Respiratory Protection Equipment Contraindications and Guidelines

Conditions that May Limit Respiratory Protection Equipment Use

Facial hair, such as beards, can interfere with the seal of negative-pressure respirators and is a common cause of leakage, according to the CDC and OSHA guidelines 1, 2, 3
Facial trauma or burns can prevent achieving an adequate seal of the mask-face interface, as recommended by the CDC and OSHA 2
Recent facial or upper airway surgery can impede the proper use of respiratory protection equipment, as stated by the CDC and OSHA 2
Orofacial anomalies can interfere with the mask-face interface and predict failure to achieve a proper fit, according to the CDC and OSHA guidelines 2

The use of conventional eyeglasses with full-face respirators can break the facial seal, and special lens kits designed for respirators should be used instead, as recommended by the MMWR Recommendations and Reports 4
Sweating or facial oils can cause the face piece to slip, compromising the effectiveness of the respirator, as stated by the MMWR Recommendations and Reports 2
Incorrect positioning of the face piece can compromise the effectiveness of the respirator, according to the MMWR Recommendations and Reports 2

The program should include medical evaluation of workers to identify conditions that may limit safe use, as required by OSHA and recommended by the MMWR Recommendations and Reports 1, 5, 6
Fit testing is mandatory to identify a respirator that fits properly, as required by OSHA and recommended by the International Journal of Occupational and Environmental Medicine 1, 6
Training on specific hazards, including the nature and extent of the hazards, should be provided, as recommended by the Praxis Medical Insights and the MMWR Recommendations and Reports 5
Instruction on proper inspection and use, including placement, adjustment, and verification, should be provided, as recommended by the MMWR Recommendations and Reports and the Praxis Medical Insights 1, 5

The use of respirators without NIOSH certification should never be allowed, as many respirators that claim to provide 95% filtration or more are actually much less effective, even as low as 25%, according to the International Journal of Occupational and Environmental Medicine 6
The lack of fit testing can significantly reduce the effectiveness of the respirator, with facial seal leaks that can vary from 0 to 20% in currently available disposable respirators, as stated by the MMWR Recommendations and Reports 2, 3