Regulating the Risk of Tuberculosis Transmission Among Health Care Workers

Details

• Personal Author:
  Nicas M
• Description:
  The 1994 Centers for Disease Control and Prevention guidelines on preventing tuberculosis (TB) transmission among health care workers (HCWs), and the 1997 Occupational Safety and Health Administration (OSHA) proposed TB standard, do not address the issue of acceptable risk. Further, many infection control personnel oppose OSHA's promulgating a standard because they believe most TB infections among HCWs are nonoccupational in origin. This article examines the relationship between TB infection and disease rates, and introduces a probability framework to apportion infection risk between occupational and nonoccupational exposure. It is argued that most TB infections among HCWs are work-related. A 0.2% overall annual risk of TB infection (accounting for both workplace and community exposure) is proposed as acceptable, because in the context of an infection surveillance program it limits an HCW's cumulative disease risk close to the value for the general United States population. Based on the probability framework, an estimate of the background community infection rate, and the traditional Wells-Riley risk model, it is shown that a target workplace infection risk value can be derived and expressed in terms of an expected pulmonary dose. The latter target dose informs risk management decision-making. [Description provided by NIOSH]
• Subjects:
  Aerosols Air Pollutants, Occupational Air Pollution Air Pollution, Indoor Communicable Disease Control Communicable Diseases Environmental Monitoring Health Care Facilities Workforce And Services Health Personnel Occupational Health Particulate Matter Risk Assessment Risk Factors Safety

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• Keywords:
  Aerosol-particles Aerosol-sampling Air-contamination Air-quality Air-quality-monitoring Air-sampling Airborne-particles Analytical-models Disease-control Disease-incidence Disease-transmission Health-care-facilities Health-care-personnel Infection-control Infectious-diseases Risk-analysis Risk-factors Simulation-methods

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• ISSN:
  0002-8894
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  California ; OSHA Region 9
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  334-339
• Volume:
  61
• Issue:
  4
• NIOSHTIC Number:
  nn:20029857
• Citation:
  Am Ind Hyg Assoc J 2000 May/Jun; 61(3):334-339
• Contact Point Address:
  Center for Occupational and Environmental Health, School of Public Health, University of California, Berkeley 94720
• Federal Fiscal Year:
  2000
• NORA Priority Area:
  Research Tools and Approaches: Risk Assessment Methods
• Performing Organization:
  University of California-Berkeley, School of Public Health, Center for Occupational and Environmental Health, Berkeley, CA 94720
• Peer Reviewed:
  True
• Start Date:
  19960701
• Source Full Name:
  American Industrial Hygiene Association Journal
• End Date:
  19990630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:c158d306f1287b2ddc848732d4791bc296834649e8fa6a2d8a3f9b251c37ef560abd5afa36d1f00facf98c942454196dd4707414bbdfb4f2f083f3a095e9b861
• Download URL:
  https://stacks.cdc.gov/view/cdc/190760/cdc_190760_DS1.pdf
• File Type:
  [PDF - 292.63 KB ]