Respiratory protective devices: Rates of medical clearance and causes for work restrictions

Background There are no published data on the outcomes and benefits of medi cal evaluations for the use of respiratory protective devices. We, therefor e, conducted a retrospective database and chart review to assess the rates of medical clearance and causes for work restrictions at a Department of En ergy complex. Methods All workers with work restrictions or denied clearance over a one-y ear period were identified and their medical records abstracted. Results Of the 5,569 workers who received medical evaluation, only 71 (1.3% ) received limitations an respirator use documented in their medical record . Of the 65 workers with sufficient medical records for additional analysis , 9 of the 5,569 workers (0.2%) were denied medical clearance, while 56 wor kers (1.1%) received work restrictions. Pregnancy was the most common. caus e for denying medical clearance for respirator use. Lung disease, cardiovas cular disease, and claustrophobia were the most common causes for work rest rictions. Physical examination and spirometry added little to the detection of relevant medical conditions. Conclusions We conclude that few workers fail medical clearance for respira tor use or receive work restrictions. Data on adverse events from respirato r use are needed to help design appropriate medical evaluations and uniform criteria for work restrictions or denial of medical clearance. Am. J. Ind. Med. 35:390-394, 1999. (C) 1999 Wiley-Liss, Inc.