Respiratory Protection: Programs, Fit Testing, and Medical Evaluations

Breathing air that contains harmful dusts, fumes, mists, gases, or vapors can cause occupational disease. OSHA's respiratory protection standard says the first goal is to keep the air clean, and it sets the rules for respirators when that cannot be done. If your employees need respirators, you must run a written program covering selection, medical evaluation, fit testing, use, care, and training.

Who it applies to

The section applies to General Industry (part 1910), Shipyards (part 1915), Marine Terminals (part 1917), Longshoring (part 1918), and Construction (part 1926) (1910.134, scope statement).

The written program is required in any workplace where respirators are necessary to protect the health of the employee, or whenever you require respirators (1910.134(c)(1)). Voluntary use has separate rules.

What the standard requires

Controls first, respirators when needed

The primary objective must be to prevent atmospheric contamination. This must be done as far as feasible with accepted engineering controls, such as enclosure, ventilation, or substituting less toxic materials. When effective engineering controls are not feasible, or while they are being put in place, appropriate respirators must be used (1910.134(a)(1)).

You must provide a respirator to each employee when it is necessary to protect that employee's health (1910.134(a)(2)). Respirators, training, and medical evaluations must be provided at no cost to the employee (1910.134(c)(4)).

Voluntary use

Where respirator use is not required, you may provide respirators at employees' request, or let them use their own, if you determine that the use will not in itself create a hazard. If you allow it, you must give those users the information in Appendix D (1910.134(c)(2)(i)).

You must also implement the parts of a written program needed to ensure a voluntary user is medically able to use the respirator, and that it is cleaned, stored, and maintained so it does not present a health hazard to the user. Exception: you are not required to include in a written program employees whose only respirator use is the voluntary use of filtering facepieces (dust masks) (1910.134(c)(2)(ii)).

Selection

• Identify and evaluate the respiratory hazards. The evaluation must include a reasonable estimate of employee exposures and the contaminant's chemical state and physical form (1910.134(d)(1)(iii)).
• Select a NIOSH-certified respirator and use it in compliance with the conditions of its certification (1910.134(d)(1)(ii)).

Medical evaluation

You must provide a medical evaluation to determine the employee's ability to use a respirator before the employee is fit tested or required to use the respirator in the workplace (1910.134(e)(1)).

• A physician or other licensed health care professional (PLHCP) performs it, using a medical questionnaire or an initial exam that obtains the same information (1910.134(e)(2)(i)).
• You must obtain a written recommendation from the PLHCP on the employee's ability to use the respirator (1910.134(e)(6)(i)).
• Additional evaluations are required in certain situations, including when an employee reports medical signs or symptoms related to the ability to use a respirator (1910.134(e)(7)(i)).

Fit testing

Fit testing applies to tight-fitting facepieces, meaning those that form a complete seal with the face (1910.134(b)). The employee must be fit tested with the same make, model, style, and size of respirator that will be used (1910.134(f)).

• Employees must pass an appropriate qualitative (QLFT) or quantitative (QNFT) fit test, using an OSHA-accepted protocol from Appendix A (1910.134(f)(1), 1910.134(f)(5)).
• Test before initial use, whenever a different facepiece (size, style, model, or make) is used, and at least annually thereafter (1910.134(f)(2)).
• Test again whenever the employee reports, or you, the PLHCP, a supervisor, or the program administrator observes, changes in the employee's physical condition that could affect fit. Examples include facial scarring, dental changes, cosmetic surgery, or an obvious change in body weight (1910.134(f)(3)).

Use

You must not permit tight-fitting facepieces to be worn by employees who have facial hair that comes between the sealing surface of the facepiece and the face or that interferes with valve function, or any condition that interferes with the face-to-facepiece seal or valve function (1910.134(g)(1)(i)).

For all tight-fitting respirators, employees must perform a user seal check each time they put on the respirator, using the procedures in Appendix B-1, or procedures recommended by the respirator manufacturer that you demonstrate are as effective as those in Appendix B-1 (1910.134(g)(1)(iii)).

Maintenance and care

• Provide each user a respirator that is clean, sanitary, and in good working order (1910.134(h)(1)).
• Clean and disinfect shared respirators before they are worn by different individuals (1910.134(h)(1)(ii)).
• Inspect respirators used in routine situations before each use and during cleaning (1910.134(h)(3)(i)(A)). Remove from service any that fail inspection or are found defective (1910.134(h)(4)).

Training

Employees who are required to use respirators must receive training that is comprehensive, understandable, and repeated annually, and more often if necessary (1910.134(k)). Provide it before requiring the employee to use a respirator (1910.134(k)(3)).

Each employee must be able to demonstrate knowledge of at least (1910.134(k)(1)):

• Why the respirator is necessary, and how improper fit, usage, or maintenance can compromise its protection.
• Its limitations and capabilities.
• Emergency use, including when the respirator malfunctions.
• How to inspect it, put it on and remove it, use it, and check the seals.
• Maintenance and storage procedures.
• Medical signs and symptoms that may limit or prevent effective use.
• The general requirements of the standard.

Retraining is required annually. It is also required when changes in the workplace or the type of respirator make previous training obsolete, when inadequacies in the employee's knowledge or use show the employee has not retained the needed understanding or skill, or when any other situation arises in which retraining appears necessary to ensure safe use (1910.134(k)(5)).

Written programs and records

The written program must have worksite-specific procedures and be updated as necessary to reflect changes in workplace conditions that affect respirator use. It must include, as applicable, selection, medical evaluations, fit testing, routine and reasonably foreseeable emergency use, maintenance, breathing air quality for atmosphere-supplying respirators, training, and regular evaluation of the program (1910.134(c)(1)).

You must designate a program administrator who is qualified by appropriate training or experience that matches the complexity of the program (1910.134(c)(3)).

• Medical evaluation records must be retained and made available in accordance with 29 CFR 1910.1020 (1910.134(m)(1)).
• Fit test records must show the employee, type of test, the specific make, model, style, and size of respirator, the date, and the results (1910.134(m)(2)(i)). Keep them until the next fit test is administered (1910.134(m)(2)(ii)).
• Keep a written copy of the current program (1910.134(m)(3)).

Easy-to-miss requirements

• Unknown exposure means IDLH. If you cannot identify or reasonably estimate the employee exposure, you must consider the atmosphere to be immediately dangerous to life or health (IDLH) (1910.134(d)(1)(iii), 1910.134(b)).
• Dust masks worn by choice still need Appendix D. Its information must be given, in any written or oral format, to employees who wear respirators when use is not required (1910.134(k)(6)).
• Glasses and other PPE. Corrective glasses, goggles, or other personal protective equipment must be worn so they do not interfere with the seal of the facepiece to the user's face (1910.134(g)(1)(ii)).
• Ask the users. You must regularly consult employees required to use respirators to assess their views on program effectiveness and identify problems. Any problems identified must be corrected (1910.134(l)(2)).

Related guides

• Hazard communication
• PPE hazard assessment
• Confined spaces

Source

This guide is based on the text of 29 CFR 1910.134 as published on osha.gov. The regulation itself always controls. States that run their own OSHA-approved State Plans may have additional or stricter rules.