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Expectant & Nursing Mothers Risk Assessment NB: If completing this form electronically, entries can only be made in the shaded areas. Shaded rectangles will expand to fit the text entered. Clicking on a tick box will enter an “x” in the box Name of Expectant / Nursing Mother: School/Department: Job title/course: Brief description of duties: Number of weeks pregnant (if known): Assessor: Date: 1. Physical Job Demands Yes No Does the work involve: Lifting or pushing heavy objects? Standing for long periods? A lot of walking? Work at height or climbing steep steps? Advice if yes Do not lift heavy objects – ask others to do this for you. Ensure that you sit down as often as you feel is necessary. If you do stand for long periods have a chair nearby. Take regular rest stops and sit down as often as is necessary. Avoid working at height (for example, work on elevated platforms). Use lifts instead of stairs where possible. Inform your line manager / tutor if and when body shape becomes a problem (for example, you cannot get close enough to the task). Night shifts and lone working should be avoided. Will any tasks become more hazardous due to expectant mother’s changing shape and size? Is shift work/lone working required? Other recommendations and comments: 2. Mental job demands Yes No Does the work: Require the expectant / nursing mother to meet challenging deadlines? Involve rapidly changing demands and priorities? Require a high degree of concentration? Rev 03 Jan 017 Advice if yes Inform your line manager / tutor immediately if you feel workload is too high and/or is causing stress. Your line manager / tutor should discuss this with you and take appropriate action. Page 1 of 5 Other recommendations and comments: 3. General Working Conditions Yes Is any relevant DSE assessment up to date? No risk Does the work involve any home working? Are toilet facilities easily accessible to the expectant mother? Can the expectant / nursing mother take toilet and rest breaks immediately when necessary? Can the expectant / nursing mother control the pace of work? Is a reasonable temperature maintained in the working environment? Is there sufficient room for the expectant mother to gain access and egress to and from workstation (consider expectant mother’s changing shape and size)? Does the expectant / nursing mother have a suitable, adjustable chair? If your job entails desk work your chair should conform to DSE standards. If you do not normally sit to undertake your work, a chair should be available for you to rest as necessary. Any control measures required additional to those already in place should be listed below. Please remember that these may have to be reconsidered in the later stages of pregnancy. In the later stages of pregnancy your mobility will be reduced as will your ability to respond to emergencies. Your emergency duties might need to be reconsidered at this time. Is there a risk of violence? Does the work or additional duties involve dealing with emergencies? Other recommendations and comments: Rev 03 Jan 017 General Advice DSE risk assessment should be reviewed annually or following a significant change to the workstation Ensure that your home working environment is comfortable and that the same display screen equipment use practices are observed as would be in work. Toilet facilities should be suitably close to allow you to take toilet breaks as often as necessary. Please take toilet and rest breaks as necessary. First Aid rooms may be used by expectant mothers to take rest breaks. If the pace of work is causing stress please consult your line manager / tutor who should discuss this with you and take appropriate action. Please report any uncomfortable temperatures to your line manager / tutor Inform your line manager as soon as body shape becomes a problem so that remedial action can be taken. Page 2 of 5 4.Specific Hazards Yes No Will the expectant / nursing mother have potential exposure to: Harmful substances Substances with greater risk potential are those with the following hazard statements: Consult suppliers’ Safety Data Sheets (SDS) and RGU COSHH assessments where applicable. If relevant hazard statements are identified, please consult Occupational Health and Environmental Safety department (OHES) as soon as possible for specific advice [email protected] H340 May cause genetic defects H341 Suspected of causing genetic defects H350 May cause cancer H351 Suspected of causing cancer H360 May damage fertility or the unborn child H361 Suspected of damaging fertility or the unborn child H362 May cause harm to breast-fed children Fumes, Smoke, Dust Any exposures to fumes, smoke or dusts arising from substances identified above may present greater risk potential. Consult suppliers’ Safety Data Sheets (SDS) and RGU COSHH assessments where applicable. If relevant hazard statements are identified, please consult the OHES department as soon as possible for specific advice. Whole-Body Vibration Whole-body vibration (WBV) comes from driving a vehicle over rough terrain. Continued exposure to vibration, or sudden shocks, e.g. driving over a tree stump, can lead to back pain and other musculoskeletal disorders. Check equipment manufacturer’s manual and identify any risk of whole-body vibration exposure >0.5 m/s2 A(8). Avoid significant wholebody vibration exposures. Consult OHES if in doubt. Ionising radiation practices A “practice” means work involving (a) the production, processing, handling, use, holding, storage, transport or disposal of radioactive substances; or (b) the operation of any electrical equipment emitting ionising radiation and containing components operating at a potential difference of more than 5kV, i.e. XRay equipment Rev 03 Jan 017 Advice if yes Please consult the OHES department as soon as possible for specific advice. Page 3 of 5 Electromagnetic Fields Sources of electromagnetic (EMF) energy that require consideration during pregnancy are: Please consult OHES department as soon as possible for specific advice. Broadcast and telecoms base stations, inside operator’s designated exclusion zone Radio frequency or microwave energised lighting equipment Radio and TV broadcasting systems and devices Work in close proximity to cables carrying high currents (>100A) Automated induction heating systems: fault-finding and repair involving close proximity to the EMF source Dielectric heating and welding Resistance welding: manual spot and seam welding Induction heating Induction soldering Magnetic particle inspection (crack detection) Industrial magnetiser and demagnetisers, e.g. tape erasers Microwave heating and drying RF plasma devices including vacuum deposition and sputtering Automated welding systems, faultfinding: repair and teaching involving close proximity to the EMF source Diathermy Transcranial Magnetic Stimulation Medical MRI / NMR equipment Radar - air traffic control, weather and long range Personal Protective Equipment If the expectant / nursing mother requires personal protective equipment (PPE) will this present a problem as the pregnancy develops? Rev 03 Jan 017 If PPE becomes restrictive, uncomfortable or cannot be worn due to body shape then do not undertake the task for which the PPE is required. Page 4 of 5 Travel Is the expectant / nursing mother required to travel on business by: Road Rail Air Sea If undertaking a long journey please ensure you allow enough time for rest breaks. Walk up and down aisles as necessary. Please consult your GP and travel agent before booking travel. Please consult your GP and travel agent before booking travel. In general – long distance business related journeys should be avoided, wherever possible, in the later stages of pregnancy. Other recommendations and comments: 5. General Comments I confirm that I have read and understood the above: ...................................................... Expectant / nursing mother (signed) ...................... Date I will ensure that expectant / nursing mother named above will be allowed to heed the above advice as appropriate. In addition, I will ensure that the above noted recommendations are implemented as appropriate and will continue for as long as is necessary. ...................................................... Line manager / Tutor (signed) ...................... Date Copies of this form should be retained by the expectant /nursing mother, the line manager / tutor and the HR Department. Further information: Guidance for Use of Facilities for Breastfeeding Rev 03 Jan 017 Page 5 of 5