To save as PDF: use your browser's Print → Save as PDF. This form prints as A4.
Assessment of heat-related risks for outdoor and high-temperature work
Assess each factor. Mark as Adequate (P), Inadequate (F), or N/A. Record actions for inadequate items.
| # | Assessment Item | P | F | N/A | Notes / Action |
|---|---|---|---|---|---|
| Environmental Conditions | |||||
| 1 | Ambient temperature recorded at work location | □ | □ | □ | |
| 2 | Humidity level assessed (higher humidity increases risk) | □ | □ | □ | |
| 3 | Radiant heat sources identified (sun, machinery, hot surfaces) | □ | □ | □ | |
| 4 | Air movement/ventilation assessed at work area | □ | □ | □ | |
| 5 | Shade availability checked for rest breaks | □ | □ | □ | |
| Work Intensity | |||||
| 6 | Physical work rate categorised (light, moderate, heavy) | □ | □ | □ | |
| 7 | Work schedule adjusted for hottest period (11am - 3pm) | □ | □ | □ | |
| 8 | Work/rest cycle established appropriate to conditions | □ | □ | □ | |
| 9 | PPE requirements assessed for heat burden contribution | □ | □ | □ | |
| Control Measures | |||||
| 10 | Cool drinking water accessible within 5 minutes walk | □ | □ | □ | |
| 11 | Minimum 250 mL water per worker per 15 minutes available | □ | □ | □ | |
| 12 | Shade structures or cooling areas provided | □ | □ | □ | |
| 13 | Lightweight, breathable clothing permitted | □ | □ | □ | |
| 14 | Job rotation implemented to reduce individual exposure | □ | □ | □ | |
| 15 | Acclimatisation period provided for new or returning workers | □ | □ | □ | |
| Monitoring | |||||
| 16 | Buddy system in place for early symptom recognition | □ | □ | □ | |
| 17 | Workers trained to recognise heat stress symptoms | □ | □ | □ | |
| 18 | Temperature monitoring continued throughout shift | □ | □ | □ | |
| 19 | Stop-work triggers defined and communicated | □ | □ | □ | |
| Emergency Response | |||||
| 20 | First aid supplies include cold packs and cooling equipment | □ | □ | □ | |
| 21 | First aider on site trained in heat illness treatment | □ | □ | □ | |
| 22 | Emergency vehicle access confirmed for medical evacuation | □ | □ | □ | |
| 23 | Communication method available to call for help | □ | □ | □ | |
Declaration
I have assessed the heat-related risks for this work activity and confirm the control measures above are in place. If conditions change (temperature rise, increased workload, additional PPE), this assessment must be reviewed immediately.