Activity Hazard
Assessment Tool
This form must be completed by the PI, Lab Manager, or their designee at least once each calendar year to
conduct an Activity Hazard Assessment specific to activities in their laboratories. The Activity Hazard
Assessment identifies hazards to employees and specifies personal protective equipment (PPE) to protect
employees during work activities. The person conducting the assessment must verify that it is complete and
that training has been conducted.
This assessment consists of:
1. Activity Hazard Assessment
2. Site-specific training conducted by the PI or their designee reviewing: When PPE is necessary, what
PPE is required, how to properly don, doff, adjust and wear PPE, limitations of PPE, proper care,
maintenance, useful life, and disposal of PPE.
EH&S personnel are available to assist you with completing your activity hazard assessment or reviewing it
after completion. Consult EH&S for specific questions regarding PPE requirements. E-mail your EH&S
representative at [email protected].
Requirement #1 - Laboratory Hazard Assessment
3. Conduct a hazard assessment of the laboratory to identify activities where PPE is needed to protect lab staff
from exposure to hazards.
4. Specify the PPE to be used by staff to protect them from the identified hazards.
5. ‘Certify’ the hazard assessment for the laboratory.
Activity
performed
Yes
Chemical Hazards
No
Activity in lab
Potential Hazard
PPE
Poisoning, increased
potential for eye and skin
damage.
Skin or eye damage, potential
poisoning through skin
contact.
Safety glasses or goggles. Light
chemical-resistant gloves. Lab
coat.
Safety goggles. Chemicalresistant gloves. Lab coat and
chemical-resistant apron.
Safety glasses or goggles.
Chemical-resistant gloves. Lab
coat.
 
Major skin or eye damage,
potential poisoning through
skin contact. Fire.
Safety glasses or goggles.
Chemical-resistant gloves. Lab
coat.
with toxic or hazardous
 Working
chemicals (solid, liquid, or gas).
Skin or eye damage, potential
poisoning through skin
contact.
Safety glasses (goggles for large
quantities). Chemical-resistant
gloves. Lab coat.
with small volumes (<4
 Working
liters) of corrosive liquids.
Working with corrosive or acutely
 toxic liquids or other materials which
creates a splash hazard.
Working with small volumes (<4
liters) of organic solvents or
flammable organic compounds.
Working with large volumes (>4
liters) of organic solvents, small to
large volumes of very dangerous
solvents, or work which creates a
splash hazard.
 
Activity Hazard Assessment 6.0
Eye or skin damage.
Page 1 of 6
Activity
performed
Yes
No
Chemical Hazards (continued)
Activity in lab

Eye or skin damage.
Working with Acutely Toxic
Chemicals.
Spills, splashes, ingestion,
inhalation, absorption.
Chemicals pose a high level
of immediate health risk
Safety glasses or goggles,
gloves, lab coat, long pants and
closed toe shoes.
Severe skin and eye damage.
Fire.


Working with pyrophoric liquids


Working with air or water reactive
chemicals.


Working with potentially explosive
chemicals.
Severe skin and eye damage.
Fire.
Splash, detonation, flying
debris, skin and eye damage.
Fire.
with low and high
 Working
temperatures.
Burns, splashes. Fire.
 Minor chemical spill cleanup
Skin or eye damage,
respiratory damage.
 
PPE
Safety glasses or goggles, face
shield for high risk activities.
Chemical-resistant gloves. Lab
coat, chemical-resistant apron
for high risk activities.
with an apparatus with
 Working
contents under pressure or vacuum.

Potential Hazard
Working with Known or Suspect
Human Carcinogens
Spills, splashes, ingestion,
inhalation, absorption. High
hazard cancer-causing
agents
 Working with Reproductive Toxins
Spills, splashes, ingestion,
inhalation, absorption. Agents
that affect reproductive
capabilities, cause mutation
and adversely affect fetal
development
with engineered
 Working
nanomaterials.
Inhalation, exposure, dermal
exposure.
Activity Hazard Assessment 6.0
Safety glasses or splash goggles
with face shield. Chemicalresistant gloves. Flame resistant
lab coat (e.g. Nomex).
Work in inert atmosphere, when
possible. Safety glasses or
goggles. Chemical-resistant
gloves. Lab coat, flame resistant
lab coat for high risk activities
(e.g. Nomex). Chemical-resistant
apron for high risk activities.
Safety glasses, face shield, and
blast shield. Heavy gloves.
Flame-resistant lab coat (e.g.
Nomex).
Safety glasses. Lab coat.
Thermal insulated gloves, when
needed.
Safety goggles. Chemicalresistant gloves. Lab coat.
Chemical-resistant apron and
boot/shoe covers for high risk
activities. Respirator as needed.
Consider keeping Silver Shield
gloves in the lab spill kit.
Safety glasses or goggles,
chemical-resistant gloves, lab
coat, long pants and closed toe
shoes. Hoods, glove boxes and
other suitable containment
device.
Safety glasses or goggles,
chemical-resistant gloves, lab
coat, long pants and closed toe
shoes. Hoods, glove boxes and
other suitable containment
device.
Goggles, gloves, lab coat.
Page 2 of 6
Activity
performed
Yes
No
 
Biological Hazards
Activity in lab
Working with human blood, body
fluids, tissues, or bloodborne
pathogens (BBP).
with preserved animal
 Working
and/or human specimens.
 
 
Working with agents or recombinant
DNA classified as Biosafety Level 1
(BSL-1).
Manipulation of cell lines, viruses,
bacteria, or other organisms
classified as Biosafety Level 2 (BSL2).
Potential Hazard
Exposure to infectious
material.
Exposure to infectious
material or preservatives.
Safety goggles, latex or nitrile
gloves, lab coat or gown.
Eye or skin irritation.
Safety goggles, latex or nitrile
gloves, lab coat or gown.
Exposure to infectious
material, particularly through
broken skin or mucous
membranes.
 
Manipulation of infectious materials
classified as Biosafety Level 2 facility
with BSL-3 practices (BSL-2+).
Exposure to infectious
materials with high risk of
exposure by contact or
mucous membranes.
 
Manipulation of infectious materials
classified as Biosafety Level 3 (BSL3).
Exposure to infectious
materials with high risk of
exposure, particularly through
the inhalation route.
with live animals (Animal
 Working
Biosafety Level 1, ABL-1).
Animal bites, scratches, eye
or skin exposure, inhalation,
allergies.
Activity
performed
Physical Hazards
Yes
No
Activity in lab
PPE
Safety glasses or goggles, latex
or nitrile gloves, lab coat or
gown.
Potential Hazard
Safety glasses or goggles for
protection from splash or other
eye hazard, light latex or nitrile
gloves, lab coat or gown.
Safety glasses or goggles for
protection from splash or other
eye hazard, light latex or nitrile
gloves (double), lab coat or
disposable gown (preferred),
surgical mask.
Safety glasses or goggles for
protection from splash or other
eye hazard, light latex or nitrile
gloves (double), full disposable
gown or Tyvek suite (preferred),
respirator, shoe cover or
dedicated shoe.
Safety glasses or goggles, light
latex, nitrile or vinyl gloves for
broken skin or skin rash, lab coat
or gown. Higher BSL levels
require hair cover, shoe covers,
surgical mask. Consider need for
wire mesh glove.
PPE
 Working with cryogenic liquids.
Major skin, tissue, or eye
damage.
Safety glasses or goggles for
large volumes, impermeable
insulated gloves, lab coat.
freezer vials from liquid
 Removing
nitrogen.
Vials may explode upon rapid
warming. Cuts to face/neck
and frostbite to hands.
Face shield, impermeable
insulated gloves, lab coat.
 
Working with very cold equipment or
dry ice.
Working with hot liquids, equipment,
 open flames (autoclave, Bunsen
burner, water bath, oil bath).
Activity Hazard Assessment 6.0
Frostbite, hypothermia.
Burns resulting in skin or eye
damage.
Safety glasses, insulated gloves
(possibly warm clothing), lab
coat.
Safety glasses or goggles for
large volumes, insulated gloves
(impermeable insulated gloves
for liquids, steam), lab coat.
Page 3 of 6
Activity
performed
Yes
No
Physical Hazards (continued)
Activity in lab
Potential Hazard
PPE
 Glassware washing.
Lacerations.
Heavy rubber gloves, lab coat.
with loud equipment,
 Working
noises, sounds, alarms, etc.
Potential ear damage and
hearing loss.
Earplugs or ear muffs as
necessary.
 Working with a centrifuge.
Imbalanced rotor can lead to
broken vials, cuts, exposure.
Safety glasses or goggles, lab
coat, latex, vinyl, or nitrile gloves.
 
Ear damage, exposure.
Safety glasses or goggles, lab
coat, latex, vinyl, or nitrile gloves,
ear plugs.
Cuts, exposure.
Safety glasses or goggles, lab
coat, latex, vinyl, or nitrile gloves.
Working with a sonicator.
 Working with sharps.
Activity
performed
Yes
No
Radiological Hazards
Activity in lab
with solid radioactive
 Working
materials or waste.
Potential Hazard
PPE
Cell damage, potential spread
of radioactive materials.
Safety glasses, impermeable
gloves, lab coat.
 hazardous chemicals (corrosives,
Cell damage or spread of
contamination plus hazards
for the specific chemical.
Safety glasses (or goggles for
splash hazard), light chemicalresistant gloves, lab coat.
 Working with ultraviolet radiation.
Conjunctivitis, corneal
damage, skin redness.
UV face shield and goggles, lab
coat.
with infrared emitting
 Working
equipment (e.g. glass blowing).
Cataracts, burns to cornea.
Appropriate shaded goggles, lab
coat.
Working with radioactive materials in
flammables, liquids, powders, etc.).
Activity
performed
Yes
No
Laser Hazards
Activity in lab
Potential Hazard
Operating open-beam laser –
Class 3B
Eye (burn/damage).
open-beam laser –
 Operating
Class 4
Eye (burn/damage).
 
 
Handling dye laser materials, such
as powdered dyes, chemicals, and
solvents.
Activity Hazard Assessment 6.0
Skin or eye damage
PPE
Appropriate protective eyewear,
wavelength and optical density
based on individual beam
parameters.
Appropriate protective eyewear,
wavelength and optical density
based on individual beam
parameters. Appropriate skin
protection (covered arms/legs)
Gloves, safety glasses, lab coat.
Page 4 of 6
Unique or Lab Specific Activities
If your lab conducts additional or unique activities not listed above, identify the potential hazards and
appropriate PPE and add these activities to the Unique or Lab-Specific Activities section below. If a lab
activity is similar to but somewhat different than one of the common activities listed, include it in this
section as well.
Activity in lab
Potential Hazard
PPE
Glove Selections for Specific Chemical Hazards
Determine chemical handling activities that require a specific type of glove material to protect from chemical
exposure. Not all glove materials offer equal protection. For this section, select more commonly used
chemicals (corrosives, organic solvents, toxic chemicals) or particularly hazardous chemicals (carcinogens,
mutagens, reproductive hazards, etc.) List the chemical, the work activity and the specific glove type.
Chemical
Activity
Glove Type(s)
Example: formaldehyde
Tissue processing with potential for skin
contact with liquid formaldehyde solution
Nitrile, neoprene or butyl rubber; light gloves may be used
for activities with incidental contact; a heavier glove is
recommended for moderate or greater contact.
Activity Hazard Assessment 6.0
Page 5 of 6
Hazard Assessment Certification All information must be completed below. This ‘certifies’ that you have
conducted the hazard assessment. Maintain a copy of the signed hazard assessment (this document) in the lab
safety records.
Department
Lab Location(s) [building and room numbers]
Principal Investigator
Name and title of person conducting assessment
Name:
Title:
Date assessment completed:
The following employees have reviewed the EH&S Activity Hazard Assessment Tool specific to this lab and
have received the following training:
1. When PPE is necessary
2. What PPE is required
3. How to properly don, doff, adjust, and wear PPE
4. Limitations of PPE
5. Proper care, maintenance, useful life, and disposal of PPE
Worker Name
Activity Hazard Assessment 6.0
UID
Training Date
Trainer
Worker Signature
Page 6 of 6