2. Medical Surveillance Purpose To ensure that one can tolerate the physiological burden associated with wearing a respirator.

3. Medical Surveillance Considerations: Medical Condition of Employee Type of Respirator Job/Workplace Conditions

4. Medical Surveillance Required before fit testing Performed by physician or other LHCP –medical evaluation v. medical examination Evaluation may consist of a medical questionnaire or medical exam that obtains the same info as the questionnaire (Appendix C)

5. Medical Surveillance Follow-up medical exam is required for any positive response to the questionnaire Medical exam shall include any procedures that the PLHCP deems necessary

6. Medical Surveillance Supplemental info to LHCP: –type and weight of respirator –duration and frequency of use –expected physical work effort –additional PPE to be worn –expected temp./humidity extremes –copy of written respiratory protection program and of the standard

7. Medical Surveillance Medical Determination Written Recommendation from PLHCP –limitations on respirator use due to medical condition or workplace conditions –the need, if any, for follow-up evaluations –statement that employee has received recommendation from PLHCP Provision for employer to provide a PAPR

8. Medical Surveillance Additional evaluations based on info from: Employee PLHCP, supervisor, or program administrator Fit testing and program evaluation Workplace changes that may increase burden