Activity Hazard Analysis (AHA)

Activity/Work Task: Fixed Scaffold Overall Risk Assessment Code (RAC) (Use highest code) M
Project Location: Risk Assessment Code (RAC) Matrix
Contract Number: Severity Probability
Date Prepared: Frequent Likely Occasional Seldom Unlikely
Prepared by (Name/Title): Catastrophic E E H H M
Critical E H H M L
Reviewed by (Name/Title): Marginal H M M L L
Negligible M L L L L
Notes: (Field Notes, Review Comments, etc.) Step 1: Review each “Hazard” with identified safety “Controls” and determine RAC (See above)
This AHA should be used in conjunction with AHA’s developed for Definable
Features of Work (DFOW). In addition, this AHA is designed as a tool to “Probability” is the likelihood to cause an incident, near miss, or accident and RAC Chart
reduce hazards / risks to a state of As Low As Reasonably Possible identified as: Frequent, Likely, Occasional, Seldom or Unlikely.
(ALARP). “Severity” is the outcome/degree if an incident, near miss, or accident did E = Extremely High Risk
occur and identified as: Catastrophic, Critical, Marginal, or Negligible H = High Risk
Step 2: Identify the RAC (Probability/Severity) as E, H, M, or L for each M = Moderate Risk
“Hazard” on AHA. Annotate the overall highest RAC at the top of AHA. L = Low Risk
Job Steps Hazards Controls RAC

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 ACTIVITY HAZARD ANALYSIS (AHA)
1. Contract Number: 2. Contractor Name: 3. Date prepared:
4. Title/Activity Performed: FIXED SCAFFOLDING 5. Location: 6. Estimated Date of Completion:
7. PRINCIPAL STEPS 8. POTENTIAL HAZARDS 9. RECOMMENDED CONTROLS
General Safety Requirements all Steps Exposure to Cold or Hot Weather Minimum Personal Protective Equipment Dress:
Long Pants
Dehydration Shirts with Sleeves
Hardhat
**Add additional potential hazards for general Covered Shoes (Steel Toe Preferred)
on site safety requirements. ** Safety Glasses (Potential Eye Hazard Areas)
The above hazards are not all inclusive and Weather:
the Site Safety and Health Officer including
the Quality Assurance Representative (QAR) Wear appropriate clothing for hot or cold weather.
shall review the AHAs (List specific clothing or refer to Company quick sheet, SOPs,
plan, etc. for specific details)
Sun block
Lip balm

Dehydration:

Drink at least ½ liter of water an hour.

Refer to Company quick sheet, SOPs, plan, etc. for
specific details on heat stress signs and symptoms.
 7. PRINCIPAL STEPS 8. POTENTIAL HAZARDS 9. RECOMMENDED CONTROLS
1.. Set-Up 1. Back Strain from uploading or moving scaffold 1a. Utilize proper lifting techniques.
components. 1b. Size up load before lifting.
2. Lacerations on hands 1c. Ask for help when lifting heavy items more than 50 lbs.
3. Scaffold failure due to damaged scaffolding
components. 2. Wear leather gloves.
4. Struck by mechanized equipment.
5. Loss of load. 3a. INSPECT all scaffolding components defects or damage such
6. Stuck by suspended loads or material. as cracks, excessive rust, metal fatigue, unauthorized repairs, bent
7. Electrical Shock tubing or frame, etc.
8. Scaffold failure due to improper set-up Frames
Tubing
Base Plates
Locking Pins
Access Ladder
Planking (Wood or Metal)
Cross Braces
3b. REMOVE damaged or defective scaffold components
immediately.
3c. Attach tag or label “DO NOT USE” on scaffold component.

4a. ALWAYS maintain eye contact with operator of equipment.

4b. NEVER stand behind (Blind Spots) equipment.
4c. NEVER stand near unloading or moving of scaffold
components.
4d. ONLY qualified operators shall operate equipment.

5a. Secure loads from displacement with ropes, cables, chains,

etc. before movement.
5b. Ensure load to be lifted is secured, balanced, etc.
5c. Keep hands, fingers, or other body parts away from pinch
points.

6a. NEVER stand underneath suspended loads.

6b. Use taglines to control loads when elevated.

7a. Check above for overhead power lines.

7b. NEVER erect scaffolding within 10 ft (3 m) of overhead power
lines. Refer to EM 385-1-1, Table 11-1 for Minimum Clearance
from Energized Overhead Electrical Lines
7c. NEVER string or hang temporary power cords, wires, etc. on
metal scaffolding. Consult with Safety Officer.

8a. Inspect ground conditions (level and firm).

8b. Stable base is necessary for proper scaffold assembly.
8c. Scaffold shall be tied into structure when the scaffold height
exceeds four times the minimum scaffold base dimension per EM
385-1-1, para 22.B.09
 7. PRINCIPAL STEPS 8. POTENTIAL HAZARDS 9. RECOMMENDED CONTROLS
2. Assembly of Scaffolding 1 Fall from Elevated Heights 1a. 100 percent fall protection required during assembly.
2. Scaffold Failure 1b. Personnel shall not be exposed to unprotected sides or falls
3. Back Strain greater than 6 ft (1.8 m).
4. Lacerations on hands 1c. Scaffolding shall not exceed 14 inches (35.5 cm) from the
planking to the face of the building or structure.
1d. Scaffolding more than 14 inches (35.5 cm) from the planking to
the face of the building or structure shall be guardrails and/or the
use of personal fall protection.
1e. Personnel shall be tied off to a vertical lifeline with a rope grab
during assembly of scaffolding.
1f. Vertical lifeline shall be secured to an anchor point of at least
5,000 lbs (2,267.9 kg) per individual.

Develop a site specific AHA for fall protection and refer to EM

385-1-1, Section 21.

1g. Contact Safety Officer for additional guidance on fall

protection requirements.

2a. See diagram below and refer EM 385-1-1, Section 22 for

specific requirements (i.e., toe boards, guard rails, safe access,
etc.)
2b. Scaffolding shall be assembled on mud sills and base plates.
2c. Mud sills shall be at least 2 times the size of the base plates
to disperse total weight of scaffolding.
2d. Scaffolding shall be plumb and level.
2e. Working levels shall be fully decked and/or planked.
2f. Planking shall extend over the end supports not less than 6 in
(30.4 cm),
2g. Planking shall be secured, supported, or braced to prevent
excessive spring or deflection and secured to prevent loosening,
tipping, or displacement. Use of tie wire, cleats, etc. are options.
2h. Planking shall overlapped at least 12 inches (30.4 cm) or
secured from movement.
2i. Scaffold shall be capable of supporting without failure at least 4
times the maximum anticipated loads.
2j. Scaffolding shall be all required cross, horizontal, or diagonal
braces to secure vertical members laterally.
2k. Scaffolding shall be rigid.

3a. Utilize proper lifting techniques.

3b. Size up load before lifting.
3c. Ask for help when lifting heavy items more than 50 lbs.

4. Wear leather gloves.

2. Assembly of Scaffolding (Diagram)

7. PRINCIPAL STEPS 8. POTENTIAL HAZARDS 9. RECOMMENDED CONTROLS

3. Use of Scaffolding 1. Scaffold Failure 1a. DO NOT overload more than 4 times the maximum load rating.
2. Falls from Heights 1b. DO NOT attached hoists or other material lifting devices
3. Slips, Trips, or Fall without Safety Officer approval.
1c. Scaffolding shall be tied into building whenever height of the
scaffold exceeds 4 times the minimal base. Refer to EM 385-1-1,
para 22.B.09 for additional guidance.
1d. Scaffold usage shall cease during high winds or severe
inclement weather conditions.

2a. Guardrails shall be used as primary fall protection. Guard rails

shall installed IAW EM 385-1-1, para 21.B.02.
2b. Securing of personal fall protection devices to scaffolding is
prohibited.
2c. Personnel shall have fall protection whenever above 6 ft (1.8
m).
2d. Climbing of braces or cross bracing is prohibited.
2e. Safe access (ladder) shall be provided.
2f. Personnel shall not stand on mid rails.
2g. Ladders shall extend at least 3 ft (0.9 m) past the work area.

3. Walking surfaces on and around scaffolding shall be clear of

debris.
3. Use of Scaffolding

The scaffold checklist is not all inclusive of the safety requirements for the assembly, use, and disassembly of scaffolding.
Competent Person onsite for work platform safety shall review EM 385-1-1 Safety and Health Requirements Manual, Host Nation
safety laws, contract specifications, manufacture specifications, etc. as additional guidance or information for work platform
safety.
 7. PRINCIPAL STEPS 8. POTENTIAL HAZARDS 9. RECOMMENDED CONTROLS
4. Disassembling of Scaffolding 1 Fall from Elevated Heights 1a. 100 percent fall protection required during disassembly.
2. Back Strain 1b. Personnel shall not be exposed to unprotected sides or falls
3. Lacerations on hands greater than 6 ft (1.8 m).
1c. Personnel shall be tied off to a vertical lifeline with a rope grab
during assembly of scaffolding.
1d. Vertical lifeline shall be secured to an anchor point of at least
5,000 lbs (2,267.9 kg) per individual.

Develop a site specific AHA for fall protection and refer to EM

385-1-1, Section 21.

1e. Contact Safety Officer for additional guidance on fall

protection requirements.

2a. Utilize proper lifting techniques.

2b. Size up load before lifting.
2c. Ask for help when lifting heavy items more than 50 lbs.

3. Wear leather gloves.

10. EQUIPMENT TO BE USED 11. INSPECTION REQUIREMENTS 12. TRAINING REQUIREMENTS

Scaffold components Inspect scaffold components prior to use Scaffold Assembly
Hammers Fall Protection
Mud sills Inspect scaffold daily (Use Checklist) Inspection of Work Platforms
Full body harness Heat or Cold Hazards
Lanyard Inspect level and plumb of scaffoldings during
Lifeline erection and daily when in use.
Fall protection anchor points
Float Daily Housekeeping of work areas and
scaffolding

13. Prepared by (Signature and Date):

14. Safety Officer Review (Signature and Date):

15. AHA Discussed at Preparatory Meeting Held On (Signature and Date):