Who is covered: Every employee required to use a respirator must receive a medical evaluation before fit testing or use. 8 CCR 5144 applies across covered work (general industry and construction) — Cal/OSHA does not split respiratory protection into separate GI/construction sections; medical-evaluation provisions in 5144(e) track 1910.134(e) nearly verbatim.
Evaluation performed by: PLHCP — physician or other licensed health care professional (California licensure scope)
🩺 Baseline / Pre-Placement
Before the employee is fit tested or required to use a respirator — 8 CCR 5144(e)(1)
- OSHA Respirator Medical Evaluation Questionnaire — Appendix C (Mandatory), Part A, Section 1 (basic info: name, age, height, weight, job title, respirator type) and Section 2 (mandatory medical-history/symptom questions, Q1-8 cardiopulmonary; Q10-15 mandatory for full-facepiece/SCBA users) — covering tobacco use; seizures/diabetes/allergies/claustrophobia; pulmonary conditions (asthma, emphysema, TB, lung cancer); current respiratory symptoms (shortness of breath, cough, wheeze, chest pain); cardiovascular history/symptoms (heart attack, angina, arrhythmia); current cardiac/respiratory/BP/seizure medications; prior respirator-use problems
- Alternatively, an initial medical examination that obtains the SAME information as the Appendix C questionnaire (equivalent entry pathway)
- Appendix C Part B questions at the PLHCP's discretion (occupational exposures, work intensity/duration, environmental conditions, additional protective clothing)
Abnormal results & exposure-event protocols
Abnormal Results & Exposure-Event Protocols
- Employee answers 'yes' to any of questions 1-8 in Section 2, Part A of Appendix C, OR the initial medical exam shows a need 8 CCR 5144(e)(3): Employer provides a FOLLOW-UP medical examination by the PLHCP; the follow-up exam includes any medical tests, consultations, or diagnostic procedures the PLHCP deems necessary to make a determination of fitness to use a respirator. Tests: Medical examination by the PLHCP, Any medical tests, consultations, or diagnostic procedures the PLHCP deems necessary (e.g., spirometry or chest X-ray ONLY if the PLHCP deems them necessary — not mandated by the standard)
- Additional medical re-evaluation required when: (i) the employee reports medical signs/symptoms related to ability to use a respirator; (ii) a PLHCP, supervisor, or respirator program administrator informs the employer that re-evaluation is needed; (iii) information from the respiratory protection program (including observations during fit testing or program evaluation) indicates a need; or (iv) a workplace change occurs that may substantially increase the physiological burden on the employee. 8 CCR 5144(e)(7): Provide an additional medical evaluation (questionnaire or exam as appropriate) to re-determine the employee's ability to use the respirator. Tests: Repeat medical evaluation via Appendix C questionnaire or examination, as indicated by the trigger
Reporting Requirements
| Who performs the evaluation | PLHCP (physician or other licensed health care professional whose scope of practice permits the services in paragraph (e)) |
|---|---|
| Reported to employer | PLHCP provides a WRITTEN RECOMMENDATION limited to: whether the employee is medically able to use the respirator; any limitations on respirator use (including for emergency/high-burden conditions); the need for a follow-up medical evaluation; and a statement that the PLHCP has provided the employee a copy of the recommendation. No clinical findings or diagnoses are disclosed. |
| Reported to / for the employee | PLHCP must provide the employee a copy of the PLHCP's written recommendation. |
| Time limits | Evaluation must be completed before fit testing or first respirator use. No fixed turnaround stated for the recommendation beyond that it precede respirator use. |
| Recordkeeping | Medical evaluation records retained per 8 CCR 3204 — duration of employment plus 30 years. The completed questionnaire is confidential to the PLHCP; the employer is not given the questionnaire itself. |
Medical Removal Protection
No medical removal protection — medical clearance to use a respirator, not removal-based surveillance. No fixed periodic interval; re-evaluation is trigger-based (see abnormal_protocols).