Text For Citation: 01 Item/Group: 001 Hazard: TB

Section 5(a)(1) of the Occupational Safety and Health Act of 1970: %% The employer did not furnish employment and a place of employment which were free from recognized hazards that were causing or likely to cause death or serious physical harm to employees in that: Employees including but not limited to emergency medical technicians were exposed to the hazards of being infected with tuberculosis through contact with clients from long term care facilities for the elderly who were or may be infected with tuberculosis in that; (a)On 7/1/93, worksite A client with suspect or active TB was transported by ambulance from Concourse Nursing Home to Mt. Sinai Hospital. During transport, the emergency medical technician performed patient care activities, such as but not limited to, the taking of vital signs and the administration of oxygen. (b)On 7/10/93 A client with suspect or active TB was transported by ambulance from Dry Harbor Nursing Home to St. Johns Hospital. During the transport, the emergency medical technician performed patient care activity, such as but not limited to, the taking of vital signs and the administration of oxygen. (c)On 7/23/93 A client with suspect or active TB was transported by ambulance from Fairview Nursing Home to Parkway Hospital. During the transport, the emergency medical technician performed patient care activity, such as but not limited to, the taking of vital signs. ABATEMENT NOTE: Feasible and useful abatement methods for reducing this hazard, include: 1 Protocol for early identification of individuals with active tuberculosis. 2 Medical surveillance (at no cost to employees) including preplacement evaluation, administration and interpretation of TB Mantoux skin tests, and periodic evaluations shall be offered to employees as follows: an initial baseline screening at the time of employment for all employees in covered facilities; annually for all employees in the covered facilities; retesting every six months for workers with exposure as defined above (see MMWR pp.1819). Attachment A. 3 Evaluation and management (at no cost to employees) of workers with a positive skin test, or with skin test conversion onrepeat testing, or who are exhibiting symptoms of TB, including work restrictions for infectious employees. Workers who experience a TB exposure incident (exposure to a patient/client with infectious TB for whom infection control precautions have not been taken) shall also be managed according to CDC recommendations (see MMWR p.19). 4 Training and information to ensure employee knowledge of such issues as the hazard of TB transmissions, its signs and symptoms, medical surveillance and therapy, and sitespecific protocols including the purpose and proper use of