Voluntary Respirator Provision Compliance

6739 (d) Medical Evaluation

Conduct a medical evaluation before the employee is fit tested or uses the respirator for work. The medical evaluation process involves the following:

1. Identify a physician or licensed health care professional (PLHCP)
2. Either have employee fill out medical questionnaire found in California Code of Regulation (CCR), section 6739 (q) or send employee to the PLHCP for an initial medical examination
   • Employee fills out the questionnaire during work hours and confidentially
3. Provide the PLHCP with the following:
   1. The type and weight of respirator
      • How often and how long the respirator will be worn
   2. The type of work to be performed
      • Other PPE that will be worn
   3. The temperature extremes expected
   4. A copy of your written respiratory protection program and a copy of CCR, section 6739.
      • The Medical Recommendation form found in CCR, section 6739 (s)
4. After the medical evaluation, make certain to obtain the completed Medical Recommendation form you originally gave the PLHCP. You will need this for your records.

6739 (r) Voluntary Respirator Provision Information

After you establish that an employee is medically able to wear a respirator (not including filtering face piece respirators/dust mask):

1. You need to provide the employee with the information contained in CCR, section 6739 (r).
2. The information in section 6739 (r) can be displayed with the Hazard Communication Information for Employees Handling Pesticides in Agricultural Settings (Pesticide Safety Information Series Leaflet A-8), or Hazard Communication Information for Employees Handling Pesticides in Noncrop Settings (Information Series Leaflet N-8), at a central location in the workplace.

(a) Written Respiratory Protection Program

• Not Required (True if either employee or employer provides the respirator)

(d) Medical Evaluation

• Not Required (True if either employee or employer provides the respirator)

(d)(1)(A) Find Physician or Licensed Health Care Professional (PLHCP)

• Not Required (True if either employee or employer provides the respirator)

(d)(3) Administer Medical Questionnaire and Examination confidentially

• Not Required (True if either employee or employer provides the respirator)

(d)(5) Obtain Medical Recommendation,use form in subsection (s)

• Not Required (True if either employee or employer provides the respirator)

(e) Conduct Fit Test

• Not Required 

(r) Voluntary Respirator Provision Information

• Required

(a) Written Respiratory Protection Program

•  Only those provisions necessary to ensure employee is medically able (Only if employer provides the respirator)

(d) Medical Evaluation

• Required (Only if employer provides the respirator)

(d)(1)(A) Find Physician or Licensed Health Care Professional (PLHCP)

• Required (Only if employer provides the respirator)

(d)(3) Administer Medical Questionnaire and Examination confidentially

• Required (Only if employer provides the respirator)

(d)(5) Obtain Medical Recommendation,use form in subsection (s)

• Required (Only if employer provides the respirator)

(e) Conduct Fit Test

• Not Required 

(r) Voluntary Respirator Provision Information

• Required

(a) Written Respiratory Protection Program

•  Only those provisions necessary to ensure employee is medically able (Only if employer provides the respirator)

(d) Medical Evaluation

• Required  (Only if employer provides the respirator)

(d)(1)(A) Find Physician or Licensed Health Care Professional (PLHCP)

• Required  (Only if employer provides the respirator)

(d)(3) Administer Medical Questionnaire and Examination confidentially

• Required  (Only if employer provides the respirator)

(d)(5) Obtain Medical Recommendation,use form in subsection (s)

• Required  (Only if employer provides the respirator)

(e) Conduct Fit Test

• Not Required 

(r) Voluntary Respirator Provision Information

• Required

(a) Written Respiratory Protection Program

• Only those provisions necessary to ensure employee is medically able (Only if employer provides the respirator) 

(d) Medical Evaluation

• Required (Only if employer provides the respirator) 

(d)(1)(A) Find Physician or Licensed Health Care Professional (PLHCP)

• Required (Only if employer provides the respirator) 

(d)(3) Administer Medical Questionnaire and Examination confidentially

• Required (Only if employer provides the respirator) 

(d)(5) Obtain Medical Recommendation,use form in subsection (s)

• Required (Only if employer provides the respirator) 

(e) Conduct Fit Test

• Not Required 

(r) Voluntary Respirator Provision Information

• Required

(a) Written Respiratory Protection Program

•   Only those provisions necessary to ensure employee is medically able (Only if employer provides the respirator)  

(d) Medical Evaluation

• Required  (Only if employer provides the respirator)

(d)(1)(A) Find Physician or Licensed Health Care Professional (PLHCP)

• Required  (Only if employer provides the respirator))

(d)(3) Administer Medical Questionnaire and Examination confidentially

• Required  (Only if employer provides the respirator)

(d)(5) Obtain Medical Recommendation,use form in subsection (s)

• Required  (Only if employer provides the respirator)

(e) Conduct Fit Test

• Not Required 

(r) Voluntary Respirator Provision Information

• Required

For a functional guide to help you develop a Written Respiratory Protection Program and the full text of California Code of Regulations (CCR), section 6739, it is highly recommended that you read:

• Text of Final Respirator Regulations - CCR 6739(PDF: 114kB)
• DPR’s Guidelines for Development of a Respiratory Protection Program (HS-1513)(PDF: 106kB)