Display Screen Equipment Risk Assessment: User/Workstation Questionnaire

DSE Self- Issue No.
1 Issue Date: Issued By: H&S

Assessment 17/02/21 Dept.
Document Changes
Display Screen Equipment Risk Assessment:
User/Workstation Questionnaire
Name/User: Date:
Manager:
Dept:
Answer
No Question Yes/No/
N/a
1.Work Chair
1 Is your chair stable and have a five-star base?
2 Does it allow you to adopt a proper seated posture by adjusting the back support?
3 Is the seat height easily adjustable?
4 Do the arms of the chair (if any) allow you to sit right up to the front edge of the desk?
2.Desk/Worksurface
1 Is the work surface large enough for the screen, keyboard, documents, etc?
2 Is there enough legroom underneath it?
3 Is there room at the front of the keyboard to support/rest the wrists?
3.Keyboard
1 Can the keyboard place on feet from a flat position
2 Is the keyboard easy to use and clean? i.e., keys do not stick
4.Screen
1 When sat in front of the screen is it free from reflective glare?
2 If you sit opposite or next to a window, is your screen at a right angle to it to prevent
reflective glare?
3 Are you aware of how to swivel/tilt the screen?
4 Is it free from flicker?
5 Are the characters sharp?
6 Can you change the brightness/contrast easily?
5.Accessories
1 If a document holder is used, is it at the correct height?
2 Is your mouse within easy reach and do you have a mat?
3 Is a footrest used?
6. Awareness
1 Are you aware of the Display Screen Equipment Regulations 1992? These make it a legal
requirement for DSE workstation assessments conducted.
2 Are you aware how to adjust your chair and workstation?
3 Can you comfortably use the software?
DSE RISK ASSESSMENT 2021 Page 1 of 3

DSE Self- Issue No. 1 Issue Date: Issued By: H&S
Document Changes
7.Working environment
1 Are cables routed/covered to avoid trip?
2 Is the noise level low enough to conduct a normal conversation?
3 Do you have sufficient space to change position and vary movements?
4 Is there sufficient lighting?
5 Do the windows in the area have coverings to reduce reflective glare?
6 Does the equipment produce excess heat liable to cause you any discomfort?
7 Are there any electrical hazards, e.g., worn or improperly connected cords?
User Assessment
8.Back
1 Can you conduct your DSE work without undue twisting of your back?
2 Do you sit square to the keyboard and screen?
3 Is your lower back supported by the lumbar support of your chair?
9.Shoulders, upper arms, forearms, and wrists

1 Are your shoulders in a neutral, relaxed position?
2 Are your forearms almost horizontal when using the PC?
3 Is your forearm supported (rested on the desk) when using a mouse?
4 Are your wrists kept straight when using the keyboard/mouse?
5 Are you aware that you should take frequent breaks away from your PC to vary muscle
use and avoid eye strain?
10.Head and eyes

1 Is your head slightly inclined downward in line with your line of vision?
2 Do you wear contact lens or glasses?
3 Are your glasses specifically for DSE work?
4 Please tell us the date of your last eye test
11.Personal
1 Have you experienced any specific health problems during/after DSE work? If yes,
please specify e.g., sore eyes, painful back
If yes, what can you do to minimise these problems?
2 Do you have any pre-existing health issues which could affect your comfort whilst at
your workstation? If yes, please specify and state what action you take to minimise your
discomfort.
3 Do you have any problems with vision (e.g., focussing difficulties, difficulties in seeing or
reading the screen or source documents?
4 Do you use a PC or other similar hobbies at home e.g., computer games?

DSE Self- Issue No. 1 Issue Date: Issued By: H&S
Document Changes
Important Note: if you are suffering with any medical conditions prior or post your assessment which in turn
require adjustments/ changes to your current workstation you must inform your Line Manager straight
away.
Please record any comments you would like to make about your assessment or workstation
For Use by Manager: Date:

H&S Dept: Assessed by: Date:
Display Screen Equipment Risk Assessment

Reviewers Action Sheet
Question
Number Action Required Due Date
H&S use: Reviewed by: Date:

Feedback to manager/user: Date:
Thank you for your time and help, please return the completed form to nicholas.adams@eandj.co.uk
All DSE assessments reviewed and any individuals’ concerns are to be

actioned
Signed: N. Adams

Display Screen Equipment Risk Assessment: User/Workstation Questionnaire

Uploaded by

Copyright:

Available Formats

Display Screen Equipment Risk Assessment: User/Workstation Questionnaire

Uploaded by

Document Information

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Display Screen Equipment Risk Assessment: User/Workstation Questionnaire

Uploaded by

Copyright:

Available Formats

DSE Self- Issue No.

1 Issue Date: Issued By: H&S

Display Screen Equipment Risk Assessment:

DSE RISK ASSESSMENT 2021 Page 1 of 3

9.Shoulders, upper arms, forearms, and wrists

10.Head and eyes

If yes, what can you do to minimise these problems?

4 Do you use a PC or other similar hobbies at home e.g., computer games?

DSE RISK ASSESSMENT 2021 Page 2 of 3

For Use by Manager: Date:

Display Screen Equipment Risk Assessment

H&S use: Reviewed by: Date:

All DSE assessments reviewed and any individuals’ concerns are to be

DSE RISK ASSESSMENT 2021 Page 3 of 3

You might also like