Infection control and prevention
Infection control principles and practices for local public health
| Policy issues |
PPE | Respiratory
protection | TB
- What is a PAPR, and how do I clean it?
- A PAPR is a powered,
air-purifying respirator. It is a battery operated device that draws
air through a filter to remove very small infectious agents such as
TB bacteria. The air then flows into a hood that covers the wearer’s
head and face, and in this way the user is able to breathe air that
has only minimum or no infectious agents. PAPRs should be cleaned
according to manufacturer’s instructions to avoid damage to the
- Who can perform a medical evaluation?
The OSHA respiratory protection standard states that a physician or
other licensed health care professional must perform the medical
evaluation. This refers to an individual whose legal scope of practice
(that is holding a license, registration, or certification) allows him
or her to independently provide a medical evaluation. If the
evaluation questionnaire reveals a medical condition requiring further
evaluation, the employee should be referred to a physician (MD or DO
in Wisconsin) or practitioner whose scope of practice legally allows
them this action. Generally further evaluation is done by nurses,
physician assistants, or other licensed health professionals working
under MD or DO orders.
- How often do medical evaluations need to be completed?
- An initial medical evaluation must be completed before the employee
can wear a respirator and periodically thereafter as determined by the
physician or other licensed health professional In addition an
evaluation must be completed:
- if an employee reports signs and symptoms related to the ability to
wear a respirator.
- if the medical advisor or respiratory protection program administrator
- if observations made during fit testing indicate the need for a
- if changes in the workplace conditions occur that may result in
increased physical burdens to the employee.
- Can an agency contract out for services related to respiratory
- Yes, but an in-house, on-site program administrator must also be
present. Agencies can use other companies to provide fit testing,
medical evaluation, and other components of the respiratory protection
program. Any contracting company should be carefully evaluated before
enlisting their services.
- What types of respiratory protection devices require fit-testing?
- All respirators that fit tightly on the face must be fit-tested
(e.g. N-95 filtering face pieces, PAPRs with half or full face
pieces). Those with loose-fitting face pieces do not need to be fit-
- How often must fit-testing occur?
- Fit-testing must occur before an employee first uses a respirator,
at least annually thereafter, before a different make or model of
respirator is used, or when there are changes in an employees physical
condition that may affect the fit of the respirator (e.g. significant
weight changes, changes in facial features).
- Do I need to be certified or have any other training to do
- Persons do not need to be certified or have specific qualifications
in order to perform fit-testing. They should, however, receive
training and become proficient in fit-testing procedures.
- Who can administer a respiratory protection program?
- Although no specific requirements are listed in the OSHA Respiratory Protection Standard, an employer should designate someone
who is qualified by appropriate training or experience to manage the
complexity of the program.
- How often do employees under a respiratory protection program need
to receive training?
- Training must occur before initial use of respiratory protection
and at least annually thereafter, when changes in the workplace render
previous training obsolete, or when inadequacies in an employee’s
knowledge or use of the respirator indicate the employee has not
retained the information or skills from the previous training.
- What records must be kept in a respiratory protection program?
Employers must keep records of medical evaluations and fit-testing
procedures. Medical evaluations are part of the employee’s medical
record and as such must be kept for the period of employment plus 30
years. Information on access to employee exposure and medical records
OSHA Standard 29 CFR 1910.1020 (Exit DHS)
- I have a staff member who refuses to shave his beard. What should I
- OSHA does not allow employees to wear tight-fitting respirators if
they have facial hair that comes between the sealing surface of the
face piece and the face or if the hair interferes with valve function.
So employees must either shave if they need to wear a tight-fitting
respirator or they can use a loose fitting PAPR, which does not
Gwen Borlaug, Infection Control Epidemiologist
Wisconsin Division of Public Health
Bureau of Communicable Diseases and Emergency Response
(Phone 608-267-7711) (Fax 608-261-4976)
January 23, 2014