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

• Hospitals. OSHA eTool. Focuses on some of the hazards and controls found in the hospital setting and describes standard requirements as well as recommended safe work practices for employee safety and health.
• 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.
• Biosafety Resources and Tools. Centers for Disease Control and Prevention (CDC).
• Proposed Guidelines: Goals for Working Safely with Mycobacterium Tuberculosis in Clinical, Public Health and Research Laboratories. Centers for Disease Control and Prevention (CDC) Federal Register Notice, (April 28, 1997). Describes safety and control measures for those working closely with mycobacterium tuberculosis to reduce risk of infection to employees and others.
• TB Guidelines. Centers for Disease Control and Prevention (CDC). Provides a listing of major TB guidelines.
• Treatment of Tuberculosis. Centers for Disease Control and Prevention (CDC), Morbidity and Mortality Weekly Report (MMWR) 52(RR11);1-77, (June 20, 2003). 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, (March 21, 2003).
• The Role of BCG Vaccine in the Prevention and Control of Tuberculosis in the United States (PDF). Centers for Disease Control and Prevention (CDC), Morbidity and Mortality Weekly Report (MMWR) 45(RR4);1-18, (April 26, 1996).
• Protect Yourself Against Tuberculosis - A Respiratory Protection Guide for Health Care Workers. U.S. Department of Health and Human Services (DHHS), National Institute for Occupational Safety and Health (NIOSH) Publication No. 96-102, (December 1995).
• Essential Components of a Tuberculosis Prevention and Control Program Recommendations of the Advisory Council for the Elimination of Tuberculosis (PDF). Centers for Disease Control and Prevention (CDC), Morbidity and Mortality Weekly Report (MMWR) 44(RR-11);1-16, (September 8, 1995). 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, (February 8, 2002).

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, (December 30, 2005). 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, (June 20, 2003). 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 (PDF). U.S. Department of Health and Human Services (DHHS), National Institute of Occupational Safety and Health (NIOSH) Publication No. 99-143, (September 1999). Provides a sample program, and respirator inspection record.
• Healthcare. OSHA Safety and Health Topics Page.

Correctional

• TB in Correctional Facilities in the United States. Centers for Disease Control and Prevention (CDC). Provides TB-related links for correctional facilities.
• 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(RR09);1-44, (July 7, 2006). Outlines prevention and control measures for workers and inmates in short-term and long-term correctional facilities.
  • Slide Set - Prevention and Control of Tuberculosis in Correctional and Detention Facilities

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, (April 17, 1992). Contains a section on training and educating public and private healthcare providers in prevention and control of the disease.

Elderly

• Prevention and Control of Tuberculosis in Facilities providing Long-term Care to the Elderly. Centers for Disease Control and Prevention (CDC), Morbidity and Mortality Weekly Report (MMWR) 39(RR-10);7-20, (July 13, 1990). Contains a brief section on employee safety.
• Nursing Homes and Personal Care Facilities. OSHA Safety and Health Topics Page.

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, (January 23, 2004).
• 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, (October 30, 1998). 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, (September 5, 1997).