CHECKLIST FOR MEDICAL EVALUATION

Check that:

All employees have been evaluated to determine their ability to wear a respirator prior to being fit tested for or wearing a respirator for the first time in your workplace.

A physician or other licensed health care professional (PLHCP) has been identified to perform the medical evaluation.

The medical evaluations obtain the information requested in Sections 1 and 2, Part A of Appendix C of the standard, 29 CFR 1910.134.

Employees are provided follow-up medical exams if they answer positively to any of questions 1 through 8 in Section 2, Part A of Appendix C, or if their initial medical evaluation reveals that a follow-up exam is needed.

Medical evaluations are administered confidentially during normal working hours, and in a manner that is understandable to employees.

Employees are provided the opportunity to discuss the medical evaluation results with the PLHCP (Professional Licensed Health Care Provider)

The following supplemental information is provided to the PLHCP before he or she makes a decision about respirator use:

Type and Weight of the respirator.

Duration and frequency of respirator use.

Expected physical work effort.

Additional protective clothing to be worn.

Potential temperature and humidity extremes.

Written copies of the respiratory protection program and the Respiratory Protection standard.

Written recommendations are obtained from the PLHCP regarding each employee’s ability to wear a respirator, and that the PLHCP has given the employee a copy of these recommendations.

Employees who are medically unable to wear a negative pressure respirator are provided with a powered air purifying respirator (PARP) if they are found by the PLHCP to be medically able to use a PARP.

Employees are given additional medical evaluations when:

The employee reports symptoms related to his or her ability to use a respirator.

The PLHCP, respiratory protection program administrator, or supervisor determines that a medical reevaluation is necessary.

Information from the respiratory protection program suggests a need for reevaluation.

Workplace conditions have changed in a way that could potentially place an increased burden on the employee’s health.

Periodic medical evaluations shall be administered according to the following schedule:

Employees: up through 35 years of age – at least every 5 years

36 – 40 years of age - at least every two years

Over 40 years old - at least annually