November 16, 1998

Mr. David Taylor
OCAW Local 4-227
2306 Broadway
Houston, TX 77012

Dear Mr. Taylor:

This letter is in response to your letter to Ray Skinner of our Houston office. It was forwarded to our office for response. In your letter you have requested clarification of the medical evaluation provisions in the revised respiratory protection standard.

The respiratory protection standard requires the employer to provide a medical evaluation for each employee who is required to wear a respirator and also for those employees who voluntarily wear elastomeric facepieces for comfort or other reasons when there is no recognized hazard.

The standard does not prohibit an employee from using his own physician to evaluate his or her ability to wear a respirator. This arrangement may work fine for small employers, but can become difficult to administer for larger employers, because the employer would need to maintain contact with each physician and provide each physician with a copy of the supplemental information. If the employer chooses to use the employees' physicians as the PLCHP, then both the physicians' fees and employees' time must be paid for by the employer. For most companies the evaluation would normally be done by the company physician or by an arrangement with a local health care facility. The employer's requirement to provide an evaluation is satisfied when he provides the services of a PLCHP. If an employee chooses not to use the provided PLCHP, the employer would not be required to pay for any duplicate efforts.

The standard does not require all employees who may wear an SCBA respirator to have a physical exam. The standard allows these employees to take the mandatory questionnaire and to answer the additional questions 10 through 15 in Section A. However, due to the additional stress on employees required to use an SCBA, many physicians doing the evaluation will probably want to physically examine most employees who say they will occasionally need to wear an SCBA.

After evaluating the questionnaire and/or any physical examinations, the PLCHP supplies the employer with a written recommendation stating the employee's ability to wear a respirator. The employer must retain a copy of this written recommendation. OSHA will look for this documentation to determine if a PLCHP has evaluated each employee required by the standard to be evaluated. The standard states specifically what should be included in the written recommendation. The recommendation shall provide only the following information:

1. Any limitations on respirator use related to the medical condition of the employee, or relating to the workplace conditions in which the respirator will be used, including whether or not the employee is medically able to use the respirator;
    
2. The need, if any, for follow-up medical evaluations; and
    
3. A statement that the PLHCP has provided the employee with a copy of the PLHCP's written recommendation.
    

All information from the questionnaire and/or the medical exam is confidential, and arrangements must be made by the employer to ensure it is kept confidential. Usually these records are maintained by the PLCHP.

OSHA has provided several resources on its website (http://www.osha.gov) which should clarify many of the questions you might have on respirators and the new standard. Among these resources are the Small Entity Compliance Guide for the Respiratory Protection Standard, Questions and Answers on the Respiratory Protection Standard, and CPL 2-0.120 — Inspection Procedures for the Respiratory Protection Standard. If you have any further questions, you may contact OSHA's [Office of Health Enforcement].

Sincerely,



Richard E. Fairfax
Acting Director
Directorate of Compliance Programs

[Corrected 10/20/06]