Upon determination that a respirator is required in the workplace, a medical evaluation will be provided before the initial fit testing and before a respirator is used for the first time. Medical evaluations must be performed by a physician or other licensed health care professional (PLHCP) using either a mandatory medical questionnaire or an initial medical examination that obtains the same information as the medical questionnaire (sections 1 and 2, part A). Any PLHCP (e.g., nurse practitioner, physician assistant, occupational health nurse) may evaluate the employee's medical ability to use a respirator provided that the PLHCP is authorized to do so by state license, certification, or registration.
At a minimum, the Production should provide additional medical evaluations if:
- An employee reports medical signs or symptoms that are related to his/her ability to use a respirator;
- A PLHCP, supervisor, or the Respiratory Program Administrator informs the Production that an employee needs to be reevaluated;
- Information from the Respiratory Protection Program, including observations made during fit testing and program evaluation, indicates a need for employee reevaluation; or
- A change occurs in workplace conditions (e.g., physical work effort, protective clothing, and temperature) that may result in a substantial increase in the physiological burden placed on an employee.