Respirator Medical Evaluations

Breathing through a respirator puts extra strain on your heart and lungs. Before you’re fit tested or required to wear one, OSHA requires a medical evaluation to make sure it’s safe for you.

• Construction
• General Industry

How it works

1. Your employer arranges an evaluation by a physician or other licensed health care professional (PLHCP).
2. You fill out a medical questionnaire (OSHA’s Appendix C or an equivalent) or have an initial exam that covers the same questions.
3. The questionnaire is confidential. You fill it out on paid time, at a convenient place, and your employer may not look at your answers.
4. You get a chance to talk with the health care professional about your answers.
5. The PLHCP may order a follow-up exam or tests, such as a breathing test.
6. Your employer gets only a written recommendation: whether you can wear the respirator, any limits, and the need for follow-up.

What they look at

• Heart and lung conditions, such as asthma, COPD and heart disease
• Past problems wearing a respirator, and claustrophobia
• The type of respirator, its weight and breathing resistance
• How hard the work is, how long you’ll wear it, and the temperature and humidity

If you’re not cleared

If you can’t safely wear a negative-pressure respirator, the PLHCP may clear you for a powered air-purifying respirator (PAPR), which is easier to breathe through. Ask about it. See PAPRs.

When you need a new evaluation

• You report signs or symptoms related to respirator use
• The PLHCP, supervisor or program administrator says you need one
• Fit testing or program observations suggest a problem
• Work conditions change in a way that adds stress, like heavier work, heat or a different respirator

OSHA doesn’t require yearly re-evaluation, but some standards and many employers do it periodically.

Last updated: October 2, 2026