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29 CFR 1910.134

Respirator Medical Evaluation

Wearing a tight-fitting respirator imposes real physiological load: added breathing resistance, heat retention, and for some people a claustrophobic response that matters at height or in a confined space. The evaluation identifies the…

What the evaluation is for

Wearing a tight-fitting respirator imposes real physiological load: added breathing resistance, heat retention, and for some people a claustrophobic response that matters at height or in a confined space. The evaluation identifies the people for whom that load is a genuine risk. It is required before fit testing and before first use.

The questionnaire, and who sees it

Employees complete Appendix C confidentially, during work hours, somewhere they can answer honestly. It goes to the PLHCP. You receive a recommendation and nothing else. If your current process has supervisors collecting completed questionnaires, that process is not compliant and should change before your next audit.

When a follow-up exam is triggered

Certain answers require a follow-up medical examination - cardiovascular symptoms, significant respiratory disease, prior difficulty wearing a respirator. A follow-up is not a rejection. Most people who go to follow-up are cleared, sometimes with a condition such as a different respirator type.

Re-evaluation triggers

There is no fixed annual requirement, which surprises people. A new evaluation is required when the employee reports relevant symptoms, when the PLHCP or supervisor observes a problem, when fit testing reveals a need, or when workplace conditions change in a way that increases physiological burden - heavier work, higher temperatures, added protective clothing.

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Sources

Primary regulations and standards referenced above. Where a standard is published commercially it is named in full rather than linked to a copy.