| OEH&S
Tuberculosis (TB) Exposure Control Program
Tuberculosis is a growing
occupational health problem in the United States. Until
recently, TB had long been on the decline in the United
States thanks to improvements in nutrition, hygiene, and
medical care. After 1985, however, the number of TB cases
began to increase. Several elements have contributed to
this resurgence, including increasing homelessness,
greater numbers of immigrants from regions with high
rates of TB infection, substance abuse, institutional
transmission and HIV infection. A consequence of this
resurgence has been the development of drug resistant
strains of TB. All of these factors have lead to the need
for more comprehensive TB control programs.
TB is a disease caused
primarily by the bacterium Mycobacterium tuberculosis. TB
is spread from person to person by means of airborne
particles (droplet nuclei), which can be generated when
infected people sneeze, cough, speak or sing. At 1-5
microns in diameter, these particles can be kept airborne
for hours. Thus, the risk for exposure is dependent upon
air that is contaminated with droplet nuclei produced by
a person with infectious tuberculosis.
UCSF is required to
provide routine training to all its employees who are at
risk of contracting TB during their work duties. The
three main strategies of the Medical Center's TB exposure
control program, in order or reliability, are: Top of Page
1.
Preventing the release of TB bacteria, or containing
their release at the source, through administrative and
engineering control measures. Administrative control
measures include policies that ensure a high index of
suspicion for TB, resulting in rapid identification,
prompt isolation, and early treatment. Also included is
instructing patients to cover their coughs or use masks.
Engineering control measures include booths, hoods,
tents, negative pressure isolation rooms and other
selected areas, and the directed exhaust of the air from
these areas to the outside and not recirculated back to
you. OEH&S has a scheduled inspection program to check
the integrity of portable HEPA exhaust units. Facility
Management, in consultation with OEH&S, also performs
negative pressure check on isolation rooms.
2.
Reducing the number of viable TB bacteria already
released by infectious patients. Examples of this
strategy include the use of dilution ventilation, and
increasing the rate of air circulation to remove
contaminated air.
3.
Providing a barrier between the healthcare worker and air
that is potentially contaminated with tuberculosis
bacteria. One example is the use of an appropriate
respirator in conjunction with a comprehensive
respiratory protection program. Correct respirator
selection and use provides effective protection from
potential exposure for the healthcare worker. It is
UCSF’s requirement that a NIOSH approved N-95
respirator or a PAPR respirator be used to care for
patients on airborne precautions. All respirator user
must be trained, medically evaluated and fit tested prior
to obtaining a respirator certification.
Obtaining A Respirator
Campus Departments
Medical Center Departments
|
