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Page last reviewed: 10/06/2008 |
Highlights |
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Tuberculosis
According to the Centers
for Disease Control and Prevention (CDC) in 2008, nearly
one-third
of the world's population is infected with Tuberculosis (TB), which kills almost
1.6 million people
per year. TB is now the second most common cause of death from infectious disease in the
world
after human immunodeficiency virus/acquired immunodeficiency syndrome
(HIV/AIDS). In the mid-1980s, a resurgence of outbreaks in the United States brought
renewed attention to TB. An increase in high risk, immuno-suppressed
individuals, particularly those infected with HIV, lead to an increase in TB
cases. Drug-resistant strains of this deadly disease also contributed to the
problem. However, through a broad range of Federal and community initiatives, TB
rates have declined steadily. For 2010, a total of 11,182 tuberculosis (TB) cases were reported in the United States. The TB rate was 3.6 cases per 100,000 population, a decrease of 3.8% from the rate reported for 2009.
More... [3 MB PDF, 166 pages]
TB is addressed in specific standards for recording and reporting occupational injuries and illnesses and in specific standards for the general industry.
OSHA Standards
This section highlights OSHA standards, Federal Registers (rules, proposed rules, and notices), directives (instructions for compliance officers), and standard interpretations (official letters of interpretation of the standards) related to tuberculosis.
Note:
Twenty-five states, Puerto Rico and the Virgin Islands have
OSHA-approved
State Plans and have adopted their own standards and enforcement policies. For the most part, these States adopt standards that are
identical to Federal OSHA. However, some States have adopted different standards applicable to this topic or may have different enforcement
policies.
Recording and Reporting Occupational Injuries and Illnesses (29
CFR 1904)
- 1904.11,
Recording criteria for work-related tuberculosis cases. States that for any employee
who has been occupationally exposed to anyone
with a known case of active tuberculosis, and subsequently develops a tuberculosis infection,
the employer must record the case. [related
topic page]
General Industry (29
CFR 1910)
Federal Registers
Directives
-
Enforcement Procedures and Scheduling for Occupational Exposure to Tuberculosis.
CPL 02-00-106 [CPL 2.106], (1996, February 9). Provides uniform inspection procedures and guidelines to be followed when conducting inspections and issuing
citations under Section 5(a)(1) of the OSH Act and pertinent standards for employees who are occupationally exposed to tuberculosis.
- Respiratory
Protection Program Guidelines. CPL 02-02-054 [CPL 2-254A], (2000, July 14).
Sets forth guidelines for establishing
and implementing an OSHA respirator program to ensure that all OSHA
employees are protected from exposure to respiratory hazards.
- Inspection
procedures for the Respiratory Protection Standard. CPL
02-00-120 [CPL
2-0.120], (1998, September 25). Establishes
agency interpretations and enforcement policies, and provides
instructions to ensure uniform enforcement of the Respiratory
Protection Standard, 29 CFR
1910.134.
- Respirator
Fit-Testing. CPL 02-02-029 [CPL 2-2.29], (1980, October 27). Provides guidance regarding enforcement policy for the
respirator fit-testing requirement under
29
CFR 1910.134(e)(5).
- Search all available directives
on tuberculosis.
Standard Interpretations
Hazard Recognition
Nationwide, at least several hundred workers have become infected and have
required medical treatment after workplace exposure to TB. The following
references aid in recognizing and evaluating hazards associated with TB in the
workplace.
- Hospital.
OSHA eTool. Focuses on hazards and controls found in the hospital setting.
The following modules contain sections on tuberculosis:
-
Nursing Home. OSHA eTool. Centers for Disease Control and
Prevention (CDC) have identified nursing homes and long-term care
facilities as high-risk settings for exposure to TB.
-
Nursing Homes and Personal Care Facilities. OSHA Safety and Health
Topics Page.
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Tuberculosis. Centers for Disease Control and Prevention (CDC).
-
NIOSH-Funded Study Simulates Hospital Room to Test UV System for Employee TB
Protection. National Institute for Occupational Safety and Health (NIOSH), (2003, April
29). Researchers conducted a
six-year study whose results will help NIOSH and others in ongoing efforts
to protect employees in health-care and other industries from job-related
tuberculosis infection.
-
Mission Statement and Activities.
Centers for Disease Control and Prevention (CDC),
Division of Tuberculosis Elimination (DTBE).
Provides links to up-to-date information on tuberculosis including education and training resources
and fact sheets.
- Health Hazard Evaluations: Tuberculosis 1990-1999.
US Department of Health and Human Services (DHHS), National Institute for Occupational Safety and Health (NIOSH) Publication No. 2001-116, (2001,
January). Presents titles and summaries of Health Hazard Evaluations (HHEs) related to TB, organized by type of facility.
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Interactive Core Curriculum on Tuberculosis. US Department of Health and Human
Services (DHHS). Intended
as a reference manual for clinicians caring for people with or at high risk for tuberculosis.
Increases clinicians' awareness of appropriate screening, diagnosis, management, and
treatment measures to prevent tuberculosis transmission in the health care setting.
- Controlling
Tuberculosis in the United States - Recommendations from the American Thoracic Society, CDC, and the Infectious Diseases Society of
America. Centers for Disease Control and Prevention (CDC), Morbidity and Mortality
Weekly Report (MMWR) 54(RR12);1-81, (2005, November 4).
- Tuberculosis. Medline Plus Health Information,(2008, August 17).
Possible Solutions
Tuberculosis (TB) outbreaks are likely to occur in healthcare facilities,
correctional institutions, homeless shelters, nursing homes, and residential
care facilities for AIDS patients.
There are numerous
solutions to reduce or eliminate the risks of contracting tuberculosis (TB) including the
implementation of an effective control program. Solutions that
may be helpful in preventing TB are early identification, isolation, and treatment of people
with TB, the use of engineering and administrative procedures, and the use of respiratory protection.
The following references aid in implementing controls associated with TB in
the workplace.
General
-
Hospital.
OSHA eTool. Focuses on hazards and controls found in the hospital setting.
The following modules contain sections on tuberculosis:
-
Medical and First Aid. OSHA Safety and Health Topics Page.
-
Respiratory Protection.
OSHA Safety and Health Topics Page.
-
Tuberculosis.
National Institute for Occupational Safety and Health (NIOSH) Workplace Safety and Health Topic Page.
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Biosafety. Centers for Disease Control and Prevention (CDC) Topic.
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Proposed Guidelines: Goals for Working Safely with Mycobacterium Tuberculosis
in Clinical, Public Health and Research Laboratories [609 KB PDF, 14 pages] . Federal Register Notice for the Centers for Disease Control and Prevention (CDC), (1997, April 28). Describes safety and control measures for those working closely with mycobacterium tuberculosis to reduce risk of infection to employees and others.
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TB
Guidelines. Centers for Disease Control and Prevention (CDC), Division
of Tuberculosis Elimination (DTBE). Provides a listing of major TB
guidelines.
-
Treatment of Tuberculosis. Centers for Disease
Control (CDC), Morbidity and Mortality
Weekly Report (MMWR) 52(RR11);1-77, (2003, June 20).
Provides recommendations intended to guide the treatment of
tuberculosis in settings where mycobacterial cultures, drug susceptibility
testing, radiographic facilities, and second-line drugs are routinely
available.
- Trends in Tuberculosis Morbidity - United States, 1992-2002.
Centers for Disease Control and Prevention (CDC), Morbidity and Mortality
Weekly Report (MMWR) 52(11);217-222, (2003, March 21).
- The
Role of BCG Vaccine in the Prevention and Control of Tuberculosis in the
United States. Centers for Disease Control and Prevention (CDC),
Morbidity and Mortality Weekly Report (MMWR) 45(RR4);1-18, (1996,
April 26). Also available as a 266 KB PDF, 27 pages.
- Protect
Yourself Against Tuberculosis - A Respiratory Protection Guide for Health
Care Workers. US Department of Health and Human Services (DHHS), National Institute for Occupational Safety and Health
(NIOSH) Publication No. 96-102, (1995, December).
- Essential Components of a Tuberculosis Prevention and Control Program
Recommendations of the Advisory Council for the Elimination of Tuberculosis.
Centers for Disease Control and Prevention (CDC), Morbidity and Mortality
Weekly Report (MMWR) 44(RR-11);1-16, (1995, September 8). Also available
as a 375 KB PDF,
15 pages. Provides a national standard by which policymakers, TB
control program managers, and others evaluating TB programs can assess
individual TB control programs.
-
Tuberculosis Morbidity Among U.S.-Born and Foreign-Born Populations --
United States 2000.
Centers for Disease Control and Prevention (CDC), Morbidity and Mortality
Weekly Report (MMWR) 51(05);101-4, (2002, February 8).
Healthcare
-
Guidelines for Preventing the Transmission of
Mycobacterium tuberculosis in Health Care Facilities, 2005.
Centers for Disease Control and Prevention (CDC), Morbidity and
Mortality Weekly Report (MMWR) 54(RR17);1-141, (2005, December 30).
Emphasizes the
importance of screening, training, and educating healthcare workers to
eliminate nosocomial transmission of M. tuberculosis.
- Treatment
of Tuberculosis.
Centers for Disease Control and Prevention (CDC), Morbidity and Mortality
Weekly Report (MMWR) 52(RR11);1-77, (2003, June 20). Provides recommendations intended to guide the treatment of tuberculosis in settings
where mycobacterial cultures, drug susceptibility testing, radiographic
facilities, and second-line drugs are routinely available.
- TB
Respiratory Protection Program In Health Care Facilities, Administrator's Guide.
US Department of Health and Human Services (DHHS), National Institute of
Occupational Safety and Health (NIOSH) Publication
No. 99-143, (1999, September). Also available as an 807 KB PDF, 120 pages.
Provides a sample program, and respirator inspection record.
- Healthcare.
OSHA Safety and Health Topics Page.
Correctional
Homeless
-
Prevention
and Control of Tuberculosis among Homeless Persons.
Centers for Disease Control and Prevention (CDC) Morbidity and Mortality
Weekly Report (MMWR) 41(RR-5);001, (1992,
April 17). Contains a section on training and educating
public and private healthcare providers in prevention and control of
the disease.
Elderly
Human Immunodeficiency Virus (HIV)
- Notice
to Readers: Updated Guidelines for the Use of Rifamycins for the
Treatment of Tuberculosis Among HIV-Infected Patients Taking Protease
Inhibitors or Nonnucleoside Reverse Transcriptase Inhibitors.
Centers for Disease Control and Prevention (CDC), Morbidity and
Mortality Weekly Report (MMWR) 53(02);37, (2004, January 23).
-
Prevention
and Treatment of Tuberculosis Among Patients Infected with Human
Immunodeficiency Virus: Principles of Therapy and Revised
Recommendations. Centers for Disease Control and Prevention (CDC),
Morbidity and Mortality Weekly Report (MMWR) 47(RR20);1-51, (1998, October 30).
Updates previous CDC recommendations for the diagnosis,
treatment, and prevention of tuberculosis among adults and children
co-infected with human immunodeficiency virus (HIV) in the United
States.
-
Anergy Skin Testing and Preventive Therapy for HIV Infected Persons:
Revised Recommendations.
Centers for Disease Control and Prevention (CDC), Morbidity and Mortality
Weekly Report (MMWR) 46(RR15);1-10, (1997, September 5).
Additional Information
Related Safety and Health Topics Pages
Training
Other Resources
- Prevention and Control of Tuberculosis in Correctional and Detention Facilities: Recommendations from CDC.
Centers for Disease Control and Prevention (CDC), Morbidity and
Mortality Weekly Report (MMWR) 55(RR9);1-44, (2006, July 7). Also
available as a 589 KB
PDF, 64 pages.
- Guidelines for Using the QuantiFERON®-TB
Gold Test for Detecting Mycobacterium tuberculosis
Infection, United States. Centers for Disease Control and
Prevention (CDC), Morbidity and Mortality Weekly Report (MMWR) 54(RR15);49-55, (2005,
December 16). Also available as a 544 KB
PDF, 62 pages.
- TB
Notes Newsletter. Centers for Disease Control and Prevention (CDC), Division of Tuberculosis
Elimination (DTBE). Contains news about the DTBE activities and highlights state and local TB problems across the country.
- Tuberculosis (TB). World Health
Organization (WHO). Includes a selection of recent tuberculosis (TB) articles by WHO staff from journals, book chapters, and other
publications.
Accessibility Assistance: Contact the OSHA Directorate of Technical Support and Emergency Management at (202) 693-2300 for assistance accessing PDF materials.
*These files are provided for downloading.
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