WISHA Interim Operations Memorandum #96-2-J

WISHA Interim Interpretive Memorandum
#96-2-J
Tuberculosis Enforcement

Approved:
Michael Wood, Senior Program MAnager
Policy & Technical Services

Date Issued:
February 26, 1996

Background

On February 9, 1996, the federal Occupational Safety and Health Administration issued Instruction CPL 2.106, which updated their Enforcement Procedures for Occupational Exposure to tuberculosis (TB) based on the 1994 "Guidelines for Preventing the Transmission of TB in Health-Care Facilities" of the Centers for Disease Control.

This CPL notes that 25,313 new cases of TB were reported in the United States in 1993. In addition, drug resistant strains have recently become a serious concern and cases of multi-drug-resistant TB have occurred in 40 states. The 1994 CDC Guidelines emphasize the control of TB through early identification, isolation, and treatment of persons with TB, through use of engineering and administrative controls to reduce the risk of exposure, and through use of respiratory protection.

The new OSHA CPL replaces and cancels the OSHA Compliance Memorandum dated October 8, 1993, entitled "Enforcement Policy and Procedures for Occupational Exposure to TB" (which was based on the 1990 CDC Guidelines on TB). WISHA has followed OSHA's 1993 Compliance Memorandum on enforcement procedures for tuberculosis during compliance inspections, but is presently reviewing enforcement practices based on the 1994 CDC TB Guidelines and the new OSHA CPL 2.106.

WISHA recognizes the 1994 CDC Guidelines as widely accepted by industry in recognition of hazards and standards of practice. OSHA has based their new CPL on the CDC guideline, but there are differences that raise a number of issues (e.g., how doctor's offices, clinics, and dentist offices are addressed; specifics on risk assessments and written TB infection control plans, etc.). These issues will be reviewed internally and with affected employers and labor representatives to help determine appropriate WISHA enforcement procedures for TB. The resulting enforcement practices will continue to be based on the CDC guideline as a reflection of industry practice and may differ somewhat from those adopted by federal OSHA. This interim memo will provide enforcement guidance until such time as this review is complete and a formal directive on the issue is finalized.

Reference copies of CPL 2.106 have been distributed to all WISHA regional supervisors.

Policy

1. With the addition of #2 below, WISHA staff shall follow OSHA Instruction CPL 2.106, Enforcement Procedures and Scheduling for Occupational Exposure to Tuberculosis.
2. Workplaces within the scope of the OSHA CPL shall be expected, at a minimum, to address TB hazards as part of their written accident prevention program, required under WAC 296-24-040.