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 were exposed to the hazard of being infected with Mycobacterium tuberculosis through unprotected contact with patients, who was/were infectious or suspected to infectious with tuberculosis. (a)Initial Exams. The employer did not conduct,TB skin tests (at no cost to the employees) to all current employees potentially exposed until after the employee became exposed. A two-step baseline should have been accomplished for new employees who have an initially negative PPD test result and who have not had a documented negative TB skin test result during the preceding 12 months. The employee had not had a TB skin test for the last two years of employment with the company. (b)The follow-up and treatment evaluations were not offer to the employee at no cost. (c)The TB skin test should have been annually, since this is a low risk area which was not accomplished. (d)There was no risk assessment accomplished after the employee tested positive for TB skin test. (e)There was no site specific written training program to ensure employees knowledge of such issues as the mode of TB transmission, its signs and symptoms, medical surveillance and therapy. Feasible and useful abatement methods for reducing this hazard: (a)Develop employees education and training for current employees and new workers upon hiring, with refresher training as needed to ensure employee knowledge of such issues as the mode of TB transmission, its signs and symptoms, medical surveillance and therapy, and site specific protocols including the purpose and proper use of controls. (b)Annual TB skin testing conducted for employees in low risk area. (c)Train employees to recognize, and report to a designated person, any patients or clients with symptoms suggestive of infection. (d)Develop a medical surveillance program that would not be at no cost to the employees, that will cover (1) Initial examinations: TB skin tests including a two-step baseline for new employees, follow-up and treatment evaluations. (2) Periodic evaluations: TB skin testing at intervals specified by the CDC guidelines according to low risk category.unless it changes, then facility must complete an annual TB risk assessment to establish required testing frequencies based on the areas.