An occupational health consultant asked OSHA three questions about spirometry (pulmonary function) test records: whether they are medical records under the access standard, who must retain them when a contracted physician or licensed health care professional performs the testing, and whether the silica and respiratory protection standards let providers hand results to employers.
OSHA confirmed that spirometry results are employee medical records under 29 CFR 1910.1020(c)(6)(i)(B). Under 29 CFR 1910.1020(d), each employee's medical record must be preserved and maintained for at least the duration of employment plus 30 years, with a limited exception for employees who worked less than one year and receive their records upon termination. When employers contract out testing, 29 CFR 1910.1020(b)(3) still makes the employer responsible for assuring the preservation and access requirements are met, regardless of how or where records are kept; this can be handled through written agreements specifying retention obligations or by directly communicating the OSHA requirements to the provider.
On confidentiality, OSHA explained that the silica and respiratory protection standards do not authorize transferring spirometry records to the employer without the employee's written authorization. Under 29 CFR 1910.1053(i)(6) and 29 CFR 1926.1153(h)(6), the written medical opinion the employer receives may contain only the examination date, a statement of compliance with the standard, and any respirator use recommendations; with written authorization, information about silica exposure limitations and specialist referral recommendations may also be disclosed. Under 29 CFR 1910.134(e)(6)(i), respiratory protection opinions are similarly limited to respirator limitations, follow-up needs, and confirmation the employee was notified. The letter also notes HIPAA restricts disclosure without consent, and the compliance-need exception does not apply to spirometry records specifically.