Department:
Document:
The University of Maine Safety and Environmental Management Department
Fieldwork Safety Plan – Appendix B
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MP15310, 01/07/15
APPENDIX B
Field Research Hazard Assessment/Safety Plan
Field research activates can present some unique hazards. These hazards require you
have the same procedures, training, and personal protective equipment in place that we
mandate to protect research teams that work on campus.
As the Principle Investigator (PI) you are responsible of the safety of your team and
completing a Field Research Hazard Assessment/Safety Plan.
Proper planning and implementation will help you reduce the potential of an injury or
illness for everyone on your team.
This form has been designed to assist the Principal Investigator, or faculty member in
charge of the project or field trip as they evaluate risks involved in their field research so
they can develop a comprehensive safety plan.
The completed Safety Plan must be shared with all the members of the field research
team and kept on file on campus. A single Safety Plan can cover multiple trips to the
same location or the same type of work. The Field Research Safety Plan must be revised
whenever a significant change to the location or scope of fieldwork occurs. The
Department of Safety and Environmental Management (SEM) is available to review
these plans, and may conduct periodic reviews of departmental plans.
I.
General Description of Fieldwork
Principal Investigator:
Department:
Phone number:
E-mail address:
Field Research Title:
Briefly describe the fieldwork to be conducted:
II.
Itinerary
Location(s) of fieldwork
Country:
Arrival date:
City (nearest):
Departure date:
Geographic Site:
Accommodations for overnight travel:
B-1
Department:
Document:
The University of Maine Safety and Environmental Management Department
Fieldwork Safety Plan – Appendix B
Modes of transportation (including registration numbers of vehicles/boats that are owned/leased:
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Department:
Document:
III.
The University of Maine Safety and Environmental Management Department
Fieldwork Safety Plan – Appendix B
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MP15310, 01/07/15
Communications
Team Leader:
Phone/email:
University Emergency Contact:
Phone/email:
Family Emergency Contact:
Phone/email:
What means of communication will be available during fieldwork (equipment):
Communication Plan (describe your protocol/schedule for maintaining contact with the university
representative):
Action Plan (describe your protocol/timeline for alerting authorities to begin search and rescue if the
communication plan is not met):
Field Team Membership (Please list the names of all members of the field research team, and the Field Team
Leader.) Include a separate sheet if necessary.
Name/Cell Phone Number (if applicable on site)
Name
Designated Emergency Contact
1. Team Leader 2.
3.
4.
5.
6.
Note: Distribute final plan with all team members and emergency contacts.
B-3
Department:
Document:
IV.
The University of Maine Safety and Environmental Management Department
Fieldwork Safety Plan – Appendix B
Local Contacts
Local (field) Contact:
Phone/email:
Nearest hospital:
Phone/location:
Emergency Services (police, fire, rescue):
Phone/radio:
V.
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Hazard/Risk Assessment
Prior to beginning the fieldwork, a hazard assess must be completed to evaluate the potential hazards
associated with the project. Information that you obtain from this assessment should assist you in determining
the appropriate equipment and training required for the fieldwork.
This section is design to help you identify the potential risks/hazards that you might face during your field
activities.
Risk / Hazards – Please check all that apply:
Infectious diseases
Wildfires
Animal handling
Confined spaces (ex. caves)
Local hazardous plants
Heights (ex. trees, cliffs)
Local wildlife
Unusual terrain
Local insects/arthropods
Historical structures
Water hazards (ex. travel,
High risk community (ex. disaster, health alert)
Ice hazards
Violence (ex. political, military)
Adverse weather conditions
Other:
Notes / Comments:
B-4
Department:
Document:
VI.
The University of Maine Safety and Environmental Management Department
Fieldwork Safety Plan – Appendix B
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MP15310, 01/07/15
Hazards/Risk Considerations
Check all of the items in Column A that apply to your project, Column B provides a list of potential: Necessary
equipment, procedures and tools that will help you prepare and experience a safe and successful research trip,
check all that apply and purchase or prepare those items for your trip.
(Column A)
(Column B)
Work Related Hazards
Personal Protective Equipment:
Animal handling
Flying debris or impact (eyes)
Impact or electrical contact (head)
Excessive noise
Cuts, abrasions (hands)
Impact or compression (feet)
Fall hazards
Water hazards
Low visibility hazards (hunting, road work, etc.)
Electrical
Fire hazards (welding, cutting)
Other:
Environmental Hazard:
Barriers for direct contact with animals
Safety glasses/goggles/face shield
Hard hat (with/without headlight)
Hearing protection
Gloves (as appropriate)
Work boots (hiking, steel toe)
Personal fall arrest system
Floatation devices
Fluorescent orange or reflectorized vests
Flame-resistant or flame-retardant clothing
Portable fire extinguisher
Other:
Clothing/Equipment/Provision:
Excessive heat/sunlight
Excessive cold
Under water/diving (must be certified. See
UMaine Dive Safety Program)
Remote location
Insects/Ticks/Spiders
Other:
Personal Health:
Light clothing, wide-brimmed hat, sunscreen
Thermal clothing, blankets, etc.
Wet suit
Navigation Tools, Bivouac gear, etc.
Insect repellant, appropriate clothing
Other:
Preparedness:
Medical conditions
Allergies (food, plant, insect, etc.)
Inadequate food source
Inadequate drinking water source
Medications (taken on a regular basis)
Allergy treatments (as needed)
Adequate food supplies
Water purification tablets or filter devices
B-5
Department:
Document:
The University of Maine Safety and Environmental Management Department
Fieldwork Safety Plan – Appendix B
Emergency:
Equipment/Provision:
Injury or medical emergency
Flat tire, out-of-gas, etc.
Night work, caving, etc.
Lost, trapped, stranded
Ice
Other:
VII.
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First aid training, kit and field manual
Vehicle emergency kit (spare tire, jack, flares)
Flashlight with extra batteries
Ability to signal (flares, mirror, light sticks, etc.)
Two-way radio and/or cellular phone
Flagging tape or entrance marker flag
Shovel, rakes, hand tools
Generator with sufficient fuel
Extra food, water, and clothing
Other:
Training and Certification
Personnel must receive the appropriate training or possess the years of experience for the functions
and environment they will be operating in either beforehand or as part of the work. The training of
leaders is particularly important and for some activities it will be required. Some require formal
qualifications (e.g. Wilderness First Aid, Diving, Watercraft training, etc.). Check all the apply in
Column A and review Column B to determine what training is required.
Column A
Column B
Hazard/Equipment/Work:
Please check all that apply.
Injury – remote location, high hazard
Confined Space Entry
Electrical Hazards
Fall Hazards
Ladders
Chain Saws
Excavations and Trenching
Forklift
Chemicals, biological, radiation
Hazardous energy sources
Work-related health exposures
Highway or construction sites
Boating
Caving
Research Diving
Large Animals
All Terrain Vehicles (ATVs)
Other:
Other:
Other:
Other:
Other:
Required Training (See SEM for assistance)
VIII.
Wilderness First Aid and CPR Certification
Confined Space Entrant/Attendant/Supervisor
Electrical Awareness or Qualified Person
Fall Protection User
Ladder Safety
Chain Saw Safety
Excavation Competent Person
Forklift Operator Certification
Chemical/Biological/Radiation Safety
Lockout/Tagout Authorized Person
Medical Surveillance
Flagger Certification/Reverse Signal Operations
Boating license
Cave Work Plan
Certified Scientific Diver
Trained by a competent person
ATV Safety
Other:
Other:
Other:
Other:
Other:
Critical Procedures, Protocols, and Rules
B-6
Department:
Document:
The University of Maine Safety and Environmental Management Department
Fieldwork Safety Plan – Appendix B
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MP15310, 01/07/15
Now that you have completed the Hazard Assessment and identified many of the tools you will need to
maintain a safe working environment, please describe the critical procedures, protocols, and rules that are
required for you. If they are unique hazards/safety protocol that must be followed, this is the section to
document such items.
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