1. Supervisors of work groups utilizing respiratory protective devices will coordinate
the scheduling of initial and annual respirator use pulmonary evaluations with
SLCC's MP.
2. The employee will complete the "Employee" portion of the Respiratory Use
Pulmonary Health Evaluation form upon arrival at the clinic.
3. SLCC's MP will review the health history and conduct a PFT if appropriate.
4. SLCC's MP will evaluate the results of the PFT and determine the employee's
ability or inability to work while using respiratory protective devices in
accordance with NIOSH recommended pulmonary fitness standards as
adopted for SLCC's Respiratory Fitness Evaluation Program and set forth
below:
a. Forced Vital Capacity (FVC)
• Pass - FVC of 66% or greater of the predicted value;
• Fail - FVC is less than 66% of the predicted value;
b. Ratio of the Forced Expiratory Volume in One Second divided by the
Forced Vital Capacity (FEV1/FVC)
• Pass - FEV1/FVC is 0.61 or greater.
• Fail - FEV1/FVC is less than 0.61.
c. Other NIOSH recommended consideration factors include history of
spontaneous pneumothorax; claustrophobia/anxiety reaction; use of
contact lens; moderate or severe pulmonary disease; angina pectoris;
significant arrhythmia's; recent myocardial infarction; symptomatic or
uncontrolled hypertension; etc.
5. Based upon the results of the pulmonary health evaluation, the City's Medical
Provider will either:
a. Sign and date the respirator use pulmonary health evaluation form stating
that the employee has met the requirements specified above and then
issue a respiratory fitness card and evaluation form to the employee, or
b. Sign and date the respirator use pulmonary health evaluation form, and
issue a letter to the designated department representative stating that
the employee did not meet the requirements specified above, along with
a letter to the employee addressing any possible medical conditions.
This letter will serve as a notice to the employee that he/she has or may
have a medical condition which may affect his/her functional ability to
safely utilize respiratory protective devices.
6. It will be the department's designated respirator fit testers responsibility, after
observing employee's respiratory fitness card, to fit test the employee for the
appropriate respirator(s), and determine their final ability or inability to use the
respirator(s) on the job.
Employees Restricted From Respirator Use:
Employees who are unable to meet the criteria for respirator use will be restricted from using respirators. The employee's respirator use status may only be changed based upon a written medical opinion from a private medical provider. A change of respirator use status is the responsibility of the employee and is permissible provided:
1. The private medical provider has received and acknowledged receipt of a
complete job description including information pertaining to the types of
respirators used, the expected duration of use, and an indication of the work
load or amount of exertion necessary to perform the tasks,
2. Any restriction(s) specified by the private medical provider will not adversely
affect the employee's ability to perform the functions required of the job, and
3. The written medical opinion from the employee's private medical provider
supporting a change in respirator use status is submitted to the city's MP within
fifteen (15) working days following the issuance of the letter restricting respirator
use by SLCC's MP.
When the requirements for changing an employees respirator use status are achieved, reviewed (with HR representative and department representative), and accepted, SLCC's MP will issue the employee a letter and/or card indicating the employee's level of ability to work using respiratory protective devices. A copy of this letter will be submitted to the employee's human resource representative and their department representative for record keeping and appropriate processing.
Cases where the employee cannot successfully pass the City's pulmonary fitness standards and his/her private medical provider is unable to satisfy the requirement for changing the employee's respirator use status, will be resolved through SLCC's Human Resources Department in accordance with City policies regarding fitness for duty and the American’s with Disabilities Act.