Injuries and Illness

Occupational Lung Disease: Preventing Tuberculosis

According to the Centers for Disease Control and Prevention (CDC), nearly one third of the world’s population is infected with tuberculosis (TB), which kills almost 1.5 million people per year. In 2013, 9,582 TB cases were reported in the United States, and 383 of those cases were among healthcare workers. On July 13, OSHA updated its instructions for conducting inspections and issuing citations related to worker exposures to TB in healthcare settings.

Keep reading to find out what the new developments mean for your facility.

TB Infection

Multi-drug and extremely drug-resistant TB continues to pose serious threats to workers in healthcare settings. TB is the second most common cause of death from infectious disease in the world after human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS).

Caused by bacteria, TB is a contagious disease that primarily affects the lungs. Transmission is generally through droplets transported through air when an infected person coughs, speaks, or sneezes.


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Not everyone who becomes infected with TB gets sick (however, a person will still test positive on a TB skin test). Some people will become sick immediately after becoming infected; in others, the disease will lie dormant for an indefinite period of time and cause disease later. A minority of people will not manifest active disease.

For those whose infections lead to active disease, TB is generally contagious and has symptoms that include cough, fever, chills, and weight loss. Once infected, regardless of the state of the disease, people are treated with drugs to prevent active disease. It generally takes 6 months to a year of treatment to rid the body of TB.

Updated Guidance, Expanded Coverage

OSHA’s new instructions incorporate guidance from the CDC report, “Guidelines for Preventing the Transmission of Mycobacterium tuberculosis in Health-Care Settings, 2005.” The directive does not create any additional enforcement burdens for employers; it simply updates OSHA’s inspection procedures with the most currently available public health guidance.


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The directive also covers additional workplaces regarded as healthcare settings, such as sites where emergency medical services are provided and laboratories handling clinical specimens that may contain M. tuberculosis. Other changes include:

  • The introduction of a newer screening method for analyzing blood for M. tuberculosis;
  • Classifying healthcare settings as low risk, medium risk, or potential ongoing transmission; and
  • Reducing the frequency of TB screenings for workers.

Need updated guidance for your workplace on other hazards? You’ll find all the latest at Safety.BLR.com®.