dures should not use a respirator (e.g., one with an expiration valve) that might contaminate the surgical field.

Situations Requiring More Protective Respirators

The CDC guidelines note that facilities may identify certain situations (e.g., bronchoscopies on patients with diagnosed or suspected infectious tuberculosis) that warrant respiratory protections that exceed those recommended by standard criteria. The proposed OSHA rule would not require employers to identify such situations or supply more protective personal respiratory devices. OSHA, however, requested comments on whether the final rule should include such requirements.

CONCLUSION

Because OSHA relied substantially on the 1994 CDC guidelines in developing the its 1997 proposed rule, the two documents are generally similar in their basic provisions. Some differences, such as those related to record keeping, are mainly administrative. Others, particularly OSHA’s proposed financial protections for workers temporarily removed from their position while undergoing treatment for active tuberculosis, reflect differences in organizational missions and responsibilities.

The final standard is likely to differ from the 1997 proposal but specific details were not available during the course of this study. In Chapter 7, the committee’s assessment of the likely effects of a final OSHA standard examines three areas of difference that could affect its impact. These areas involve tuberculin skin testing, respiratory protections, and methods for assessing facility risk for occupational transmission of tuberculosis and requirements for control measures.



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