A risk identification form was introduced as part of Southmead Health
Services NHS Trust's pre-employment procedure. Its purpose was to allo
w occupational health nurses to identify employees with specific occup
ational health needs. One hundred employees' risk identification forms
were studied and a comparison made between the manager's assessment a
nd that or an independent occupational health nurse's assessment based
on job title alone. The actual risks involved in the post were identi
fied by the employee after 1 month employment, together with an occupa
tional health nurse from Southmead NHS Trust. There was a greater agre
ement between the managers' assessments and the actual risks identifie
d (range 83-100%), than between the independent nurse's assessments an
d the actual risks identified (range 59-100%), in all categories other
than driving. The sensitivity of the managers' risk assessments were
higher than that of the independent nurse in all categories and the po
sitive predictive Value of the managers' risk assessments were higher
than that of the independent nurse in all but two categories.