clothing thoroughly with water before removing it, or wear appropriate gloves. Accident Reporting: Accidents or near misses should be reported to Safety Advisor and Supervisor. Inhalation: Move exposed person to fresh air. Keep person warm and at rest. If unconscious, place in recovery position and seek medical attention immediately. Loosen tight clothing such as collar, tie, belt, or waistband. Get medical help if the person’s condition worsens. Ingestion: Wash out mouth with water. Move the exposed person to fresh air. Keep person warm and at rest. If vomiting occurs, the head should be kept low so that the vomit does not enter the lungs. Never give anything by mouth to an unconscious person. If unconscious, place in recovery position and obtain medical attention immediately. Maintain an open airway. Loosen any clothing such as collar, tie, belt or waistband. Seek medical help. Skin contact: Flush with running water for at least 20mins. For corrosives substances apply diphoterine spray to neutralise the chemical burn. Wear gloves to remove contaminated clothing and shoes. Use emergency shower if there is one nearby and the burn is significant. Seek medical help if symptoms persist. Eye contact: Flush eyes with sterile eyewash for at least 20mins, lifting upper and lower eyelids. Remove contact lenses if present and easy to do so. For corrosives substances apply diphoterine spray to neutralise the chemical burn. Keep rinsing. Seek medical help if symptoms persist. Additional information specific to this task, not covered by the above:
This is a chemical risk assessment only and other assessments may be required. All associated assessment forms must be displayed close to the procedure.
(3) Risk Assessment Number/Code:	Click here to enter text.	(4) Name and status of researcher e.g. Phd..	Click here to enter text.	(5) Emergency contact details:	Click here to enter text.
(6) Assessment Date:	Click here to enter a date.	(7) Review/Expiry Date:	Click here to enter a date.	(8) Building and office Number:	Click here to enter text.	(9) Lab Number:	Click here to enter text.	(10) People Affected:	Click here to enter text.
(11) Title of procedure:	Click here to enter text.
(12) Details of procedure and where applicable reaction scheme (Including starting materials, products/by-products and pressure):	(14) Associated Assessments and Ref
Click here to enter text.	General risk assessment for experiment	☐
Equip/Exp overnight running	☐
General lab activities	☐
Ionizing radiation	☐
Non-Ionizing radiation	☐
Laser Safety	☐
Biological/Bio-COSHH	☐
Radiological	☐
(13) Duration, Frequency and Temperature Range:	RA/P&M Sheets/SOP/Other (include ref):
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(15) Substances used and produced	(16) Quantity used and handled	(17) Duration of potential exposure	(18) Hazard Symbols	(19) Physical and health hazard statements Highlight primary hazard	(20) Workplace Exposure Limits	(21) Control Measures	(22) Disposal Route	(23) Extremely or Highly Flammable?
1. Click here to enter text.	Click here to enter text.	Click here to enter text.	Click Here Click Here Click Here Click Here	TWA – STEL –	Engineering controls - Storage - PPE - Incompatibilities - Conditions to avoid -	Click here to enter text.	☐
2. Click here to enter text.	Click here to enter text.	Click here to enter text.	Click Here Click Here Click Here Click Here	Click here to enter text.	TWA - STEL -	Engineering controls - Storage - PPE - Incompatibilities - Conditions to avoid -	Click here to enter text.	☐
3. Click here to enter text.	Click here to enter text.	Click here to enter text.	Click Here Click Here Click Here Click Here	Click here to enter text.	TWA - STEL -	Engineering controls - Storage - PPE - Incompatibilities - Conditions to avoid -	Click here to enter text.	☐
4. Click here to enter text.	Click here to enter text.	Click here to enter text.	Click Here Click Here Click Here Click Here	Click here to enter text.	TWA - STEL -	Engineering controls - Storage - PPE - Incompatibilities - Conditions to avoid -	Click here to enter text.	☐
5. Click here to enter text.	Click here to enter text.	Click here to enter text.	Click Here Click Here Click Here Click Here	Click here to enter text.	TWA - STEL -	Engineering controls - Storage - PPE - Incompatibilities - Conditions to avoid -	Click here to enter text.	☐
6.Click here to enter text.	Click here to enter text.	Click here to enter text.	Click Here Click Here Click Here Click Here	Click here to enter text.	TWA - STEL -	Engineering controls - Storage - PPE - Incompatibilities - Conditions to avoid -	Click here to enter text.	☐
(24) Operation is (mark as appropriate): Open ☐ Closed ☐ Pressurised ☐ Pressure relief system ☐ other ☐ Please specify here.
(25) Are you carrying out an activity/chemical reaction that is at risk of a thermal runaway or explosion? Choose an item. If yes, what additional controls are required? Click here to enter text.
(26) Will the activity involve handling or storage of pyrophoric or unstable substances such as peroxide? Choose an item. If yes, what additional controls are required? Click here to enter text.
(27) Will flammable vapours, solid particles, fibrous particles etc. capable of forming an explosive atmosphere be present? Choose an item. If yes, what additional controls are required? Click here to enter text.
(28) Can less hazardous substances be used? Choose an item.
(29) Procedure for checking effectiveness of control measures Click here to enter text.
(30) If Carcinogens, mutagens or reproductive toxins (CMR), skin sensitisers, respiratory sensitisers, occupational asthmagens or nanoparticles are listed, is the fitness to work certificate for each individual still valid? Choose an item.	(31) If any of the Substances above are highly flammable and extremely flammable, What control measures are in place? Click here to enter text.
(32) Is lone working permitted for this procedure? Choose an item. If yes, what additional controls for lone working are required? Click here to enter text.	(33) Is out of hours working permitted for this procedure? Choose an item. If yes, what additional controls for out of hours working are required? Click here to enter text.
(34) Additional control measures or relevant information. Click here to enter text.
(35) Risk rating of the experiment: Choose an item.
Signatories We have discussed this chemical risk assessment and understand the hazards and the associated control measures required. A copy of this form must be displayed close to the reaction.
(36) Signature of Assessor: ……………………………………………………………………… (37) Signature of Approver: ……………………………………………………………………… (38) Signature of Verifier: ……………………………………………………………………… (where necessary)	Print Name: ………………………………………………………………………………… Print Name: ………………………………………………………………………………… Print Name: …………………………………………………………………………………	Date: …………………………………………………………… Date: …………………………………………………………… Date: ……………………………………………………………

The purpose of this Chemical Risk Assessment (CRA) is to assess the hazards to health, and other identified hazards and risks, associated with the use of chemicals and other hazardous substances and to put into place suitable control measures to enable work to proceed safely.

General risk assessments for the procedure will be required to accompany this CRA.

Put in as much relevant detail as possible for all the sections (if appropriate use continuation pages. You must assess both the risks to yourself and others in the working environment.

If you are unsure about any aspect of the activity, then seek advice from your supervisor or someone who has suitable expertise in that area.

All CRAs must be approved by a supervisor and in some cases verified/checked by a Safety Advisor in advance of starting the work, i.e. during the planning stage of the work, not the day before. You must check the approval procedure applicable in your School.

Live CRAs must be kept local to the activity in accordance with local School procedures. On occasion, you may be asked to discuss your work and the associated risk assessments. Should this prove to be unsatisfactory, you may be asked to resubmit your assessments. You must check the procedure applicable to your School.

They must be reviewed at least annually or when significant changes occur.

Any risk assessments not completed correctly will result in repeat submission, and consequently a delay in commencing your work

Each section of the form has a number. Please see the table below for guidance.

The SDS used in this guidance is from Sigma Aldrich - www.sigmaaldrich.com/united-kingdom.html

1	In case of Emergency
Services used	Tick as appropriate and detail gases (E.g. electricity, water, gases, others)
Action in case of Fire	Provide instructions on what to do in the event of a fire. Consult local arrangements and information from applicable SDS
First aid requirements	Specify first aid instructions. Consult local arrangements and information from applicable SDS
Spillage and release measures	Provide instructions on what to do in the event of spillage or release of substances for both the activity and any stored.
2	Fire Fighting Medium	Specify the type required: CO2, Powder, Foam, Water or Other as applicable. Consult local arrangements and information from applicable SDS
3	Risk Assessment Number/Code	If not applied automatically this needs to be assigned by the safety advisor. You must check the procedure within your School.
4	Assessor’s name and status	Enter details of the person completing the assessment. Enter Status e.g. Academic supervisor, PDRA, PhD, MSc etc.
5	Emergency contact details	This information would normally be the assessor and approver of the risk assessment.
6	Assessment Date	Date of assessment
7	Review/Expiry Date	Date when the assessment needs to be reviewed This should be at least annually or when significant changes occur.
8	Building and office number	Location of where the assessor is based
9	Lab Number	Location of where the activity will be conducted even if not strictly a laboratory.
10	People Affected	Detail any co-workers otherwise detail groups of people such as; other lab users, cleaners etc.
11	Title of procedure	Insert the title of your activity.
12	Details of procedure	List the steps or outline what the activity is. Be specific and include significant hazards (E.g. Starting materials, products/by-products, temperature range, pressure, compressed gases, use of machinery etc. Schematic diagram of the chemical reaction should be used if appropriate )
13	Duration, Frequency and temperature range:	Length of the activity (e.g. 30mins, 2 hrs), how frequently it is performed (e.g. once a day, once a week) and the range of temperature to be used. (e.g. 100 – 120 °C) Note: the temperature must be in °C for wider comprehension.
14	Associated Assessments and Ref	Other risk assessments, e.g. general, biological and references for the procedures that the chemicals are used, e.g. SOP. Provide all relevant reference numbers.
15	Substances used and produced	Insert name of all the hazardous substances to be used in the experiment, including the physical form and CAS numbers (SDS Section 1)
16	Quantities used and handled	Insert quantity and concentration of each substance used and handled (e.g. mg, g, %)
17	Duration of potential exposure	Approximate length of potential exposure to each substance (e.g. 5 mins or 1 hr)
18	Hazard Symbols	Select the applicable Hazard Pictogram for each substance (SDS Section 2) Note: If you are working on the word for mac, then you will not be able to select the pictogram. In this instance copy the pictogram from the bottom of the document into place holders.
19	Physical and health hazard statements	Insert H codes and Hazard Statements for each substance (SDS Section 2)
20	Workplace Exposure Limits	Specify Time Weighted Average (TWA) and Short Term Exposure Limit (STEL) for each substance if applicable (SDS Section 8)
21	Control Measures	Specify the location of where each substance is stored (e.g. lab bench, fridge, flammables cabinet). Consider incompatibilities. Also, consult SDS Section 7 & 10
Fume Cupboard or Glove Box Segregation (Specify) Other Extraction (Specify) Lab Coat (identify type) Safety Glasses (BS EN 166), Goggles (BS EN 166) or Face Visor (BS EN 166) Gloves (BS EN 374)- Specify type and thickness (SDS Section 8, Splash Contact) Buddy System (Specify) Others (Specify)
Specify the conditions to avoid while using the substances, e.g. avoid moisture, heat, sparks (SDS Section 10)
Specify (i) substances in the experiment that are incompatible with each other and the controls to be used where appropriate. (ii) all other substances the chemicals should not be mixed with or be stored with (SDS Section 10)
22	Disposal Route	Specify on how to dispose of the waste produced, e.g. Non-hazardous waste, Hazardous Solid, Hazardous Liquid, Halogenated, Organic, and Heavy Metal If collecting hazardous waste, specify how this is carried out and the controls required. For example, collect in a suitable waste disposal container, do not fill more than ¾ full and do not mix with incompatible materials. Label container with user names, chemicals, concentration and date. Store in designated area away from sources of ignition and direct sunlight. Vent the container periodically to prevent build-up of fumes. Do not accumulate chemical waste.
23	Extremely or Highly Flammable?	If your substance meets either statement below tick the box on the CRA. Extremely flammable Liquids which have a flashpoint lower than 0°C and a boiling point (or, in the case of a boiling range, the initial boiling point) lower than or equal to 35°C. Highly flammable Liquids which have a flashpoint below 21°C but which are not extremely flammable. This information can be found in the (SDS Section 9)
24	Operation type	Specify if the procedure will be open/ closed/ pressurised/ using pressure relief system/ other or N/A
25	Risk of thermal runaway	Specify if the activity/chemical reaction is at risk of a thermal runaway or explosion. If yes, provide details of the additional controls
26	Pyrophoric or peroxide	Specify if the activity involves the use of pyrophoric or other unstable substances. If yes, provide details of the additional controls
27	Risk of an explosive atmosphere	Specify if the substances used or the activity has the potential of forming an explosive atmosphere. If yes, provide details of the additional controls. Calculations may be required to demonstrate and should be entered here if appropriate. Consult the Lower Explosive limit for this information (SDS Section 9).
28	Can less hazardous substances be used?	State if you can replace with less hazardous substances
29	Procedure for checking the effectiveness of control measures	Specify checking procedures (E.g. How to ensure LEV is working effectively; What to do if the gloves become contaminated)
30	CMRs, Sensitisers, Asthmagens & Nanoparticles	Specify if any substance used is a CMR, sensitiser, asthmagen or nanoparticle (SDS Section 2) Please confirm that a fitness to work certificate is up to date for all those affected by selecting “Yes”. If not, select “No” and ensure Occupational Health is informed of the additional substances being used. If an individual doesn’t already have a fitness to work certificate, they will need to complete the Lab Screen Questionnaire and return it to Occupational Health.
31	If any of the Substances above are Highly flammable and Extremely Flammable, What control measures are in place?	If the Highly flammable and Extremely Flammable box is selected for a substance, you must detail the control measures to prevent ignition.
32	Lone working	Specify additional controls if the activity is permitted for lone working. You must check the procedure at your School.
33	Out of hours working	Specify additional controls if the activity is permitted for out of hours working. You must check the procedure within your School.
34	Additional control measures	Outline hazards from any reaction (e.g. exothermic, fumes, toxic gases) that may arise during the process and detail how these will be controlled. Specify any additional control measures or relevant information associated with the activity
35	Risk Rating	On a rating of Likelihood vs Consequence, how would you score the residual risk of the experiment with all control measures in place? This Low, Medium or High. Use the image below to help visualise this.
36	Signature of Assessor	Signed by the person completing the assessment. You must check the procedure within your School.
37	Signature of Approver	Signed by the Academic Supervisor approving the work. You must check the procedure at your School.
38	Signature of Verifier	Signed by Safety Advisor if necessary. You must check the procedure within your School.