Nurses conducting respirator medical evaluations

September 2, 2014

Ms. Patti Szydel, RN, BSN

Prevea Health

Employee Health Services

[Recipient address omitted]

Dear Ms. Szydel,

Thank you for your letter dated June 18, 2014, to the Occupational Safety and Health Administration (OSHA). Your letter was referred to OSHA's Directorate of Enforcement Programs for an interpretation of OSHA's Respiratory Protection Standard, 29 CFR 1910.134, regarding whether or not a Registered Nurse licensed in the state of Wisconsin can be classified as a licensed health care professional for purposes of conducting medical evaluations. This letter constitutes OSHA's interpretation only of the requirements discussed and may not be applicable to issues not delineated within your original correspondence. Your paraphrased question and our response are below.

Question: Can a Registered Nurse licensed in the state of Wisconsin be classified as a licensed health care provider for purposes of conducting medical evaluations for respirator use under OSHA's Respiratory Protection standard, 29 CFR 1910.134?

Response: Paragraph 29 CFR 1910.134(e)(2)(i) of the Respiratory Protection Standard states that, "The employer shall identify a physician or other licensed health care professional (PLHCP) to perform medical evaluations using a medical questionnaire or an initial medical examination that obtains the same information as the medical questionnaire." The term PLHCP means "an individual whose legally permitted scope of practice (i.e., license, registration, or certification) allows him or her to independently provide, or be delegated the responsibility to provide some or all of the health care services required by paragraph (e) of this section."

A variety of health care professionals may perform medical evaluations for respirator use depending on the scope of practice permitted by the state's licensing, registration, or certification agencies, in your case the state of Wisconsin. Therefore, you may wish to contact the Wisconsin Department of Safety and Professional Services, Board of Nursing, to determine if Registered Nurses licensed in Wisconsin can, under state law, independently perform this evaluation, or if they must do so under the direction of a licensed physician. You can reach this agency at:

State of Wisconsin

Department of Safety and Professional Services

Board of Nursing

P.O. Box 8935

Madison, WI 53708

Phone: 608-266-2112 / 877-617-1565

Fax: 608-261-7083

http://dsps.wi.gov/home

Please note that on August 3, 1998, OSHA published Questions and Answers on the Respiratory Protection Standard. This 79-page document contains guidance on respiratory protection. The section on medical evaluation may be particularly helpful in developing a respiratory protection program. This can be found on the Internet at the OSHA Home Page at http://www.osha.gov.

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. Note that 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 OSHA's 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,

Thomas Galassi, Director

Directorate of Enforcement Programs