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OSHA TB standard now officially history
But agency still can cite under general duty
After years of fierce protest by infection control professionals, the Occupational Safety and Health Administration (OSHA) has officially withdrawn its proposed health care tuberculosis standard.1
The defeat of the controversial standard, which fell victim to both criticism from ICPs and a waning incidence of TB in the United States, represents a major victory for the Association of Professionals in Infection Control and Epidemiology (APIC). The 1997 proposed OSHA standard also was dealt a serious political blow when a scientific panel of the prestigious Institute of Medicine concluded that the regulation was inflexible because it would impose requirements that provide little additional protection in low-risk areas while adding significant costs and administrative burdens on health care facilities.
However, even in the absence of the rule, OSHA still can come after hospitals that do not protect their workers from occupational exposures to TB. In that regard, APIC recently posted the following Q&A on its web site to clarify the implications of the move by OSHA to formally withdraw the proposed TB rule:
Question: Can OSHA cite and fine hospitals for noncompliance using TB guidelines by the Centers for Disease Control and Prevention?
Answer: OSHA has always had the ability and continues to have the ability to cite and fine healthcare facilities where there is evidence of occupational exposure to tuberculosis under the general duty clause. This directive relies heavily upon the 1994 CDC guidelines for preventing the transmission of TB in health care facilities, which can be found at www.cdc.gov.
Question: Does OSHA require fit-testing of respirators for TB control?
Answer: The current OSHA respiratory protection standard for M. tuberculosis (1910.139) defers to the 1994 CDC guidelines for the selection and use of respiratory protection equipment. The standard requires initial fit testing and subsequent fit checking with each use. Although annual fit testing is not required, a fit test must be performed when/if there is a change in the manufacturer or model of respirator or when there is a change in the facial characteristics of the wearer.
1. 68 Fed Reg 30,588-30,589 (May, 27, 2003).