What this is
What is a periodic health assessment?
What is a periodic health assessment?
A periodic health assessment is a scheduled, recurring check for a worker in a role with a specific exposure, run at the interval the health surveillance plan sets, to detect any adverse effect developing before it becomes irreversible.
How is it different from a pre-placement assessment?
A pre-placement assessment happens once, before a worker starts a role, to confirm fitness for its demands. A periodic assessment happens repeatedly, throughout the exposed role, and depends on the pre-placement baseline to have anything to compare against.
What decides the interval between assessments?
The hazard-specific standard governing the exposure. Noise, respiratory hazards, skin exposure and biological monitoring each carry their own interval, set in the surveillance plan for each group.
Scope
When is a periodic health assessment required?
This assessment is the recurring step in a surveillance schedule that a hazard exposure has already put a worker onto. Used outside that schedule, or without the baseline it depends on, it produces a result with nothing to be compared against.
Use this template when
- A worker is in a role the health surveillance plan has assigned to a recurring surveillance programme, and the due date has arrived
- A similar exposure group's surveillance plan sets the interval this assessment is being run against
- A prior periodic assessment or the pre-placement baseline exists, so the result has something to be compared to
- You are running the Occupational Health Surveillance programme and this is the recurring step within it
- A linked record needs this one to exist: the worker and the similar exposure group the surveillance plan covers
Do not use it for
- Pre-Placement Health Assessment, the one-time check before a worker starts, which establishes the baseline this assessment compares against
- Exit Health Assessment, which records health status when a worker leaves a hazardous exposure, closing the surveillance record rather than continuing it
- Health Surveillance Plan, which sets the schedule and interval this assessment is run against, rather than the individual result itself
- Chemical Exposure Assessment or the relevant exposure record, which examines the hazard and controls directly rather than the worker's health outcome
- A one-off medical check with no surveillance plan behind it, which is not what this template is for regardless of how similar the form looks
Compliance mapping
Which OSHA substance specific standards requirements does this satisfy?
Periodic health assessment sits inside OSHA's substance-specific medical surveillance provisions in the US, and inside COSHH-type surveillance duties elsewhere, both prescribing surveillance at intervals tied to the specific hazard rather than a general schedule.
| Clause | Requirement | Where it lands |
|---|---|---|
| OSHA substance-specific standards, e.g. 29 CFR 1910.1000 subpart Z | Periodic medical surveillance required at defined intervals for workers exposed above the substance's action level or limit | Header |
| OSHA 29 CFR 1910.95(g) | Annual audiometric testing for workers in a hearing conservation programme, compared to the baseline audiogram | Assessment carried out |
| OSHA 29 CFR 1910.134(e) | Periodic medical evaluation for continued respirator use where protection factor or duty conditions change | Assessment carried out |
| OSHA 29 CFR 1904.5 | Work-relatedness determination required for a recordable adverse health finding linked to occupational exposure | Findings |
| OSHA 29 CFR 1910.1020 | Access to exposure and medical records restricted and controlled, with employee access rights preserved | Header |
| ISO 45001 cl.9.1.1 | Monitoring and measurement of the effectiveness of controls, which surveillance findings are evidence for or against | Consequences |
| Human rights legislation, duty to accommodate | A fitness outcome short of unrestricted fit triggers consideration of accommodation rather than automatic removal from the role | Consequences |
What it does not cover
- Pre-Placement Health Assessment, the one-time entry check that establishes the baseline this assessment must be compared against.
- Exit Health Assessment, which closes out the surveillance record when the worker leaves the exposed role.
- Health Surveillance Plan, which decides who is on this schedule and at what interval, rather than recording an individual result.
- Chemical Exposure Assessment or the relevant exposure record, which examines the hazard and controls directly, triggered by but distinct from a finding here.
- A CAPA or corrective action record, which carries the actual remediation once an adverse finding or review has identified what needs to change.
Global
Periodic Health Assessment requirements by country
The duty to run recurring, hazard-specific checks is set substance by substance in the US, through a general surveillance duty in the UK, and through a management-system monitoring requirement internationally.
OSHA substance-specific standards, 29 CFR 1910 subpart Z (e.g. lead 1910.1025, noise 1910.95, respiratory protection 1910.134)
Each substance or hazard carries its own medical surveillance provisions, with its own trigger levels and prescribed interval.
There is no general periodic assessment standard; interval and content are set by the specific hazard standard, not a company default.
Control of Substances Hazardous to Health Regulations 2002, regulation 11
Surveillance is required where exposure could result in an identifiable disease or effect, and a valid technique must exist to detect it.
Surveillance is only required where a valid detection technique exists; the duty is tied to what can be measured, not to exposure alone.
ISO 45001, clause 9.1.1
Monitoring and measurement of the effectiveness of controls is a management system requirement, and surveillance results are evidence within it.
An adverse periodic finding is treated as a signal about the control, not filed only as an individual medical event.
How to complete it
How to complete a periodic health assessment, step by step
The interval and the test almost always get run as scheduled. What determines whether the assessment catches a developing problem is what happens to the result once it exists.
Annual is a default, not a rule. The interval that matters is the one the substance-specific standard sets for the actual exposure, and a plan running everyone on the same generic cycle is tracking the calendar, not the hazard.
Both figures should be recorded, and neither substitutes for the other. A run of small changes from the previous assessment is exactly the pattern a baseline comparison exists to catch.
A developing health effect in an exposed worker is evidence a control has failed for the group, not only the individual. The finding should trigger a review of the exposure assessment, and closing it as a personal medical matter loses that signal.
The same confidentiality boundary that applies at pre-placement applies here without loosening. The manager needs to know whether the worker can continue and under what restriction, not what the finding was or what caused it.
What auditors find
Most common periodic health assessment findings
The assessment is almost always completed. The findings concern whether the comparison was made and whether an adverse result went anywhere beyond the individual file.
| Finding | Clause | What fixes it |
|---|---|---|
| Assessment run later than the interval the substance-specific standard requires, with no escalation recorded. | OSHA substance-specific standards | Flag a late or missed assessment against the standard's own interval and route it for immediate scheduling. |
| Change recorded against the previous assessment only, with no comparison against the original baseline. | OSHA 29 CFR 1910.95(g) | Require both comparisons on every record; a cumulative shift from baseline can exist even where each prior comparison looked minor. |
| Adverse health effect detected with no linked review of the exposure assessment or controls. | ISO 45001 cl.9.1.1 | Make an adverse finding automatically raise the review of the relevant exposure assessment. |
| Finding judged possibly or likely work-related with no work-relatedness determination or referral on file. | OSHA 29 CFR 1904.5 | Record the work-relatedness determination explicitly and raise a referral wherever the answer is not a clear no. |
| Clinical detail behind the finding reaches the manager rather than fitness and restrictions alone. | OSHA 29 CFR 1910.1020 | Restrict the manager-facing outcome to fitness and restriction summary; keep the finding with occupational health. |
| Fitness outcome other than unrestricted fit recorded with no accommodation consideration or restriction record raised. | Human rights legislation, duty to accommodate | Require a restriction record and accommodation reasoning before any change to duties is actioned. |
Case in point
Case in point: three slight changes and no significant one
A foundry ran annual audiometric testing for workers in its hearing conservation programme. One worker's results for three consecutive years each came back a slight change from the previous assessment, comfortably inside what the provider treated as unremarkable year-on-year variation, and each assessment closed without further action.
A referral triggered by an unrelated symptom four years in led a specialist to compare the worker's latest audiogram directly against the original baseline rather than the previous assessment. The cumulative shift across three years met the threshold for a standard threshold shift, available in the data the whole time but never read against baseline at any of the three assessments in between.
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.
4 sections
- Reference
- HLT-011
- Archetype
- Assessment
- Record ID
- PHA-2026-000
- Scoring
- Fit, fit with limits, unfit
- Direction
- n/a
- Singleton
- No
- Basis
- OSHA substance specific standards
- Links
- Links Worker, SEG
- Tags
- Health, Surveillance
- Sections
- 4
- Fields
- 45
- Follow up fields
- 7
- Repeating sections
- 0
- Links out
- 7
Header
17 fieldsAssessment ID*
Auto sequence. Format PHA-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
Surveillance Programme*
Due Date*
Completed On Time*
- Yes3 pts
- Late1 pt
- Not completed0 pts
Plan ID
Links to HLT-009 Plan ID
Years In Exposed Role
Assessment carried out
5 fieldsAssessment Type*
Carried Out By*
Qualified occupational health practitioner, technician under supervision, or self questionnaire.
Baseline Available For Comparison*
- Yes3 pts
- No0 pts
Change From Baseline*
- None3 pts
- Slight1 pt
- Significant0 pts
Change From Previous Assessment*
- None3 pts
- Slight1 pt
- Significant0 pts
Findings
6 fieldsAdverse Health Effect Detected*
- No3 pts
- Yes0 pts
Effect Category
Hearing, respiratory, skin, musculoskeletal or other. No diagnosis recorded here.
Severity
- Minor3 pts
- Moderate1 pt
- Serious0 pts
Likely Work Related
- No3 pts
- Possibly1 pt
- Yes0 pts
Referral Made
Referral ID
Links to HLT-013 Referral ID
Consequences
17 fieldsFitness Outcome*
- Fit3 pts
- Fit with restrictions2 pts
- Temporarily unfit1 pt
- Unfit0 pts
Restrictions Apply*
- No3 pts
- Yes1 pt
Restriction Record ID
Links to HLT-017 Record ID
Exposure Assessment Review Triggered*
An adverse finding means a control has failed. Reviewing the exposure is not optional.
- Yes3 pts
- No0 pts
Assessment ID
Links to HLT-006 Assessment ID
Case ID
Work related ill health is a reportable event in most jurisdictions.
Thread key
Worker Advised Of Results*
- Yes3 pts
- No0 pts
Manager Informed Of Outcome Only*
- Yes3 pts
- More was shared0 pts
Next Assessment Due*
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-011 · record IDs look like PHA-2026-000 · Links Worker, SEG
Open in KnowellaRun it with agents
From a document you fill in to a programme that runs itself
The individual assessment nearly always happens on schedule. What fails is the connection outward, from one visit to the trend across visits, and from an adverse finding to the control it is evidence about.
Holds each periodic assessment against the worker's baseline and prior results, and surfaces a cumulative shift no single comparison would show.
Receives the trigger from an adverse finding and connects it to the relevant exposure assessment and similar exposure group for review.
Tracks due dates against each hazard standard's own interval and escalates a missed assessment before it rolls into the next cycle unremarked.
This template lives in KnowHealth — employee wellbeing. Exposure monitoring, health surveillance, case management and return to work.
Meet KnowHealth→Glossary
Periodic Health Assessment definitions and key terms
- Standard threshold shift
- A defined amount of hearing loss, averaged across specified frequencies, measured against the baseline audiogram rather than the previous test.
- Similar exposure group
- A group of workers with reasonably comparable exposure to a hazard, used to assign a shared surveillance schedule rather than assessing individually.
- Baseline
- The first measurement taken at pre-placement, held as the fixed reference point every subsequent periodic assessment is compared against.
- Work-relatedness
- The determination of whether a health effect is plausibly connected to occupational exposure, deciding whether it must be recorded and referred.
- Surveillance interval
- The time between recurring assessments, set by the applicable hazard-specific standard rather than organisational convention.
FAQ
Frequently asked questions about periodic health assessment
How often should a periodic health assessment happen?+
At the interval the hazard-specific standard sets for the exposure the worker is under. Noise, respiratory and biological hazards each carry their own interval, recorded in the health surveillance plan for each exposed group, not decided fresh each time.
Should the result be compared to the last assessment or to baseline?+
Both, kept as separate figures. A comparison to the previous assessment alone can look unremarkable for years while a cumulative shift from baseline builds underneath it, exactly the pattern periodic surveillance exists to catch.
What happens when an adverse finding is detected?+
It should trigger a review of the exposure assessment behind the worker's surveillance plan, not just a note on the individual's file. An adverse finding is evidence about the control, and treating it purely as a personal health event loses that signal for the group.
What can the employer be told about the result?+
Fitness and any restrictions, nothing else. The same confidentiality boundary that applies to a pre-placement assessment applies here without loosening; the finding itself stays with occupational health.
Does a work-related finding have to be reported?+
Where the finding is judged possibly or likely work-related, a work-relatedness determination and a referral should be on the record, not left implicit in a severity rating.
What if the worker misses their due date?+
A missed or late assessment should be escalated against the hazard standard's own interval, not folded into the next routine cycle. The interval exists because the exposure continues regardless of the calendar.
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
Exit Health Assessment
Records a worker's health status when they leave a role with hazardous exposure
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:
- OSHA 29 CFR 1910.1000 subpart Z, substance-specific medical surveillance provisions
- OSHA 29 CFR 1910.95(g), hearing conservation audiometric testing
- OSHA 29 CFR 1910.134(e), respiratory protection periodic medical evaluation
- Control of Substances Hazardous to Health Regulations 2002, regulation 11 (UK)
- ISO 45001:2018 clause 9.1.1, monitoring, measurement, analysis and evaluation
This page is general guidance, not legal advice. Confirm requirements with your jurisdiction’s regulator.