Tuberculosis in the workplace: OSHA's compliance experience.
OBJECTIVE
Inspections of 272 facilities were performed between May 1992 and October 1994 to determine compliance with applicable Occupational Safety and Health Administration (OSHA) requirements for prevention of tuberculosis (TB) transmission.


METHODS
Retrospective record review of two data sources: (1) OSHA's Computerized Integrated Management Information System and (2) an inspector-completed questionnaire on inspection results.


METHODS
Inspections of five types of facilities: healthcare institutions, correctional facilities, homeless shelters, long-term-care facilities for the elderly, and others, including drug treatment centers that the Centers for Disease Control and Prevention (CDC) identified as having a higher than expected rate of TB.


METHODS
The OSHA Compliance Memorandum, based on the 1990 CDC Guidelines, which outlined elements of a TB prevention program, was used in performing 272 inspections of facilities between May 1992 and October 1994. Elements of compliance were recorded and reviewed from the IMIS database and inspectors' questionnaires.


RESULTS
Regulated facilities were not fully compliant with OSHA guidance. Generally, healthcare facilities performed better than other facilities. Most facilities (79%) were compliant with administrative elements of a comprehensive TB control program, such as early identification of known or suspected infectious TB patients and skin testing of workers. Only 29% of inspected facilities were found to have acceptable respiratory protection programs for the prevention of occupational TB.


CONCLUSIONS
Facilities have not been fully compliant with the OSHA memorandum describing protection of workers from TB. Facility compliance was better with some traditionally recognized TB infection control elements, but was weaker in the area of respiratory protection programs. This may reflect a lack of familiarity with the latter type of hazard protection.
McDiarmid
M
M
Department of Labor and Occupational Safety and Health Administration, Washington, DC 20210.
Gamponia
M J
MJ
Ryan
M A
MA
Hirshon
J M
JM
Gillen
N A
NA
Cox
M
M
D005161:Facility Regulation and Control; D006801:Humans; D017758:Infectious Disease Transmission, Patient-to-Professional / Q000517:prevention & control*; D008499:Medical Records; D009515:New Jersey; D009518:New York; D010356:Patient Isolation; D012134:Respiratory Protective Devices; D012189:Retrospective Studies; D014374:Tuberculin Test; D014376:Tuberculosis / Q000517:prevention & control* / Q000635:transmission; D014481:United States; D014489:United States Occupational Safety and Health Administration