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 https://www.osha.gov.

February 5, 2004

Ms. Bernice B. Friedman
Chief, Infection Control Service
Department of the Army
Walter Reed Army Medical Center
Washington, DC 20307-5001

Dear Ms. Friedman:

Thank you for your letter of November 6, 2003 concerning the Occupational Safety and Health Administration (OSHA) regulation on Respiratory Protection for M. tuberculosis, 29 CFR 1910.139. Specifically, you asked how often a health care facility must perform fit testing for employees who must wear a respirator for protection against Mycobacterium tuberculosis (M. tuberculosis), SARS, Smallpox and Monkeypox. This letter constitutes OSHA's interpretation only of the requirements discussed and may not be applicable to any question not delineated within your original correspondence.

In your letter, you mentioned a previous letter we had written regarding our enforcement policy for the Respiratory Protection for M. tuberculosis standard, 1910.139. That letter, as well as others, that refer to 1910.139 have recently been removed from our website as they no longer express OSHA policy. OSHA withdrew the proposed standard for Occupational Exposure to M. Tuberculosis on December 31, 2003 (Federal Register, Vol. 68, No. 250, P. 75768). At the same time, the temporary standard for Respiratory Protection for M. Tuberculosis, 1910.139 was also rescinded [Federal Register, Vol. 68, No. 250, P. 75776-75780]. Employers are now required to follow the same respiratory protection standard that is used for all other substances, 29 CFR 1910.134. Respiratory protection for the other diseases you mentioned has always been covered under 1910.134.

Under 1910.134, fit testing must be performed initially (before the employee is required to wear the respirator in the workplace) and must be repeated at least annually. Fit testing must also be conducted whenever respirator design or facial changes occur that could affect the proper fit of the respirator. Examples of conditions which would require additional fit testing of an employee include (but are not limited to) the use of a different size or make of respirator, weight loss, cosmetic surgery, facial scarring, the installation of dentures or absence of dentures that are normally worn by the individual.

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