Respiratory Protection Standard Inspection procedures -
OSHA Directive CPL 2-0.120

Where employers use a transient workforce, (e.g., temporary or construction workers), the employer may accept the written medical recommendation of the employee's ability to use a respirator as determined by their previous employer's PLCHP only if the work conditions and type and weight of the respirator remains the same and appropriate for use at their new work site. In this situation, the employer must obtain from the previous employer a copy of the PLCHPs written recommendation.

Section (e)(2)(ii) requires the employer to obtain the information required in the questionnaire or provide the initial examination prior to performing fit testing of employees and prior to requiring the employee to wear the respirator in the workplace. When using the questionnaire, the employer may not change the wording of questions in Part A , if the form is being used as the sole means to evaluate employees. The Physician or other Licensed Health Care Professional (PLHCP) may add questions to the questionnaire that could assist in determining whether the employee can perform the work while wearing respiratory protection.

In order to maintain strict confidentiality of the information obtained in the questionnaire, the employer's role is limited to distributing the blank questionnaire to the employee for him or her to fill out, or providing it to the PLHCP, who will administer the questionnaire to the employee. If the employer provides the questionnaire to the employee, an addressed and postage-paid envelope should also be provided for the employee to mail it to the PLHCP. The questionnaire and findings may also be maintained by the employer's medical office, if the health office is administratively separate from the employer's central administration offices.

If the employer does not have or chooses not to use an in-house medical staff, arrangements must be made for a physician or other licensed healthcare professional (PLHCP) to perform the medical evaluations. The PLHCP may be a physician, a registered nurse, a nurse practitioner, a physician assistant, or other licensed health care professional acting within the scope of his or her state license, registration, or certification. The PLCHP must be legally permitted by his or her professional license to conduct the type of medical evaluation required by the respirator standard. Scope of practice for non-physician PLCHPs will vary from state to state. All PLCHPs who participate in any aspect of the medical evaluation must be practicing within the scope of their license. For assistance in determining which state licensing board or agency to contact to determine a PLCHP's legally permitted scope of practice, the CSHO can contact the Directorate of Technical Support in OSHA's National Office.

The employer must ensure that the questionnaire is administered in such a manner that employees can understand the content and the confidentiality of the record is maintained. Where the employee cannot understand English, the employer must have the questionnaire translated into the employee's language either through a translator or a translated written copy. The questionnaire has been translated into Spanish and is available on OSHA's homepage (www.osha.gov) in the Respirator Q & A Document. In cases where the employee cannot read, the employee can request someone other than the employer to orally read them the questionnaire or the PLHCP may obtain through an interview or examination the same information requested on the medical questionnaire.

1. Inspection Guidelines. The CSHO should determine if the requirements of paragraph (e) are being met by interviewing a number of employees and asking if they have been provided with a confidential evaluation of their ability to wear a respirator, either by the administration of the medical questionnaire or by physical examination. Compliance officers should determine what mechanism the employer is using to ensure that the employer does not see the answers to the questionnaire in order to maintain confidentiality. The CSHO can verify that these medical evaluations have in fact been conducted by asking the employer to see the written recommendation of the employee's ability to use a respirator. The employee should have also received a copy. The recommendation must contain only the information required by subparagraph (e)(6).

   The CSHO should determine what supplemental information was given to the PLHCP by the employer. This can be done through interviewing the PLHCP or reviewing documentation from the employer. If the employer is relying on a medical evaluation for the employee from a previous employer (which is allowed only when the employer uses a transient workforce), the CSHO should determine that the work conditions and respirator remained the same.

   If the CSHO suspects the employee(s) did not receive a medical evaluation or have not answered the questionnaire honestly (e.g., been "coached" by the employer on how to respond to the mandatory questions from Appendix C), then the CSHO should ask to interview the PLHCP. If this interview still results in questions, the CSHO may wish to obtain a Medical Access Order and review the actual medical questionnaire and/or the physical examination records where necessitated by this paragraph of the rule.

   The CSHO should also ensure that any required physical examinations have in fact been conducted, as per (e)(3) and (e)(7). A positive answer to any question in Part A, Section 2, Questions 1-8 (also questions 10-15 for SCBA and full-face respirator users) requires a follow-up by the PLCHP. The PLCHP may evaluate positive responses through consultation with the employee to determine if the positive response is not relevant to the employee's ability to wear a respirator or if further physical examination is necessary (e.g., brief smoking history in the past, as compared to current heavy smoker status).

   If questions arise regarding the issue of qualifications of the PLHCP, the CSHO should inquire with the state licensing board or the applicable registration or certification agencies in that state to ensure that the PLCHP is acting within the scope of his or her practice.

2. Citation Guidelines: If medical evaluations are not provided, a violation of (e)(1) exists. If the PLHCP designated by the employer is not operating within the scope of their license or their license has expired or is invalid, the employer should be cited under paragraph (e)(2)(i) for choosing an inappropriate PLHCP.

   1. If the employer's medical evaluation does not obtain the mandatory information required in Part A, Sections 1 and 2 of Appendix C, then a violation of (e)(2)(ii) exists.

   2. If the PLHCP is not provided with the appropriate supplemental information, a violation of (e)(5) exists.

1. Facepiece Seal Protection (g)(1):

   1. Inspection Guidelines - The CSHO should be alert for the presence of facial hair (more than one day's growth) that comes between the sealing surface of the respirator and the face as well as other conditions that could result in facepiece seal leakage or interfere with valve function of tight-fitting respirators, such as the presence of facial scars, the wearing of jewelry, or the use of headgear that projects under the facepiece seal. Corrective glasses or goggles or other personal protective equipment (such as faceshields, protective clothing, and helmets) must not interfere with the seal of the facepiece to the face of the user. If employees wear other safety equipment with their respirators, the employee must pass an appropriate fit test while wearing the equipment to determine if it interferes with the seal.

      Employees should be observed to determine if the seal check procedures are being performed each time the respirator is donned. The procedure used must be one listed in Appendix B-1 or recommended by the manufacturer if the employer demonstrates it is as effective as those listed in Appendix B-1. Alternative seal checks must be based on scientific studies. [The face fit is considered satisfactory if a slight positive pressure can be built up inside the facepiece when the exhalation valve or surface is covered, the user exhales gently, and there is no evidence of outward leakage at the seal. The negative check requires covering the inlet opening or surface, inhaling gently, and having the facepiece remain in a slightly collapsed condition with no inward leakage of air detected.]

   2. Citation Guidelines - CSHO should cite (g)(1)(i)(A) when employees' facial hair comes between the sealing surface of the facepiece and the face or interferes with valve function; (g)(1)(i)(B) when any other condition except for those listed in (g)(1)(ii) interferes with the face-to-facepiece seal; (g)(1)(ii) when the employee is wearing equipment (e.g., glasses, goggles, helmets, etc.) that affects the face-to-facepiece seal, but was not worn during fit testing; (g)(1)(iii) if user seal checking is not being performed or the employer has not demonstrated that the procedures used are those listed in or as effective as those in Appendix B-1. This paragraph should not be cited in voluntary use situations, if overexposures are not found.

2. Continuing Respirator Effectiveness (g)(2):

   1. Inspection Guidelines - The employer is required, by paragraph (c)(1)(ix), to address in its written program the type of regular surveillance of the workplace necessary to evaluate the effectiveness of the respirator program. The surveillance procedures may include continuous or periodic monitoring, on-site observations, and notation of problems. The intensity of the surveillance should be tailored to the hazards present in the workplace. Highly hazardous substances that pose acute respiratory hazards merit a higher degree of surveillance.

      Section (g)(2)(ii) requires that employers ensure that employees leave the respirator-use area to correct certain problems associated with respirator use, including the detection of contaminant breakthrough, and to replace the respirator or its filters or cartridges. Employees should be interviewed [e.g., What do you do if you notice a leak? ] to determine whether there are any policies or actions which would prohibit or impede them from leaving the area should they have significant problems with their respirators or which impede the replacing of filters or cartridges. Paragraph (g)(2)(iii) is designed to prevent employees from reentering a workplace after leaving because of a significant respirator failure without first assuring the proper functioning of the respirator.

   2. Citation Guidelines - The CSHO should cite (c)(1)(ix) if the written procedures are inadequate to identify problems or changes; (g)(2)(i) if the routine surveillance of the work conditions is not performed; the appropriate section of (g)(2)(ii)(A), (B) or (C), if prohibitions to leaving an area are identified or if employees fail to leave the area when the standard requires them to do so; (g)(2)(iii) if employees are allowed back into an area before the employer has replaced or repaired the respirator.

3. Procedures for IDLH Atmospheres (g)(3):

   1. Inspection Guidelines - The employer must be prepared for emergency rescue or respirator failure whenever employee(s) are working inside of an IDLH atmosphere. At least one person must be on standby outside the IDLH atmosphere and maintain communication with the person inside at all times. The standby person(s) must be trained and equipped to provide an effective emergency rescue. Except in emergency situations, environments containing IDLH atmospheres are frequently well enough characterized and controlled that a single standby person can monitor the status of multiple entrants. The need for multiple standbys should be evaluated in context with the ability of the standby personnel to meet all their standby duties, including their ability to monitor the worker(s) in the area and their ability to initiate effective rescue procedures. Planning is critical for effective response to emergency situations through the development of specific emergency procedures. These procedures should address how the employer will be notified when standby person(s) outside of the IDLH atmosphere enter the IDLH atmosphere to provide emergency rescue and what actions will be taken or assistance provided by the employer. Emergency procedures must be developed and included in the employer's written respirator program.

      For work performed outside of visual contact, voice, radio or signal line are permitted. CSHOs should specifically review protocols for communication, rescue, and notification for employees entering IDLH atmospheres. Communication protocols must be established that allow the standby person to monitor entrant status and enable the standby(s) to alert entrants of the need to evacuate the area. It is not sufficient to rely on the employees in the IDLH area to call for help when needed.

      Paragraph (g)(3) does not apply to IDLH atmospheres in a permit-required confined space (PRCS) or to environments in which there is an uncontrolled release of a hazardous substance. IDLH atmospheres in a PRCS are specifically addressed in the PRCS standard, 1910.146, and its accompanying directive, CPL 2.100. Environments in which there is an emergency release of a hazardous substance are addressed in paragraph (q) of OSHA's HAZWOPER standard, 1910.120 or 1926.65, and its accompanying directive, CPL 2-2.59A. In facilities where an uncontrolled release of a hazardous substance could create an emergency IDLH atmosphere, employers must follow the requirements of HAZWOPER paragraph (q). These situations must be addressed in the employer's emergency response plan and the response procedures must be consistent with that standard.

   2. Citation Guidelines - If an IDLH area meets the definition of a confined space, then the requirements of 1910.146 would apply and the appropriate section of 1910.146 should be cited where deficiencies are noted. If the IDLH is a result of an uncontrolled release of a hazardous substance, then the appropriate section of the HAZWOPER standard, 1910.120 should be cited. Otherwise, violations should be cited under the applicable subparagraph of (g)(3). If adequate communication is not maintained between the entrants and the standby personnel located outside the IDLH area, (g)(3)(ii) should be cited.

4. Procedures for Interior Structural Firefighting, 1910.134(g)(4): This section applies to private sector workers engaged in firefighting, including those working in industrial fire brigades and private incorporated fire companies, and to Federal employees under Section 19 of the Act. These or equivalent provisions apply to State and local government firefighters only in the 25 States that operate OSHA-approved State plans which are required to adopt an identical or "at least as effective" standard and extend its coverage to public employees. (Coverage of volunteer firefighters in these States varies by State and depends on State law.) The following guidance will have applicability primarily in the State Plan States and in responding to general inquiries.

   The provision is limited to workers performing an interior attack on an interior structural fire. In Subpart L ( 1910.155), OSHA has defined "interior structural fire fighting" to mean: "the physical activity of fire suppression, rescue or both, inside of buildings or enclosed structures which are beyond the incipient stage." This is firefighting to control or extinguish a fire in an advanced stage of burning, producing large amounts of smoke, heat and toxic products of combustion. Firefighter exposure during this activity is extremely hazardous. The atmosphere is considered IDLH and the use of Self Contained Breathing Apparatus is required. By contrast, incipient stage fire fighting involves the control or extinguishment of a fire in the initial or beginning stage, using portable fire extinguishers or small hose lines without the need for personal protective equipment. It is the incident commander's responsibility, based on training and experience, to judge whether a fire is an interior structural fire, and how it will be attacked.

   OSHA has discussed this provision in a number of documents.

   1. Summarized below are some key points from those documents.
      must always be at least two firefighters stationed outside during interior structural firefighting, and they must be trained, equipped and prepared to enter if necessary to rescue the firefighters inside. However, the incident commander has the responsibility and flexibility to determine when more than two outside firefighters are necessary given the circumstances of the fire. The two-in/two-out rule does not require an arithmetic progression for every firefighter inside, i.e. the rule should not be interpreted as 4-in-4-out, 8-in-8-out, etc.

      is important that the CSHO recognize that life-saving activities in interior structural fire fighting are not precluded by the standard. There is an explicit exemption in the standard that if life is in jeopardy, firefighters have the discretion to perform the rescue, and the "two-in/two-out" requirement is waived. There is no violation of the standard under such life-saving rescue circumstances.

      two-in/two-out provision is not intended as a staffing requirement. It does not require fire departments to hire additional firefighters; it does not require four-person fire companies; it does not require four persons on a fire truck. Most fire departments have more than four firefighters and can assemble the numbers required on the scene by waiting for others to arrive. During this time the fire may be attacked only from the outside, sizing-up operations may occur, and emergency rescue necessary to save lives may take place as discussed above. The "two-in/two-out" rule is a worker safety practice requirement, not a staffing requirement.

      standard allows one of the standby firefighters to have other duties such as serving as the incident commander, safety officer, or operator of fire apparatus. However, one of the outside firefighters must actively monitor the status of the inside firefighters and may not be assigned additional duties. The second outside firefighter may be involved in a wide variety of activities. Both of the outside personnel must be able to provide support and assistance to the two interior firefighters; any assignment of additional duties for one of the outside firefighters must be weighed against the potential for interference with this requirement. Proper assignment of firefighting activities at an interior structural fire must be determined on a case-by-case basis and is dependent on the existing firefighting situation. Compliance will always depend on consideration of all the worksite variables and conditions, and the judgement of the incident commander is critical in meeting this performance standard.

      two firefighters (buddies) entering an IDLH atmosphere to perform interior structural firefighting must maintain visual or voice communication at all times. Electronic methods of communication such as the use of radios shall not be substituted for direct visual contact between the team members in the danger area. However, reliable electronic communication devices are not prohibited and certainly have value in augmenting communication and may be used to communicate between inside team members and outside standby personnel.

      further explanation refer to the preamble of the Respiratory Protection standard (vol. 63, No. 5, 1245-1248) and the Respirator Question and Answer document (August 3, 1998). Both documents can be found at OSHA's Homepage - www.osha.gov.

   2. Inspection Guidelines - Section (g)(4) includes the requirements of (g)(3). The first and critical step in evaluating an employers response using the two-in/two-out rule is to determine if there was interior structural fire fighting activity. This determination will require consideration of the factors existing at the time of the firefighting action and the basis for the Incident Commander's finding. CSHO should seek expert opinion from other authorities such as a state or local fire Marshall or other fire protection professionals and should thoroughly interview affected personnel to document the violation.

   3. Citation Guidelines - If the CSHO's investigation reveals that the two-in/two-out rule was not followed during the interior attack of an interior structural fire and there was no reasonable expectation that someone was in jeopardy inside the building, the CSHO should cite (g)(4)(i) or (g)(4)(ii) as a serious violation. If adequate communication is not maintained between the team inside and the standby personnel located outside the IDLH, (g)(3)(ii) should be cited.