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At a minimum, medical examinations should consist of an examination of the lungs and a standardized respiratory symptom questionnaire that addresses all the potential respiratory conditions that have been associated with MWF publicity. OSHA has a respiratory symptom questionnaire related to the Respiratory Safety Normal, Appendix C to 29 CFR 1910.134. The respiratory protection questionnaire contains acceptable questions about respiratory circumstances. Nonetheless, questions on different situations referring to MWF publicity needs to be added when questionnaires are used for medical monitoring for MWFs.

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* Solely NIOSH/MSHA-authorized or NIOSH-approved (effective date July 10, 1995) respiratory tools should be used.

+ Respirators with increased assigned safety factors (APFs) could also be substituted for these with lower APFs [NIOSH 1987a].

~~ APF instances the NIOSH REL for whole particulate mass. The APF [NIOSH 1987b] is the minimum anticipated stage of safety provided by each kind of respirator.

@ See text for recommendations concerning workers with asthma and for other staff affected by MWF aerosols.

** A respirator that needs to be discarded after the end of the manufacturer’s really useful interval of use, or after a noticeable improve in respiration resistance, or when physical damage, hygiene concerns, or other warning indicators render the respirator unsuitable for further use.

++ An APF of 10 is assigned to disposable particulate respirators if they’ve been properly fitted.

## Excessive-effectivity particulate air filter. When organic vapors are a possible hazard during metalworking operations, a mixture particulate and organic vapor filter is important.