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What Should Be the Content and Frequency of Performing a Medical Evaluation to Determine Fitness to Wear a Respirator?

Desautels, Nicole BS; Singh, Joginder BS, BSc; Burrell, Joy BS; Rosenman, Kenneth D. MD

Journal of Occupational and Environmental Medicine: September 2016 - Volume 58 - Issue 9 - p 892–895
doi: 10.1097/JOM.0000000000000815

Objective: The aim of this study was to assess the standard of care among occupational medicine practioners for determining medical fitness to wear a respirator.

Methods: A 15-item email/telephone survey was conducted of members of the Michigan Occupational and Environmental Medical Association.

Results: Sixty-seven percent of occupational medicine practioners who responded performed respirator evaluations; 75% did more than just the required Occupational Safety Health Administration questionnaire. Cardiovascular and respiratory symptoms and problems wearing a respirator (87% to 95%) were the most common reasons for additional testing and denying medical clearance (58% to 82%). Sixty percent of practioners required workers to have an annual evaluation.

Conclusions: The frequency of medical evaluation, which specific tests were performed, and the criteria used to determine fitness to wear a respirator varied markedly between practioners. Further research is needed to determine whether the widespread variation is a sign of too little or too much testing by different practioners.

Wayne State University School of Medicine, Detroit (Ms Desautels); and Michigan State University College of Human Medicine, East Lansing (Mr Singh, Ms Burrell, Dr Rosenman).

Address correspondence to: Kenneth D. Rosenman, MD, Michigan State University, 909 Fee Road, Room 117 West Fee, East Lansing, MI 48824 (

Funding for this study was provided by Michigan Occupational and Environmental Medicine Educational Foundation.

There are no conflicts of interests to declare.

Copyright © 2016 by the American College of Occupational and Environmental Medicine