V. NIOSH Recommendations for Personal Respiratory Protection
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V. NIOSH Recommendations for Personal Respiratory Protection
A. Summary of Conclusions and Recommendations—
- The National Institute for Occupational Safety and Health (NIOSH) concludes that any tuberculosis infection in health-care-facility workers[1] due to occupational transmission is unacceptable. Infection of health-care-facility workers with tuberculosis, whether with or without clinical disease, is a material impairment of these workers' health and establishes a finite probability of subsequently developing clinical tuberculosis. Additionally, treatment of tuberculosis-infected workers with isoniazid (INH+) for chemoprophylactic purposes can present these treated workers with another significant risk of material impairment of their health or functional capacity due to isoniazidrelated health effects (e.g., isoniazid-associated hepatitis).
- NIOSH recommends that wherever there exists the potential exposure of workers to droplet nuclei from a tuberculosis transmitter, the first and highest priority is to reduce the probability of exposure through the use of administrative controls (e.g., rapid identification, early treatment, and isolation of potential tuberculosis transmitters; limiting access to acid-fast bacilli (AFB) isolation rooms; other isolation precautions) implemented in conjunction with engineering controls (e.g., negative-pressure ventilation for AFB isolation rooms to contain any hazard to these rooms; booths, hoods, tents, or other devices for containing droplet nuclei at the source—i.e., a person with infectious pulmonary tuberculosis). However, it is unlikely that the exposure of workers to droplet nuclei can be completely controlled at the infectious source even when these techniques are implemented to a high degree of efficiency. Therefore, for a limited range of specific hazardous locations and procedures, when confirmed or potential tuberculosis transmitters are present, use of effective and reliable personal
- ↑ The term health-care-facility-workers refers to all persons working in a health-care setting-including physicians, nurses, aides, and persons not directly involved in patient care (e.g., dietary, housekeeping, maintenance, clerical, and janitorial staff, and volunteers) (1).
