Industrial Hygiene in Construction

Before you can wear a respirator here’s what has to happen:

If you’re an employer and your employees wear a respirator, they are required to have a medical approval (Appendix C of OSHA respiratory standard). more details here.

The employee fills out the confidential questionnaire and then submits it to the medical provider of the employer’s choice. 95% (I made that # up) of the time, based upon the questionnaire ONLY, they give an approval to wear a respirator.

Occasionally, some employees are requested to come into the medical office to have a spirometry test performed, which tests for lung function. (a video of how it is done, cool accent included) This tests provides more information for the physician/nurse to determine if wearing a respirator will be too difficult for an employee to wear.

The cost for either test is usually pretty close to the same price… spirometry test, or not.

Here’s my suggestion:  Have every employee perform a spirometry test before wearing a respirator. This helps to guarantee they are capable of wearing a respirator. Maybe they forgot to list a risk factor, maybe they have a hidden serious lung problem, or, maybe they lied on the questionnaire so they can wear a respirator and keep their job.?

It is also beneficial for pre-employment screening, claims defense, and for a baseline in health. The specific results are usually NOT view-able by the employer, but they can be subpoenaed.

There is much confusion over the requirements and best practices of employees using respirators voluntarily.

Let me first clarify. You must do air monitoring (or have other verifiable information) that employees are not REQUIRED to wear respirators (if they are overexposed to something, you must protect them). Also, they cannot voluntarily wear a respirators if there is a known hazard above the exposure limit (the employee cannot opt-out of wearing a respirator and be overexposed).

Some points about voluntary use:

• Assuming the above statement (s) is true, firstly, you do not have to allow them to wear respirators. I am sure this is arguable from a human resources/PR/legal stance. However, if you have documented no overexposure and have not provided a respirator, they should not need to wear one.
• Next, the employees need to be educated and you need to prove it. Having them sign Appendix D of the OSHA respiratory rule is a minimum. Training them would be better.
• What respirator are they wearing? A paper dust mask (N95, P100, or similar) is a respirator. If they are wearing anything other than this type of mask they need a medical evaluation (Appendix C of respiratory standard).
• If they are wearing a 1/2 face tight fitting negative pressure respirators (or more protective ones) the company needs to have a written respiratory program.
• Fit testing is not required to be performed
• Maintenance, inspection, storage, and training should always be done. Can you verify that the employee does this?

I personally do not recommend the paper dust masks (N95, or similar) for this simple reason. Why would you wear this type of respirator if you could have a 1/2 face, tight fitting one with the correct cartridge? The cost difference is negligible, the protection is better, and you can be assured of a better fit. If you’re going to do it, do it right.