{"id":35456,"date":"2022-01-02T10:06:35","date_gmt":"2022-01-02T10:06:35","guid":{"rendered":"https:\/\/www.ub.edu\/ossma\/procedimientos-tramites\/hoja-declaracion-actividades"},"modified":"2022-01-02T10:06:35","modified_gmt":"2022-01-02T10:06:35","slug":"hoja-declaracion-actividades","status":"publish","type":"page","link":"https:\/\/www.ub.edu\/ossma\/es\/procedimientos-tramites\/hoja-declaracion-actividades","title":{"rendered":"Hoja de declaraci\u00f3n de actividades"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\">La hoja se divide en varios apartados, el primero de general aplicaci\u00f3n. Completa el resto de apartados s\u00f3lo si te son de aplicaci\u00f3n.<\/p>\n\n<p class=\"wp-block-paragraph\">Puedes rellenar el formulario que encontrar\u00e1s a continuaci\u00f3n o descargar los PDF&#8217;s de cada apartado, rellenarlos y enviarlos a ossma@ub.edu:<a href=\"https:\/\/www.ub.edu\/ossma\/wp-content\/uploads\/2020\/04\/full-declaracio-activitats-1-general.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">Datos generales<\/a>, <a href=\"https:\/\/www.ub.edu\/ossma\/wp-content\/uploads\/2020\/04\/full-declaracio-activitats-2-eines-epis.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">Herramientas de trabajo y EPI&#8217;s<\/a>, <a href=\"https:\/\/www.ub.edu\/ossma\/wp-content\/uploads\/2020\/04\/full-declaracio-activitats-3-productes-quimics.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">Productos qu\u00edmicos<\/a>, <a href=\"https:\/\/www.ub.edu\/ossma\/wp-content\/uploads\/2020\/04\/full-declaracio-activitats-4-biologics.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">Agentes biol\u00f3gicos<\/a>, <a href=\"https:\/\/www.ub.edu\/ossma\/wp-content\/uploads\/2020\/04\/full-declaracio-activitats-5-nanomaterials.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">Nanomateriales<\/a>, <a href=\"https:\/\/www.ub.edu\/ossma\/wp-content\/uploads\/2020\/04\/full-declaracio-activitats-6-agents-fisics.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">Agentes f\u00edsicos<\/a> y <a href=\"https:\/\/www.ub.edu\/ossma\/wp-content\/uploads\/2020\/04\/full-declaracio-activitats-7-sortides-camp.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">Salidas de campo<\/a>.<\/p>\n\n<h2 class=\"wp-block-heading\" id=\"formulari\">Formulario<\/h2>\n\n<div class=\"wp-block-contact-form-7-contact-form-selector\">\n<div class=\"wpcf7 no-js\" id=\"wpcf7-f35458-o1\" lang=\"es-ES\" dir=\"ltr\" data-wpcf7-id=\"35458\">\n<div class=\"screen-reader-response\"><p role=\"status\" aria-live=\"polite\" aria-atomic=\"true\"><\/p> <ul><\/ul><\/div>\n<form action=\"\/ossma\/es\/wp-json\/wp\/v2\/pages\/35456#wpcf7-f35458-o1\" method=\"post\" class=\"wpcf7-form init\" aria-label=\"Formulario de contacto\" novalidate=\"novalidate\" data-status=\"init\">\n<fieldset class=\"hidden-fields-container\"><input type=\"hidden\" name=\"_wpcf7\" value=\"35458\" \/><input type=\"hidden\" name=\"_wpcf7_version\" value=\"6.1.6\" \/><input type=\"hidden\" name=\"_wpcf7_locale\" value=\"es_ES\" \/><input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f35458-o1\" \/><input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/><input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/><input type=\"hidden\" name=\"_wpcf7cf_hidden_group_fields\" value=\"[]\" \/><input type=\"hidden\" name=\"_wpcf7cf_hidden_groups\" value=\"[]\" \/><input type=\"hidden\" name=\"_wpcf7cf_visible_groups\" value=\"[]\" \/><input type=\"hidden\" name=\"_wpcf7cf_repeaters\" value=\"[]\" \/><input type=\"hidden\" name=\"_wpcf7cf_steps\" value=\"{}\" \/><input type=\"hidden\" name=\"_wpcf7cf_options\" value=\"{&quot;form_id&quot;:35458,&quot;conditions&quot;:[{&quot;then_field&quot;:&quot;group-relacio-pdi&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;relacio-ub&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;PDI&quot;}]},{&quot;then_field&quot;:&quot;group-relacio-pas&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;relacio-ub&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;PTGAS&quot;}]},{&quot;then_field&quot;:&quot;group-relacio-investigador&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;relacio-ub&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Investigador&quot;}]},{&quot;then_field&quot;:&quot;group-relacio-becari&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;relacio-ub&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Becario de colaboraci\\u00f3n&quot;}]},{&quot;then_field&quot;:&quot;eines&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;obrir-eines&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;S\\u00ed&quot;}]},{&quot;then_field&quot;:&quot;quimics&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;obrir-quimics&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;S\\u00ed&quot;}]},{&quot;then_field&quot;:&quot;biologics&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;obrir-biologics&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;S\\u00ed&quot;}]},{&quot;then_field&quot;:&quot;nanomaterials&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;obrir-nanomaterials&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;S\\u00ed&quot;}]},{&quot;then_field&quot;:&quot;fisics&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;obrir-fisics&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;S\\u00ed&quot;}]},{&quot;then_field&quot;:&quot;sortides&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;obrir-sortides&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;S\\u00ed&quot;}]}],&quot;settings&quot;:{&quot;animation&quot;:&quot;yes&quot;,&quot;animation_intime&quot;:200,&quot;animation_outtime&quot;:200,&quot;conditions_ui&quot;:&quot;normal&quot;,&quot;notice_dismissed&quot;:false,&quot;repeater_remove_button&quot;:&quot;bottom&quot;}}\" \/>\n<\/fieldset>\n<h3>Progresi\u00f3n\n<\/h3>\n<p>Este formulario tiene apartados generales y otros en relaci\u00f3n con el tipo de actividad desarrollada:<br \/>\nDatos generales, Herramientas de trabajo y EPI's, Productos qu\u00edmicos, Agentes biol\u00f3gicos, Nanomateriales, Agentes f\u00edsicos y Salidas de campo.\n<\/p>\n<div class=\"form-two-columns\">\n\t<h3>Datos generales\n\t<\/h3>\n\t<p>Los campos con asterisco (*) son obligatorios.<br \/>\n<label for=\"pla-acollida\">\u00bfEst\u00e1s completando el Plan de acogida?*<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"pla-acollida\"><span class=\"wpcf7-form-control wpcf7-radio\" id=\"pla-acollida\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"pla-acollida\" value=\"S\u00ed\" checked=\"checked\" \/><span class=\"wpcf7-list-item-label\">S\u00ed<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"pla-acollida\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n\t<\/p>\n\t<fieldset>\n\t\t<legend>Datos personales\n\t\t<\/legend>\n\t\t<p><label for=\"nom\">Apellidos y nombre*<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"nom\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" id=\"nom\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"nom\" \/><\/span>\n\t\t<\/p>\n\t\t<p><label for=\"tel\">Tel\u00e9fono de contacto*<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"tel\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-tel wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-tel\" id=\"tel\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"tel\" name=\"tel\" \/><\/span>\n\t\t<\/p>\n\t\t<p><label for=\"email\">Correo electr\u00f3nico*<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"email\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-email wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-email\" id=\"email\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"email\" name=\"email\" \/><\/span>\n\t\t<\/p>\n\t\t<p><label for=\"email\">Declaraci\u00f3n voluntaria de especial sensibilidad<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"sensibilitat\"><select class=\"wpcf7-form-control wpcf7-select\" id=\"sensibilitat\" aria-invalid=\"false\" multiple=\"multiple\" name=\"sensibilitat[]\"><option value=\"Embarazo\">Embarazo<\/option><option value=\"Lactancia\">Lactancia<\/option><option value=\"Discapacidad f\u00edsica motora\">Discapacidad f\u00edsica motora<\/option><option value=\"Discapacidad f\u00edsica no motora\">Discapacidad f\u00edsica no motora<\/option><option value=\"Discapacidad sensorial visual\">Discapacidad sensorial visual<\/option><option value=\"Discapacidad sensorial auditiva\">Discapacidad sensorial auditiva<\/option><option value=\"Discapacidad intelectual\">Discapacidad intelectual<\/option><option value=\"Enfermedad mental\">Enfermedad mental<\/option><option value=\"Otros casos de especial sensibilidad\">Otros casos de especial sensibilidad<\/option><option value=\"No procede\">No procede<\/option><\/select><\/span>\n\t\t<\/p>\n\t<\/fieldset>\n\t<fieldset>\n\t\t<legend>Datos profesionales\n\t\t<\/legend>\n\t\t<p><label for=\"relacio-ub\">Relaci\u00f3n con la UB*<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"relacio-ub\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" id=\"relacio-ub\" aria-required=\"true\" aria-invalid=\"false\" name=\"relacio-ub\"><option value=\"\"><\/option><option value=\"PDI\">PDI<\/option><option value=\"PTGAS\">PTGAS<\/option><option value=\"Investigador\">Investigador<\/option><option value=\"Becario de colaboraci\u00f3n\">Becario de colaboraci\u00f3n<\/option><\/select><\/span>\n\t\t<\/p>\n\t\t<div data-id=\"group-relacio-pdi\" data-orig_data_id=\"group-relacio-pdi\"  class=\"\" data-class=\"wpcf7cf_group\">\n\t\t\t<p><label for=\"tipus-relacio\">Especifica tipo de relaci\u00f3n*<br \/>\n<span class=\"small\">(Tipo de PDI)<\/span><\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"tipus-relacio\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" id=\"tipus-relacio\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"tipus-relacio\" \/><\/span>\n\t\t\t<\/p>\n\t\t<\/div>\n\t\t<div data-id=\"group-relacio-pas\" data-orig_data_id=\"group-relacio-pas\"  class=\"\" data-class=\"wpcf7cf_group\">\n\t\t\t<p><label for=\"tipus-relacio\">Especifica tipo de relaci\u00f3n*<br \/>\n<span class=\"small\">(Categor\u00eda y plaza)<\/span><\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"tipus-relacio\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"tipus-relacio\" \/><\/span>\n\t\t\t<\/p>\n\t\t<\/div>\n\t\t<div data-id=\"group-relacio-investigador\" data-orig_data_id=\"group-relacio-investigador\"  class=\"\" data-class=\"wpcf7cf_group\">\n\t\t\t<p><label for=\"tipus-relacio\">Especifica tipo de relaci\u00f3n*<br \/>\n<span class=\"small\">(A\u00f1o de doctorado)<\/span><\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"tipus-relacio\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"tipus-relacio\" \/><\/span>\n\t\t\t<\/p>\n\t\t<\/div>\n\t\t<div data-id=\"group-relacio-becari\" data-orig_data_id=\"group-relacio-becari\"  class=\"\" data-class=\"wpcf7cf_group\">\n\t\t\t<p><label for=\"tipus-relacio\">Especifica tipo de relaci\u00f3n*<br \/>\n<span class=\"small\">(Tipo de becario)<\/span><\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"tipus-relacio\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"tipus-relacio\" \/><\/span>\n\t\t\t<\/p>\n\t\t<\/div>\n\t\t<p><label for=\"facultat\">Facultad\/centro*<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"facultat\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" id=\"facultat\" aria-required=\"true\" aria-invalid=\"false\" multiple=\"multiple\" name=\"facultat[]\"><option value=\"\u00c1rea de Formaci\u00f3n Complementaria\">\u00c1rea de Formaci\u00f3n Complementaria<\/option><option value=\"Aulario Josep Carner\">Aulario Josep Carner<\/option><option value=\"Edificio Baldiri Reixac 2 (CRAI Bibliotecas)\">Edificio Baldiri Reixac 2 (CRAI Bibliotecas)<\/option><option value=\"Edificio El Carme (Badalona)\">Edificio El Carme (Badalona)<\/option><option value=\"Edificio Hist\u00f3rico\">Edificio Hist\u00f3rico<\/option><option value=\"Edificio Sol\u00e9 y Sabar\u00eds (CCiTUB)\">Edificio Sol\u00e9 y Sabar\u00eds (CCiTUB)<\/option><option value=\"Facultad de Bellas Artes - Aulario Florensa\">Facultad de Bellas Artes - Aulario Florensa<\/option><option value=\"Facultad de Bellas Artes - Edificio principal, talleres y aulario antiguos Comedores\">Facultad de Bellas Artes - Edificio principal, talleres y aulario antiguos Comedores<\/option><option value=\"Facultad de Bellas Artes - Anexo II Parch\u00eds\">Facultad de Bellas Artes - Anexo II Parch\u00eds<\/option><option value=\"Facultad de Biolog\u00eda\">Facultad de Biolog\u00eda<\/option><option value=\"Facultad de Ciencias de la tierra\">Facultad de Ciencias de la tierra<\/option><option value=\"Facultad de Derecho\">Facultad de Derecho<\/option><option value=\"Facultad de Econom\u00eda y Empresa - Edificio 690\">Facultad de Econom\u00eda y Empresa - Edificio 690<\/option><option value=\"Facultad de Econom\u00eda y Empresa - Edificio 696\">Facultad de Econom\u00eda y Empresa - Edificio 696<\/option><option value=\"Facultad de Educaci\u00f3n - Edificio Levante\">Facultad de Educaci\u00f3n - Edificio Levante<\/option><option value=\"Facultad de Educaci\u00f3n - Edificios Mediod\u00eda I y Mediod\u00eda II\">Facultad de Educaci\u00f3n - Edificios Mediod\u00eda I y Mediod\u00eda II<\/option><option value=\"Facultad de Farmacia y Ciencias de la Alimentaci\u00f3n - Edificio Gaud\u00ed (Campus de Torribera)\">Facultad de Farmacia y Ciencias de la Alimentaci\u00f3n - Edificio Gaud\u00ed (Campus de Torribera)<\/option><option value=\"Facultad de Farmacia y Ciencias de la Alimentaci\u00f3n - Edificio La Masia (Campus de Torribera)\">Facultad de Farmacia y Ciencias de la Alimentaci\u00f3n - Edificio La Masia (Campus de Torribera)<\/option><option value=\"Facultad de Farmacia y Ciencias de la Alimentaci\u00f3n - Edificio Marina (Campus de Torribera)\">Facultad de Farmacia y Ciencias de la Alimentaci\u00f3n - Edificio Marina (Campus de Torribera)<\/option><option value=\"Facultad de Farmacia y Ciencias de la Alimentaci\u00f3n - Edificio Verdaguer (Campus de Torribera)\">Facultad de Farmacia y Ciencias de la Alimentaci\u00f3n - Edificio Verdaguer (Campus de Torribera)<\/option><option value=\"Facultad de Farmacia y Ciencias de la alimentaci\u00f3n (Diagonal Sur)\">Facultad de Farmacia y Ciencias de la alimentaci\u00f3n (Diagonal Sur)<\/option><option value=\"Facultad de Filosof\u00eda y Facultad de Geograf\u00eda e Historia\">Facultad de Filosof\u00eda y Facultad de Geograf\u00eda e Historia<\/option><option value=\"Facultad de F\u00edsica y Facultad de Qu\u00edmica\">Facultad de F\u00edsica y Facultad de Qu\u00edmica<\/option><option value=\"Facultad de Informaci\u00f3n y Medios Audiovisuales (Campus Sants)\">Facultad de Informaci\u00f3n y Medios Audiovisuales (Campus Sants)<\/option><option value=\"Facultad de Medicina y Ciencias de la salud (Campus Cl\u00ednic)\">Facultad de Medicina y Ciencias de la salud (Campus Cl\u00ednic)<\/option><option value=\"Facultad de Medicina y Ciencias de la salud (Campus de Bellvitge)\">Facultad de Medicina y Ciencias de la salud (Campus de Bellvitge)<\/option><option value=\"Facultad de Psicolog\u00eda (Campus Mundet - Edificio Ponente)\">Facultad de Psicolog\u00eda (Campus Mundet - Edificio Ponente)<\/option><option value=\"Pabell\u00f3n Rosa\">Pabell\u00f3n Rosa<\/option><option value=\"Servicio de Deportes\">Servicio de Deportes<\/option><option value=\"Otros espacios de la UB\">Otros espacios de la UB<\/option><option value=\"Otors espacios fuera de la UB\">Otors espacios fuera de la UB<\/option><\/select><\/span>\n\t\t<\/p>\n\t\t<p><label for=\"departament\">Departamento\/servicio\/unidad*<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"departament\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" id=\"departament\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"departament\" \/><\/span>\n\t\t<\/p>\n\t\t<p><label for=\"edifici\">Edificio\/s<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"edifici\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" id=\"edifici\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"edifici\" \/><\/span>\n\t\t<\/p>\n\t\t<p><label for=\"ubicacio\">Ubicaci\u00f3n habitual <small>(Zona, piso, n\u00fam. de despacho, n\u00fam. de laboratorio)<\/small><\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"ubicacio\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" id=\"ubicacio\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"ubicacio\" \/><\/span>\n\t\t<\/p>\n\t\t<p><label for=\"altres-ubicacions\">Otras posibles ubicaciones<small>(PCB, hospitales, centros de investigaci\u00f3n)<\/small><\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"altres-ubicacions\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" id=\"altres-ubicacions\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"altres-ubicacions\" \/><\/span>\n\t\t<\/p>\n\t<\/fieldset>\n\t<fieldset>\n\t\t<legend>Datos de investigaci\u00f3n\n\t\t<\/legend>\n\t\t<p><label for=\"grup-recerca\">Grupo de investigaci\u00f3n<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"grup-recerca\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" id=\"grup-recerca\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"grup-recerca\" \/><\/span>\n\t\t<\/p>\n\t\t<p><label for=\"linia-recerca\">L\u00ednea de investigaci\u00f3n<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"linia-recerca\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" id=\"linia-recerca\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"linia-recerca\" \/><\/span>\n\t\t<\/p>\n\t\t<p><label for=\"investigador-projecte\">Investigador principal del proyecto<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"investigador-projecte\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" id=\"investigador-projecte\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"investigador-projecte\" \/><\/span>\n\t\t<\/p>\n\t\t<p><label for=\"projecte\">Proyecto de investigaci\u00f3n<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"projecte\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" id=\"projecte\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"projecte\" \/><\/span>\n\t\t<\/p>\n\t<\/fieldset>\n\t<fieldset>\n\t\t<legend>Tareas\n\t\t<\/legend>\n\t\t<p>% de tiempo aproximado de dedicaci\u00f3n (considere la situaci\u00f3n habitual, calculada sobre un total del 100%)\n\t\t<\/p>\n\t\t<p><label for=\"tasques-administracio\">Administraci\u00f3n y gesti\u00f3n<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"tasques-administracio\"><input class=\"wpcf7-form-control wpcf7-number wpcf7-validates-as-number\" id=\"tasques-administracio\" min=\"0\" max=\"100\" aria-invalid=\"false\" value=\"\" type=\"number\" name=\"tasques-administracio\" \/><\/span>\n\t\t<\/p>\n\t\t<p><label for=\"tasques-docencia-aula\">Docencia en aula<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"tasques-docencia-aula\"><input class=\"wpcf7-form-control wpcf7-number wpcf7-validates-as-number\" id=\"tasques-docencia-aula\" min=\"0\" max=\"100\" aria-invalid=\"false\" value=\"\" type=\"number\" name=\"tasques-docencia-aula\" \/><\/span>\n\t\t<\/p>\n\t\t<p><label for=\"tasques-docencia-laboratoris\">Docencia en laboratorios de pr\u00e1cticas<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"tasques-docencia-laboratoris\"><input class=\"wpcf7-form-control wpcf7-number wpcf7-validates-as-number\" id=\"tasques-docencia-laboratoris\" min=\"0\" max=\"100\" aria-invalid=\"false\" value=\"\" type=\"number\" name=\"tasques-docencia-laboratoris\" \/><\/span>\n\t\t<\/p>\n\t\t<p><label for=\"tasques-laboratori\">Trabajo de laboratorio<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"tasques-laboratori\"><input class=\"wpcf7-form-control wpcf7-number wpcf7-validates-as-number\" id=\"tasques-laboratori\" min=\"0\" max=\"100\" aria-invalid=\"false\" value=\"\" type=\"number\" name=\"tasques-laboratori\" \/><\/span>\n\t\t<\/p>\n\t\t<p><label for=\"tasques-taller\">Trabajo en el taller<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"tasques-taller\"><input class=\"wpcf7-form-control wpcf7-number wpcf7-validates-as-number\" id=\"tasques-taller\" min=\"0\" max=\"100\" aria-invalid=\"false\" value=\"\" type=\"number\" name=\"tasques-taller\" \/><\/span>\n\t\t<\/p>\n\t\t<p><label for=\"tasques-sortides\">Salidas de campo<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"tasques-sortides\"><input class=\"wpcf7-form-control wpcf7-number wpcf7-validates-as-number\" id=\"tasques-sortides\" min=\"0\" max=\"100\" aria-invalid=\"false\" value=\"\" type=\"number\" name=\"tasques-sortides\" \/><\/span>\n\t\t<\/p>\n\t\t<p><label for=\"tasques-recerca\">B\u00fasqueda documental<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"tasques-recerca\"><input class=\"wpcf7-form-control wpcf7-number wpcf7-validates-as-number\" id=\"tasques-recerca\" min=\"0\" max=\"100\" aria-invalid=\"false\" value=\"\" type=\"number\" name=\"tasques-recerca\" \/><\/span>\n\t\t<\/p>\n\t\t<p><label for=\"tasques-altres\">Otras tareas<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"tasques-altres\"><input class=\"wpcf7-form-control wpcf7-number wpcf7-validates-as-number\" id=\"tasques-altres\" min=\"0\" max=\"100\" aria-invalid=\"false\" value=\"\" type=\"number\" name=\"tasques-altres\" \/><\/span><br \/>\n<label for=\"tasques-altres-text\"><small>(Especifica estas tareas)<\/small><\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"tasques-altres-text\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"tasques-altres-text\" \/><\/span>\n\t\t<\/p>\n\t\t<p><label for=\"tasques\">Breve descripci\u00f3n de las tareas que realiza*<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"tasques\"><textarea cols=\"40\" rows=\"3\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea wpcf7-validates-as-required\" id=\"tasques\" aria-required=\"true\" aria-invalid=\"false\" name=\"tasques\"><\/textarea><\/span>\n\t\t<\/p>\n\t\t<p>Zonas a las que accede o en las que desarrolla sus tareas <small>(Especifique, en su caso, n\u00ba de despacho, nombre de aulario, etc...)<\/small>\n\t\t<\/p>\n\t\t<p><label for=\"zones-despatx\">Despacho\/oficina<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"zones-despatx\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" id=\"zones-despatx\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"zones-despatx\" \/><\/span>\n\t\t<\/p>\n\t\t<p><label for=\"zones-aulari\">Aulario<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"zones-aulari\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" id=\"zones-aulari\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"zones-aulari\" \/><\/span>\n\t\t<\/p>\n\t\t<p><label for=\"zones-laboratori\">Laboratorio\/s<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"zones-laboratori\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" id=\"zones-laboratori\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"zones-laboratori\" \/><\/span>\n\t\t<\/p>\n\t\t<p><label for=\"zones-experimentacio\">Unidad de experimentaci\u00f3n animal<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"zones-experimentacio\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" id=\"zones-experimentacio\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"zones-experimentacio\" \/><\/span>\n\t\t<\/p>\n\t\t<p><label for=\"zones-quirofan\">Quir\u00f3fano\/s<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"zones-quirofan\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" id=\"zones-quirofan\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"zones-quirofan\" \/><\/span>\n\t\t<\/p>\n\t\t<p><label for=\"zones-radiactiva\">Instalaci\u00f3n radiactiva<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"zones-radiactiva\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" id=\"zones-radiactiva\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"zones-radiactiva\" \/><\/span>\n\t\t<\/p>\n\t\t<p><label for=\"zones-cultius\">Sala de cultivos<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"zones-cultius\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" id=\"zones-cultius\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"zones-cultius\" \/><\/span>\n\t\t<\/p>\n\t\t<p><label for=\"zones-freda\">C\u00e1mara fr\u00eda<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"zones-freda\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" id=\"zones-freda\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"zones-freda\" \/><\/span>\n\t\t<\/p>\n\t\t<p><label for=\"zones-taller\">Taller\/s<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"zones-taller\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" id=\"zones-taller\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"zones-taller\" \/><\/span>\n\t\t<\/p>\n\t\t<p><label for=\"zones-altres\">Otras<small>(especifiqueu)<\/small><\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"zones-altres\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" id=\"zones-altres\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"zones-altres\" \/><\/span>\n\t\t<\/p>\n\t<\/fieldset>\n\t<p><b>Identificaci\u00f3n de los posibles factores de riesgo (ergonom\u00eda)<\/b>\n\t<\/p>\n\t<fieldset>\n\t\t<legend>Factores de riesgo ergon\u00f3micos\n\t\t<\/legend>\n\t\t<p><label for=\"equips-gestio\">Uso de pantallas<\/label><span class=\"formulari-dreta\"><span class=\"wpcf7-form-control-wrap\" data-name=\"equips-gestio\"><span class=\"wpcf7-form-control wpcf7-checkbox\" id=\"equips-gestio\"><span class=\"wpcf7-list-item first\"><input type=\"checkbox\" name=\"equips-gestio[]\" value=\"Ordenador de sobremesa\" \/><span class=\"wpcf7-list-item-label\">Ordenador de sobremesa<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"equips-gestio[]\" value=\"Tableta\" \/><span class=\"wpcf7-list-item-label\">Tableta<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"checkbox\" name=\"equips-gestio[]\" value=\"Ordenador port\u00e1til\" \/><span class=\"wpcf7-list-item-label\">Ordenador port\u00e1til<\/span><\/span><\/span><\/span><\/span>\n\t\t<\/p>\n\t\t<p><label for=\"equips-gestio-altres\">Otros<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"equips-gestio-altres\"><textarea cols=\"40\" rows=\"3\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" id=\"equips-gestio-altres\" aria-invalid=\"false\" name=\"equips-gestio-altres\"><\/textarea><\/span>\n\t\t<\/p>\n\t\t<p><label for=\"risc-ergonomic\">Tipo de riesgo<\/label><span class=\"formulari-dreta\"><span class=\"wpcf7-form-control-wrap\" data-name=\"risc-ergonomic\"><span class=\"wpcf7-form-control wpcf7-checkbox\" id=\"risc-ergonomic\"><span class=\"wpcf7-list-item first\"><input type=\"checkbox\" name=\"risc-ergonomic[]\" value=\"Manipulaci\u00f3n de cargas\" \/><span class=\"wpcf7-list-item-label\">Manipulaci\u00f3n de cargas<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"risc-ergonomic[]\" value=\"Posiciones forzadas\" \/><span class=\"wpcf7-list-item-label\">Posiciones forzadas<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"risc-ergonomic[]\" value=\"Movimientos con elevada repetitivitat\" \/><span class=\"wpcf7-list-item-label\">Movimientos con elevada repetitivitat<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"risc-ergonomic[]\" value=\"Trabajo con ordenador m\u00e1s de 4h\/d\u00eda o 20 h\/sem\" \/><span class=\"wpcf7-list-item-label\">Trabajo con ordenador m\u00e1s de 4h\/d\u00eda o 20 h\/sem<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"checkbox\" name=\"risc-ergonomic[]\" value=\"Altas exigencias visuales\" \/><span class=\"wpcf7-list-item-label\">Altas exigencias visuales<\/span><\/span><\/span><\/span><\/span>\n\t\t<\/p>\n\t\t<p><label for=\"risc-ergonomic-especificar\">En caso de marcar alguna casilla, especifica el riesgo<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"risc-ergonomic-especificar\"><textarea cols=\"40\" rows=\"3\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" id=\"risc-ergonomic-especificar\" aria-invalid=\"false\" name=\"risc-ergonomic-especificar\"><\/textarea><\/span>\n\t\t<\/p>\n\t<\/fieldset>\n\t<fieldset id=\"altres-riscos\">\n\t\t<legend>Otros factores de riesgo detectados\n\t\t<\/legend>\n\t\t<p><label for=\"soroll\">Ruido<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"soroll\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" id=\"soroll\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"soroll\" \/><\/span>\n\t\t<\/p>\n\t\t<p><label for=\"vibracions\">Vibraciones<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"vibracions\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" id=\"vibracions\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"vibracions\" \/><\/span>\n\t\t<\/p>\n\t\t<p><label for=\"temperatura\">Temperatura<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"temperatura\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" id=\"temperatura\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"temperatura\" \/><\/span>\n\t\t<\/p>\n\t\t<p><label for=\"organitzacio\">Factores relacionados con la organizaci\u00f3n, contenido o ejecuci\u00f3n<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"organitzacio\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" id=\"organitzacio\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"organitzacio\" \/><\/span>\n\t\t<\/p>\n\t\t<p><label for=\"viatges\">Viajes y participaci\u00f3n en seminarios\/congresos, etc.<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"viatges\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" id=\"viatges\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"viatges\" \/><\/span>\n\t\t<\/p>\n\t\t<p><label for=\"altres-riscos-detectats\">Otros riesgos detectados<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"altres-riscos-detectats\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" id=\"altres-riscos-detectats\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"altres-riscos-detectats\" \/><\/span>\n\t\t<\/p>\n\t<\/fieldset>\n\t<fieldset>\n\t\t<legend>Observaciones\n\t\t<\/legend>\n\t\t<p><label for=\"altres-observacions\">Otras observaciones<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"altres-observacions\"><textarea cols=\"40\" rows=\"3\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" id=\"altres-observacions\" aria-invalid=\"false\" name=\"altres-observacions\"><\/textarea><\/span>\n\t\t<\/p>\n\t<\/fieldset>\n\t<h3>Herramientas de trabajo y EPI's\n\t<\/h3>\n\t<p><label for=\"obrir-eines\">Utilizo herramientas de trabajo o EPI's<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"obrir-eines\"><span class=\"wpcf7-form-control wpcf7-radio\" id=\"obrir-eines\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"obrir-eines\" value=\"S\u00ed\" \/><span class=\"wpcf7-list-item-label\">S\u00ed<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"obrir-eines\" value=\"No\" checked=\"checked\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n\t<\/p>\n\t<div data-id=\"eines\" data-orig_data_id=\"eines\" data-clear_on_hide class=\"\" data-class=\"wpcf7cf_group\">\n\t\t<fieldset id=\"eines\">\n\t\t\t<legend>Equipos de trabajo\n\t\t\t<\/legend>\n\t\t\t<p><label for=\"equips-maquines\">M\u00e1quinas y herramientas de taller<\/label><span class=\"formulari-dreta\"><span class=\"wpcf7-form-control-wrap\" data-name=\"equips-maquines\"><span class=\"wpcf7-form-control wpcf7-checkbox\" id=\"equips-maquines\"><span class=\"wpcf7-list-item first\"><input type=\"checkbox\" name=\"equips-maquines[]\" value=\"Sierra\" \/><span class=\"wpcf7-list-item-label\">Sierra<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"equips-maquines[]\" value=\"Taladro\" \/><span class=\"wpcf7-list-item-label\">Taladro<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"equips-maquines[]\" value=\"Torno\" \/><span class=\"wpcf7-list-item-label\">Torno<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"equips-maquines[]\" value=\"Machacadora\" \/><span class=\"wpcf7-list-item-label\">Machacadora<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"equips-maquines[]\" value=\"Herramientas el\u00e9ctricas port\u00e1tiles\" \/><span class=\"wpcf7-list-item-label\">Herramientas el\u00e9ctricas port\u00e1tiles<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"checkbox\" name=\"equips-maquines[]\" value=\"Herramientas cortantes\/punzantes\" \/><span class=\"wpcf7-list-item-label\">Herramientas cortantes\/punzantes<\/span><\/span><\/span><\/span><\/span>\n\t\t\t<\/p>\n\t\t\t<p><label for=\"equips-maquines-altres\">Otras<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"equips-maquines-altres\"><textarea cols=\"40\" rows=\"3\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" id=\"equips-maquines-altres\" aria-invalid=\"false\" name=\"equips-maquines-altres\"><\/textarea><\/span>\n\t\t\t<\/p>\n\t\t\t<p><label for=\"equips-laboratori\">Equipamiento de laboratorio<\/label><span class=\"formulari-dreta\"><span class=\"wpcf7-form-control-wrap\" data-name=\"equips-laboratori\"><span class=\"wpcf7-form-control wpcf7-checkbox\" id=\"equips-laboratori\"><span class=\"wpcf7-list-item first\"><input type=\"checkbox\" name=\"equips-laboratori[]\" value=\"Ba\u00f1o ultrasonidos\" \/><span class=\"wpcf7-list-item-label\">Ba\u00f1o ultrasonidos<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"equips-laboratori[]\" value=\"Centr\u00edfuga\" \/><span class=\"wpcf7-list-item-label\">Centr\u00edfuga<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"equips-laboratori[]\" value=\"Autoclave\" \/><span class=\"wpcf7-list-item-label\">Autoclave<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"equips-laboratori[]\" value=\"Dip\u00f3sitos dewar\" \/><span class=\"wpcf7-list-item-label\">Dip\u00f3sitos dewar<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"equips-laboratori[]\" value=\"Equipos RMN\" \/><span class=\"wpcf7-list-item-label\">Equipos RMN<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"equips-laboratori[]\" value=\"Difract\u00f3metro RX\" \/><span class=\"wpcf7-list-item-label\">Difract\u00f3metro RX<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"equips-laboratori[]\" value=\"Horno \/ mufla\" \/><span class=\"wpcf7-list-item-label\">Horno \/ mufla<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"equips-laboratori[]\" value=\"Molinos\" \/><span class=\"wpcf7-list-item-label\">Molinos<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"equips-laboratori[]\" value=\"Bunsen\" \/><span class=\"wpcf7-list-item-label\">Bunsen<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"equips-laboratori[]\" value=\"Material de vidrio\" \/><span class=\"wpcf7-list-item-label\">Material de vidrio<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"equips-laboratori[]\" value=\"Material cortante \/ punzante\" \/><span class=\"wpcf7-list-item-label\">Material cortante \/ punzante<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"equips-laboratori[]\" value=\"Microscopio \u00f3ptico\" \/><span class=\"wpcf7-list-item-label\">Microscopio \u00f3ptico<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"equips-laboratori[]\" value=\"Microscopio electr\u00f3nico\" \/><span class=\"wpcf7-list-item-label\">Microscopio electr\u00f3nico<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"equips-laboratori[]\" value=\"Micr\u00f3tomo\" \/><span class=\"wpcf7-list-item-label\">Micr\u00f3tomo<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"checkbox\" name=\"equips-laboratori[]\" value=\"Ultramicr\u00f3tomo\" \/><span class=\"wpcf7-list-item-label\">Ultramicr\u00f3tomo<\/span><\/span><\/span><\/span><\/span>\n\t\t\t<\/p>\n\t\t\t<p><label for=\"equips-laboratori-altres\">Otros<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"equips-laboratori-altres\"><textarea cols=\"40\" rows=\"3\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" id=\"equips-laboratori-altres\" aria-invalid=\"false\" name=\"equips-laboratori-altres\"><\/textarea><\/span>\n\t\t\t<\/p>\n\t\t<\/fieldset>\n\t\t<fieldset id=\"epis\">\n\t\t\t<legend>Equipos de protecci\u00f3n\n\t\t\t<\/legend>\n\t\t\t<p><b>Equipos de protecci\u00f3n colectiva<\/b>\n\t\t\t<\/p>\n\t\t\t<p><label for=\"proteccio-colectiva\">Indica los equipos<\/label><span class=\"formulari-dreta\"><span class=\"wpcf7-form-control-wrap\" data-name=\"proteccio-colectiva\"><span class=\"wpcf7-form-control wpcf7-checkbox\" id=\"proteccio-colectiva\"><span class=\"wpcf7-list-item first\"><input type=\"checkbox\" name=\"proteccio-colectiva[]\" value=\"Vitrina de extracci\u00f3n de gases\" \/><span class=\"wpcf7-list-item-label\">Vitrina de extracci\u00f3n de gases<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"proteccio-colectiva[]\" value=\"Vitrina de sobremesa\" \/><span class=\"wpcf7-list-item-label\">Vitrina de sobremesa<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"proteccio-colectiva[]\" value=\"Cabina de bioseguridad\" \/><span class=\"wpcf7-list-item-label\">Cabina de bioseguridad<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"checkbox\" name=\"proteccio-colectiva[]\" value=\"Cabina de flujo laminar\" \/><span class=\"wpcf7-list-item-label\">Cabina de flujo laminar<\/span><\/span><\/span><\/span><\/span>\n\t\t\t<\/p>\n\t\t\t<p><label for=\"proteccio-colectiva-altres\">Otros sistemas de extracci\u00f3n<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"proteccio-colectiva-altres\"><textarea cols=\"40\" rows=\"3\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" id=\"proteccio-colectiva-altres\" aria-invalid=\"false\" name=\"proteccio-colectiva-altres\"><\/textarea><\/span>\n\t\t\t<\/p>\n\t\t\t<p><b>Equipos de protecci\u00f3n individual<\/b>\n\t\t\t<\/p>\n\t\t\t<p><label for=\"guants\">Guantes protecci\u00f3n qu\u00edmicos \/ biol\u00f3gico<\/label><span class=\"formulari-dreta\"><span class=\"wpcf7-form-control-wrap\" data-name=\"guants\"><span class=\"wpcf7-form-control wpcf7-checkbox\" id=\"guants\"><span class=\"wpcf7-list-item first\"><input type=\"checkbox\" name=\"guants[]\" value=\"L\u00e1tex\" \/><span class=\"wpcf7-list-item-label\">L\u00e1tex<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"guants[]\" value=\"Vinilo\" \/><span class=\"wpcf7-list-item-label\">Vinilo<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"guants[]\" value=\"Nitrilo\" \/><span class=\"wpcf7-list-item-label\">Nitrilo<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"guants[]\" value=\"Neopreno\" \/><span class=\"wpcf7-list-item-label\">Neopreno<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"checkbox\" name=\"guants[]\" value=\"PVC\" \/><span class=\"wpcf7-list-item-label\">PVC<\/span><\/span><\/span><\/span><\/span>\n\t\t\t<\/p>\n\t\t\t<p><label for=\"guants-altres\">Otros<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"guants-altres\"><textarea cols=\"40\" rows=\"3\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" id=\"guants-altres\" aria-invalid=\"false\" name=\"guants-altres\"><\/textarea><\/span>\n\t\t\t<\/p>\n\t\t\t<p><label for=\"guants-term\">Guantes protecci\u00f3n t\u00e9rmica \/ mec\u00e0nica<\/label><span class=\"formulari-dreta\"><span class=\"wpcf7-form-control-wrap\" data-name=\"guants-term\"><span class=\"wpcf7-form-control wpcf7-checkbox\" id=\"guants-term\"><span class=\"wpcf7-list-item first\"><input type=\"checkbox\" name=\"guants-term[]\" value=\"Criogenia\" \/><span class=\"wpcf7-list-item-label\">Criogenia<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"guants-term[]\" value=\"Radiaci\u00f3n t\u00e9rmica\" \/><span class=\"wpcf7-list-item-label\">Radiaci\u00f3n t\u00e9rmica<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"checkbox\" name=\"guants-term[]\" value=\"Cuero o similar\" \/><span class=\"wpcf7-list-item-label\">Cuero o similar<\/span><\/span><\/span><\/span><\/span>\n\t\t\t<\/p>\n\t\t\t<p><label for=\"guants-term-altres\">Otros<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"guants-term-altres\"><textarea cols=\"40\" rows=\"3\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" id=\"guants-term-altres\" aria-invalid=\"false\" name=\"guants-term-altres\"><\/textarea><\/span>\n\t\t\t<\/p>\n\t\t\t<p><label for=\"ulleres\">Protecci\u00f3n ocular<\/label><span class=\"formulari-dreta\"><span class=\"wpcf7-form-control-wrap\" data-name=\"ulleres\"><span class=\"wpcf7-form-control wpcf7-checkbox\" id=\"ulleres\"><span class=\"wpcf7-list-item first\"><input type=\"checkbox\" name=\"ulleres[]\" value=\"Gafas seguridad\" \/><span class=\"wpcf7-list-item-label\">Gafas seguridad<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"ulleres[]\" value=\"Pantalla facial\" \/><span class=\"wpcf7-list-item-label\">Pantalla facial<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"checkbox\" name=\"ulleres[]\" value=\"Gafas soldadura\" \/><span class=\"wpcf7-list-item-label\">Gafas soldadura<\/span><\/span><\/span><\/span><\/span>\n\t\t\t<\/p>\n\t\t\t<p><label for=\"ulleres-altres\">Otros<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"ulleres-altres\"><textarea cols=\"40\" rows=\"3\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" id=\"ulleres-altres\" aria-invalid=\"false\" name=\"ulleres-altres\"><\/textarea><\/span>\n\t\t\t<\/p>\n\t\t\t<p><label for=\"mascares\">Protecci\u00f3n respiratoria (m\u00e1scaras)<\/label><span class=\"formulari-dreta\"><span class=\"wpcf7-form-control-wrap\" data-name=\"mascares\"><span class=\"wpcf7-form-control wpcf7-checkbox\" id=\"mascares\"><span class=\"wpcf7-list-item first\"><input type=\"checkbox\" name=\"mascares[]\" value=\"Tipo quir\u00fargica\" \/><span class=\"wpcf7-list-item-label\">Tipo quir\u00fargica<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"mascares[]\" value=\"Povo\/part\u00edculas\" \/><span class=\"wpcf7-list-item-label\">Povo\/part\u00edculas<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"checkbox\" name=\"mascares[]\" value=\"Gases\/vapores\" \/><span class=\"wpcf7-list-item-label\">Gases\/vapores<\/span><\/span><\/span><\/span><\/span>\n\t\t\t<\/p>\n\t\t\t<p><label for=\"mascares-altres\">Otras<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"mascares-altres\"><textarea cols=\"40\" rows=\"3\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" id=\"mascares-altres\" aria-invalid=\"false\" name=\"mascares-altres\"><\/textarea><\/span>\n\t\t\t<\/p>\n\t\t\t<p><label for=\"auditiva\">Protecci\u00f3n auditiva y otros<\/label><span class=\"formulari-dreta\"><span class=\"wpcf7-form-control-wrap\" data-name=\"auditiva\"><span class=\"wpcf7-form-control wpcf7-checkbox\" id=\"auditiva\"><span class=\"wpcf7-list-item first\"><input type=\"checkbox\" name=\"auditiva[]\" value=\"Tapones\" \/><span class=\"wpcf7-list-item-label\">Tapones<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"auditiva[]\" value=\"Auriculares\" \/><span class=\"wpcf7-list-item-label\">Auriculares<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"auditiva[]\" value=\"Casco\" \/><span class=\"wpcf7-list-item-label\">Casco<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"checkbox\" name=\"auditiva[]\" value=\"Botas\" \/><span class=\"wpcf7-list-item-label\">Botas<\/span><\/span><\/span><\/span><\/span>\n\t\t\t<\/p>\n\t\t\t<p><label for=\"auditiva-altres\">Otros<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"auditiva-altres\"><textarea cols=\"40\" rows=\"3\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" id=\"auditiva-altres\" aria-invalid=\"false\" name=\"auditiva-altres\"><\/textarea><\/span>\n\t\t\t<\/p>\n\t\t<\/fieldset>\n\t<\/div>\n\t<h3>Productos qu\u00edmicos\n\t<\/h3>\n\t<p><label for=\"obrir-quimics\">Utilizo productos qu\u00edmicos en mi trabajo<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"obrir-quimics\"><span class=\"wpcf7-form-control wpcf7-radio\" id=\"obrir-quimics\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"obrir-quimics\" value=\"S\u00ed\" \/><span class=\"wpcf7-list-item-label\">S\u00ed<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"obrir-quimics\" value=\"No\" checked=\"checked\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n\t<\/p>\n\t<div data-id=\"quimics\" data-orig_data_id=\"quimics\" data-clear_on_hide class=\"\" data-class=\"wpcf7cf_group\">\n\t\t<fieldset id=\"quimics\">\n\t\t\t<legend>Productos qu\u00edmicos\n\t\t\t<\/legend>\n\t\t\t<p><small>Clasificaci\u00f3n de los productos seg\u00fan frases de peligrosidad (frases H) de acuerdo con etiquetado GHS (Global Harmonized System)<\/small>\n\t\t\t<\/p>\n\t\t\t<p><label for=\"quimics-desconeguts\">Productos qu\u00edmicos de los que desconoces la clasificaci\u00f3n<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"quimics-desconeguts\"><textarea cols=\"40\" rows=\"3\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" id=\"quimics-desconeguts\" aria-invalid=\"false\" name=\"quimics-desconeguts\"><\/textarea><\/span>\n\t\t\t<\/p>\n\t\t\t<p><b>Productos qu\u00edmicos cancer\u00edgenos (H 350 - H351) | Productos qu\u00edmicos mut\u00e1genos (H340 - 341) | Productos qu\u00edmicos t\u00f3xicos para la reproducci\u00f3n (H360 - H361 - H362) | Productos qu\u00edmicos con toxicidad aguda 1\u00f3 2 y\/o con toxicidad espec\u00edfica en determinantes \u00f3rganos (STOT 1)<\/b>\n\t\t\t<\/p>\n\t\t\t<p><label for=\"quimics-cancerigens\">Tipo de producto<\/label><span class=\"formulari-dreta\"><span class=\"wpcf7-form-control-wrap\" data-name=\"quimics-cancerigens\"><span class=\"wpcf7-form-control wpcf7-checkbox\" id=\"quimics-cancerigens\"><span class=\"wpcf7-list-item first\"><input type=\"checkbox\" name=\"quimics-cancerigens[]\" value=\"Bromuro de etidio\" \/><span class=\"wpcf7-list-item-label\">Bromuro de etidio<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"quimics-cancerigens[]\" value=\"Acrilamida\" \/><span class=\"wpcf7-list-item-label\">Acrilamida<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"quimics-cancerigens[]\" value=\"Hexano\" \/><span class=\"wpcf7-list-item-label\">Hexano<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"quimics-cancerigens[]\" value=\"Dicromato pot\u00e1sico\" \/><span class=\"wpcf7-list-item-label\">Dicromato pot\u00e1sico<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"quimics-cancerigens[]\" value=\"Cloroformo\" \/><span class=\"wpcf7-list-item-label\">Cloroformo<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"quimics-cancerigens[]\" value=\"Formaldeh\u00eddo\" \/><span class=\"wpcf7-list-item-label\">Formaldeh\u00eddo<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"quimics-cancerigens[]\" value=\"Fenol\" \/><span class=\"wpcf7-list-item-label\">Fenol<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"checkbox\" name=\"quimics-cancerigens[]\" value=\"Metanol\" \/><span class=\"wpcf7-list-item-label\">Metanol<\/span><\/span><\/span><\/span><\/span>\n\t\t\t<\/p>\n\t\t\t<p><label for=\"quimics-cancerigens-altres\">Otros<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"quimics-cancerigens-altres\"><textarea cols=\"40\" rows=\"3\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" id=\"quimics-cancerigens-altres\" aria-invalid=\"false\" name=\"quimics-cancerigens-altres\"><\/textarea><\/span>\n\t\t\t<\/p>\n\t\t\t<p><b>Productos qu\u00edmicos con toxicidad aguda 3 y\/o con toxicidad espec\u00edfica en determinados \u00f3rganos (STOT 2) (H301 - H310 - H311 - H330 - H331)<\/b>\n\t\t\t<\/p>\n\t\t\t<p><label for=\"quimics-toxicitat\">Tipo de producto<\/label><span class=\"formulari-dreta\"><span class=\"wpcf7-form-control-wrap\" data-name=\"quimics-toxicitat\"><span class=\"wpcf7-form-control wpcf7-checkbox\" id=\"quimics-toxicitat\"><span class=\"wpcf7-list-item first\"><input type=\"checkbox\" name=\"quimics-toxicitat[]\" value=\"Tetr\u00f3xido de osmio\" \/><span class=\"wpcf7-list-item-label\">Tetr\u00f3xido de osmio<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"quimics-toxicitat[]\" value=\"Fluoruro s\u00f3dico\" \/><span class=\"wpcf7-list-item-label\">Fluoruro s\u00f3dico<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"checkbox\" name=\"quimics-toxicitat[]\" value=\"Cloruro de bario\" \/><span class=\"wpcf7-list-item-label\">Cloruro de bario<\/span><\/span><\/span><\/span><\/span>\n\t\t\t<\/p>\n\t\t\t<p><label for=\"quimics-toxicitat-altres\">Otros<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"quimics-toxicitat-altres\"><textarea cols=\"40\" rows=\"3\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" id=\"quimics-toxicitat-altres\" aria-invalid=\"false\" name=\"quimics-toxicitat-altres\"><\/textarea><\/span>\n\t\t\t<\/p>\n\t\t\t<p><b>Productos qu\u00edmicos sensibilizantes (H317 - H334) | Productos qu\u00edmicos irritantes (H315 - H316 - H319 - H320 - H335) | Productos qu\u00edmicos con toxicidad aguda 4 y\/o toxicidad espec\u00edfica en determinados \u00f3rganos (STOT 3) (H302 - H303 - H305 - H312 - H313 - H332 - H333 - H336)<\/b>\n\t\t\t<\/p>\n\t\t\t<p><label for=\"quimics-sensibilitzants\">Tipo de producto<\/label><span class=\"formulari-dreta\"><span class=\"wpcf7-form-control-wrap\" data-name=\"quimics-sensibilitzants\"><span class=\"wpcf7-form-control wpcf7-checkbox\" id=\"quimics-sensibilitzants\"><span class=\"wpcf7-list-item first\"><input type=\"checkbox\" name=\"quimics-sensibilitzants[]\" value=\"Acetonitrilo\" \/><span class=\"wpcf7-list-item-label\">Acetonitrilo<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"quimics-sensibilitzants[]\" value=\"Isopropanol\" \/><span class=\"wpcf7-list-item-label\">Isopropanol<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"quimics-sensibilitzants[]\" value=\"\u00c1cido trifluoroac\u00e9tico\" \/><span class=\"wpcf7-list-item-label\">\u00c1cido trifluoroac\u00e9tico<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"quimics-sensibilitzants[]\" value=\"\u00c1cido ox\u00e1lico\" \/><span class=\"wpcf7-list-item-label\">\u00c1cido ox\u00e1lico<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"quimics-sensibilitzants[]\" value=\"Trietilamina\" \/><span class=\"wpcf7-list-item-label\">Trietilamina<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"checkbox\" name=\"quimics-sensibilitzants[]\" value=\"Xileno\" \/><span class=\"wpcf7-list-item-label\">Xileno<\/span><\/span><\/span><\/span><\/span>\n\t\t\t<\/p>\n\t\t\t<p><label for=\"quimics-sensibilitzants-altres\">Otros<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"quimics-sensibilitzants-altres\"><textarea cols=\"40\" rows=\"3\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" id=\"quimics-sensibilitzants-altres\" aria-invalid=\"false\" name=\"quimics-sensibilitzants-altres\"><\/textarea><\/span>\n\t\t\t<\/p>\n\t\t\t<p><b>Productos qu\u00edmicos corrosivos (H314 - H318)<\/b>\n\t\t\t<\/p>\n\t\t\t<p><label for=\"quimics-corrosius\">Tipo de producto<\/label><span class=\"formulari-dreta\"><span class=\"wpcf7-form-control-wrap\" data-name=\"quimics-corrosius\"><span class=\"wpcf7-form-control wpcf7-checkbox\" id=\"quimics-corrosius\"><span class=\"wpcf7-list-item first\"><input type=\"checkbox\" name=\"quimics-corrosius[]\" value=\"\u00c1cido n\u00edtrico\" \/><span class=\"wpcf7-list-item-label\">\u00c1cido n\u00edtrico<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"quimics-corrosius[]\" value=\"\u00c1cido sulf\u00farico\" \/><span class=\"wpcf7-list-item-label\">\u00c1cido sulf\u00farico<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"quimics-corrosius[]\" value=\"\u00c1cido ac\u00e9tico\" \/><span class=\"wpcf7-list-item-label\">\u00c1cido ac\u00e9tico<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"quimics-corrosius[]\" value=\"\u00c1cido f\u00f3rmico\" \/><span class=\"wpcf7-list-item-label\">\u00c1cido f\u00f3rmico<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"quimics-corrosius[]\" value=\"\u00c1cido fosf\u00f3rico\" \/><span class=\"wpcf7-list-item-label\">\u00c1cido fosf\u00f3rico<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"checkbox\" name=\"quimics-corrosius[]\" value=\"Hidr\u00f3xico s\u00f3dico\" \/><span class=\"wpcf7-list-item-label\">Hidr\u00f3xico s\u00f3dico<\/span><\/span><\/span><\/span><\/span>\n\t\t\t<\/p>\n\t\t\t<p><label for=\"quimics-corrosius-altres\">Otros<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"quimics-corrosius-altres\"><textarea cols=\"40\" rows=\"3\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" id=\"quimics-corrosius-altres\" aria-invalid=\"false\" name=\"quimics-corrosius-altres\"><\/textarea><\/span>\n\t\t\t<\/p>\n\t\t\t<p><b>Gases licuados, gases t\u00e9cnicos en bombona y\/o gases t\u00e9cnicos en instalaci\u00f3n<\/b>\n\t\t\t<\/p>\n\t\t\t<p><label for=\"quimics-gasos\">Tipo de producto<\/label><span class=\"formulari-dreta\"><span class=\"wpcf7-form-control-wrap\" data-name=\"quimics-gasos\"><span class=\"wpcf7-form-control wpcf7-checkbox\" id=\"quimics-gasos\"><span class=\"wpcf7-list-item first\"><input type=\"checkbox\" name=\"quimics-gasos[]\" value=\"Nitr\u00f3geno l\u00edquido\" \/><span class=\"wpcf7-list-item-label\">Nitr\u00f3geno l\u00edquido<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"quimics-gasos[]\" value=\"Helio l\u00edquido\" \/><span class=\"wpcf7-list-item-label\">Helio l\u00edquido<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"quimics-gasos[]\" value=\"Hidr\u00f3geno\" \/><span class=\"wpcf7-list-item-label\">Hidr\u00f3geno<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"quimics-gasos[]\" value=\"Di\u00f3xido de carbono\" \/><span class=\"wpcf7-list-item-label\">Di\u00f3xido de carbono<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"quimics-gasos[]\" value=\"Ox\u00edgeno\" \/><span class=\"wpcf7-list-item-label\">Ox\u00edgeno<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"quimics-gasos[]\" value=\"Aire comprimido\" \/><span class=\"wpcf7-list-item-label\">Aire comprimido<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"quimics-gasos[]\" value=\"Nitr\u00f3geno\" \/><span class=\"wpcf7-list-item-label\">Nitr\u00f3geno<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"checkbox\" name=\"quimics-gasos[]\" value=\"Arg\u00f3n\" \/><span class=\"wpcf7-list-item-label\">Arg\u00f3n<\/span><\/span><\/span><\/span><\/span>\n\t\t\t<\/p>\n\t\t\t<p><label for=\"quimics-gasos-altres\">Otros<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"quimics-gasos-altres\"><textarea cols=\"40\" rows=\"3\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" id=\"quimics-gasos-altres\" aria-invalid=\"false\" name=\"quimics-gasos-altres\"><\/textarea><\/span>\n\t\t\t<\/p>\n\t\t<\/fieldset>\n\t\t<fieldset  id=\"residus\">\n\t\t\t<legend>Gesti\u00f3n de residuos\n\t\t\t<\/legend>\n\t\t\t<p><label for=\"residus-tipologia\">Tipolog\u00eda de residuos<\/label><span class=\"formulari-dreta\"><span class=\"wpcf7-form-control-wrap\" data-name=\"residus-tipologia\"><span class=\"wpcf7-form-control wpcf7-checkbox\" id=\"residus-tipologia\"><span class=\"wpcf7-list-item first\"><input type=\"checkbox\" name=\"residus-tipologia[]\" value=\"Qu\u00edmicos\" \/><span class=\"wpcf7-list-item-label\">Qu\u00edmicos<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"residus-tipologia[]\" value=\"Biopeligrosos (sanitarios grupo III)\" \/><span class=\"wpcf7-list-item-label\">Biopeligrosos (sanitarios grupo III)<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"residus-tipologia[]\" value=\"Citot\u00f3xicos (sanitarios grupo IV)\" \/><span class=\"wpcf7-list-item-label\">Citot\u00f3xicos (sanitarios grupo IV)<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"checkbox\" name=\"residus-tipologia[]\" value=\"Animales de experimentaci\u00f3n\" \/><span class=\"wpcf7-list-item-label\">Animales de experimentaci\u00f3n<\/span><\/span><\/span><\/span><\/span>\n\t\t\t<\/p>\n\t\t\t<p><label for=\"residus-activitat\">Actividad<\/label><span class=\"formulari-dreta\"><span class=\"wpcf7-form-control-wrap\" data-name=\"residus-activitat\"><span class=\"wpcf7-form-control wpcf7-checkbox\" id=\"residus-activitat\"><span class=\"wpcf7-list-item first\"><input type=\"checkbox\" name=\"residus-activitat[]\" value=\"Generaci\u00f3n\" \/><span class=\"wpcf7-list-item-label\">Generaci\u00f3n<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"checkbox\" name=\"residus-activitat[]\" value=\"Transporte al almac\u00e9n del centro\" \/><span class=\"wpcf7-list-item-label\">Transporte al almac\u00e9n del centro<\/span><\/span><\/span><\/span><\/span>\n\t\t\t<\/p>\n\t\t<\/fieldset>\n\t<\/div>\n\t<h3>Agentes biol\u00f3gicos\n\t<\/h3>\n\t<p><label for=\"obrir-biologics\">Debo manipular agentes biol\u00f3gicos en mi trabajo<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"obrir-biologics\"><span class=\"wpcf7-form-control wpcf7-radio\" id=\"obrir-biologics\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"obrir-biologics\" value=\"S\u00ed\" \/><span class=\"wpcf7-list-item-label\">S\u00ed<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"obrir-biologics\" value=\"No\" checked=\"checked\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n\t<\/p>\n\t<div data-id=\"biologics\" data-orig_data_id=\"biologics\" data-clear_on_hide class=\"\" data-class=\"wpcf7cf_group\">\n\t\t<fieldset  id=\"biologics\">\n\t\t\t<legend>Manipulaci\u00f3n de agentes biol\u00f3gicos\n\t\t\t<\/legend>\n\t\t\t<p><small>Clasificaci\u00f3n de los grupos de riesgo biol\u00f3gico de acuerdo con el Anexo II del RD 664\/1997, de 12 de mayo, sobre la protecci\u00f3n de los trabajadores contra los riesgos relacionados con la exposici\u00f3n a agentes biol\u00f3gicos durante el trabajo.<\/small>\n\t\t\t<\/p>\n\t\t\t<p><b>Microorganismos<\/b>\n\t\t\t<\/p>\n\t\t\t<p><label for=\"microorganismes-1\">Grupo de riesgo 1<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"microorganismes-1\"><textarea cols=\"40\" rows=\"3\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" id=\"microorganismes-1\" aria-invalid=\"false\" name=\"microorganismes-1\"><\/textarea><\/span>\n\t\t\t<\/p>\n\t\t\t<p><label for=\"microorganismes-2\">Grupo de riesgo 2<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"microorganismes-2\"><textarea cols=\"40\" rows=\"3\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" id=\"microorganismes-2\" aria-invalid=\"false\" name=\"microorganismes-2\"><\/textarea><\/span>\n\t\t\t<\/p>\n\t\t\t<p><label for=\"microorganismes-3\">Grupo de riesgo 3<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"microorganismes-3\"><textarea cols=\"40\" rows=\"3\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" id=\"microorganismes-3\" aria-invalid=\"false\" name=\"microorganismes-3\"><\/textarea><\/span>\n\t\t\t<\/p>\n\t\t\t<p><b>Muestras de procedencia humana \/ animal \/ vegetal<br \/>\n<small>(Especifica si son garantizadas o con posibilidad de alg\u00fan tipo de infecci\u00f3n)<\/small><\/b>\n\t\t\t<\/p>\n\t\t\t<p><label for=\"mostres-teixit\">Muestras de tejido<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"mostres-teixit\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" id=\"mostres-teixit\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"mostres-teixit\" \/><\/span>\n\t\t\t<\/p>\n\t\t\t<p><label for=\"mostres-cultius\">Cultivos primarios<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"mostres-cultius\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" id=\"mostres-cultius\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"mostres-cultius\" \/><\/span>\n\t\t\t<\/p>\n\t\t\t<p><label for=\"mostres-hemoderivats\">Hemoderivados<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"mostres-hemoderivats\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" id=\"mostres-hemoderivats\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"mostres-hemoderivats\" \/><\/span>\n\t\t\t<\/p>\n\t\t\t<p><label for=\"mostres-fluids\">Fluidos corporales<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"mostres-fluids\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" id=\"mostres-fluids\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"mostres-fluids\" \/><\/span>\n\t\t\t<\/p>\n\t\t\t<p><label for=\"mostres-altres\">Otros<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"mostres-altres\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" id=\"mostres-altres\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"mostres-altres\" \/><\/span>\n\t\t\t<\/p>\n\t\t\t<p><b>Manipulaci\u00f3n de animales de laboratorio<\/b>\n\t\t\t<\/p>\n\t\t\t<p><label for=\"animal-especie\">Especie animal<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"animal-especie\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" id=\"animal-especie\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"animal-especie\" \/><\/span>\n\t\t\t<\/p>\n\t\t\t<p><label for=\"animal-activitat\">Actividad<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"animal-activitat\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" id=\"animal-activitat\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"animal-activitat\" \/><\/span>\n\t\t\t<\/p>\n\t\t\t<p><label for=\"animal-inoculat\">Inoculado<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"animal-inoculat\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-exclusive-checkbox\" id=\"animal-inoculat\"><span class=\"wpcf7-list-item first\"><input type=\"checkbox\" name=\"animal-inoculat\" value=\"S\u00ed\" \/><span class=\"wpcf7-list-item-label\">S\u00ed<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"checkbox\" name=\"animal-inoculat\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n\t\t\t<\/p>\n\t\t\t<p><label for=\"animal-agent\">Agente inoculado<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"animal-agent\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" id=\"animal-agent\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"animal-agent\" \/><\/span>\n\t\t\t<\/p>\n\t\t<hr \/>\n\t\t\t<p><label for=\"animal-especie1\">Especie animal<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"animal-especie1\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" id=\"animal-especie1\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"animal-especie1\" \/><\/span>\n\t\t\t<\/p>\n\t\t\t<p><label for=\"animal-activitat1\">Actividad<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"animal-activitat1\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" id=\"animal-activitat1\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"animal-activitat1\" \/><\/span>\n\t\t\t<\/p>\n\t\t\t<p><label for=\"animal-inoculat1\">Inoculado<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"animal-inoculat1\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-exclusive-checkbox\" id=\"animal-inoculat1\"><span class=\"wpcf7-list-item first\"><input type=\"checkbox\" name=\"animal-inoculat1\" value=\"S\u00ed\" \/><span class=\"wpcf7-list-item-label\">S\u00ed<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"checkbox\" name=\"animal-inoculat1\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n\t\t\t<\/p>\n\t\t\t<p><label for=\"animal-agent1\">Agente inoculado<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"animal-agent1\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" id=\"animal-agent1\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"animal-agent1\" \/><\/span>\n\t\t\t<\/p>\n\t\t\t<p><b>Organismos modificados gen\u00e9ticamente<\/b>\n\t\t\t<\/p>\n\t\t\t<p><label for=\"omg-1\">Grupo de riesgo 1<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"omg-1\"><textarea cols=\"40\" rows=\"3\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" id=\"omg-1\" aria-invalid=\"false\" name=\"omg-1\"><\/textarea><\/span>\n\t\t\t<\/p>\n\t\t\t<p><label for=\"omg-2\">Grupo de riesgo 2<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"omg-2\"><textarea cols=\"40\" rows=\"3\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" id=\"omg-2\" aria-invalid=\"false\" name=\"omg-2\"><\/textarea><\/span>\n\t\t\t<\/p>\n\t\t\t<p><label for=\"omg-3\">Grupo de riesgo 3<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"omgs-3\"><textarea cols=\"40\" rows=\"3\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" id=\"omg-3\" aria-invalid=\"false\" name=\"omgs-3\"><\/textarea><\/span>\n\t\t\t<\/p>\n\t\t\t<p><label for=\"replicatiu\">\u00bfEl inserto es replicativo?<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"replicatiu\"><span class=\"wpcf7-form-control wpcf7-radio\" id=\"replicatiu\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"replicatiu\" value=\"S\u00ed\" checked=\"checked\" \/><span class=\"wpcf7-list-item-label\">S\u00ed<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"replicatiu\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n\t\t\t<\/p>\n\t\t\t<p><label for=\"oncogen\">\u00bfEl inserto codifica para un onc\u00f3geno?<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"oncogen\"><span class=\"wpcf7-form-control wpcf7-radio\" id=\"oncogen\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"oncogen\" value=\"S\u00ed\" checked=\"checked\" \/><span class=\"wpcf7-list-item-label\">S\u00ed<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"oncogen\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n\t\t\t<\/p>\n\t\t\t<p><label for=\"punxada\">Da\u00f1o potencial a la salud en caso de pinchazo o inoculaci\u00f3n accidental<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"punxada\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" id=\"punxada\" aria-invalid=\"false\" name=\"punxada\"><\/textarea><\/span>\n\t\t\t<\/p>\n\t\t<\/fieldset>\n\t\t<fieldset  id=\"residus\">\n\t\t\t<legend>Gesti\u00f3n de residuos\n\t\t\t<\/legend>\n\t\t\t<p><label for=\"residus-tipologia1\">Tipolog\u00eda de residuos<\/label><span class=\"formulari-dreta\"><span class=\"wpcf7-form-control-wrap\" data-name=\"residus-tipologia1\"><span class=\"wpcf7-form-control wpcf7-checkbox\" id=\"residus-tipologia1\"><span class=\"wpcf7-list-item first\"><input type=\"checkbox\" name=\"residus-tipologia1[]\" value=\"Qu\u00edmicos\" \/><span class=\"wpcf7-list-item-label\">Qu\u00edmicos<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"residus-tipologia1[]\" value=\"Biopeligrosos (sanitarios grupo III)\" \/><span class=\"wpcf7-list-item-label\">Biopeligrosos (sanitarios grupo III)<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"residus-tipologia1[]\" value=\"Citot\u00f3xicos (sanitarios grupo IV)\" \/><span class=\"wpcf7-list-item-label\">Citot\u00f3xicos (sanitarios grupo IV)<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"checkbox\" name=\"residus-tipologia1[]\" value=\"Animales de experimentaci\u00f3n\" \/><span class=\"wpcf7-list-item-label\">Animales de experimentaci\u00f3n<\/span><\/span><\/span><\/span><\/span>\n\t\t\t<\/p>\n\t\t\t<p><label for=\"residus-activitat1\">Actividad<\/label><span class=\"formulari-dreta\"><span class=\"wpcf7-form-control-wrap\" data-name=\"residus-activitat1\"><span class=\"wpcf7-form-control wpcf7-checkbox\" id=\"residus-activitat1\"><span class=\"wpcf7-list-item first\"><input type=\"checkbox\" name=\"residus-activitat1[]\" value=\"Generaci\u00f3n\" \/><span class=\"wpcf7-list-item-label\">Generaci\u00f3n<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"checkbox\" name=\"residus-activitat1[]\" value=\"Transporte al almac\u00e9n del centro\" \/><span class=\"wpcf7-list-item-label\">Transporte al almac\u00e9n del centro<\/span><\/span><\/span><\/span><\/span>\n\t\t\t<\/p>\n\t\t<\/fieldset>\n\t<\/div>\n\t<h3>Manipulaci\u00f3n de Nanomateriales\n\t<\/h3>\n\t<p><label for=\"obrir-nanomaterials\">Tengo que manipular nanomateriales en mi trabajo<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"obrir-nanomaterials\"><span class=\"wpcf7-form-control wpcf7-radio\" id=\"obrir-nanomaterials\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"obrir-nanomaterials\" value=\"S\u00ed\" \/><span class=\"wpcf7-list-item-label\">S\u00ed<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"obrir-nanomaterials\" value=\"No\" checked=\"checked\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n\t<\/p>\n\t<div data-id=\"nanomaterials\" data-orig_data_id=\"nanomaterials\" data-clear_on_hide class=\"\" data-class=\"wpcf7cf_group\">\n\t\t<fieldset>\n\t\t\t<legend>Forma f\u00edsica\n\t\t\t<\/legend>\n\t\t\t<p><label for=\"nano-accidental\">Nanomateriales accidentales o incidentales<\/label><span class=\"formulari-dreta\"><span class=\"wpcf7-form-control-wrap\" data-name=\"nano-accidental\"><span class=\"wpcf7-form-control wpcf7-checkbox\" id=\"nano-accidental\"><span class=\"wpcf7-list-item first\"><input type=\"checkbox\" name=\"nano-accidental[]\" value=\"Humos de soldadura\" \/><span class=\"wpcf7-list-item-label\">Humos de soldadura<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"checkbox\" name=\"nano-accidental[]\" value=\"Productos de combusti\u00f3n\" \/><span class=\"wpcf7-list-item-label\">Productos de combusti\u00f3n<\/span><\/span><\/span><\/span><\/span>\n\t\t\t<\/p>\n\t\t\t<p><label for=\"nano-accidental-altres\">Otros<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"nano-accidental-altres\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" id=\"nano-accidental-altres\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"nano-accidental-altres\" \/><\/span>\n\t\t\t<\/p>\n\t\t\t<p><label for=\"nano-objectes\">Nanomaterials manufacturats: Nano-objectes<\/label><span class=\"formulari-dreta\"><span class=\"wpcf7-form-control-wrap\" data-name=\"nano-objectes\"><span class=\"wpcf7-form-control wpcf7-checkbox\" id=\"nano-objectes\"><span class=\"wpcf7-list-item first\"><input type=\"checkbox\" name=\"nano-objectes[]\" value=\"Nanoplaca\" \/><span class=\"wpcf7-list-item-label\">Nanoplaca<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"nano-objectes[]\" value=\"Nanofil (nanofibra el\u00e8ctricament conductora)\" \/><span class=\"wpcf7-list-item-label\">Nanofil (nanofibra el\u00e8ctricament conductora)<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"nano-objectes[]\" value=\"Nanotub (nanofibra buida)\" \/><span class=\"wpcf7-list-item-label\">Nanotub (nanofibra buida)<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"nano-objectes[]\" value=\"Nanovareta (nanofibra s\u00f2lida)\" \/><span class=\"wpcf7-list-item-label\">Nanovareta (nanofibra s\u00f2lida)<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"checkbox\" name=\"nano-objectes[]\" value=\"Nanopart\u00edcula\" \/><span class=\"wpcf7-list-item-label\">Nanopart\u00edcula<\/span><\/span><\/span><\/span><\/span>\n\t\t\t<\/p>\n\t\t\t<p><label for=\"nano-objectes-altres\">Altres<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"nano-objectes-altres\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" id=\"nano-objectes-altres\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"nano-objectes-altres\" \/><\/span>\n\t\t\t<\/p>\n\t\t\t<p><label for=\"nanoestructurats\">Nanomateriales manufacturados: Materiales nanoestructurados<\/label><span class=\"formulari-dreta\"><span class=\"wpcf7-form-control-wrap\" data-name=\"nanoestructurats\"><span class=\"wpcf7-form-control wpcf7-checkbox\" id=\"nanoestructurats\"><span class=\"wpcf7-list-item first\"><input type=\"checkbox\" name=\"nanoestructurats[]\" value=\"Polvo nanoestructurado\" \/><span class=\"wpcf7-list-item-label\">Polvo nanoestructurado<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"nanoestructurats[]\" value=\"Nanocompost\" \/><span class=\"wpcf7-list-item-label\">Nanocompost<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"nanoestructurats[]\" value=\"Nanoespuma s\u00f3lida\" \/><span class=\"wpcf7-list-item-label\">Nanoespuma s\u00f3lida<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"nanoestructurats[]\" value=\"Material nanoporoso\" \/><span class=\"wpcf7-list-item-label\">Material nanoporoso<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"checkbox\" name=\"nanoestructurats[]\" value=\"Nanodispersi\u00f3n fluida\" \/><span class=\"wpcf7-list-item-label\">Nanodispersi\u00f3n fluida<\/span><\/span><\/span><\/span><\/span>\n\t\t\t<\/p>\n\t\t<\/fieldset>\n\t\t<fieldset>\n\t\t\t<legend>Forma y composici\u00f3n qu\u00edmica\n\t\t\t<\/legend>\n\t\t\t<p><label for=\"nano-inorganic\">Nanomateriales inorg\u00e1nicos no met\u00e1licos<\/label><span class=\"formulari-dreta\"><span class=\"wpcf7-form-control-wrap\" data-name=\"nano-inorganic\"><span class=\"wpcf7-form-control wpcf7-checkbox\" id=\"nano-inorganic\"><span class=\"wpcf7-list-item first\"><input type=\"checkbox\" name=\"nano-inorganic[]\" value=\"S\u00edlice amorfa sint\u00e9tica\" \/><span class=\"wpcf7-list-item-label\">S\u00edlice amorfa sint\u00e9tica<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"nano-inorganic[]\" value=\"\u00d3xido de aluminio\" \/><span class=\"wpcf7-list-item-label\">\u00d3xido de aluminio<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"nano-inorganic[]\" value=\"Di\u00f3xido de titanio\" \/><span class=\"wpcf7-list-item-label\">Di\u00f3xido de titanio<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"nano-inorganic[]\" value=\"\u00d3xido de cerio\" \/><span class=\"wpcf7-list-item-label\">\u00d3xido de cerio<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"nano-inorganic[]\" value=\"\u00d3xido de zinc\" \/><span class=\"wpcf7-list-item-label\">\u00d3xido de zinc<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"nano-inorganic[]\" value=\"\u00d3xido de hierro\" \/><span class=\"wpcf7-list-item-label\">\u00d3xido de hierro<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"checkbox\" name=\"nano-inorganic[]\" value=\"\u00d3xido de zirconio\" \/><span class=\"wpcf7-list-item-label\">\u00d3xido de zirconio<\/span><\/span><\/span><\/span><\/span>\n\t\t\t<\/p>\n\t\t\t<p><label for=\"nano-inorganic-altres\">Otros<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"nano-inorganic-altres\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" id=\"nano-inorganic-altres\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"nano-inorganic-altres\" \/><\/span>\n\t\t\t<\/p>\n\t\t\t<p><label for=\"nano-metalls\">Metales y aleaciones<\/label><span class=\"formulari-dreta\"><span class=\"wpcf7-form-control-wrap\" data-name=\"nano-metalls\"><span class=\"wpcf7-form-control wpcf7-checkbox\" id=\"nano-metalls\"><span class=\"wpcf7-list-item first\"><input type=\"checkbox\" name=\"nano-metalls[]\" value=\"Oro\" \/><span class=\"wpcf7-list-item-label\">Oro<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"nano-metalls[]\" value=\"Plata\" \/><span class=\"wpcf7-list-item-label\">Plata<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"nano-metalls[]\" value=\"Aleaci\u00f3n de platino\" \/><span class=\"wpcf7-list-item-label\">Aleaci\u00f3n de platino<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"checkbox\" name=\"nano-metalls[]\" value=\"Aleaci\u00f3n de paladio\" \/><span class=\"wpcf7-list-item-label\">Aleaci\u00f3n de paladio<\/span><\/span><\/span><\/span><\/span>\n\t\t\t<\/p>\n\t\t\t<p><label for=\"nano-metalls-altres\">Otros<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"nano-metalls-altres\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" id=\"nano-metalls-altres\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"nano-metalls-altres\" \/><\/span>\n\t\t\t<\/p>\n\t\t\t<p><label for=\"nano-carboni\">Nanomateriales con base de carbono<\/label><span class=\"formulari-dreta\"><span class=\"wpcf7-form-control-wrap\" data-name=\"nano-carboni\"><span class=\"wpcf7-form-control wpcf7-checkbox\" id=\"nano-carboni\"><span class=\"wpcf7-list-item first\"><input type=\"checkbox\" name=\"nano-carboni[]\" value=\"Fullereno\" \/><span class=\"wpcf7-list-item-label\">Fullereno<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"nano-carboni[]\" value=\"Grafeno\" \/><span class=\"wpcf7-list-item-label\">Grafeno<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"nano-carboni[]\" value=\"Nanotubos de pared simple\" \/><span class=\"wpcf7-list-item-label\">Nanotubos de pared simple<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"nano-carboni[]\" value=\"Nanotubos de pared m\u00faltiple\" \/><span class=\"wpcf7-list-item-label\">Nanotubos de pared m\u00faltiple<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"nano-carboni[]\" value=\"Nanofibras de carbono\" \/><span class=\"wpcf7-list-item-label\">Nanofibras de carbono<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"checkbox\" name=\"nano-carboni[]\" value=\"Negro de humo (carbono puro elemental en forma de part\u00edculas)\" \/><span class=\"wpcf7-list-item-label\">Negro de humo (carbono puro elemental en forma de part\u00edculas)<\/span><\/span><\/span><\/span><\/span>\n\t\t\t<\/p>\n\t\t\t<p><label for=\"nano-carboni-altres\">Otros<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"nano-carboni-altres\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" id=\"nano-carboni-altres\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"nano-carboni-altres\" \/><\/span>\n\t\t\t<\/p>\n\t\t<\/fieldset>\n\t\t<fieldset>\n\t\t\t<legend>Otros\n\t\t\t<\/legend>\n\t\t\t<p><label for=\"nanopolimers\">Nanopol\u00edmeros<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"nanopolimers\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" id=\"nanopolimers\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"nanopolimers\" \/><\/span><br \/>\n<label for=\"dendrimers\">Dendr\u00edmeros<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"dendrimers\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" id=\"dendrimers\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"dendrimers\" \/><\/span><br \/>\n<label for=\"quantics\">Puntos cu\u00e1nticos<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"quantics\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" id=\"quantics\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"quantics\" \/><\/span><br \/>\n<label for=\"nanoargiles\">Nanoarcillas<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"nanoargiles\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" id=\"nanoargiles\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"nanoargiles\" \/><\/span><br \/>\n<label for=\"nano-mes-altres\">Otros<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"nano-mes-altres\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" id=\"nano-mes-altres\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"nano-mes-altres\" \/><\/span>\n\t\t\t<\/p>\n\t\t<\/fieldset>\n\t\t<fieldset>\n\t\t\t<legend>Proceso de trabajo con nanomateriales\n\t\t\t<\/legend>\n\t\t\t<p><label for=\"nano-descripcio\">Descripci\u00f3n<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"nano-descripcio\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" id=\"nano-descripcio\" aria-invalid=\"false\" name=\"nano-descripcio\"><\/textarea><\/span><br \/>\n<label for=\"nano-manufacturacio\">Fabricaci\u00f3n del nanomaterial<\/label><span class=\"formulari-dreta\"><span class=\"wpcf7-form-control-wrap\" data-name=\"nano-manufacturacio\"><span class=\"wpcf7-form-control wpcf7-checkbox\" id=\"nano-manufacturacio\"><span class=\"wpcf7-list-item first\"><input type=\"checkbox\" name=\"nano-manufacturacio[]\" value=\"Por fresado\" \/><span class=\"wpcf7-list-item-label\">Por fresado<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"nano-manufacturacio[]\" value=\"Por s\u00edntesis en fase gaseosas\" \/><span class=\"wpcf7-list-item-label\">Por s\u00edntesis en fase gaseosas<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"checkbox\" name=\"nano-manufacturacio[]\" value=\"Por s\u00edntesis en fase l\u00edquida o coloidal\" \/><span class=\"wpcf7-list-item-label\">Por s\u00edntesis en fase l\u00edquida o coloidal<\/span><\/span><\/span><\/span><\/span>\n\t\t\t<\/p>\n\t\t\t<p><label for=\"nano-incorporacio\">Incorporaci\u00f3n del nanomaterial en un producto intermedio o final (especificar)<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"nano-incorporacio\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" id=\"nano-incorporacio\" aria-invalid=\"false\" name=\"nano-incorporacio\"><\/textarea><\/span>\n\t\t\t<\/p>\n\t\t\t<p><label for=\"nano-procesar\">Manera de manipular el nanomaterial<\/label><span class=\"formulari-dreta\"><span class=\"wpcf7-form-control-wrap\" data-name=\"nano-procesar\"><span class=\"wpcf7-form-control wpcf7-checkbox\" id=\"nano-procesar\"><span class=\"wpcf7-list-item first\"><input type=\"checkbox\" name=\"nano-procesar[]\" value=\"Part\u00edculas primarias\" \/><span class=\"wpcf7-list-item-label\">Part\u00edculas primarias<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"nano-procesar[]\" value=\"Aglomerados\" \/><span class=\"wpcf7-list-item-label\">Aglomerados<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"nano-procesar[]\" value=\"Agregados\" \/><span class=\"wpcf7-list-item-label\">Agregados<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"nano-procesar[]\" value=\"Polvo\" \/><span class=\"wpcf7-list-item-label\">Polvo<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"nano-procesar[]\" value=\"Soluci\u00f3n\" \/><span class=\"wpcf7-list-item-label\">Soluci\u00f3n<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"nano-procesar[]\" value=\"Matriz\" \/><span class=\"wpcf7-list-item-label\">Matriz<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"nano-procesar[]\" value=\"Suspensi\u00f3n\" \/><span class=\"wpcf7-list-item-label\">Suspensi\u00f3n<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"checkbox\" name=\"nano-procesar[]\" value=\"Otros\" \/><span class=\"wpcf7-list-item-label\">Otros<\/span><\/span><\/span><\/span><\/span>\n\t\t\t<\/p>\n\t\t\t<p><label for=\"nano-dades\">Otros datos de inter\u00e9s<\/label><span class=\"formulari-dreta\"><span class=\"wpcf7-form-control-wrap\" data-name=\"nano-dades\"><span class=\"wpcf7-form-control wpcf7-checkbox\" id=\"nano-dades\"><span class=\"wpcf7-list-item first\"><input type=\"checkbox\" name=\"nano-dades[]\" value=\"Biopersistente\" \/><span class=\"wpcf7-list-item-label\">Biopersistente<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"nano-dades[]\" value=\"Soluble en agua o medio biol\u00f3gico\" \/><span class=\"wpcf7-list-item-label\">Soluble en agua o medio biol\u00f3gico<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"nano-dades[]\" value=\"Inflamable\" \/><span class=\"wpcf7-list-item-label\">Inflamable<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"checkbox\" name=\"nano-dades[]\" value=\"Otros\" \/><span class=\"wpcf7-list-item-label\">Otros<\/span><\/span><\/span><\/span><\/span>\n\t\t\t<\/p>\n\t\t\t<p><label for=\"nano-treball\">Trabajo en<\/label><span class=\"formulari-dreta\"><span class=\"wpcf7-form-control-wrap\" data-name=\"nano-treball\"><span class=\"wpcf7-form-control wpcf7-checkbox\" id=\"nano-treball\"><span class=\"wpcf7-list-item first\"><input type=\"checkbox\" name=\"nano-treball[]\" value=\"Cabina de bioseguridad\" \/><span class=\"wpcf7-list-item-label\">Cabina de bioseguridad<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"nano-treball[]\" value=\"Caja seca\" \/><span class=\"wpcf7-list-item-label\">Caja seca<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"checkbox\" name=\"nano-treball[]\" value=\"Sala blanca\" \/><span class=\"wpcf7-list-item-label\">Sala blanca<\/span><\/span><\/span><\/span><\/span>\n\t\t\t<\/p>\n\t\t\t<p><label for=\"nano-treball-altres\">Otros<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"nano-treball-altres\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" id=\"nano-treball-altres\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"nano-treball-altres\" \/><\/span>\n\t\t\t<\/p>\n\t\t\t<p><label for=\"nano-epi\">Equipo de protecci\u00f3n individual<\/label><span class=\"formulari-dreta\"><span class=\"wpcf7-form-control-wrap\" data-name=\"nano-epi\"><span class=\"wpcf7-form-control wpcf7-checkbox\" id=\"nano-epi\"><span class=\"wpcf7-list-item first\"><input type=\"checkbox\" name=\"nano-epi[]\" value=\"Guants (especifiqueu)\" \/><span class=\"wpcf7-list-item-label\">Guants (especifiqueu)<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"nano-epi[]\" value=\"M\u00e1scara para polvo y part\u00edculas FFP3\" \/><span class=\"wpcf7-list-item-label\">M\u00e1scara para polvo y part\u00edculas FFP3<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"nano-epi[]\" value=\"Gafas de seguridad (abiertas\/ cerradas)\" \/><span class=\"wpcf7-list-item-label\">Gafas de seguridad (abiertas\/ cerradas)<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"nano-epi[]\" value=\"Ropa de trabajo de poli\u00e9ster\" \/><span class=\"wpcf7-list-item-label\">Ropa de trabajo de poli\u00e9ster<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"nano-epi[]\" value=\"Mono de trabajo tipo TYVEC\" \/><span class=\"wpcf7-list-item-label\">Mono de trabajo tipo TYVEC<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"nano-epi[]\" value=\"Protecci\u00f3n cabelln\" \/><span class=\"wpcf7-list-item-label\">Protecci\u00f3n cabelln<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"checkbox\" name=\"nano-epi[]\" value=\"Protecci\u00f3n pies\" \/><span class=\"wpcf7-list-item-label\">Protecci\u00f3n pies<\/span><\/span><\/span><\/span><\/span>\n\t\t\t<\/p>\n\t\t<\/fieldset>\n\t<\/div>\n\t<h3>Exposici\u00f3n a agentes f\u00edsicos\n\t<\/h3>\n\t<p><label for=\"obrir-fisics\">En mi trabajo estoy expuesto a agentes f\u00edsicos<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"obrir-fisics\"><span class=\"wpcf7-form-control wpcf7-radio\" id=\"obrir-fisics\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"obrir-fisics\" value=\"S\u00ed\" \/><span class=\"wpcf7-list-item-label\">S\u00ed<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"obrir-fisics\" value=\"No\" checked=\"checked\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n\t<\/p>\n\t<div data-id=\"fisics\" data-orig_data_id=\"fisics\" data-clear_on_hide class=\"\" data-class=\"wpcf7cf_group\">\n\t\t<fieldset  id=\"fisics\">\n\t\t\t<legend>Exposici\u00f3n a agentes f\u00edsicos\n\t\t\t<\/legend>\n\t\t\t<p><label for=\"radiacions\">Radiaciones no ionizantes<\/label><span class=\"formulari-dreta\"><span class=\"wpcf7-form-control-wrap\" data-name=\"radiacions\"><span class=\"wpcf7-form-control wpcf7-checkbox\" id=\"radiacions\"><span class=\"wpcf7-list-item first\"><input type=\"checkbox\" name=\"radiacions[]\" value=\"Luces germicidas UV\" \/><span class=\"wpcf7-list-item-label\">Luces germicidas UV<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"radiacions[]\" value=\"Pantallas de visualizaci\u00f3n de ADN\" \/><span class=\"wpcf7-list-item-label\">Pantallas de visualizaci\u00f3n de ADN<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"radiacions[]\" value=\"Radiaci\u00f3n IR-A \/ IR-B \/ IR-C\" \/><span class=\"wpcf7-list-item-label\">Radiaci\u00f3n IR-A \/ IR-B \/ IR-C<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"radiacions[]\" value=\"Radiaci\u00f3n l\u00e1ser clase 3A \/ 3B \/ 4\" \/><span class=\"wpcf7-list-item-label\">Radiaci\u00f3n l\u00e1ser clase 3A \/ 3B \/ 4<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"radiacions[]\" value=\"Campos electromagn\u00e9ticos estables (RMN)\" \/><span class=\"wpcf7-list-item-label\">Campos electromagn\u00e9ticos estables (RMN)<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"checkbox\" name=\"radiacions[]\" value=\"Campos electromagn\u00e9ticos variables\" \/><span class=\"wpcf7-list-item-label\">Campos electromagn\u00e9ticos variables<\/span><\/span><\/span><\/span><\/span>\n\t\t\t<\/p>\n\t\t\t<p><label for=\"radiacions-altres\">Otras<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"radiacions-altres\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" id=\"radiacions-altres\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"radiacions-altres\" \/><\/span>\n\t\t\t<\/p>\n\t\t\t<p><label for=\"radiacions-ionitzants\">Radiaciones ionizantes<\/label><span class=\"formulari-dreta\"><span class=\"wpcf7-form-control-wrap\" data-name=\"radiacions-ionitzants\"><span class=\"wpcf7-form-control wpcf7-checkbox\" id=\"radiacions-ionitzants\"><span class=\"wpcf7-list-item first\"><input type=\"checkbox\" name=\"radiacions-ionitzants[]\" value=\"Equipos de radiodiagn\u00f3stico m\u00e9dico dental (rayos X)\" \/><span class=\"wpcf7-list-item-label\">Equipos de radiodiagn\u00f3stico m\u00e9dico dental (rayos X)<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"radiacions-ionitzants[]\" value=\"Equipos de radiodiagn\u00f3stico m\u00e9dico con finalidad no m\u00e9dica (rayos X)\" \/><span class=\"wpcf7-list-item-label\">Equipos de radiodiagn\u00f3stico m\u00e9dico con finalidad no m\u00e9dica (rayos X)<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"radiacions-ionitzants[]\" value=\"Equipos de rayos X para equipos de control de procesos y t\u00e9cnicas anal\u00edticas\" \/><span class=\"wpcf7-list-item-label\">Equipos de rayos X para equipos de control de procesos y t\u00e9cnicas anal\u00edticas<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"radiacions-ionitzants[]\" value=\"Is\u00f3topos radiactivos. Fuente encapsulada\" \/><span class=\"wpcf7-list-item-label\">Is\u00f3topos radiactivos. Fuente encapsulada<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"checkbox\" name=\"radiacions-ionitzants[]\" value=\"Is\u00f3topos radiactivos. Fuente no encapsulada\" \/><span class=\"wpcf7-list-item-label\">Is\u00f3topos radiactivos. Fuente no encapsulada<\/span><\/span><\/span><\/span><\/span>\n\t\t\t<\/p>\n\t\t\t<p><label for=\"radiacions-ionitzants-altres\">Otros<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"radiacions-ionitzants-altres\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" id=\"radiacions-ionitzants-altres\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"radiacions-ionitzants-altres\" \/><\/span>\n\t\t\t<\/p>\n\t\t<\/fieldset>\n\t<\/div>\n\t<h3>Salidas de campo\n\t<\/h3>\n\t<p><label for=\"obrir-sortides\">Mi trabajo implica salidas de campo<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"obrir-sortides\"><span class=\"wpcf7-form-control wpcf7-radio\" id=\"obrir-sortides\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"obrir-sortides\" value=\"S\u00ed\" \/><span class=\"wpcf7-list-item-label\">S\u00ed<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"obrir-sortides\" value=\"No\" checked=\"checked\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n\t<\/p>\n\t<div data-id=\"sortides\" data-orig_data_id=\"sortides\" data-clear_on_hide class=\"\" data-class=\"wpcf7cf_group\">\n\t\t<fieldset  id=\"sortides\">\n\t\t\t<legend>Salidas de campo\n\t\t\t<\/legend>\n\t\t\t<p>En caso de que realices trabajos de campo, marca los espacios donde puedes realizar la actividad:\n\t\t\t<\/p>\n\t\t\t<p><label for=\"sortides\">Tipo<\/label><span class=\"formulari-dreta\"><span class=\"wpcf7-form-control-wrap\" data-name=\"sortides\"><span class=\"wpcf7-form-control wpcf7-checkbox\" id=\"sortides\"><span class=\"wpcf7-list-item first\"><input type=\"checkbox\" name=\"sortides[]\" value=\"Museos, bibliotecas o similares (salidas urbanas)\" \/><span class=\"wpcf7-list-item-label\">Museos, bibliotecas o similares (salidas urbanas)<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"sortides[]\" value=\"Campo, monta\u00f1a (actividades asimilables a excursiones con bajo nivel de dificultad)\" \/><span class=\"wpcf7-list-item-label\">Campo, monta\u00f1a (actividades asimilables a excursiones con bajo nivel de dificultad)<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"sortides[]\" value=\"Alta monta\u00f1a (actividades con cierto nivel de dificultad y necesidad de material de monta\u00f1a)\" \/><span class=\"wpcf7-list-item-label\">Alta monta\u00f1a (actividades con cierto nivel de dificultad y necesidad de material de monta\u00f1a)<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"sortides[]\" value=\"Entorno de playa, r\u00edo, lago o similar\" \/><span class=\"wpcf7-list-item-label\">Entorno de playa, r\u00edo, lago o similar<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"sortides[]\" value=\"Mar, lago, r\u00edo o similar (requiere embarcaci\u00f3n)\" \/><span class=\"wpcf7-list-item-label\">Mar, lago, r\u00edo o similar (requiere embarcaci\u00f3n)<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"sortides[]\" value=\"Mar, lago, r\u00edo o similar (requiere inmersi\u00f3n)\" \/><span class=\"wpcf7-list-item-label\">Mar, lago, r\u00edo o similar (requiere inmersi\u00f3n)<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"sortides[]\" value=\"Yacimientos arqueol\u00f3gicos\" \/><span class=\"wpcf7-list-item-label\">Yacimientos arqueol\u00f3gicos<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"sortides[]\" value=\"Expediciones a zonas \u00e1rticas\" \/><span class=\"wpcf7-list-item-label\">Expediciones a zonas \u00e1rticas<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"sortides[]\" value=\"Expediciones en zonas des\u00e9rticas\" \/><span class=\"wpcf7-list-item-label\">Expediciones en zonas des\u00e9rticas<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"checkbox\" name=\"sortides[]\" value=\"Expediciones en zonas boscosas ecuatoriales o tropicales\" \/><span class=\"wpcf7-list-item-label\">Expediciones en zonas boscosas ecuatoriales o tropicales<\/span><\/span><\/span><\/span><\/span>\n\t\t\t<\/p>\n\t\t\t<p><label for=\"sortides-altres\">Otros<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"sortides-altres\"><textarea cols=\"40\" rows=\"3\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" id=\"sortides-altres\" aria-invalid=\"false\" name=\"sortides-altres\"><\/textarea><\/span>\n\t\t\t<\/p>\n\t\t<\/fieldset>\n\t\t<fieldset>\n\t\t\t<legend>Salidas de campo. Trabajos de riesgo\n\t\t\t<\/legend>\n\t\t\t<p>En caso de que realice trabajos de campo con condiciones especiales de riesgo, explique las situaciones:\n\t\t\t<\/p>\n\t\t\t<p><label for=\"camp-alcada\">Trabajos en altura<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"camp-alcada\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" id=\"camp-alcada\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"camp-alcada\" \/><\/span>\n\t\t\t<\/p>\n\t\t\t<p><label for=\"camp-confinat\">Trabajos en espacios confinados<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"camp-confinat\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" id=\"camp-confinat\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"camp-confinat\" \/><\/span>\n\t\t\t<\/p>\n\t\t\t<p><label for=\"camp-aillat\">Trabajos en zonas aisladas o monta\u00f1a<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"camp-aillat\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" id=\"camp-aillat\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"camp-aillat\" \/><\/span>\n\t\t\t<\/p>\n\t\t\t<p><label for=\"camp-rius\">Trabajos en zonas cercanas a r\u00edos, zonas pantanosas, etc.<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"camp-rius\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" id=\"camp-rius\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"camp-rius\" \/><\/span>\n\t\t\t<\/p>\n\t\t\t<p><label for=\"camp-barrancs\">Trabajos en zonas cercanas a barrancos, acantilados, etc.<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"camp-barrancs\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" id=\"camp-barrancs\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"camp-barrancs\" \/><\/span>\n\t\t\t<\/p>\n\t\t\t<p><label for=\"sortides-risc-altres\">Otras salidas de riesgo<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"sortides-risc-altres\"><textarea cols=\"40\" rows=\"3\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" id=\"sortides-risc-altres\" aria-invalid=\"false\" name=\"sortides-risc-altres\"><\/textarea><\/span>\n\t\t\t<\/p>\n\t\t\t<p>Si la respuesta es s\u00ed en alguno de los puntos anteriores, indique el nombre de la persona responsable del grupo de investigaci\u00f3n que realiza las funciones de direcci\u00f3n de grupo y recurso preventivo:\n\t\t\t<\/p>\n\t\t\t<p><label for=\"nom-risc\">Nombre y apellidos<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"nom-risc\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" id=\"nom-risc\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"nom-risc\" \/><\/span>\n\t\t\t<\/p>\n\t\t\t<p><label for=\"nif-risc\">NIF<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"nif-risc\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" id=\"nif-risc\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"nif-risc\" \/><\/span>\n\t\t\t<\/p>\n\t\t\t<p><label for=\"camp-descripcio\">Breve descripci\u00f3n de las actividades de campo<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"camp-descripcio\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" id=\"camp-descripcio\" aria-invalid=\"false\" name=\"camp-descripcio\"><\/textarea><\/span>\n\t\t\t<\/p>\n\t\t\t<p>Recuerda que si eres ub y desarrollas tu labor en otro centro, debes agasajar <a href=\"https:\/\/www.ub.edu\/ossma\/es\/seguridad-salud\/espacio-preventivo-pas-pdi-pi\/cae-ub\/\">el siguiente tr\u00e1mite<\/a>.\n\t\t\t<\/p>\n\t\t<\/fieldset>\n\t<\/div>\n\t<fieldset>\n\t\t<legend>Conformidad\n\t\t<\/legend>\n\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"faig-constar\"><span class=\"wpcf7-form-control wpcf7-acceptance\"><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"faig-constar\" value=\"1\" id=\"faig-constar\" aria-invalid=\"false\" \/><span class=\"wpcf7-list-item-label\">Hago constar que los datos aqu\u00ed indicados son ciertos y me comprometo a notificar al OSSMA cualquier modificaci\u00f3n en mi ubicaci\u00f3n, tareas o actividades se\u00f1aladas*<\/span><\/label><\/span><\/span><\/span>\n\t\t<\/p>\n\t\t<div class=\"form-two-columns\">\n\t\t\t<p><label for=\"signatura\">Firma del trabajador*<br \/>\n<small>(Dibuja tu firma en el recuadro)<\/small><\/label><span class=\"formulari-dreta\"><div class=\"dscf7_signature\">\n\t\t\t<div class=\"dscf7_signature_inner\">\n\t\t\t\t<canvas id=\"digital_signature-pad_signatura\" name=\"signatura\" class=\"digital_signature-pad\" color=\"#000000\" backcolor=\"#dddddd\" width=\"300\" height=\"200\"><\/canvas>\n\t\t\t\t<input class=\"clearButton\" type=\"button\" value=\"+\">\n\t\t\t<\/div>\n\t\t\t<span class=\"wpcf7-form-control-wrap signatura\" data-name=\"signatura\">\n\t\t\t\t<input class=\"wpcf7-form-control wpcf7-signature wpcf7-validates-as-required wpcf7-validates-as-signature dscf7-signature\" id=\"signatura\" value=\"\" type=\"hidden\" name=\"signatura\"\/>\n\t\t\t\t<input type=\"hidden\" name=\"signatura-attachment\" class=\"wpcf7_input_signatura_attachment\"\/>\n\t\t\t\t<input type=\"hidden\" name=\"signatura-inline\" class=\"wpcf7_input_signatura_inline\"\/>\n\t\t\t<\/span>\n\t\t<\/div><\/span>\n\t\t\t<\/p>\n\t\t<\/div>\n\t<\/fieldset>\n\t<p><b>Derecho de informaci\u00f3n relativo al tratamiento de datos personales<\/b>\n\t<\/p>\n\t<p>(1) El responsable del tratamiento de sus datos es la Secretar\u00eda General de la Universidad de Barcelona. (2) La finalidad del tratamiento es gestionar la prevenci\u00f3n de riesgos laborales. (3) Tiene derecho a acceder a sus datos, rectificarlos, suprimirlos, oponerse a su tratamiento, solicitar la portabilidad y la limitaci\u00f3n de los tratamientos, en determinadas circunstancias. (4) Puede consultar <a href=\"https:\/\/www.ub.edu\/ossma\/es\/derecho-informacion-relativo-datos-personales\" target=\"_blank\">la informaci\u00f3n detallada de los tratamientos mencionados<\/a>\n\t<\/p>\n<\/div>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"dret-informacio\"><span class=\"wpcf7-form-control wpcf7-acceptance\"><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"dret-informacio\" value=\"1\" id=\"dret-informacio\" aria-invalid=\"false\" \/><span class=\"wpcf7-list-item-label\">Declaro que he le\u00eddo el derecho de informaci\u00f3n<\/span><\/label><\/span><\/span><\/span>\n<\/p>\n<p><input class=\"wpcf7-form-control wpcf7-submit has-spinner\" type=\"submit\" value=\"Enviar\" \/>\n<\/p>\n<p>(El formulario puede tardar unos segundos en confirmar el env\u00edo. Por favor, no lo reenv\u00edes ni recargues la p\u00e1gina)\n<\/p><p style=\"display: none !important;\" class=\"akismet-fields-container\" data-prefix=\"_wpcf7_ak_\"><label>&#916;<textarea name=\"_wpcf7_ak_hp_textarea\" cols=\"45\" rows=\"8\" maxlength=\"100\"><\/textarea><\/label><input type=\"hidden\" id=\"ak_js_1\" name=\"_wpcf7_ak_js\" value=\"74\"\/><script>\ndocument.getElementById( \"ak_js_1\" ).setAttribute( \"value\", ( new Date() ).getTime() );\n<\/script>\n<\/p><div class=\"wpcf7-response-output\" aria-hidden=\"true\"><\/div>\n<\/form>\n<\/div>\n<\/div>\n\n<p class=\"wp-block-paragraph\"><\/p>\n","protected":false},"excerpt":{"rendered":"<p class=\"wp-block-paragraph\">La hoja se divide en varios apartados, el primero de general aplicaci\u00f3n. Completa el resto de apartados s\u00f3lo si te son de aplicaci\u00f3n.<\/p>\n","protected":false},"author":1,"featured_media":27800,"parent":35388,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"advgb_blocks_editor_width":"","advgb_blocks_columns_visual_guide":"","footnotes":""},"class_list":["post-35456","page","type-page","status-publish","has-post-thumbnail"],"coauthors":[],"author_meta":{"author_link":"https:\/\/www.ub.edu\/ossma\/es\/author\/ossmau1","display_name":"OSSMA"},"relative_dates":{"created":"Publicado 5 a\u00f1os hace","modified":"Actualizado 5 a\u00f1os hace"},"absolute_dates":{"created":"Publicado el 2 de enero de 2022","modified":"Actualizado el 2 de enero de 2022"},"absolute_dates_time":{"created":"Publicado el 2 de enero de 2022 10:06","modified":"Actualizado el 2 de enero de 2022 10:06"},"featured_img_caption":"","featured_img":"https:\/\/www.ub.edu\/ossma\/wp-content\/uploads\/2021\/04\/banner-notificacions.jpg","series_order":"","_links":{"self":[{"href":"https:\/\/www.ub.edu\/ossma\/es\/wp-json\/wp\/v2\/pages\/35456","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.ub.edu\/ossma\/es\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.ub.edu\/ossma\/es\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.ub.edu\/ossma\/es\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.ub.edu\/ossma\/es\/wp-json\/wp\/v2\/comments?post=35456"}],"version-history":[{"count":1,"href":"https:\/\/www.ub.edu\/ossma\/es\/wp-json\/wp\/v2\/pages\/35456\/revisions"}],"predecessor-version":[{"id":35457,"href":"https:\/\/www.ub.edu\/ossma\/es\/wp-json\/wp\/v2\/pages\/35456\/revisions\/35457"}],"up":[{"embeddable":true,"href":"https:\/\/www.ub.edu\/ossma\/es\/wp-json\/wp\/v2\/pages\/35388"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.ub.edu\/ossma\/es\/wp-json\/wp\/v2\/media\/27800"}],"wp:attachment":[{"href":"https:\/\/www.ub.edu\/ossma\/es\/wp-json\/wp\/v2\/media?parent=35456"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}