1910.134(e)(6): Medical Determination for Respirator Use
Employers must get a written recommendation from the PLHCP on whether an employee can use a respirator, listing only limits on use, any need for follow-up evaluations, and a statement that the employee got a copy. If a negative pressure respirator could put the employee's health at increased risk, the employer must provide a PAPR if the PLHCP finds the employee can use one.
Key takeaways
- 1910.134(e)(6) is part of OSHA's general industry standards (29 CFR Part 1910, Subpart I).
- OSHA cited it 52 times in the last 3 years, in 52 inspections, with $56,372 in current penalties.
- Most citations: OR (14), CT (7), NJ (6).
- Related part: 1910.134(e) Medical evaluation (2,653 citations).
- Free 5-minute toolbox talk for your crew below.
In this article
What this rule covers
29 CFR 1910.134(e)(6) ("Medical determination") is one requirement inside 1910.134 Respiratory protection, an OSHA general industry standard (Part 1910, Subpart I). It includes 5 sub-paragraphs. The official text below is copied word for word from the Electronic Code of Federal Regulations (eCFR). The numbers, injury cases and training on this page show how OSHA enforces it on real job sites.
Official text
(6) Medical determination. In determining the employee's ability to use a respirator, the employer shall: 52 citations
(i) Obtain a written recommendation regarding the employee's ability to use the respirator from the PLHCP. The recommendation shall provide only the following information: Open (e)(6)(i) 52 citations
(A) Any limitations on respirator use related to the medical condition of the employee, or relating to the workplace conditions in which the respirator will be used, including whether or not the employee is medically able to use the respirator; Open (e)(6)(i)(a)
(B) The need, if any, for follow-up medical evaluations; and Open (e)(6)(i)(b) 1 citations
(C) A statement that the PLHCP has provided the employee with a copy of the PLHCP's written recommendation. 3 citations
(ii) If the respirator is a negative pressure respirator and the PLHCP finds a medical condition that may place the employee's health at increased risk if the respirator is used, the employer shall provide a PAPR if the PLHCP's medical evaluation finds that the employee can use such a respirator; if a subsequent medical evaluation finds that the employee is medically able to use a negative pressure respirator, then the employer is no longer required to provide a PAPR.
Source: eCFR, text current as of 2026-10-15. Read all of 1910.134.
Where and how often it was cited
| Year | Citations |
|---|---|
| 2023 | 2 |
| 2024 | 17 |
| 2025 | 19 |
| 2026 | 14 |
Top states: OR (14), CT (7), NJ (6), WI (3), NY (3)
Largest penalties
| Employer | Location | Penalty for this rule |
|---|---|---|
| QUALITY SAUSAGE COMPANY LLC | DALLAS, TX | $9,669 |
| TOWNSHIP OF FRANKLIN | SOMERSET, NJ | $7,000 |
| BOROUGH OF OLD TAPPAN | OLD TAPPAN, NJ | $7,000 |
| THE L.C. DOANE COMPANY | IVORYTON, CT | $5,807 |
| PRAM SINGING WOODS TE LLC DBA SPRING HILLS SINGING WOODS | DAYTON, OH | $4,113 |
Free toolbox talk
A 5-minute crew talk on 1910.134(e)(6), plus alerts when this rule changes. Free.
OSHA interpretation letters
- Whether the respiratory protection medical evaluation may consider factors beyond respirator use (2025-08-01)
- Retention of Spirometry Records (2019-09-18)
- Mandatory annual blood work requirements in OSHA's Respiratory Protection and Ethylene Oxide standards (2017-06-12)
Related parts of this rule
- 1910.134(e) Medical evaluation 2,653 citations
- 1910.134(e)(1) General 2,526 citations
- 1910.134(e)(6)(i) 52 citations
- 1910.134(e)(2) Medical evaluation procedures 22 citations
- 1910.134(e)(4) Administration of the medical questionnaire and examinations 19 citations
- 1910.134(e)(2)(i) 17 citations
- 1910.134(e)(7) Additional medical evaluations 17 citations
- 1910.134(e)(4)(i) 16 citations
- 1910.134(e)(7)(ii) 11 citations
- 1910.134(e)(5) Supplemental information for the PLHCP 10 citations
- 1910.134(e)(5)(i) 6 citations
- 1910.134(e)(3) Follow-up medical examination 5 citations
Get your crew competent
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Frequently asked questions
What does the PLHCP's recommendation include?
Only limitations on respirator use, the need for follow-up evaluations, and a statement that the employee received a copy.
What if I cannot safely wear a negative pressure respirator?
The employer must provide a PAPR if the PLHCP's evaluation finds you can use one.
Do I get a copy of the recommendation?
Yes. The recommendation must state that the PLHCP provided the employee a copy.
About this page
Sources
- 29 CFR 1910.134 (eCFR), text current as of 2026-10-15
- U.S. Department of Labor enforcement data: OSHA inspections, citations and accident records, copied nightly; data as of 2026-10-20
3-year window. Federal OSHA only; state-plan rules are not counted. Plain-language text is a summary, not legal advice; the official text controls. Black Belt Safety is not part of OSHA or the Department of Labor.