Job Safety Analysis

RSG-HS-FRM-0001

RED_SEA_GLOBAL

Instructions for completing Job Safety Analysis (JSA) form

Section I -Enter general information about the site and job task.

Section II - Determine whether any of these operations apply to the job task to be performed. Make note of any special training, permit, certification, and risk assessment requirements.

Section III - Identify any human/organizational factors that could impact the ability to perform the work safely.

Break the job down into steps - Be as specific as possible. Write each job step in a new row of column A (Activity/Step). It’s a good idea to leave an extra row between steps in case you
1 need them later. Add additional rows to the table as needed, or if completing the JSA on paper, print additional copies of the sheet to accommodate all job steps.
Determine the hazards associated with each job step and write them in column B (Hazards). Use the examples of hazards provided below to trigger your thinking about different types of
2 hazards and energy sources.
List any control measures that will be taken to ensure that step is done safely in column C (Control Measures). Use the control measure examples and hierarchy provided to trigger your
thinking about different types of controls and their effectiveness at reducing risk. Controls toward the top of the table tend to be more effective at minimizing the severity and/or likelihood
3 of an event than the controls toward the bottom of the table. If this job involves a Life Crucial Operation, continue to step 4. Otherwise, repeat steps 2-3 for each of the job steps identified,
Considering the hazards involved and the control measures that will be in place, determine the worst credible severity of an incident that could result from this job step. Use the severity
4 table provided. Write the severity number in column D (Severity).
Considering the hazards involved and the control measures that will be in place, determine the likelihood that an incident will result from this job step. Use the likelihood table provided.
5 Write the likelihood number in column E (Likelihood).

Multiply the severity number by the likelihood number and enter the product in column F (Risk).
6

Consider the risk rating against the thresholds provided in the Overall Risk Ratings.
7

P Very low and low risk ratings of 1-2. This level is generally considered acceptable provided that all control measures are applied.

Medium risk ratings of 3-9. Medium risk requires a planned approach to control the hazard and applies additional controls if required. Action taken must be documented on the
P
risk assessment form.
High and Very High-Risk ratings of 10-25. For all high and very high risk, Column G (Additional control measures) must be implemented to further reduce the risk to a medium or
P low level. Such activities shall not be proceeded until applying additional control measures. The Construction Director/Manager or facility Manager must personally review the
activities with a High or Very High residual risk score and approve additional control measures by signing off the JSA
Repeat steps 2-7 for each of the job steps identified.
8
Section IV - Provide the name, company, and title of those who prepared and reviewed/approved this form in the signature box provided. The Construction Director/Manager or facility Manager must
review and approve the additional control measures that have a High or Very High-Risk rating before proceeding the task. Additional space is also provided for crew members to sign the JSA if desired.

Reference Table in completing Section III – Job Safety Analysis (Column B – Hazard)
Biological & Electrical Chemical Gravity/Height Mechanical & Motion
Environmental Arc Flash Air Emissions Equipment Tipping/Collapsing Being Thrown Off/Under Equipment
Altitude Buried Utilities Chemical Products; Excavation/Trench Disintegration of Moving Components
Animal Bite/Sting Damage to Leads/Cables •Carcinogenic Falling Objects Driving/Vehicle Traffic
Blood-Borne Pathogens Damage to Switches •Combustible/Flammable Floor Openings/Edges Ejection of Workpiece/Debris
Contaminated Energized Circuits/Conductors •Explosive Grating Removed Entanglement
Food/Water Inadvertent Energization •Toxic Inadequate Support Friction
Insect-Borne Disease Lack of Isolation/Grounding •Corrosive Lack of Access Ladders/Stairs Movement/Shifting
Pests Missing/Damaged Insulation •Reactive Suspended Load Moving Parts
Poisonous Plants Overhead Lines Client/Process Chemicals Unstable/Insecure Materials Pinch/Crush Points
Precipitation Overload of Circuits Lack of Containment Work Above/Below Others Projectiles
Temperature/Humidity Stored Energy (Batteries/Capacitors) Leakage/Spills Work at Height/Fall Hazards Rotating Equipment
Unsanitary Conditions Water Near Electrical Conductors Material Incompatibility Walking/Working Surface; Sharp Edges, Corners, or Points
Weather Produced/Disturbed by Work; •Slippery Shearing
•Asbestos •Uneven Stored Energy (Springs/Accumulators)
•Lead •Obstructed Striking
•Silica •Steep Trapped Between Equipment and Fixed
•Welding Fumes •Moving/Swaying/Pitching Structures
•Dust •Insufficient/Unstable Unexpected/Uncontrolled Movement
Water Discharges
Wastes Generated;
•Hazardous
Pressure Work Environment
•Non-Hazardous
Abrasive Blasting Cluttered
Compressed Gases Confined Space
High Pressure Fluid Damaged Tools/Equipment
Pressure Testing Entrapment
Pressure Erosion
Washing/Blasting Hazardous Atmosphere;
•Oxygen Rich/Deficient
•Contaminants
Ignition Sources
Inadequate Ventilation
Radiation Poor Lighting/Glare Sound Ergonomic
Intense Light Restricted Access/Egress Continuous Noise Awkward Postures/Movement
Lasers Runoff Intermittent Noise Excessive Force/ Exertion
Microwaves Extreme Noise Heavy/Awkward Load
Naturally Occurring Impact Noise Repetitive Motion
Radioactivity Radioactive Same Position
Material Vibration
X-Rays

Job Safety Analysis

Rev.00, 30 March 2023 Page 1 of 2
 Job Safety Analysis
RSG-HS-FRM-0001

RED_SEA_GLOBAL

Reference Table in completing Section III – Job Safety Analysis (Column C – Control Measure)

Controls Examples
Elimination
(Remove the hazard altogether)

Substitution
(Replace the material/process with a less
hazardous one)

Engineering/Isolation
(Design effective control measures to protect
people and the environment)

Warning
(Alert people to the hazards)

Administrative
(Provide training, procedures, etc.)

PPE
Less (Personal Protective Equipment)
Effective

Reference Table in completing Section III – Job Safety Analysis (Column E –

Reference Table in completing Section III – Job Safety Analysis (Column D –Severity)
Likelihood)

Impact On Chances of
Severity Level Likelihood Level Probability
Occurrence
People Equipment / Property

Extensive losses of high value

equipment/property Likely to occur within the next 1
Almost year.
Major 5 Single / Multiple fatalities 5 0 in 100
Loses exceeding SAR 3,750,000; or Certain More than 80% chance of
Major unplanned impact on budget and occurring
schedule

Losses of equipment/property that

cannot be readily replaced; or Likely to occur within the next 2
Injury or illness resulting in
years.
Significant 4 permanent total or partial Likely 4 0 in 1,000
Losses exceeding SAR 375,000; or More than 60% and less than 80%
disability
Significant unplanned impact on project chance of occurring
budget

Loss of equipment that can be readily

Injury or illness resulting in
Modrate 3 medical treatment or temporary
disability/loss of function
Likely to occur and may do so
replaced; or
within the next 3 years.
Possible 3 1 in 10,000
More than 40% and less than 60%
Losses exceeding SAR 37,500; or
chance of occurring
Minor impact on the budget

Unlikely to occur and may do so

Loss of equipment that can be readily
Injury or illness requiring first-aid within the next 5 years.
Minor 2 replaced, or Rare 2 1 in 100,000
treatment only More than 20% and less than 40%
Losses less than SAR 37,500
chance of occurring.

Extremely unlikely to occur within

Negligible 1 Near Miss/no harm Unlikely 1 the next 5 years. 1 in 1,000,000
equipment or property
Less than 20% chance of occurring

Reference Table in completing Section III – Job Safety Analysis (Column F – Risk)
Risk Matrix
Very Low Low Medium High Very High
Severity
Likelyhood 1 2 3-9 10-16 20-25
1-Negligible 2-Minor 3–Moderate 4-Significant 5-Major
Medium Hgh High High High High and Very High-Risk ratings of 10-25.
5 – Almost Certain
(5) (10) (15) (20) (25)
Additional control measures must be implemented to further reduce the High
Medium Medium High High High
4 – Likely and very high risk to acceptable level.
(5) (5) (12) (16) (20)

3 – Possible
Medium Medium High High Note: The Construction Director/Manager or Facility Manager must personally
-5
(5) (5) (12) (15) review the activities with a High or Very High residual Risk score and approve
Low Medium Medium Medium High
2- Rare suitable additional control measures by signing the JSA.
(2) (5) (5) (8) (10)
Very Low Low Medium Medium Medium
1 – Unlikely
(1) (2) (5) (4) (5)

Job Safety Analysis

Rev.00, 30 March 2023 Page 2 of 2