Update SDS Form

Hazardous Chemical *
(Product Name)

Use *
(How the chemical is used)

Nature of Hazard

Toxic
(Poisonous)

Carcinogenic
(Cancerous)

Teratogen
(Harmful substance that could effect abnormal prenatal development)

Sensitiser
(Reaction to an antigen, such as pollen)

Mutagenic
(Capable of mutating DNA, such as radiation)

Irritant
(Inflammation of the skin, eye or respiratory system)

Flammability
(The ease with which a substance will ignite, causing fire or combustion)

Route of Exposure

Eyes

Skin

Inhalation

Ingestion

Risk of Injury Acute (short term)

HIGH

MEDIUM

LOW

Risk of Injury Chronic (long term)

HIGH

MEDIUM

LOW

Monitoring

Monitoring Required

Health surveillance program

Air monitoring program

Control Measures to reduce exposure * (e.g. Product substitution, environmental ventilation, or P.P.E. usage:

First Aid Requirements and Storage Requirements: *

Assessment by: *

Date: *

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Trained Personnel:

Date:

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