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OSHA Cotton Dust Respiratory Questionnaire (App B-I)

Employers covered by OSHA's cotton dust standard must provide medical surveillance that pairs a standardized respiratory questionnaire with spirometry to detect byssinosis. Appendix B-I is that questionnaire. It is administered at the initial exam before first assignment and at periodic exams, and the physician grades each worker on Schilling's byssinosis classification from the answers.

Who completes it

A trained interviewer administers the questionnaire to the employee. The examining physician, a licensed physician or someone under their supervision, reviews it with the spirometry results, assigns the Schilling grade and issues the written opinion.

Submitting and payment

How to submit it
The completed questionnaire is kept in the employer's medical surveillance records for at least 20 years. The physician's written opinion goes to the employer, who must give the employee a copy.
Who pays
The employer pays; cotton dust exams and procedures must be provided at no cost to the employee.

Good to know

  • Spirometry (FVC, FEV1 and FEV1/FVC) is done before the first shift after at least 35 hours without exposure, then repeated during the shift.
  • Exams are annual above the action level in yarn manufacturing, slashing and weaving, cotton washing and waste houses, and every two years for other covered groups.
  • Testing moves to every six months for an FEV1 below the lower limit of normal or a first-day decrement of 5% or 200 ml; FEV1 under 60% predicted requires referral.
  • Appendix B-II is the version for non-textile workers and B-III is an abbreviated questionnaire; Appendix C sets the spirometry procedure.

Get the official form

Download the current version from the source each time; forms change without notice.

Respiratory Questionnaire

Official page

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Frequently asked questions

What goes in the physician's written opinion for cotton dust?

The opinion gives test results including FEV1, FVC and the ratio, states whether the employee has conditions that increase risk from cotton dust, and recommends exposure or respirator limits, including whether a negative-pressure respirator or a powered air-purifying respirator is acceptable. It confirms the employee was told the results and must not reveal unrelated findings.

Who can perform spirometry for cotton dust surveillance?

Exams must be done by or under the supervision of a licensed physician. A non-physician who performs the pulmonary function tests must have completed a NIOSH-approved spirometry training course. The procedures follow Appendix C to 29 CFR 1910.1043.