OSHA Respirator Medical Evaluation Questionnaire
People at an ordinary pace on level ground: Yes No Stopping for breath when walking at your own pace Yes No Shortness of breath when washing or dressing Yes No Shortness of breath that interferes with your job Yes No Coughing that produces phlegm (thick sputum) Yes No Coughing that wakes you early in the morning Yes No Coughing that occurs when ... ................
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