제  목 : TB rule to protect 5.3 million
  일  자 : 1997년 12월
  제공처 : INTERNET

   TB rule to protect 5.3 million
   -------------------------------

 More than 130 lives would be saved annually and 5.3 million workers protected
under a proposed new OSHA standard to protect workers exposed to tuberculosis
(TB).

 OSHA estimates that as many as 13 million adults in the United States are
currently infected with TB, and about 5.3 million workers are exposed at work.
Introduced in October, the proposed standard would help protect these workers
in more than 100,000 hospitals, homeless shelters, long-term care facilities for
the elderly, detention facilities, certain laboratories, and other work settings
with a high risk of TB infection. The standard would prevent 70-90 percent of
work-related TB infections.

"The battle against TB is far from over," said Labor Secretary Alexis Herman.
"While the rate of active TB in the general population has declined overall
during the past 40 years, the risk for the workers who care for clients and
patients infected with TB continues to be high, and in some areas is growing.

 "Of even greater worry now," she said, "is the emergence of a new and deadly
form of the disease that is resistant to current treatment. Infection with these
multi-drug-resistant strains can lead to severe lung damage and is often fatal.
One of my top priorities is to ensure a safe and healthful workplace. We must
do all in our power to protect workers against this deadly disease."

OSHA estimates that the proposed standard would prevent between 21,000 and
25,000 infections per year and save from $89 million to $116 million in medical
costs for treatment and lost production caused by employee absence from work and
disabilities associated with active cases of TB. Annual costs for implementing
the standard are estimated to be $245 million, or about $2,400 per establish-
ment.

"We want to give employers clearly defined steps to protect their workers while,
at the same time, assuring workers that steps will be taken to help protect them
against this deadly disease," said Greg Watchman, OSHA's Acting Director. "This
proposed rule represents OSHA's best ideas for preventing workplace transmission
of TB. However,we are seeking broad public participation through a series of
hearings to ensure that the final rule is refined and tailored to address the
many different types of workplaces it would cover."

The proposal incorporates basic infection control provisions designed to reduce
occupational risks for exposed workers. It would require employers to develop a
written exposure control plan and identify and isolate individuals with suspect-
ed or confirmed infectious TB or transfer them to facilities with isolation
capabilities. Theproposed standard would also require the installation of en-
gineering controls in some facilities, such as negative pressure isolation rooms
or areas that would reduce o reliminate exposures to employees. Other provisions
in the proposed standard include tuberculin skin testing, hazard communication
and training, and record keeping.

Respiratory protection would also be required by the proposal under specific
conditions. Respirators selected for use must be approved by NIOSH. "The pro-
posed standard, following CDC recommendations, would allow the use of low-cost
respirators that can be used multiple times," Watchman said. "We believe that,
in combination with other controls, respirators are effective in preventing TB
transmission."

TB is a national concern, occurring in every state among people in every age
group,and among both low-wage and high-wage workers. However, employers with
 facilities that are located in counties where the risk of TB infection is
low would be subject to fewer requirements. The proposal would permit an em-
ployer to implement a more limited program if the facility (1) doesn't admit or
provide medical services to persons with suspected or confirmed infectious TB,
(2) has had no cases of confirmedinfectious TB in the past 12 months, and (3)
is located in a county that, in the past two years, had reported no case of
confirmed infectious TB in one year and fewer than six cases of confirmed
infectious TB reported in the other year.

 These employers would be responsible only for preparing a written exposure
control plan, providing baseline skin tests, and making medical management
available after an exposure incident. They would also need to provide
medical removal protection if necessary, and give information and training to
employees with potential occupational exposure, while complying with pertinent
record keeping requirements. Periodic medical surveillance and respiratory pro-
tection would not be required.

 Because the standard would have a significant impact on small businesses
(averaging approximately $1,600 per small entity or establishment), it under-
went a joint review involving OSHA, the Small Business Administration, and the
Office of Management and Budget. OSHA also has held a series of meetings to
discuss development of the proposal with 33 stakeholder groups representing
labor unions, professional organizations, trade associations, governmental
agencies, and employer representatives.

 OSHA will continue to work with representatives of drug treatment facilities
and homeless shelters to ensure that a final standard, and its subsequent en-
forcement,would not impose unreasonable burdens on these facilities. Public
hearings, beginning February 3, will also provide time for discussion of home-
less shelter issues. Finally, OSHA has contracted for a special study regarding
implementation of the proposed standard in homeless shelters.

Comments on the proposed standard, as well as notices of intent to appear at
hearings, testimony, and documentary evidence should be submitted in quadrupl-
icate to the Docket Officer, Docket No. H-371, Room N-2625, U.S. Department of
Labor, 200 Constitution Ave., N.W., Washington, D.C. 20210. Comments of 10
pages or less may be transmitted by fax to 202-219-5046.