In the U.S., an estimated 5 million workers must wear respirators on the job. And, according to the Bureau of Labor Statistics U.S. employers reported 54,000 respiratory illness cases in 2024.
While these two figures measure different things, both show respiratory hazards remain a major occupational safety concern.
On July 1, 2025, OSHA proposed changes that would eliminate mandatory medical evaluations for certain respirator users. The agency held public hearings on the proposal in August 2026, with the deadline for final written briefs October 4, 2026.
Here, we’ll cover what might change, who it would affect, what it could mean for worker safety, and what steps you should take.
Related: Don’t Overlook These Occupational Respiratory Illnesses.
Related: Respiratory Violations Contribute to Two Deaths, $800K in OSHA Fines.
Proposed Changes To OSHA’s Respiratory Protection Standard
OSHA’s proposed rule changes would remove the mandatory medical evaluation requirement for employees who use filtering facepiece respirators (FFRs) and loose-fitting powered air-purifying respirators (PAPRs).
Today, the general-industry standard, 29 CFR 1910.134, requires employers to provide a medical evaluation to determine whether an employee can use a respirator before fit-testing or required workplace use.
OSHA’s rule changes aim to cut the regulatory burden by asking whether these two respirator types need medical evaluations at all. It does not remove respiratory protection requirements altogether.
Keep in mind this is still only a proposal, not a final rule. So, employers must keep following existing requirements until any amendment takes effect.
Respirators Affected By The Proposed OSHA Rule
The proposal targets two categories of respiratory protection equipment.
1. Filtering Facepiece Respirators (FFRs):
These disposable respirators include N95 models, which are common in healthcare, construction, manufacturing, and other workplaces with airborne particle hazards.
2. Loose-fitting Powered Air-Purifying Respirators (PAPRs):
A powered blower pushes filtered air into a hood or helmet that does not seal tightly against the face.
Tight-fitting half-mask and full-facepiece respirators, supplied-air respirators, and self-contained breathing apparatus (SCBA) would remain subject to the applicable medical evaluation requirements.
Before changing any procedure, confirm the specific respirator type and the standard that applies to it, rather than assuming one rule fits every device.
OSHA Respirator Medical Evaluations: Are They Still Required?
Yes. Existing requirements stay in force while OSHA considers the proposal.
Under 29 CFR 1910.134(e), employers must provide medical evaluations before employees are fit-tested or required to use respirators at work. The proposed exemption would cover only the specified respirator categories.
A medical evaluation checks whether a worker can handle the physical demands of respirator use. Physical workload, breathing resistance, workplace temperature, and an individual’s medical status all affect how safely someone can wear respiratory protection.
A proposed rule is not a reason to stop required medical evaluations.
For now, keep tracking the rulemaking process and, if something changes, confirm the final requirements & effective dates before revising your program. Until OSHA publishes a final rule, the current standard governs every covered respirator user.
How The Proposed Rule Could Affect Employers and Worker Safety
If adopted, the proposal could cut administrative work and medical evaluation costs for employers whose workers use the affected respirators on a regular basis. Organizations with large workforces may gain simpler procedures and fewer scheduling issues when issuing qualifying respiratory protection.
Fewer mandatory evaluations also leave an open question: how will employers identify workers who may struggle to tolerate a respirator?
Consider a construction company that requires N95 respirators during dusty tasks. It still has to address the airborne hazards and each worker’s safety concerns. A worker with an underlying respiratory or cardiovascular condition may need medical guidance even if a revised rule no longer mandates an evaluation.
The proposal would not remove an employer’s responsibility to maintain an effective respiratory protection program or to meet other applicable requirements.
What Employers And Safety Officers Should Do Now
Employers, HR personnel, and occupational safety professionals should take these steps while the proposal is pending:
- Review your respiratory protection program. Confirm that written procedures meet current OSHA requirements.
- Identify affected respirator users. Determine which employees use N95 respirators, PAPRs, and other respiratory protection equipment.
- Maintain required medical evaluations. Don’t drop evaluations on the strength of a proposed rule.
- Assess workplace exposures. Evaluate airborne hazards and prioritize feasible engineering and work-practice controls.
- Maintain other required protections. Continue fit testing, training, respirator selection, cleaning, maintenance, and storage procedures as applicable.
- Monitor OSHA updates. Read the official rulemaking notice and verify any final changes before updating workplace policies.
Following these steps helps you avoid premature compliance decisions while keeping workers protected from occupational respiratory hazards.
Bringing It All Together
OSHA’s proposal could reduce medical evaluation requirements for certain respirator users and lower administrative costs for employers.
It would not end all medical evaluation requirements or employers’ broader respiratory protection responsibilities. Employers should keep complying with current standards, maintain required evaluations, and address workplace exposure risks.
HR teams and safety officers should review existing procedures and watch for OSHA updates before changing any workplace policy.
Whatever happens to the proposed rule, effective respiratory protection remains essential to worker safety.
Don’t wait – get your team’s OSHA-compliant respirator medical clearance today!
Medical Surveillance And Monitoring With Worksite Medical
In most cases, OSHA requires medical surveillance testing, and at no cost to employees.
Worksite Medical makes that program easier with mobile medical testing.
We travel right to your workplace to conduct vision testing, on-site respirator fit tests (including N95 masks), silica exam physicals, audiometric exams, OSHA and HIPAA compliant online respirator medical clearances, pulmonary function tests, heavy metal lab work, and much more, right on your job site.
We also keep accurate, easy-to-access medical records for your convenience. You’ll keep your employees at work, and stay ahead of OSHA & MSHA inspections.
With Worksite Medical, a mobile medical testing unit — we can bring all the resources of a lab to you. Our certified lab technicians can perform both qualitative and quantitative respirator tests to ensure a perfect fit.
You’ll keep your employees at work, and stay ahead of OSHA and MSHA inspections.
Protect your team and your workplace now with Worksite Medical. Not sure what you need? Try our medical testing wizard here, or reach out to us with questions.
Give us a call at 1-844-622-8633, or complete the form below to schedule an on-site visit or to get your free quote.
