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The Job Safety Analysis (JSA) form serves as a critical tool for ensuring workplace safety by systematically identifying potential hazards associated with specific job activities. It captures essential business details, including the name, ABN, and contact information of the organization, alongside the work activity and its location. This form outlines the personnel involved in the task and the equipment and tools required, which helps in maintaining clarity and accountability. Authorization is documented, ensuring that the analysis is validated by a responsible individual. The JSA includes a comprehensive risk assessment section, where risks are rated based on likelihood and consequence, allowing teams to prioritize safety measures effectively. Furthermore, it emphasizes the importance of risk controls, detailing a hierarchy of control measures that range from elimination and substitution to engineering controls and administrative changes, ultimately highlighting the role of personal protective equipment as a last line of defense. By utilizing the JSA form, organizations can proactively manage risks, comply with relevant legislation, and foster a culture of safety among their workforce.

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Job Safety Analysis (JSA)

 

 

 

 

Ref:

Version:

 

 

 

 

 

 

Business details

 

 

 

 

 

 

 

 

 

 

 

Business name:

 

 

 

 

 

 

 

 

 

 

 

ABN:

 

 

Contact person:

 

 

 

 

 

 

 

 

Address:

 

 

Contact position:

 

 

 

 

 

 

 

 

Contact phone number

 

 

Contact email

 

 

 

 

address:

 

 

 

 

 

 

 

 

 

 

 

 

 

Job Safety Analysis details

 

 

 

 

 

 

 

 

 

 

Work activity:

 

 

Location:

 

 

 

 

 

 

 

 

Who are involved in the

 

 

This job analysis has been authorised by:

 

activity:

 

 

Name:

 

 

 

Plant and equipment used:

 

 

 

 

 

 

 

 

 

 

Position:

 

Maintenance checks required:

 

 

 

 

 

 

 

 

 

 

Signature:

 

Tools used:

 

 

 

 

Date:

 

 

 

 

 

 

 

 

 

Materials used:

 

 

 

 

 

 

 

 

 

 

 

Personal protective

 

 

 

 

 

equipment:

 

 

 

 

 

 

 

 

 

 

 

Certificates, permits

 

 

 

 

 

and/approvals required

 

 

 

 

 

 

 

 

 

 

 

Relevant legislation, codes,

 

 

 

 

 

standard MSDSs etc

 

 

 

 

 

applicable to this activity

 

 

 

 

 

 

 

 

 

 

 

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Risk assessment

**Use the risk rating table to assess the level of risk for each job step.

 

 

 

 

 

 

 

 

 

Likelihood

 

 

 

 

 

 

 

 

1

 

2

 

3

 

4

 

5

 

 

Consequence

 

Rare

 

Unlikely

 

Moderate

 

Likely

 

Almost Certain

 

 

The event may occur in

 

The event could occur

 

The event should occur

 

The event will probably occur

 

The event is expected to

 

 

 

exceptional circumstances

 

sometimes

 

sometimes

 

in most circumstances

 

occur in most circumstances

1

Insignificant

 

LOW

 

 

LOW

 

 

LOW

 

 

LOW

 

 

MODERATE

 

 

No injuries or health

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

issues

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2

Minor

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

First aid treatment

 

LOW

 

 

LOW

 

 

MODERATE

 

 

MODERATE

 

 

HIGH

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3

Moderate

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Medical treatment,

 

LOW

 

 

MODERATE

 

 

HIGH

 

 

HIGH

 

 

CRITICAL

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

potential LTI

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

4

Major

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Permanent disability or

 

LOW

 

 

MODERATE

 

 

HIGH

 

 

CRITICAL

 

 

CATASTROPHIC

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

disease

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

5

Extreme

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Death

 

MODERATE

 

 

HIGH

 

 

CRITICAL

 

 

CATASTROPHIC

 

 

CATASTROPHIC

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Risk rating:

Low risk:Acceptable risk and no further action required as long as risk has been minimised as possible. Risk needs to be reviewed periodically.

Moderate risk:Tolerable with further action required to minimise risk. Risk needs to be reviewed periodically.

High risk:Tolerable with further action required to minimise risk. Risk needs to be reviewed continuously.

Critical risk:Unacceptable risk and further action required immediately to minimise risk.

Catastrophic:Unacceptable risk and urgent action required to minimise risk.

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Risk controls

The hierarchy of control can be used as an effective tool to deal with health and safety issues at work. Use the type of control suggested as measures to deal with the hazard. Aim to use control measures from as high on the hierarchy of control list as possible. If that is not possible the next option down the list or a combination of the measures should be implemented. The least effective control measure is the use of personal protective equipment (PPE) and it should be used as a last resort or a support to other control measures. Information and training should be integrated with all levels of control to explain how controls work.

1.Eliminate – if it is possible, the hazard should be removed completely. For example, get rid of dangerous machines.

2.Substitute – replace something that produces the hazard with something that does not produce a hazard. For example, replacing solvent based paint with water based paint. Risk assessment on the substitution must be conducted to ensure that it will not pose another hazard.

3.Engineering control – isolate a person from the hazard by creating physical barrier or making changes to process, equipment or plant to reduce the hazard. For example, install ventilation systems.

4.Administrative control – change the way a person works by establishing policies and procedures to minimise the risks. For example, job scheduling to limit exposure and posting hazard signs.

5.Use personal protective equipment (PPE) – protect a person from the hazard by wearing PPE. For example, wearing gloves, safety glasses, hard hats and high-visibility clothing. PPE must be correctly fitted, used and maintained to provide protection.

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JSA – Action steps

 

Step No

 

 

Job step details

 

 

Potential hazards

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Risk rating**

How to control risks***

Name of persons responsible for work

Review number:

Version:

Page 4 of 6

 

Step No

 

 

Job step details

 

 

Potential hazards

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Risk rating**

How to control risks***

Name of persons responsible for work

Review number:

Version:

Page 5 of 6

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:

Dates:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Review No

01

02

03

04

05

06

07

08

09

 

 

 

 

 

 

 

 

 

 

Initial:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Date:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

A10592057

 

 

 

 

 

 

 

 

 

Page 6 of 6

Form Specifications

Fact Name Description
Purpose The Job Safety Analysis (JSA) form is designed to identify potential hazards associated with a specific job or task.
Business Information The form collects essential business details, including the business name, contact person, and contact information.
Risk Assessment It includes a risk assessment section that uses a rating table to evaluate the likelihood and consequence of potential hazards.
Hierarchy of Controls The JSA outlines a hierarchy of controls to manage risks, emphasizing the importance of eliminating hazards when possible.
Risk Ratings Risk ratings range from low to catastrophic, guiding the necessary actions to minimize risks effectively.
Legal Compliance The form ensures compliance with relevant legislation, codes, and standards applicable to workplace safety.
Signature Requirement A designated person must authorize the JSA, confirming that the analysis has been reviewed and approved.
Review Process The JSA must be reviewed periodically to ensure that it remains relevant and effective in managing job safety.

Jsa: Usage Guidelines

Filling out the Job Safety Analysis (JSA) form is an important step in ensuring workplace safety. By carefully completing this form, you will identify potential hazards and implement measures to control risks associated with specific job activities. Follow these steps to effectively fill out the JSA form.

  1. Start by entering the business details at the top of the form. Include the business name, ABN, contact person, address, contact position, phone number, and email address.
  2. Next, fill in the Job Safety Analysis details. Specify the work activity and location, and list the individuals involved in the activity.
  3. Identify the person who authorized the job analysis. Write their name, position, and provide a signature.
  4. Document the plant and equipment used for the job, along with any maintenance checks required.
  5. List the tools and materials used in the job, and specify any personal protective equipment (PPE) needed.
  6. Indicate any certificates, permits, and approvals required for the activity, along with relevant legislation and standards.
  7. Move on to the risk assessment section. Use the risk rating table to evaluate the likelihood and consequence of each job step.
  8. Assess the risk rating for each job step and categorize it as low, moderate, high, critical, or catastrophic.
  9. Outline the risk controls that will be implemented. Follow the hierarchy of control measures to effectively manage hazards.
  10. In the action steps section, detail each job step, potential hazards, risk ratings, and how to control the risks. Assign responsibilities to specific individuals.

After completing the form, review it for accuracy and ensure all necessary signatures are obtained. This process will help maintain a safe working environment and promote compliance with safety regulations.

Your Questions, Answered

What is a Job Safety Analysis (JSA) form?

A Job Safety Analysis (JSA) form is a tool used to identify and evaluate hazards associated with specific job tasks. It helps ensure that safety measures are in place before starting work. By documenting potential risks and outlining control measures, the JSA promotes a safer work environment for all involved in the activity.

Who should complete the JSA form?

The JSA form should be completed by the person responsible for the job or activity, often referred to as the contact person. This individual is usually knowledgeable about the task and its associated risks. In some cases, team members involved in the work may also contribute to the analysis to ensure all potential hazards are identified.

What information is required on the JSA form?

The JSA form requires various details, including the business name, contact information, job activity, location, and the names of individuals involved. It also includes sections for identifying plant and equipment used, maintenance checks, tools, materials, personal protective equipment, and any necessary permits or approvals. Additionally, a risk assessment must be conducted to evaluate potential hazards.

How is risk assessed in a JSA?

Risk is assessed using a risk rating table that evaluates the likelihood and consequence of potential hazards. Each job step is rated based on how likely it is for an event to occur and the severity of its consequences. The risk rating helps determine the level of risk associated with each step, guiding the implementation of appropriate control measures.

What are the different levels of risk in a JSA?

The JSA categorizes risks into five levels: low, moderate, high, critical, and catastrophic. Low risk indicates acceptable conditions, while moderate and high risks require further action to minimize hazards. Critical and catastrophic risks are deemed unacceptable and demand immediate action to ensure safety. Each risk level dictates how often the risk should be reviewed and what controls should be implemented.

What are the hierarchy of controls in a JSA?

The hierarchy of controls is a systematic approach to managing hazards. It includes five levels: elimination, substitution, engineering controls, administrative controls, and personal protective equipment (PPE). The goal is to use the highest level of control possible. For example, eliminating a hazard is preferable to relying on PPE. Each level aims to minimize risks effectively and protect workers.

How often should a JSA be reviewed?

The frequency of JSA reviews depends on the risk level associated with the job. Low-risk jobs may require periodic reviews, while moderate and high-risk jobs need more frequent assessments. Critical and catastrophic risks should be reviewed continuously. Regular reviews ensure that the JSA remains relevant and that any new hazards are addressed promptly.

Common mistakes

  1. Incomplete Business Details: Failing to fill in all required fields, such as the business name, ABN, or contact information, can lead to delays in processing the JSA form.

  2. Neglecting Risk Assessment: Not using the risk rating table to assess each job step can result in an inaccurate understanding of potential hazards and risks associated with the work activity.

  3. Ignoring the Hierarchy of Control: Skipping the recommended hierarchy of control measures can lead to ineffective risk management. It is crucial to consider elimination and substitution before relying solely on personal protective equipment.

  4. Missing Signatures: Failing to obtain necessary signatures from the authorized personnel can invalidate the JSA. All required approvals must be secured before proceeding.

  5. Inadequate Review Process: Not reviewing the JSA periodically, especially after changes in work activities or personnel, can increase the likelihood of accidents. Regular reviews are essential for maintaining safety standards.

Documents used along the form

The Job Safety Analysis (JSA) form is a critical document in workplace safety management. It identifies potential hazards associated with specific job tasks and outlines control measures to mitigate those risks. Several other forms and documents complement the JSA, enhancing safety protocols and compliance with regulations. Below is a list of these relevant documents.

  • Risk Assessment Form: This document evaluates the likelihood and severity of potential hazards in the workplace. It categorizes risks based on their impact and helps determine necessary safety measures.
  • Incident Report Form: Used to document any accidents or near misses that occur on the job site. This form captures details about the incident, including time, location, and individuals involved, facilitating further investigation and prevention strategies.
  • Safety Training Record: This form tracks employee training related to safety protocols and equipment handling. It ensures that all personnel are adequately trained and certified for their specific job functions.
  • Permit to Work: This document is required for specific high-risk tasks. It outlines the scope of work, identifies hazards, and ensures that necessary safety measures are in place before work begins.
  • Personal Protective Equipment (PPE) Checklist: A checklist used to ensure that all required PPE is available and in good condition. It serves as a reminder for workers to wear appropriate gear for their tasks.
  • Emergency Response Plan: This document outlines procedures for responding to emergencies, including evacuation routes and contact information for emergency services. It is essential for ensuring worker safety during unforeseen events.
  • Maintenance Log: A record of inspections and maintenance performed on equipment and machinery. This log helps ensure that all tools and equipment are safe to use and function correctly.

Utilizing these forms in conjunction with the JSA enhances workplace safety and compliance. Each document plays a specific role in identifying, assessing, and mitigating risks, contributing to a safer working environment.

Similar forms

  • Risk Assessment Form: Similar to the JSA form, a risk assessment form identifies potential hazards associated with specific activities. Both documents require evaluation of risks and the implementation of control measures to mitigate them.
  • Job Hazard Analysis (JHA): The JHA focuses on identifying hazards related to job tasks. Like the JSA, it emphasizes risk evaluation and the establishment of safety protocols to protect workers.
  • Safety Data Sheet (SDS): An SDS provides detailed information about hazardous materials used in the workplace. While the JSA assesses risks related to specific tasks, the SDS offers insights into the safety measures necessary when handling particular substances.
  • Permit to Work (PTW): A PTW is required for high-risk tasks and outlines the safety measures to be followed. Similar to the JSA, it ensures that risks are assessed and managed before work begins.
  • Incident Report Form: This form documents accidents or near misses in the workplace. Both the incident report and the JSA aim to enhance safety by analyzing risks and preventing future occurrences.
  • Training Records: Training records track employee safety training and competencies. They complement the JSA by ensuring that workers are adequately trained to understand and manage the risks identified in the analysis.
  • Emergency Response Plan (ERP): An ERP outlines procedures for responding to emergencies. Like the JSA, it focuses on risk management but specifically addresses actions to take when incidents occur.

Dos and Don'ts

When filling out the Job Safety Analysis (JSA) form, it is essential to approach the task with care and attention to detail. Here are some key points to consider:

  • Do: Ensure all fields are completed accurately. Include the business name, contact details, and specific job activity information.
  • Do: Use the risk rating table diligently. Assess each job step's risks based on likelihood and consequence to determine the appropriate risk rating.
  • Do: Involve all relevant personnel in the process. Their input can provide valuable insights into potential hazards and control measures.
  • Do: Review the completed form regularly. Periodic reviews help ensure that the risk assessments remain relevant and effective.
  • Don't: Rush through the form. Taking time to think through each section can prevent oversights that may lead to safety issues.
  • Don't: Skip the risk control measures. Always include specific actions that will be taken to mitigate identified risks.
  • Don't: Assume that everyone understands the hazards. Clear communication about risks and controls is crucial for safety.
  • Don't: Forget to obtain signatures. Ensure that all necessary authorizations are documented to validate the JSA.

Misconceptions

  • Misconception 1: The JSA form is only necessary for high-risk jobs.
  • This is not true. The Job Safety Analysis (JSA) form is a valuable tool for all work activities, regardless of their perceived risk level. It helps identify potential hazards and ensures that safety measures are in place, promoting a culture of safety across all tasks.

  • Misconception 2: Completing a JSA is a one-time task.
  • Many believe that once a JSA is completed, it remains valid indefinitely. However, the JSA should be reviewed and updated regularly, especially when there are changes in the work environment or processes.

  • Misconception 3: Only managers need to be involved in the JSA process.
  • In reality, everyone involved in the work activity should participate in the JSA process. Their insights and experiences are crucial in identifying hazards and developing effective safety measures.

  • Misconception 4: The JSA form is just another piece of paperwork.
  • This perception undermines the importance of the JSA. It is a proactive approach to safety, designed to prevent accidents and injuries by systematically analyzing risks before work begins.

  • Misconception 5: The JSA only focuses on physical hazards.
  • While physical hazards are a significant concern, the JSA also addresses other types of risks, including chemical, ergonomic, and psychological hazards. A comprehensive analysis considers all potential dangers.

  • Misconception 6: Personal protective equipment (PPE) is the first line of defense.
  • Many people mistakenly think that PPE is the primary method of risk control. In fact, it should be the last resort, used only after other controls have been considered and implemented.

  • Misconception 7: A JSA is only needed for construction or industrial jobs.
  • This is a common misunderstanding. Any job, regardless of the industry, can benefit from a JSA. Office environments, healthcare settings, and even remote work can present hazards that need to be assessed.

  • Misconception 8: Once risks are identified, the job can proceed without further action.
  • Identifying risks is just the beginning. The JSA must also include specific control measures to mitigate those risks. Without these measures in place, the job may still be unsafe.

  • Misconception 9: The JSA process is too time-consuming.
  • While it may seem that way initially, taking the time to conduct a thorough JSA can save time and resources in the long run by preventing accidents and injuries that could halt work and lead to costly repercussions.

  • Misconception 10: A completed JSA guarantees safety.
  • Completing a JSA does not guarantee that accidents won't happen. It is a critical step in the safety process, but ongoing training, communication, and vigilance are essential to ensure a safe work environment.

Key takeaways

Filling out and utilizing the Job Safety Analysis (JSA) form is essential for maintaining workplace safety. Here are six key takeaways to keep in mind:

  • Identify all relevant details: Ensure that all business information, including the business name, ABN, and contact details, is accurately filled out. This information is crucial for communication and accountability.
  • Conduct a thorough risk assessment: Use the risk rating table to evaluate each job step. Assess both the likelihood and consequence of potential hazards to determine the overall risk rating.
  • Implement appropriate risk controls: Utilize the hierarchy of controls to address identified hazards. Prioritize elimination and substitution over engineering and administrative controls, with personal protective equipment as a last resort.
  • Involve all personnel: Clearly list who is involved in the job analysis. This ensures that everyone understands their roles and responsibilities in maintaining safety.
  • Document and authorize: Ensure that the JSA form is signed by an authorized person. This adds an important layer of accountability and ensures that safety measures are taken seriously.
  • Review and update regularly: The JSA should be reviewed periodically, especially when new hazards are identified or when changes occur in work processes. Continuous improvement is key to workplace safety.