TDI/DWC
Personal Protective Equipment (PPE) Analysis Worksheet
|Department |Hazard Key |Body Part Key |PPE Required Key |
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|________________________ |Cut |Head |A. Hard hat |
| |Abrasion |Face |B. Chemical goggles |
|Job Title |Burn |Eye(s) |C. Safety glasses |
| |Fall |Ear(s) |D. Ear plugs |
|________________________ |Falling objects |Respiratory System |E. Ear muffs |
| |Noise |Trunk |F. Body harness |
|Location of Job Duties |Flying particles |Arm(s) |G. Gloves (list type) |
| |Inhalation |Hand(s) | |
|________________________ |Bump |Finger(s) |________________________ |
| |Slip |Leg(s) | |
|Analysis Done By |Splash |Foot/Feet |H. Shoes/boots (list type) |
| |Other |Toe(s) | |
|________________________ | |Other |________________________ |
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|Date | | |I. Respirator |
| | | |J. Other ________________ |
|________________________ | | | |
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|Activities/Tasks |Potential Hazards |Body Part(s) |PPE Required |
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