Job Survey - Work Environment

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Work Environment

Listed below are a number of Work Environment factors which may be required in your job.
In a typical work day, indicate the frequency of which job activities are performed in the following environmental factors by checking the appropriate frequency column.

Constantly indicates 5-8 hrs per day, 30-40 hrs per week.
Frequently indicates 2-5 hrs per day, 10-30 hrs per week.
Occasionally indicates Up to 2 hrs per day, up to 10 hrs per week.
Rarely indicates rarely required, less than 1 hr per week.

Activity	Rarely	Occasionally	Frequently	Constantly
Exposure to electrical hazards
Works in cramped quarters
Exposure to dust/smoke
Exposure to fumes/odors/grease/oil
Works in hot/cold temperatures
Works inside in an office
Works outside
Exposure to noise
Exposure to chemicals
Stand on concrete
Vibration
Exposure to toxic materials
Works at unprotected heights
Walk on uneven or slippery surface
Works in wet conditions
Works with machinery
Care for the personal needs of others to include toileting, feeding, and other matters related to hygiene or well-being.
Travel required
Be on call
Rotating shift work