Respirator fit testing for home health workers

March 29, 2004

Ms. Noreen Coyne

Director of Clinical Standards and Development

Tender Loving Care/ Staff Builders Home Health Care

[Recipient address omitted]

Dear Ms. Coyne:

Thank you for your February 13, 2004 letter to the Occupational Safety and Health Administration (OSHA), Directorate of Enforcement Programs, concerning annual fit testing requirements for employees potentially exposed to tuberculosis. This letter constitutes OSHA's interpretation only of the requirements discussed and may not be applicable to any questions or situations not delineated within your original correspondence.

In your letter you state that your business provides home health care and your most recent TB Risk Assessment found that all but one location had very low risk. You also state your current practice for those employees that may be occupationally exposed to tuberculosis is to have them fit tested prior to assignment to a patient with suspected or actual TB. Other employees are not exposed and are not required to wear a respirator.

The practice you have outlined above appears to be in compliance with OSHA standards. OSHA standards require any employee required to wear a respirator to be fit-tested before wearing it in a hazardous environment. If there is no hazardous atmosphere and the employee has no need to wear a respirator, then there would be no need for that employee to have an annual fit test.

Thank you for your interest in occupational safety and health. We hope you find this information helpful. OSHA requirements are set by statute, standards, and regulations. Our interpretation letters explain these requirements and how they apply to particular circumstances, but they cannot create additional employer obligations. This letter constitutes OSHA's interpretation of the requirements discussed. Our enforcement guidance may be affected by changes to OSHA rules. Also, from time to time we update our guidance in response to new information. To keep apprised of such developments, you can consult the OSHA website at http://www.osha.gov. If you have any further questions, please feel free to contact the Office of Health Enforcement at (202) 693-2190.

Sincerely,

Richard E. Fairfax, Director

Directorate of Enforcement Programs