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Voluntary Use Authorization Form

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N95 User Considerations:

OSHA defines a filtering facepiece respirator in 29 CFR 1910.134(b) as "a negative pressure particulate respirator with a filter as an integral part of the facepiece or with the entire facepiece composed of the filtering medium." By this definition, an N95 is an air-purifying negative pressure respirator equipped with an N95 filter. When used in the workplace, N95 respirators may be used in two circumstances:

Voluntary Use

Non-Voluntary Use

Exposure assessment shows respiratory protection is not required.

Respiratory protection is required when such equipment is necessary to protect the health of the employee or whenever respirators are required by the employer.

Complete the Voluntary Use Authorization Form

Annual Medical Evaluation by physician certified in Occupational Medicine

Medical Evaluation and fit test not required

Annual Fit Test, performed by Auburn RMS

 

A medical evaluation is required for non-voluntary use of a respirator, as wearing one may place a burden on the user’s health. Though voluntary use of an N95 respirator does not require a professional medical evaluation, exercise caution when considering utilizing an N95 if you experience any of the following medical conditions:

  • Cardiovascular and respiratory disease, such as high blood pressure, angina, asthma, chronic bronchitis, or emphysema.
  • Cardiovascular damage caused by heart attack or stroke.
  • Reduced lung function caused by factors such as smoking or prior exposure to respiratory hazards.
  • Neurological disorders, such as epilepsy.
  • Musculoskeletal disorders, such as lower back pain.
  • Psychological conditions, such as claustrophobia and severe anxiety.
  • This list provides examples of only some medical conditions that may interfere with safe use of a respirator, or specific type of respirator. In addition, certain medications may interfere with safe use of a respirator. Speak to your medical care provider for professional guidance for voluntary use.

 

Medical evaluation information from OSHA’s “Small Entity Compliance guide for the Respiratory Protection Standard”.

 

Additional information regarding N95 selection and usage can be found in the resource links below:

NIOSH’s Respirator Trusted-Source Information Page

How to interpret NIOSH approval on package labels and the respirator itself

NIOSH-Approved N95 Particulate Filtering Face Piece Respirators

Decontamination and Reuse of Filtering Face Piece Respirators 

Donning and Doffing an N95 Respirator Instructional Video

ADDITIONAL N95 INFOGRAPHICS

 

 

 

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