Review for Respirator Use
Completion of the Review for Respirator Use form is required for all employees, students, volunteers and contractors (working under direct UF supervision) who are required, or elect, to wear respiratory protection as part of their work with the University of Florida. Care must be exercised to match the type of respirator to the potential respiratory hazard. Individuals who voluntarily wear filtering facepieces (dustmasks) are covered by this policy only as addressed in the Voluntary Use section. Additional instructions for respiratory protection may be found in UF’s Respiratory Protection Policy and other EH&S policies and programs addressing specific hazards (e.g. Asbestos, Q-Fever, or Confined Space Entry).
Environmental Health and Safety (EH&S) reviews the specific details of the requested respirator use and identifies the type of respirator to be used. The Student Health Care Center (SHCC) Occupational Medicine Clinic then reviews the medical history to determine potential health risks to the individual and whether further clinical interaction or preventative steps are necessary to protect the individual’s health. Once the medical clearance is established, EH&S provides the required initial and annual fit tests and training.
Routing of Review for Respirator Use Form
- Online version: https://connect.ufl.edu/ehs/occmed/respiratorreview/default.aspx
- PDF version: http://webfiles.ehs.ufl.edu/respreq.pdf (if online version is unavailable)
- The supervisor completes the Employee, the Supervisor, the Respirator Use and Contaminant Information on the Review for Respirator Use form and submits it to EH&S.
EH&S reviews the description of use, identifies the type of respirator to be used and forwards the form to the SHCC.
- The individual completes the health questionnaire and forwards it to the SHCC for review.
For a tight-fitting respirator, use the Initial Medical Questionnaire for Respirator Use form.
For an N95 respirator, use the Medical History Questionnaire for N95 Filtering Face Piece Respirators form.
- The SHCC Occupational Medicine Clinic reviews both the Review for Respirator Use and the health questionnaire and establishes a clearance status.
- Once cleared, the supervisor contacts EH&S at 392-1591 for a fit test and training appointment.
|Environmental Health and Safety||Ph: (352) 392-1591; Fax: (352) 392-3647|
|SHCC Occupational Medicine Clinic||Ph: (352) 294-5700; Fax: (352) 846-2003|
AN INDIVIDUAL MUST BE MEDICALLY CLEARED AND FIT TESTED BEFORE HE OR SHE USES A RESPIRATOR AT THE UNIVERSITY OF FLORIDA.
In addition to the initial requirements, there are annual requirements
- For a tight-fitting respirator, annual medical clearance and fit testing is also required;
- For an N95 respirator, annual fit test is also required.
ORIG 3/10; Revised 1/21/14