Voluntary Use Respirator Request Form - Risk Management 2025

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If you permit the use of respirators other than filtering facepieces, you must pay for required medical evaluations for voluntary users and provide voluntary users with appropriate facilities and time to clean, disinfect, maintain, and store respirators.
In addition, the employer must establish and implement those elements of a written respiratory protection program necessary to ensure that any employee using a respirator voluntarily is medically able to use that respirator, and that the respirator is cleaned, stored, and maintained so that its use does not present a
Read and heed all instructions provided by the manufacturer on use, maintenance, cleaning, care, and warnings regarding the respirators limitations. Choose respirators certified for use to protect against the air contaminant youre dealing with.
Another example where you might want to voluntarily use a respirator would be to reduce exposure and increase comfort when working in a non-hazardous but dusty situation; for example, sweeping a shop floor.
If you will be voluntarily using a respirator, your employer is also required to provide you with a copy of Appendix D of OSHAs Respiratory Protection Standard or the equivalent State OSHA Agency document. This document contains certain precautions you should take when wearing a respirator voluntarily.
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