Quest.riscos Ambientais

7/25/2019 Quest.riscos Ambientais

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QUESTIONRIO DE RISCOS AMBIENTAIS

1.Centro:.............................................................................2.Data:..............................

3.Departamento:...........................................................................................................4.Uniae:......................................................................................................................!.N" e Ser#iore$ %Do&ente$'T(&ni&o)Amini$trati#o$*:........................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................

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................................................+.Ei,i&a-o6.1.Localizao:.........................................................................................................................................................................................................................................................6.2.rea Construda..............m6.3.Descrio do Local de Trabalo !de"end#ncias: nome do laborat$rio ou sala%dimens&es% "' direito% "resena de ca"ela% e(austores% )entilao natural ou*orada e a"arelos de ar condicionado+:

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..................................................................................................../.E0ipamento$ !estu*as% re*ri,eradores% autocla)es% balanas% centr*u,as"eneiradores e outros e-ui"amentos e(istentes+:


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...............................De$&ri-o a$ Ati#iae$ por Caro$ e n-5e$ En#o6#ia$:..........................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................7.Aente$ E8i$tente$ no Am9iente e Tra9a6o:7.1.R;o

.1.1./0 rudo im o

.1.2.Caso 4ositi)o% incomoda im o.1.3.5uem e -uantos ser)idores *icam e("ostos ao a,ente............................................................................................................................................................................................................................................................................................................................................................................................................

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...............................1..5ual o tem"o de "erman#ncia no local..................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................

7.2.Ca6or.2.1./0 calor e(cessi)o im o.2.2.Caso "ositi)o% in*ormar como ' *eito o contato com o a,ente.........................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................


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.2.3.5uem e -uantos ser)idores *icam e("ostos ao a,ente................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................

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.2..5ual o tem"o de "erman#ncia no local..............................................................................................................................................................................................................................................................................................................................................................................................................................

7.3.Raia-o Ioni


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...................................................................................................................................5ual o tem"o de e("osio ao a,ente........................................................................................................................................................................................................................................................................

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..7.5uem e -uantos ser)idores *icam e("ostos ao a,ente............................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................6.8usti*icar a "resena do a,ente% detalando a o"erao ou "rocesso -ueocorre:............................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................7.!.rio.7.1.o e(ecutados trabalos no interior de c


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.6.1./0 trabalos e(ecutados em locais ala,ados e=ou encarcados

im o.6.2.Caso "ositi)o% descre)a o modo de contato com o a,ente:........................................................................................................................................................................................................................................................................

.......................................................................................................................................................6.3.5ual o tem"o de e("osio a esta sitiuao....................................................................................................................................................................................................................................................................................

.6..5uem e -uantos ser)idores *icam e("ostos ao a,ente........................................................................................................................................................................................................................................................................

.......................................................................................................................................................6.7.5ual a *re-u#ncia do trabalo....................................................................................................................................................................................................................................................................7./.Aente$ Bio6=i&o$

.>.1./0 contato com a,entes biol$,icos im oCaso "ositi)o% !,ri*ar com caneta es*ero,r0*ica ou idro,r0*ica em )ermelo+%a"ontar se 0:Trabalos ou o"era&es com: "acientes em isolamento "or doena in*ecto?conta,iosas% bem como ob@etos de seu uso% no "re)iamente esterilizados%

carnes% ,l


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.............................. 8usti*icar o trabalo detalando a o"erao ou "rocesso -ue ocorre:

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.>.3.5uem e -uantos ser)idores *icam e("ostos ao a,ente

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..............................7..>roto$ In,6am?#ei$

..1./0 contato e=ou mani"ulao com "rodutos in*lam0)eis im o

..2.Caso "ositi)o% indi-ue os "rodutos e a -uantidade e(istente:....................................................................................................................................

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.3.Como so armazenados

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....................................................................................................................................8usti*i-ue a "resena do "roduto% detalando a o"erao ou "rocesso em -ueo "roduto ' em"re,ado:....................................................................................................................................

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...............................................................................................................................7.7

.>roto$ Q;mi&o$

..1./0 contato com "rodutos -umicos im o..2.Caso "ositi)o% a"ontar se e(iste contato e=ou e("osio aos a,entes abai(orelacionados !,ri*ar com caneta es*ero,r0*ica ou idro,r0*ica em )ermelo+:


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acetaldedo% acetato de cellosol)e ou acetato de 'ter monoetlico de etileno,licol%acetato de etila% acetato de 2?et$(i etila% acetileno% acetona% acetonitrila% 0cidoac'tico% 0cido ciandrico% 0cido clordrico% 0cido crmico% 0cido etan$ico% 0cido*luordrico% 0cido *$rmico% 0cido metan$lico% acrilato de metila% acrilonitrila% 0lcoolisoamlico% 0lcool n?butlico% 0lcool isobutlico% 0lcool sec?butlico !2?butanol+% 0lcool

terc?butlico% 0lcool etlico% 0lcool *ur*urlico% 0lcool metil amlico% 0lcool metlico%0lcool n?"ro"lico% 0lcool iso"ro"lico% aldedo ac'tico% aldedo *$rmico% amnia%anidrido sul*uroso% anilina% ar,nio% arsina !arsenamina+%

benzeno !benzol+ brometo de etila% brometo de metila% bromo bromoetano%bromo*$rmico% bromometamo% 1%3 butadieno% n?butano% n?butanol% butanona% ;?butanotiol% n?butilamina% butil cellosol)e% n?butil merca"tana% 2?buto(i etanol%

cellosol)e% cumbo% cianeto de metila% cianeto de )inila% ciano,#nio% cicloe(ano%cicloe(anol% cicloe(ilamina% cloreto de carbonila% cloreto de etila% cloreto de*enila% cloreto de metila% cloreto de metileno% cloreto de )inila% cloreto de )inilideno%cloro clorobenzeno% clorobromometano% cloroetano% cloroetileno%clorodi*luormetano !Ereon 22+% cloro*$rmio% ;?cloro ;?nitro"ro"ano% cloro"rene%cumeno%

decaborano% demetron% diamina% diborano% 1%2?dibramoetano% a?diclorobenzeno%diclorodi*luormetano !Ereon 12+% 1%1 dicloroetano% 1%2 dicloroetano% 1%1dicloroetileno% 1%2 dicloro"ro"ano% diclorotetra*luoretano !Ereon 11+% dietil amina%dietil 'ter% 2% diisocianato de tolueno !TD;+% diiso"ro"ilamina% dimetilacetamida%dimetilamina% dimetil*ormamida% 1%1 dimetil idrazina% di$(ido de carbono% di$(idode cloro% di$(ido de en(o*re% di$(ido de nitro,#nio% dissul*eto de carbono%

estibina% estireno% etano% etanol% atanotiol% 'ter decloroetlico% 'ter etlico% 'termonobutlico de etileno ,licol% 'ter monoetlico do etileno ,licol% 'ter monometlicodo etileno ,licol% etilamina% etilbenzeno% etileno% etilenoimina% etil merca"tana% n?etilmor*olina% 2?et$(ietanol%

*enol% *luortriclorometano !Ereon 11+% *ormaldedo !*ormal+% *os*ina !*os*amina+%*os,#nio% *reon 11% *reon 12% *reon 22% *reon 113% *reon 11%

,0s amoni0co% ,0s carbnico% ,0s ciandrico% ,0s clordrico% ,0s sul*drico%

'lio% idrazina% idreto de antimnio% idr,enio%

isobutanol% iso"ro"ilamina% iso"ro"il benzeno%

mercArio !todas as *ormas e(ceto or,


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nenio% n-uel carbonila !n-uel tetracarbonila+% nitrato de n?"ro"ila% nitroetano%nitrometano% 1?nitro"ro"ano% 2?nitro"ro"ano%

$(ido de etileno% $(ido ntrico !F+ $(ido nitroso !2F+% Fzona%

4entaborano% n?"entano% "ercloroetileno% "iridina% n?"ro"ano% n?"ro"anol%iso"ro"anol% "ro"anona% "ro"ileno% "ro"ileno imina%

sul*ato de dimetila% sul*eto de idro,#nio% sGsto(%

1%1%2%2% tetrabromoetano% tetracloreto de carbono% tetracloroetano%tetracloroetileno% tetraidro*urano% tolueno !toluol+% tolueno?2%?diisocianato !TD;+%tribromometano% tricloreto de )inila% 1%1%1 tricloroetano% 1%1%2 tricloroetano%tricloroetileno% triclorometano% 1%2%3 tricloro"ro"ano% 1%1%2 tricloro% 1%2%2tri*luoretano !Ereon 113+% trietilamina% tri*luormonobramometano%

)inilbenzeno

(ileno !(ilol+

??????????????????????????????????????????????????????????????????????????????????????????????????????????????Hrs#nico% Car)o% Com"ostos de Cumbo% Cromo% E$s*oro !de*ensi)os *os*oradose or,ano*os*orados+% /idrocarbonetos e outros com"ostos de Carbono !$leosminerais% $leo -ueimado% "ara*ina% ne,ro de *umo% alcatro% breu?betume%antraceno% "intura I "istola com esmaltes% tintas% )ernizes e sol)entes comidrocarbonetos arom0ticos+% 9ercArio !*orma or,


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??????????????????????????????????????????????????????????????????????????????????????????????????????????????

Futros H,entes 5umicos -ue Nntram em Contato e -ue no Constam da elaoHcima 9encionada:

H,ente 5umico Descrio do 9odo de Contato Durante eu 9anuseio


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..3.o caso de ser indicado e=ou relacionado al,um!uns+ do!s+ "roduto!s+-umico!s+ acima mencionado!s+% in*orme -uem e -uantos ser)idores *icame("ostos ao a,ente

UUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUU

UUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUU...5ual a *re-V#ncia de uso do!s+ "roduto!s+ -umico!s+ no trabalo

UUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUU..7.Como so armazenados os "rodutos

UUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUU..6.5ual a -uantidade e(istente

UUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUU..>.8usti*icar a "resena do a,ente -umico% detalando a o"erao ou "rocesso-ue ocorre:

UUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUU

[email protected]$ e >rote-o Ini#ia6'E0ipamento e >rote-o Co6eti#a1W.1.Fs ser)idores *azem uso de N-ui"amento de 4roteo ;ndi)idual

;9 o

1W.2.;ndi-ue -uais os N4;sUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUU


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UUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUU1W.3.4ossui N-ui"amento de 4roteo Coleti)a no ambiente de trabalo

im o

1W..;ndi-ue -uais os N4CsUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUU

UUUUUUUUUUUUUUUUUU UUUUUUUUUUUUUUUUUUUHssinatura do er)idor Ce*ia do De"artamento

!carimbo e assinatura+

QUESTIONRIO DE RISCOS AMBIENTAIS

INSTRUES >ARA >REENCIMENTO

Nste -uestion0rio ' de uso ,eral% "odendo ser utilizado em -ual-uer

dos Centros e(istentes% atualmente% na ECar.1. Centroa -ue "ertence o!s+ ser)idor!es+

2. Data do "reencimento do -uestion0rio

3.Departamentoa -ue "ertence!m+ o!s+ ser)idor!es+


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. Uniaea -ue "ertence!m+ o!s+ ser)idor!es+

7. Nmero e Ser#ior%e$* ser0 o total de ser)idores Docentes e T'cnico?Hdministrati)os lotados na nidade% relacionando?os "elo car,o de cada um% semmencionar nomes% "ois o laudo a ser emitido ' im"essoal e ir0 se re*erir ao

local!is+ e=ou ati)idade!s+ desen)ol)ida!s+ no trabalo.N(: 7 !cinco+ Docentes 6 !seis+ T'cnicos de Laborat$rio

1 !um+ er)ente de Lim"ezaFutros

6. Ei,i&a-o6.1. o&a6ir(io% no cam"us onde os ser)idores a"ontados no tem 7realizam trabalos.6.2.rea Con$tr;ada edi*icao mencionada no tem 6.16.3.De$&ri-o o o&a6 e Tra9a6o relacionado os locais% de acordo com osolicitado na e("licao entre "ar#nteses

>. E0ipamento$ relacionar% se"aradamente os e-ui"amentos e(istentes emcada de"end#ncia a"ontada no tem 6.3N(: Laborat$rio de.... 1 re*ri,erador 22W )

2 *reezer 11W )1 estu*aoutros

Laborat$rio de... 1 rota)a"or1 coluna de destilaooutros

.De$&ri-o a$ Ati#iae$ por Caro$ e n-5e$ En#o6#ia$:descre)er asati)idades rotineiras e *un&es -ue en)ol)em diretamente o desen)ol)imento dostrabalos da nidade.

. Aente$ E8i$tente$ no Am9iente e Tra9a6o: Nste tem cont'm o!s+a,ente!s+ -ue "ode!m+ ou no% ser encontrado!s+ no ambiente de trabalo.

1W. F tem 1W contido na *ola 12% deste -uestion0rio% ser0 "reencido "elos"ro*issionais da Comisso de ;nsalubridade e 4ericulosidade da ECar.

FJ:? a "er,unta Q5uem e -uantos ser)idores *icam e("ostos a um determinadoa,ente e=ou situao de trabaloR% de)er0 ser indicado a"enas o car,o e total deser)idores e("ostos% ressaltando -ue ' di*erente do tem 7 -ue "ede o total deser)idores lotados na nidade.


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Importante:K necess0rio -ue todos os tens se@am res"ondidos de *orma "ermitiruma an0lie% a ser *eita "ela Comisso.

11.Meia$ E,etaa$ no Am9iente: o "reencimento desta *ola ser0 *eito"elos "ro*issionais com"onentes da Comisso de ;nsalubridade e 4ericulosidade

da ECarR;o:UUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUdJ na Eai(aUUUUUUUUUUUUUUUU;nstrumento=9arca:UUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUU

I6mina-o:UUUUUUUUUUUUUUUUUUUaturalUUUUUUUUUUUUUUULu(UUUUUUUUUUUU Hrti*icialUUUUUUUUUUUUUUULu(UUUUUUUUUUUU

Hrti*icial e aturalUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUULu(UUUUUUUUUUUU;nstrumento=9arca:UUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUU

UUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUU

Con,ortoT(rmi&o%IBUTF*:UUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUU;nstrumento=9arca:UUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUU

UUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUOtra$ Mei-5e$:H,entes 5umicos% Esicos% 9ec


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em Nscalaealizado 4or:UUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUU

Car,o:UUUUUUUUUUUUUUUUUUUUUU UUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUU Comisso de ;nsalubridade= 4ericulosidade

Quest.riscos Ambientais

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