performance-monitoring procedures for high-efficiency particulate air (HEPA) filters used for contaminated air that may be recirculated into general-use areas.

The rest of this section briefly reviews differences in the settings and people covered by the CDC guidelines and the proposed OSHA rule. The remaining sections focus on differences between the exposure control measures described in the guidelines and those in the proposed rule.

Covered Settings and Employers

The proposed OSHA rule is not limited to health care workers, employers, and settings. It would cover a wide range of employers and employees including

  • Hospitals

  • Long-term-care facilities serving the elderly

  • Hospices

  • Substance abuse treatment centers

  • Home health care providers

  • Emergency medical service providers

  • Research and clinical laboratories handling tuberculosis bacteria

  • Medical examiners’ offices

  • Other facilities where certain high-hazard procedures are performed

  • Homeless shelters

  • Correctional facilities

  • Immigration detainment facilities

  • Law enforcement facilities

  • Contractors working on ventilation systems or areas that might contain airborne tuberculosis bacteria

  • Social service workers, attorneys, and teachers visiting those with suspected or confirmed tuberculosis

  • Personnel agencies or other organizations providing temporary or contract workers to covered facilities

The list of workplaces and employees provided above does not cover all those in which higher rates of tuberculosis have been documented. For example, workers in certain mining industries often have workplace-related physical conditions (e.g., silicosis) that make them more susceptible to tuberculosis. Because these workers are not anticipated to have a high risk of workplace exposure to the disease, the proposed OSHA rule does not cover them. (Also, mine safety is covered by another U.S. Department of Labor agency, the Mine Safety and Health Administration.)

Some health care settings are unexpectedly omitted from the listing in the 1997 proposed rule. For example, tuberculosis clinics are not men-

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