Effective form templates

This example COSHH risk assessment has been prepared using the
F-HS5 COSHH Assessment form template which has been designed to record and manage the risks associated with substances hazardous to health and includes:

• Substance details
• Physical description
• Health effects and first aid
• Workplace exposure limits (WELs)
• CLP hazard classification — visual hazard icons
• Risk rating
• Control measures
• PPE required — visual PPE icons
• Environmental considerations

The file is supplied in fully editable MS Word format and can be easily customised and saved to Google Docs format if required. The document uses pre-defined style formatting throughout with styles to match the risk-ratings. All text is in Calibri font for improved readability.
The following document labelling is included in the footer:

• Form number and title
• Information-classification
• Version
• Page number / total pages

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COSHH Assessment — AdBlue (Aqueous Urea Solution)

This pre-completed COSHH assessment covers AdBlue — a 32.5% aqueous urea solution used as a diesel exhaust fluid (DEF) in selective catalytic reduction (SCR) systems on modern diesel vehicles and plant.

What Does This COSHH Assessment Cover?

The assessment is fully completed and ready to use, covering all sections required for a complete hazardous substance risk assessment:

• Substance identification — trade name (AdBlue / DEF), chemical name (32.5% aqueous urea solution), SDS reference and physical state
• Health effects and first aid — inhalation, ingestion, skin contact and eye contact, with specific first aid for each route
• Ammonia release hazard — urea decomposes to release ammonia when heated or spilled; ammonia is corrosive and irritates the respiratory tract and eyes
• Workplace exposure limits — ammonia TWA 25 ppm and STEL 35 ppm, from workplace exposure limits guidance
• CLP hazard classification — Irritant pictogram
• PPE requirements — including eye protection and gloves when handling in bulk
• Emergency procedures — spillage response and guidance on ammonia release risks

Who Is This COSHH Assessment For?

This assessment is suitable for any workplace where AdBlue is handled or stored, including:

• Transport and logistics operators with Euro 6 diesel fleets
• Construction and plant hire businesses
• Agricultural operations using modern tractors and machinery
• Local authority and public sector fleet operations

COSHH Compliance

This document provides ready-to-use evidence of COSHH compliance and supports occupational health and safety management. The assessment is based on the F-HS5 COSHH Assessment template, is fully editable in Microsoft Word, and can be customised with your company details, site-specific information and review dates.