Using a respirator may place a physiological burden on employees that varies with the type of respirator worn, the job, and workplace conditions in which the respirator is used, and the medical status of the employee.
The City of Portland provides a medical evaluation to determine employee's ability to use a respirator, before the employee is fit tested or required to use the respirator in the workplace. The City has identified the Occupational Health and Well-being Nurse Practitioner as the licensed healthcare professional (LHCP) to perform medical evaluations using a medical questionnaire or an initial medical examination that obtains the same information as the medical questionnaire.
Follow-up medical examination is provided for any employee who gives a positive response to any questions among questions 1 through 8 in section 2, part A of the full questionnaire (see below) or whose initial medical examination demonstrates the need for a follow-up medical examination. This may be completed by the nurse practitioner or referred to Providence Occupational Health for additional evaluation and examination. The follow-up medical examination shall include any medical tests, consultations, or diagnostic procedures that the LHCP deems necessary to make a final determination.
The medical questionnaire and examinations shall be administered confidentially during the employee's normal working hours or at a time and place convenient to the employee. The medical questionnaire shall be administered in a manner that ensures that the employee understands its content.
The City provides the employee with an opportunity to discuss the questionnaire and examination results with the LHCP.
The medical determination about the employee's ability to use a respirator shall be shared with the employee in writing, and will not contain any specific medical information but include any limitations on respirator use related to the medical condition of the employee, or relating to the workplace conditions in which the respirator will be used, including whether or not the employee is medically able to use the respirator, the need, if any, for follow-up medical evaluations, and a statement that the LCHP has provided the employee with a copy of the written opinion.
Additional evaluations will be provided if an employee reports medical signs or symptoms that are related to ability to use a respirator, or if a LHCP, supervisor, or respirator program administrator informs the employer that an employee needs to be reevaluated. The re-evaluation will be done using the full respiratory questionnaire (see below).
Yearly re-evaluations can be managed using the screening questionnaire (see below) to determine if a more complete re-evaluation is required.
Fit testing is handled by bureau safety staff once the employee has been medically cleared to use a respirator.