DISPLAY EQUIPMENT HEALTH AND SAFETY CHECK LIST Name:
Department /Workstation Location: When was the last time you had your Eyes tested? Date: Do you use your computer to carry out your work on a daily basis? Yes ☐ No ☐ Do you work on your computer for more than an hour at any one time? Yes ☐ No ☐ There is no requirement to complete this form If the answer to both of the above questions is NO. Equipment Screen: Does the screen swivel and tilt? Is the screen free of glare and reflections? Is the image stable? Is the text size comfortable to read? Can brightness and contrast be adjusted? Keyboard and Mouse: Is the keyboard separate from the screen? Can the keyboard be moved to a comfortable position in front of you? Can the keyboard be tilted? Can a comfortable keying position be found? Can your hands be rested in front of the keyboard? Can the characters on the keys be read easily? Is the keyboard clean? Is the mouse/ trackball suitable for the tasks it is used for? Does it work smoothly at a speed that suits you? Can you easily adjust the software settings for speed and accuracy of pointer? Is the mouse positioned close to you? Do you have a mouse mat, if required? Desk: Is the desk stable? Is there adequate work surface to allow a flexible arrangement for the screen, keyboard and mouse operation? Do you have enough room for your legs? Is the area where you rest your feet free from cables/obstructions? Is the surface free of reflections and glare?
Comments Yes ☐ Yes ☐ Yes ☐ Yes ☐ Yes ☐
No ☐ No ☐ No ☐ No ☐ No ☐ Comments
Yes ☐ No ☐ Yes ☐ No ☐ Yes ☐ No ☐ Yes ☐ No ☐ Yes ☐ No ☐ Yes ☐ No ☐ Yes ☐ No ☐ Yes ☐ No ☐ Yes ☐ No ☐ Yes ☐ No ☐ Yes ☐ No ☐ Yes ☐ No ☐ Comments Yes ☐ No ☐ Yes ☐ No ☐ Yes ☐ No ☐ Yes ☐ No ☐ Yes ☐ No ☐
Chair: Is the chair suitable and stable i.e. has a fivestar configuration on castors? Do the adjustment mechanisms work? Can you adjust the height of your chair? Can you adjust your backrest? Does the chair swivel to allow access to the work surface and storage? Are you comfortable? If the chair is fitted with arms, can you place the chair into a comfortable position under the desk without it being obstructed by the arms?
Comments Yes ☐ No ☐ Yes ☐ No ☐ Yes ☐ No ☐ Yes ☐ No ☐ Yes ☐ No ☐ Yes ☐ No ☐ Yes ☐ No ☐ N/A ☐
Environment Is there enough room to change position and Yes ☐ move/stretch? Is the work arranged so that there are breaks Yes ☐ away from the DSE? Are the levels of heat, light and humidity Yes ☐ comfortable? Is there a source of fresh air? Yes ☐ Are the noise levels comfortable? Yes ☐ Do you have a document holder, if required? Yes ☐ Posture Is the display screen located in front of you when using the equipment? Can you view the screen without turning your head? Is the top of the screen level with your eye level? Is there sufficient room in front of the keyboard to rest your wrists when not using the keyboard? Is the keyboard directly in front of you? When positioned to use the keyboard are your upper arms in line with your upper body? Are your forearms approximately horizontal when typing? With your fingers on the keys are your wrists straight? Can you operate the mouse/ trackball without reaching? Can you operate the mouse/ trackball with your hand/ wrist resting on the desk? Is there adequate space to manoeuvre the mouse/ trackball? Is the small of your back supported by the chairs backrest? Are your forearms horizontal when the chair is adjusted?
No ☐ No ☐ No ☐ No ☐ No ☐ No ☐
Yes ☐ No ☐ Yes ☐ No ☐ Yes ☐ No ☐ Yes ☐ No ☐ Yes ☐ No ☐ Yes ☐ No ☐ Yes ☐ No ☐ Yes ☐ No ☐ Yes ☐ No ☐ Yes ☐ No ☐ Yes ☐ No ☐ Yes ☐ No ☐ Yes ☐ No ☐
Do your feet rest comfortably on the floor without the seat digging into the back of your knees / thighs? Is there adequate knee room to obtain a comfortable position? Is there adequate leg room under the desk to move your legs and feet?
Yes ☐ No ☐ Yes ☐ No ☐ Yes ☐ No ☐
Health Whilst using the computer, have you ever suffered from: Eyestrain? Pain in the back/neck/shoulders? Pain in the arms (elbows/wrists/hands)? Pain elsewhere? (please specify)
Comments / Specify Yes ☐ Yes ☐ Yes ☐ Yes ☐
No ☐ No ☐ No ☐ No ☐
Software Is the software easy to use and suitable for the Yes ☐ No ☐ task? Laptop Users Is the laptop your main computer? Yes ☐ Do you use a separate keyboard when using the Yes ☐ laptop for long periods? Do you use a separate mouse when using the Yes ☐ laptop for long periods? Is there sufficient space in front of the keyboard Yes ☐ to support your wrists? Is the laptop on a firm and level surface and at a Yes ☐ comfortable height for typing? Do you have a docking station or other suitable device to ensure that the screen is at a suitable Yes ☐ viewing height, when using it for long periods?
No ☐ No ☐ No ☐ No ☐ No ☐ No ☐
Information/Training Have you been given information on how to set Yes ☐ No ☐ up your workstation? Do you know who to ask for further advice? Yes ☐ No ☐ Signed by User:
If completed electronically tick box (no signature required) ☐
Date:
This section is to be completed by your Manager/Supervisor Manager’s Comments /Further control Further Control Measures Follow up Measures Required: Allocated to Target Date (Name) Date Completed
Manager’s Name:
If completed electronically tick box (no signature required) ☐
Date: