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Noise Risk Assessment Template
Section 1: Identification Of Noise Hazards
1. 1. Has a hazard identification for noise been carried out? For example, do people need to raise their voices to speak with someone one meter away? Are there very loud impact noises?
Yes
No
N/A
2. 2. Have there been any workers’ compensation claims for hearing loss?
Yes
No
N/A
Section 2: Noise Risk Assessment
1. 1. Have noise risk assessments been carried out by a competent person?
Yes
No
N/A
2. 2. Are any workers exposed above the exposure standard?
Yes
No
N/A
3. 3. Is the noise risk assessment current? That is, is it less than five years ago and has noise exposure not substantially changed since?
Yes
No
N/A
Section 3: Hazard Controls
1. 1. Is there a ‘buy/hire quiet’ policy to choose quieter tools and equipment? For example, noise-reducing circular saw blades.
Yes
No
N/A
2. 2. Does the workplace layout position noisy work well away from quiet work? For example, tile cutting and brick cutting.
Yes
No
N/A
3. 3. Are tools/equipment and noise controls maintained so as to minimize noise?
Yes
No
N/A
4. 4. Is work planned to minimize the time workers are exposed to excessive noise?
Yes
No
N/A
5. 5. Are noise sources and noise controls maintained so as to minimize noise?
Yes
No
N/A
Section 4: Personal Hearing Protectors
1. 1. Are compliant hearing protectors supplied to and correctly worn by workers who may be exposed to a noise hazard?
Yes
No
N/A
2. 2. Do hearing protector areas have signs in accordance with local regulations?
Yes
No
N/A
3. 3. Are workers trained in fitting, use, selection, maintenance, replacement, and storage of hearing protectors?
Yes
No
N/A
Section 5: Information And Training
1. 1. Are information and training on noise hazards, effects, and controls provided?
Yes
No
N/A
Section 6: Hearing Tests
1. 1. Is an audiometric testing program made available to workers exposed above the exposure standard?
Yes
No
N/A
2. 2. Are appropriate actions taken if hearing loss is found to occur?
Yes
No
N/A