Occupational Safety and Hygiene for Disabled Employees
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Appendix B: Environmental risks survey for employees with
physical and sensorial disabilities
Employees with physical and sensorial disabilities – environmental safety and
health survey
Left
Right
Dominance
No
Yes
Shifts
Diagnosis:
Job:
Employment Percentage:
Is there an accessibility officer in the workplace
Did the accessibility coordinator pass accessibility
coordinators course
Remarks – mark: 1- in order, 2- needs to be improved, 3- problematic
Everything marked 3 requires immediate care, everything marked 2 needs to be taken care
of as well.
1. To what extent can the employee get injured on his way from the parking lot
to the door of his workplace from each of the following potential obstacles?
Unmarked areas, traffic of vehicles on the road, unmarked areas, pits, trenches and beams,
sharp or smooth slopes, stairways, unstitched or unglued carpets, and more.
Stairways
Vehicles
traffic on
the road
Sharp
slopes
Pits
Trenches /
beams
S
mooth
area
Unmarked
Road
With disability
Without disabilit
y
