Fitness for Respirator and SCBA Use

Breathing through air-purifying (AP) respirators (such as disposable masks and canister respirators) poses a small load to the respiratory system, and most persons capable of the job demands without using a respirator will be capable of using these types of respirators. A medical fitness assessment typically consists of a short respiratory health questionnaire, followed by respirator fit testing by safety specialists or industrial hygienists. A physician assessment and lung function testing (spirometry) may be required for workers with current respiratory conditions.

Supplied-air (SA) and self-contained breathing apparatus (SCBA) are required for more hazardous work environments, and can pose medium physical demands. Medical assessments will typically include a more detailed respiratory health questionnaire and lung function testing (spirometry), followed by respirator fit testing by safety specialists or industrial hygienists. A physician assessment may be required for workers with current respiratory conditions.
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Key challenges in the development of a medical fitness program for respirator users are to:

* Assess the airborne (inhalational) hazards in the workplace and determine what type of respiratory protection is required to control exposure to below the occupational exposure limit
* Assess the physical demands and working conditions while using respiratory protection
* Develop health questionnaires and medical screening protocols appropriate to the airborne hazard(s) and type of respiratory protection being used
* Implement fit testing programs for all respirator users
* Identify when a worker’s medical condition will limit or restrict the use of respirators.
Reference Article
Double US Occupational Safety and Health Administration (OSHA). Occupational Exposure to Respirable Crystalline Silica -- Review of Health Effects Literature and Preliminary Quantitative Risk Assessment [2010]
UK Health and Safety Executive (HSE). Health surveillance in silica exposed workers. [2010]

Lappi VG et al. Silica exposure and silicosis in Alberta, Canada. J Occup Environ Med. 2014 Oct;56 Suppl 10:S35-9.

American Conference of Governmental Industrial Hygienists (ACGIH). Recommendations for a Threshold Limit Value – Crystalline Silica. [2010]

US National Institute for Occupational Safety and Health (NIOSH). Health Effects of Occupational Exposure to Respirable Crystalline Silica. [2002]

Dahmann et al. Assessment of exposure in epidemiological studies: the example of silica dust. Journal of Exposure Science and Environmental Epidemiology (2008) 18, 452–461
Raymond LW and Wintermeyer S. Medical Surveillance of Workers Exposed to Crystalline Silica. JOEM (2006) 48;1 95-101
UK Health and Safety Executive (HSE). Variability in fibrogenic potency and exposure-response relationships for silicosis. EH75/4
(2002) Click to Edit