What this is
What is an exit health assessment?
What is an exit health assessment?
It is a health surveillance record taken as a worker leaves a role with hazardous exposure, establishing their health state on the way out. It compares against the pre-placement baseline and the periodic assessments in between, and asks whether any change is likely work related. It closes that worker's surveillance sequence.
Why does it matter if the worker seems well?
Because the value of the record is evidential, not diagnostic. Long-latency occupational disease — noise-induced hearing loss, asbestos-related disease, occupational asthma, hand-arm vibration syndrome — commonly presents years after exposure ends. A normal exit record answers a later claim; an absent one leaves the question open, which resolves against the employer.
What separates it from a periodic assessment?
A periodic assessment surveils a continuing exposure and feeds controls still operating. An exit assessment closes the sequence and asks a retrospective question about the whole employment, comparing against baseline rather than the last visit. It also carries obligations the periodic one does not, notably giving the worker a copy of their records.
Scope
When is an exit health assessment required?
This closes an individual's surveillance sequence. It sits between the surveillance plan that scheduled it and the exposure records that give it context.
Use this template when
- A worker in a similar exposure group is leaving the organisation
- A worker is transferring permanently out of an exposed role into an unexposed one
- A fixed-term or agency placement in an exposed role is ending
- Surveillance is being discontinued because the exposure has been eliminated at source
- A worker under active surveillance is retiring and the sequence needs a closing entry
Do not use it for
- Pre-Placement Health Assessment, which establishes the baseline this record is compared against and is taken before exposure begins
- Periodic Health Assessment, which is the scheduled in-post check and feeds live control decisions rather than closing a sequence
- Health Referral Record, which handles the onward clinical referral where an adverse finding needs investigation
- Exposure Incident Record, which captures an acute unplanned exposure event and has its own reporting clock
- Worker Offboarding Checklist, which is the HR-owned closure of access, property and pay, and should not carry clinical content
Compliance mapping
Which OSHA recordkeeping requirements does this satisfy?
The template is anchored on OSHA recordkeeping, but the operative duties split across records access, hazard-specific surveillance standards and the data protection rules governing clinical content.
| Clause | Requirement | Where it lands |
|---|---|---|
| 29 CFR 1910.1020(d) | Employee medical records shall be preserved for at least the duration of employment plus thirty years. | Records and reporting |
| 29 CFR 1910.1020(e) | Employees and their designated representatives shall be given access to their own exposure and medical records on request. | Records and reporting |
| 29 CFR 1904.5 | An injury or illness is work related if an event or exposure in the work environment caused or contributed to it, or aggravated a pre-existing condition. | Assessment |
| COSHH 2002 Reg.11 | Health surveillance shall be carried out where exposure may result in identifiable disease, and health records kept for at least forty years. | Header |
| UK GDPR Art.9 | Health data is special category data and requires an Article 9 condition in addition to a lawful basis for processing. | Header |
| ISO 45001:2018 cl.10.2 | Where an incident or nonconformity occurs, review the effectiveness of controls and take action to eliminate the cause. | Records and reporting |
What it does not cover
- An assessment marked complete with no baseline comparison, which records a health state but cannot attribute it, leaving a file able to demonstrate a condition and unable to defend against it.
- Consent ticked with the full clinical report on the personnel file, which exceeds what the worker agreed to share; consent covers the fitness outcome, not the diagnosis.
- A record retained by the employer but never given to the worker, which fails the access duty and removes their own means of evidencing exposure decades later.
- Work-related change found with no exposure control review triggered, which treats a confirmed occupational effect as a closed personnel matter while the exposure continues for the group.
- A retention period entered as seven years by default, which destroys the record two decades early, usually because the HR schedule was applied to a clinical file.
Global
Exit Health Assessment requirements by country
Exit surveillance is one of the few areas where the substantive duty, not just the paperwork, differs by jurisdiction — chiefly on how long records live and whether surveillance is discretionary.
29 CFR 1910.1020; 29 CFR 1910.95; 29 CFR 1910.1001
There is no general exit surveillance duty; obligations attach to specific substance standards, with medical records preserved for employment plus thirty years.
Whether an exit assessment is owed depends on which standard covered the worker. Where none applies, doing it is a defensive choice, and the retention rule still governs the record you create.
COSHH 2002 Reg.11; Control of Noise at Work Regulations 2005 reg.9
Health surveillance is mandatory wherever exposure may result in an identifiable disease attributable to work, and health records are kept for forty years.
The trigger is the exposure, not the employer's appetite. A departing worker in a surveillance group is owed a closing record, and the forty-year clock means the file outlasts the site itself.
Directive 2004/37/EC Art.14; Directive 98/24/EC Art.10
Member states must ensure health surveillance for workers exposed to carcinogens, mutagens and hazardous chemical agents, with records kept for at least forty years after exposure ends.
The forty-year clock runs from the end of exposure, not the end of employment, so records must survive transfer, restructuring and business sale.
How to complete it
How to complete an exit health assessment, step by step
The clinical content belongs to the provider. The calls that decide whether the record is defensible are about consent, attribution and what happens next.
The consent question is narrow: it authorises sharing a fitness outcome and any restrictions with the employer. It is not consent to put clinical findings in the personnel record, and it cannot be assumed from attendance. Withdrawal is the worker's right at any point, after which the employer holds the fact that an assessment took place, not its content.
The middle option exists because certainty is rare and 'no' is often wrong. Use possibly where the exposure history fits the finding but confounders — age, smoking, previous employment, hobbies — cannot be excluded. Treating possibly as a soft no is how work-related conditions go unrecorded; treating it as a hard yes overstates an attribution the clinician did not make.
'No baseline exists' is a real and common answer, and more useful than comparing against a periodic assessment taken three years into exposure and calling that a baseline. It also flags a gap in the programme: if exit assessments repeatedly report no baseline, the pre-placement step is not running for that exposure group.
An adverse work-related finding at exit is evidence about the exposure group, not just about one person, and the exposure control review trigger is what carries it outward. If it stays No while a work-related change was found, the organisation learned something about its controls at the moment it stopped acting on it, and the next worker in that group inherits the exposure.
What auditors find
Most common exit health assessment findings
These recur when exit surveillance files are sampled against exposure group registers rather than reviewed one at a time.
| Finding | Clause | What fixes it |
|---|---|---|
| Leavers in surveillance groups with no exit record at all | COSHH 2002 Reg.11 | Trigger the assessment from the HR notice event against the exposure group register, rather than relying on the line manager to remember the role was in scope. |
| Clinical reports filed in the general personnel folder | UK GDPR Art.9 | Restrict the template to occupational health and publish only the fitness outcome and restrictions. Audit folder permissions rather than trusting the process note. |
| Records destroyed on the standard employee retention schedule | 29 CFR 1910.1020(d) | Classify health surveillance separately from personnel data before any deletion job runs, with retention set from the end of exposure, not the leaving date. |
| Workers never given a copy of their own records | 29 CFR 1910.1020(e) | Make issuing the copy a completion condition on the record rather than a courtesy, and capture the date it was provided alongside the tick. |
| Work-related findings closed without an exposure control review | ISO 45001:2018 cl.10.2 | Make the exposure control review trigger conditional on a work-related change, and route the case ID to the exposure result review for the affected group. |
| Assessments booked after the last working day and marked declined | 29 CFR 1904.5 | Distinguish 'not offered in time' from 'offered and declined' in the record. Book from the notice date so the decline, if it comes, is genuinely the worker's choice. |
Case in point
Case in point: the audiogram that was never taken
A fabrication business defended a noise-induced hearing loss claim from a welder who had left eleven years earlier. The file was in reasonable order: a pre-placement audiogram, five annual audiograms showing gradual threshold shift the provider had flagged as monitorable, and a documented hearing protection programme. It held nothing after the fifth test, because the worker resigned two months before the sixth was due.
The last eighteen months were unevidenced, and included a period the claimant said he spent on a louder process. The gap did not decide the case alone, but it removed any ability to show where the loss did and did not progress. The change afterwards was small: the exposure group register now fires an exit assessment on any notice event for a worker under surveillance.
The template
The template, field by field
The form exactly as it installs. Every field, option, score and conditional rule is editable, and the links to other templates come with it.
3 sections
- Reference
- HLT-012
- Archetype
- Assessment
- Record ID
- EHA-2026-000
- Scoring
- Not scored
- Direction
- n/a
- Singleton
- No
- Basis
- OSHA recordkeeping
- Links
- Links Worker, SEG
- Tags
- Health, Surveillance
- Sections
- 3
- Fields
- 39
- Follow up fields
- 5
- Repeating sections
- 0
- Links out
- 3
Header
19 fieldsAssessment ID*
Auto sequence. Format EHA-2026-000.
The record's own ID. Other templates point at this value.
Status*
Drives who this goes to next.
- Planned2 pts
- In progress2 pts
- Complete3 pts
- Deferred0 pts
- Open0 pts
- Closed3 pts
- Overdue0 pts
Date and Time*
Completed By*
Site*
Site ID*
Format SITE-000.
Links to FDN-001 Site ID
Worker*
Person ID*
Format PER-0000.
Links to FDN-003 Person ID
Record Confidentiality
Clinical detail stays with occupational health. Management receives a fitness outcome and any restrictions, never a diagnosis. Restrict access to this template accordingly.
Clinical Detail Held Separately*
- Yes3 pts
- No0 pts
Access Restricted To Occupational Health*
- Yes3 pts
- Partly1 pt
- No0 pts
Worker Consent Obtained*
Consent to share the fitness outcome with the employer. Withdrawal is the worker's right.
- Yes3 pts
- No0 pts
The Last Chance To Know
An exit assessment establishes the health state at the point of leaving. Without it, any later claim about harm caused here cannot be answered either way.
Leaving Date*
Reason For Leaving
Years In Exposed Role*
Assessment Offered*
- Yes3 pts
- No0 pts
Assessment Accepted*
- Yes3 pts
- No1 pt
Reason If Declined
Assessment
6 fieldsAssessment Type
Compared With Baseline
- Yes3 pts
- No baseline exists0 pts
Change Over Employment
- None3 pts
- Slight1 pt
- Significant0 pts
Adverse Change Detected
- No3 pts
- Yes0 pts
Likely Work Related
- No3 pts
- Possibly1 pt
- Yes0 pts
Referral Made
Records and reporting
14 fieldsWork Related Change Found*
Repeats the assessment conclusion, so the reporting follow ups sit in this section.
- No3 pts
- Yes0 pts
Worker Given Copy Of Their Records*
They will need it if symptoms appear years later. Give it to them.
- Yes3 pts
- No0 pts
Records Retained By Employer*
- Yes3 pts
- No0 pts
Retention Period Years
Case ID
Thread key
Exposure Control Review Triggered
- Yes3 pts
- No0 pts
Action Required*
Raise the action record, then enter its reference here.
- No2 pts
- Yes0 pts
Priority
- High0 pts
- Medium1 pt
- Low3 pts
CAPA ID
Format CAPA-2026-00000.
Links to FDN-014 CAPA ID
Action Owner
Occupational Health*
Signature*
Worker*
Second Signature*
HLT-012 · record IDs look like EHA-2026-000 · Links Worker, SEG
Open in KnowellaRun it with agents
From a document you fill in to a programme that runs itself
The clinical work belongs to the provider. What slips is the trigger, the confidentiality boundary, and the follow-through from one leaver's finding to the group still exposed.
Fires the exit assessment from the exposure group register at notice, pulls baseline and periodic history into the comparison, and keeps clinical content behind an occupational health boundary.
Takes a work-related finding out of the individual file into the exposure control review for the affected group, so a leaver's diagnosis becomes a change to the controls remaining workers rely on.
Joins the notice event to the surveillance obligation, so offboarding cannot close as complete while an owed exit assessment sits unbooked, and health records are excluded from leaver deletion runs.
Watches leavers against surveillance groups, flags the ones whose last working day is approaching with no assessment booked, and holds every write for approval before touching a record.
This template lives in KnowHealth — employee wellbeing. Exposure monitoring, health surveillance, case management and return to work.
Meet KnowHealth→Glossary
Exit Health Assessment definitions and key terms
- Health surveillance
- Ongoing health checks for workers exposed to hazards capable of causing identifiable disease, intended to detect adverse effects early and test whether controls are working.
- Baseline
- The pre-placement health measurement taken before exposure begins, against which all later assessments are compared; without it, change over employment cannot be established.
- Similar exposure group
- Workers whose tasks, materials and conditions give comparable exposure, used to decide who needs which surveillance and to generalise findings from one worker to the group.
- Fitness outcome
- The management-facing conclusion of a health assessment — fit, fit with restrictions, or not fit — deliberately stripped of the clinical detail that produced it.
- Latency
- The interval between exposure and the appearance of disease, which for several occupational conditions runs to decades and is why exit records outlive employment.
FAQ
Frequently asked questions about exit health assessment
Is an exit assessment legally required?+
In Great Britain and the EU it follows from the surveillance duty: if the exposure required surveillance in post, a closing record is expected. In the United States it depends on which substance standard applied. Where no duty exists, most organisations run it anyway, because the evidential value at a later claim is the point.
What if the worker declines?+
Record the assessment as offered, acceptance as no, and enter the reason where one is given. The employer's obligation is to offer, arrange and document; attendance is the worker's decision. A documented decline is a strong position. An assessment that was never offered is not.
Who can see the record?+
Occupational health holds the clinical content. Management receives a fitness outcome and any restrictions, nothing more. The template asks explicitly whether access is restricted, because the most common breach is a well-meaning administrator filing the full report where HR can read it.
How long must the record be kept?+
Longer than anything else in the worker lifecycle: employment plus thirty years under 29 CFR 1910.1020, at least forty under COSHH Reg.11 and the EU carcinogens directive, with the EU clock running from the end of exposure. Routine leaver deletion must exclude these files.
What happens if an adverse finding appears at exit?+
Three things in parallel: a referral where clinically indicated, a case record so the follow-up has a thread, and an exposure control review for the group, because a work-related effect in one leaver is information about everyone still doing that job.
Can the template be changed?+
Yes. Every field, option, score and conditional rule is editable, and the links to the worker profile and the similar exposure group register travel with it. Most organisations extend the assessment type list to match the modalities their provider offers.
Keep going
Related templates and programmes
Industries this is written for
Programmes this belongs to
Used together in Occupational Health Surveillance
Similar Exposure Group Register
Groups workers who share the same tasks, agents and exposure patterns
Qualitative Exposure Assessment
Rates likely exposure using professional judgement, task knowledge and existing data, before any sampling
Personal Air Sampling Record
Records a sample taken from a worker's breathing zone over a shift
Area Monitoring Record
Records fixed point sampling in a work area rather than on a person
Noise Dosimetry Record
Records a worker's noise exposure over a full shift using a personal dosimeter
Chemical Exposure Assessment
Assesses exposure to a specific chemical across the tasks where it is used
More in Health Surveillance
Health Surveillance Plan
Sets out which workers need which health checks, how often and why
Pre-Placement Health Assessment
Assesses whether a worker can safely perform the physical demands of a role, before they start
Periodic Health Assessment
A scheduled health check for workers exposed to specific hazards
Health Referral Record
Records a referral to occupational health, with the reason and what is being asked
Vaccination Record
Records vaccinations offered and given where a role carries biological risk
Health Surveillance Compliance Review
Checks that scheduled health assessments are actually happening on time
Written and reviewed by
Siddarth Singh
Founder & Chief Executive Officer, Knowella
Certified Safety Professional and industrial and systems engineer with more than a decade inside food supply chain, freight and manufacturing operations. This page was written against the current text of the standards it cites, not against secondary summaries of them.
- Certified Safety Professional (CSP), Board of Certified Safety Professionals
- MBA, University of Chicago Booth School of Business
- MS and BS, The Ohio State University, Industrial and Systems Engineering
- Six Sigma Black Belt
Sources and last review. Reviewed 16 August 2026 against:
- 29 CFR 1910.1020 — access to employee exposure and medical records, retention and employee access
- 29 CFR 1910.95(m) — occupational noise exposure, audiometric record retention
- COSHH 2002 Reg.11 — health surveillance and health records
- Directive 2004/37/EC Art.14 — health surveillance for carcinogens and mutagens
- ISO 45001:2018 cl.10.2 — incident, nonconformity and corrective action
This page is general guidance, not legal advice. Confirm requirements with your jurisdiction’s regulator.