Free COSHH Assessment Template [2026]

COSHH ASSESSMENT

Assessment Reference:	[COSHH-001]
Date of Assessment:	[DD/MM/YYYY]
Review Date:	[DD/MM/YYYY. max 12 months]
Project Name:	[Enter project name]
Assessed By:	[Name, qualification]
Activity:	[Activity where substance is used]

1. Substance Details

Product Name:	[Exact product name as on label]
Manufacturer:	[Manufacturer name]
SDS Reference:	[Safety Data Sheet ref / date]
Hazardous Ingredients:	[List active hazardous ingredients]
Physical Form:	[Liquid / Powder / Paste / Gas / Dust / Fibre]
GHS Hazard Pictograms:	[List applicable symbols: Skull, Exclamation, Corrosion, Health Hazard, Flame, etc.]
H-Statements:	[E.g. H315 Causes skin irritation, H335 May cause respiratory irritation]
WEL / OEL:	[Workplace Exposure Limit if applicable, e.g. "Silica dust: 0.1 mg/m3"]

2. How Substance is Used

[Describe exactly how the substance is used on site, quantities used, frequency of use, and duration of exposure. E.g. "PU adhesive applied by hand using cartridge gun. Approximately 10 cartridges per day. Each application takes 5 minutes. Used daily for 3 weeks."]

3. Route of Exposure

Route	Applicable?	Details
Inhalation	[Yes / No]	[Fumes, vapour, dust generated during use]
Skin Contact	[Yes / No]	[Direct handling, splashes, contaminated surfaces]
Eye Contact	[Yes / No]	[Splashes, airborne particles]
Ingestion	[Yes / No]	[Hand-to-mouth transfer, contaminated food/drink]

4. Persons at Risk

[Identify all persons who may be exposed: operatives using the substance, others working nearby, visitors. Consider vulnerable groups: asthmatics, pregnant workers, those with existing skin conditions.]

5. Health Effects

[Describe the potential health effects from the Safety Data Sheet. Distinguish between acute effects (immediate: irritation, burns, dizziness) and chronic effects (long-term: occupational asthma, dermatitis, cancer). E.g. "Acute: skin and eye irritation, respiratory irritation. Chronic: occupational dermatitis with repeated exposure."]

6. Control Measures (Hierarchy)

Level	Control Measure	Implemented?
Elimination	[Can the substance be eliminated entirely? E.g. mechanical fixing instead of adhesive]	[Yes/No/N/A]
Substitution	[Can a less hazardous product be used? E.g. water-based instead of solvent-based]	[Yes/No/N/A]
Enclosure / LEV	[Local exhaust ventilation, enclosed mixing areas, on-tool extraction]	[Yes/No/N/A]
Administrative	[Training, safe system of work, reduced exposure time, rotation of workers]	[Yes/No/N/A]
PPE	[List specific PPE required. type of gloves, respirator filter type, goggles vs safety glasses]	[Yes/No/N/A]

7. PPE Requirements

PPE Item	Standard / Type	Notes
Gloves	[E.g. Nitrile, chemical resistant to EN 374]	[Change every X hours, check for degradation]
Respirator	[E.g. FFP3 disposable / Half-mask with A2P3 filters]	[Face-fit tested, clean-shaven policy]
Eye Protection	[E.g. Chemical splash goggles EN 166]	[Required during mixing and application]
Coveralls	[E.g. Type 5/6 disposable coveralls]	[Dispose after use, do not reuse]

8. Storage and Disposal

[Detail storage requirements: temperature, ventilation, segregation from incompatible materials, COSHH cabinet. Disposal: licensed waste carrier, correct waste code, never pour down drains.]

9. Emergency Procedures

[First aid measures for each route of exposure (as per SDS). Spill procedure. Fire precautions. Emergency contact numbers. Location of eyewash station and emergency shower if applicable.]

10. Monitoring and Health Surveillance

[Is exposure monitoring required? Is health surveillance required (e.g. lung function tests for isocyanates, skin checks for cement dermatitis)? State frequency and responsible person.]

Sign-Off

Role	Name	Signature	Date
Assessor
Approved