Medical Evaluations Prior to Using a Respirator: What medical professionals need to know

Every employee who will be required to use a respirator based on pesticide product label information must receive a medical evaluation by a physician or licensed healthcare professional** (examiner) before using the respirator (see OSHA Respiratory Protection Standard). Such an evaluation must consider the employee's health, their specific job duties, the respirator type, and workplace conditions.

Why is a medical evaluation needed before employees use a respirator at work?

It is more difficult to breathe through a respirator than in ambient air. The additional physiological burden may be significant for people with certain medical conditions. As the examiner, your aim is to identify any health conditions that could place the employee at risk by using a respirator, and whether the employee is medically able to wear the respirator.

It is more difficult to breathe through
a respirator than in ambient air.

What should the healthcare provider evaluate?

Having information from both the employee and the employer allows the examiner to determine medical clearance for respirator use in a specific context. An evaluation may be done by reviewing the employee's responses to the medical questionnaire (Appendix C of OSHA's Respiratory Protection Standard) or through an in-person examination gathering the same information. View the entire questionnaire in English and Spanish. The information from the medical evaluation is confidential. Only the employee and you as the examiner may see it.

**An individual whose legally permitted scope of practice (i.e., license, registration, or certification) allows them to independently provide, or be delegated the responsibility to provide, some or all of the healthcare services required by OSHA Respiratory Protection Standard 1910.134(e).

How do the employer-provided answers come into play?

The employer must provide information about how the respirator is to be used at work. Examples include the type and weight of the respirator and filters, length and frequency of respirator use, personal protective equipment worn during use, workplace exposures, expected exertion levels during use, and working conditions (such as heat/humidity). The employer must also provide you with the OSHA Respiratory Protection Standard.

What are the potential outcomes of the medical evaluation?

Additional testing and/or follow-up evaluations may be necessary to make a final clearance determination. The need for re-evaluation, or the length of time between evaluations, depends on several factors such as the employee reporting signs of shortness of breath or dizziness related to respirator use, or a change occurs in working conditions (Medical Evaluations). You may place limitations on the medical clearance, for example, in situations where the employee has to manage a health condition when using a respirator. Medical clearance may be denied if the employee has a health condition prohibiting them from safely using a respirator under the described conditions. Medical clearance may be granted for longer periods, but it must be repeated if there are changes in the employee's health status, facial structure, the respirator, or the nature of the employee's work or workplace conditions.

Additional detailed resources can be found on the U.S. Department of Labor OSHA website.

For a printable version click here.

Authors: Pesticide Educational Resources Collaborative – Medical (PERC-med)
Rebecca Belloso, MPH, University of California Davis Continuing and Professional Education
Kaci Buhl, MS, Oregon State University National Pesticide Information Center
Diana Simmes, MPH, University of California Davis Continuing and Professional Education
Suzanne Forsyth, MPH, University of California Davis Continuing and Professional Education

Reviewed by: Charlotte Halverson, BSN, COHN-S, Agrisafe Network
Robin Tutor Marcom, EdD, MPH, NC Agromedicine Institute


AgriSafe Network
  1. Respirator Medical Evaluation
Pesticide Educational Resources Collaborative (PERC)
  1. Worker Protection Standard (WPS) Respiratory Protection Guide, Requirements for Employers of Pesticide Handlers. Medical Evaluations. 2017: 17-18
Occupational Safety and Health Administration (OSHA)
  1. OSHA Respiratory Protection Standard
  2. OSHA Info Sheet Respirator Medical Evaluation Questionnaire
  3. Appendix C – OSHA Respirator Medical Evaluation Questionnaire (Mandatory)
  4. Medical Evaluations for Workers Who Use Respirators

PERC-med Projects

Resources for the prevention, recognition, and treatment of pesticide-related health conditions.

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