Checklist

Human Factors & Ergonomics Quick Assessment

Interactive frontline ergonomics checklist to identify common ergonomic risks, record quick mitigations, and capture referrals for a more detailed ergonomics study. Designed for supervisors during safety rounds to produce consistent, actionable records.

Interactive Tool

Human Factors & Ergonomics Quick Assessment

Use this short assessment during safety rounds or task observations to quickly identify common ergonomic risks and record low-effort mitigations. The form is designed to be completed in a few minutes at the point of observation. If you mark an item as a concern, record any immediate action and whether the task should be referred for a detailed ergonomics study.

Who should use this: frontline supervisors, safety observers, team leads. When to use: weekly safety rounds, after process changes, or following near-misses or discomfort reports.

Enter your name.
Use YYYY-MM-DD.
Where was the task observed? e.g., Press Line A, Deck 1119.
Short description of the task or operation being performed.
Look for sustained awkward postures (bent back, twisted torso, extreme wrist angles). Quick mitigations: adjust workstation height, provide seating, add supports, change tool orientation.
High repetition or short cycle times increase risk. Quick mitigations: microbreaks, task rotation, automation study.
Look for heavy lifts, high push/pull forces, or impact forces. Quick mitigations: mechanical aids, lifting tools, reduce weight handled.
Check for poor grips, vibration, poorly balanced tools. Quick mitigations: swap to ergonomic tools, add handles, anti-vibration measures.
Excessive reaching, twisting, or bending to access items. Quick mitigations: bring items within primary reach, relocate work, reconfigure layout.
Lighting, glare, noise, temperature, floor traction can affect posture and risk. Quick mitigations: fix lighting, reduce glare, provide anti-fatigue mats.
Use your judgement combining the items above. 1 = low risk, 5 = urgent concern.
1.0 10.0
Record any quick fixes implemented during the observation (e.g., adjusted workstation, provided stool, swapped tool).
These are common, low-effort mitigations to try immediately.
Select 'Yes' if risks are major, recurring, or beyond quick mitigations.
Choose the primary reason for referral.
Optional — YYYY-MM-DD. Use to schedule verification or re-check.
Who will implement or coordinate follow-up?
Optional: note photo filename, mobile photo ID, or where images are stored for the observation.
Anything else relevant (worker comments, constraints, temporary workarounds).
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