PHYSICAL DEMANDS ANALYSIS
JOB DATA
Department: _____________________________________________
Work Hours: _____________________________________________
Breaks: __________________________________________________
PPE: ____________________________________________________
Special Training Requirements:
JOB PHOTO
Purpose and Nature of the Job:
Essential Tasks of the Job: (provide % of time each task is performed)
Non-Essential Tasks Performed: (continue numbering from last step above)
POSITION/JOB TITLE:
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310-003-18-IGDO © 2013, Workplace Safety & Prevention Services (WSPS)
1 877 494 WSPS (9777) | 905 614 1400 | www.wsps.ca
Additional Job Details (e.g., task, product, materials, workstation and/or equipment details):
Hand Tools Used:
Equipment Used:
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310-003-18-IGDO © 2013, Workplace Safety & Prevention Services (WSPS)
1 877 494 WSPS (9777) | 905 614 1400 | www.wsps.ca
PHYSICAL
DEMAND
TASK #
FREQUENCY
DESCRIBE ACTIVITY
Note distances, durations and surfaces
NROFC
MOBILITY
Walking
Standing
Sitting
Crawl
Driving (Forklift/Vehicle/Other)
POSTURE – Back
Bending Forward
Bending Backwards
Twisting
POSTURE – Reaching Note forward and/or side reach distances
Above Shoulder Level
Chest to Shoulder Level
Below Chest Level
Behind Body
POSTURE – Elbow/Forearm/Wrist
Elbow Flexion/Extension
Wrist Flexion/Extension
Wrist Rotation
POSTURE – Neck
Forward Bending/Flexion
Backward Bending/Ext.
Twisting/Turning/Tilting
POSTURE – Hip/Knee/Ankle/Foot
Crouching/Squatting
Kneeling
Climbing (Stairs/Other)
Jumping
Foot Pedal/Action
N = Not required, R = Rarely (<2%), O = Occasional (3-33%), F = Frequent (34-66%), C = Constant (67-100%)
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310-003-18-IGDO © 2013, Workplace Safety & Prevention Services (WSPS)
1 877 494 WSPS (9777) | 905 614 1400 | www.wsps.ca
STRENGTH DEMANDS OF THE JOB
*Adapted from Dictionary of Occupational Titles (4
th
ed. Rev. 1991)
Physical
Demand
Task #
Force/Weight
Frequency
and Duration
(N/R/O/F/C)
Height
Describe Activity/Posture
Avg. Max. Start Finish
Lifting
Task # Avg. Max.
Frequency
and Duration
(N/R/O/F/C)
Height/
Distance/
Grade
Describe Activity/Posture
Carrying
Task #
Avg./
Sustained
Initial/
Peak
Frequency
and Duration
(N/R/O/F/C)
Height/
Distance/
Grade
Describe Activity/Posture
Pushing/
Pulling
N = Not required, R = Rarely (<2%), O = Occasional (3-33%), F = Frequent (34-66%), C = Constant (67-100%)
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310-003-18-IGDO © 2013, Workplace Safety & Prevention Services (WSPS)
1 877 494 WSPS (9777) | 905 614 1400 | www.wsps.ca
HAND ACTIVITY
Task #
Approximate
Force
Frequency
and Duration
(N/R/O/F/C)
Describe Activity/Posture
Gripping/
Grasping
Pushing
(palm
press/
finger)
Pinching
Fine Finger
Movement
Writing
Other
N = Not required, R = Rarely (<2%), O = Occasional (3-33%), F = Frequent (34-66%), C = Constant (67-100%)
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310-003-18-IGDO © 2013, Workplace Safety & Prevention Services (WSPS)
1 877 494 WSPS (9777) | 905 614 1400 | www.wsps.ca
ADDITIONAL CONDITIONS AND DEMANDS
Environmental
Conditions
Hot
Cold
Outdoor
Indoor
Dry
Humid
Noise
Vibration
Glare
Adequate lighting
Moving objects
Working at heights
Slippery surface
Congested area
Sharp edges
Fumes/vapours/
gases
Electromagnetic
fields
Comments:
Psychological/
Mental Demands
Working under
pressure/deadlines
Fast work pace
Deal with multiple
tasks
Perform complex
or varied tasks
Perform simple
and repetitive
tasks
Attain precise
standards/
attention to detail
Control of work
pace
Direct/control/
plan of work
Close supervision
Follow instructions
Influence people
Confrontation
situations
Incentive/piece
work
Irregular hours
Overtime
Reading
Working alone
Working in a
group
Travelling
Comments:
Sensory Demands
Hearing
Speech
Colour vision
Near vision
Far vision
Spatial perception
Tactile
Smell
Ta ste
Comments:
_____________ ______________________________________ ________________________ ________________
_____________ ______________________________________ ________________________ ________________
_____________ ______________________________________ ________________________ ________________
_____________ ______________________________________ ________________________ ________________
Insert Signature
Insert Signature
Insert Signature
Insert Signature
Date
Date
Date
Date
Type Name/Position
Type Name/Position
Type Name/Position
Type Name/Position
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310-003-18-IGDO © 2013, Workplace Safety & Prevention Services (WSPS)
1 877 494 WSPS (9777) | 905 614 1400 | www.wsps.ca
ADDENDUM (Place additional task photos here)
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310-003-18-IGDO © 2013, Workplace Safety & Prevention Services (WSPS)
1 877 494 WSPS (9777) | 905 614 1400 | www.wsps.ca
© Workplace Safety & Prevention Services 2013. Workplace Safety & Prevention Services (WSPS) grants permission to approved
end users to reproduce this document in whole or in part, provided its intended use is for non-commercial, educational purposes
and that full acknowledgement is given to the WSPS. Approved end users are firms registered with the Workplace Safety and
Insurance Board. WSPS reserves the right to extend this permission to other stakeholders and interested parties by express
written permission upon application. WSPS extends no warranty to materials amended or altered by the end user. Under no
circumstances
is this document, or any portion thereof, to be duplicated for purposes of sale or for external reproduction or distribution.
(Sample WSPS acknowledgement, “Reproduced or adapted from name of solution with permission of Workplace Safety &
Prevention Services, Mississauga, Ontario.”)
The information contained in this reference material is distributed as a guide only. It is generally current to the best of our
knowledge as at the revision date, having been compiled from sources believed to be reliable and to represent the best current
opinion on the subject. No warranty, guarantee, or representation is made by WSPS as to the absolute correctness or sufficiency
of any representation contained in this reference material. WSPS assumes no responsibility in connection therewith; nor can it be
assumed that all acceptable safety measures are contained in this reference material, or that other or additional measures may not
be required in particular or exceptional conditions or circumstances.
Revised: September 2011
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