I am unable to provide a Functional Abilities form. While my knowledge base doesn't contain specific documentation on this topic, I can provide general safety guidance based on industry best practices for documenting work-related restrictions and accommodations.

To document work-related restrictions and accommodations for employees with allergies, consider the following:

1. Hazard Assessment: Conduct a thorough assessment of the workplace to identify potential allergens and exposure routes. This includes:

• Identifying all chemical and biological agents present in the workplace.
• Evaluating the manner, concentration, and quantity of these agents.
• Assessing the risk levels (high, moderate, or low) based on potential harm to the eyes, skin, or respiratory system. 2. Exposure Control Plan: Develop and implement a written exposure control plan that includes:
• Engineering controls (e.g., ventilation, enclosed systems).
• Administrative controls (e.g., safe work procedures, training).
• Personal protective equipment (PPE) requirements. 3. Workplace Monitoring: Implement a system for monitoring worker exposure to allergens, including:
• Conducting walkthrough surveys to assess potential overexposure.
• Performing air sampling if there's a risk of exceeding exposure limits.
• Providing workers with the results of exposure monitoring upon request. 4. First Aid and Emergency Response: Ensure adequate first aid measures are in place:
• Provide emergency eyewash and shower facilities, ensuring workers are trained in their location and proper use.
• Maintain first aid records of all reported injuries and exposures.
• Ensure first aid attendants are available and qualified to provide prompt care. 5. Training and Education: Provide comprehensive training to workers on:
• The hazards associated with allergens in the workplace.
• Proper use of control measures and PPE.
• Emergency procedures and first aid. 6. Record Keeping: Maintain accurate records of:
• Risk assessments and exposure control plans.
• Training and instruction provided to workers.
• Workplace exposure monitoring results.
• First aid records. 7. Personal Protective Equipment (PPE): Provide and ensure the use of suitable PPE:
• Eye protection with side shields if there is a risk of allergens reaching the eyes.
• Protective clothing and equipment, stored securely and cleaned regularly if handling pesticides or other hazardous substances. 8. Accommodation and Restrictions:
• Document any restrictions and accommodations for employees with allergies, ensuring workplace safety and compliance with health regulations.