Medical Evaluation Requirements

Employees need to be medically cleared to wear respirators before commencing use. All respirators generally place a burden on the employee. Negative pressure respirators restrict breathing, some respirators can cause claustrophobia and self-contained breathing apparatuses are heavy.

A physician or other licensed health care professional operating within the scope of his/her practice needs to medically evaluate employees to determine under what conditions they can safely wear respirators. Based upon a review of the patient’s OSHA Respirator Medical Evaluation Questionnaire as well, the job description one of four (4) determinations will be selected.

• Employment per job description
• Pending further medical records
• Employment with restrictions
• Rejected

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Respirators must be used in workplaces in which employees are exposed to hazardous airborne contaminates. When respiratory protection is required, employers must have a respirator protection program as specified in OSHA’s Respiratory Protection standard (29 CFR 1910.134). Before wearing a respirator, workers must first be medically evaluated using the mandatory medical questionnaire or an equivalent method. The Medical Evaluation Questionnaire is used to facilitate these medical evaluations and can be downloaded below.

The process begins with an employee completing a Respirator Medical Evaluation Questionnaire. After review of the Respirator Medical Evaluation Questionnaire by a physician, some employees may require a Pulmonary Function Test to ensure they are medically able to participate in a mask fit test.

Certain respirators, known as tight-fitting respirators, must form a tight seal with your face or neck to work properly. So before you wear a tight-fitting respirator at work, your employer must be sure that your respirator fits you. Your employer does this by performing a fit test on you while you wear the same make, model, and size of respirator that you will be using on the job. That way, you know that your respirator fits you properly and can protect you, as long as you use it correctly.

In addition, before you use a respirator or are fit-tested, your employer must ensure that you are medically able to wear it. So what is a fit test? A “fit test” tests the seal between the respirator's face piece and your face. It takes about fifteen to twenty minutes to complete and is performed at least annually. After passing a fit test with a respirator, you must use the exact same make, model, style, and size respirator on the job.

There are two types of fit tests:

Qualitative

Qualitative fit testing is a pass/fail test method that uses your sense of taste or smell, or your reaction to an irritant in order to detect leakage into the respirator face piece. Qualitative fit testing does not measure the actual amount of leakage. Whether the respirator passes or fails, the test is based simply on you detecting leakage of the test substance into your face piece. There are four qualitative fit test methods accepted by OSHA.

• Isoamyl acetate - which smells like bananas
• Saccharin - which leaves a sweet taste in your mouth
• Bitrex - which leaves a bitter taste in your mouth
• Irritant smoke - which can cause coughing

Quantitative

Quantitative fit testing uses a machine to measure the actual amount of leakage into the facepiece and does not rely upon your sense of taste, smell, or irritation in order to detect leakage. There are three quantitative fit test methods accepted by OSHA.

• Generated aerosol
• Ambient aerosol
• Controlled Negative Pressure

Fit testing can be done by your employer or an outside party, including a union, an apprenticeship program, a contractor's association, or a past employer. Your current employer is permitted to accept fit testing you have received from an outside party (such as a former employer) within the last 12 months, as long as you use the same respirator make, model, style, and size at your new work site.