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Health Hazard Evaluation Form for Philippines

Health Hazard Evaluation Form Template for Philippines

A comprehensive workplace assessment document compliant with Philippine regulations, specifically designed to identify, evaluate, and document potential health hazards in the workplace. This form aligns with Republic Act No. 11058 and DOLE Department Order No. 198-18, providing a structured approach to assess chemical, physical, biological, ergonomic, and psychosocial hazards. It includes detailed sections for risk assessment, control measures, and recommendations, serving as both a compliance document and a practical tool for improving workplace safety and health conditions.

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What is a Health Hazard Evaluation Form?

The Health Hazard Evaluation Form is a crucial document required under Philippine labor laws and occupational safety regulations. It serves as a systematic tool for assessing and documenting workplace health risks in compliance with Republic Act No. 11058 and its implementing rules. The form is mandatory for businesses operating in the Philippines where workers may be exposed to health hazards, and must be completed by qualified safety officers or occupational health professionals. It encompasses comprehensive evaluation of various hazard types, exposure assessments, control measures, and compliance status with relevant DOLE and DOH standards. This document plays a vital role in risk management, regulatory compliance, and protecting worker health and safety.

What sections should be included in a Health Hazard Evaluation Form?

1. Form Identification: Form number, date, and revision number for document control

2. Facility Information: Name and complete address of the workplace, type of business/industry, total number of workers

3. Evaluation Team: Names, positions, and qualifications of personnel conducting the evaluation

4. Purpose of Evaluation: Reason for conducting the hazard evaluation (routine, incident-based, or complaint-based)

5. Area/Process Description: Detailed description of the workplace area or process being evaluated

6. Hazard Categories Assessment: Systematic evaluation of chemical, physical, biological, ergonomic, and psychosocial hazards

7. Exposure Assessment: Documentation of exposure levels, duration, and frequency for identified hazards

8. Control Measures: Existing control measures and their effectiveness

9. Risk Assessment: Evaluation of risk levels based on likelihood and severity of health impacts

10. Recommendations: Specific corrective actions and preventive measures

11. Compliance Status: Assessment of compliance with relevant DOLE and DOH regulations

What sections are optional to include in a Health Hazard Evaluation Form?

1. Emergency Response Procedures: Required when evaluating high-risk areas or processes with potential for immediate health emergencies

2. Environmental Impact: Include when operations may affect community health or environment

3. COVID-19 Risk Assessment: Required for workplaces with high human interaction or as per current health protocols

4. Noise Level Assessment: Required for industrial or manufacturing facilities

5. Air Quality Monitoring: Include for indoor workplaces or facilities with potential air contaminants

6. Special Population Considerations: Required when workplace includes pregnant women, PWDs, or other vulnerable groups

What schedules should be included in a Health Hazard Evaluation Form?

1. Appendix A: Hazard Measurement Data: Detailed measurements, sampling results, and technical data from hazard assessments

2. Appendix B: Photographic Documentation: Visual evidence of hazards, control measures, and workplace conditions

3. Appendix C: PPE Requirements: Detailed list of required personal protective equipment for identified hazards

4. Appendix D: Reference Standards: Applicable DOLE, DOH, and international standards used in the evaluation

5. Appendix E: Testing Equipment Calibration Records: Certification and calibration records for measurement equipment used

6. Appendix F: Previous Assessment History: Summary of previous evaluations and status of implemented recommendations

Authors

Alex Denne

Head of Growth (Open Source Law) @ Ƶ | 3 x UCL-Certified in Contract Law & Drafting | 4+ Years Managing 1M+ Legal Documents | Serial Founder & Legal AI Author

Jurisdiction

Philippines

Publisher

Ƶ

Cost

Free to use
Relevant legal definitions







































Clauses




















Relevant Industries

Manufacturing

Construction

Mining

Healthcare

Chemical Processing

Agriculture

Pharmaceuticals

Food Processing

Automotive

Electronics Manufacturing

Textile Industry

Oil and Gas

Shipping and Maritime

Waste Management

Laboratory and Research

Relevant Teams

Health and Safety

Occupational Health

Risk Management

Compliance

Operations

Quality Assurance

Production

Facilities Management

Human Resources

Environmental Management

Medical Services

Emergency Response

Industrial Hygiene

Legal

Worker Representatives

Relevant Roles

Safety Officer

Industrial Hygienist

Occupational Health Nurse

Environmental Health Officer

Risk Management Specialist

Compliance Manager

Quality Assurance Manager

Production Supervisor

Facility Manager

Operations Director

HSE Coordinator

Plant Manager

Laboratory Supervisor

Medical Officer

Safety Engineer

Industries







Teams

Employer, Employee, Start Date, Job Title, Department, Location, Probationary Period, Notice Period, Salary, Overtime, Vacation Pay, Statutory Holidays, Benefits, Bonus, Expenses, Working Hours, Rest Breaks,  Leaves of Absence, Confidentiality, Intellectual Property, Non-Solicitation, Non-Competition, Code of Conduct, Termination,  Severance Pay, Governing Law, Entire Agreemen

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