Workplace Ergonomic Assessment Checklist Template - FREE PDF

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Workplace ergonomic assessment checklist template

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Use this template with Lumiform

The Lumiform application helps frontline teams uphold internal standards effortlessly.

Customize this template or build your own
Fill out templates via mobile app
Assign and track corrective actions
Get reports and analyse your data

Prices start from ░░░ per month

Book a demo

Learn more

Our workplace ergonomic assessment checklist helps you identify and address potential ergonomic hazards before they lead to injuries. This comprehensive template guides you through evaluating workstations, equipment, posture, and environmental factors that impact employee comfort and safety.

When your manufacturing team started reporting increased discomfort after equipment rearrangements, this checklist helped pinpoint improper monitor heights and inadequate chair adjustments, preventing costly musculoskeletal disorders. According to Ergocenter at NC State University, companies implementing ergonomic improvements see an average 59% reduction in musculoskeletal disorders and also a 65% decrease in associated workers’ compensation costs.

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Preview of the template

Page 1

Workstation Setup

Is the chair height adjusted so your thighs are parallel to the ground and your feet are flat on the floor?

Is the backrest adjusted to provide good lower back support?

Is the desk height adjusted so your elbows are at a 90-100 degree angle when typing?

Is the monitor height adjusted so the top third of the screen is at or slightly below eye level?

Is the monitor positioned directly in front of you, about an arm's length away?

Is the keyboard and mouse positioned close to the body, within easy reach?

Work Environment

Is the lighting adequate and free of glare on the computer screen?

Is the work area free of clutter and tripping hazards?

Is the temperature and humidity comfortable?

Is the noise level appropriate for the work being performed?

Break Time

Do you take regular breaks to stretch and move around?

Do you avoid prolonged periods of sitting or standing?

Frequently asked questions

What should I focus on first when using a workplace ergonomic assessment checklist?

Begin with the most frequently used workstations and areas with reported discomfort. Prioritize evaluating chair adjustability, monitor positioning, keyboard and mouse placement, and lighting conditions. These elements typically have the greatest impact on employee comfort and are often the easiest to correct.

How often should I conduct workplace ergonomic assessments using this checklist?

Conduct comprehensive assessments annually, but also perform targeted evaluations when purchasing new equipment, rearranging workspaces, or receiving employee complaints about discomfort. For new employees, complete an assessment within their first month to ensure proper workstation setup from the start.

How can I use the results from the workplace ergonomic assessment checklist effectively?

Document all findings with photos and detailed notes, prioritize issues based on risk severity, and develop an action plan with specific timelines. Track improvements over time by comparing assessment results, and also use the data to justify budget requests for ergonomic equipment and modifications.

How do I address ergonomic issues that require significant changes or budget?

Start by implementing no-cost or low-cost solutions like adjusting existing equipment, rearranging workstations, or providing ergonomic education. Document how these issues impact productivity and health to build a business case. Present a phased implementation plan that prioritizes high-risk areas first.

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.