What Should Be the Content and Frequency of Performing a Medical Evaluation to Determine Fitness to Wear a Respirator?

Abstract

The aim of this study was to assess the standard of care among occupational medicine practioners for determining medical fitness to wear a respirator. A 15-item email/telephone survey was conducted of members of the Michigan Occupational and Environmental Medical Association. Sixty-seven percent of occupational medicine practioners who responded performed respirator evaluations; 75% did more than just the required Occupational Safety Health Administration questionnaire. Cardiovascular and respiratory symptoms and problems wearing a respirator (87% to 95%) were the most common reasons for additional testing and denying medical clearance (58% to 82%). Sixty percent of practioners required workers to have an annual evaluation. The frequency of medical evaluation, which specific tests were performed, and the criteria used to determine fitness to wear a respirator varied markedly between practioners. Further research is needed to determine whether the widespread variation is a sign of too little or too much testing by different practioners.