3.

Providing follow-up diagnostic evaluation and—when appropriate—treatment for workers with positive skin tests

NOTE: The proposed OSHA rule would, in addition, require employers to provide each employee with a written medical opinion following evaluation by a physician or other licensed health care professional.

4.

Evaluating workers with symptoms or signs of tuberculosis and excluding those with infectious tuberculosis from the workplace until they are noninfectious

NOTE: The medical removal provisions of the proposed OSHA rule would, in addition, require wage, benefit, and other protections for workers removed from work due to suspected or confirmed infectious tuberculosis. The proposed rule would require employers to pay for follow-up services for employees with converted skin tests or suspected or confirmed active disease.

1.

Evaluating possible workplace exposure to and transmission of tuberculosis a. Establishing procedures to identify exposure incidents, transmission of disease, and factors associated with exposure or transmission b. Investigating worker skin test conversions, diagnoses of tuberculosis in workers, and exposure incidents

Educating, Training, and Counseling Workers

1.

Educating workers (as appropriate for their work responsibilities) about tuberculosis infection, disease, transmission, symptoms, treatment, and risks in their community and facility

2.

Training workers in tuberculosis control measures applicable to their work responsibilities

NOTE: The proposed rule would also require that workers be informed about the OSHA rule. It would require annual retraining unless the employer could show that each employee had the skills and knowledge needed. The proposed rule would require that training be appropriate to employees’ level of literacy, education, and language.

1.

Counseling workers as appropriate about positive skin tests, suspected or known personal exposure to active tuberculosis, diagnosis of active disease, treatment options, etc.

2.

Offering assignments involving low risk of tuberculosis exposure to employees known to be immunocompromised

NOTE: The proposed OSHA rule would not require alternative assignment for immunocompromised workers but would require that workers be educated about tuberculosis risks for individuals with these and other conditions.

Coordinating with Public Health Officials

1.

Reporting cases of active tuberculosis

2.

Assisting in investigations of tuberculosis exposure and transmission

NOTE: The proposed OSHA rule would require reporting of cases of occupational tuberculosis infection and disease to OSHA, but it does not explicitly require coordination with public health authorities.

NOTE: The proposed OSHA rule includes a variety of additional recordkeeping requirements related to employee medical records, medical surveillance, employee training, engineering controls, confidentiality, record availability and transfer, and other matters.

SOURCES: CDC (1994b) and 62 FR 201 (October 17, 1997).



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