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BRIEF™ Survey – Step 1
B ASELINE R ISK I DENTIFICATION
Job Name:
Complete Job Information
E RGONOMIC F ACTORS
Site:
Date:
Step 2
OF
Station:
Dept:
Hands and Wrists
Version 3.0
Shift:
Elbows
Product:
Shoulders
Neck
Back
Legs
Identify Risks
≤ 45°
▼ 2a. Mark Posture and Force boxes when risk factors are observed.
Flexed > 45°
≥135°
Ulnar Deviation
Squat
Arm Raised > 45° Flexed > 30° Sideways
▼ 2b. For body parts with Posture or Force marked, mark Duration Extended > 45° Radial Deviation and/or Frequency box(es) when limits are exceeded. Left Right
Rotated Forearm
Fully Extended
Arm Behind Body
Flexed > 20°
Sideways Kneel
Shoulders Shrugged
Extended Extended
Twisted > 20°
Left
Right
Left
Right
> 10 lb (4.5 kg)
> 10 lb (4.5 kg)
> 10 lb (4.5 kg)
> 10 lb (4.5 kg)
> 2 lb (0.9 kg)
> 25 lb (11.3 kg)
Foot Pedal > 10 lb (4.5 kg)
Twisted Unsupported
Unsupported
2a.
Posture
Force
Pinch Grip or Finger Press > 2 lb (0.9 kg), or Power Grip > 10 lb (4.5 kg)
2b.
Duration
Frequency
> 10 sec.
> 10 sec.
> 10 sec.
> 10 sec.
> 10 sec.
> 10 sec.
> 10 sec.
> 10 sec.
> 30% of day
> 30/min.
> 30/min.
> 2/min.
> 2/min.
> 2/min.
> 2/min.
> 2/min.
> 2/min.
> 2/min.
Score Risk Rating Step 3 Determine Risk Rating
© 2002 by Humantech, Inc.
H
M
L
H
M
L
H
M
L
H
In the Score box, write the number of risk factor categories (0-4) checked for each body part. Using the table at Risk Rating Score right, circle the 3 or 4 = High (H) corresponding ► 2 = Medium (M) Risk Rating for 0 or 1 = Low (L) each body part.
M
L
H
M
Step 4 Identify Physical Stressors
L
H
M
L
H
M
L
H
M
L
H
M
L
Mark physical stressors observed: Vibration (V) Low Temperatures (L) Soft Tissue Compression (S) Impact Stress (I) Glove Issues (G)
►
Use the corresponding letters to show location of stressors.
www.humantech.com
!
►
Tel. 734.663.6707 Fax 734.663.7747
