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CON CIDIM Corporate Safety Program HSP-2. Respiratory Protection °°°1• °° Rev. 1 08/23/2018 The employer shall provide the PLHCP with a copy of the written respiratory protection program. 6.2.6 Medical Determination A written recommendation regarding the employee's ability to use the respirator shall be obtained from the PLHCP. The recommendation shall provide the following information: • Any limitations on respirator use related to the medical condition of the worker, or relating to the workplace conditions in which the respirator will be used; • The need, if any, for follow-up medical evaluations; and • A statement that the PLHCP has provided the worker with a copy of the PLHCP's written recommendation. If the PLHCP finds a medical condition that may place the worker's health at increased risk with the use of a negative pressure respirator, a Powered Air-Purifying Respirator will be provided until a subsequent medical evaluation finds that the worker is medically able to use a negative pressure respirator. 6.2.7 Additional Medical Evaluations At a minimum, additional medical evaluations must be provided if: • A worker reports medical signs or symptoms that are related to his/her ability to use a respirator; • A PLHCP, the PM, the SHSO or the HSPM informs the employer that a worker needs to be reevaluated; • Information obtained during the respiratory protection program, including observations made during fit testing and program evaluation, indicates a need for employee reevaluation; or • A change occurs in workplace conditions (e.g., physical work effort, protective clothing, temperature) that may result in a substantial increase in the physiological burden placed on a worker. 6.3 FIT TESTING Before a worker may use any respirator with a negative or positive pressure tight-fitting facepiece, the employee must be fit-tested with the same make, model, style, and size of respirator that will be used. Employees using a tight-fitting facepiece respirator must pass an appropriate qualitative fit test (QLFT) or quantitative fit test(QNFT). Fit testing must be performed: • Prior to initial use of the respirator; • Whenever a different respirator facepiece (size, style, model or make) is used; and • At least annually thereafter. Additional fit tests shall be conducted whenever the employee reports, or the PLHCP, supervisor, or program administrator makes visual observations of changes in the employee's physical condition that could affect respirator fit. Such conditions include, but are not limited to, facial scarring, dental changes, cosmetic surgery, or an obvious change in body weight. If, after passing a QLFT or QNFT, the employee subsequently notifies the program administrator, supervisor, or PLHCP that the fit of the respirator is unacceptable (e.g., uncomfortable), the employee shall be given a reasonable opportunity to select a different respirator facepiece and be retested. The fit test shall be administered using an OSHA-accepted QLFT or QNFT protocol. The OSHA-accepted QLFT and QNFT protocols and procedures are contained in Appendix A of the OSHA regulations at 29 CFR 1910.134. QLFT may only be used to fit test negative pressure air-purifying respirators with a fit factor of 100 or less, as determined through an OSHA-accepted protocol. If the fit factor, as determined through an OSHA- accepted QNFT protocol, is equal to or greater than 100 for tight-fitting half facepieces, or equal to or greater than 500 for tight-fitting full facepieces, the QNFT has been passed with that respirator. Page 6 of 13