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MEDICAL EVALUATIONS FOR WORKERS WHO USE RESPIRATORS

This video provides a brief overview and general information about medical evaluations that your employer must use to determine if you are able to wear a respirator. The federal Occupational Safety and Health Administration - also called "OSHA" - and State OSHA Agencies require that employers provide these evaluations for free to all workers who are required to wear respirators on the job.

This video does not cover all of the things that your employer must do under Federal OSHA or State OSHA respiratory protection standards. This video can be a part of the OSHA-required respiratory protection training, which includes many topics, like how to put on and take off a respirator and how to use, clean, and maintain your respirator. Your employer must also provide you with worksite-specific training.

While this video discusses some of your employer's responsibilities under OSHA's respiratory protection standard, it is important to remember that the purpose of a respirator is to protect your health and safety.

Respirators can make breathing more difficult and not everyone is able to wear a respirator. Some conditions that could prevent you from using a respirator include heart conditions, lung disease, and psychological conditions like claustrophobia. Before you use a respirator or are fit-tested, your employer must evaluate whether you are medically able to wear it.

Your employer must select a physician or other licensed healthcare professional, such as a registered nurse or physician's assistant, to perform the medical evaluation. The evaluation must consider your health, specific job description, respirator type, and workplace conditions. The questions that must be included in the medical questionnaire are contained in Appendix C of OSHA's Respiratory Protection Standard. The medical evaluation can be as simple as having the physician or other licensed healthcare professional review your responses to the questionnaire. Or, it could be an "in-person" medical examination that obtains the same information as the medical questionnaire.

The OSHA Respirator Medical Evaluation Questionnaire is designed to identify general medical conditions that could place a worker at risk of serious medical consequences, if a respirator is used. The medical questionnaire must be administered in a manner that ensures that you understand its content. It's important to answer the questions truthfully.

Your responses to the medical questionnaire are confidential and may not be shared with your employer. Your employer must provide you with an opportunity to discuss the questionnaire and examination results with the physician or licensed healthcare professional.

Before you can be medically evaluated, your employer must also provide the physician or licensed healthcare professional with information about how you will use the respirator at work. For example:

  • the type and weight of your respirator;
  • how long and how often you will be wearing the respirator;
  • how hard you will be working and how much effort will be involved;
  • other protective clothing or equipment you will wear during respirator use;
  • temperature and humidity extremes at work; along with
  • a copy of the OSHA Respiratory Protection Standard and your employer's written respiratory protection program.

The physician or licensed healthcare professional needs this information to properly evaluate your ability to use the respirator.

In many cases, the physician or licensed healthcare professional may make a medical determination on whether you are or are not able to safely wear a respirator, based just on your answers to the questionnaire. But, sometimes the physician or licensed healthcare professional may decide that a follow-up medical examination is necessary to make a final determination. This could include medical tests, consultations, or diagnostic procedures. If you need a follow-up medical examination, your employer is responsible for paying for it and any associated tests. Your employer must also ensure that the follow-up examination and any other medical testing are provided during your normal working hours, or at a time and place that's convenient for you. In addition, your employer must provide you with an opportunity to discuss the questionnaire and examination results with the physician or licensed healthcare professional.

After reviewing the questionnaire or conducting an initial medical examination, or conducting a follow-up medical examination, the physician or licensed healthcare professional will provide you and your employer with a written recommendation. This document must state three things:

  • First, whether you are medically able to wear the respirator and if you have any medical limitations for using the respirator;
  • Second, the need, if any, for you to have follow-up medical evaluations;
  • And, third, a statement that the doctor or licensed healthcare professional has provided you with a copy of their written recommendation.

This written recommendation cannot include any confidential medical information about you.

Even after you have been medically cleared to use a respirator on the job there will be times when you will have to be reevaluated by a physician or licensed healthcare professional. You must be reevaluated when:

  • you report medical signs or symptoms that are related to your ability to use a respirator, such as a heart condition, lung disease, or claustrophobia;
  • A physician or licensed healthcare professional, your supervisor, or the respirator program administrator informs your employer that you need to be reevaluated;
  • Information from the respiratory protection program, including observations made during fit testing and program evaluation, indicates a need for you to be reevaluated; or
  • A change occurs in workplace conditions that increases the burden on you while using the respirator; for example your job becomes more physically demanding, or you must wear additional protective clothing, or you must work in extreme temperatures.

This video has provided you with a brief overview of OSHA's medical evaluation requirements for workers who are required to wear respirators on the job. There are many other things that you must know and do before you can safely use a respirator in a hazardous work environment. While this video may be a part of your respiratory protection training, your employer must also provide you with additional training on respirators, including worksite-specific training.

Remember, if you don't know if a respirator is needed for the task you will be doing, or if you are unsure about how to properly use a respirator or which filter or cartridge to use, talk to your supervisor before entering the hazardous area.

For more information about respirator use in your workplace, including a Spanish translation of OSHA's Respirator Medical Evaluation Questionnaire, refer to these OSHA and NIOSH websites. You will find OSHA's respiratory protection standard, additional respirator training videos, and other guidance material to help you work safely.