Respirator Medical Evaluations and Fit Testing

By Accident Fund Senior Loss Control Consultant Richard McLaughlin

All respirators restrict breathing and place a burden on the wearer that varies with the type of respirator, workplace conditions and the health of the employee. Medical evaluations are necessary to determine if the user can wear a respirator without adverse health effects and fit testing is necessary to make sure the respirator is providing adequate protection to the wearer.

Medical Evaluation

Before requiring workers to wear a respirator, identify a licensed health care professional to medically evaluate employees and determine their ability to safely wear respirators.

• Use the mandatory medical questionnaire from OSHA or a comparable method.
• Administer the questionnaire and examinations confidentially during normal working hours, or at a time and place convenient to the employee, and in a way that employees will understand.
• Obtain a written recommendation about the employee’s ability to use the respirator from the health care professional.
• Only allow medically cleared employees to use respirators.

Fit Testing

Use either qualitative or quantitative procedures to annually check respirators that rely on a mask-to-face seal to make sure they provide an acceptable fit to the wearer.

The relative workplace exposure level determines what constitutes an acceptable fit and which fit test procedure is required:

• Qualitative testing relies on a sensation (taste, irritation, smell) of the respirator wearer to a test agent.
• Quantitative testing uses instruments to measure face seal leakage.

Additional considerations:

• A quantitative fit-test procedure must be used for exposure levels greater than 10 times the occupational exposure limit (OEL).
• Qualitative or quantitative procedures may be used for negative pressure air-purifying respirators when exposure levels are less than 10 times the OEL.
• For tight-fitting atmosphere-supplying respirators and tight-fitting powered air-purifying respirators, perform quantitative or qualitative fit testing in the negative pressure mode.