Respiratory Protection Resources

Before selecting respirators for use at your workplace, you must find out what respiratory hazards, such as chemicals or particles, workers are potentially exposed to on the job. An OEHS professional must assess these hazards to determine their frequency, duration, and routes of potential exposures. See the Resources Section for a list of private consultants or OSHA On-Site Consultation Programs in your state. After the consultant performs their assessment, they will determine if workers’ health and safety are at risk and if respiratory protection and other personal protective equipment (PPE) are necessary.

As an employer or worker, your role in the exposure assessment process is as follows:

• Inventory all chemicals and materials used in the workplace, if you haven’t already done so (see the OSHA Hazard Communication Standard for more details). 
• Keep up-to-date safety data sheets (SDSs) for every work task (see the Hazard Communication Standard for more details).
• Contact an OEHS consultant (see the Resources Section) to assess workers’ exposures to respiratory hazard during typical work tasks. The consultant may tell you workers must use respirators because exposure levels in the workplace are above limits set by OSHA standards or consensus guidelines, or they may recommend voluntary respirator use as a best practice. 

Questions an employer and/or a sole proprietor should ask an OEHS consultant when seeking an exposure assessment:

• Do you provide exposure assessments to small business owners (or collections care workers, gig workers, contractors, or sole proprietors, as applicable)?
• Can you help me select the type of respiratory protection my employees and I need based on an exposure assessment?
• What information will you need from me in advance to conduct an exposure assessment?
• How much experience do you have with workplaces like mine?
• Do you have any professional credentials, such as the Certified Industrial Hygienist® (CIH®) or Certified Safety Professional® (CSP®)?

Completion of a medical evaluation is an essential (and mandatory) step towards respirator fit testing. Since a respirator places physical burdens on the wearer due to the weight of the device and restriction of the wearer’s breathing, a medical evaluation ensures a person has no underlying health conditions that may cause problems if they wear a respirator. OSHA requires that a physician or other licensed healthcare professional medically evaluate a person to determine whether, and under what conditions, they can safely wear a respirator.

Healthcare providers may advise some people against wearing respirators due to medical conditions such as pregnancy or hypertension. A respirator may not offer full protection for people who are hypersensitive to some substances used in their workplaces, so physicians may advise these individuals to use other methods of controlling hazardous exposures, such as local ventilation.

An individual suffering from claustrophobia related to wearing respirators may feel as though they are suffocating from a lack of oxygen. Research supports the idea that panic-prone individuals may be at higher risk of respiratory discomfort when wearing tight-fitting respirators. The medical evaluation should help identify individuals who may suffer from anxiety, depression, claustrophobia, or other psychological distress upon wearing a respirator.

Actions to take for obtaining a medical evaluation:

• Print and fill out the OSHA respirator medical evaluation questionnaire (Appendix C in the OSHA respiratory protection standard). Take the completed questionnaire to your evaluation. Your healthcare provider will require, at a minimum, the information you will provide on the questionnaire to perform your evaluation. You can download a copy from OSHA’s website (see the Resources Section).
• Contact your primary care physician to ask them if they can perform medical evaluations for occupational respirator use.
• Alternatively, reach out to occupational health clinics in your region to find providers able to complete your medical evaluation (see the Resources Section).
• Refer to your state’s occupational health agency for other resources related to medical evaluations.

Questions an employer and/or a sole proprietor should ask an OEHS consultant when seeking a medical evaluation:

• Will the medical evaluation be conducted by a physician or other licensed health care professional per the requirements of Section E of the OSHA Respiratory Protection Standard?
• Does the provider have physicians on hand to interpret questionnaires and medical evaluations so you will receive your results right away, or will you need to return for another appointment?
• Does the provider have a secure, web-based portal (such as MyChart) so you can access your medical evaluation records? If they do not have a web portal, how will you and your employer access your records?
• Can the provider send your employer proof of your medical evaluation? Is this included with the cost of the evaluation? Does the provider have a mobile clinic that can visit your work site?
• If applicable to your workplace: Can the provider conduct medical evaluations for employees during late or early-shift hours?
• Does the provider also have an OEHS professional on staff who can provide respiratory protection training and fit testing to other workers and yourself after passing the medical evaluation?
• Can the provider send you annual notifications for your subsequent OSHA-required medical evaluations?

Before a worker receives a respirator from their employer, they must be trained to properly wear the respirator and use it correctly. OSHA requires that employers provide effective, comprehensive, understandable training that recurs annually and as necessary to workers required to use respirators. If a worker is not required to use a respirator but chooses to do so voluntarily, their employer must provide them with Appendix D of OSHA’s respiratory protection standard. The employer must document all respirator training.

This training must be conducted by a person or vendor competent in Respiratory Protection (see the Resources Section for Solutions Providers and Training/FitTesting). At a minimum, training on respirator use provided by employers must cover:

• The proper fit, usage, and maintenance of the respirator.
• The limitations and capabilities of the respirator.
• The effective use of the respirator in emergency situations, including situations in which the respirator malfunctions.
• The correct procedures for inspecting, putting on, using, removing, and checking the seals of the respirator.
• The general elements of the employer’s respirator program.

Training must be repeated at least annually, or more often when necessary, to ensure workers’ safe use of respirators. Situations that may require employers to retrain workers on respirator use may include:

• Before changes to work tasks, the chemicals or materials in use, or the type of respirator provided to workers.
• After the employer has observed that workers use their respirators incorrectly or have insufficient knowledge of the devices.
• Before workers perform tasks requiring respirator use in a new environment.

A fit test is a protocol for evaluating respirator fit. Before a worker undertakes a task while wearing a respirator, they and their employer must be sure their respirator fits properly. Workers may struggle to find appropriately fitting respirators for various reasons, and in the field, they may encounter conditions that cause their respirators to fit poorly. Fit testing allows employers to make sure workers are using the proper styles and sizes of respirator, workers are comfortable with wearing their respirators, and that their respirators function well with other PPE they may be wearing, such as earmuffs. Fit testing is also required by OSHA’s respiratory protection standard.

Workers must receive a fit test whenever they are required to wear tight-fitting respirators, even respirators in a positive pressure mode. Fit testing must be performed at least annually or whenever a new or different respirator is worn (make, model, style, or size) . Fit test operators shall be properly trained and demonstrate proficiency in the fit test methods being used. The respiratory protection program administrator is responsible for evaluating and verifying the training and qualifications of operators (see ASTM F3537-21 for more details). A worker may also need additional fit testing if their respirator no longer fits properly, or if they, their employer, or a licensed healthcare provider observes a physical change, such as weight loss or gain or have dental work like dentures, that could affect the fit. AIHA has compiled a list of other factors (see the Resources Section) that could cause respirators to fit poorly.

The OSHA respiratory protection standard also states employers cannot permit workers with facial hair “that comes between the sealing surface of the facepiece and the face or that interferes with valve function” to wear respirators with tight-fitting facepieces. Since fit testing determines whether users’ respirators fit properly, this restriction extends to fit testing. The National Institute for Occupational Safety and Health (NIOSH) provides guidance and an infographic on facial hair styles permissible under respiratory protection programs.

There are two main methods of fit testing: qualitative and quantitative. Quantitative fit tests are conducted with a machine to measure respirator fit and create an electronic record of the fit test procedure. Qualitative fit tests determine respirator fit based on wearers’ responses to challenge agents, require the person performing the fit test to write down the results, and are less expensive and easier to perform than quantitative fit tests. AIHA has created a sample fit testing form (see the Resources Section) for your use. The table below summarizes the key points of different types of qualitative fit test agents.

OSHA requires any workplace in which workers wear respirators to have a written Respiratory Protection Program (RPP)—a cohesive collection of worksite-specific procedures intended to address all aspects of the OSHA respiratory protection standard for any situation in which respirators may be used. A written respiratory protection program, like any other standard operating procedure (SOP) your business uses, records requirements and deadlines you must meet. The written RPP may be as simple or as complicated as it needs to be to fit the complexity and scope of the respiratory hazards in the workplace, as long as it meets OSHA’s requirements for written respiratory protection programs (see the Resources Section). Many OEHS professionals, including the one you may have consulted for your exposure assessment, can assist you with developing a written RPP and reviewing the program every year. The annual review is done to ensure the provisions of the program are being effectively implemented. The program evaluation should also include consulting respirator users to assess their views on program effectiveness and to identify any problems with the program implementation. This annual review must be documented. Your written program must address the specific respiratory hazards, procedures, and respirators in use at your work site and be updated as necessary to reflect changes in workplace conditions. Several written program templates are included in the Resources Section to help you assemble your written RPP.

OSHA requires your workplace’s written RPP to include the following procedures:

• Selecting respirators for use in your workplace.
• Performing medical evaluations for workers who are required to use respirators.
• Fit testing for tight-fitting respirators.
• Proper use of respirators in routine and reasonably foreseeable emergency situations.
• Cleaning, disinfecting, storing, inspecting, repairing, discarding, and otherwise maintaining respirators.
• Ensuring adequate air quality, quantity, and flow for atmosphere-supplying respirators.
• Training employees on the respiratory hazards they may be exposed to during routine and emergency situations.
• Training employees on proper respirator use, including putting on and removing respirators, respirator maintenance, and any limitations on respirator use.
• Reviewing the effectiveness of the RPP on a regular basis.

Your workplace must select and designate, via a formal, written letter, a respiratory program administrator to develop and oversee the written RPP and administer all elements of the program for the workforce. A sole proprietor can administer their own program; the important point is for there to be a written procedure. The respiratory program administrator is responsible for the following:

• Identifying work areas, processes, or tasks for which workers are required to use respiratory protection.
• Having access to and direct communication with supervisors on matters impacting worker safety and health.
• Ensuring all respirators are certified by NIOSH via the standard for respiratory protective device approval (42 CFR 84) and are used properly under the terms of their certification. All NIOSH-approved respirators are supplied with an approval label and user instructions.
• Ensuring all respirator filters, cartridges, and canisters have an appropriate NIOSH certification label and that the label is not removed or defaced while the equipment is in use.
• Revising and updating the workplace’s hazard assessment, as needed.
• Ensuring medical evaluations, fit testing, and worker training is performed, respirators and cartridges are correctly selected, and respirators are properly maintained.
• Determining if workers may voluntarily use respirators in the workplace.
• Reviewing the written RPP every year.

The respiratory program administrator’s annual review is intended to determine the effectiveness of the RPP and if the RPP is being properly implemented. This review should include consultation with workers to ensure they are using respirators properly, to assess their views on the program’s effectiveness, and to identify any problems affecting implementation of the RPP. Your workplace should correct any problems uncovered during the respiratory program administrator’s review.

Factors the respiratory program administrator should assess during their review include, but are not limited to:

• Respirator fit, including workers’ ability to use the respirator without it interfering with their performance.
• Type of respirator selected and whether it is appropriate for the hazards workers are exposed to.
• Respirator use under conditions encountered by workers.
• Respirator maintenance.