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Respiratory Protection Program

Program Overview	Medical Evaluation & Clearance	Fit Tests

Training Requirements	Recordkeeping Requirements	Forms and Documents

Participant Survey	Voluntary Use Provisions	Contact Administrator

Program Overview

UC ANR’s respiratory protection program is administered by the UC ANR Environmental Health and Safety Office. Any ANR employee who is required to use a respirator at work must participate in UC ANR’s respiratory protection program (unless they are participating in a UC campus program or a USDA-sponsored program).

The primary regulations guiding UC ANR's respiratory protection program are California Code of Regulations (CCR) title 8, section 5144 (general requirements), CCR title 3, section 6739 (for pesticide applicators), and CCR title 8, section 5199 (for aerosol-transmissible and zoonotic disease exposures). Medical evaluations and other occupational health services are provided through the UC Davis Occupational Health Clinic or through designated local occupational health care providers.

Program evaluation is conducted by use of employee surveys, EH&S review of program operations and records, and annual consultation with occupational health physicians.

Medical evaluation requirements for respirator users

All employees who are required to use a tight-fitting respirator, an N95 filtering face mask (N95), or a powered-air purifying respirator (PAPR) for protection from respiratory hazards in the workplace must have a medical evaluation before they can be fit tested or use a respirator. The medical evaluation must be conducted by a physician or other licensed health care professional (PLHCP) before the employee is fit tested or required to use the respirator in the workplace. Medical evaluation shall be conducted by PLCHP review of the OSHA-mandated respirator questionnaire or a medical examination that obtains the same information as the questionnaire. Medical evaluations are provided by the employer at no cost to the employee (through the designated occupational health care provider).

In addition to initial medical evaluation, the employer shall provide additional medical evaluations if:

An employee reports medical signs or symptoms that are related to ability to use a respirator
A PLHCP, supervisor, or the respirator program administrator informs the employer that an employee needs to be reevaluated
Information from the respiratory protection program, including observations made during fit testing and program evaluation, indicates a need for employee reevaluation
A change occurs in workplace conditions or frequency/duration of respiratory use that may result in a substantial increase in the physiological burden placed on an employee

Clearances and fit tests obtained through a UC campus will be honored by ANR, and must be re-verified annually in order to be authorized to use a respirator at an ANR facility. Employees must follow the applicable requirements of the specific UC campus and occupational health provider. If none of the above-listed changed have triggered the requirements for a new medical evaluation, employees are required to have medical evaluations according to age-based guidelines described in American National Standard ANSI 88.6-2006 (every 5 years for employees under age 35, every two years for employees 35-45, and annually for employees over age 45).

Once an employee has been evaluated, the PLHCP will provide a written medical clearance which indicates that the employee is able to use a respirator.

Instructions for obtaining a respirator clearance through UC Davis Occupational Health Services:

Download and complete a Request for Services form and a Respirator Questionnaire form. The respirator user should retain copies of these forms until they receive their respirator clearance from the doctor.
1. A recharge number and signature of supervisor or manager (as authorizing party) is required on the request for service form. There is no charge for review of respirator questionnaires or occupational health services.
2. The completed respirator questionnaire contains confidential medical information. This form must be completed and submitted directly to the doctor by the respirator user and should NOT be maintained in departmental files.
Submit the completed forms to the UC Davis Occupational Health Clinic via FAX (530) 752-5277 or email (occupationalhealth@ucdavis.edu) or by mailing the forms to: UC Davis Occupational Health Clinic, One Shields Ave, Davis, CA 95616.
1. The doctor will review the questionnaire and respond by providing a written clearance document or request for in-person evaluation. The doctor's response will be mailed to the postal address provided on the respirator clearance form.
The written clearance document received from the doctor should be retained by the department and the employee. This written clearance is required for all respirator users.
1. If the written response from the doctor indicates that the employee must have an in-person evaluation, the employee must make an appointment to see the UC Davis Occupational Health Physician or complete the process with an alternate occupational health provider.

Fit test requirements:

Respirator users must receive a fit test annually (if respirator is required for job duties). Additional fit tests may be required at any time if the employee want to use a different model of respirator or there have been significant changes to the employee’s face that affect the fit of the respirator (such as gain or loss of 20 pounds, significant changes in facial structure or skin). Fit tests must be conducted by a qualified individual authorized under UC ANR’s respiratory protection program. Fit tests may also be obtained through a designated local occupational health care provider or through a local UC campus respiratory fit test program. UC ANR employees whose primary work location is a UC campus should obtain their fit test through their home campus, if possible.

Employees should arrive to their fit test with the following:

A clean shaven face (area where respirator makes contact with face must be completely free of facial hair)
Their own clean uncontaminated respirator (new respirator users will be provided with a respirator during their first fit test)
A printed copy of their latest medical clearance document

Annual training requirements

Annual training is required for use of respirators. This training is provided by EHS at time of respirator fit test. Training may consist of formal classroom training or one-on-one individual training. Online trainings and webinars are available for employees who do not require fit tests (contact program administrator for scheduling).

Record keeping requirements

The following records should be maintained at the local office for all respirator users:

Records of annual fit tests
Records of annual training
Most recent (current) medical clearance
A roster of employees who are using N95 filtering face masks under voluntary use provisions

At least five years of past records should immediately available for review. Records older than 5 years may be kept in archived files. UC ANR Risk and Safety Services will retain copies of all records as a back-up for local offices and employees.

Forms and Documents

Voluntary Use Provisions

Contact Administrator