title: Respirators, recommendations, and regulations: the controversy surrounding protection of health care workers from tuberculosis.
abstract: Recent nosocomial outbreaks of tuberculosis have increased concern about the occupational acquisition of tuberculosis by health care workers. The Centers for Disease Control and Prevention (CDC), Department of Health and Human Services, and the Occupational Safety and Health Administration, Department of Labor, have issued recommendations and regulations in an effort to decrease health care workers' risk for exposure to patients with infectious tuberculosis. Within the CDC, the National Center for Infectious Diseases, the National Center for Prevention Services, and the National Institute for Occupational Safety and Health collaborated to produce the 1994 Guidelines for Preventing the Transmission of Tuberculosis in Health-Care Facilities. As stated in the Draft Guidelines, the major components of health care worker protection from Mycobacterium tuberculosis infection include administration or source controls, engineering controls, and respiratory protective devices. We review the evolution of the seemingly conflicting recommendations for respiratory protective devices made by these Centers of the CDC and explain how the recommendations in the current CDC Guidelines were reached.
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, GA.
authors.forename: W R
authors.initials: WR
authors.lastname: Jarvis
authors.forename: E A
authors.initials: EA
authors.lastname: Bolyard
authors.forename: C J
authors.initials: CJ
authors.lastname: Bozzi
authors.forename: D R
authors.initials: DR
authors.lastname: Burwen
authors.forename: S W
authors.initials: SW
authors.lastname: Dooley
authors.forename: L S
authors.initials: LS
authors.lastname: Martin
authors.forename: R J
authors.initials: RJ
authors.lastname: Mullan
authors.forename: P M
authors.initials: PM
authors.lastname: Simone
mesh_terms: D002487:Centers for Disease Control and Prevention, U.S.; D003428:Cross Infection / Q000517:prevention & control* / Q000635:transmission*; D005374:Filtration / Q000295:instrumentation; D017408:Guidelines as Topic; D006801:Humans; D017053:Infection Control / Q000592:standards*; D017758:Infectious Disease Transmission, Patient-to-Professional; D009314:National Institute for Occupational Safety and Health, U.S.; D016273:Occupational Exposure / Q000517:prevention & control*; D010564:Personnel, Hospital; D012134:Respiratory Protective Devices / Q000592:standards*; D018088:Tuberculosis, Multidrug-Resistant / Q000517:prevention & control* / Q000635:transmission*; D014481:United States; D014489:United States Occupational Safety and Health Administration