Medical clearance for respirator use: sensitivity and specificity of a questionnaire.

Abstract:

BACKGROUND:OSHA regulations require that workers receive medical clearance prior to respirator use, and recently, a detailed questionnaire has been provided to assist with this purpose. However, there are limited published data on the sensitivity and specificity of self-administered questionnaires for identifying individuals who may safely wear a respirator. METHODS:We tested 474 consecutive workers at a Department of Energy complex. After completing the self-administered questionnaire, all workers received a standardized physician evaluation including interview, physical examination, and spirometry. The outcomes of the questionnaire assessment were compared to the outcomes of physician evaluation. RESULTS:Data for analysis were available from 413 of workers (87%). All workers received medical clearance; only 10 workers (2.4%) received work restrictions. The questionnaire demonstrated 100% sensitivity in identifying workers who required work restrictions, but had specificity of only 19%. Compared to physician evaluation, the questionnaire had modest sensitivity to the detection of chronic medical conditions. CONCLUSIONS:These data suggest that the rates of medical clearance for respirator use are very high, and that a self-administered questionnaire may be appropriate for medical clearance in certain settings. It is recommended that the policy of routine physician evaluation and spirometry for respirator clearance be re-examined.

journal_name

Am J Ind Med

authors

Pappas GP,Takaro TK,Stover B,Beaudet N,Salazar M,Calcagni J,Shoop D,Barnhart S

doi

10.1002/(sici)1097-0274(199904)35:4<395::aid-ajim1

subject

Has Abstract

pub_date

1999-04-01 00:00:00

pages

395-400

issue

4

eissn

0271-3586

issn

1097-0274

pii

10.1002/(SICI)1097-0274(199904)35:4<395::AID-AJIM1

journal_volume

35

pub_type

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