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THEUNIVERSITYOFMISSISSIPPIMEDICALCENTER
STUDENTEMPLOYEEHEALTH
AppendixCtoSec.1910.134:OSHARespiratorMedicalEvaluationQuestionnaire(Mandatory)
Totheemployer:AnswerstoquestionsinSection1,andtoquestioninSection2ofPartA,donotrequireamedical
examination.
Totheemployee:Contoured?
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How to fill out voluntary respiratory use procedure

How to fill out voluntary respiratory use procedure
01
Start by washing your hands thoroughly with soap and water.
02
Take a clean and dry respiratory mask from the packaging.
03
Ensure that the mask is in good condition, without any tears or holes.
04
Hold the mask by the ear loops and place it over your nose and mouth.
05
Adjust the mask to fit snugly against the sides of your face, covering both your nose and mouth completely.
06
Secure the mask by tying the ear loops or using the adjustable straps.
07
Make sure the mask is comfortable and does not restrict your breathing.
08
Avoid touching the mask once it is in place.
09
If the mask becomes damp or dirty, replace it with a new one.
10
After use, remove the mask by the ear loops or straps, avoiding touching the front of the mask.
11
Discard disposable masks into a closed bin and wash reusable masks with soap and water.
12
Wash your hands again thoroughly after removing the mask.
Who needs voluntary respiratory use procedure?
01
Voluntary respiratory use procedure is recommended for individuals who want to take extra precautions to protect themselves and others from airborne particles, such as viruses or pollutants.
02
It is particularly important for healthcare professionals, caregivers, and individuals who are in close contact with people who may be infected with contagious diseases.
03
People living or working in areas with poor air quality or high pollution levels can also benefit from using respiratory masks as a preventive measure.
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