Workplace Exposure Assessment Record Template

What requires or shapes this record

No source opened for this page gives one rule for how an exposure assessment must be recorded, and this form does not say that any record, measurement or limit is or is not required where you work. What the sources set are duties around assessing and controlling exposure. In Great Britain, regulation 6 of the COSHH Regulations 2002 asks employers to assess the risk from work with substances hazardous to health, with the exposure level, type and duration, any relevant exposure limit, the controls and any monitoring results all considered, and regulations 7, 9, 10 and 11 deal with control, maintenance and testing, monitoring and health surveillance. HSE's COSHH pages explain the steps and the role of workplace exposure limits. In the United States, 29 CFR 1910.1000 limits exposure to the substances listed in its tables and says controls come before protective equipment. CCOHS in Canada describes exposure limits and the hierarchy of controls, and warns against treating a limit as a line between safe and unsafe. EU rules and other national rules were not opened for this page, so check the ones that apply to you. The form takes no position on which limit applies to your agent: you enter the value, its source and its date. The form is a voluntary record, the section titles and tick choices are our own wording, and this page is not legal advice.

• Control of Substances Hazardous to Health Regulations 2002 (SI 2002/2677), regulations 6, 7, 9, 10 and 11 (Great Britain; legislation.gov.uk, read 20 October 2026)

  Regulation 6 says an employer must not carry out work liable to expose employees to a substance hazardous to health without a suitable and sufficient assessment of the risk, and lists what the assessment includes: the hazardous properties and the supplier's information including any safety data sheet, the level, type and duration of exposure, the amount involved, activities such as maintenance with a potential for high exposure, any relevant workplace exposure limit or similar occupational exposure limit, the effect of the controls, the results of monitoring and of health surveillance, and combined exposure to more than one substance. It must be reviewed regularly, and at once if there is reason to suspect it is no longer valid, the work changes significantly or monitoring results make it necessary; an employer with five or more employees records the significant findings. Regulation 7 asks for exposure to be prevented or, where that is not reasonably practicable, adequately controlled, with substitution by preference and protection measures in an order of priority that puts protective equipment last and only in addition to the other measures. Regulation 9 covers maintenance, examination and testing of controls, with local exhaust ventilation examined at least every 14 months unless a schedule says otherwise, and a record kept for at least 5 years. Regulation 10 asks for monitoring where the assessment shows it is needed, unless another method of evaluation shows control is adequate, at regular intervals and when a change may affect exposure, and sets record keeping of at least 5 years or, for a record representative of the personal exposures of identifiable employees, at least 40 years. Regulation 11 asks for health surveillance where it is appropriate, in the cases the regulation describes. The site notes that revised legislation may not be fully up to date, so check the current text. This form records the points of regulation 6 in our own wording, and a completed form does not show that you meet any of these regulations.

• HSE, COSHH basics: How to carry out a COSHH risk assessment; Workplace exposure limits; Monitoring the control of exposure to hazardous substances; COSHH health surveillance (Great Britain; four pages under hse.gov.uk/coshh/basics, read 20 October 2026, no date shown)

  The assessment page says harmful substances include those made by a process, such as wood dust from sanding, silica dust from tile cutting and welding fume, and that an assessment asks how workers might be exposed (breathed in, on or through the skin or swallowed), how often and for how long, who else could be exposed (maintenance workers, contractors, visitors), what is already done and what further action is needed, by whom and by when. It lists controls from elimination, changing the process, containment, systems of work and cleaning to protective equipment, and says not to opt for protective equipment automatically because it is not as reliable or effective as other measures. It asks for the controls to be reviewed to check they work and for review if staff, a process, the substances or the equipment change, or after problems, accidents or near misses, and it says workers must be made aware of the results of monitoring. The exposure limits page says GB workplace exposure limits are concentrations in air averaged over a set period, that only about 500 substances have one, that the list in EH40 is legally binding under COSHH, that a monitoring measurement of what a worker breathes can show whether exposure is below the limit, and that for carcinogens, mutagens and asthmagens exposure must be controlled to as low as reasonably practicable. The monitoring page says monitoring means measuring to show that control is adequate and has nothing to do with the state of a worker's health, and it separates screening, personal air monitoring and biological monitoring. The health surveillance page says it means obtaining information about employees' health, that the clinical outcomes are personal, and that an occupational health professional may need to do it. That is why the form keeps exposure monitoring and health surveillance apart and holds no health details.

• 29 CFR 1910.1000, Air contaminants (United States; eCFR text current to 16 October 2026, read 20 October 2026 through the eCFR API; OSHA's own site was not read)

  A US rule for general industry. It limits an employee's exposure to the substances listed in its Tables Z-1, Z-2 and Z-3. A ceiling value, marked C, must never be exceeded, and other Table Z-1 limits are 8-hour time weighted averages over a shift of a 40-hour week. Paragraph (d) gives a formula for the equivalent exposure over a shift, adding concentration times duration for each period and dividing by 8, and a formula for mixtures that adds each concentration divided by its limit and requires the total not to exceed 1. Paragraph (e) says administrative or engineering controls must first be determined and implemented whenever feasible, and that protective equipment or other measures are used when they are not feasible, with respirator use following 29 CFR 1910.134. The rule covers listed substances only and applies in the US, so the table that applies to you may differ. The form does not hold any of its limit values and does not claim to meet it. The rule's text is not reproduced here.

• CCOHS, Occupational Hygiene: Occupational Exposure Limits (OSH Answers, last revised 25 March 2022) and Hazard and Risk: Hierarchy of Controls (OSH Answers, last revised 14 August 2024) (Canada, read 20 October 2026)

  The first fact sheet says an occupational exposure limit is generally the level of exposure, for a length of time (usually 8 hours), that is not likely to affect a worker's health, that different organisations name them differently (ACGIH threshold limit values, NIOSH recommended exposure limits), and that a list of Canadian legislative references is available. It describes time-weighted average, short-term and ceiling values and says the limits are set for an 8-hour day and 40-hour week, so longer shifts need an adjustment. It warns that a limit should never be seen as a line between safe and unsafe and that exposure should be kept as low as possible, applying the as low as reasonably practicable principle to carcinogens and allergens. It gives a way to add up exposure to several substances with a similar effect and lists cases where that should not be used. The second fact sheet describes the hierarchy of controls as a step-by-step approach, from most to least effective: elimination, substitution, engineering controls, administrative controls and protective equipment, with some sources adding a layer of warning systems between engineering and administrative controls. It says engineering controls are reliable if designed, used and maintained properly, that administrative controls rank lower because the hazard remains, that the controls should be reviewed to see they work and do not create new hazards, and that both the hazard and the control should be monitored. The form's order of controls follows this ranking in our own wording, and the OEL sheet's remarks on limits shaped the comparison and decision sections.

Each source checked on 20 October 2026. Not legal advice; check the text in force for your site.

Field by field

The form records one assessment of one agent for one exposed group, so that a later reader can see what was assessed, against which limit, how exposure was found and why the decision was made. It supplies no limit values: you enter the value, its source and its date. It holds roles and amounts, not people and their health: do not record individual health data on it. It is not the SDS summary (a register of agents and their hazard information), not the risk matrix (a scoring scale) and not the workplace inspection checklist (a routine look at conditions). The section titles, tick choices and example wording are ours and can be changed; keep the same headings from one assessment to the next so that records can be compared.

Record details

Why: A result belongs to one assessment, one date, one site and one assessor. The version and the record it replaces show how this assessment follows an earlier one. The assessor's training or competence is there because a reader judging the result needs to know who made the judgement.

Common mistake: Overwriting the earlier assessment, so nobody can say what was concluded last time or what changed.

The agent and where it comes from

Why: HSE notes that harmful substances include those made by a process, such as wood dust from sanding or welding fume, and not only products with a label. Writing the source, the form and the amount used or released says what the exposure is of.

Common mistake: Naming the product but not the process that releases the dust, fume or noise, which is often where the exposure comes from.

Safety data sheet or other hazard information

Why: COSHH regulation 6 includes the supplier's information, with any safety data sheet, among the points to consider. The revision date shows which version was read. A sheet is an input and not an assessment, and the hazards are written in words with no individual health information.

Common mistake: Taking the sheet as the assessment, or reading an old revision.

Who is exposed

Why: The level, type and duration of exposure and the number of people exposed all matter, and HSE says not to forget maintenance workers, contractors and visitors. Roles keep the record about the work and not about named people.

Common mistake: Listing only the operators and missing the cleaner or the maintenance fitter, or writing the names of people instead of roles.

Tasks and how exposure happens

Why: HSE asks how exposure happens (breathed in, on or through the skin or swallowed), how often and for how long. A table of tasks with their peaks shows which task drives the exposure, so the controls can be aimed there.

Common mistake: Describing the whole job as one exposure, so a short, intense task is averaged away and never controlled.

Existing controls, in order of the hierarchy

Why: COSHH regulation 7 and the CCOHS fact sheet rank controls, with protective equipment last and only in addition where other measures cannot control exposure. Writing why a higher level is not used shows that it was considered, and the evidence column shows the control was checked.

Common mistake: Listing protective equipment first, or listing a control that is in place on paper but never tested.

Exposure limit or reference value you chose

Why: The form supplies no limit values. You enter the value with its units and averaging period, the document and edition it came from, the date of that edition and the date you checked it, because limits change and differ between countries and bodies. HSE says the GB list in EH40 is legally binding under COSHH, and CCOHS notes that other limits are set by professional organisations such as ACGIH and NIOSH, which name their values differently.

Common mistake: Writing a number with no source and no date, or using a guideline value as if it were the legal limit, or the reverse.

Measurement or estimate used

Why: A result is only as good as how it was found. The basis, method, dates, who did it and the instrument and laboratory report let a reader judge it. HSE separates screening, personal air monitoring and biological monitoring; this form is for exposure measures only.

Common mistake: Writing "sampled" with no method, date or report, so the result cannot be checked or repeated.

Result, units and sample duration

Why: A result without units and a duration cannot be compared with a limit that has an averaging period. Where there are several periods, the average over the same period as the limit is worked out and the working shown, as in the formula in 29 CFR 1910.1000(d).

Common mistake: Comparing a 15-minute result with an 8-hour limit, or averaging over only the hours that were sampled.

Representative or not

Why: A result describes one day, one person and one set of conditions. Saying whether it is representative, and why, with the days and shifts sampled and whether the controls were running as usual, tells the reader how far to trust it.

Common mistake: Sampling on the quietest day, or sampling the person least exposed, and treating the result as typical.

Comparison with the limit

Why: States above, below or uncertain, in the same units and averaging period, with the reasoning. CCOHS says a limit should never be seen as a line between safe and unsafe, and where exposures to several substances with a similar effect are combined, 29 CFR 1910.1000(d) and CCOHS describe a sum of each concentration divided by its limit.

Common mistake: Writing "below the limit" with no margin and no mention of what makes the result uncertain.

Decision

Why: Acceptable, reduce further or measure more, with the reason. Below the limit is not by itself the end of the question where your rules say to keep exposure as low as reasonably practicable. HSE gives carcinogens, mutagens and asthmagens as GB examples.

Common mistake: Ticking acceptable because the number is under the limit, without asking whether a higher level of control is practicable.

Actions

Why: Each action says what will change, at which level of the hierarchy, who owns it, when it is due, when it was done and who checked it. HSE asks what further action is needed, who carries it out and by when.

Common mistake: An action with no owner or date, or one closed by the person who raised it without a check that the control then worked.

Health surveillance or monitoring needed

Why: HSE says monitoring is measuring and has nothing to do with the state of a worker's health, while health surveillance is about people and its clinical results are personal. The form records only whether surveillance is needed and who decides, not any health details, and whether repeat exposure monitoring is needed. Regulation 11 describes when surveillance is appropriate in Great Britain.

Common mistake: Writing an individual's symptoms or test results on this form, where many people can read them.

Review date and triggers for an earlier review

Why: COSHH regulation 6 asks for review regularly and at once on certain events, and HSE lists changes of staff, process, substances or equipment, and problems, accidents or near misses. The triggers are ticked so the review is not left to memory. Concerns are recorded as concerns, not as who raised them.

Common mistake: Setting a review date but no triggers, so a changed process runs for months on the old assessment.

Sign-off

Why: Shows who assessed, who reviewed and who owns the process. HSE says workers must be made aware of the results of monitoring, so the form records how and when the results were shared, and where the record is kept and for how long, which depends on your rules. COSHH regulation 10 sets 5 or 40 years for monitoring records in Great Britain.

Common mistake: Signing the assessment and never telling the people who are exposed what it found.

Worked example

IllustrativeA record for an invented powder-filling line (invented product, company, limit and figures: the limit is not a real one)

The figures, the limit and the trigger are invented to show the method and are not recommendations or real limits. The arithmetic checks: 3.0 x 2 = 6.0, 0.5 x 6 = 3.0, 6.0 + 3.0 = 9.0, and 9.0 / 8 = 1.125. One shift cannot show what other shifts are like, which is why the decision is to measure more.

When a spreadsheet stops being enough

A word-processor or spreadsheet file works for a few agents and one assessor. It stops working when many agents and exposed groups are assessed on a schedule, when each result must be tied to the limit, its source and the date it was checked, and when a new edition of a limit or a new safety data sheet revision must lead to a review. It also strains when laboratory reports and sampling results must be matched to the right group and shift, and when reviews, actions and their owners must be chased.

A software record holds the assessment for each agent and group, keeps the limit with its source, edition and date as data, links sample results to the task and the exposed group, shows results against the limit over time, and turns a decision to reduce or measure more into actions with an owner and a due date. Ask where any health information would be kept and who could see it, because this form deliberately holds none. The list below applies the industrial hygiene rule used by that guide. Nothing in it shows that a product holds a record of this shape, so test it with one of your own assessments.

Same rule for every product: tagged “Industrial Hygiene”, “Occupational Health” or “Chemical Management”, with a sourced industrial hygiene or exposure assessment capability in its record, or one the vendor stated to us, labelled as vendor-stated. Documented and conditional capabilities qualify; check the linked scope before treating a module as included.

Tekmon pays for a sponsored placement (above); its place in this list follows the same rule as every entry. How lists are ordered

• 3E Protect · Chemical approval workflows · Documented

  Product scope and boundaries

  Vendor source · Profile checked 12 October 2026

• Tekmon · Industrial Hygiene (vendor-stated) · Vendor-stated, not yet publicly confirmed

  Product scope and boundaries

  Ask to see it in a demo · Profile checked 28 September 2026

• Cority · Industrial hygiene exposure assessment and sampling · Documented

  Product scope and boundaries

  Vendor source · Profile checked 14 October 2026

• VelocityEHS · Industrial hygiene programme and sample management · Documented

  Product scope and boundaries

  Vendor source · Profile checked 14 October 2026

All 4 matching profiles are shown. Documentation review, not hands-on testing or a claim of compliance.