Medical evaluation for respirator use

The purpose of a respirator is to prevent the inhalation of harmful airborn e substances or to provide a source of respirable air when breathing in oxy gen-deficient atmospheres. For a physician to recommend the use of respirat or general background information on respiratory-protective devices is requ ired. The first part of this clinical practice review describes the general aspects of industrial hygiene respirators and a respirator-certification p rogram. The second part addresses matters related to medical certification for respirator use. Medical certification for respirators is an important part of the activitie s of the occupational physician. To determine whether a worker is able to t olerate the added strain of a respiratory protective device is a complex pr ocess in which factors such as fitness for work, health of the individual, characteristics of the work itself and the properties, type, and requiremen ts of the respiratory protective device, have to be considered. Medical cer tification is of utmost importance for respirator use, and it should be vie wed as an element in a comprehensive respiratory protection program. A comp rehensive program is the key element in affording the workers' effective re spiratory protection once the initial steps of the hierarchy of methods of hazard control have proved insufficient or infeasible. As a result, the nee d for the industrial hygiene/safety officer the worker; the employer and th e medical professional to work as a team is much more than in any other fie ld of occupational medicine-a necessary requirement for making the right de cision. Am. J. Ind. Med. 37:142-157, 2000. (C) 2000 Wiley-Liss, Inc.