Management of occupational respiratory hazards is integral to workplace health and safety. At workplaces where airborne particulates and toxic vapors are present, a key part of the overall plan to protect the workers is the use of respirators. Over 5 million workers at 1.3 million workplaces in the United States use respirators (Occupational Safety and Health Administration [OSHA], n.d.). While respirators are effective in preventing inhalation of particulates and dangerous vapors, the devices place a physiological and psychological burden on users ("Respiratory protection," 1998, pp. 1159-1160). Because of the stresses respirators create, the Occupational Health and Safety Administration (OSHA) has published detailed regulations governing the medical clearance of workers for respirator use. The regulations, however, are unwieldy, and they do not set objective medical standards for respirator clearance. Specifically, the regulations, last revised in 1998, do not differentiate between workers who are at high risk and those at low risk for respirator use. Nor do the regulations delineate the risk levels of the different conditions under which workers use respirators. The failure of the federal regulations to address risk levels has led to confusion among employees, employers, and health professionals as to the requirements workers must meet to be approved for respirator use. The lack of objective standards is a serious deficiency of the regulations in light of the importance of accurately assessing workers for respirator use. Workers who are denied respirator clearance can lose their jobs, and employers can incur unnecessary costs when workers undergo needless testing. Additionally, because health professionals have no objective standards for determining respirator clearance, they are placed in legal jeopardy when making decisions. Despite the physiological and psychological burdens that respirators place on users, recent research has shown that wearing a respirator is remarkably benign. In view of this finding, and because of the importance of assessing workers against objective standards, the OSHA regulations governing medical clearance for respirator use need to be revised.