Respirator Medical Examinations: Current Practices and Future Needs.

Abstract

This pilot survey of occupational health providers describes processes and outcomes for respirator wearer medical assessment. A web-based survey was conducted with providers recruited through the American College of Occupational and Environmental Medicine and the Web. Evaluations rarely prevent individuals from respirator use but significantly impact accommodation by adjusting recommended respirator type or use conditions. The service delivery processes vary greatly (eg, proportion of assessments by nurses, physician assistants, nurse practitioners, and physicians). Most clinics provide routine initial and periodic examinations, but fewer than half provide more complex assessments. The OSHA Respiratory Questionnaire is frequently the sole data source for decision making. This pilot study defines critical questions and necessary skills. Systematic study of the process and outcomes is needed to reduce inappropriate variation and improve accuracy and efficiency.