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Tuberculosis (TB) is a chronic bacterial infection. TB is spread when a person who is infected in the lungs or throat sneezes, coughs, speaks, or sings, and then the airborne particles containing the bacterium M. tuberculosis are inhaled by another person. The disease most commonly affects the lungs; although, it can affect several organs of the body, including the brain, kidneys, and bones. Left untreated, the infection multiplies and destroys the affected tissues, leading to serious illness or death.
TB outbreaks are likely to occur in healthcare facilities, correctional institutions, homeless shelters, nursing homes, and residential care facilities for AIDS patients.
Employers should identify employees who have occupational exposure to TB at their work setting. That determination would include a list of job classifications in which all employees have occupational exposure and a list of job classifications in which some employees have occupational exposure, including a list of tasks and procedures performed by these employees that involve occupational exposure.
A written infection control plan can help and should be updated whenever necessary to reflect new or modified tasks, procedures, or engineering controls that affect occupational exposure, in addition to new or revised employee classifications with occupational exposure.
Employers are required to:
When conducting a TB-related inspection, OSHA directive CPL 02-02-078, “Enforcement Procedures and Scheduling for Occupational Exposure to Tuberculosis,” June 30, 2015, explains that OSHA officers may evaluate whether the employer has implemented appropriate abatement measures to reduce the hazard. The directive adds that OSHA may cite under the General Duty Clause if any one of the following are found to be deficient:
Directive CPL 02-02-078 summarizes some widely accepted standards of practice and refers OSHA officers to the Centers for Disease Control and Prevention (CDC) “Guidelines for Preventing the Transmission of Mycobacterium tuberculosis in Health-Care Settings,” December 30, 2005. Employers should consult the 2005 guidelines, along with any more recent guidelines. The CDC indicates that its “Tuberculosis Screening, Testing, and Treatment of U.S. Health Care Personnel: Recommendations from the National Tuberculosis Controllers Association and CDC,” May 17, 2019, updates the recommendations for screening, testing, and treatment of U.S. healthcare personnel.