Introduction In hospitals, Health Care Workers (HCWs) are exposed to a wide range of respiratory hazards, which requires using respiratory protection equipment and implementation of Respiratory Protection Program (RPP). The aim of this cross-sectional study was to investigate the level of RPP implementation in 36 educational hospitals of Fars province, Iran.

Methods A Self-made checklist including nine components of RPP standard were prepared and completed by the occupational hygienists in hospitals. Fuzzy Analytical Hierarchy Process (FAHP) was used to determine the weight coefficient of RPP components. Finally, Respiratory Protection Program Index (RPPI) was developed to calculate the compliance degree of RPP.

Results The results showed that RPP was not fully implemented in the studied hospitals and the highest and lowest RPPI scores were related to training and fit testing, respectively.

Conclusion Effective protection of HCWs against respiratory hazards requires the full implementation of respiratory protection program in the hospitals. This program must be include evaluation of respiratory hazards, appropriate selection and maintenance of respirators, medical evaluation, fit testing, employee training record keeping, and program evaluation. However, the largest gaps in the RPP elements were discovered in the components of fit testing and medical evaluation which requires significant attempts to promote the situation of RPP in the studied hospital.