Standard Interpretations - Table of Contents Standard Interpretations - (Archived) Table of Contents
• Status: Archived

Archive Notice - OSHA Archive

NOTICE: This is an OSHA Archive Document, and may no longer represent OSHA Policy. It is presented here as historical content, for research and review purposes only.

September 1, 1995

MEMORANDUM FOR:     NATIONAL OFFICE DIRECTORS
                   REGIONAL TB COORDINATORS

FROM:               STEPHEN MALLINGER 
                   Acting Director 
                   Directorate of Technical Support

SUBJECT:            OSHA Tuberculosis Control Training and Resource Guide
Attached for your use is an OSHA document entitled "OSHA Tuberculosis Control Training and Resource Guide". The document was developed by a Nurse Intern at the request of the Directorate of Health Standards.

The document is designed to assist field compliance safety and health officers (CSHOs) with the distribution of pertinent educational and informational materials on tuberculosis.

The document has been reviewed by the Office of Occupational Health Nursing staff and selected field representatives.

Since the intent of the document is to assist CSHOs with inspections, our plan at this time is only to provide copies of it internally to OSHA staff (National Office and Regional TB Coordinators). Wider distribution will be considered, if the need arises.

Additionally, this document is being made available through the DOL Electronic Bulletin Board System at (202) 219-4784. Specific instructions to assist users in accessing the document are also attached.

Attachment



To access the "TB Control and Resource Guide" document through the DOL 
Bulletin Board, several steps are required as outlined below: 

DOL BBS -      Dial into system (202-219-4784) 
              Complete log-on 
              Select M Main Library of Files  
              Select M Main Library of Files again 
              Select S Select Library  
              Type OSHA  
              Select F Find files  
              Select K Keyword Search  
              Type any key word from title of document 


                     ______________________________ 

                               OSHA 

                       TUBERCULOSIS CONTROL 

                     TRAINING AND RESOURCE GUIDE 

                               - 1995 - 
             _______________________________________________ 


                           INTRODUCTION 

This document was produced by Mary Dirksen and edited by Robert Nester, 
OSHA Nurse Interns, assigned to the Office of Occupational Health Nursing, 
Directorate of Technical Support during the summer of 1995.  Project 
assistance was provided by Carla Slaughter, Office of Occupational Health 
Nursing. 

The materials contained herein have been reviewed for their relevance. 
Their inclusion has been based primarily upon the authority of the source 
rather than an in-depth review of the reference. 

OSHA does not endorse, certify, regulate, nor recommend any of these 
programs or products in whole or in part.  The purpose is to provide OSHA 
staff with viable resources related to the control and management of 
tuberculosis (TB). 

The information contained in this resource guide is not to be considered a 
substitute for compliance, but rather may be useful in developing an 
effective TB control program. 


                      _______________________________ 

                                 OSHA 

                          TUBERCULOSIS CONTROL 

                      TRAINING AND RESOURCE GUIDE 

                ______________________________________________ 

                            Table of Contents 

I.   Program and Management Resources 

    A.      General Management Assistance 

    B.      Prevention / Control 

    C.      Engineering Controls 

    D.      Respiratory Protection 

    E.      Population / Site Specific Assistance 

            i.     Health care facilities 

            ii.    Long-term care facilities 

            iii.   Drug treatment facilities 

            iv.    Correctional facilities 

            v.     Homeless shelters and homeless care facilities 

            vi.    Other high-risk populations 

    Attachment A:  Smoke Trail Test for Negative Pressure Isolation Rooms 

II.  Training Programs and Materials 

III. Worker Education Materials/Resources 

    A.      General Information 

    B.      Screening 

    C.      Medications/Treatment 

    D.      Prevention/Control 

    E.      TB/HIV 

IV.  Non-English Language Resources 

V.   Publications and Resources for Clinicians 

VI.  State and Territorial Health Departments - Offices of TB Control 

Appendices 

A.   Addresses / Contact Information 

B.   Centers for Disease Control and Prevention, Education and Training 
    Materials Order Form (copy ready) 



                                   I 
_________________________________________________________________________ 

                                  PROGRAM AND 

                             MANAGEMENT RESOURCES 
                               _____________ 

The resources in Section I, Program and Management Resources, include 
general assistance in the development, implementation and management of a 
work place tuberculosis control program. 
_________________________________________________________________________ 



                  ____________________________________ 

                   PROGRAM and MANAGEMENT RESOURCES 
                  ____________________________________ 

A.   GENERAL MANAGEMENT ASSISTANCE 

A Tool for Program Review Procedures in TB Control 
1989 
    A formal outline procedure to evaluate a program's effectiveness. 
    Review process promotes quality assurance and allows for feedback 
    and formal recommendations to flow in both directions. 

    Mississippi State Department of Health. 

__________________ 


Centers for Disease Control and Prevention (CDC) Tuberculosis 
Guidelines (Condensed) Virginia Epidemiology Bulletin 
1994 

    Synopsis of the CDC 1994 Tuberculosis Guidelines; 3-pages.  Designed 
    to assist employers to be in compliance with the CDC guidelines. 

    Virginia Department of Health, Office of Epidemiology. 

__________________ 


Enablers and Incentives 
1989 
    36-page booklet appropriate for health care workers working with 
    high-risk populations.  Includes an article which describes the use 
    of incentives and enablers, and a transcription of a recorded 
    roundtable discussion by tuberculosis nurses in South Carolina who 
    have first-hand experience in the use of incentives and enablers. 

    American Lung Association of South Carolina. 

__________________ 


Guide for Tuberculosis Programming in the 1990s 
1991 
    Organized outline of suggested program indicators used to gather 
    information for use in evaluation of tuberculosis (TB) control 
    programs.  17-page booklet aimed at TB control workers. 

    American Lung Association, local chapter. 

__________________ 


OSHA Enforcement Policy on Tuberculosis - Fact Sheet 
1993 
    Addendum to October, 1993 OSHA TB Compliance Directive. 

__________________ 


OSHA Enforcement Policy and Procedures for Occupational Exposure to 
Tuberculosis:  A Checklist 

    American Federation of State, County and Municipal Employees, 
    AFL-CIO. 

__________________ 


Tuberculosis - Protection For Healthcare Workers 
1995 
    A comprehensive packet designed to assist the Infection Control 
    Practitioner in implementing current CDC recommendations for the 
    control of tuberculosis in health care facilities.  Complements a 
    health care worker educational video [see Worker Education Materials 
    and Resources - Association for Practitioners in Infection Control 
    (APIC) for detail description of video].  Distributed by Lincoln 
    Medical Education Foundation, Attn:  Tuberculosis Video, 4600 Valley 
    Road, Lincoln, Nebraska  68510; (402) 483-4581; FAX (402) 483-4184. 
    Packet + video:  $225.00 APIC members, $250.00 non-members; $35.00 
    preview/rental applied toward purchase. 

    Association for Practitioners in Infection Control and Epidemiology, 
    Inc.. 

__________________ 


Tuberculosis Skin Testing Facility Record Card 

    Card to record employee skin testing information.  For facilities 
    with employee skin testing programs. 

    Washington (State of) Department of Health, TB Control Program. 

__________________ 


B.   PREVENTION / CONTROL 

Infection Control Video 

    Association for Practitioners in Infection Control and Epidemiology, 
    Inc.. 

__________________ 


Controlling Occupational Exposure to Tuberculosis 
1993 
    Joint Commission on Accreditation of Healthcare Organizations. 
    Monograph.  $40.00. 

__________________ 


Industrial Hygiene Considerations in the Prevention of Tuberculosis 
Transmission 
1994 
    A compilation of regulatory, research, and technical materials 
    related to the environmental, occupational health, and industrial 
    hygiene issues of workplace tuberculosis control. 

    Hunter College School of Health Sciences, Center for Occupational & 
    Environmental Health, (Daniel Kass, Director).  Permission to 
    photo-copy granted by Hunter College. 

__________________ 


Tuberculosis:  A Teacher's Resource Handbook 

    For teachers and school workers involved in tuberculosis prevention 
    and education programs. 

    American Lung Association of Los Angeles County. 

__________________ 


Tuberculosis (TB) Blueprint:  Goals and Objectives 
1993 
    Outlines the plan by the New York City Department of Health to 
    control the spread of TB.  States three major goals:  1) increase 
    treatment completion rate, 2) prevent the spread of TB in congregate 
    settings, and 3) preventing future cases of active TB through 
    screening and preventive treatment.  Includes objectives and 
    implementation steps for each goal. 

    New York City, Department of Health. 

__________________ 


The following materials are available at no charge from the Centers 
for Disease Control and Prevention (CDC), Information Services 
(address in Appendix A).  A CDC Materials Order Form, suitable for 
copying, is enclosed in Appendix B. 

    Centers for Disease Control and Prevention.  (1994).  Guidelines 
    for preventing the transmission of Mycobacterium tuberculosis 
    in health-care facilities.  Morbidity and Mortality Weekly 
    Report, 43(RR-13), October 28. 


    Control of tuberculosis (TB) in correctional facilities. (1993). 
    A 16-page booklet providing an overview of TB in correctional 
    facilities and outlining a program of surveillance, containment, and 
    prevention.  Includes screening guidelines for staff of correctional 
    facilities.  Aimed at health care workers in corrections. 


    Centers for Disease Control and Prevention.  (1993).  Tuberculosis 
    control laws - United States, 1993:  Recommendations of the 
    Advisory Council for the Elimination of Tuberculosis (ACET). 
    Morbidity and Mortality Weekly Report, 42(No. RR-15). 


    Centers for Disease Control and Prevention.  (1992).  Prevention 
    and control of tuberculosis among homeless persons and prevention 
    and control of tuberculosis in U.S. communities with at-risk 
    minority populations.  Morbidity and Mortality Weekly Report, 
    41(No. RR-5), April 17. 


    Centers for Disease Control and Prevention. (1992).  Prevention 
    and control of tuberculosis in migrant farm workers.  Morbidity 
    and Mortality Weekly Report, 41(No.RR-10), June 5. 


    TB in correctional facilities.  (1992).  A set of 67 slides on 
    TB prevention and control; a 67-page booklet of slide facsimiles; 
    and an 18-page narrative text designed to accompany the slide set. 
    May be ordered separately. 


    American Thoracic Society (ATS).  (1992).  Control of tuberculosis 
    in the United States.  American Review of Respiratory Disease, 
    146(6), 1623-1633. 


    Centers for Disease Control and Prevention.  (1990).  Prevention 
    and control of tuberculosis in facilities providing long-term 
    care for the elderly.  Morbidity and Mortality Weekly Report, 
    July 13, 1990. 


    Centers for Disease Control and Prevention.  (1990).  Prevention 
    and control of tuberculosis among foreign-born persons entering 
    the United States.  Morbidity and Mortality Weekly Report, 
    39(No. RR-18), December 28. 


    What drug treatment centers can do to prevent tuberculosis. 
    4-page guidelines with recommendations from the CDC. 


    Centers for Disease Control and Prevention.  (1995). 
    USPHS/IDSA guidelines for the prevention of opportunistic 
    infections in persons infected with Human Immunodeficiency 
    Virus:  A summary.  Morbidity and Mortality Weekly Report: 
    Recommendations and Reports, 44(No. RR-8), July 14, 1995. 


C.   ENGINEERING CONTROLS 

Controlling Occupational Exposure to Tuberculosis 
1993 
    Joint Commission on Accreditation of Healthcare Organizations. 
    Monograph.  $40.00. 

__________________ 


Engineering Controls 
1995 
    A 20-minute video from the OSHA Office of Training and Education 
    (OTI), Des Plaines, Illinois.  Includes a demonstration of smoke 
    trail testing. 

__________________ 


Centers for Disease Control and Prevention.  (1994).  Guidelines for 
preventing the transmission of Mycobacterium tuberculosis in 
health-care facilities.  Morbidity and Mortality Weekly Report, 43(No. 
RR-13), October 28. 

    Includes an engineering control section and other sections when 
    considering the special needs of such diverse health care settings 
    as dental clinics, long-term care facilities, and others. 

    MMWR reprint available at no charge from the CDC, Information 
    Services. 

__________________ 


Reducing the Spread of Tuberculosis in Your Workplace 
1995 
    15-page guidebook designed to assist small organizations, agencies, 
    and businesses which serve people at risk for tuberculosis to 
    evaluate and maximize their indoor air quality.  Emphasis is on 
    low-tech, low-cost administrative controls and the enhancement of 
    natural ventilation systems. 

    Contact Daniel Kass, Director, Hunter College School of Health 
    Sciences, Center for Occupational & Environmental Health; $4.00/copy 
    for less than 5, decreasing to $2.00/copy for 51 or more.  Permission 
    to photo-copy granted by Hunter College. 

__________________ 


Smoke-Trail Test for Negative Pressure Isolation Rooms 

    Procedural guideline drafted by OSHA in January, 1994.  Copy 
    enclosed at the end of Section I - Attachment A. 

__________________ 


Using Ultraviolet Radiation and Ventilation to Control Tuberculosis (TB). 
1990 
    Booklet discusses the use, effectiveness, and technical 
    installation details about UV radiation in the control of TB. 
    Discusses technical details about both local exhaust and dilution 
    ventilation. 

    California Indoor Air Quality Program, California Department of 
    Health Services.  Permission is granted to reproduce booklet, 
    provided credit is given to the source. 

__________________ 


D.   RESPIRATORY PROTECTION 

Centers for Disease Control and Prevention.  (1994).  Guidelines for 
preventing the transmission of Mycobacterium tuberculosis in 
health-care facilities, Notice.  Morbidity and Mortality Weekly Report, 
43(No. RR-13), October 28. 

    MMWR reprints available at no charge from the CDC, Information 
    Services. 

__________________ 


Exposure Control Manual 
1995 
    A manual of materials offering providers of long-term care facilities 
    the necessary tools for implementing a tuberculosis (TB) control 
    program.  Includes a sample risk assessment guide for use at the 
    facility level, protocols for each of five categories of risk, 
    NIOSH's technical guide to respiratory protection, and worksheets, 
    checklists, and forms to help implement a facility-based TB infection 
    control plan.  Includes engineering and administrative guidelines. 
    Also includes copies of the OSHA TB guidelines, and the Guidelines 
    for control of TB in long-term care facilities. 

    American Health Care Association.  $15.00 for members; $25.00 for 
    non-members. 

__________________ 


Respiratory Protection Devices 
1995 
    National Institute for Occupational Safety and Health (NIOSH). 
    Federal Register, June 8, 1995, 42 CFR Part 84, 60(110), 30336-30404. 

__________________ 


Tuberculosis Control in Hospitals 
1994 
    A Tuberculosis (TB) resource packet providing materials to assist 
    in tuberculosis control in hospital settings.  Includes the CDC 
    guidelines (1994), OSHA's enforcement policy and procedures (issued 
    10/93), OSHA's TB inspection survey checklist, guidelines on the 
    elements of a respiratory protection program, and a resource list for 
    training and education materials. 

    American Hospital Association.  To order, call (800) AHA-2626, 
    request order # 094692; $15.00 for members, $55.00 for non-members. 

__________________ 


E.   POPULATION / SITE SPECIFIC ASSISTANCE 


i.   Health Care Facilities 

Centers for Disease Control and Prevention.  (1994).  Guidelines for 
preventing the transmission of Mycobacterium tuberculosis in health 
care facilities.  Morbidity and Mortality Weekly Reports, 43(No. RR-13), 
October 28. 

    MMWR reprints available at no charge from the CDC, Information 
    Services. 

__________________ 


Protection for Healthcare Workers 
1995 
    20-minute video addressing the following content areas:  increased 
    incidence of tuberculosis, transmission, prevention, skin testing, 
    environmental controls, treatment, personal protection, medical 
    monitoring, and others. 

    Association for Practitioners in Infection Control and Epidemiology, 
    Inc.; order video from Lincoln Medical Education Foundation. 

_________________ 


Tuberculosis Control in Hospitals 
1994 
    A Tuberculosis (TB) resource packet providing materials to assist in 
    tuberculosis control in hospital settings.  Includes the CDC 
    guidelines (1994), OSHA's enforcement policy and procedures (issued 
    10/93), OSHA's TB inspection survey checklist, guidelines on the 
    elements of a respiratory protection program, and a resource list for 
    training and education materials. 

    American Hospital Association.  To order, call (800) AHA-2626, 
    request order # 094692; $15.00 for members, $55.00 for non-members. 

__________________ 


ii.  Long-Term Care Facilities 

Exposure Control Manual 
1995 
    A manual of materials offering providers of long-term care 
    facilities the necessary tools for implementing a tuberculosis (TB) 
    control program.  Includes a sample risk assessment guide for use 
    at the facility level, protocols for each of five categories of 
    risk, NIOSH's technical guide to respiratory protection, and 
    worksheets, checklists, and forms to help implement a facility-based 
    TB infection control plan.  Includes engineering and administrative 
    guidelines.  Also includes copies of the OSHA TB guidelines, and the 
    Guidelines for control of TB in long-term care facilities. 

    American Health Care Association.  $15.00 for members; $25.00 for 
    non-members. 

__________________ 


Guidelines for Prevention of TB Transmission in Nursing Homes 
1986 
    Texas Department of Health. 

__________________ 


Centers for Disease Control and Prevention.  (1990).  Prevention and 
Control of Tuberculosis in Facilities Providing Long-Term Care for the 
Elderly.  Morbidity and Mortality Weekly Report, 39(No. RR-10), July 13. 

    Reprint available at no charge from the CDC, Information Services. 

__________________ 


TB Control Screening Guidelines for Convalescent Homes 
1988 

    American Lung Association of Connecticut. 

__________________ 


iii. Drug Treatment Facilities 

What Drug Treatment Centers Can Do To Prevent Tuberculosis 
1991 
    Discusses tuberculosis transmission and infection rates, high risk 
    persons, infection versus disease, symptoms, screening, and 
    preventive therapy. 

    Available at no charge from the CDC, Information Services. 

__________________ 


iv.  Correctional Facilities 

Clark, J.H.  (1993).  Strategies for guerrilla warfare.  American 
Jails, January/February. 

    Discusses controlling the spread of tuberculosis in correctional 
    facilities.  Dr. Clark is the Chief Medical Officer at the Los 
    Angeles County Sheriffs' Office.  (213) 974-0149. 

__________________ 


Infectious Diseases:  A Management Issue 

    Jail Managers Bulletin # III-2.  Teaches managers how to recognize 
    infectious diseases and how to prevent the spread of infectious 
    diseases in correctional facilities. 

    American Jail Association. 

__________________ 


Control of Tuberculosis in Correctional Facilities:  A Guide for 
Health Care Workers 
1993 
    A 16-page booklet providing an overview of tuberculosis (TB) in 
    correctional facilities and outlining a program of surveillance, 
    containment, and prevention.  Includes information on HIV and TB. 
    Also includes screening guidelines for staff of correctional 
    facilities.  Aimed at health care workers in corrections. 

    Available from the U.S. Government Printing Office, Publication 
    No. 1993-533-001 (80540). 

__________________ 


Communicable Diseases 
1995 
    6-page Jail Operations Bulletin (# VI-4) which covers tuberculosis. 
    Contains a self test for learner evaluation. 

    American Jail Association. 

__________________ 


Guidelines for Prevention of TB Transmission in City and County Jails 
1987 
    Texas Department of Health. 

__________________ 


TB in Correctional Facilities 
1992 
    A set of 67 slides on tuberculosis prevention and control in 
    correctional settings; a 67-page booklet of slide facsimiles; and 
    an 18-page narrative text designed to accompany the slide set.  May 
    be ordered separately. 

    Available at no charge from the CDC, Information Services. 

__________________ 


v.   Homeless Shelters and Homeless Care Facilities 

Health Care for the Homeless:  Annotated Bibliographies 
1995 
    Annotated Bibliography # 6:  Tuberculosis and homeless persons. 
    9-pages of references for the period January 1987 - April 1995. 

    Annotated Bibliography # 12:  Tuberculosis and HIV/AIDS.  45-pages 
    of references for the period January 1987 - April 1995. 

    Health Care for the Homeless Information Resource Center (HCHIRC). 
    Questions to Yvonne Wallace, Librarian, HCHIRC.  Order from John 
    Snow, Inc.. 

__________________ 


Centers for Disease Control and Prevention.  (1992).  Prevention and 
control of tuberculosis among homeless persons and prevention and 
control of tuberculosis in U.S. communities with at-risk minority 
populations.  Morbidity and Mortality Weekly Report, 41(No. RR-5), 
April 17. 

    Reprint available at no charge from the CDC, Information Services. 

__________________ 


TB Training for Shelter Workers 

    Slide presentation for training homeless shelter workers to identify 
    symptoms of tuberculosis.  Includes a skin testing protocol and a 
    policy for tuberculin skin testing in homeless populations. 

    Alma Illery Medical Center (Pittsburgh, Pennsylvania); contact Nurse 
    Coordinator of Primary Health Care Services. 

__________________ 


Wasatch Homeless Health Care Program 

    This community based program has developed guidelines for PPD 
    testing and follow-up of the staff at the homeless shelter. 

    Contact:  Allan Ainsworth, Ph.D., Director, Fourth Street Clinic, 
    404 South 400 West, Salt Lake City, Utah  84101; (801) 364-0058; 
    FAX (801) 364-0161. 

__________________ 


vi.  Other High Risk Populations 

Centers for Disease Control and Prevention.  (1990).  Prevention and 
control of tuberculosis among foreign-born persons entering the United 
States.  Morbidity and Mortality Weekly Report, 39(No. RR-18). 
December 28. 

__________________ 


Centers for Disease Control and Prevention.  (1992).  Prevention and 
control of tuberculosis among homeless persons and prevention and 
control of tuberculosis in U.S. communities with at-risk minority 
populations.  Morbidity and Mortality Weekly Report, 41(No. RR-5), 
April 17. 

    Reprint available at no charge from the CDC, Information Services. 

__________________ 


Enablers and Incentives 
1989 
    36-page booklet appropriate for health care workers working with 
    high risk populations.  Includes an article which describes the use 
    of incentives and enablers, and a transcription of a recorded 
    roundtable discussion by tuberculosis nurses in South Carolina who 
    have first hand experience in the use of incentives and enablers. 

    American Lung Association of South Carolina. 

__________________ 


Guidelines for Prevention and Control of TB Among Individuals with HIV 
Infection 
1989 
    Texas Department of Health, Tuberculosis Control Division 

__________________ 


Centers for Disease Control and Prevention.  (1992).  National 
action plan to combat multidrug-resistant tuberculosis:  Management 
of persons exposed to multidrug-resistant tuberculosis.  Morbidity 
and Mortality Weekly Report, 41(No. RR-11), June 19. 

    Available at no charge from the CDC, Information Services. 

__________________ 


Centers for Disease Control and Prevention.  (1992). Prevention and 
control of tuberculosis in migrant farm workers.  Morbidity and 
Mortality Weekly Report, 41(No. RR-10), June 5, 1992. 

    Reprint available at no charge from the CDC, Information Services. 

__________________ 


Managing Tuberculosis and HIV Infection in Today's General Workplace 
1992 
    National Leadership Coalition on AIDS; $5.00 for members, $10.00 for 
    non-members. 

__________________ 


Migrant Clinicians Network 

    Publishes a newsletter with occasional information on tuberculosis 
    issues among migrant workers. 

    Migrant Clinicians Network, Michael Koroscik, Director of Education. 

__________________ 


Office of Minority Health Resource Center (OMH-RC) 

    Resource and referral service on minority health issues, including 
    tuberculosis.  Offers database searches, information exchange, 
    publications, mailing lists, technical assistance, data and 
    statistics, and referrals.  Resource Person Network (volunteers) 
    available to provide technical assistance, conduct professional and 
    non-professional education training and workshops, and serve as 
    reference specialists.  Brochures, articles, journals, and other 
    literature accessible through the database search service.  English 
    and Spanish speaking information specialists are available.  All 
    resource center services are free of charge. 

__________________ 


Tuberculosis and HIV/AIDS 
1995 
    Annotated bibliography # 12, 45-pages of references for the period 
    January 1987 to April 1995. 

    Health Care for the Homeless Information Resource Center (HCHIRC); 
    Questions to Yvonne Wallace, Librarian, HCHIRC.  Order from John 
    Snow, Inc.. 

__________________ 


Tuberculosis:  A Resource Kit 

    This resource kit provides current materials on tuberculosis (TB) 
    to clinicians and other staff caring for high risk populations. 
    Document is divided into 11-sections:  using the kit, surveillance 
    and epidemiology, diagnosis, patient management, infection control, 
    screening and preventive therapy, treatment of susceptible TB, 
    multidrug-resistant TB, HIV/AIDS and TB, health education materials 
    and organizations.  Each section includes an annotated bibliography 
    detailing current literature.  Additional materials include Fact 
    Sheets summarizing key information from the literature and selected 
    articles and publications. 

    John Snow, Inc. (JSI) under contract to Health Resources & Services 
    Administration (HRSA's) Bureau of Primary Health Care.  Order from 
    JSI, note account # 1569 on check; $25.00.  Send to the attention 
    of Yvonne Wallace - Library, JSI/HCHIRC. 

_________________ 



                                 ATTACHMENT A: 

             Smoke Trail Test for Negative Pressure Isolation Rooms. 



January 14, 1994 

MEMORANDUM FOR:     Regional Administrators 

ATTENTION:          ARA/Technical Support 

THROUGH:            Leo Carey 
                   Director 
                   Office of Field Programs 

FROM:               Patricia K. Clark 
                   Director 
                   Directorate of Technical Support 

SUBJECT:            Smoke-trail Test for Negative Pressure Isolation Rooms 

The attached smoke-trail test procedure for negative pressure isolation 
rooms was drafted to answer questions raised by the Tarrytown AO during a 
recent inspection at a health-care facility.  This procedure may be useful 
to other OSHA Compliance Officers performing inspections related to 
occupational exposure to Tuberculosis. 

This procedure will be discussed during the next teleconference on 
January 27, 1993. 


SMOKE-TRAIL TESTING METHOD FOR NEGATIVE PRESSURE ISOLATION ROOM 

The OSHA TB Memorandum of October 8, 1993 provides clarification for 
OSHA-wide enforcement policy and procedures for inspections concerning 
occupational exposure to TB.  The OSHA TB Memorandum outlines OSHA's 
expectations that employers follow the principles of TB control published 
in the CDC document "Guidelines for Preventing the Transmission of 
Tuberculosis in Health-care Settings, with Special Focus on HIV-Related 
Issues (December 1990 MMWR)". 

The CDC Guidelines recommend that the TB isolation room be under negative 
pressure compared to surrounding spaces such that it induces airflow into 
the room to prevent TB contaminant from escaping the room.  The CDC 
publication also recommends employing smoke or flutter strips to prove 
direction of airflow.  The CDC is recommending the use of qualitative 
methods for demonstrating the performance of negative pressure isolation 
rooms rather than quantitative methods such as measuring supply/exhaust 
volumetric flow differentials, measuring space pressurization 
differentials or measuring velocity of airflow at openings into the 
isolation room.  The employer may choose to perform quantitative tests 
in order to characterize and track the dynamic performance of these 
negative pressure isolation rooms.  OSHA's expectations of conformance 
to the CDC Guidelines can be adequately demonstrated by qualitative 
testing such as smoke-trails without expending the employer's and OSHA's 
resources on more complex quantitative testing.  The message here is to 
"keep it simple". 


TEST METHOD DESCRIPTION: 

One of the purposes of a negative pressure TB isolation room is to prevent 
TB contaminant from escaping the isolation room and entering the corridor 
or other surrounding uncontaminated spaces.  To check for room negative 
pressure, use smoke-trails to demonstrate that the pressure differential 
is inducing airflow from the corridor, through the crack at the bottom of 
the door (undercut) and into the isolation room.  When performing a 
smoke-trail test follow these recommendations where applicable: 

1.  Test only with the isolation room door shut.  If not equipped with 
   an anteroom, it is assumed that there will be a loss of space 
   pressure control when the isolation room door is opened and closed. 
   It is not necessary to demonstrate direction of airflow when the 
   door is open. 

2.  If there is an anteroom, release smoke at the inner door undercut, 
   with both anteroom doors shut. 

3.  In addition to a pedestrian entry, some isolation rooms are also 
   accessed through a wider wheeled-bed stretcher door.  Release smoke 
   at all door entrances to isolation rooms. 

4.  So that the smoke is not blown into the isolation room, hold the 
   smoke bottle/tube parallel to the door so the smoke is released 
   perpendicular to the direction of airflow through the door undercut. 

5.  Position the smoke bottle/tube tight to the floor, centered in 
   the middle of the door jamb and approximately two inches out in 
   front of the door. 

6.  Release a puff of smoke and observe the resulting direction of 
   airflow.  Repeat the test at least once or until consistent results 
   are obtained. 

7.  Minimize momentum imparted to the smoke by squeezing the bulb or 
   bottle slowly.  This will also help minimize the volume of smoke 
   released. 

8.  Depending on the velocity of the air through the door undercut, the 
   smoke plume will either stay disorganized or it will form a distinct 
   streamline.  In either case, the smoke will directionally behave 
   in one of three ways.  It will:  (1) go through the door undercut 
   into the isolation room, (2) remain motionless or (3) be blown back 
   into the corridor.  Obviously, compliance with the intent of the CDC 
   Guidelines for negative pressure requires that the smoke be drawn 
   into the isolation room through the door undercut. 

   Supply air diffusers in the ceiling or upper sidewall of the 
   corridor may throw air directly at the isolation room door and 
   disrupt the test.  If the room is unoccupied, proceed to step nine 
   and release smoke on the inside of the door. 

9.  Release smoke from the corridor side of the door only for occupied 
   TB isolation rooms.  CSHOs should not enter occupied isolation 
   rooms per the OSHA TB Memorandum of October 8, 1993.  If the room 
   is unoccupied, also release smoke inside the isolation room (same 
   position as step 5) to verify that released smoke remains contained 
   in the isolation room (i.e. smoke as surrogate for TB contaminant). 

10. If photography or videotaping is performed, it is recommended that 
   a dark surface be placed on the floor to maximize contrast.  Be 
   aware that most autofocusing cameras cannot focus on smoke. 


TESTING "AS-USED" CONDITIONS: 

Testing of negative pressure isolation rooms requires that the test 
reflect "as-used" conditions.  Consider the following use variables which 
may affect space pressurization and the performance of the negative 
pressure isolation room: 

1.  Patient toilet rooms (TR) are mechanically exhausted to control 
   odors.  The position of the toilet room door may affect the 
   pressure differential between the isolation room and the corridor. 
   Smoke-trail tests should be performed with the TR door open and the 
   TR door closed.  This will not be necessary if the TR door is 
   normally closed and controlled to that position by a mechanical door 
   closer. 

2.  An open window will adversely affect the performance of a negative 
   pressure isolation room.  If the isolation room is equipped with 
   operable windows, perform smoke-trail tests with the window open and 
   the window closed. 

3.  There may be corridor doors that isolate the respiratory ward or 
   wing from the rest of the facility.  These corridor doors are 
   provided in the initial design to facilitate space pressurization 
   schemes and/or building life-safety codes.  Direct communication 
   with the rest of the facility may cause pressure transients in the 
   corridor (e.g., proximity to elevator lobby) and affect the 
   performance of the isolation room.  Perform isolation room 
   smoke-trail testing with these corridor doors in their "as-used" 
   position which is either normally open or normally closed. 

4.  Isolation rooms may be equipped with auxiliary, fan-powered, 
   recirculating, stand-alone HEPA filtration of UV units.  These units 
   must be running when the smoke-trail test is performed. 

5.  Do not restrict corridor foot traffic while performing smoke-trail 
   tests. 

6.  Negative pressure is accomplished by exhausting more air than is 
   supplied to the isolation room.  Some HVAC systems employ variable 
   air volume (VAV) supply air and sometimes VAV exhaust air.  By 
   varying the supply air delivered to the space to satisfy thermal 
   requirements, these VAV systems can adversely impact the performance 
   of a negative pressure isolation room.  If the isolation room or the 
   corridor is served by a VAV system you should perform the smoke test 
   twice.  Perform the smoke test with the zone thermostat thermally 
   satisfied and again with the zone thermostat thermally unsatisfied 
   thus stimulating the full volumetric flowrate range of the VAV 
   system serving the area being tested. 


SMOKE: 

Most smoke tubes, bottles and sticks use titanium chloride (TiCl(4)) to 
produce visible fume.  There is no OSHA PEL or ACGIH TLV for this chemical 
although it is a recognized inhalation irritant.  Health-care 
professionals are concerned about releasing TiCl(4) around pulmonary 
patients.  The smoke released at the door undercut makes only one pass 
through the isolation room and is exhausted directly outside.  Isolation 
room air is typically not recirculated. 

As an alternative to TiCl(4), the literature suggests the use of "dry-ice" 
in water.  Any product that is employed should be tested to insure 
sufficient opacity for videotaping and photography. 

Be prepared to present to the employer the Material Safety Data Sheet 
(MSDS) for the smoke that you intend to release. 


CSHO PROTECTION: 

1.  The CSHO should be familiar with the MSDS for the smoke.  If TiCl(4) 
   is used, the CSHO should avoid direct inhalation of the smoke or 
   skin contact with the liquid. 

2.  The CSHO should follow the recommendations in the OSHA TB Memorandum 
   of October 8, 1993. 

3.  If an isolation room is occupied by a patient infectious or suspect 
   with TB, then the CSHO performing the smoke-trail test shall use a 
   respirator.  You should assume that the isolation room is not 
   under negative pressure.  Recent surveys (Infect Control Hosp 
   Epidemiol 1993; 14:623-628) indicate that almost half of the 
   isolation rooms tested were not under negative pressure. 



                                   II 

___________________________________________________________________________ 

                             TRAINING PROGRAMS 

                               AND MATERIALS 

                              ________________ 

Training Programs and Materials consist of those resources which can 
assist in the successful development and implementation of a tuberculosis 
(TB) control and prevention program.  Included are self-directed studies, 
videos, slides, and lecture-format courses of varying duration.  These 
resources are generally aimed at personnel who are responsible for the 
health and safety program or the TB control program of an organization. 
However, many are appropriate for workers who are, themselves, at risk. 

___________________________________________________________________________ 



_____________________________________________________________________________ 

                    TRAINING PROGRAMS and MATERIALS 
                   _________________________________ 

Core Curriculum on Tuberculosis, 3rd Edition 
1994 
    For providers of health care services providers.  A 95-page training 
    guide on clinical and public health aspects of tuberculosis control. 
    A set of 82 slides are available to accompany the training guide, 
    or may be ordered separately. 

    Available at no charge from the CDC, Information Services. 

__________________ 


HHS-PHS-Federal Occupational Health - Tuberculosis Training Programs 
1995 

    A 2-volume tuberculosis (TB) education/training program marketed 
    to federal agencies; available on an interagency agreement basis 
    with Federal Occupational Health (FOH).  Program utilizes the CDC 
    Core Curriculum and can be customized for the agency receiving the 
    training.  Cost is negotiated on an interagency contract basis. 

            Tuberculosis Orientation:  A Self-Study Guide for FOH 
            Professionals 

            >      Updates the latest information from the CDC 
            >      Reviews importance of patient history 
            >      Reviews rationale and procedure for 2-step testing 

            FOH Presents Tuberculosis in the Workplace 

            >      Orients participants to signs/symptoms of TB 
            >      Reviews screening process 
            >      Reviews importance of diagnostic follow-up 
            >      Reviews CDC treatment guidelines 

    Contact:  Peggy Coleman, RN, MS, Occupational Health Nurse Consultant 
    to FOH, 4350 East-West Highway, Bethesda, Maryland; (301)594-0260. 

__________________ 


Mantoux Tuberculin Skin Testing 

    Video tape, wall chart.  Visual aids for training in the 
    administration and interpretation of the Mantoux PPD Tuberculin Skin 
    Test. 

    Available at no charge from the CDC, Information Services. 

__________________ 


Mantoux Skin Test Pretest/Posttest 
1990 
    12-questions relating to the Mantoux skin test.  Answer key and 
    explanations on a separate sheet.  Designed to be used with the 
    Mantoux Skin Test Instructional Video developed by the CDC; however, 
    may be used without the video. 

    New Hampshire Division of Public Health Services. 

__________________ 


National Tuberculosis Model Centers 

    3 national model center sites (San Francisco, New York City, and 
    Newark, NJ) are funded by the Division of Tuberculosis (TB) 
    Elimination, Centers for Disease Control and Prevention.  These 
    centers provide training courses, offer clinical consultation for 
    difficult cases, provide epidemiologic consultation, and have access 
    to an extensive library of both written and video materials 
    pertaining to TB, including translated materials. 

    Training courses include: 

    >    Preventing Tuberculosis in the Workplace - 8-hour 
         course covering environmental and behavioral changes 
         necessary to minimize potential for transmission of M. 
         tuberculosis in clinical, institutional and workplace 
         settings, including the implementation of OSHA 
         regulations. 

    >    Tuberculosis Update - 4 to 8-hour class.  Content 
         may include epidemiology, diagnosis, management and 
         treatment, multiple drug resistance, managing difficult 
         cases, reporting, infection control, community control, 
         TB and HIV. 

    >    Tuberculosis 101 - 1 to 3-day course for non-medical 
         health workers.  Content includes epidemiology, 
         transmission, pathogenesis, screening, prevention, 
         diagnosis, treatment, infection control.  Appropriate 
         for health outreach workers, social service agency 
         staff, drug treatment facility workers, HIV counseling 
         center staff. 

    >    Tuberculosis and the Law - 1 & 1/2-day course. 
         Content includes transmission and pathogenesis, legal 
         aspects of TB control, and infection control. 

    >    Tuberculosis Program Manager's Course - 4-day 
         intensive course for administrative and health care 
         personnel involved in TB program administration. 

         See address for the "National TB Model Centers", Appendix A. 

__________________ 


Postgraduate Courses on Clinical Management and Control of Tuberculosis 

    Intensive, 5-day courses aimed at health care professionals.  The 
    purpose of these courses is to present current scientific knowledge 
    about tuberculosis (TB), its prevention and control to health care 
    professionals who are responsible for the management and control 
    of TB.  Course content relevant to occupational management of TB 
    includes factors influencing infectiousness of TB, advances in 
    tuberculin testing, immunization, and planning TB control programs. 

    National Jewish Center for Immunology and Respiratory Medicine. 

__________________ 


Self-Study Modules on Tuberculosis 
1995 
    A set of 5 self-guided learning modules for health care staff and 
    health and safety workers who are relatively new to tuberculosis 
    (TB) control and with entry level knowledge of TB control issues. 
    Aimed at staff/workers in high-risk facilities. 

    Modules include:   1.  Transmission and Pathogenesis 
                       2.  Epidemiology 
                       3.  Diagnosis of TB Infection and Disease 
                       4.  Treatment of TB Infection and Disease 
                       5.  Infectiousness and Infection Control 

    Centers for Disease Control and Prevention, Tuberculosis Division. 


__________________ 


Tuberculosis:  Identification, Prevention and Control 
1994 
    Computer assisted instruction program aimed at licensed health 
    care professionals.  Thoroughly covers CDC and OSHA guidelines. 
    Includes learning objectives and a post-test.  Appropriate for 
    facility awarded continuing education.  Program can be modified to 
    include site-specific information. 

    Developed and written by APIC.  Available from Healthsoft, Inc., 
    PO Box 3069, Orlando, Florida 32802-9773; (800) 235-0882.  Preview 
    disk available at no charge. 

__________________ 


Tuberculosis in the Workplace:  A Workbook for Working People 
1994 
    A self-guided workbook, 103-pages, $3.00.  A 24-minute video, 
    entitled "Droplets of Death" ($15.00), is available to accompany 
    the workbook. 

    The Labor Institute. 

__________________ 



                                   III 

_____________________________________________________________________________ 

                         WORKER EDUCATION MATERIALS 

                               AND RESOURCES 
                                  ____________ 


The following agencies and organizations produce educational and 
informational materials for distribution to workers in a variety of 
occupational settings.  While all states provide tuberculosis educational 
materials, those listed here may not be widely known or distributed, and 
may be of additional value to a particular workplace or program.  The list 
is not exhaustive. 

A basic reading ability is required for the worker educational materials. 
Materials focused toward health care professionals are more technically 
challenging for the reader.  All materials are in English unless otherwise 
noted. 

Appendix A provides the contact information for the cited resources. 

The reader will note in the cited resources that several sources do not 
have documents listed.  The available documents were too extensive to be 
listed in-total in this publication.  It is recommended the user of this 
guide contact the source for a complete listing of the available 
documents. 

___________________________________________________________________________ 



                   _______________________________________ 

                   WORKER EDUCATION MATERIALS / RESOURCES 
                   _______________________________________ 


A.     GENERAL INFORMATION 

[Includes materials aimed at worker populations identified as high risk 
for tuberculosis (TB) exposure.] 

    American Federation of State, County and Municipal Employees (AFSCME) 

            *    Tuberculosis.  Fact sheet. 

            *    TB in Correctional Institutions.  Fact sheet. 

            *    Tuberculosis Questions and Answers.  Fact sheet. 

            *    Multidrug-Resistant TB (MDR TB).  Fact sheet. 

            *    OSHA Enforcement Policy & Procedures for 
                 Occupational Exposure to Tuberculosis.  Checklist. 


    American Federation of Teachers (AFT) 

            *    Tuberculosis - The "New" Epidemic.  Fact sheet. 


    American Jail Association 

            *    Jail Operations Training Bulletin on Tuberculosis. 


    American Lung Association (ALA) 

            *    Tuberculosis Education Resource Guide.  (1993). 
                 An extensive listing of patient/public educational 
                 materials, many of which are appropriate for worker 
                 education and training, both written and audio-visual. 
                 Each citation notes the intended audience, the 
                 languages the materials are available in, and the cost. 
                 Contact local chapters by calling (800) LUNG-USA 
                 (800-586-4872). 


    American Nurses Association (ANA) 

            *    Tuberculosis:  A Deadly Disease Makes a Comeback. 
                 (1993).  Pamphlet. 


    Association for Practitioners in Infection Control and Epidemiology, 
    Inc. (APIC) 

            *    Tuberculosis:  Identification, Prevention and 
                 Control.  (1994).  Computer assisted instruction 
                 (CAI) program aimed at licensed health care 
                 professionals.  Thoroughly covers CDC and OSHA 
                 guidelines.  Includes learning objectives and a 
                 post-test.  Appropriate for facility awarded 
                 continuing education.  Program can be modified to 
                 include site-specific information.  Available from 
                 Healthsoft, Inc., PO Box 3069, Orlando, Florida, 
                 32802-9773; (800) 235-0882. Preview disk available 
                 at no charge. 

            *    TB:  What You Need To Know.  (1994).  Computer 
                 assisted instruction (CAI) program for non-clinical 
                 workers.  Program can be modified to include 
                 site-specific information.  Available at a basic 
                 reading level in English and Spanish.  30-minutes or 
                 less to complete the post test.  Available from 
                 Healthsoft, Inc., PO Box 3069, Orlando, Florida, 
                 32802-9773; (800) 235-0992.  Preview disk available 
                 at no charge. 

            *    Tuberculosis:  Protection For Healthcare 
                 Workers. (1995).  Videotape.  Approximately 
                 20-minutes.  Addresses the following:  increased 
                 incidence of tuberculosis, current crisis, disease 
                 process, transmission, prevention, skin testing, 
                 laboratory identification, environmental controls, 
                 treatment, personal protection, medical monitoring. 
                 Accompanied by a comprehensive packet designed to 
                 assist in the implementation of current CDC 
                 recommendations. 

                 Distributed by Lincoln Medical Education Foundation, 
                 Attn:  Tuberculosis Video, 4600 Valley Road, Lincoln, 
                 Nebraska, 68510; (402) 483-4581; FAX (402) 483-4184. 
                 $225.00 APIC members, $250.00 non-members; $35.00 
                 preview/rental applied toward purchase. 


    Centers for Disease Control and Prevention (CDC); Information Services 

            *    TB Facts for Health Care Workers.  (1993). 
                 7-page booklet. 

            *    Think TB!  (1992).  Poster listing symptoms of 
                 tuberculosis (TB); also available in Spanish. 

            *    Exposure to TB.  (1991).  Pad of tear-off 
                 sheets designed for correctional facility inmates; 
                 also available in Spanish. 

            *    Tuberculosis - Get the Facts.  (1990).  1-page 
                 pamphlet on basic facts about transmission, infection, 
                 and testing; also available in Spanish. 

            *    Stop TB!  (1994).  Poster describing transmission 
                 & TB pathogenesis. 

            *    Stop TB!  (1994).  Pad of tear-off sheets 
                 duplicating the Stop TB! poster. 

            *    Questions and Answers About TB.  (1994).  16-page 
                 booklet about transmission, skin test, and treatment. 


    Indiana State Board of Health 


    The Labor Institute 

            *    Tuberculosis in the Workplace:  A Workbook for 
                 Working People (1994).  A worker-oriented 
                 training workbook (103-pages).  $3.00 each; 
                 discounted prices for large orders of workbooks 
                 - contact distributor, The Apex Press, at 
                 (914) 271-6500. 

            *    Droplets of Death:  TB in the Workplace. 
                 Videotape, 24-minutes; $15.00. 


    Mississippi State Department of Health, Tuberculosis Control Branch 

            *    Homeless Person Poster.  (1992).  Poster, 
                 $2.00 each for 1-100. 


    Missouri Department of Health, Bureau of Tuberculosis Control 

            *    Facts About TB as it Occurs Among Inmates in 
                 Correctional Facilities.  Videotape, 2 parts, 14 
                 minutes and 31 minutes. 

            *    Facts About TB.  Videotape, 14 minutes. 

            *    Guidelines for Education of Staff/Clients of 
                 Homeless Shelters. 


    National Institutes of Health, National Institute of Allergy 
    and Infectious Diseases (NIH, NIAID) 

            *    Tuberculosis.  (1995).  Fact sheet, 8-pages. 

            *    Tuberculosis:  What Health Care Workers Should 
                 Know.  (1993).  Pamphlet; includes graphic 
                 flow-chart to determine high-risk persons. 


    New York Academy of Medicine 

            *    Tuberculosis, poster, several languages available. 


    New York State, Department of Health 

            *    Pamphlets for health care workers, criminal justice 
                 workers. 

            *    Fact sheets in English and Spanish. 

            *    Question & answer sheets about tuberculosis. 

            *    Tuberculosis, poster. 

            *    When a Co-Worker Has TB:  What You Need to Know 
                 About Tuberculosis in the Workplace.  (1994). 
                 Video. 


    Service Employees International Union (SEIU) 

            *    TB:  The Real Deal.  (1995).  Fact sheet. 

            *    No One is Immune to TB:  Important Facts For All 
                 Workers.  (1995).  Fact sheet. 

            *    Your Right to Workers' Compensation.  (1995). 
                 Fact sheet. 


    University of California, San Diego, Preventive Pulmonary Medicine 

            *    The Many Faces of TB.  (1992).  15-minute 
                 video; $100.00. 


The U.S. Public Health Service has a tuberculosis (TB) control 
office in every state and can provide general information on TB.  The 
contact information for each state's TB control office is located in 
Section VI - State and Territorial Health Departments, Offices of TB 
Control. 


B.   SCREENING / TESTING 

    American Federation of State, County and Municipal Employees 
    (AFSCME) 

            *    Screening and Skin Testing.  Fact sheet. 


    American Federation of Teachers (AFT) 

            *    Tuberculosis and the Health Care Worker 
                 - Surveillance and Preventive Therapy.  Fact sheet. 


    American Lung Association of Hawaii 

            *      Fact sheet (basic). 

    Centers for Disease Control and Prevention (CDC), Information Services 

            *    Mantoux Tuberculin Skin Testing.  (1991). 
                 Videotape training aid on the administration and 
                 interpretation of the Mantoux skin test. 

            *    Mantoux Tuberculin Skin Testing.  (1990). 
                 Wall chart visual aid for interpreting the results 
                 of the skin test. 

            *    The TB Skin Test.  (1991).  Pad of tear-off 
                 sheets designed for correctional facility inmates; 
                 also available in Spanish. 


    Florida Department of Health and Rehabilitation Services 


    Kentucky Department for Health Services, Tuberculosis Control Program 


    Massachusetts Department of Health, Tuberculosis Control Program 


    Maryland Department of Health and Mental Hygiene, Tuberculosis Control 


    New York State Department of Health, Tuberculosis Control Program 

            *    Fact About the TB Skin Test.  (1992).  In 
                 English and Spanish. 

            *    Skin Testing and Classification of Tuberculosis. 
                 Fact sheet. 


    Oakland County Health Division (Michigan) 


    Service Employees International Union (SEIU) 

            *    TB Skin Test:  What You Need to Know About Your 
                 Health.  (1995).  Fact sheet. 


    Texas Department of Health 


    Washington (State of) Department of Health, TB Control Program 


C.   MEDICATIONS / TREATMENT 


    American Federation of Teachers (AFT) 

            *      Multiple-Drug Resistant TB.  Fact sheet. 


    Centers for Disease Control and Prevention (CDC), Information Services 

            *    TB Can Be Cured.  (1991).  Pad of tear-off 
                 sheets designed for correctional facility inmates; 
                 also available in Spanish. 


    County of Sonoma Public Health Department (California) 


    Florida Department of Health and Rehabilitative Services, 
    Tuberculosis Control Program 


    Hawaii Department of Health, Tuberculosis Branch 

            *      Individual medication instruction sheets. 


    Massachusetts Department of Public Health, Tuberculosis 
    Control Program 

            *    Pamphlets on isoniazid, ethambutol, pyrazinamide, 
                 rifampin, streptomycin. 


    Montgomery County Health Department (Maryland) 


    New York State Department of Health, Tuberculosis Control Program 


    North Carolina Department of Environment, Health, and Natural Resources 


    Oakland County Health Division (Michigan) 

            *    Pamphlet on positive reactors who may or may not 
                 need INH. 


    Pennsylvania Department of Health, Tuberculosis Control Program 

            *    Pamphlets on streptomycin, rifampin, pyrazinamide, 
                 isoniazid, and ethambutol. 


    South Dakota Lung Association 


    Spokane County Health District (Washington state) 


    Washington (State of), Department of Health 

            *    Pills Prevent TB.  (1994).  Pamphlet; available 
                 in several languages. 


    Whatcom County Health Department (Washington state) 


    Wisconsin Department of Health and Human Services, Tuberculosis 
    Control Program 

            *    Pamphlets and drug information sheets on rifampin, 
                 pyrazinamide, isoniazid, and ethambutol. 


D.     PREVENTION / CONTROL 

    American Federation of State, County and Municipal Employees 
    (AFSCME) 

            *    Controlling Transmission in High Risk Settings. 
                 Fact sheet. 

            *    Respiratory Protection.  Fact sheet. 


    American Federation of Teachers (AFT) 

            *    TB:  Steps for Protecting Staff and Students. 
                 Fact sheet. 

            *    Tuberculosis and the Health Care Worker 
                 - Surveillance and Preventive Therapy.  Fact sheet. 

            *    Tuberculosis and the Health Care Worker 
                 - Control Measures Against Exposure.  Fact sheet. 

            *    TB:  Steps for Protecting Workers from Workplace 
                 Exposure.  Fact sheet. 


    American Journal of Nursing (AJN) 

            *    TB or Not TB:  New Guidelines for Prevention and 
                 Treatment.  (1995).  19-minute video aimed at 
                 health care workers; $285.00 to purchase; $70.00 
                 rental.  Approved for CE credit. 


    Centers for Disease Control and Prevention (CDC), Information Services 

            *    TB in Correctional Facilities.  (1992).  Set 
                 of 67 slides on prevention and control of 
                 tuberculosis in correctional settings; 67-page 
                 booklet of slide facsimiles based on slide set; 
                 18-page narrative text designed to accompany slide set. 

            *    You Can Prevent TB.  (1991).  Pad of tear-off 
                 sheets designed for correctional facility inmates; 
                 also available in Spanish. 


    New York State Department of Health, Tuberculosis Control Program 

            *    Preventive Therapy for Tuberculosis.  Fact Sheet. 


    Service Employees International Union (SEIU) 

            *    A Workplace TB Plan:  Putting the Pieces 
                 Together. (1995).  Fact sheet. 

            *    Union Tools that Work.  (1995).  Fact sheet. 


E.   TB / HIV 


    American Federation of State, County and Municipal Employees 
    (AFSCME) 

            *    The TB/HIV Connection.  Fact sheet. 


    American Lung Association (ALA) 


    Centers for Disease Control and Prevention (CDC); Information Services 

            *    TB and HIV (The AIDS Virus).  (1991).  Pad of 
                 tear-off sheets designed for correctional facility 
                 inmates; also available in Spanish. 

            *    TB/HIV Double Trouble.  (1992).  Poster. 

            *    TB/HIV - The Connection:  What Health Care 
                 Workers Should Know.  (1993).  16-page booklet. 

            *    Tuberculosis - The Connection Between TB and HIV 
                 (the AIDS Virus).  (1990).  1-page pamphlet on 
                 the risk of HIV-related TB, testing, and therapy; 
                 also available in Spanish. 


    CDC National AIDS Clearinghouse 


    Hawaii (State of), Department of Health, AIDS/STD Project 


    Maryland Department of Health and Mental Hygiene 


    National Institutes of Health, National Institute of Allergy 
    and Infectious Diseases (NIH, NIAID) 

            *    HIV-Related TB:  How to Help Yourself. 
                 (1993).  8-page booklet. 


    National Leadership Coalition on AIDS 


    New York State Department of Health, Tuberculosis Control Program 


    North Carolina Department of Environment, Health and Natural 
    Resources 



                                   IV 

_________________________________________________________________________ 

                           NON-ENGLISH LANGUAGE 

                               RESOURCES 
                               _________ 

Tuberculosis (TB) educational and informational materials are available 
for workers whose primary language is not English.  These materials 
include general information on TB, its prevention, and treatment 
medications.  The addresses or other contact information for the 
organizations cited are located in Appendix A. 

____________________________________________________________________________ 



                       ______________________________ 

                       NON-ENGLISH LANGUAGE RESOURCES 
                       ______________________________ 


OFFICE OF MINORITY HEALTH RESOURCE CENTER (OMH-RC) 

    Assists in locating educational and other literature and 
    publications in languages other than English through 
    computerized database searches.  A group of publications is 
    also available from OMH-RC which lists organizations and 
    programs that provide minority health materials.  OMH-RC 
    services are free. 


AMHERIC 

    Fairfax County (Virginia) Health Department 


ARABIC 

    Francis J. Curry, National Tuberculosis Model Center 


ASIAN LANGUAGE LIST OF RECOMMENDED TUBERCULOSIS HEALTH EDUCATION 
MATERIALS 

    Association of Asian Pacific Community Health Organization (AAPCHO) 
    provides a list of tuberculosis educational materials and their 
    sources which have been evaluated and approved for linguistic accuracy, 
    cultural appropriateness, and clinical accuracy in Chinese, Korean, 
    Tagalog, and Vietnamese.  The 3-page list is in English and is 
    continually being updated.  No charge. 


CAMBODIAN 

    American Lung Association of Maryland 

    American Lung Association of San Diego and Imperial Counties 
    (California) 

    American Lung Association of Virginia 

    Fairfax County (Virginia) Health Department 

    Francis J. Curry, National Tuberculosis Model Center 

    Hawaii State Department of Health 

    Maryland Department of Health and Mental Hygiene, Tuberculosis Control 

    Massachusetts Department of Public Health, TB Control Program 

    Massachusetts Refugee Health Program 

    Seattle-King County Department of Public Health (Washington state) 

    Sonoma County TB Control Chest Clinic (California) 

    State of Hawaii, AIDS/STD Project 

    Washington (state) Department of Health, Tuberculosis Control 


CAPE VERDEAN 

    Massachusetts Department of Public Health, Tuberculosis Control Program 


CHINESE 

    American Lung Association of Alameda County (California) 

    American Lung Association of Hawaii 

    American Lung Association of Los Angeles County (California) 

    American Lung Association of Maryland 

    American Lung Association of San Francisco 

    American Lung Association of Virginia 

    Asian Health Services 

    Association of Asian Pacific Community Health Organizations 

    California Department of Health Services 

    Francis J. Curry, National Tuberculosis Model Center 

    Massachusetts Department of Public Health, Tuberculosis Control Program 

    North East Medical Services (NEMS) 

    San Francisco Department of Public Health, Division of TB Control 

    Seattle-King County Department of Public Health, Tuberculosis Division 
    (Washington state) 

    Sonoma County TB Control Chest Clinic (California) 

    State of Hawaii, AIDS/STD Project 

    The New York Academy of Medicine 


CANTONESE CHINESE 

    American Lung Association of San Francisco 

    San Francisco Department of Public Health, Division of TB Control 


CREOLE (HAITIAN) 

    American Lung Association of Virginia 

    Dade County Public Health Unit, Tuberculosis Control Program (Florida) 

    Massachusetts Department of Public Health, Tuberculosis Control Program 

    The New York Academy of Medicine 


DARI 

    American Lung Association of Virginia 


ETHIOPIAN (Tigrinia) 

    American Lung Association of Virginia 

    Fairfax County Health Department (Virginia) 

    Francis J. Curry, National Tuberculosis Model Center 

    Sonoma County TB Control Chest Clinic (California) 


FARSI 

    American Lung Association of Virginia 

    Fairfax County Health Department (Virginia) 


FILIPINO (TAGALOG) 

    American Lung Association of Hawaii 

    American Lung Association of Virginia 

    Asian Health Services 

    Association of Asian Pacific Community Health Organizations 

    California Department of Health Services 

    Francis J. Curry, National Tuberculosis Model Center 

    State of Hawaii, AIDS/STD Project 


FRENCH 

    American Public Health Association 

    Massachusetts Department of Public Health, Tuberculosis Control Program 

    New York City Health Department, Bureau of Tuberculosis 


GREEK 

    Massachusetts Department of Public Health, Tuberculosis Control Program 


HMONG 

    American Lung Association of Hawaii 


ILOCANO 

    American Lung Association of Hawaii 

    Association of Asian Pacific Community Health Organizations 

    Hawaii State Department of Health 

    State of Hawaii, AIDS/STD Project 


ITALIAN 

    American Public Health Association 

    Massachusetts Department of Public Health, Tuberculosis Control Program 


JAPANESE 

    American Lung Association of Hawaii 

    Spokane County Health District (Washington state) 

    State of Hawaii, AIDS/STD Project 

    Washington (state) Department of Health, Tuberculosis Control Program 


KOREAN 

    American Lung Association of Hawaii 

    American Lung Association of Los Angeles County 

    American Lung Association of Virginia 

    Asian Health Services 

    Association of Asian Pacific Community Health Organizations 

    California Department of Health Services 

    Fairfax County Health Department (Virginia) 

    Francis J. Curry, National Tuberculosis Model Center 

    Hawaii State Department of Health 

    Los Angeles County Health Department 

    Louisville and Jefferson County Board of Health (Kentucky) 

    Madigan Army Hospital Medical Center (Washington state) 

    Seattle-King County Department of Public Health, Tuberculosis 
    Division (Washington state) 

    State of Hawaii, AIDS/STD Project 

    Washington (state) Department of Health, Tuberculosis Control Program 


LAOTIAN 

    American Lung Association of Hawaii 

    American Lung Association of Los Angeles 

    American Lung Association of Maryland 

    American Lung Association of San Diego and Imperial Counties (California) 

    American Lung Association of Virginia 

    Fairfax County Health District (Virginia) 

    Francis J. Curry, National Tuberculosis Model Center 

    Hawaii State Department of Health 

    Louisville and Jefferson County Board of Health (Kentucky) 

    Maryland Department of Health and Mental Hygiene, Tuberculosis Control 

    Massachusetts Department of Public Health, TB Control Program 

    Massachusetts Refugee Health Program 

    Seattle-King County Department of Public Health, Tuberculosis 
    Division (Washington state) 

    Sonoma County TB Control Chest Clinic (California) 

    Spokane County Health District (Washington state) 

    State of Hawaii, AIDS/STD Project 

    Washington (state) Department of Health, Tuberculosis Control Program 


POLISH 

    Washington (state) Department of Health, Tuberculosis Control Program 


PORTUGUESE 

    Massachusetts Department of Public Health, Tuberculosis Control Program 


ROMANIAN 

    Sonoma County TB Control Chest Clinic (California) 


RUSSIAN 

    American Lung Association 

    American Lung Association of Massachusetts 

    Dupage County Health Department, Tuberculosis Clinic (Illinois) 

    Francis J. Curry, National Tuberculosis Model Center 

    Massachusetts Department of Public Health 

    Washington (state) Department of Health, Tuberculosis Control Program 


SAMOAN 

    American Lung Association of Hawaii 

    Hawaii State Department of Health 

    State of Hawaii, AIDS/STD Project 


SAUDI 

    Spokane County Health District (Washington state) 


SPANISH 

    American Academy of Pediatrics-Committee on Infectious Diseases 

    American Lung Association 

    American Lung Association of Brooklyn (New York) 

    American Lung Association of Los Angeles County 

    American Lung Association of Massachusetts 

    American Lung Association of San Francisco 

    American Public Health Association 

    Centers for Disease Control and Prevention, Division of Tuberculosis 
    Elimination 

    Chelan-Douglas Health District (Washington state) 

    County of Los Angeles Department of Health Services, Tuberculosis 
    Control (California) 

    County of Los Angeles, Health Education Unit (California) 

    Dade County Public Health Unit, Tuberculosis Control Program (Florida) 

    Fairfax County Health Department (Virginia) 

    Florida Department of Health and Rehabilitative Services, Tuberculosis 
    Control Program 

    Francis J. Curry, National Tuberculosis Model Center 

    Louisville and Jefferson County Board of Health (Kentucky) 

    Madigan Army Hospital Medical Center (Washington state) 

    Malheur County Health Department (Oregon) 

    Massachusetts Department of Public Health, Tuberculosis Control Program 

    Montgomery County Health Department (Maryland) 

    New Hampshire Division of Public Health Services 

    New Mexico, Health and Environment Department, TB Control Program 

    New York City Health Department, Bureau of Tuberculosis 

    Orange County Health Care Agency (California) 

    Prince George's County TB Control Division (Maryland) 

    San Francisco Department of Public Health, Division of TB Control 

    Seattle-King County Department of Public Health, Tuberculosis 
    Division (Washington state) 

    Skagit County Health Department (Washington state) 

    Sonoma County TB Control Chest Clinic (California) 

    Spokane County Health District (Washington state) 

    Texas Department of Health, Tuberculosis Control Division 

    The New York Academy of Medicine 

    US-Mexico Border Health Association (JUNTOS Project) 

    Wake County Department of Health (North Carolina) 

    Washington (state) Department of Health, Tuberculosis Control Program 


THAI 

    State of Hawaii, AIDS/STD Project 


TONGAN 

    Hawaii State Department of Health, Tuberculosis Branch 

    State of Hawaii, AIDS/STD Project 


VIETNAMESE 

    American Lung Association of Hawaii 

    American Lung Association of San Diego and Imperial Counties 
    (California) 

    American Lung Association of Virginia 

    Asian Health Services 

    Association of Asian Pacific Community Health Organizations 

    California Department of Health Services 

    Fairfax County Health Department (Virginia) 

    Francis J. Curry, National Tuberculosis Model Center 

    Louisville and Jefferson County Board of Health (Kentucky) 

    Maryland Department of Health and Mental Hygiene, Tuberculosis Control 

    Massachusetts Department of Public Health, TB Control Program 

    Massachusetts Refugee Health Program 

    Montgomery County Health Department (Maryland) 

    Orange County Health Care Agency (California) 

    Prince George's County TB Control Division (Maryland) 

    Seattle-King County Department of Public Health, Tuberculosis 
    Division (Washington state) 

    Sonoma County TB Control Chest Clinic (California) 

    Spokane County Health District (Washington state) 

    State of Hawaii, AIDS/STD Project 

    Washington (state) Department of Health, Tuberculosis Control Program 


VISAYAN 

    State of Hawaii, AIDS/STD Project 



                                    V 

__________________________________________________________________________ 

                        PUBLICATIONS AND RESOURCES 

                            FOR CLINICIANS 

                            _____________ 

This section, Publications and Resources for Clinicians, contains 
resources for health care providers who are delivering care to persons 
with tuberculosis.  The materials are highly technical and 
clinically-oriented.  The addresses and other contact information for 
the organizations cited are located in Appendix A. 

____________________________________________________________________________ 


                  _________________________________________ 

                  PUBLICATIONS and RESOURCES for Clinicians 
                  _________________________________________ 


American Association of Occupational Health Nurses. (1994).  AAOHN 
    advisory:  Tuberculosis.  AAOHN Journal, 42(10).  Reprints from 
    AAOHN: $5.00 members; $8.00 non-members. 


American Thoracic Society.  (1990).  Diagnostic standards and 
    classification of tuberculosis.  American Review of 
    Respiratory Disease, 142, 725-735. 


Association of Asian Pacific Community Health Organizations.  (1994). 
    Clinical TB protocol.  Available at no charge from AAPCHO. 


Association of State & Territorial Public Health Laboratory Directors; 
    and, Public Health Practice Program Office, Division of Laboratory 
    Systems (CDC).  (1995).  Mycobacterium tuberculosis:  Assessing 
    your laboratory, (ASTPHLD #U60-CCU303019).  Atlanta, GA:  CDC 


Carmon, M.  (1993).  Legal challenges of tuberculosis in the workplace. 
    AAOHN Journal, 41(2), 96-100. 


Centers for Disease Control and Prevention.  (1994).  Expanded 
    tuberculosis surveillance and tuberculosis morbidity - United 
    States, 1993.  Morbidity and Mortality Weekly Report, 43(20), 
    361-366. 


Centers for Disease Control and Prevention.  (1993).  Initial therapy 
    for tuberculosis in the era of multi-drug resistance: 
    Recommendations of the advisory council for the elimination of 
    tuberculosis (ACET).  Morbidity and Mortality Weekly Report, 
    42(No. RR-7). 


Centers for Disease Control and Prevention.  (1991).  Purified protein 
    derivative (PPD)-tuberculin anergy and HIV infection:  Guidelines 
    for anergy testing and management of anergic persons at risk of 
    tuberculosis.  Morbidity and Mortality Weekly Report, 40(No. RR-5). 


Centers for Disease Control and Prevention.  (1993).  Technical 
    guidance on HIV counseling.  Morbidity and Mortality Weekly 
    Report, 42(No. RR-2). 


Colditz, G.A., Brewer, T.F., Berkey, C.S., Wilson, M.E. Burdick, E., 
    Fineberg, H.V., & Mosteller, F. (1994).  Efficacy of BCG vaccine 
    in the prevention of tuberculosis:  Meta-analysis of the published 
    literature.  JAMA, 271(9), 698-702. 


Daugherty, J.S., Hutton, M.D., & Simone, P.M.  (1993).  Prevention and 
    control of tuberculosis in the 1990s.  Nursing Clinics of North 
    America, 28(3), 599-611. 


Directly observed therapy (DOT):  It can help you cure TB. 
    Informational brochure for physicians to introduce them to the benefits 
    of DOT.  Available from New York State Department of Health. 


Huebner, R.E., Schein, M.F., & Bass, J.B., Jr.  (1993).  The 
    tuberculin skin test.  Clinical Infectious Diseases, 17, 968-975. 


National AIDS Clearinghouse (CDC).  (1995).  HIV/AIDS and tuberculosis. 
    A database search drawn from the CDC National Clearinghouse's 
    Educational Materials Database.  The database is updated twice yearly. 


National Institutes of Health, National Institute of Allergy and 
    Infectious Diseases.  (1993).  Tuberculosis:  Resurgence of an 
    old problem. 


Office of Minority Health Resource Center (OMH-RC) 
    Resource and referral service.  Offers database searches, information 
    exchange, publications, mailing lists, technical assistance, data and 
    statistics, and referrals.  Resource Person Network (volunteers) 
    available to provide technical assistance, conduct professional level 
    education training and workshops, and serve as reference specialists. 
    Database searches to locate brochures, articles, bibliographies, 
    journals, and other literature.  All resource center services are free 
    of charge. 


The following resources are available at no charge from the Centers 
for Disease Control & Prevention (CDC), Information Services (IS).  The 
address for IS, National Center for Prevention Services, at the CDC is 
listed in Appendix A.  In addition, a reproducible order form for CDC 
material is located in Appendix B. 

    American Thoracic Society.  (1992).  Control of 
    tuberculosis in the United States.  American Review of 
    Respiratory Disease, 146(6), 1623-1633. 

    American Thoracic Society.  (1994).  Treatment of 
    tuberculosis and tuberculosis infection in adults and 
    children.  American Journal of Respiratory and Critical 
    Care Medicine, 149(5), 1359-1374. 

    Centers for Disease Control and Prevention.  (1990). 
    Screening for tuberculosis and tuberculosis infection in 
    high-risk populations and use of preventive therapy for 
    tuberculosis infection in the US.  Morbidity and Mortality 
    Weekly Report, March 18. 

    Centers for Disease Control and Prevention.  (1993). 
    Tuberculosis control laws - United States, 1993:  
    Recommendations of the advisory council for the elimination 
    of tuberculosis (ACET).  Morbidity and Mortality Weekly 
    Report, 42,(No. RR-15), November 12. 

    Centers for Disease Control and Prevention.  (1992). 
    Management of persons exposed to multidrug-resistant 
    tuberculosis.  Morbidity and Mortality Weekly Report, 
    41(No. RR-11), June 19. 

    Core curriculum on tuberculosis, 3rd Edition.  (1994). 
    For providers of health care services.  A 95-page training 
    guide on clinical and public health aspects of tuberculosis 
    control.  A set of 82 slides to accompany the training 
    booklet is also available. 

    Reported tuberculosis in the United States, 1993. 
    Statistics on tuberculosis cases and case rates reported for 
    1993. 

    TB care guide:  Highlights from core curriculum on 
    tuberculosis.  (1994).  A 57-page booklet for clinicians 
    on care of TB patients, with a tear-off card for dosage 
    calculation and reference. 

    Treating tuberculosis:  A clinical guide.  (1994).  A 
    fold-out chart with 8 panels with tables on TB treatment and 
    medications for clinicians' reference. 



                                 VI 

__________________________________________________________________________ 

                        STATE AND TERRITORIAL 

                    OFFICES OF TUBERCULOSIS CONTROL 

                             __________ 

Each state and territory of the United States has an Office of 
Tuberculosis Control.  The point of contact for each office listed 
is current as of May 1995.  Your local telephone directory should be 
consulted for any number or personnel changes. 
____________________________________________________________________________ 



                 STATE AND TERRITORIAL HEALTH DEPARTMENTS 
                         Tuberculosis Control Offices 
____________________________________________________________________________ 
                                  | 
Frank K. Bruce                     | William W. Stead, MD 
Director                           | Director 
Tuberculosis Control Branch        | Tuberculosis Control Division 
Alabama Department of Public Health| Arkansas Department of Health 
434 Monroe Street                  | 4815 West Markham Street 
Montgomery, ALABAMA  36130-3017    |  - Mailstop 45 
                                  | Little Rock, ARKANSAS  72205 
                                  | 
Consultant:  N/A                   | Consultant:  Dory Moers, RN 
                                  | 
Phone:  (334) 613-5330             | Phone:  (501) 661-2398 
Fax:    (334) 288-5021             | Fax:    (501) 661-2759 
___________________________________|________________________________________ 
                                  | 
Elizabeth Funk, MD                 | Sarah Royce, MD, MPH 
Epidemiologist                     | Chief 
Infectious Disease Group           | TB Control Branch 
Alaska Health Department and       | California Department of 
Social Services                   |  Health Services 
Section of Epidemiology            | 2151 Berkeley Way, Room 715 
P.O. Box 240249                    | Berkeley, CALIFORNIA  94704-1101 
Anchorage, ALASKA  99524           | 
                                  | 
Consultant:  Suzanne Banda, RN     | Consultant:  N/A 
                                  | 
Phone:  (907) 561-4406             | Phone:  (510) 540-2973 
Fax:    (907) 562-7802             | Fax:    (510) 849-5269 
___________________________________|________________________________________ 
                                  | 
Edgar Reed, MD                     | Richard E. Hoffman, MD, MPH 
Department of Health               | Tuberculosis Control Officer 
Government of American Samoa       | Colorado Department of Health 
LBJ Tropical Medical Center        | 4300 Cherry Creek Drive South 
Pago Pago, AMERICAN SAMOA  96799   | DCEED-A3 
                                  | Denver, COLORADO  80222-1530 
                                  | 
Consultant:  N/A                   | Consultant:  N/A 
                                  | 
Phone:  9-011-684-633-2243         | Phone:  (303) 692-2676 
Fax:    9-011-684-633-5379         | Fax:    (303) 782-0904 
___________________________________|________________________________________ 
                                  | 
Norman J. Petersen, FM             | Joseph Marino 
Acting Assistant Director          | Program Director 
Disease Prevention Services        | TB Control Program 
Arizona Department of Health       | Connecticut Department of Public 
Services                          |  Health Services 
3815 North Black Canyon Highway    | 150 Washington Street 
Phoenix, ARIZONA  85015            | Hartford, CONNECTICUT  06106 
                                  | 
Consultant:  Caroline Nejedlo, RN  | Consultant:  Patricia Kucharski, RN 
                                  | 
Phone:  (602) 230-5808             | Phone:  (203) 566-3099 
Fax:    (602) 230-5959             | Fax:    (203) 566-5823 
___________________________________|________________________________________ 
                                  | 
Kathleen E. Russell, MPH           | Beverly Devoe, MHS 
Coordinator                        | Program Manager 
Tuberculosis Elimination Program   | Tuberculosis Control Program 
Delaware Dept. of Health and       | Georgia Department of 
Social Services                   |  Human Resources 
Jessie Cooper Building             | 1305 Redmond Circle, Building 512 
P.O. Box 637                       | Rome, GEORGIA  30161-1393 
Dover, DELAWARE  19903             | 
                                  | 
Consultant:  N/A                   | Consultant:  N/A 
                                  | 
Phone:  (302) 739-6620             | Phone:  (706) 295-6292 
Fax:    (302) 739-6617             | Fax:    (706) 295-6747 
___________________________________|________________________________________ 
                                  | 
VACANT                             | Cecilia T. Arciaga 
Chief                              | Tuberculosis Program Coordinator 
Bureau of Tuberculosis Control     | Department of Public Health 
Department of Health and           |  and Social Services 
Human Services                    | Government of Guam 
DCGH - Building 15                 | P.O. Box 2816 
1905 E Street, SE                  | Agana, GUAM  96910 
Washington, DISTRICT OF COLUMBIA   | 
20003                             | 
                                  | 
Consultant:  Jean Mainer, RN       | Consultant:  N/A 
                                  | 
Phone:  (202) 724-2195             | Phone:  9-001-671-734-7145 
Fax:    (202) 724-2363             | Fax:    9-001-671-734-5910 
___________________________________|________________________________________ 
                                  | 
Lerina Nena, RN                    | Azucena Ignacio, MD 
TB Program Manager                 | Chief 
Dept. of Health Services           | Tuberculosis Branch 
P.O. Box PS70, Palikir Station     | Hawaii Department of Health 
Palikir                            | 1700 Lanakila Avenue 
Pohnpei, FEDERATED STATES OF       | Honolulu, HAWAII  96817-2199 
MICRONESIA  96941                 | 
                                  | 
Consultant:  N/A                   | Consultant:  N/A 
                                  | 
Phone:  9-011-691-320-2619         | Phone:  (808) 832-5731 
Fax:    9-011-670-233-0214         | Fax:    (808) 832-5846 
___________________________________|________________________________________ 
                                  | 
James Jackson                      | Jesse Greenblatt, MD, MPH 
Director, HIV/STD/TB Prevention    | State Epidemiologist 
Florida Department of Health &     | Idaho Department of Health 
Rehab. Services                   |  and Welfare 
1317 Winewood Blvd., Building E    | 450 West State Street 
4th Floor, Room 416                | Boise, IDAHO  83720 
Tallahassee, FLORIDA  32399-0700   | 
                                  | 
Consultant:  N/A                   | Consultant:  N/A 
                                  | 
Phone:  (904) 487-3684             | Phone:  (208) 334-5941 
Fax:    (904) 487-1521             | Fax:    (208) 334-6581 
___________________________________|________________________________________ 
                                  | 
Ben Atkinson, MPH                  | Gene D. Simmons, MPH 
Chief                              | Program Manager 
TB Control Program                 | Tuberculosis Control Program 
Illinois Department of             | Kentucky Department for 
Public Health                     |  Health Services 
525 West Jefferson Street          | 275 East Main Street 
- 1st Floor                       | Frankfort, KENTUCKY  40621-001 
Springfield, ILLINOIS  62761       | 
                                  | 
Consultant:  N/A                   | Consultant:  Donna Perkins, 
                                  |                   RN, BSN 
                                  | 
Phone:  (217) 785-5371             | Phone:  (502) 564-4276 
Fax:    (217) 524-4515             | Fax:    (502) 564-4553 
___________________________________|________________________________________ 
                                  | 
VACANT                             | Vic Tomlinson 
Director                           | Tuberculosis Control Section 
Division of Communicable Disease   | Louisiana Department of Health 
Indiana State Department of Health |  and Hospitals 
P.O. Box 1964                      | 325 Loyola, Room 617 
1330 West Michigan Street          | New Orleans, LOUISIANA  70112 
Indianapolis, INDIANA  46206-1964  | 
                                  | 
Consultant:  N/A                   | Consultant:  N/A 
                                  | 
Phone:  (317) 383-6458             | Phone:  (504) 568-5015 
Fax:    (317) 383-6747             | Fax:    (504) 568-5016 
___________________________________|________________________________________ 
                                  | 
Patricia Quinlisk, MD              | Kathy Gensheimer, MD 
Iowa Department of Public Health   | Director, TB Control and 
Lucas State Office Building        |  Refugee Program 
321 East 12th Street               | Bureau of Health 
Des Moines, IOWA  50319-0075       | Department of Human Services 
                                  | 157 Capitol - State House, 
                                  |  Station #11 
                                  | Augusta, MAINE  04333 
                                  | 
Consultant:  N/A                   | Consultant:  Joan Blossom, RN 
                                  | 
Phone:  (515) 281-4941             | Phone:  (207) 287-3748 
Fax:    (515) 242-4958             | Fax:    (207) 287-6865 
___________________________________|________________________________________ 
                                  | 
Harold H. Geer                     | Sarah Bur, RN, MPH 
Director, TB Control Section       | Chief 
Bureau of Disease Control          | Division of Tuberculosis Control 
Kansas Department of Health        | Maryland Dept. of Health and 
and Environment                   |  Mental Hygiene 
109 Southwest Ninth Street         | 201 West Preston Street 
Mills Building, Suite 605          | O'Connor Building - 3rd Floor, 
Topeka, KANSAS  66612-1271         |  Rm 307A 
                                  | Baltimore, MARYLAND  21201-2399 
                                  | 
Consultant:  Angela Akerstron, RN  | Consultant:  N/A 
                                  | 
Phone:  (913) 296-5589             | Phone:  (410) 225-6692 
Fax:    (913) 296-4197             | Fax:    (410) 669-4215 
___________________________________|________________________________________ 
                                  | 
Sue C. Etkind, RN, MS              | Mahree Skalar 
Director                           | Deputy Director 
Tuberculosis Control Program       | Division of Environmental Health 
Massachusetts Department of        |  and Epidemiology 
Public Health                     | Missouri Department of Health 
305 South Street                   | 1730 East Elm Street 
Jamaica Plain, MASSACHUSETTS  02130| P.O. Box 570 
                                  | Jefferson City, MISSOURI 
                                  |  65102-0570 
                                  | 
Consultant:  Janice Boutotte, RN   | Consultant:  Marty Huber, RN 
                                  | 
Phone:  (617) 983-6970             | Phone:  (314) 751-6080 
Fax:    (617) 983-8735             | Fax:    (314) 526-6892 
___________________________________|________________________________________ 
                                  | 
Dennis Minnice                     | Denise Ingman 
Chief                              | TB Program Coordinator 
Division of Tuberculosis Control   | Preventive Health Services 
Michigan Department of             | Montana State Department of 
Public Health                     |  Health and Environmental Science. 
P.O. Box 30035                     | 1400 Broadway - Cogsweil Building 
3500 N. Martin Luther King Blvd.   | Helena, MONTANA  59620-0901 
Lansing, MICHIGAN  48909           | 
                                  | 
Consultant:  N/A                   | Consultant:  N/A 
                                  | 
Phone:  (517) 335-8063             | Phone:  (406) 444-0275 
Fax:    (517) 335-8121             | Fax:    (406) 444-2606 
___________________________________|________________________________________ 
                                  | 
Kristine MacDonald, MD, MPH        | Roger Murray 
Director, TB Control Program       | Coordinator 
Minnesota Department of Health     | Tuberculosis Control Program 
P.O. Box 9441                      | Nebraska Department of Health 
717 Delaware Street SE             | 301 Centennial Mall South 
Minneapolis, MINNESOTA  55440      | P.O. Box 95007 
                                  | Lincoln, NEBRASKA  68509-5007 
                                  | 
Consultant:  Claudia Miller        | Consultant:  N/A 
                                  | 
Phone:  (612) 623-5526             | Phone:  (402) 471-2937 
Fax:    (612) 623-5743             | Fax:    (402) 471-6426 
___________________________________|________________________________________ 
                                  | 
James M. Holcombe, MPA             | Sandra Henneke, RN 
Director                           | Program Manager 
Tuberculosis Control Branch        | Tuberculosis Control Program 
Mississippi State Department       | Nevada State Department of 
of Health                         |  Human Resources 
2423 North State Street            | 505 East King Street, Room 304 
Jackson, MISSISSIPPI  39216        | Carson City, NEVADA  89710 
                                  | 
Consultant:  Paulette W. Smith, RN | Consultant:  N/A 
                                  | 
Phone:  (601) 960-7700             | Phone:  (702) 687-4800 
Fax:    (601) 354-0661             | Fax:    (702) 687-4988 
___________________________________|________________________________________ 
                                  | 
Richard DiPentima, RN, MPH         | James Jones, MPH 
TB Program Chief                   | Chief, Tuberculosis Control 
Bureau                             |  Section 
Bureau Disease Control             | Dept. of Environment, Health, & 
New Hampshire Division of Public   |  Natural Resources 
Health Services                   | P.O. Box 27687 
6 Hazen Drive                      | Raleigh, NORTH CAROLINA 
Concord, NEW HAMPSHIRE  03301-6527 |  27611-7687 
                                  | 
Consultant:  Janice Oberacker      | Consultant:  Dee Foster, RN 
                                  | 
Phone:  (603) 271-4496             | Phone:  (919) 733-7286 
Fax:    (603) 271-4933             | Fax:    (919) 715-4699 
___________________________________|________________________________________ 
                                  | 
Clifford G. Freund                 | Larry Shireley, MPH 
Director                           | TB Control Program 
Communicable Disease Services      | Division of Disease Control 
New Jersey State Department        | North Dakota Department of 
of Health                         |  Health 
University Office Plaza - CN 369   | 600 East Boulevard Avenue 
Trenton, NEW JERSEY  08625-0369    | Bismarck, NORTH DAKOTA 
                                  |  58505-0200 
                                  | 
Consultant:  Doris Lewis,          | Consultant:  N/A 
                 RN, MA, MPA      | 
                                  | 
Phone:  (609) 588-7539             | Phone:  (701) 328-2378 
Fax:    (609) 588-7431             | Fax:    (701) 328-4727 
___________________________________|________________________________________ 
                                  | 
Doris Fields                       | Isamu J. Abraham, MO 
Director, Tuberculosis Control     | Secretary of Health 
Program                           | Commonwealth of the Northern 
Bureau of Infectious Disease       |  Mariana Islands 
Prevention & Control              | Department of Health 
Public Health Division             | P.O. Box 409 CK 
Health and Environment Department  | Saipan, MARIANA ISLANDS 
P.O. Box 26110                     | 
1990 St. Francis Drive             | 
Santa Fe, NEW MEXICO  87502        | 
                                  | 
Consultant:  Jean Smithpeter,      | Consultant:  Lupe Hofschnieder 
                 RN, MSN          | 
                                  | 
Phone:  (505) 827-0156             | Phone:  9-011-670-234-8950 
Fax:    (505) 827-0163             | Fax:    9-011-670-234-8930 
___________________________________|________________________________________ 
                                  | 
George DiFerdinando, MD, MPH       | Thomas J. Halpin, MD 
Director                           | Director 
Bureau TB Control                  | Division of Prevention Medicine 
New York State Department of Health| Ohio Department of Health 
Corning Tower, Room 840/859        | P.O. Box 118 
Empire State Plaza                 | 246 North High Street 
Albany, NEW YORK  12237            | Columbus, OHIO  43266-0118 
                                  | 
Consultant:  Elizabeth Foster, RN  | Consultant:  Shirley Dobbins, RN 
                                  | 
Phone:  (518) 474-7000             | Phone:  (614) 466-0304 
Fax:    (518) 473-6164             | Fax:    (614) 644-8526 
___________________________________|________________________________________ 
                                  | 
Jon Tillinghast, MD, MPH           | Mildred Soto, MPH 
TB Control Officer                 | Director 
Communicable Disease Division      | Tuberculosis Control Program 
Oklahoma State Department of Health| Department of Health 
1000 NE Tenth Street               | P.O. Box 71423, Correo General 
Oklahoma City, OKLAHOMA  73117-1299| San Juan, PUERTO RICO  00936-1423 
                                  | 
Consultant:  Helen Gretz, RN       | Consultant:  Millie Rodriquez, 
                                  |                   RN, MSN 
                                  | 
Phone:  (405) 271-4063             | Phone:  (809) 721-2000, x 205 
Fax:    (405) 271-5149             | Fax:    (809) 723-3565 
___________________________________|________________________________________ 
                                  | 
Elizabeth Brown, MS, RN            | Janet O'Connel, MPH 
TB Program Director                | Program Administrator for 
Oregon Health Division             |  TB Control 
800 NE Oregon, Suite 772           | Office of Disease Control 
Portland, OREGON  97232            | Rhode Island Department of Health 
                                  | 3 Capitol Hill 
                                  | Providence, RHODE ISLAND  02908-5097 
                                  | 
Consultant:  Liz Binam, RN         | Consultant:  Jean Mainer 
                                  | 
Phone:  (503) 731-4024             | Phone:  (401) 277-2577 
Fax:    (503) 731-4798             | Fax:    (401) 272-3771 
___________________________________|________________________________________ 
                                  | 
Anthony Polloi, MD                 | Donald F. Capella 
Director                           | Secretary of Health and Environment 
ATTN:  Jill McCready               | P.O. Box 16 
Bureau of Health Services          | Majuro Hospital 
Republic of Palau                  | Majuro, REPUBLIC OF MARSHALL 
P.O. Box 6027                      |  ISLANDS  96960 
Koror, PALAU - W.C. Is.  96940     | 
                                  | 
Consultant:  N/A                   | Consultant:  Justina R. Langidrik, MPH 
                                  | 
                                  | 
Phone:  9-011-680-488-2813         | Phone:  9-011-692-625-7246 
Fax:    9-011-680-488-1211         | Fax:    9-011-692-625-3432 
___________________________________|________________________________________ 
                                  | 
VACANT                             | Carol J. Pozsik, RN, MPH 
Tuberculosis Control Program       | Director 
Pennsylvania Department of Health  | Division of Tuberculosis Control 
P.O. Box 90                        | S. Carolina Department of Health & 
Health and Welfare Building        |   Environmental Control 
- 10th Floor West                 | 2600 Bull Street 
Commonwealth and Forster Street    | Columbia, SOUTH CAROLINA  29201 
Harrisburg, PENNSYLVANIA           | 
17108-0090                        | 
                                  | 
Consultant:  N/A                   | Consultant:  Betty Gore, RN, 
                                  |                   MSN, CIC 
                                  | 
Phone:  (717) 787-6267             | Phone:  (803) 737-4150 
Fax:    (717) 783-3794             | Fax:    (803) 737-6531 
___________________________________|________________________________________ 
                                  | 
Kristin Schweigert                 | William Graham, MD 
TB Project Coordinator             | Medical Director 
Office of Communicable Disease     | Tuberculosis Control Program 
Prevention and Control             | Vermont Department of Health 
South Dakota State Department      | P.O. Box 70 
of Health                         | 109 Cherry Street 
445 East Capitol Avenue            | Burlington, VERMONT  05402 
Pierre, SOUTH DAKOTA  57501-3182   | 
                                  | 
Consultant:  N/A                   | Consultant:  N/A 
                                  | 
Phone:  (605) 773-3364             | Phone:  (802) 863-7245 
Fax:    (605) 773-6623             | Fax:    (802) 865-7701 
___________________________________|________________________________________ 
                                  | 
H. David Crowder                   | VACANT 
Division of Tuberculosis Control   | Bureau of Tuberculosis Control 
Tennessee Department of Health     | Virginia State Department of Health 
and Environment                   | 1500 East Main Street, Rm. 119 
Tennessee Tower Building           | Richmond, VIRGINIA  23218 
- 13th Floor                      | 
Nashville, TENNESSEE  37247-4911   | 
                                  | 
Consultant:  Pat Johnson, RN       | Consultant:  N/A 
                                  | 
Phone:  (615) 532-2691             | Phone:  (804) 786-6251 
Fax:    (615) 532-8478             | Fax:    (804) 371-0248 
___________________________________|________________________________________ 
                                  | 
Michael F. Kelley, MD, MPH         | Sylvia Buntin-Simmons, PhD 
Bureau Chief                       | Project Director 
Bureau of Communicable Disease     | TB Control Program 
Control                           | Virgin Islands Department of Health 
Texas Department of Health         | Community Health Services 
1100 West 49th Street              | 48 Sugar Estate 
Austin, TEXAS  78756-3199          | St Thomas Hospital 
                                  | St Thomas, VIRGIN ISLANDS  00802 
                                  | 
Consultant:  Isabel Vitek,         | Consultant:  N/A 
                 RN, BSN          | 
                                  | 
Phone:  (512) 458-7455             | Phone:  (809) 774-3168 
Fax:    (512) 458-7787             | Fax:    (809) 771-4001 
___________________________________|________________________________________ 
                                  | 
Lillian Tom-Orme, RN, PhD          | Kay Anderson, RN 
Director, Community Health         | TB Controller 
Services                          | Washington Department of Health 
Refugee and Pulmonary Program      | 1511 Third Avenue, Suite 201 
Utah Department of Health          | Seattle, WASHINGTON  98101 
P.O. Box 142868                    | 
288 North, 1460 West               | 
Salt Lake City, UTAH  84114-2868   | 
                                  | 
Consultant:  Margaret Chamberlin,  | Consultant:  Sheryl Palaniuk, RN 
                 RN, BSN          | 
                                  | 
Phone:  (801) 538-6141             | Phone:  (206) 464-5327 
Fax:    (801) 538-6694             | Fax:    (206) 464-6123 
___________________________________|________________________________________ 
                                  | 
James H. Walker, MD                | Dawn Tuckey 
Director                           | Director 
Tuberculosis Control Program       | Tuberculosis Control Program 
West Virginia Department of Health | Wisconsin Department of Health 
1422 East Washington Street        |  & Social Services 
Charleston, WEST VIRGINIA  25301   | 1414 East Washington Avenue 
                                  | Madison, WISCONSIN  53703 
                                  | 
Consultant:  Carolyn Winkler, RN   | Consultant:  N/A 
                                  | 
Phone:  (304) 558-2669             | Phone:  (608) 266-9452 
Fax:    (304) 558-6335             | Fax:    (608) 266-3696 
___________________________________|________________________________________ 
                                  | 
Alex Bowler                        | 
Coordinator                        | 
Wyoming Department of Health       | 
and Social Services               | 
Hathaway Building, 4th Floor,      | 
Room 419                          | 
Cheyenne, WYOMING  82002           | 
                                  | 
Consultant:  N/A                   | 
                                  | 
Phone:  (307) 777-5658             | 
Fax:    (307) 777-5402             | 
___________________________________|________________________________________ 



                             APPENDIX A 

                   Addresses / Contact Information 


                        Addresses & Contacts 
                          for TB Resources 

AIDS Action Council 
    1875 Connecticut Ave., NW, Suite 700 
    Washington, DC  20009 

    (202) 986-1300 - FAX: (202) 986-1345 

AIDS Coalition to Unleash Power ("Act-Up") 
    135 W. 29th Street, #10 
    New York, New York  10001 

    (212) 564-2437 - FAX (212) 594-5441 

Alma Illery Medical Center 
    7227 Hamilton Avenue 
    Pittsburgh, Pennsylvania  15208 

    (412) 244-4775 

American Academy of Family Physicians 
    8880 Ward Parkway 
    Kansas City, Missouri  64114 

    (816) 333-9700 or (800) 274-2237 (toll free) 

American Academy of Pediatrics 
    141 Northwest Point Boulevard 
    Elk Grove Village, Illinois  60007-0927 

    (708) 228-5005 - FAX (708) 228-5097 

American Ambulance Association 
    50 Monroe, NW 
    Suite 420 
    Grand Rapids, MI  49503-6201 

    (616) 454-0775 

American Association for Continuity of Care 
    1730 N. Lynn Street, Suite 502 
    Arlington, Virginia  22209 

    (703) 525-1191 - FAX (703) 276-8196 

American Association for Respiratory Care 
    11030 Ables Lane 
    Dallas, Texas  75229 

    (214) 243-2272 - FAX (214) 484-2720 

American Association for World Health 
    1129 20th Street, NW, Suite 400 
    Washington, DC  20036 

    (202) 466-5883 - FAX (202) 466-5896 

American Association of Occupational Health Nurses (AAOHN) 
    50 Lenox Pointe 
    Atlanta, GA  30324-3176 

    (800) 241-8014 / (404) 262-1162 / FAX (404) 262-1165 

American College of Chest Physicians 
    3300 Dundee Road 
    Northbrook, Illinois  60062-2348 

    (708) 498-1400 - FAX (708) 498-5460 

American College of Internal Physicians 
    711 Second Street, NE, Suite 200 
    Washington, DC  20002 

    (202) 544-7498 - FAX (202) 546-7105 

American College of Physicians 
    Independence Mall West, Sixth Street at Race 
    Philadelphia, Pennsylvania  19106-1572 

    (215) 351-2829 - FAX (215) 351-2829 

American College of Preventive Medicine 
    1015 15th Street, NW, Suite 403 
    Washington, DC  20005 

    (202) 789-0003 - FAX (202) 289-8274 

American Correctional Health Services Association 
    11 West Monument Ave., Suite 510 
    P.O. Box 2307 
    Dayton, Ohio  45401-2307 

    (513) 223-9630 - FAX (513) 223-6307 

American Federation of State, County and Municipal Employees, AFL-CIO 
(AFSCME) 
    1625 L Street, NW 
    Washington, DC  20036-5687 

    (202) 429-1000 - FAX (202) 429-1293 

American Federation of Teachers, AFL-CIO (AFT) 
    555 New Jersey Avenue, NW 
    Washington, DC  20001-2079 

    (202) 393-5674 - FAX (202) 879-4597 

American Geriatrics Society 
    770 Lexington Avenue, Suite 400 
    New York, New York  10021 

    (212) 308-1414 

American Health Care Association (AHCA) 
    1201 L Street, NW 
    Washington, DC  20005 

    (202) 898-2850 - FAX (202) 842-3860 

American Hospital Association 
    1 North Franklin Street 
    Chicago, Illinois  60606 

    (312) 422-3000 

American Jail Association 
    2053 Day Road, Suite 100 
    Hagerstown, Maryland  21740-9795 
    ATTN:  Training Coordinator 

    (301) 790-3930 - FAX (301) 790-2941 

American Journal of Nursing Company (AJN) 
    Educational Services Division 
    555 West 57th Street 
    New York, New York  10019-2961 

    (800) CALL-AJN [(800) 225-5256] - FAX (212) 944-9055 

American Lung Association 
    1740 Broadway 
    New York, New York  10019-4374 

    (212) 315-8700 - FAX (212) 265-5642 

    (800) LUNG-USA [(800) 586-4872] to contact local chapters or 
     request information. 

American Medical Association 
    515 North State Street 
    Chicago, Illinois  60610 

    (312) 464-5000 - FAX (312) 464-4184 

American Nurses Association 
    600 Maryland Avenue, SW, Suite 100W 
    Washington, DC  20024-2571 

    (202) 651-7126 - (800) 637-0323 

American Public Health Association 
    1015 15th Street NW 
    Washington, DC  20005 

    (202) 789-5600 - FAX (202) 789-5681 

American Society for Microbiology 
    1325 Massachusetts Avenue, NW 
    Washington, DC  20005 

    (202) 737-3600 

American Thoracic Society 
    1740 Broadway 
    New York, New York  10019-4374 

    (212) 315-8778 - FAX (212) 265-5642 

Asian Health Services 
    310 Eighth Street 
    Suite 200 
    Oakland, California  94607 

    (510) 465-3374 

Association for Practitioners in Infection Control and Epidemiology, Inc. 
(APIC) 
    1016 16th Street, NW, 6th Floor 
    Washington, DC  20036 

    (202) 296-2742 - FAX (202) 296-5645 

    Exec. Director:  Rick Dorman 

Association of Asian Pacific Community Health Organizations 
(AAPCHO) 
    1212 Broadway, Suite 730 
    Oakland, California  94612-1825 

    (510) 272-9536 - FAX (510) 272-0817 

    Program Coordinator:  Jeff Caballero 

Association of Community Health Nursing Educators 
    President 
    Bianca M. Chambers, RN, D.N.Sc. 
    Indiana University School of Nursing 
    Department of Community Health Nursing 
    1111 Middle Drive 
    Indianapolis, Indiana  46202-5107 

    (317) 274-2129 - FAX (317) 278-1378 

Association of State and Territorial Directors of Nursing 
    Elfrida Nord, RN, MPH 
    Chief, Section of Nursing 
    Department of Health and Social Services 
    P.O. Box 110611 
    Juneau, Alaska  99811-0611 

    (907) 465-3150 - FAX (907) 465-3913 

Association for Professionals in Infection Control and Epidemiology, Inc. 
    1016 16th Street, NW - Sixth Floor 
    Washington, DC  20036 

    (202) 296-2742 - FAX (202) 296-5645 

Association of State and Territorial Health Officials 
    415 Second Street, NW, Suite 200 
    Washington, DC  20002 

    (202) 546-5400 

California Department of Health Services 
    California Indoor Air Quality Program 
    Dr. Janet Macher 
    Dr. Kenneth W. Kizer, ME, MPH, Director of CA Dept Health 
    Services 
    2151 Berkeley Way 
    Berkeley, California 

    (510) 540-2469 

Centers for Disease Control and Prevention (CDC) 
    Division of Tuberculosis Elimination and Control 
    1600 Clifton Road, NE, Mailstop E-10 
    Atlanta, Georgia  30333 

    (404) 639-8120; (404) 639-1819 (voice activated, for ordering 
    specific materials) 

    FAX (404) 639-8628 

    RN Consultant: Susan Dougharty Gibson: (404) 639-8135 

Centers for Disease Control and Prevention (CDC) 
    Information Services 
    National Center for Prevention Services 
    1600 Clifton Road, NE, Mailstop E-06 
    Atlanta, Georgia  30333 

    (404) 639-1819 (voice activated, for ordering 
    materials/publications) 

    FAX (404) 639-8628 

Centers for Disease Control and Prevention (CDC) 
    National AIDS Clearinghouse 
    P.O. Box 6003 
    Rockville, Maryland  20849-6003 

    (800) 458-5231 - (301) 217-5343 - FAX - (301) 251-5343 

Centers for Disease Control and Prevention (CDC) 
    Office of Safety & Health 
    1600 Clifton Road 
    Atlanta, Georgia  30333 

    (404) 639-3235 (copy of Biosafety in Microbiological & 
    Biomedical Laboratories, 3rd Ed.) 

College of American Pathologists 
    325 Waukegan Road 
    Northfield, Illinois  50093-2750 

    (708) 446-8800 

Congress of National Black Churches 
    1225 I Street, NW, Suite 750 
    Washington, DC  20005 

    (202) 371-1091 - FAX (202) 371-0908 

Department of Defense 
    Office of the Assistant Secretary of Defense (Clinical Services) 
    1200 Defense Pentagon - Health Affairs 
    Washington, DC  20301-1200 

    (703) 695-7116 

Department of Veterans Affairs 
    Office of Geriatrics and Extended Care (114) 
    810 Vermont Avenue, NW 
    Washington, DC  20420 

    (202) 535-7165 - FAX (202) 535-7006 

Drug Strategies 
    2445 M Street, NW, Suite 480 
    Washington, DC  20037 

    (202) 663-6090 - FAX (202) 663-6110 

1199 National Health and Human Service Employee Union 
    330 West 42nd Street, 15th Floor 
    New York, New York  10036 

    (212) 631-4580 - FAX (212) 695-0538 

Food and Drug Administration 
    5600 Fishers Lane 
    HFD (NLRC) 
    Rockville, Maryland  20857 

    (301) 443-2410 - FAX (301) 443-9292 

Hawaii (State of), Department of Health 
    AIDS/STD Project 
    1250 Punchbowl Street 
    Honolulu, Hawaii  96813 

Health Care Finance Administration 
    Hubert Humphrey Building, Room 314G 
    200 Independence Avenue, SW 
    Washington, DC  20201 

    (202) 690-5727 - FAX (202) 690-6262 

Health Care for the Homeless Information Resource Center 
    John Snow, Inc. 
    210 Lincoln Street 
    Boston, Massachusetts  02111 

    (617) 482-9485 - FAX (617) 482-0617 

Health Resources & Services Administration 
    5600 Fishers Lane, Rm 7-05 
    Rockville, Maryland  20857 

    (301) 443-1993 - FAX (301) 443-9645 

Home Health Services and Staffing Association (HHSSA) 
    115 D South 
    Saint Asaph Street 
    Alexandria, Virginia  23314 

    Mark Ranslem (703) 836-9863 

Hunter College School of Health Sciences 
    The Center for Occupational & Environmental Health 
    425 East 25th Street 
    New York, New York  10010 

    (212) 481-8790 - FAX (212) 481-8795 

    Director:  Daniel Kass (212) 481-4361 

Indian Health Service 
    5600 Fishers Lane, Room 6-05 
    Rockville, Maryland  20857 

    (301) 443-1083 

Infectious Diseases Society of America 
    Yale University School of Medicine 
    333 Cedar Street, 201 LCI 
    New Haven, Connecticut  06510-8056 

    (203) 785-4141 - FAX (203) 785-6179 

Joint Commission on Accreditation of Healthcare Organizations 
(JCAHO) 
    One Renaissance Boulevard 
    Oakbrook Terrace, Illinois  60181 

    (708) 916-5600 

Labor Institute, The 
    853 Broadway, Room 2014 
    New York, New York  10003 

    (212) 674-3322 - FAX (212) 353-1203 

Lincoln Medical Education Foundation 
    Attn:  Tuberculosis Video 
    4600 Valley Road 
    Lincoln, Nebraska  68510 

    (402) 483-4581 - FAX (402) 483-4184 

Madigan Army Health Social Service Department 
    Medical Center 
    Tacoma, Washington  98431 

    (206) 968-2302 

Massachusetts Refugee Health Program 
    305 South Street 
    Jamaica Plains, Massachusetts  02130 

    (617) 522-3700 

Migrant Clinicians Network 
    5524 Bee Caves Road, Building I, Suite 1 
    Austin, Texas  78746 

    (512) 327-2017 - (512) 327-0719 

National Association of Community Health Centers, Inc. 
    1330 New Hampshire Avenue, Suite 122 
    Washington, DC  20036 

    (202) 659-8008 - FAX (202) 659-8519 

National Association of County Health Officials 
    440 First Street, NW, Suite 500 
    Washington, DC  20001 

    (202) 783-5550 

National Black Nurses Association 
    1511 K Street, NW, Suite 415 
    Washington, DC  20006 

    (202) 393-6870 - FAX (202) 347-3808 

National Coalition for the Homeless 
    1612 K Street, NW, Suite 1004 
    Washington, DC  20006 

    (202) 775-1322 - FAX (202) 775-1316 

National Commission for Clinical Laboratory Standards (NCCLS) 
    771 East Lancaster Avenue 
    Villanova, Pennsylvania  19085 

    (215) 525-2435 

National Commission on Correctional Health Care 
    2105 North Southport, Suite 200 
    Chicago, Illinois  60614-4017 

    (312) 528-0818 

National Council of La Raza 
    810 First Street, NE, Suite 300 
    Washington, DC  20002 

    (202) 289-1380 - FAX (202) 289-8173 

National Foundation for Infectious Diseases 
    4733 Bethesda Avenue, Suite 750 
    Bethesda, Maryland  20814-5228 

    (301) 656-0003 - FAX (301) 907-0878 

National Health Care for the Homeless Council 
    P.O. Box 68019 
    Nashville, Tennessee  37206-8019 

    (615) 226-2292 - FAX (615) 226-1656 

National Heart, Lung and Blood Institute 
    National Institutes of Health 
    9000 Rockville Pike 
    Building 31, Room 5A52 
    Bethesda, Maryland  20892 

    (301) 496-5166 - FAX (301) 496-7408 

National Institute of Allergy and Infectious Diseases (NIAID) 
    National Institutes of Health 
    9000 Rockville Pike 
    Building 31, Room 7A03 
    Bethesda, Maryland  20892 

    (301) 496-2263 - FAX (301) 496-4409 

National Institute of Nursing Research 
    National Institutes of Health 
    Building 45, Room 3AN-12 
    MSC 6300 
    Bethesda, Maryland  20892-6300 

    (301) 594-6908 - FAX (301) 480-8260 

National Jewish Center for Immunology and Respiratory Medicare 
    TB Office K624 
    1400 Jackson Street 
    Denver, Colorado  80206 

    (303) 398-1700 - (800) 423-8891, extension: 1700 

National Leadership Coalition on AIDS 
    1730 M Street, NW, Suite 905 
    Washington, DC  20036 

    (202) 429-0930 - FAX (202) 872-1977 

National Minority AIDS Council 
    300 I Street, NW, Suite 400 
    Washington, DC  20002 

    (202) 544-1076 - FAX (202) 544-0378 

National Public Health Information Coalition 
    P.O. Box 941804 
    Atlanta, Georgia  30341-0804 

National Rural Health Association 
    1 West Armour, Suite 301 
    Kansas City, Missouri  64111 

    (816) 756-3140 - FAX (816) 756-3144 

National Technical Information Service 
    U.S. Department of Commerce 
    5285 Port Royal Road 
    Springfield, Virginia  22161 

    (800) 553-6847 

National Tuberculosis Model Centers 
    Francis J. Curry, National Tuberculosis Center 
    3180 18th Street, Suite 101 
    San Francisco, California  94110 

    (415) 502-4600 - FAX (415) 502-4620 

           Director:  Gisela Schecter, MD, MPH 
           Education Director:  Wesley S. Wong 

National Tuberculosis Model Centers (continued) 
    National Tuberculosis Center, UMDNJ 
    University of Medicine and Dentistry of New Jersey 
    65 Bergen Street, Suite GB-1 
    Newark, New Jersey  07107-3001 

    (201) 982-3270 - FAX (201) 982-3268 

           Education Director:  Debra Bottinick 

New Hampshire Division of Public Health Services 
    6 Hazen Drive 
    Concord, New Hampshire  03301 

    (603) 271-4661 

New York Academy of Medicine 
    1216 Fifth Avenue 
    New York, New York  10029 

New York City Department of Health 
    Bureau of Tuberculosis Control 
    125 Worth Street, Box 74 
    New York, New York  10013 

    (212) 788-4153 - FAX (212) 788-4179 

Nursing Organization Liaison Forum 
    American Nurses Association 
    600 Maryland Avenue, SW 
    Washington, DC  20024 

    (202) 651-7120 

Office of Minority Health 
    5515 Security Lane, Suite 1000 
    Rockville, Maryland  20852 

    (301) 443-5084 - FAX (301) 594-0767 

Office of Minority Health Resource Center (OMH-RC) 
    PHS-DHHS 
    PO Box 37337 
    Washington, DC  20013-7337 

    (800) 444-MHRC [(800) 444-6472] 
    TDD: (301) 589-0951 
    FAX: (301) 589-0884 

Pharmaceutical Manufacturers Association 
    1100 15th Street, NW, Suite 900 
    Washington, DC  20005 

    (202) 835-3550 - FAX (202) 835-3597 

Services Employees International Union, AFL-CIO 
    1313 L Street, NW 
    Washington, DC  20005 

    (202) 898-3434 - FAX (202) 898-3491 

Society for Hospital Epidemiology of America 
    875 Kings Highway, Suite 200 
    Woodbury, New Jersey  08096 

    (609) 845-1636 - FAX (609) 853-0411 

Substance Abuse and Mental Health Services Administration 
    5515 Security Lane 
    Rockwall II Building, Room 880 
    Rockville, Maryland  20852 

    (301) 443-8391 - FAX (301) 443-8345 

UMDNJ New Jersey Medical School 
    National Tuberculosis Center 
    65 Bergen Street, Suite GB1 
    Newark, New Jersey  07107-3001 

    (201) 982-3270 - FAX (201) 982-3268 

United States - Mexico Border Health Association 
    JUNTOS Program 
    6006 North Mesa, Suite 600 
    El Paso, Texas  79912 

    (915) 581-6645 - FAX (915) 833-4768 

           Fernando J. Gonzalez, MD, MPH 
           Bi-National TB Control Project Coordinator 

University of California, San Diego Medical Center 
    Preventive Pulmonary Medicine 
    225 Dickinson Street 
    San Diego, California  92103-8377 

    Attn:  Andrew Ries, MD 

University Hospital & Clinics 
    Infection Control Department 
    DC092.00  212 Dockery Hall 
    One Hospital Drive 
    Columbia, Missouri  65212 

U.S. Department of Health and Human Services 
    Division of Federal Occupational Health 

    (301) 594-0260 

U.S. Department of Labor - OSHA 
    Office of Training and Education 
    1555 Times Drive 
    Des Plaines, Illinois  60018 

    (708) 297-4810 

U.S. Government Printing Office 
    Superintendent of Documents 
    Washington, D.C.  20402 

    (202) 512-2356 

Utah (State of) 
    Industrial Commission of Utah 
    Utah Job Safety and Health Consultation Services 
    160 East 300 South, 3rd Floor 
    PO Box 146650 
    Salt Lake City, Utah  84114-6650 

    (801) 530-6855 / (800) 222-1238 - FAX (801) 530-6992 

    Consultant:  Eldon Tryon, PhD 

Wasatch Homeless Health Care Program 
    404 South 400 West 
    Salt Lake City, Utah  84101 

    (801) 364-0058 - FAX (801) 364-0161 



                              APPENDIX B 

  Centers for Disease Control and Prevention, Education and Training 
                        Materials Order Form. 


                Division of Tuberculosis Elimination 
                 Educational and Training Materials 

Please indicate desired quantity in the blank provided.  All materials are 
free of charge. 


For Health Care Providers 

Multidrug Resistant Tuberculosis - 1994 
___    (00-6529)      8-page article on the causes, treatment, and 
                     control of drug-resistant tuberculosis 

Core Curriculum on Tuberculosis, 3rd Edition - 1994 
___    (00-5763)      95-page training guide on important clinical and 
                     public health aspects of TB control 
___    (00-6077)      Set of 82 slides that accompany this training 
                     guide (Slides limited to one set per order) 

TB Care Guide - 1994 
___    (00-6470)      57-page booklet for clinicians on care of TB 
                     patients, with a tear-off card for dosage 
                     calculation and reference 

TB Treatment:  A Clinical Guide - 1994 
___    (00-6471)      Fold-out chart with 8 panels with tables on TB 
                     treatment and medications for clinicians' 
                     reference 

TB Facts for Health Care Workers - 1993 
___    (00-5655)      7-page booklet on TB transmission, diagnosis, 
                     prevention, and treatment 

Think TB! - Poster listing the symptoms of tuberculosis 
___    (00-6186)      English language - 1992 
___    (00-6406)      Spanish language - 1993 

Improving Patient Adherence to Tuberculosis Treatment - 1994 
___    (00-5988)      55-page booklet on measuring, predicting, and 
                     improving compliance 

Mantoux Tuberculosis Skin Testing - Visual aids for training to 
administer and interpret the Mantoux test 
___    (00-5564)      Wall chart - 1990 
___    (00-5457)      Videotape - 1991 

TB/HIV - The Connection:  What Health Care Workers Should Know - 1993 
___    (00-5316)      16-page booklet on diagnosis, prevention, and 
                     treatment of TB in persons with HIV infection 

Reported TB in the United States - 1993 
___    (00-6481)      Statistics on tuberculosis cases and case rates 
                     reported for 1993 


For Drug Treatment Center Staff 

What Drug Treatment Centers Can Do To Prevent Tuberculosis - 1991 
3-page pamphlet on TB infection, disease, screening, and prevention for 
drug treatment centers 
___    (00-5748)      English Language 
___    (00-6038)      Spanish language 

For Correctional Facility Inmates 

Tuberculosis Facts - 1991 - Pad of 40 tear-off sheets providing basic 
information on the subject specified: 
English language 
___    (00-5983)      Exposure to TB 
___    (00-5984)      The TB Skin Test 
___    (00-5981)      You Can Prevent TB 
___    (00-5985)      TB Can Be Cured 
___    (00-5982)      TB and HIV (The AIDS Virus) 

Spanish language 
___    (00-6200)      Exposure to TB 
___    (00-6201)      The TB Skin Test 
___    (00-6198)      You Can Prevent TB 
___    (00-6202)      TB Can Be Cured 
___    (00-6199)      TB and HIV (The AIDS Virus) 



                                        GUIDELINES 
TB PREVENTION AND CONTROL 

___    (00-5856)      Guidelines for preventing the Transmission of 
                     Mycobacterium tuberculosis in Health Care 
                     Facilities.  MMWR, 1994. 
___    (00-6410)      Tuberculosis Control Laws - United States 
                     1993.  MMWR, November 12, 1993. 
___    (00-6330)      Control of Tuberculosis in the United States. 
                     Reprint from the American Review of Respiratory 
                     Disease, December 1992. 
___    (00-6224)      National Action Plan to Combat Multidrug- 
                     Resistant Tuberculosis.  MMWR, June 19, 1992. 
___    (00-6223)      Prevention and Control of Tuberculosis in 
                     Migrant Farm Workers.  MMWR, June 5, 1992. 
___    (00-6148)      Prevention and Control of Tuberculosis Among 
                     Homeless Persons and Prevention and Control of 
                     Tuberculosis in U.S. Communities with At-Risk 
                     Minority Populations.  MMWR.  April 17, 1992 
___    (00-5897)      Prevention and Control of Tuberculosis Among 
                     Foreign-Born Persons Entering the United States. 
                     MMWR, July 13, 1990. 


TB SCREENING AND TREATMENT 

___    (00-6453)      Treatment of Tuberculosis and Tuberculosis 
                     Infection in Adults and Children.  Reprint from 
                     the American Journal of Respiratory and Critical 
                     Care Medicine, May 1994. 
___    (99-3307)      Screening for Tuberculosis and Tuberculosis 
                     Infection in High-Risk Populations and Use of 
                     Preventive Therapy for Tuberculosis Infection in 
                     the U.S.  MMWR, March 18, 1990. 
___    (00-6225)      Management of Persons Exposed to Mulitdrug- 
                     Resistant Tuberculosis.  MMWR, June 19, 1992. 


For Patients and the General Public 

Questions and Answers about TB - 1994 
___    (00-6469)      16-page booklet about TB transmission, skin test, 
                     and treatment, including DOT and side effects of 
                     medications 

Stop TB! - 1994 
___    (00-6474)      Poster describing the transmission and 
                     pathogenesis of TB 
___    (00-6475)      Pad of 50 tear-off sheets duplicating the Stop TB! 
                     poster 

Tuberculosis - Get the Facts! - 1990 
One-page pamphlet on basic facts about TB transmission, 
infection, and the tuberculin test 
___    (00-5743)      English language 
___    (00-5772)      Spanish language 

Tuberculosis - The Connection Between TB and HIV (the AIDS Virus) - 1990 
One-page pamphlet on the risk of HIV-related TB, tuberculin testing, and 
preventive therapy 
___    (00-5738)      English language 
___    (00-5745)      Spanish language 

TB/HIV Double Trouble - 1992 
___    (00-6154)      Poster stressing the importance of tuberculin 
                     testing for persons with HIV infection 

To order tuberculosis educational and training materials or guidelines, 
you may (1) call the National Center for Preventive Services Voice 
Information System (recording) at (404) 639-1819; (2) FAX this form to 
Information Services at (404) 639-8628; OR (3) mail this form to: 
Information Services, NCPS, CDC, 1600 Clifton Road NE. Mailstop E-06, 
Atlanta, Georgia 30333. 

Please provide the following information: 
Name:          _______________________________________________________ 

Address:       _______________________________________________________ 

              _______________________________________________________ 

              _______________________________________________________ 

              _______________________________________________________ 

Phone:         (     ) _______________________________________________ 


Archive Notice - OSHA Archive

NOTICE: This is an OSHA Archive Document, and may no longer represent OSHA Policy. It is presented here as historical content, for research and review purposes only.


Standard Interpretations - Table of Contents Standard Interpretations - (Archived) Table of Contents