Individual
level - Health and
Safety Questionnaire
There are at least eight dimensions
to be considered regarding the potential health and
safety effects of innovation and new technology:
The questionnaire items are listed below. In order to score the questionnaire for each individual, simply sum the scores within a questionnaire section or take a mean score. You can then average individuals' scores to compare scores between areas and/or you can compare scores before and after the implementation.
Physical
Work Environment Satisfaction Questionnaire
The purpose of this questionnaire is to get your views on issues relating
to your physical work environment.
In this booklet you will find questions about the work you do and about how satisfied you are with many aspects of your work. Please answer these questions to the best of your knowledge and ability. There are no "right" and "wrong" answers; this is an opinion survey.
WHAT YOU SAY IN THIS QUESTIONNAIRE IS CONFIDENTIAL.
Do not put your name on any of these forms. No one from your organisation will see your individual answers, nor will it be possible to identify your individual responses once the data are analysed. Your managers and you will only see a report of summary data.
1. Please start at the beginning of the booklet and answer all questions in order. There are no right and wrong answers; this is an opinion survey.
2. All questions should be answered by circling the number of the alternative that best represents your choice. For our purposes your first reaction to a question is usually the best. Do not dwell on any one question.
3. If a question does not apply to you or you have no opinion, please select "Neutral" or "Neither Disagree or Agree." Please do not leave any questions blank.
4. Feel free to make comments on the questionnaire.
Upon completion please insert this booklet into the envelope provided, to ensure confidentiality, and return the envelope as instructed. Thank you for your time and cooperation.
Please think of your present job when answering the following questions. These questions are designed to examine what you think and feel about the physical surroundings in your work place.
Please use the following scale to answer the questions below. Record your answers by circling the number which corresponds to your answer in the selections provided next to each question.
Ambient
conditions
How satisfied are
you with:
The lighting in your work area...................................................... 1 2 3 4 5
The air quality in your work area................................................... 1 2 3 4 5
The surfaces you usually walk on.................................................. 1 2 3 4 5
The direction of the light which enters your work area.......................... 1 2 3 4 5
The surfaces you frequently work on.............................................. 1 2 3 4 5
The general atmosphere in your work area........................................ 1 2 3 4 5
In general, the type of facilities provided at work................................ 1 2 3 4 5
The cleanliness of the facilities at work............................................ 1 2 3 4 5
The size of the eating facilities/lunch room provided............................. 1 2 3 4 5
The cleanliness of the eating facilities/lunch room................................ 1 2 3 4 5
The pleasantness of the eating facilities/lunch room.............................. 1 2 3 4 5
The pleasantness of the restrooms/toilets you use................................ 1 2 3 4 5
The cleanliness of the restrooms/toilets you use...................................1 2 3 4 5
The recreation facilities provided.................................................... 1 2 3 4 5
Work and system characteristics
How your time at work is scheduled............................................... 1 2 3 4 5
The length of the rest breaks you receive.......................................... 1 2 3 4 5
The amount of work you are required to do....................................... 1 2 3 4 5
The amount of activity/movement required to do your job....................... 1 2 3 4 5
The flexibility of your work pace.................................................... 1 2 3 4 5
The general design of your work system........................................... 1 2 3 4 5
The amount of time you are given to complete your work....................... 1 2 3 4 5
The quality of information you receive to do your work......................... 1 2 3 4 5
How information is handled (e.g., moved & stored) at work................... 1 2 3 4 5
The number of tools with which you have to work............................... 1 2 3 4 5
The effectiveness of the machines with which you work........................ 1 2 3 4 5
The efficiency of the machines with which you work............................ 1 2 3 4 5
The effectiveness of the tools with which you have to work.................... 1 2 3 4 5
The efficiency of the tools with which you have to work........................ 1 2 3 4 5
The quality of the materials you are given to do your job........................ 1 2 3 4 5
How accidents are avoided at work................................................ 1 2 3 4 5
The safety precautions taken in your work place................................. 1 2 3 4 5
The warnings you are given regarding workplace hazards...................... 1 2 3 4 5
The safety training you have received.............................................. 1 2 3 4 5
How hazards are controlled in your work place................................... 1 2 3 4 5
The safety training available to you through work................................ 1 2 3 4 5
How hazardous materials/products are handled/moved.......................... 1 2 3 4 5
The safety training other workers receive.......................................... 1 2 3 4 5
The way accidents are reported at work............................................ 1 2 3 4 5
The way accidents are investigated at work........................................ 1 2 3 4 5
The fire prevention system(s) you have at work.................................. 1 2 3 4 5
The amount of privacy you have at work.......................................... 1 2 3 4 5
The level of noise in your work area............................................... 1 2 3 4 5
The number of times you are distracted while working.......................... 1 2 3 4 5
The amount of space in which you have to work................................. 1 2 3 4 5
The size of your work area.......................................................... 1 2 3 4 5
Your ability to control your physical surroundings.............................. 1 2 3 4 5
Your ability to change/rearrange the physical surroundings.................... 1 2 3 4 5
The temperature in your work area................................................ 1 2 3 4 5
The colours used in your work area (walls, furnishings, etc.)................. 1 2 3 4 5
The amount of tobacco smoke to which you are exposed....................... 1 2 3 4 5
The amount of lifting you have to do.............................................. 1 2 3 4 5
The weight of objects you have to lift............................................. 1 2 3 4 5
The amount of bending you have to do........................................... 1 2 3 4 5
The amount of squatting you have to do.......................................... 1 2 3 4 5
The amount of standing you have to do .......................................... 1 2 3 4 5
The amount of walking you have to do........................................... 1 2 3 4 5
The number of time you repeat the same motions............................... 1 2 3 4 5
The amount of reaching or stretching you have to do .......................... 1 2 3 4 5
The way your wrist (s) feel after a day of work ................................ 1 2 3 4 5
The way your elbow(s) feel after a day of work ............................... 1 2 3 4 5
The way your knee(s) feel after a day of work ................................. 1 2 3 4 5
The way your ankle(s) feel after a day of work ................................ 1 2 3 4 5
The way your upper back feels after a day of work ........................... 1 2 3 4 5
The way your lower back feels after a day of work ........................... 1 2 3 4 5
The way your neck feels after a day of work .................................. 1 2 3 4 5
The way your hip(s) feel after a day of work .................................. 1 2 3 4 5
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Holistic Management Pty. Ltd.