Respiratory protection programme template for US workplaces
A written respiratory protection programme is required under federal OSHA 29 CFR 1910.134(c) when respirators are necessary to protect employees or required by the employer. It must describe worksite-specific procedures, be administered by a suitably trained programme administrator, and be updated when conditions affecting use change. The template below is a drafting framework. It is not a ready-made selection decision, medical clearance, fit test, or guarantee that a workplace meets the rule.
The existing Complys written safety programme guide explains why specific OSHA standards need written programmes. This page is a fillable respiratory-programme artifact for the person responsible for building one. OSHA also provides its own Small Entity Compliance Guide and sample programme; use that primary-source model and the current regulation alongside this worksheet. Identify any OSHA-approved state-plan or sector-specific requirements before adopting it.
Copyable programme document
1. Identification, scope and responsibility
| Field | Employer entry |
|---|---|
| Company / establishment and address | ___ |
| Work areas and operations covered | ___ |
| Issue date, version and review owner | ___ |
| Qualified programme administrator, role and contact | ___ |
| Backup administrator | ___ |
| Supervisors responsible for implementation | ___ |
| Workers/contractors in scope | ___ |
| Separately applicable substance, construction, state-plan or client provisions | ___ |
Programme statement to adapt: “This employer will identify respiratory hazards, use feasible engineering controls where required, and provide suitable respirators when necessary. Required respirator use will follow this written worksite-specific programme. The programme administrator will evaluate its effectiveness, update it when conditions change, and ensure that medical evaluation, fit testing, training, maintenance and records are managed as applicable.” Do not sign this until the procedures below have actual owners and resources.
2. Respiratory-hazard and respirator-selection register
| Work area/task | Contaminant, form and exposure evidence | Engineering/work-practice control | Remaining exposure and oxygen/IDLH question | Selected respirator make/type and filter/cartridge | Selection basis, limits and reviewer |
|---|---|---|---|---|---|
| ___ | ___ | ___ | ___ | ___ | ___ |
| ___ | ___ | ___ | ___ | ___ | ___ |
The administrator must evaluate the respiratory hazards and relevant workplace and user factors under 1910.134(d). A generic “N95 for dust” line is not a substitute for identifying the contaminant, its concentration or plausible exposure range, and whether the respirator is suitable. Cartridge selection and replacement schedules, assigned protection factors and any immediately-dangerous-to-life-or-health (IDLH) work require specialist attention under the standard. If exposure cannot be identified or reasonably estimated, do not guess a filter from this table. Stop and obtain competent exposure/selection advice. Feasible engineering controls remain a first-line question under 1910.134(a)(1).
3. Medical evaluation before required use
| Procedure | Site-specific entry |
|---|---|
| Physician or other licensed health care professional (PLHCP) provider and confidential contact route | ___ |
| How the OSHA questionnaire or equivalent initial examination is arranged | ___ |
| How the employee can discuss answers with the PLHCP confidentially | ___ |
| How the employer receives only the written use recommendation and restrictions | ___ |
| How follow-up or reevaluation triggers are handled | ___ |
| Record custodian and access controls | ___ |
Under 1910.134(e), medical evaluation is required before fit testing or required use. The employer should receive the PLHCP's written recommendation about ability to use the respirator, limits and need for follow-up, not routinely collect the employee's full medical answers into an ordinary safety folder. Reevaluate when the standard's triggers arise, including symptoms, provider or supervisor direction, programme findings, or a material change in physical burden. This form is not a medical questionnaire.
4. Fit testing and use rules
| Item | Site-specific procedure |
|---|---|
| Tight-fitting facepieces in use and approved fit-test method for each | ___ |
| Fit-test provider and record location | ___ |
| Initial, changed-facepiece and annual fit-test scheduling | ___ |
| Extra fit-test process after physical change or fit complaint | ___ |
| User seal check and facial-hair/facepiece-seal rule | ___ |
| Routine-use instructions and conditions that require leaving the area | ___ |
| Emergency-use or IDLH procedure, if any; competent reviewer | ___ |
For a tight-fitting respirator, 1910.134(f) requires fit testing before initial use, when the facepiece make/model/style/size changes, and at least annually. Additional testing is needed when physical changes may affect fit. The test must use an accepted Appendix A protocol. A worker's seal check at each use is a different step; it does not replace a fit test. The programme must explain correct use in normal and reasonably foreseeable emergencies, including when a worker must leave a contaminated area because a respirator fails or breathing becomes difficult. Do not copy an IDLH rescue procedure from another site: if such exposure exists, the employer must develop the standard's specific controls with qualified help.
5. Care, breathing air and training
| Programme element | Responsible person | Frequency/trigger and method | Evidence location |
|---|---|---|---|
| Cleaning and disinfection | ___ | ___ | ___ |
| Storage against damage/contamination | ___ | ___ | ___ |
| Inspection, repair, disposal and replacement | ___ | ___ | ___ |
| Filter/cartridge change schedule where applicable | ___ | ___ | ___ |
| Breathing-air quality, quantity and flow for supplied-air equipment, if used | ___ | ___ | ___ |
| Training on hazards, use, limits, donning/doffing and maintenance | ___ | ___ | ___ |
| Annual or change-triggered retraining | ___ | ___ | ___ |
1910.134(c)(1) calls for procedures and schedules for care, maintenance and, where atmosphere-supplying respirators are used, adequate breathing air. Training must cover the respiratory hazards and proper respirator use. The regulation includes annual retraining and earlier retraining when workplace/equipment changes or worker performance shows a gap. A general toolbox-talk attendance sheet should not be treated as proof of task-specific understanding. Record the respirator model, training content, worker, trainer and date, then verify the worker can use the actual device.
6. Programme evaluation and records
| Question | Findings and action |
|---|---|
| Are selected respirators still suitable for current tasks and exposures? | ___ |
| Do users report fit, breathing, discomfort or maintenance problems? | ___ |
| Have work methods, materials, staffing or equipment changed? | ___ |
| Are medical recommendations, fit tests and training current? | ___ |
| Are cleaning, replacement and breathing-air processes working? | ___ |
| What corrective action, owner and due date follow? | ___ |
Under 1910.134(l), evaluate the workplace as needed to see whether the programme is implemented and effective, and consult required users about fit, selection, use and maintenance. Under 1910.134(m), retain the written programme and required medical and fit-test records using the standard's rules; protect medical confidentiality and apply the appropriate retention/access requirements. A calendar reminder can trigger review, but a change in exposure or observed failure warrants immediate action.
7. Voluntary use is a separate pathway
Record whether any worker chooses to wear a respirator when neither OSHA nor the employer requires it: ___. If yes, the administrator must first decide whether voluntary use itself creates a hazard. Under 1910.134(c)(2), give the worker Appendix D information. For voluntary respirator use other than the narrow filtering-facepiece-only exception, implement the programme elements needed for medical ability and cleaning/storage/maintenance. The filtering-facepiece exception is not permission to relabel a respirator as “voluntary” when the exposure actually requires respiratory protection.
Example of a decision that must not be guessed
A maintenance crew grinds an old coating in a poorly ventilated room. A manager proposes disposable filtering facepieces because the task lasts only an hour. The administrator should first identify the coating and potential airborne contaminants, look for exposure evidence and engineering/work-practice controls, and determine whether respiratory protection is required. A short task can still involve a material exposure; duration alone does not establish the right filter or adequate protection. If a tight-fitting respirator is required, arrange medical evaluation and an appropriate fit test before use, supply training, and record the actual selection basis. If the coating may contain a substance with its own OSHA standard, incorporate those additional requirements. Do not approve the task using only the blank table above.
Product and internal-link boundary
The Complys US OSHA software page is a possible next step for organising programme documents and training evidence if the current US implementation actually supports the intended workflow. Verify the exact route and function before publishing a CTA. Software cannot perform a PLHCP medical evaluation, conduct a physical fit test, measure airborne exposure, select a cartridge for an unknown contaminant, or make the employer compliant by itself.
Source and claim register
| Claim | Primary source | Writer check |
|---|---|---|
| Written worksite-specific programme and nine required element categories; administrator | OSHA 1910.134(c) | Checked 2026-10-06; scope depends on required/voluntary use. |
| Hazard-based selection, medical evaluation, fit testing, use, care, training, evaluation and records | OSHA 1910.134(d)–(m) | Checked 2026-10-06; programme administrator must localise. |
| Fit-test method and voluntary-user information | OSHA Appendix A; Appendix D | Distinct mandatory materials; not replaced by this page. |
| Official sample programme | OSHA Small Entity Compliance Guide | Primary sample; compare current edition before publishing. |
| Existing broad written-programme owner | Complys US guide | Observed 2026-10-06; does not supply this worksite-specific form. |