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Medical Evaluation

3M Center for Respiratory Protection

Medical Evaluations for Respirator Usage

Wearing a respirator can put an extra burden on the body. People with underlying medical conditions may put themselves at risk if they work while wearing one. So the Occupational Safety and Health Administration (OSHA) requires medical evaluation before any employee can even be fit-tested for — let alone wear — a respirator.

If respirators aren’t required in your workplace but employees wear them voluntarily, OSHA says you still have to perform a medical evaluation. The sole exception is if the only type of respirator voluntarily worn is a filtering facepiece respirator, though 3M still highly recommends evaluations in those circumstances.

What’s Involved

The medical evaluation is a questionnaire located in Appendix C of the OSHA respiratory protection standard that the employee completes. A physician or licensed health care professional (PLHCP) must review it to assess whether:


  • A follow-up exam with a physician is required for that worker.
  • The worker is cleared for respirator use with no restrictions.
  • The worker is cleared with restrictions. That may mean they can’t use a negative pressure respirator on the job but could consider a positive pressure respirator instead.
  • The worker isn’t cleared for any respirator usage.


In order to complete the assessment, the PLHCP must know the type of respirator you plan to use, the nature of the work and the conditions in which the work will be done. OSHA regulations require that you provide time during normal working hours for employees to complete the questionnaire, at no cost to the workers.

The Virtual Option

Online medical evaluations are a convenient way to fulfill this requirement, since employees can complete them without having to travel to see a physician (unless a follow-up is necessary). 3M offers an online medical evaluation that meets the OSHA criteria. It can be completed at work and processed typically within hours, providing fast notification of results and clearance letters from a PLHCP via fax or email.


Other Requirements

Some hazardous substances have additional requirements beyond the standard medical evaluation. For example, workers wearing respirators for exposure to asbestos must complete a separate questionnaire, as well as get a pulmonary function test (PFT) and periodic chest X-rays. Other substances may also trigger the need for PFTs and/or chest X-rays, or in-person annual exams.

Fast Facts About Medical Evaluations for Respirator Usage

Medical evaluations are a vital part of a respiratory protection program and are required by the U.S. Occupational Safety and Health Administration (OSHA). Here are some facts you should know about this part of your respiratory protection program.

  • Q: What is a medical evaluation?

    A: The standard evaluation is a questionnaire. See the OSHA questionnaire (link below). A physical visit with a doctor isn’t necessary unless a PLHCP requires it based on responses to certain questions. Follow-up visits could include medical tests, consultations or diagnostic procedures.

    OSHA Standard Medical Questionnaire

  • A: No. The employer must cover the cost of the initial medical evaluation, in addition to the cost of any necessary follow-up visits.

  • A: Before employees can be fit-tested for a respirator and use it on the job, they must get medical clearance indicating that they’re able to wear respiratory protection.

  • A: The PLHCP who reviews the questionnaire and/or conducts the follow-up exam will provide both the worker and employer with a medical clearance letter stating:

    • Whether the employee is cleared to wear the respirator.
    • If so, whether there are restrictions.
    • Whether a follow-up exam is needed.

    The letter will not contain any confidential medical information about the employee.

  • A: Voluntary usage still requires medical evaluation. The only exception OSHA makes is for voluntary usage of filtering facepiece respirators. If that’s the only type of respirator your employee wears, and it’s voluntary, then you don’t need to perform a medical evaluation (although 3M still highly recommends it).

  • A: Wearing a respirator can put an extra burden on the body. Employees with certain medical conditions affecting the heart or lungs could risk injury or death if they wear a respirator on the job. The medical evaluation questionnaire helps identify at-risk employees who may need an in-person visit with a physician to determine their ability to safely wear a respirator while working. The questionnaire also helps identify other conditions that may affect workers’ ability to wear a respirator, such as claustrophobia and migraines.

  • A: To assess the employee’s ability to use a respirator, the PLHCP needs you to provide information about how respirators are expected to be used in the workplace, including:

    • The type and weight of the respirator.
    • How long and how often the employee will likely wear the respirator.
    • The physical demands of the work and amount of effort involved.
    • What other protective clothing or equipment will also be worn during respirator use.
    • Temperature and humidity extremes at work.
    • A copy of both the OSHA Respiratory Protection Standard and your written respiratory program.
  • A: No. The employer isn’t allowed to review the responses, and must advise the employee where to send the questionnaire as well as provide the name of the PLHCP who will be reviewing it, in case the worker has questions.

  • A: Some OSHA substance specific standards require diagnostic tests to monitor lung function. For example, workers wearing respirators for asbestos exposure must complete a different medical questionnaire to gain a deeper understanding of respiratory health. They also must complete an annual PFT as well as periodic chest X-rays, to monitor for asbestos related lung disease. PFTs and chest X-rays aren’t part of the standard medical evaluation for most workers.

    OSHA Asbestos Worker Medical Questionnaire

  • A: If an employee chose to use his/her own doctor instead of the PLHCP designated by your company, the employee would be responsible for the cost of the evaluation and any associated medical tests.

See the next step in your journey to optimizing your respiratory protection program. 

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