Você está na página 1de 16

Check List

O questionrio abaixo usado para facilitar o levantamento dos riscos, se a CIPA


considerar necessrio, lembre se de sempre colocar o nvel do risco, grande,
mdio e pequeno para que na elaborao do Mapa eles sejam devidamente
marcados.

Riscos Ambientais
Grupo I
Agentes
Qumicos
Poeira

Grupo II
Agentes
Fsicos
Rudo

Grupo III
Agentes
Biolgicos
Vrus

Fumos Metlicos

Vibrao

Bactria

Nvoas

Radiao
ionizante
e no ionizante
Presses
anormais

Protozorios

Gases

Temperatura
extremas

Bacilos

Trabalho
noturno

Produtos qumicos
em geral

Frio

Parasitas

Responsabilidade
e
Conflito
Tenses
emocionais
Desconforto
Monotonia

Vapores

Fungos

Calor

Grupo V
Agentes
Mecnicos
Arranjo
fsico deficiente
Mquinas
sem proteo
Matria-prima
fora de
especificao
Equipamentos
inadequados/
defeituosos ou
inexistentes
Ferramentas
defeituosas/
inadequadas ou
inexistentes
Iluminao
deficiente
Eletricidade

Substncias,
compostos ou
produtos qumicos
em geral
outros

Umidade

outros

outros

outros

outros

VERMELHO

VERDE

MARROM

AMARELO

AZUL

Risco Grande

Insetos
cobras
aranhas, etc.

Grupo IV
Agentes
Ergonmicos
Trabalho
fsico pesado
Posturas
incorreras
Treinamento
inadequado/
inexistente
Jornadas
prolongadas
de trabalho

Risco
Mdio

Incndio
Edificaes
Armazenamento

Risco
Pequeno

Setor: __________________________________
1.

Grupo Agentes Qumicos

01. Existem produtos qumicos na seo? Quais? Medida preventiva, Grau do Risco
e fonte geradora.
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
02. Existem emanaes de gases, vapores, nvoas, fumos, neblinas e outros? De
onde so provenientes? Medida preventiva, Grau do Risco e fonte geradora.
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
03. Como so manipulados os produtos qumicos? Medida preventiva, Grau do Risco
e fonte geradora.
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
04. Existem equipamentos de proteo coletiva na seo? Quais? Medida
preventiva, Grau do Risco e fonte geradora.
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
05. Estes equipamentos so eficientes? Se no forem eficientes, indique as causas.
Medida preventiva, Grau do Risco e fonte geradora.
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________

06. Quais so os Equipamentos de Proteo Individual EPIs utilizados na seo?


Medida preventiva, Grau do Risco e fonte geradora.
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
07. Existem riscos de respingos na seo? Por qu? Medida preventiva, Grau do
Risco e fonte geradora.
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
08. Existe risco de contaminaes? Atravs de qu? Medida preventiva, Grau do
Risco e fonte geradora.
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
09. Usam leos/graxas e lubrificantes em geral? Medida preventiva, Grau do Risco
e fonte geradora.
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
10. Usam solventes? Quais? Medida preventiva, Grau do Risco e fonte geradora.
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________

11. Sobre os processos existem outros fiscos a considerar? Medida preventiva,


Grau do Risco e fonte geradora.
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________

Observaes complementares:

Recomendaes:

2. Grupo

Riscos Fsicos

01. Existe rudo constante na seo? Medida preventiva, Grau do Risco e fonte
geradora.
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
02. Existe rudo intermitente na seo? Medida preventiva, Grau do Risco e fonte
geradora.
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________

03. Indique os equipamentos mais ruidosos:


_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
04. Os funcionrios utilizam protetor Auricular?
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
05. Existe calor excessivo na seo? Medida preventiva, Grau do Risco e fonte
geradora.
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
06. Existem problemas com o frio na seo? Medida preventiva, Grau do Risco e
fonte geradora.
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
07. Existe radiao na seo? Medida preventiva, Grau do Risco e fonte geradora.
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
08. Indique os pontos deficientes:
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________

09. Existem problemas de vibraes? Medida preventiva, Grau do Risco e fonte


geradora.
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________

10. Existe umidade na seo? Medida preventiva, Grau do Risco e fonte geradora.
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
11. Existem Equipamentos de Proteo Coletiva na seo? Eles so eficientes? Se
ho, indique as causas:
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________

Observaes complementares:

Recomendaes:

3. Grupo

Riscos Biolgicos

01. Existe problema de contaminao por vrus, bactrias, protozorios, fungos e


bacilos na seo? Medida preventiva, Grau do Risco e fonte geradora.
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
02. Existe problema de parasitas? Medida preventiva, Grau do Risco e fonte
geradora.
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
03. Existe problema de proliferao de insetos? Onde? Medida preventiva, Grau do
Risco e fonte geradora.
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
04. Existe problema de aparecimento de ratos? Onde? Medida preventiva, Grau do
Risco e fonte geradora.
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
05. Existe problema de mau acondicionamento de lixo orgnico? Medida preventiva,
Grau do Risco e fonte geradora.
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________

Observaes complementares:

Recomendaes:

4. Grupo

Riscos Ergonmicos

01. 0 trabalho exige esforo fsico pesado? Medida preventiva, Grau do Risco e
fonte geradora.
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
02. Indique as funes e o local relativos a esforos fsicos.
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
03. 0 trabalho exercido em postura incorrera? Medida preventiva, Grau do Risco
e fonte geradora.
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________

04. Indique as causas da postura incorreta.


_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
O5. 0 trabalho exercido em posio incmoda? Medida preventiva, Grau do Risco
e fonte geradora.
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
06. Indique a funo, o local e equipamentos ou objetos relativos posio
incomoda.
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
07. 0 ritmo de trabalho excessivo? Em que funes? Medida preventiva, Grau do
Risco e fonte geradora.
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
08. 0 trabalho montono? Em que funes? Medida preventiva, Grau do Risco e
fonte geradora.
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
9. H excesso de responsabilidade ou acmulo de funo? Sim ( ) No ( )
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________

10. H problema de adaptao com EPIs? Quais?


_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________

Observaes complementares:

Recomendaes:

5. Grupo Riscos de Acidentes (Mecnicos)


01 - Com relao ao arranjo fsico, os corredores e passagens esto desimpedidos
e sem obstculos? Medida preventiva, Grau do Risco e fonte geradora.
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
02 - Indique os pontos onde aparecem estes problemas.
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________

03. Os materiais ao lado das passagens esto convenientemente arrumados?


Medida preventiva, Grau do Risco e fonte geradora.
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
04 - Os produtos qumicos esto convenientemente guardados? Medida preventiva,
Grau do Risco e fonte geradora.
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
05, - Os servios de limpeza so organizados na seo? Medida preventiva, Grau do
Risco e fonte geradora.
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
06 - 0 piso oferece segurana aos trabalhadores? Medida preventiva, Grau do
Risco e fonte geradora.
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
07 -Existem chuveiros de emergncia e lava olhos na seo? Medida preventiva,
Grau do Risco e fonte geradora.
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________

08 -Com relao a ferramentas manuais, estas so usadas em bom estado? Onde?


Medida preventiva, Grau do Risco e fonte geradora.
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
09 - As ferramentas utilizadas so adequadas? Medida preventiva, Grau do Risco e
fonte geradora.
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
10 - As mquinas e equipamentos esto em bom estado?
Se no, indique os problemas e identifique funo / local. Medida preventiva, Grau
do Risco e fonte geradora.
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
11 - As mquinas esto em local seguro? Medida preventiva, Grau do Risco e fonte
geradora.
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
12 -0 operador para as mquinas para lubrific-las? Se no, explique por qu.
Medida preventiva, Grau do Risco e fonte geradora.
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________

13. 0 boto de parada de emergncia da mquina visvel e est em local prximo


ao operador? Indique as mquinas onde o boto de parada est longe ou no
funciona. Medida preventiva, Grau do Risco e fonte geradora.
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
14. A chave geral das mquinas de fcil acesso? Medida preventiva, Grau do Risco
e fonte geradora.
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
15. Indique outros problemas de acionamento ou desligamento de equipamentos.
Medida preventiva, Grau do Risco e fonte geradora.
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
16. As mquinas tm proteo (nas engrenagens, corretas, polias, contra
estilhaos)? Indique os equipamentos e mquinas que necessitam de proteo.
Medida preventiva, Grau do Risco e fonte geradora.
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
17. Os operadores param as mquinas para limp-las, ajust-las ou consert-las? se
no, explique por qu. Medida preventiva, Grau do Risco e fonte geradora.
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________

18. Os dispositivos de segurana das mquinas atendem s necessidades de


segurana? Se no, indique os casos. Medida preventiva, Grau do Risco e fonte
geradora.
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
19. Nas operaes que oferecem perigo os operadores usam EPIs?
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
20. Quanto aos riscos com eletricidade, existem mquinas ou equipamentos com
fios soltos sem isolamento? Indique onde. Medida preventiva, Grau do Risco e
fonte geradora.
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
21. Os interruptores de emergncia esto sinalizados (pintados de vermelho)?
Indique onde falta. Medida preventiva, Grau do Risco e fonte geradora.
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
22. Existem cadeados de segurana nas caixas de chaves eltricas, ao operar com
alta tenso? Indique onde falta. Medida preventiva, Grau do Risco e fonte
geradora.
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________

23. A iluminao adequada e suficiente? Medida preventiva, Grau do Risco e


fonte geradora.
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
24. H instalaes eltricas provisrias? Indique onde. Medida preventiva, Grau do
Risco e fonte geradora.
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
25. Indique pontos com sinalizao insuficiente ou inexistente. Medida preventiva,
Grau do Risco e fonte geradora.
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
26. Quanto aos transportes de materiais, indique o meio de transpor te e aponte os
riscos. Medida preventiva, Grau do Risco e fonte geradora.
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
27. Quanto edificao, existem riscos aparentes? onde? Medida preventiva, Grau
do Risco e fonte geradora.
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________

Observaes complementares:

Recomendaes: