Ergonomic Risk Assessment Checklist Template - FREE PDF

Ergonomic risk assessment checklist template

Created for safety professionals, HR managers, and facility supervisors, this ergonomic risk assessment template provides a structured framework to evaluate workplace ergonomic hazards and prevent musculoskeletal disorders. The average cost of a workplace repetitive motion injury is approximately $40,000, making prevention essential for your bottom line.

This template includes sections for evaluating physical demands, workstation design, tool usage, and environmental factors showing all key elements in identifying ergonomic risks. You’ll assess factors like force requirements, repetition frequency, awkward postures, and contact stress, then prioritize interventions based on risk severity.

The template’s scoring system helps you quantify risks and track improvements over time, ensuring your ergonomic initiatives deliver measurable results for both employee wellbeing and operational efficiency.

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Preview of the template

Audit

General Information

How many employees do you have?

Describe the work:

Attach a photo of the workplace:

Ergonomic

Are all workers aware of lifting techniques, uses, and carrying devices?

Are workers preserved against eyestrain or brightness while they're working?

Are all employees informed of safe working postures?

Do all workers know about ergonomics policies and methods?

Do the employees use rotation or rest breaks decrease time in uncomfortable postures?

Does work scheduling decrease unnecessary overtime that leads to tiredness?

Do workers report ergonomic symptoms when there are any and know who to report them to?

Are there sufficient workers to do all the workloads?

Can the work be done without turning too much or overly bending the (lower) back?

Are workstations installed correctly?

Are neck and shoulders relaxed when performing tasks?

Are all employees directed to get help when lifting weighty materials?

Are all items of furniture or equipment adjusted, put in place, and designed to reduce strain on all bodyparts?

Are workers performing their job without experiencing any pressure points on any bodypart?

Surfaces for Walking and Working

Are walking surfaces flat/balanced?

Are surfaces (working as well as walking) neat and dry?

Are all working surfaces unobstructed?

Materials Handling

Are there vehicles, dollies, or other assistants readily accessible for transferring loads?

Is the place clear enough to allow the usage of carts?

Are all loads marked with their size and weight?

Do (especially heavy) loads have handles to help carry them?

Are all supplies delivered as nearby as possible to where they will be used?

Are all materials deposited at waist height?

Tools and Equipment

Are all tools light weight and well balanced?

Is there any device that can be used to decrease kneeling?

Is there minimal vibration when using tools and equipment?

Do all tools have right handle design?

Are knee pads or cushions ready when operating at floor level?

Is it feasible to use adjustable stools to give workers a place to rest?

Are all tools sharp and in good condition?

Are there scaffolds, platforms, or other equipment available to reduce the need to work overhead?

Is there anti-exhaustion matting provided when a worker is ordered to stand all day?

Seating

Are the seats well-created, simple to modify, and comfortable?

Is the vibration at the minimum on the seats of any heavy equipment?

Do employees have to bend forward to see/perform their task when operating on heavy equipment?

Completion

Any further recommendations?

Overall evaluation:

Name and signature of the inspector:

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Frequently asked questions

What specific risk factors does the ergonomic risk assessment template help identify?

The template helps identify key ergonomic risk factors including awkward postures, repetitive motions, forceful exertions, contact stress, vibration exposure, and static postures. It guides you through evaluating each factor’s frequency, duration, and intensity to determine overall risk levels and prioritize interventions that will have the greatest impact on preventing musculoskeletal disorders.

How often should I conduct ergonomic risk assessments using this template?

Conduct assessments annually as a baseline, but also when introducing new equipment, changing work processes, after an ergonomic-related injury, or when employees report discomfort. Regular assessments help identify emerging issues before they cause injuries and allow you to evaluate the effectiveness of previously implemented controls

How do I prioritize which areas or workstations to assess first?

Prioritize areas with high injury rates, departments where employees report frequent discomfort, workstations with repetitive tasks, jobs requiring forceful exertions, and positions with limited mobility. Also consider assessing workstations where employees have recently returned from ergonomic-related injuries to ensure proper accommodations are in place.

What should I do after identifying high-risk ergonomic issues with the template?

After identifying high-risk issues, develop an action plan that includes engineering controls (modifying equipment or workstations), administrative controls (job rotation or work pace adjustments), and training. Prioritize interventions based on risk severity, implementation feasibility, and potential impact. Document your plan, assign responsibilities, set deadlines, and schedule follow-up assessments to verify effectiveness.

This template, developed by Lumiform employees, serves as a starting point for businesses using the Lumiform platform and is intended as a hypothetical example only. It does not replace professional advice. Companies should consult qualified professionals to assess the suitability and legality of using this template in their specific workplace or jurisdiction. Lumiform is not liable for any errors or omissions in this template or for any actions taken based on its content.