Workplace Health & Safety
Noise Risk Assessment
Assessment of occupational noise exposure against the WHS Regulation exposure standard (85 dB(A) LAeq,8h / 140 dB(C) peak), with controls identification.
33 checklist items
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Checklist Items
| Item | Pass / Yes | Fail / No |
|---|---|---|
| WORKPLACE AND TASK DETAILS | ||
| Workplace / Site Name | ___________________________ | |
| Work Area / Department | ___________________________ | |
| Assessment Date | ___________________________ | |
| Assessed By | ___________________________ | |
| Task / Process Being Assessed | ___________________________ | |
| Workers Potentially Exposed | ___________________________ | |
| Duration of exposure (hours per shift) | ___________________________ | |
| NOISE SOURCES | ||
| Identify all noise sources in the work area | ___________________________ | |
| Is noise continuous, intermittent, or impulsive? | ___________________________ | |
| Equipment / machinery generating noise | ___________________________ | |
| NOISE MEASUREMENTS | ||
| Noise measurement instrument used | ___________________________ | |
| Calibration certificate current? | Yes ☐ | No ☐ |
| Measured LAeq,8h dB(A) | ___________________________ | |
| Measured peak noise level dB(C) | ___________________________ | |
| Does LAeq,8h exceed 85 dB(A) exposure standard? | Yes ☐ | No ☐ |
| Does LAeq,8h exceed 80 dB(A) action level? | Yes ☐ | No ☐ |
| Does peak level exceed 140 dB(C)? | Yes ☐ | No ☐ |
| Measurement location(s) | ___________________________ | |
| RISK RATING | ||
| Overall noise risk level (Low / Medium / High) | ___________________________ | |
| CONTROL MEASURES | ||
| Elimination: Can the noisy process be eliminated? | Yes ☐ | No ☐ |
| Substitution: Can quieter equipment be used? | Yes ☐ | No ☐ |
| Isolation: Can noise source be enclosed or isolated? | Yes ☐ | No ☐ |
| Engineering controls identified (acoustic enclosures, barriers) | ___________________________ | |
| Administrative controls identified (job rotation, scheduling) | ___________________________ | |
| Hearing protection type required (earmuffs / earplugs / combination) | ___________________________ | |
| Hearing protection SLC80 / SNR rating adequate for exposure? | Yes ☐ | No ☐ |
| Mandatory hearing protection zone established and signed? | Yes ☐ | No ☐ |
| HEALTH SURVEILLANCE | ||
| Audiometric testing required (exposure >85 dB(A))? | Yes ☐ | No ☐ |
| Baseline audiogram completed for exposed workers? | Yes ☐ | No ☐ |
| Date of last audiometric testing | ___________________________ | |
| REVIEW | ||
| Review date | ___________________________ | |
| Assessor Signature | ___________________________ | |
| Manager / PCBU Representative Signature | ___________________________ | |