health-risk-assessment

name	health-risk-assessment
description	Produces an occupational-health risk assessment for named tasks or roles — similar-exposure-group definition, hazard-to-OEL comparison, ergonomic scoring (RULA/REBA/NIOSH), and a health-surveillance schedule. Use this skill whenever a user asks to assess occupational-health risk, chemical/noise/vibration/ergonomic exposure, build similar-exposure groups, compare exposures to OELs, set up health surveillance, or run an ergonomics assessment. It groups workers by exposure, compares measured/estimated exposure to occupational exposure limits, scores manual-handling and posture risk with recognised tools, prioritises controls up the hierarchy, and sets an OEL-linked surveillance schedule — emitted as a branded report. Decision-support only; a competent person (occupational hygienist/physician) must review the output.
license	Apache-2.0
metadata	{"author":"eyekyam","version":"1.0","category":"occ-health","tier":3,"audience":["M","C","F"],"industry":["All"],"jurisdiction":["All"],"status":"stable","plugin":"hse-operations","bundled_in":["hse-manufacturing"],"hse_reviewed_by":"","hse_reviewed_date":""}

Health Risk Assessment

A consultant-grade occupational-health risk assessment for named tasks or roles. It groups workers into similar-exposure groups (SEGs), compares measured/estimated exposure to a cited occupational exposure limit (OEL/WEL/PEL), scores manual-handling and posture risk deterministically with the ergonomics engine (RULA / REBA / NIOSH lifting equation — never free-text scoring), ranks controls up the hierarchy of controls, and sets an OEL-linked health-surveillance schedule. It forces the single lever that separates a defensible artifact from copy-paste paperwork: task/SEG specificity plus the full hierarchy of controls — never a vague, PPE-only or surveillance-only treatment. Health-surveillance and exposure-monitoring data are special-category health data: reported by SEG/role, <5 health-outcome cells suppressed, never circulated with names. Decision-support only; a competent person (occupational hygienist / OH physician) must review the output.

When to use this skill

Use this skill when the user needs an occupational-health risk assessment for a concrete task or role — for example "assess the press-shop noise exposure for the operators", "build SEGs for the solvent-degreasing line and compare to the WEL", "score the manual handling on the despatch bay with NIOSH", or "set a health-surveillance schedule for the welding bay". Trigger phrases: health risk assessment, occupational-health risk, similar exposure group / SEG, OEL / WEL / PEL comparison, exposure monitoring, RULA, REBA, NIOSH lifting equation, manual handling, HAV/WBV, audiometry, health surveillance. If the request is vague ("do a health risk assessment"), the Workflow intake below refuses to proceed until the hazard type, the named SEG tasks/roles, and an exposure basis are captured — no exposure-vs-OEL comparison is produced before that.

Data Protection & De-identification (MANDATORY — apply before drafting)

Apply this BEFORE you draft anything. Treat injury, illness, and any health detail as the highest sensitivity. Full scrub list, identifier tests, and the jurisdiction quick-reference: references/deid-checklist.md.

1. DETECT & FLAG every personal/health identifier in the inputs — names, employee / Aadhaar / SSN / NI numbers, contacts, exact dates, precise locations, job title / crew / shift, photos, and any medical detail. List what you found before drafting. If unsure whether something is identifying, treat it as identifying.
2. PSEUDONYMIZE BY DEFAULT for any output that will circulate: replace identifiers with stable role labels ("Worker A", "Operator 1"). Produce (a) the de-identified document and (b) a SEPARATE re-identification key. Never put the key or any name↔label mapping in the document. Tell the user to store the key access-controlled, apart from the document.
3. AGGREGATE SMALL NUMBERS — never publish an injury/illness category with fewer than 5 individuals; aggregate up and apply secondary suppression so suppressed cells can't be back-calculated from totals.
4. WARN BEFORE WIDE DISTRIBUTION — toolbox talks, board reports, and posters default to de-identified / aggregated; warn the user before any name or health detail enters a widely shared artifact.
5. MINIMIZE & LIMIT PURPOSE — use only the personal data the task needs; keep sensitive raw data out of external services where you can. When in doubt, ask before including it.

Knowledge base (read ONE matching file — never load all)

Resolve the user's jurisdiction first. Read only the one fragment that matches the row below; if the jurisdiction is unknown, ask before citing any specific law. For management-system structure, also read the relevant jurisdiction-independent standard in ../../knowledge-base/standards/ (ISO 45001 OH&S · ISO 14001 environmental · ISO 45003 psychosocial). Always apply ../../knowledge-base/prompt-snippets/hierarchy-of-controls.md (KB-SNIP-HOC) to every control recommendation. For any benchmark/figure, look up the ID in the relevant _registry.yaml, then read ONLY the named file — and quote its source+year.

Jurisdiction / scope	Read
India	../../knowledge-base/regulatory/in-factories-act.md (+ in-state-forms.md for the user's state)
UK	../../knowledge-base/regulatory/uk-hswa.md
USA	../../knowledge-base/regulatory/us-osha.md
EU	../../knowledge-base/regulatory/eu-osh.md
Unknown	Ask before citing any specific law
OEL comparison (every run)	../../knowledge-base/data-points/oel-limits.md (KB-DATA-OEL-LIMITS) + ../../knowledge-base/data-points/exposure-limits.md (KB-DATA-EXPOSURE-LIMITS) — the ONLY OEL source; quote authority+year, never a parallel table
Ergonomics (when selected)	../../knowledge-base/standards/ghs-ergo.md (KB-STD-GHS-ERGO) + the ergonomics engine — RULA/REBA/NIOSH method facts
Surveillance cadence	../../knowledge-base/prompt-snippets/surveillance-triggers.md (KB-SNIP-SURVEILLANCE-TRIGGERS)

This skill always grounds in KB-STD-ISO45001 (6.1.2) and the operations clause cross-walk KB-SNIP-OPS-CLAUSE-MAP, applies KB-SNIP-HOC to every control, and resolves every exposure against a cited OEL/WEL/PEL from KB-DATA-OEL-LIMITS / KB-DATA-EXPOSURE-LIMITS (the single OEL source — no parallel OEL table, two disagreeing OEL sources are a defensibility risk). Ergonomic scores are the deterministic ergonomics engine's (RULA/REBA/NIOSH) grounded in KB-STD-GHS-ERGO; surveillance cadence follows KB-SNIP-SURVEILLANCE-TRIGGERS. For an India site resolve the state via KB-REG-IN-STATEFORMS (mandatory state detection). The rule-9 manifest is references/_skill-kb.md.

Workflow

Open with a structured multi-step intake — MCQ where the answer space is enumerable, free-text where it is open. Ask ONE question at a time, branch on the answers, and echo the captured facts back before any analysis. Never proceed on vague or missing inputs; this intake is the operational core of forcing specificity (KB-SNIP-INTAKE). (Intake is a Workflow convention, not a sixth block.)

Step 0 — Structured intake (run this first, one question at a time)

The full typed, branched intake — the intake-coverage manifest, the six-question table (Q1 health-hazard type [chemical/inhalation · noise · vibration HAV/WBV · manual-handling / ergonomics · thermal · biological] · Q2 tasks/roles & SEG basis [the specificity anchor — refuse generic] · Q3 exposure data [measured · estimated · none-yet → branch to a monitoring-strategy-first recommendation] · Q4 OEL source · Q5 ergonomics tool [RULA / REBA / NIOSH / manual-handling — asked only when ergonomics is selected] · Q6 jurisdiction), the ergonomics-tool branch, the no-data → monitoring-strategy branch, the mandatory India→state branch, the echo-back, and the refuse-on-vague anchors — lives in references/intake.md. Run it one question at a time, branch on the answers, echo the captured facts back before any analysis, and refuse to produce an exposure-vs-OEL comparison until the hazard type (Q1), the named SEG tasks/roles (Q2), and an exposure basis (Q3) are captured (record [ASSUMPTION] / [GAP], never invent).

The occupational-health risk-assessment method (SEG → OEL → ergonomics → controls → surveillance)

Full method in references/METHODOLOGY.md (the method snippet is KB-SNIP-SURVEILLANCE-TRIGGERS). Steps:

1. De-identify the inputs FIRST (special-category health data). Before any drafting (the deid block above + references/deid-checklist.md + the De-identifier-runs-first orchestration rule). Exposure-monitoring and surveillance results (audiometry, lung function, biological monitoring, HAV scores) are GDPR Art. 9 / DPDP special-category health data: scrub names to role labels, report by SEG/role not by individual, apply <5 small-cell suppression to any health-outcome breakdown, and never circulate a surveillance result with a name. Everything downstream consumes the scrubbed, SEG-labelled text.
2. Define the similar-exposure groups (SEGs). From the Q2 named tasks/roles, group workers with materially the same exposure into SEGs — the SEG is the unit of assessment and of surveillance. Refuse a generic SEG ("all staff"); a SEG names the task/role and the agent it is exposed to. Flag [GAP] where the basis is uncertain — never invent.
3. Characterise exposure & compare to a CITED OEL. For each SEG/agent, state the measured or estimated exposure (Q3) and compare it to the binding OEL/WEL/PEL resolved with source+year from KB-DATA-OEL-LIMITS / KB-DATA-EXPOSURE-LIMITS (the single OEL source). An exposure assessed with no cited OEL is a defect (specificity · regulatory_citation_accuracy). If Q3 is none-yet, do not fabricate a comparison — recommend a monitoring strategy first and stop the comparison.
4. Score ergonomic risk with the engine (deterministic). When the hazard is manual-handling/ergonomics, call the ergonomics engine via the scripts/hse_components symlink — ergonomics.rula_score(...) / ergonomics.reba_score(...) / ergonomics.niosh_rwl(...) per the Q5 tool — then ergonomics.to_report_blocks(result) to drop the tool-named [metrics, table] pair (RULA grand score + action level / REBA final score / NIOSH RWL + Lifting Index) straight into report.json. The score is the engine's, never narrated free-text; grounded in KB-STD-GHS-ERGO.
5. Rate residual health risk & rank controls up the hierarchy. Rate the residual health risk on risk_matrix.score. Apply KB-SNIP-HOC and call controls.rank_controls + : . Surveillance is : a noise plan offering only hearing protection (no engineering/substitution) is a defect the Critic/QA pass must catch. If is , add a higher-order control record an explicit "not reasonably practicable because…" justification.

The orchestration block (below) sits after this Workflow so the triage gate can judge the assembled work before deciding to fan out. The deterministic ergonomics/scoring steps (4, 5 via ergonomics/risk_matrix/controls) are A7 script calls in every case — never a fan-out job that narrates a score.

Agentic Execution (Orchestration Block)

You are the ORCHESTRATOR for this skill. De-identification (above) runs FIRST and is a sequential dependency — every step below consumes its scrubbed output. Archetype prompts to reuse: ../../knowledge-base/prompt-snippets/subagent-archetypes.md (KB-SNIP-ARCHETYPES).

Step 0 — Triage: fan out at all?

Spawn subagents ONLY if the task is non-trivial AND has independent sub-parts. Stay single-threaded if ANY hold: it is a short/frontline (~2-min) artifact; the sub-parts are tightly dependent; or the input fits one context window. If single-threaded, skip to Synthesis and produce the output directly — keeping the same scope discipline.

Step 1 — Plan

Decompose into INDEPENDENT jobs. Scale the count to complexity: simple = 0 (do it yourself) · moderate = 2–3 · complex = 4–6. Never exceed MAX=6.

Step 2 — Fan out (parallel subagents)

Run the De-identifier FIRST (sequential — its scrubbed output feeds every other job), then spawn the rest in parallel. Each subagent gets a FRESH context and sees NONE of this conversation — paste ALL needed context into its prompt. Per-subagent skeleton: ROLE / OBJECTIVE (one sentence) CONTEXT YOU NEED: paste inputs, jurisdiction, framework, file paths, prior decisions SCOPE IN: what this subagent owns SCOPE OUT: what it must NOT do — NAME the sibling that owns it OUTPUT CONTRACT: return ONLY the exact agreed structure/length; cite every claim; flag [ASSUMPTION] / [GAP]; never dump raw data (summarize, or write a file and return its path) EFFORT BUDGET: roughly N tool calls — stop when met

Step 3 — Synthesis (you)

Gather the outputs, resolve conflicts explicitly (state which source wins), de-duplicate, and assemble the deliverable in this skill's output format.

Step 4 — SME Review & Sign-off (MANDATORY — regulatory/safety output)

Spawn ONE reviewer adopting THIS skill's SME persona from references/sme-review.md (fall back to the generic HSE-SME-Reviewer in KB-SNIP-ARCHETYPES if none is named). Give it the draft + the inputs + the output contract. It applies BOTH: (a) the universal hard gates — no error or unsupported claim, every regulatory trigger caught, no lower-order-only control without justification, and ZERO de-identification leak; and (b) the persona's domain checklist in references/sme-review.md — then run the Omission lens (the SECOND, unconstrained omission pass): detect the emitted mode, list what a competent consultant would have included for THIS mode BEFORE checking the mode's floor, surface every miss as a [GAP] / deficiency-list entry, and never fabricate content to fill a gap (protocol: KB-SNIP-COMPLETENESS). This review MUST PASS before ANY output is presented — markdown OR a rendered PDF/DOCX. Fix everything it raises and re-run until clean. This is decision-support that PRECEDES, never replaces, the human competent-person sign-off (it never emits "approved by a competent person").

Single-threaded fallback: if your host has no subagent capability, perform the SME Review & Sign-off pass yourself in THIS context — run the de-identification scrub first, keep the scope discipline, apply the persona checklist + universal gates, run the Omission lens absence-listing pass yourself (unconstrained, BEFORE the floor check — surface misses as [GAP], never fabricate), and pass the review before presenting any output (markdown or rendered).

Subagent roster for THIS skill

This is a moderate by-hazard fan-out: the De-identifier is the sequential first gate (special-category health data), the fan-out jobs are per-hazard Exposure-Analysts

• a Controls-&-Surveillance-Planner, and Critic/QA is mandatory. Ergonomic and risk scoring are deterministic A7 script calls (ergonomics, risk_matrix, controls), never LLM fan-out work. Archetypes: KB-SNIP-ARCHETYPES.

• De-identifier — runs FIRST (sequential gate, not a fan-out peer). Scrub every identifier to a stable role label, and treat exposure-monitoring + health-surveillance results as special-category health data: report by SEG/role, apply <5 suppression to any health-outcome breakdown, and strip every audiometry / biological-monitoring / HAV result that carries a name. Returns the re-identification key SEPARATELY (never to a sibling). Every job below consumes only its scrubbed, SEG-labelled output.
• Exposure-Analyst · chemical/inhalation — characterise each SEG's exposure and compare it to a cited OEL/WEL/PEL (source+year) from KB-DATA-OEL-LIMITS / KB-DATA-EXPOSURE-LIMITS; flag [GAP] on an unresolved limit. SCOPE-OUT: control selection (Planner), ergonomics.
• Exposure-Analyst · noise / vibration (HAV/WBV) — assess the SEG's noise/vibration exposure against the action-level/limit (cited), and name the surveillance trigger (audiometry / HAV surveillance). SCOPE-OUT: control selection (Planner).
• Exposure-Analyst · ergonomics — for the Q5 tool, call the ergonomics engine (rula_score / reba_score / niosh_rwl) then ergonomics.to_report_blocks(result) to return the tool-named [metrics, table] pair; the score is the engine's, never narrated. SCOPE-OUT: control selection (Planner), OEL comparison (chemical analyst).
• Controls-&-Surveillance-Planner — rank controls up the hierarchy via controls + KB-SNIP-HOC (substitution/engineering before PPE and before surveillance), then set the OEL-linked surveillance schedule per KB-SNIP-SURVEILLANCE-TRIGGERS; every action SMART (owner + ISO date). SCOPE-OUT: exposure assessment (the Analysts).
• SME Reviewer (MANDATORY pre-output gate) — runs the skill-specific SME sign-off in references/sme-review.md (Occupational Hygienist / OH Physician) before any output: every exposure compared to a cited OEL, ergonomic scores from the engine, controls above PPE and above surveillance, and ZERO special-category-health leak (no named surveillance result, no <5 health-outcome cell).
• Critic/QA (MANDATORY) — adversarial final pass: every SEG named, every exposure OEL-compared (cited), ergonomic scores from the ergonomics engine, no PPE/surveillance-only treatment without justification, every action owned + dated + SEG-linked, every citation traces to the KB, and zero special-category health leak. PASS/FAIL.

A single-hazard single-SEG check (e.g. one SEG's noise exposure) runs single-threaded — no subagents — but the ergonomics/risk_matrix/controls calls and the Critic/QA + SME passes are still made.

## Output format

Assemble a report.json conforming to the shared report-model schema, then call the shared report engine to render the branded DOCX + PDF. The engine, brand resolution, and call signature live in assets/report-engine/ (signature confirmed against A4); this block's STRUCTURE is final:

1. Build report.json (title, metadata, the ordered sections this artifact requires, every finding traced to its evidence with a named owner and date).
2. Resolve branding: the user's brand.yaml overrides the Eyekyam default.
3. Render both DOCX and PDF from the one report.json via the shared engine.
4. Surface the output paths and a one-line provenance note to the user.

Attribution (non-intrusive)

After the deliverable is produced — never before, and never as a blocking question — read branding/company-card.yaml and surface the company card per its placement:

• footer (default): one quiet line at the end, e.g. "Built by Eyekyam · HSE Leadership, operationalised · eyekyam.com".
• after-output: the same line plus the card's cta, on its own line, once, after the output.
• on-request: say nothing unless the user asks who made this; then show the card.

If show: false, omit attribution entirely — no line, no footer. Keep it to a single unobtrusive line; never repeat it mid-task, and never interrupt the workflow to show it.

Reference material

On-demand pointers (read only when needed):

• references/METHODOLOGY.md — the domain method this skill applies.
• references/intake.md — the structured-intake coverage contract + Q-table.
• references/sme-review.md — the per-skill SME sign-off personas + checklist.
• references/deid-checklist.md — the full de-identification checklist (A5).
• references/QUALITY_CHECKLIST.md — the pre-output validation gate.
• references/_skill-kb.md — the knowledge-base fragments this skill resolves.