How to Decide Whether or Not a Worker Can Wear a Respirator

Our plain-English summary of How to Decide Whether or Not a Worker Can Wear a Respirator, by W.C. Cooper (1974).

The study

• Author: W.C. Cooper
• Published: American Industrial Hygiene Conference, May 12-17, 1974
• Type of article: Conference paper
• Our copy: from Johns-Manville's own medical library. The article is still under copyright, so we describe it here rather than post it.

In plain English

This 1974 conference paper presented no original study data. The author reviewed how OSHA regulations, including the June 7, 1972 asbestos dust standard, and NIOSH criteria documents handled medical checks on whether workers could wear respirators, and offered general guidelines. The author noted that the asbestos standard required respirators for jobs such as spraying asbestos, so lacking medical approval could affect employability. The author's group described its own practice for insulating workers: men with forced vital capacity less than 80% of predicted and/or one-second forced expiratory ventilation less than 70% of forced vital capacity should not be required to wear a non-powered respirator if breathing was difficult. Outright prohibition was used almost entirely for cardiovascular problems. The author regarded coronary artery disease, severe or progressive hypertension, and grand mal epilepsy (unless well controlled) as reasons against such respirators, while stating that no epidemiologic studies proved the cardiovascular view. The author concluded that information was insufficient for numerical criteria, that standards should be general and allow professional judgement, and that research on respirator stress should be supported.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Conference paper reviewing regulations and current practice, with the author's opinion-based guidelines and recommendations; no original study data
• Who was studied: No study subjects. The paper concerns workers required to wear respirators, and describes the author's group's practice with insulating workers they examined
• Exposure: Respirator use required under the OSHA asbestos dust standard (June 7, 1972) for operations such as spraying, removal or demolition of asbestos-containing materials; no fiber types named
• Main results:
  • Policy for insulating workers with x-ray evidence of pneumoconiosis and moderately impaired lung function: not required to wear a respirator if breathing is difficult, but not prohibited if reasonably comfortable
  • The middle category ('should not be required to wear a non-powered respirator if there is any difficulty in breathing') was used for men with forced vital capacity less than 80% of predicted
  • The same middle category also applied, as an and/or alternative, to men with one-second forced expiratory ventilation less than 70% of forced vital capacity
  • The prohibition category was used almost entirely for workers with cardiovascular problems
  • The author considered severe or progressive hypertension a contraindication, and stated that people with coronary artery disease (angina or past heart attack) probably should not wear non-powered respirators
  • The author considered grand mal epilepsy a contraindication unless well controlled
  • The author stated that psychological ability to wear a respirator cannot be judged by a physician at a preplacement or periodic examination
• The authors' conclusion: The authors concluded that there was not enough information for numerical medical criteria, that standards should for now be written in general terms permitting professional judgement, and that NIOSH or other federal agencies should support studies of the stress respirators impose on workers with various impairments
• Limitations the authors state:
  • The author stated that no epidemiologic studies prove the view on cardiovascular risk; it is the author's belief
  • The author stated that predicted values in pulmonary function tests are often misleading because of wide individual variation
  • The author described the state of knowledge as inadequate

Topics

Medical terms in this study, explained in our Lexicon: Respirator, OSHA, NIOSH.

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