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1. Assessment Information: Basic details including date of assessment, assessor name, employee details, and workplace location
2. Employee Job Role Details: Description of normal duties, working hours, and typical tasks performed
3. Physical Workplace Risks: Assessment of risks related to manual handling, prolonged standing/sitting, awkward spaces, and movement requirements
4. Environmental Hazards: Evaluation of workplace temperature, noise levels, vibration, radiation, and other environmental factors
5. Chemical Exposure Risks: Assessment of any potential exposure to harmful substances, including cleaning products and industrial chemicals
6. Biological Hazards: Evaluation of exposure to infectious diseases or biological agents
7. Work Pattern Risks: Assessment of working hours, shift patterns, and stress factors
8. Current Control Measures: Existing workplace safety measures and their adequacy
9. Required Adjustments: Specific changes needed to accommodate the pregnant worker
10. Implementation Timeline: Schedule for implementing required changes and adjustments
11. Review and Monitoring: Process for ongoing assessment and adjustment of control measures
1. Display Screen Equipment Assessment: Detailed assessment for office-based workers who primarily use computers
2. Laboratory Safety Measures: Additional section for employees working in laboratory environments
3. Heavy Machinery Operations: Specific assessment for workers who normally operate industrial machinery
4. Customer-Facing Duties: Assessment of risks related to public-facing roles
5. Travel Requirements: Evaluation of business travel risks and necessary adjustments
6. Emergency Procedures: Special considerations for emergency evacuation and response procedures
7. Post-Return Arrangements: Planning for return to work and breastfeeding arrangements
1. Appendix A: Risk Assessment Matrix: Detailed risk scoring matrix used for the assessment
2. Appendix B: Workplace Measurements: Specific measurements of noise levels, temperature, radiation etc. where applicable
3. Appendix C: Chemical Safety Data Sheets: Relevant safety information for any chemicals present in the workplace
4. Appendix D: Legislative Requirements: Summary of relevant Dutch legal requirements and employer obligations
5. Appendix E: Employee Rights: Summary of pregnant employee's rights and entitlements
6. Schedule 1: Control Measure Checklist: Detailed checklist of all required control measures and their implementation status
7. Schedule 2: Review Schedule: Timetable for periodic reviews of the assessment and adjustments
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