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Whsmp · OPW16/0021
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Hazardous Substance Risk Assessment
HB-HSEQ-F-040-A
Version: 4
6 DO YOU BELIEVE AIR MONITORING IS REQUIRED?
Yes No
If the degree of exposure is high and the existing control measures are inadequate, then it is
likely air monitoring is required.
7 DO YOU BELIEVE HEALTH SURVEILLANCE IS REQUIRED?
Yes No
If the degree of exposure is high and/or one of the following substances is contained within
the substance then health surveillance will be required:
• 4,4’ methylenebis (2-chloroaniline) (MOCA) • acrylonitrile
• asbestos • benzene
• cadmium • creosote
• crystalline silica • inorganic arsenic
• inorganic chromium • inorganic mercury
• isocyanates • organophosphate pesticides
• pentachlorophenol (PCP) • polycyclic aromatic hydrocarbons (PAH)
• thallium • vinyl chloride
Reference: Work Health and Safety Regulation 2011
SIGNATURE OF
ASSESSOR/S: Date:
APPROVED BY SITE Date:
MANAGER:
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