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Osha respirator medical evaluation questionnaire fillable 2025

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The document is the OSHA Respirator Medical Evaluation Questionnaire, which is mandatory for employees selected to use respirators. It outlines the information that must be provided by employees regarding their health and medical history, including questions about smoking, lung and heart conditions, and any symptoms related to respiratory issues. The questionnaire ensures confidentiality and requires employers to facilitate its completion during work hours. Additionally, it includes sections for healthcare professionals to assess the employee's fitness for respirator use.

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What can prevent someone from being able to use a respirator?

Some conditions that could prevent you from using a respirator include heart conditions, lung disease, and psychological conditions like claustrophobia. Before you use a respirator or are fit-tested, your employer must evaluate whether you are medically able to wear it.

What is the OSHA respirator medical evaluation questionnaire?

This easy-to-use OSHA respirator medical evaluation questionnaire helps establish the workers clearance level for using a specific respirator in your work conditions. It can be completed in 15-20 minutes using any computer with internet access, and is available every day, any time, to fit your employees schedules.

What medical conditions would limit respirator use?

Individuals with impaired lung function, due to asthma or emphysema for example, may be physically unable to wear a respirator. Individuals who cannot get a good facepiece fit, including those individuals whose beards or sideburns interfere with the facepiece seal, will be unable to wear tight-fitting respirators.

How do I get an OSHA respirator medical clearance?

The employer must identify a physician or other licensed health care professional (PLHCP) to perform all medical evaluations using the medical questionnaire in Appendix C of the Respiratory Protection standard or a medical examination that obtains the same information.

What disqualifies you from wearing a respirator?

Facial deformities and facial hair, where the respirator forms a seal to the face; 2. Perforated tympanic membranes; 3. Respiratory diseases affecting pulmonary function; 4. Symptomatic coronary artery disease, docHub arrhythmias, or history of recent myocardial infarction; 5.

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Does OSHA require an annual medical evaluation of a respirator?

There is not a specific annual requirement for medical evaluations in the standard. However, the physician or other licensed healthcare provider (PLHCP) may prescribe annual tests to ensure employees continued ability to wear a respirator.

Osha respirator medical evaluation questionnaire fillable 2025

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What can prevent someone from being able to use a respirator?

What is the OSHA respirator medical evaluation questionnaire?

What medical conditions would limit respirator use?

How do I get an OSHA respirator medical clearance?

What disqualifies you from wearing a respirator?

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Does OSHA require an annual medical evaluation of a respirator?

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