Form 23 Notification of lead-risk work

FORM 23
V1.3.12
Notification relating to lead risk work
ABN 13 846 673 994
Work Health and Safety Act 2011
Guidelines for completing this form are available at the end of this document. Additional information may be obtained by phoning the WHS
Infoline on 1300 369 915.
1. Type of notification
A1 New notification of lead risk work
A2 Amended notification of lead risk work (please provide the date of the previous notification / /
B Removal of worker from lead risk work
For A1 and A2 notifications, please complete sections 2 through 6
For B notifications, please complete sections 2, 4, 7 and 8
2. Contact details of the person conducting the business or undertaking (PCBU)
Title (Mr, Mrs, Miss, Ms):
First given name:
Family name/surname:
Telephone: Mobile: Facsimile:
Email:
Registered name of body corporate or emergency service organisation (if applicable):
Business registration (trading) name (if applicable):
ABN
Principal business address (must be an Australian address and not a PO box): unit number/ street number/ street name
Suburb/locality: State: Postcode:
Postal address (must be an Australian address)
Tick this box if the postal address is the same as the address above
PO box number: GPO box number: Private bag number: Locked bag number:
Suburb: State: Postcode:
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Declaration
I have authority as the PCBU, or as their delegate, to complete and submit this notification
The information in this notification is true and correct to the best of my knowledge
I consent to Workplace Health and Safety Queensland making enquiries and exchanging information with WHS regulators in other states,
territories or the Commonwealth regarding any matter relevant to this notification.
Date: Name in full (please print): Signature:
3. Describe the lead process carried out at the workplace
Tick more than one box if applicable
work that exposes a person to lead dust or lead fumes arising from the manufacture or handling of dry lead compounds
work in connection with the manufacture, assembly, handling or repair of, or parts of, batteries containing lead that involves the
manipulation of dry lead compounds, or pasting or casting lead
breaking up or dismantling batteries containing lead, or sorting, packing and handling plates or other parts containing lead that are
removed or recovered from the batteries
spraying molten lead metal or alloys containing more than 5% by weight of lead metal
melting or casting lead alloys containing more than 5% by weight of lead metal in which the temperature of the molten material exceeds
450°C
recovering lead from its ores, oxides or other compounds by thermal reduction process
dry machine grinding, discing, buffing or cutting by power tools alloys containing more than 5% by weight of lead metal
machine sanding or buffing surfaces coated with paint containing more than 1% by dry weight of lead
a process by which electric arc, oxyacetylene, oxy gas, plasma arc or a flame is applied for welding, cutting or cleaning, to the surface of
metal coated with lead or paint containing more than 1% by dry weight of lead metal
radiator repairs that may cause exposure to lead dust or lead fumes
fire assays if lead, lead compounds or lead alloys are used
hand grinding and finishing lead or alloys containing more than 50% by dry weight of lead
spray painting with lead paint containing more than 1% by dry weight of lead
melting lead metal or alloys containing more than 50% by weight of lead metal if the exposed surface area of the molten material exceeds
0.1 square metre and the temperature of the molten material does not exceed 450°C
using a power tool, including abrasive blasting and high pressure water jets, to remove a surface coated with paint containing more than
1% by dry weight of lead and handling waste containing lead resulting from the removal
a process that exposes a person to lead dust or lead fumes arising from manufacturing or testing detonators or other explosives that
contain lead
a process that exposes a person to lead dust or lead fumes arising from firing weapons at an indoor firing range
foundry processes involving:
(i)
melting or casting lead alloys containing more than 1% by weight of lead metal in which the temperature of the molten material
is more than 450°C or;
(ii) dry machine grinding, discing, buffing or cutting by power tools lead alloys containing more than 1% by weight of lead metal
a process decided by Workplace Health and Safety Queensland to be a lead process under regulation 393.
4. Address of the workplace for this lead risk work
(if different from the address of the PCBU)
Building name/unit number/ street number/ street name:
Suburb/locality: State: Postcode:
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5. Date of commencement of the lead risk work
/ /
6. Proposed (or known) completion date of the lead risk work
(if the work is short term such as abrasive blasting of lead paint from a structure)
/ /
7. Reason for notification of removal
Select one of the following:
Removal due to exceeding relevant blood lead level for the worker
Registered medical practitioner has recommended that the worker be removed from carrying out lead risk work:
Provide a brief description of the reason:
Indication that risk control measures have failed:
Provide a description of the failure of the control measures and the new risk control measures put in place:
8. Attach a copy of the lead health monitoring report provided by the registered medical
practitioner in relation to any worker who has been recommended for removal from lead
risk work
How to lodge this form
Post the completed form and the attached lead health monitoring
report if (required) to:
Health and Hygiene Unit, HICB
Workplace Health and Safety Queensland
PO Box 820
LUTWYCHE QLD 4030
or
Fax the completed form and any necessary attachments to
(07) 3247 9412
For office use only
Date notification received:
Data input date:
Data input by:
PRIVACY STATEMENT
The Department of Justice and Attorney-General is collecting the personal information on this form in order to receive notice of lead exposure in accordance with sections 403 and
415 of the Work Health and Safety Regulations 2011. The department may disclose this information to the applicable Commonwealth, State or Territory health and safety regulator/s
in order to obtain information relevant to the notice.
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FORM 23
V1.3.12
Guide to completing Form 23:
Notification relating to lead risk work
ABN 13 846 673 994
Work Health and Safety Act 2011
Introduction
The Work Health and Safety Regulation 2011 (WHS Regulation) provides for the notification to Workplace Health and Safety Queensland
(WHSQ) of:
• lead risk work
• the removal of a worker from lead risk work.
A person conducting a business or undertaking (PCBU) at a workplace is required to ensure, so far as reasonably practicable, the health and
safety of workers and others. Notifications of lead risk work and the removal of workers from lead risk work provide risk based information to
WHSQ so it can apply resources and target compliance and enforcement actions to areas of greatest risk to workplace health and safety.
Lead risk work means work carried out in a lead process that is likely to cause the blood lead level of a worker carrying out the work to be
more than:
• 10 µg/dL (0.48 µmol/L) for a female of reproductive capacity; or
• 30 µg/dL (1.45 µmol/L) in any other case.
[Regulation 394]
The meaning of a lead process is set out in regulation 392. Lead is defined in schedule 19 of the regulation as meaning lead metal, lead alloys,
inorganic lead compounds, and lead salts of organic acids.
Assessment for lead risk work
A PCBU at a workplace must assess each lead process carried out by the business or undertaking to determine if lead risk work is carried out
in the process. [Regulation 402(1)]
If the PCBU at a workplace is unable to determine whether lead risk work is carried out in a lead process, the process is taken to include lead
risk work until the person determines that lead risk work is not carried out in the process. [Regulation 402 (4)]
WHSQ can decide that a process to be carried out at a workplace is a lead process. A decision that a process is a lead process is a reviewable
decision. [Regulation 393]
Lead risk work
Notification is required when lead risk work is undertaken by the PCBU at a workplace after determining that the work is lead risk work.
[Regulation 403 (1)]
An emergency service organisation must give notification where work carried out to rescue a person or provide first aid to a person is
determined by the emergency services organisation to be lead risk work. [Regulation 403 (4)]
Removal of worker from lead risk work
Part 7.2 of the regulation imposes obligations on the PCBU to ensure health monitoring is provided to workers both before and after
commencing lead risk work. [Regulation 405]
Notification is required if a worker is removed from carrying out lead risk work following health monitoring where any of the following applies
• biological monitoring shows the worker’s blood lead level is, or is more than:
– 50 µg/dL (2.42 µmol/L) for females not of reproductive capacity and males
– 20 µg/dL (0.97 µmol/L) for females of reproductive capacity; or
– 15 µg/dL (0.72 µmol/L) for females who are pregnant or breastfeeding
• the registered medical practitioner recommends that the worker be removed from carrying out lead risk work
• there is an indication that a risk control measure has failed and as a result, the worker’s blood lead level is likely to reach the relevant
level for the worker to be removed from carrying out lead risk work.
[Regulation 415]
Who must notify
A PCBU at a workplace that has determined or is unable to determine that the work at the workplace is lead risk work. [Regulation 403 (1)]
A PCBU, who has removed a worker from carrying out lead risk work following health monitoring results. [Regulation 415]
A PCBU may be an individual, a body corporate, a government agency, a partnership or an unincorporated association.
An emergency service organisation where in the course of rescuing a person or providing first aid to a person, determines that the work is
lead risk work. [Regulation 403 (4)]
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When to notify
Lead risk work
Notification to WHSQ is required within seven days of the determination that the work is lead risk work or if a determination is unable to be
made. [Regulation 403 (1)]
Notification to WHSQ by an emergency service organisation is required as soon as practicable after determining that the work is lead risk
work. [Regulation 403 (5)]
Removal of worker from lead risk work
Notification to WHSQ is required as soon as reasonably practicable if a worker is removed from carrying out lead risk work.
[Regulation 415 (2)]
How to Notify
Notifications relating to lead risk work
Notifications are required to be made to WHSQ where the lead risk work is identified in a workplace located in Queensland. Use the attached
Form 23: Notification relating to lead risk work and complete the relevant sections for lead risk notification.
Notifications relating to removal of a worker
If you have to notify WHSQ in relation to the removal of a worker from lead risk work, complete the relevant sections of Form 23 and attach a
copy of the fully completed Form 86 Lead health monitoring report as provided to you by the registered medical practitioner who undertook
the health monitoring.
Fees
There is no fee for notification of lead risk work or notification of the removal of a worker from lead risk work.
What information does the regulator require?
Lead risk work
If you are notifying WHSQ in relation to lead risk work undertaken at your workplace, you need to complete sections 1 to 6 of Form 23:
Notification relating to lead risk work. This will provide sufficient information to characterise your lead risk work, where it is and who is the
responsible person making the notification.
Worker removed from lead risk work
If you are notifying WHSQ that a worker has to be removed from lead risk work as the result of an excessive blood lead level, or on
recommendation by a registered medical practitioner, then you must complete sections 2, 4, 7 and 8 of Form 23: Notification relating to lead
risk work.
You must attach a completed Form 86 Lead Health Monitoring Report as this contains information relevant to the worker to be removed, their
blood lead level or other reason for recommending removal from lead risk work.
Changes to details
The PCBU at a workplace where the work is lead risk work must advise WHSQ in writing of any changes to the information provided in a
Notification relating to lead risk work before the change or as soon as reasonably practicable after becoming aware of the change.
[Regulation 404 (1)]
Submit an amended notification using the Form 23: Notification relating to lead risk work.
Copy of notice
The PCBU at a workplace where lead risk work is carried out must:
• keep a copy of the notice or changes to the notice given to WHSQ for the period that the lead risk work is carried out at the workplace
• ensure a copy of the notice or changes to the notice are readily accessible to a worker who is likely to be exposed to lead, and the
worker’s health and safety representative. [Regulation 404 (2)]
Health monitoring
A PCBU at a workplace that carries out lead risk work must arrange for biological monitoring of each worker who carries out lead risk work at
the times prescribed. [Regulation 407 (1)]
The PCBU at a workplace that carries out lead risk work must increase the frequency of biological monitoring of a worker if the activity is likely
to significantly change the nature or increase the duration or the frequency of the worker’s lead exposure. [Regulation 407 (2)]
Application for review of decision
The table in Regulation 676 sets out decisions that are reviewable (reviewable decisions) and who is eligible (eligible person) to apply for the
review of a reviewable decision.
• The PCBU that carries out the lead process and/or a worker whose interests are affected by the decision are eligible request a review of a
decision made by WHSQ that a process is a lead process. [Regulation 393 (1)]
• The PCBU that carries out the lead process and/or a worker whose interests are affected by the decision are eligible persons to request
a review of the determination made by WHSQ of a different frequency for biological monitoring of workers at a workplace or a class of
workers, carrying out lead risk work. [Regulation 407 (3)]
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If the eligible person is not satisfied with the decision made by the regulator, they can make an application for external review pursuant to
section 229 of the WHS Act.
Further information
Should further clarification be required in reference to matters detailed in this guide, call the WHS Infoline on 1300 369 915.
Legislation
The WHS Act and the WHS Regulation can be accessed via www.worksafe.qld.gov.au.
List of jurisdiction contacts
Jurisdiction Name of regulator Telephone Web site
New South Wales WorkCover NSW 13 10 50 www.workcover.nsw.gov.au
Victoria WorkSafe Victoria 1800 136 089 www.worksafe.vic.gov.au
Queensland Workplace Health and Safety Qld 1300 369 915 www.worksafe.qld.gov.au
South Australia SafeWork SA 1300 365 255 www.safework.sa.gov.au
Western Australia WorkSafe WA 1300 307 877 www.worksafe.wa.gov.au
Australian Capital Territory WorkSafe ACT (02) 6207 3000 www.worksafety.act.gov.au
Tasmania Workplace Standards TAS 1300 366 322
www.wst.tas.gov.au
(Inside Tasmania)
(03) 62337657
(Outside Tasmania)
Commonwealth Comcare 1300 366 979 www.comcare.gov.au
Northern Territory NT WorkSafe 1800 019 115 www.nt.gov.au/justice/worksafe
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