You might want to look at the type of PPE you're using and the respiratory symptoms the worker is experiencing. Negative pressure respirators are not appropriate for asthmatics, for example, as they could exacerbate their condition.

You will likely find the Doctor is acting as patient advocate and first port of call for blame is the employer.

Send a copy of the air results to the Doctor, along with PPE requirements. That will close that problem off

That said, as added comfort I get hearing and lung functions tests done annually for staff exposed to higher risk environments. The only people with lung function change are those who smoke.

You may want to look at your engineering controls - ie air extraction / changes/filtering.

Don't be fighting battles if its not really yours to fight.

This shows the importance of carrying out lung function testing (and any medical monitoring) of employees at the on-boarding stage. Without this baseline its difficult to argue that all the good work you have done has kept the individual safe (also, where RPE is concerned, it allows you to determine if the employee is able to cope with the physical demands of breathing through a tight fitting mask due to any pre existing lung conditions).

You could always carry out your own investigation into this information by having a conversation with the individual concerned to see if they feel they have been provided with the right level of training on the wearing and maintenance of PPE. I'll assume we are talking RPE and that the Face Fit tests have been carried out and the individual knows how to do their own Fit Checks and how to maintain a seal where the facepiece meets skin. Use any near miss reports, warnings, observations that show people are not always wearing the right level of PPE to inform you of any custom and practice that may have occurred to develop any learning points to share.

Lastly, and feel free to dismiss this point as I am making a lot of assumptions here that may be unfair, but asking individuals to wear PPE, especially RPE, well ahead of when it is needed can be counterproductive. Tight fitting facepieces are uncomfortable, and asking any individual to wear one that is negative pressure for longer than 30 minutes can be laborious on the lungs and cause sweating around the facepiece which may cause movement and compromise the seal.

Good luck.

As I read your question you need the services of a hygienist.

In the latest Safeguard the incoming president of the Hygienist Group is interviewed. Check out her comments. the HAZANZ web pages have registered professionals. I would disclose that Suzanne is a personal friend who I have known for about 20 years.

You say you have excellent air quality results. This is very much a relative term. It is possible that there is a problem with the air quality in your workplace. My son told me he has an excellent fantastic car. To him it is the car of his dreams. To me hmm well I would go for a drive in it but I would not rate it as an excellent car.

Without seeing what the results are and without knowing what the risks are in the workplace difficult to say. It is very possible there are hazards in the workplace that were not assessed. Those hazards could be causing a health effect.

Each person reacts differently to air quality hazards. Someone could be fine yet their buddy next to them is coughing and spluttering.

Having "excellent air quality results" implies testing with some kind of objective outcome.

Where as your sons view is entirely subjective (I'm not allowed to call my sons car a POS - but his wallet is discovering that in its own time)

We need to split the objectivity from the subjectivity. There is evidence the air is "excellent". All good.

There is no evidence of the doctors subjective view that the employees lung issue is due to work. To come to a more complete view the Doctor needs to see the air results and then form a view relative to the lung results and all other air the employee is/has been exposed to.

The beauty of testing (both worksite air and lung function) is you end up with objective results. Still doesn't mean to say the two are linked.

I recommend that you seek advice from an occupational health physician. I would expect them to consider workplace exposures (current and past), other non-work respiratory exposures, medical history and then to provide you with opinion on causation of the lung condition and recommendations for managing the worker.

Have a look here for someone local
https://anzsom.org.nz/find-a-consultant/

Mike (occupational physician)

Totally agree Mike. Occ physicians are your one-stop shop for workplace health issues - experts in both medicine and workplace exposures. The original specialist may well have been flying a kite, based on his/her text book knowledge of the things that can cause lung damage, but he/she probably didn't have the inside knowledge to know whether the controls you have in place are sufficient to prevent harm. If you call in an occ med they will tell you if you've got a problem, but won't try to sell you anything you may not need, and should help set everyone's minds at rest.

I'd add a plug to get a good Occupational Health Nurse involved - who can work with you at the ground level and escalate to the Occupational Health Physician as needed.
Check the Nurse is up to date on their Spirometry (lung function testing) training. HASANZ register or word of mouth referral.

HI Michael
A number of questions arise on this one. The first is what do you mean by excellant air quality results. By that I mean were they static samples or personal (big difference) and did the people carrying them out apply stats to see what you actual risks were. If the air quality is excellant them the staff shouldn't have to wear RPE in any form. Yoou haven't mentioned what the suspected substance is or in what form and if you have engineeriing controls. These all will have an implication on your investigation into this.
So I would sugggest that you start by looking at the results and reports you have obtained on the air quality. Are they relaible and has statistical analysis been used to assess risks (you can be below the WES on one day but exceed it the next, stats help determione that risk) , were the controls tested and reported on along with the conditions at the time. All this will help determine if it is the workplace exposure. You would also need to look at what that employee does outside of work as that has been known to have an influence on thses type of cases.

There are other thing sthat have to be considewred in this type of case so I would suggets that you need to get somone in who can help you out and set your mind at rest as to whether it is work related or not. And if so what you can do to improve things.