September 24, 2002

Mr. Scott B. Cormier
Project Manager/Prehospital Services
HCA Richmond Market Hospitals
411 West Randolph Road
PO Box 971
Hopewell, VA 23860

Dear Mr. Cormier:

Thank you for your July 22 letter to Occupational Safety and Health Administration's (OSHA's) Directorate of Enforcement Programs. This letter constitutes OSHA's interpretation only of the requirements discussed and may not apply to any question not delineated within your original correspondence. You had questions about Hazardous Waste Operations and Emergency Response (HAZWOPER) and respirator requirements for hospital employees who may have to decontaminate patients following a terrorist attack. Your questions refer to a letter you received from the Emergency Management Strategic Healthcare Group of the Department of Veterans Affairs (VA). Your questions and our responses are listed below.

Question 1: Is every employee required to have a pulmonary function test? Our employees would be wearing either an N-95 respirator or a loose-fitting powered air-purifying respirator (PAPR).

Response: No. Neither the Respirator Standard, 1910.134, nor the HAZWOPER Standard, 1910.120, requires a pulmonary function test. However the physician or other licensed health care professional (PLHCP) may require a pulmonary function test as part of the medical evaluation along with any follow-up exams he/she may deem necessary.

Although the VA letter stated that, "a pulmonary function test, and then a physical exam" is required, the Respirator standard does not require a physical examination. The emergency response paragraph (q) of the HAZWOPER standard requires physical examinations for HAZMAT team members and hazardous materials specialists. Employees trained to perform at the first responder operations level are not in one of these categories.

Question 2: Is the employee health physician responsible for completing the questionnaire in Appendix C of 1910.134 in its entirety if the employee is only wearing an N-95 respirator or a PAPR?

Response: The PLHCP may perform the medical evaluation using either the medical questionnaire or an initial medical examination that obtains the same information as the medical questionnaire. The physician is not required to complete the questionnaire, only to obtain the requisite information in order to perform the medical evaluation.

As you may know, the questionnaire is not eight pages long as described in the attached letter from the VA. The required information is in Part A, Sections 1 and 2 of Appendix C. There are twelve questions in Section 1 asking background information such as name, age, weight, etc. Section 2 includes fifteen questions. Of these, six questions are required only for employees who will use either a full-facepiece respirator or a self-contained breathing apparatus (SCBA). The remaining questions may be added to the questionnaire at the discretion of the health care professional who will review the questionnaire.

Question 3: The OSHA standard 1910.120(q)(6)(i) describes competencies for first responder awareness level training, but does not mention a minimum hour requirement. Is there a minimum hour requirement for awareness training?

Response: No. First responder awareness level requires specific competencies, but does not specify a minimum time for the training.

Question 4: The OSHA standard 1910.120(q)(6)(ii) describes competencies for first responder operations level training, with a minimum requirement of 8 hours. Is a training course that combines the first responder awareness level and first responder operations level competencies in 8 hours acceptable?

Response: Yes. The statement made in the VA letter that a total of 16 hours of training is required for the first responder operations level is not correct.

Question 5: Is there a minimum competency or hour requirement for refresher training?

Response: No. There is no minimum time specified for emergency response refresher training. The training must be of sufficient content and duration to maintain the competencies for the responders' level. Alternately, employees may demonstrate those competencies at least annually.

Additional Comment: The VA letter stated that employees, "must be fit tested if using any respirator other than a PAPR." The Respiratory standard requires fit testing for all tight-fitting facepiece respirators. This includes tight-fitting PAPRs.

As you are aware, the Virginia Department of Labor and Industry administers an OSHA-approved state occupational safety and health program for both private and public sector employers and employees in Virginia. State plans must promulgate regulations "at least as effective" as the federal standards, but they may also be more stringent. If you would like further information regarding Virginia occupational safety and health requirements, you may contact the Virginia Department of Labor and Industry at the following address:

C. Raymond Davenport, Commissioner
Virginia Department of Labor and Industry
Powers-Taylor Building
13 South 13th Street
Richmond, Virginia 23219
Phone: (804) 786-2377
Fax: (804) 371-6524

Thank you for your interest in occupational safety and health. We hope you find this information helpful. OSHA requirements are set by statute, standards, and regulations. Our interpretation letters explain these requirements and how they apply to particular circumstances, but they cannot create additional employer obligations. This letter constitutes OSHA's interpretation of the requirements discussed. Note that our enforcement guidance may be affected by changes to OSHA rules. Also, from time to time we update our guidance in response to new information. To keep apprised of such developments, you can consult OSHA's website at http://www.osha.gov. If you have any further questions, please feel free to contact the Office of Health Enforcement at (202) 693-2190.

Sincerely,



Richard E. Fairfax, Director
Directorate of Enforcement Programs