Pregnancy Assessment

• Site conducted

  Select

• Conducted on

  Date

• Prepared by

• Location
  Address

• In accordance with the requirements of the Safety, Health and Welfare at Work (General Applications) Regulations 2007, a risk assessment was carried out in the workplace in order to establish if she or her developing child is exposed to further risks to her safety and health due to her pregnancy

• Employee Name

• Job Description

• Work Area

• Expected due date:

  Date

Physical Hazards

• Physical Shocks - Direct blows to the abdomen present?

  Yes

  No

  N/A

• Vibration - Whole body vibration present?

  Yes

  No

  N/A

Manual Handling Loads

• Manual handling has significant implications for the health of a pregnant employee, if combined with long periods of standing. As pregnancy progresses and particularly during the last three months, it becomes more difficult to achieve and maintain good postures and this further reduces manual handling capability. Particular care should be taken also for women who may handle loads during the three months following a return to work after childbirth. Where it is identified as a hazard to a pregnant employee the risk assessment should:

• Can manual handling activity/activities be removed from the employee’s task?

  Yes

  No

  N/A

• If the above is not possible, can manual handling activities be reduced?

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Can the task/s be altered to minimise manual handling and fatigue

  Yes

  No

  N/A

Noise

• There is no specific risk to new or expectant mothers or to the fetus, but prolonged exposure to loud noise may lead to increased blood pressure and tiredness. Compliance with the Noise Regulations 2007 should be sufficient to meet the needs of new or expectant mothers. Where Noise is identified as a hazard:

• Review noise risk assessments

  Yes

  No

  N/A

• If there are areas which are identified as having noise levels in exceeding 80Db(A) ensure correct action is implemented

  Yes

  No

  N/A

Excessive heat and cold

• Work area below 16℃?

  Yes

  No

  N/A

• Work area above 24℃?

  Yes

  No

  N/A

Movement and Postures

• Movement and postures that give rise to excessive fatigue or which are abrupt or severe?

  Yes

  No

  N/A

• Standing or sitting for long periods of time should be avoided especially as the pregnancy progresses. If there is a risk the work pattern should be changed to frequently alternate periods of standing or sitting

  Yes

  No

  N/A

Radiation

Ionising Radiation

• X-ray units in use are especially designed is such a way that a correctly functioning and operated unit should not result in any operator receiving a radiation dose in excess of the dose limit for a member of the public. (Ref: RPII) Is there exposure to x-ray units?

  Yes

  No

  N/A

Non-Ionising Radiation

• Pregnant or breast-feeding mothers are at no greater risk than other workers when working with optical radiation. Exposure to electrical or magnetic fields when working with electromagnetic fields and waves within current standards is not known to cause harm to the fetus or the mother

• According to the RPII metal detectors use a nonionizing electromagnetic scanning field to detect metal objects and it does not emit high energy radiation such as gamma radiation. Is there exposure to electrical or magnetic fields?

  Yes

  No

  N/A

Chemical Hazards

• Is the employee exposed to any substance and preparations classified under the classification, packaging and labeling regulations with one or more of the following risk phrases:

• R40: Limited evidence of a carcinogenic effect

  Yes

  No

  N/A

• R45: May cause cancer

  Yes

  No

  N/A

• R46: May cause heritable genetic effects

  Yes

  No

  N/A

• R49: May cause cancer by inhalation

  Yes

  No

  N/A

• R61: May cause harm to the unborn child

  Yes

  No

  N/A

• R63: Possible risk to the unborn child

  Yes

  No

  N/A

• R64: May cause harm to breast fed babies

  Yes

  No

  N/A

• R68: Possible risks of irreversible effects

  Yes

  No

  N/A

Biological Hazards

• Unless a subsequent risk assessment reveals there is no risk to the employee or the developing child, pregnant employees must not work with:

• Rubella

  Yes

  No

  N/A

• Toxoplasma

  Yes

  No

  N/A

• Is the employee exposed to any of the following biological agents which may harm themselves or the unborn child?

  Yes

  No

  N/A

• Arboviruses (such as yellow fever, dengue fever)

  Yes

  No

  N/A

• Chicken pox

  Yes

  No

  N/A

• Coxackie virus

  Yes

  No

  N/A

• Cytomegalovirus (CMV)

  Yes

  No

  N/A

• Group B Strep

  Yes

  No

  N/A

• Hepatitis B

  Yes

  No

  N/A

• Herpes simplex virus (types 1 and 11)

  Yes

  No

  N/A

• HIV and AIDS

  Yes

  No

  N/A

• Measles

  Yes

  No

  N/A

• Mumps

  Yes

  No

  N/A

• Parvovirus Syphilis

  Yes

  No

  N/A

Working Conditions

Display Screen Equipment

• Pregnant women do not need to stop working with DSE. The provisions of the Display Screen Equipment Regulations 2007 apply to all users of DSE

• DSE assessment completed?

  Yes

  No

  N/A

• Is there adequate space to move around the workstation especially as pregnancy develops?

  Yes

  No

  N/A

• Is there sitting for long periods?

  Yes

  No

  N/A

Night Work

• If a pregnant employee is regularly involved in night work and has a medical certificate stating that this will damage her health, she must be found alternative work. If that is not possible the pregnant employee may have an entitlement to be granted health and safety leave under section 18 of the Maternity Protection Act 1994

• Working between 11.00pm and 06.00am for at least 3 hours in that period or where 25% of their monthly working time is between those times

  Yes

  No

  N/A

• Are there facilities, with suitable privacy for pregnant and post natal employees to lie down to rest in appropriate conditions?

  Yes

  No

  N/A

• Is the facility situated near the welfare facilities i.e. toilets/washing facilities where possible

  Yes

  No

  N/A

• Indicate if you are aware of any other hazards the employee may be exposed to during the course of her employment that may put her or her developing child at risk?

• Notification of pregnancy

  Yes

  No

  N/A

• Doctors certificates received from employee

  Yes

  No

  N/A

• Specific medical requirements

  Yes

  No

  N/A

• Employee Signature

  Sign

• Assessor Signature

  Sign