2. University of Western Sydney Comments on your HREC Application

3. University of Western Sydney Title of Project:

4. University of Western Sydney Rationale: Aims of Project: You should list the aim and objectives of the research.

5. University of Western Sydney Division of Responsibilities: Name of Principal Researcher: Name of Students Course: Master of Applied Science (Safety Management) research project student Email Address: This MUST be given for ease of contact

6. University of Western Sydney Funding Is this protocol the subject of a grant application? NO Has this protocol been funded? NO Will there be any financial remuneration offered to the Researcher from any company or institution? NO

7. University of Western Sydney Duration and estimated finishing time:

8. University of Western Sydney Number of participants to be recruited:

9. University of Western Sydney How will you recruit your participants This needs to be covered in depth. From what population will you seek to recruit participants/subjects? Need to define how you will get participants to take part in your study. Especially if they have any relationship directly or indirectly. subjects?

10. University of Western Sydney Will any of the following groups be participants? Children Persons with a mental illness Persons with a disability Persons in vulnerable situations Persons in dependent relationships Indigenous Australians

11. University of Western Sydney Will any of the following be used? Chemical compounds Drugs Ionising or non-ionising radiation

12. University of Western Sydney The proposed research methodology and procedure: Methodology: Procedure:

13. University of Western Sydney Please indicate which, if any, of the following ethical issues, are involved in this research. (a) Is deception to be used? (b) Does the data collection process involve access to confidential participant data without their prior consent? (c) Will participants be photographed by camera or video? (d) If interviews are to be conducted, will they be tape recorded? (e) Will any treatment be used with potentially unpleasant or harmful side effects?

14. University of Western Sydney (f) In this study are there any applications of a treatment known (or thought) to be beneficial to one group of participants (EXPERIMENTAL) being WITHHELD from another group of participants (PLACEBO)? (g) Do your methods involve blood or tissue sampling or any other invasive procedures? What tissues and why are they being collected. If YES to any of the above, please amplify below.

15. University of Western Sydney Identify any risks or burdens which this research might pose for your participants/subjects: This section must be detailed as often the participants maybe working in hazardous work. You must detail what the work is, the type of precautions are being taken and the fact that you are not putting the participants in any extra danger.

16. University of Western Sydney Does this research involve subject matter of a particularly sensitive nature? This is important if the issues are likely to industrial disharmony or a person to loose their job.

17. University of Western Sydney If the research involves interviews with participants, briefly explain what mechanisms (if any) will be in place to respond to foreseeable eventualities such as: a revelation of illegal activity by or involving the participant; disclosure of institutional mismanagement; a participant becoming distraught because of the subject matter of the interview, etc You need to detail what you plan to do if any of the above occurs.

18. University of Western Sydney What steps will you take to obtain agreement of your participants/subjects to take part in the research? You will need to detail how will you will gain agreement of the participants.

19. University of Western Sydney Are potential participants in this research in dependant relationships which may limit their belief that they are free to refuse participation? You need to detail if you have nay relationship to any of the participants e.g. do you work for any of the organisations that the participants work or do you consult to any of the companies.

20. University of Western Sydney In your opinion, are there any other ethical issues involved in this research that have not been covered above? You need to address any issue that have not already been covered.

21. University of Western Sydney Signatures of responsible investigator and associates: