Workplace health and safety survey
You are invited to share your opinions about your work and how it affects your health and safety by taking this survey.
Please answer the questions below on the hazards you face on the job and the occupational health and safety (OHS) policies and
procedures in place to protect you. Please note that the survey is anonymous (i.e. we are not asking for your name). Your answers will help
pinpoint areas that may need improvement to better protect the health and safety of workers.
Answer each question carefully. There are no right or wrong answers. For each question, please indicate the response option you feel best
answers the question. (DK/NA stands for Don’t Know /Not Applicable)
Part 1: Workplace hazards
This section asks about the kinds of health and safety hazards you might be exposed to in your job. For each item below, please put an X
under the heading that best describes how often you do the stated task or are exposed to the stated condition.
In your job, how often do you ...?
Never Once a
year
Every 6
months
Every 3
months
Every
month
Every
week
Every
day
DK/NA
1. Manuallylift,carryorpushitemsheavierthan20kgatleast
10timesduringtheday
2. Dorepetitivemovementswithyourhandsorwrists(packing,
sorting,assembling,cleaning,pulling,pushing,typing)forat
least3hoursduringtheday
3. Performworktasks,oruseworkmethods,thatyouarenot
familiarwith
4. Interactwithhazardoussubstancessuchaschemicals,
ammableliquidsandgases
5. Workinabent,twistedorawkwardworkposture
6. Workataheightthatis2metresormoreabovetheground
oroor
7. Workinnoiselevelsthataresohighthatyouhavetoraise
yourvoicewhentalkingtopeoplelessthanonemetreaway
8. Experiencebeingbulliedorharassedatwork
9. Standformorethan2hoursinarow
Part 2: Workplace policies and procedures
This section asks about the kinds of policies and systems in place to make the workplace safe. For each item below, please put an X under
the heading that best describes how much you agree or disagree with the statement.
At my workplace ....
Strongly
agree
Agree Disagree Strongly
disagree
DK/NA
10. Everyonereceivesthenecessaryworkplacehealthandsafetytrainingwhenstartingajob,
changingjobsorusingnewtechniques
11. Thereisregularcommunicationbetweenemployeesandmanagementaboutsafetyissues
12. Systemsareinplacetoidentify,preventanddealwithhazardsatwork
13. Workplacehealthandsafetyisconsideredtobeatleastasimportantasproductionandquality
14. Thereisanactiveandeffectivehealthandsafetycommitteeand/orworkerhealthand
safetyrep
15. Incidentsandaccidentsareinvestigatedquicklyinordertoimproveworkplacehealthandsafety
16. CommunicationaboutworkplacehealthandsafetyproceduresisdoneinawaythatIcan
understand
Part 3: Occupational health and safety awareness
This section explores your awareness of occupational health and safety (e.g. hazards, the rights and responsibilities of both employees
and employers). For each item below, please put an X under the heading that best describes how much you agree or disagree with the
statement.
At my workplace ....
Strongly
agree
Agree Disagree Strongly
disagree
DK/NA
17. Iamclearaboutmyrightsandresponsibilitiesinrelationtoworkplacehealthandsafety
18. Iamclearaboutmyemployers’rightsandresponsibilitiesinrelationtoworkplacehealth
andsafety
19. Iknowhowtoperformmyjobinasafemanner
20. IfIbecameawareofahealthorsafetyhazardatmyworkplace,Iknowwho
(atmyworkplace)Iwouldreportitto
21. Ihavetheknowledgetoassistinrespondingtoanyhealthandsafetyconcerns
atmyworkplace
22. IknowwhatthenecessaryprecautionsarethatIshouldtakewhiledoingmyjob
Part 4: Participation in occupational health and safety
This section explores your ability to ask questions about, and participate in, health and safety at work. Your ability to participate in making
a safer workplace for yourself depends on both your actions and abilities and your employer’s actions and practices. For each item below,
please put an X under the heading that best describes how much you agree or disagree with the statement.
At my workplace ....
Strongly
agree
Agree Disagree Strongly
disagree
DK/NA
23. Ifeelfreetovoiceconcernsormakesuggestionsaboutworkplacehealthandsafety
atmyjob
24. IfInoticeaworkplacehazard,Iwouldpointitouttomanagement
25. IknowthatIcanstopworkifIthinksomethingisunsafeandmanagementwillnotgive
meahardtime
26. IfmyworkenvironmentwasunsafeIwouldnotsayanything,andhopethatthesituation
eventuallyimproves(reversescored)
27. Ihaveenoughtimetocompletemyworktaskssafely
Thank you for your participation.
www.iwh.on.ca
©2016Thisdocumentislicensedundera
CreativeCommonsAttribution-NonCommercial-
NoDerivatives4.0InternationalLicense:
http://creativecommons.org/licenses/by-nc-nd/4.0/.Thatmeansthissurvey
canbeusedandsharedaslongasIWHiscreditedasthesource,thetoolis
notmodied,andthetoolisusedfornon-commercialpurposes.Ifyouwish
tomodifyand/orusethetoolforcommercialpurposes,pleasecontact
[email protected].
ThissurveyispartoftheOHSVulnerabilityMeasuredevelopedbythe
InstituteforWork&Health(IWH),anot-for-protorganizationbasedin
Toronto,Canada,thataimstopromote,protectandimprovethesafetyand
healthofworkingpeoplebyconductingactionableresearchthatisvaluedby
employers,workersandpolicy-makers.Thefulltoolisalsoavailableonline
at:www.iwh.on.ca/ohs-vulnerability-measure
TheInstituteforWork&HealthoperateswiththesupportoftheProvinceof
Ontario.TheviewsexpressedinthispublicationarethoseoftheInstituteand
donotnecessarilyreectthoseoftheProvinceofOntario.
Formoreinformation,pleasecontact:info@iwh.on.ca
InstituteforWork&Health
481UniversityAve.,Suite800
Toronto,ONCanadaM5G2E9