Firefighter Physicals SOW.pdf

ATTACHMENT 1 STATEMENT OF WORK

MEDICAL EVALUATIONS

PART 1 GENERAL:

SCOPE:

Supplier will be expected to furnish candidate fire fighter and member fire fighter medical evaluations for Mansfield, Toledo and Rickenbacker Air National Guard Bases in accordance with NFPA 1582 (2022 edition) and the associated U.S. Air Force Technical Implementation Guide 1582-18 (RFP attachment 5), referred to as the TIG, and the National Fire Protection Association 1582-22 edition referred to as the NFPA 1582 (available by following this link https://www.nfpa.org/codes-and-standards/all-codes-and-standards/list-of-codes-and-standards/detail?code=1582).

Supplier will be expected to function as the officially designated fire department physician, as defined in NFPA 1582 3.3.8, specifically complying with NFPA 1582 Chapter 2 Sections 4.2.1 (1) through (10), 4.2.2, 4.2.3, 4.2.4, and 4.2.5.

Supplier will be expected to furnish post-infectious exposure care and testing, in accordance with National Fire Protection Association (NFPA) 1581 Standard on Fire Department Infection Control Program, 2022 edition (https://www.nfpa.org/codes-and-standards/1/5/8/nfpa-1581), Chapter 4 Section 4.6.4 (1) and (2), and fitness for duty determination in accordance with NFPA 1581 Chapter 4 Section 4.6.9.

Supplier will be expected to furnish immunizations and infectious disease screening, post-exposure bloodborne pathogen testing, and HIV testing in accordance with NFPA 1582 Chapter 7 Section 7.7.9 through 7.7.11.2, (see link above), and TIG Attachment 5.

1.01 EXPLANATION OF THE TIG: The TIG (RFP attachment 5) is implemented by the Secretary of the Air Force in accordance with Air

Force Instruction (AFI) 32-2001 dated 28 July 2022 (RFP attachment 7). The TIG gives guidance to the physician on how to implement the fire fighter physicals to meet the Air Force requirements. The TIG will let the physician know if the portion of the test is to be implemented as written in the NFPA 1582 or it will state the Air Force requirements for that test. All physicals should be scheduled and performed in accordance with the TIG. If a revised NFPA 1582 and/or TIG 1582 is released or there is any change in any regulation associated with this contract, an amendment may be issued to meet the updated requirements.

1.02 COORDINATION: The Assistant Chief of Training or alternate will coordinate the scheduling of exams. Scheduling will be done by telephone with a minimum notice request time of three days and a maximum of fourteen days. The COR and the alternate’s contact information is as follows:

Ohio Air National Guard

Rickenbacker ANGB 7370 Minuteman Way Columbus Ohio 43217

A/C Daniel Hook 614-492-4307

Mansfield ANGB 1947 Harrington Memorial Rd. Mansfield Ohio 44903

A/C Bradley Williams 419-520-6393

Toledo ANGB 2660 South Eber Rd. Swanton Ohio 43558

A/C Robert Siebenaler 419-868-4397

1.03 LOCATION: The examinations will take place at the contractor’s facility. Only one (1) main location is required for all firefighter testing. Any location within Ohio is acceptable. A medical examination travel cart may be used in addition to the main location as long as testing meets the contract requirements. Firefighters will travel to the designated testing location if no travel cart is available. Parking fees, if applicable, will be absorbed by the contractor.

https://www.nfpa.org/codes-and-standards/all-codes-and-standards/list-of-codes-and-standards/detail?code=1582 https://www.nfpa.org/codes-and-standards/all-codes-and-standards/list-of-codes-and-standards/detail?code=1582 https://www.nfpa.org/codes-and-standards/1/5/8/nfpa-1581

1.04 LENGTH OF CONTRACT: All exams are to be performed during the State fiscal year; July 1st thru June 30th. Initial start date is July 1, 2024. The contract will be awarded on a four-year basis with two (2) possible renewals.

1.05 ESTIMATED EXAMS TO BE PROVIDED:

There are 86 fire fighters estimated to be examined per fiscal year. The amount of fire fighters at each location is as follows:

Rickenbacker ANG: 38Fire fighters

Mansfield ANG: 24 Fire fighters

Toledo ANG: 24 Fire fighters

Total number of Fire fighters of Forty (40) years old or over: 49

PART 2 REPORTS:

2.01 REPORTS: All reports will be provided to the physician by the Fire Department. They are available in PDF format and can be emailed or provided on a computer disk for the physician’s convenience.

2.02 FIRE FIGHTER HEALTH HISTORY: This report will be completed by the Fire Fighter prior to the exam. The report will be given to the physician at the time of the exam for review (attachment 2 of the TIG).

2.03 NFPA 1582 PHYSICAL EXAM SUMMARY: This two-page report (RFP attachment 1) is to be completed by the physician and submitted to the records custodian as outlined in section 2.06.

2.04 MEETS OR DOES NOT MEET FOR THE RECORDS CUSTODIAN: This report (RFP attachment 2) is to be completed by the physician and submitted to the records custodian as outlined in section 2.06.

2.05 MEETS OR DOES NOT MEET FOR THE FIRE CHIEF: This report (RFP attachment 3) is to be completed by the physician and submitted to the fire chief as outlined in section 2.07.

2.06 ANNUAL MEDICAL EVALUATION REVIEW: This report will be completed by the physician annually at the completion of each 12-month period, in accordance with NFPA 1582 Chapter 4 Section 4.2.3.

2.07 RECORDS CUSTODIAN: The “Meets or Does Not Meet” report (RFP attachment 2) must be submitted via email to the records custodian within twenty-four (24) hours of the appointment.

For Return-to-Work evaluations, failing results on the “Meets or Does Not Meet” must be provided via email to the Adjutant

General’s Human Resources department prior to the fire fighter leaving the facility. The completed Physical Exam Summary report (RFP attachment 1) and “Meets or Does Not Meet” report (RFP attachment 2) will be maintained at the medical facility.

2.08 FIRE CHIEF: A copy of the completed “Meets or Does Not Meet” for the Fire Chief (RFP attachment 3) is to be submitted to the fire chief at each fire fighters work location address listed below and marked “PERSONAL AND CONFIDENTIAL”, via both regular US Mail and email.

Rickenbacker ANGB Ohio Air National Guard, 121st CEF

7370 Minuteman Way, Columbus Ohio 43217 ATTN: Chief Mark White - mark.white.6@us.af.mil

Mansfield ANGB Ohio Air National Guard 1947 Harrington Memorial Rd., Mansfield Ohio 44903 ATTN: Chief Wesley Blair - wesley.blair.5@us.af.mil

Toledo ANGB

2660 South Eber Rd., Swanton Ohio 43558 mailto:mark.white.6@us.af.mil mailto:wesley.blair.5@us.af.mil

ATTN: Chief Brian Rozick - brian.rozick.1@us.af.mil

2.09 FIRE FIGHTER: A copy of all reports along with test results and any recommendations from the physician to the patient are to be mailed to the fire fighters’ residence and marked “PERSONAL AND CONFIDENTIAL”. Any test results or recommendations are NOT to be sent to the records custodian, fire chief or submitted with invoices for payment. This information is for the fire fighter only.

PART 3 INVOICING:

3.01 CORRECT INVOICE: All invoices must include an invoice number, a correct remit to address and the State of Ohio purchase order number. The purchase order will be provided to the contractor by the purchasing department.

3.02 SUBMITTING INVOICES: Invoices must be submitted once every month for services performed that month. The invoice will include all of the fire fighter’s names, dates the services were performed and an itemized list of services provided to each fire fighter along with the associated costs.

NO test results or Health Insurance Portability and Accountability Act information are to be submitted with the invoice. All invoices are to be sent to the fire fighters work location address listed below for payment.

No invoices or billing statements are to be sent directly to the fire fighter either at their place of employment or their primary residence. All payment and invoice questions or issues should be forwarded to the office listed below.

Ohio Air National Guard 121st CE

7073 Minuteman Way, Columbus, Ohio 43217-1161

ATTN: Charles Parker

Ohio Air National Guard Mansfield ANGB

1947 Harrington Memorial Rd. Mansfield Ohio 44903

ATTN: Teresa Close

Ohio Air National Guard Toledo ANGB

2660 South Eber Rd., Swanton Ohio 43558

ATTN: Dan Jones

3.03 THIRD-PARTY BILLING: All invoicing should be submitted directly from the contracted physician’s office. If the contractor uses outside resources such as labs for testing or x-ray services, this cost should be included in the invoice. No third-party billing will be accepted, only invoices from the contracted physician’s office can be paid against the State of Ohio purchase order. At no point shall a firefighter’s medical insurance be billed for any services outlined in this Statement of Work.

3.04 PAYMENT: All invoices should be submitted on vendors company letterhead or standard invoice document to include vendors name, address, remit to address if different from main office, invoice date, invoice number, itemized description of goods delivered, or services performed to include pricing less any tax (The State of Ohio is tax exempt).

PART 4 SERVICES:

4.01 CANDIDATE MEDICAL EVALUATIONS AND CLEARANCES: This exam is the initial exam for all new candidates and should be implemented as outlined in chapter 6 of the NFPA and attachment 3 of the TIG (RFP attachment 5). An initial mailto:brian.rozick.1@us.af.mil exam includes the items listed below and is intended to detect physical or medical conditions that could adversely affect the candidate’s ability to safely perform the essential job tasks as outlined in NFPA 1582 Chapter 5 Section 5.1.

Health History: Will be filled out by the employee and taken with them to the appointment per the TIG (this form is Attachment 2 of the TIG).

Workplace Exposure Summary: Will be completed by the physician and provided to the employee using any reported exposures. Exposure reports will be provided to the physician from the Fire Chief or alternate, from each location.

Respirator Questionnaire: Will be filled out by the employee and taken with them to the appointment (Attachment 9

OSHA Respirator Medical Evaluation Questionnaire – can be found at https://www.osha.gov/sites/default/files/publications/OSHA3789info.pdf)

Vital Signs: Temperature, pulse, respiratory rate, and blood pressure.

Physical examination: In accordance with TIG Attachment 3 – Head and general body appearance and form (especially for deformities that might affect respirator or eyewear or other PPE use); Ears, nose, throat, oral cavity, including teeth and gums; Eyes, including careful funduscopic exam (dilated and performed by optometry or ophthalmology if necessary) to assess vasculature; Neck, especially range of motion, thyroid; Heart, lungs, thorax; Abdomen, including checking for ventral and inguinal hernia; Skin, including scars; Extremities and back, especially range of motion and general strength; Balance, deep tendon reflexes, gait, coordination, including checking for tremor; Pulses at both wrists and both feet; Ability to communicate (hearing and speaking), including ability to articulate understandably; General behavior and affect, including evidence of inappropriate behavior, abnormal speech, hyperactivity, or lethargy.

Audiogram: Hearing thresholds assessed in each ear at each of the following frequencies: 500 Hz, 1000 Hz, 2000 Hz, 3000 Hz, 4000 Hz, and 6000 Hz

Visual acuity and horizontal field of vision

Chest X-Ray: As a baseline only; posterior-anterior and lateral views.

Spirometry: Measure forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and the absolute

FEV1/FVC ratio. FEV1 and FVC results expressed as the absolute value and as a percent adjusted for gender, age, height, and ethnicity using NHANES III normative equations.

Electrocardiograms (EKG): Resting 12-lead EKG.

Blood tests: In accordance with TIG attachment 3

(1) CBC with differential, RBC indices and morphology, and platelet count

(2) Liver function tests (ALT, AST, direct and indirect bilirubin, alkaline phosphatase)

(3) Kidney function (BUN, creatinine)

(4) Total cholesterol, HDL, LDL, clinically useful lipid ratios (e.g. percent LDL), and triglyceride

Urinalysis: Dipstick, analysis for glucose, ketones, leukocyte esterase, protein, blood, and bilirubin; Microscopic analysis for RBC, WBC, casts, and crystals if indicated by results of dipstick analysis; Analysis for occupational chemical exposure if indicated.

Immunizations and infectious disease screening: Provide, if needed, once the candidate is deemed to pass the member evaluation in accordance with NFPA 1582 and associated TIG. These immunizations are required unless the candidate can show documentation of previous immunization.

(1) Baseline tuberculin testing

(2) Hepatitis B virus vaccinations and titers https://www.osha.gov/sites/default/files/publications/OSHA3789info.pdf

(3) Hepatitis C virus screen (Baseline)

(4) HIV screening (Baseline)

(5) Tetanus/diphtheria vaccine or tetanus/diphtheria/acellular pertussis (Tdap)

(6) Measles, mumps, rubella (MMR) vaccine

(7) Polio vaccine

(8) Hepatitis A vaccine

(9) Varicella vaccine (offered to employee, but not required)

(10) Influenza vaccine (offered to employee, but not required)

Weight and body composition: In accordance with NFPA 1582 Chapter 8 Section 8.1.

Fitness Evaluation: aerobic capacity measurement with metabolic equivalents; Evaluation of muscular strength, muscular endurance, and flexibility in accordance with NFPA 1582 Chapter 8 Sections 8.2.2.2 – 8.2.2.4.

4.02 OCCUPATIONAL MEDICAL EVALUATION OF MEMBERS: This exam is the annual physical for all current members of the fire department and should be implemented as outlined in chapter 7 of NFPA 1582 and Attachment 2 the TIG. An annual exam includes the following:

Health History: Will be filled out by the employee and taken with them to the appointment per Attachment 2 of the TIG.

Workplace Exposure Summary: Will be completed by the physician and provided to the employee using any reported exposures. Exposure reports will be provided to the physician from the Fire Chief or alternate, from each location.

Respirator Questionnaire: Will be filled out by the employee and taken with them to the appointment (Attachment 9

OSHA Respirator Medical Evaluation Questionnaire).

Physical examination: In accordance with Attachment 3 of the TIG – Head and general body appearance and form (especially for deformities that might affect respirator or eyewear or other PPE use); Ears, nose, throat, oral cavity, including teeth and gums; Eyes, including careful funduscopic exam (dilated and performed by optometry or ophthalmology if necessary) to assess vasculature; Neck, especially range of motion, thyroid; Heart, lungs, thorax; Abdomen, including checking for ventral and inguinal hernia; Skin, including scars; Extremities and back, especially range of motion and general strength; Balance, deep tendon reflexes, gait, coordination, including checking for tremor; Pulses at both wrists and both feet; Ability to communicate (hearing and speaking), including ability to articulate understandably; General behavior and affect, including evidence of inappropriate behavior, abnormal speech, hyperactivity, or lethargy.

Audiogram: Hearing thresholds assessed in each ear at each of the following frequencies: 500 Hz, 1000 Hz, 2000 Hz, Spirometry: Measure forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and the absolute

FEV1/FVC ratio. FEV1 and FVC results expressed as the absolute value and as a percent adjusted for gender, age, height, Electrocardiograms (EKG): Resting 12-lead EKG for all employees aged 40 and older, or as clinically indicated.

Blood tests: In accordance with Attachment 3 of the TIG

(2) Liver function tests (ALT, AST, direct and indirect bilirubin, alkaline phosphatase)

(3) Kidney function (BUN, creatinine)

(4) Total cholesterol, HDL, LDL, clinically useful lipid ratios (e.g. percent LDL), and triglycerides.

Blood tests: Baseline PFOS/PFOA levels for all onboard members – such tests shall include the following markers:

(1) perfluorobutanesulfonic acid (PFBS)

(2) perfluoroheptanoic acid (PFHpA)

(3) perfluorohexanesulfonic acid (PFHxS)

(4). perfluoronanoic acid (PFNA)

(5). perfluorooctane sulfonate (PFOS)

(6). perfluorooctanoic acid (PFOA)

Urinalysis: Dipstick, analysis for glucose, ketones, leukocyte esterase, protein, blood, and bilirubin; Microscopic analysis for RBC, WBC, casts, and crystals if indicated by results of dipstick analysis; Analysis for occupational chemical exposure if indicated.

Sleep Disturbance Screening: Screening for sleep disorders using a validated questionnaire, such as the Berlin

Questionnaire or Epworth Questionnaire, shall be provided annually. If a high index of suspicion for sleep disorder based upon questionnaire or biometric data, the physician shall discuss the risks and benefits of testing and treatment (testing and treatment will be provided by employee’s personal physician).

Immunizations and infectious disease screening: Provide, if needed, once the candidate is deemed to pass the member evaluation in accordance with NFPA 1582 and associated TIG. These immunizations are required unless the candidate can show documentation of previous immunization.

(1) Annual verification of Hepatitis B virus vaccinations and titers

(2) Tetanus/diphtheria vaccine or tetanus/diphtheria/acellular pertussis (Tdap) – 10-year boosters

(3) Annual verification of Hepatitis A vaccine

(4) Varicella vaccine (offered to employee, but not required)

(5) Influenza vaccine (offered to employee, but not required)

Weight and body composition: In accordance with NFPA 1582 Chapter 8 Section 8.1.

Fitness Evaluation: aerobic capacity measurement with metabolic equivalents; Evaluation of muscular strength, muscular endurance, and flexibility in accordance with NFPA 1582 Chapter 8 Sections 8.2.2.2 – 8.2.2.4.

4.03 RETURN TO WORK EVALUATION: This exam is to be completed on any fire fighter who has been off work due to any injuries or long-term illness that prohibited performance of duties. The physician will evaluate the fire fighter based on the following excerpt from the NFPA 1582 7.1.3 and per the TIG. “An occupational medical evaluation shall be performed following a member’s occupational exposure, illness, injury or protracted absence from the job”. In addition, the following excerpt from NFPA 1582 7.1.3.1

“The scope of that evaluation shall be determined by the fire department physician after reviewing the type and severity of the condition”. The “Meets or Does Not Meet” report will be used to release the fire fighter to return to duty. Results on the

“Meets or Does Not Meet” must be provided to the Adjutant General’s Human Resources department prior to the fire fighter leaving the facility due to safety issues. Notice will be provided via (email or phone) to: The record custodian as outlined in section 2.06.

4.04 POST-EXPOSURE BLOOD BORNE PATHOGEN TESTING: This is an as-needed testing, following occupational infectious exposure, as defined in National Fire Protection Association (NFPA) 1581, Section 4.6; NFPA 1582, Section 7.7.9 through 7.7.11.2; and TIG section 7.7.9 through 7.7.11.2. Employee will provide an Infectious Substance Exposure Form

(bid attachment 5). Physicians shall follow current CDC recommendations for post exposure prophylaxis for BBP. HIV testing is part of post exposure protocol. Baseline testing for heavy metal shall be required when indicated by known exposure or substantial risk. The Fire Chief shall be provided the infectious exposure data, without any personal identifiers.

4.05 TERMINATION/RETIREMENT MEDICAL EVALUATION: This exam is the final physical for members of the fire department and should be implemented as outlined in chapter 7 of NFPA 1582 and the TIG (attachment 2), conducted as close to the employee’s termination date as reasonably possible. A termination/retirement exam includes the following:

Health History: Will be filled out by the employee and taken with them to the appointment per Attachment 2 of the TIG.

Workplace Exposure Summary: Will be completed by the physician and provided to the employee using any reported exposures. Exposure reports will be provided to the physician from the Fire Chief or alternate, from each location.

Respirator Questionnaire: Will be filled out by the employee and taken with them to the appointment (Attachment 9 OSHA Respirator Medical Evaluation Questionnaire).

Physical examination: In accordance with Attachment 3 of the TIG– Head and general body appearance and form (especially for deformities that might affect respirator or eyewear or other PPE use); Ears, nose, throat, oral cavity, including teeth and gums; Eyes, including careful funduscopic exam (dilated and performed by optometry or ophthalmology if necessary) to assess vasculature; Neck, especially range of motion, thyroid; Heart, lungs, thorax; Abdomen, including checking for ventral and inguinal hernia; Skin, including scars; Extremities and back, especially range of motion and general strength; Balance, deep tendon reflexes, gait, coordination, including checking for tremor; Pulses at both wrists and both feet; Ability to communicate (hearing and speaking), including ability to articulate understandably; General behavior and affect, including evidence of inappropriate behavior, abnormal speech, hyperactivity, or lethargy.

Audiogram: Hearing thresholds assessed in each ear at each of the following frequencies: 500 Hz, 1000 Hz, 2000 Hz, Chest X-Ray: Posterior-anterior and lateral views.

Spirometry: Measure forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and the absolute

FEV1/FVC ratio. FEV1 and FVC results expressed as the absolute value and as a percent adjusted for gender, age, height, Electrocardiograms (EKG): Resting 12-lead EKG for all employees aged 40 and older, or as clinically indicated.

Blood tests: In accordance with TIG attachment 3

(2) Liver function tests (ALT, AST, direct and indirect bilirubin, alkaline phosphatase)

(3) Kidney function (BUN, creatinine)

Total cholesterol, HDL, LDL, clinically useful lipid ratios (e.g. percent LDL), and triglycerides.

Urinalysis: Dipstick, analysis for glucose, ketones, leukocyte esterase, protein, blood, and bilirubin; Microscopic analysis for RBC, WBC, casts, and crystals if indicated by results of dipstick analysis; Analysis for occupational chemical exposure if indicated.

Sleep Disturbance Screening: Screening for sleep disorders using a validated questionnaire, such as the Berlin

Questionnaire or Epworth Questionnaire, shall be provided annually. If a high index of suspicion for sleep disorder based upon questionnaire or biometric data, the physician shall discuss the risks and benefits of testing and treatment (testing and treatment will be provided by employee’s personal physician).

4.06 FIT TEST: A fit test is the assessment to evaluate the proficiency of a respirator's seal between the facepiece and the wearer's face by determining the amount of leakage that the seal permits. A fit test is carried out on a person who must wear a respirator in order to prevent them from inhaling toxic substances while performing their job. In order to ensure accuracy, the fit test must be performed using a mask of the same size and specifications as the wearer would use in practice.

A fit test must be carried out according to NFPA 1500, Air Force Instruction 48-148 RESPIRATORY PROTECTION

PROGRAM (ATTACHMENT 6) and Occupational Safety and Health Administration Standard 29CFR1910.134 PERSONAL

PROTECTIVE EQUIPMENT (provided here as a LINK). The Air Force requires fit tests for firefighters on Air Force installations and instructions for carrying out these tests by Air Force standards can be found in ATTACHMENT 8 to this contract (AFI 48-137). Agency or contractor conducting the fit test must have attachments to place the mask (MSA

Firehawk) in a negative pressure mode for fit testing purpose.

Further, NFPA 1500 and 29 CFR 1910.134 requires medical clearance prior to fit testing.

Requirements of the Fit Test according to NFPA 1500:

7.11 Fit Testing.

7.11.1 * The facepiece seal capability of each member qualified to use respiratory protection equipment shall be verified by qualitative or quantitative fit testing on an annual basis and whenever new types of respiratory protection equipment or facepieces are issued.

7.11.2 The fit of the respiratory protection equipment of each new member shall be tested before the members are permitted to use respiratory protection equipment in a hazardous atmosphere. Only members with a properly fitting facepiece shall be permitted by the fire department to function in a hazardous atmosphere with respiratory protection equipment.

7.11.3 Fit testing of tight-fitting atmosphere-supplying respirators and tight-fitting powered air-purifying respirators shall be accomplished by performing quantitative or qualitative fit testing in the negative pressure mode, regardless of the mode of operation (negative or positive pressure) that is used for respiratory protection.

7.11.4 * Qualitative or quantitative test protocols shall be conducted as required by the authority having jurisdiction.

7.11.5 Records of facepiece fitting tests shall include at least the following information:

(1) Name of the member tested

(2) Type of fitting test performed

(3) Specific make and model of facepieces tested

(4) Pass/fail results of the tests

7.11.6 * For departments that perform quantitative fitting tests, the protection factor produced shall be at least 500 for negative-pressure facepieces for the person to pass the fitting test with that make of full facepiece.

7.11.7 Nothing shall be allowed to enter or pass through the area where the respiratory protection facepiece is designed to seal with the face, regardless of the specific fitting test measurement that can be obtained.

7.11.8 * Members who have a beard or facial hair at any point where the facepiece is designed to seal with the face or whose hair could interfere with the operation of the unit shall not be permitted to use respiratory protection at emergency incidents or in hazardous or potentially hazardous atmospheres.

7.11.9 These restrictions shall apply regardless of the specific fitting test measurement that can be obtained under test conditions. When a member must wear spectacles while using a full facepiece respiratory protection, the facepiece shall be fitted with spectacles in such a manner that it shall not interfere with the facepiece-to-face seal.

7.11.10 Spectacles with any strap or temple bars that pass through the facepiece-to-face seal area shall be prohibited.

7.11.11 * Use of contact lenses shall be permitted during full facepiece respiratory protection use, provided that the member has previously demonstrated successful long-term contact lens use.

7.11.12 Any head covering that passes between the sealing surface of the respiratory protection facepiece and the member's face shall be prohibited.

7.11.13 The respiratory protection facepiece and head harness with straps shall be worn under the protective hoods.

https://www.osha.gov/laws-regs/regulations/standardnumber/1910/1910.134

7.11.14 The respiratory protection facepiece and head harness with straps shall be worn under the head protection of any hazardous chemical-protective clothing.

7.11.15 Helmets shall not interfere with the respiratory protection facepiece-to-face seal.

END OF STATEMENT OF WORK