Handing a worker an N95 or a half-mask respirator feels like the responsible thing to do. Under Title 8, Section 5144, it is also the moment a California employer takes on a written program, a medical evaluation obligation, and a fit-testing schedule. Construction crews cutting concrete, painters spraying in enclosed spaces, healthcare and dental staff, foundry and welding shops, agricultural operations, and any workplace where wildfire smoke reaches employees are all affected.
When Section 5144 Applies
The standard applies whenever respirators are necessary to protect the health of employees, or whenever the employer requires their use. Necessity is determined by the hazard: an airborne contaminant above a permissible exposure limit, an oxygen-deficient atmosphere, or a substance-specific standard that requires respirators, such as Section 1532.3 for silica, Section 1532.1 for lead in construction, or Section 5141.1 for wildfire smoke when the air quality index for fine particulate reaches unhealthy levels.
The first step is not buying respirators. It is evaluating the exposure. Engineering controls, such as ventilation, wet methods, and enclosure, come first, and respirators are used where those controls cannot bring exposure below the limit. An employer that cannot show an exposure assessment cannot show that it selected the right respirator, and that is where the citations begin.
The Written Respiratory Protection Program
Where respirators are required, the employer must have a written program with worksite-specific procedures, administered by a designated program administrator who is qualified by training or experience. The program must address:
- Procedures for selecting respirators based on the hazards in the workplace
- Medical evaluation of employees required to wear respirators
- Fit testing procedures for tight-fitting respirators
- Procedures for proper use in routine and reasonably foreseeable emergency situations
- Procedures and schedules for cleaning, disinfecting, storing, inspecting, repairing, and discarding respirators
- Procedures to ensure adequate air quality, quantity, and flow for atmosphere-supplying respirators
- Training on the respiratory hazards employees are exposed to
- Training on proper use, including donning, doffing, limitations, and maintenance
- Procedures for regularly evaluating the effectiveness of the program
The program has to describe your workplace. A template that lists supplied-air systems you do not own and omits the silica task your crews perform every day is not a worksite-specific program.
Medical Evaluation Comes First
Before an employee is fit tested or wears a respirator on the job, the employer must obtain a medical evaluation to determine the employee’s ability to use it. Respirators increase breathing resistance, add heat, and can stress the cardiovascular system. An employee with uncontrolled asthma, heart disease, or claustrophobia may not be able to wear one safely, and the employer is not allowed to find that out on the jobsite.
The evaluation is performed by a physician or other licensed health care professional using a medical questionnaire, at minimum the one in Appendix C to Section 5144, or an initial medical examination that obtains the same information. Key requirements:
- The questionnaire is confidential. The employer does not see the answers, only the health care professional’s written recommendation on whether the employee can use the respirator and any limitations.
- It is administered during working hours, at no cost to the employee, and in a manner the employee understands.
- The employee must be given the opportunity to discuss the questionnaire with the health care professional.
- A follow-up examination is required if the questionnaire raises a concern.
Additional evaluations are required when the employee reports symptoms related to respirator use, when the health care professional or program administrator recommends one, when observations during fit testing or program evaluation show a need, or when workplace conditions change in a way that substantially increases the physiological burden on the employee.
Fit Testing
Every employee who wears a tight-fitting respirator, whether a filtering facepiece like an N95, an elastomeric half mask, or a full facepiece, must be fit tested before initial use, whenever a different respirator facepiece is used, and at least annually thereafter. Fit testing is also required whenever there is a change in the employee’s physical condition that could affect fit, such as significant weight change, dental work, or facial scarring.
Fit tests are either qualitative, using a test agent such as saccharin, Bitrex, or irritant smoke that the employee can taste or smell, or quantitative, using an instrument that measures leakage. Qualitative testing is limited to respirators used at lower protection factors; quantitative testing is required for full facepieces used at higher protection factors. The test must follow the protocols in Appendix A to the standard, and the results, including the test method, the respirator make, model, and size, and the date, must be recorded and kept until the next test.
Two practical points come up constantly. First, facial hair that lies along the sealing surface of the respirator defeats the seal, and the standard prohibits it. A fit test on a clean-shaven employee who returns to work with a beard is not a valid fit test. Second, the fit test must be done with the exact make, model, and size the employee will wear. If you switch suppliers, you re-test.
Voluntary Use
Many employers allow employees to wear respirators when the exposure does not require one, for comfort during dusty work or during moderate smoke days. Section 5144 treats voluntary use differently depending on the respirator.
For voluntary use of filtering facepieces such as N95s, the employer must determine that the use will not itself create a hazard and must provide the employee with the information in Appendix D, which explains the limitations of the respirator and the user’s responsibilities. No medical evaluation, fit testing, or written program is required for voluntary filtering facepiece use.
For voluntary use of any other respirator, such as an elastomeric half mask with cartridges, the employer must provide Appendix D and must also implement the elements of a written program necessary to ensure the employee is medically able to use the respirator and that it is cleaned, stored, and maintained so it does not present a health hazard. In other words, the medical evaluation and maintenance provisions still apply.
The line between voluntary and required use is where employers get into trouble. If a supervisor tells a crew to put on respirators for a task, that is required use, and the full program applies, regardless of what the written policy calls it.
Training and Recordkeeping
Employees must be trained before first use and annually, and must be able to demonstrate why the respirator is necessary, its limitations, how to inspect, don, doff, and seal-check it, how to recognize medical signs that limit its use, and the general requirements of the standard. Records that must be kept include medical clearance letters, fit test records, and the written program itself. Cal/OSHA inspectors ask for all three, and penalties can reach well into five figures per serious violation and higher for willful or repeat violations.
What to Do Now
- Identify every task that involves airborne contaminants and determine, with sampling where necessary, whether respirators are required.
- Designate a program administrator and write a worksite-specific respiratory protection program.
- Arrange confidential medical evaluations through a licensed health care professional before anyone is fit tested.
- Schedule initial and annual fit tests using the exact respirator models in use, and record the results.
- Enforce the clean-shaven rule for tight-fitting respirators and train supervisors to check it.
- Distribute Appendix D to every voluntary user and separate voluntary from required use in your written policy.
McNeil Safety Consulting conducts exposure assessments, writes Section 5144 programs, and coordinates medical evaluations and fit testing for employers throughout California, with a licensed vocational nurse on staff for the occupational health side of the program. Learn more about our industrial hygiene services or call (626) 546-9384 to schedule an assessment.
Co-authored with Zennin Sedacey-McNeil, LVN, California Licensed Vocational Nurse, McNeil Safety Consulting.