Which workplaces must have a tuberculosis control plan?

DOSH requires the following workplaces to have a TB Control Plan in place:

a. Health care settings
b. Correctional institutions
c. Long-term care facilities for the elderly
d. Homeless shelters
e. Drug treatment centers

The CDC has identified workers in these workplaces as having a greater incidence of TB infection than in the general population.

Health-care settings include hospitals where patients with confirmed or suspect TB are treated or to which they are transported. Non-hospital health care settings (i.e., doctors' offices, clinics, etc.) may be included when evaluation and treatment services are provided to patients with suspect or active TB. Dental health care personnel are covered by the directive only if they treat suspect or active patients in one of these five high risk settings.

Homeless shelters and drug treatment centers present unique problems for the protection of workers. Shelters must establish protocols that provide for rapid early identification followed by immediate transfer of suspect cases for medical evaluation.

Tuberculosis Control: DOSH requirements

DOSH enforces the CDC Guidelines for: 1) Preventing the Transmission of Mycobacterium tuberculosis in Health-Care Settings, 2005, and 2) Prevention and Control of Tuberculosis in Correctional and Detention Facilities, 2006 .

Health Care

• WRD 11.35 - Tuberculosis Control in Health Care Settings
• Preventing the Transmission of Mycobacterium tuberculosis in Health-Care Settings, 2005. Provides elements of a risk assessment for TB in health-care settings and elements of a tuberculosis (TB) infection-control program. Characteristics of an effective TB infection-control program are also described.

Correctional Facilities

• WRD 11.36 - Tuberculosis Control in Correctional Facilities
• Prevention and Control of Tuberculosis in Correctional and Detention Facilities, 2006. These recommendations update previous recommendations for preventing and controlling tuberculosis (TB) in correctional facilities. Provides recommendations for controlling TB among inmates and employees.

Resources

The following resources provide additional information on Tuberculosis:

• WAC 296-842 - Respirators
• CDC/DTBE - Core Curriculum on Tuberculosis - Core material to teach healthcare providers about TB. How to increase the use of directly observed therapy (DOT) and other adherence-promoting methods ensure that all patients with TB disease complete therapy. HIV-infected persons with TB disease are not considered more infectious than non-HIV-infected persons with TB. 187631 bytes, updated 09-13-1999. (Adobe PDF document.  Requires Adobe Acrobat Reader available free from Adobe ).
• Francis J. Curry National Tuberculosis Center - One of three national model tuberculosis centers funded by the Centers for Disease Control and Prevention, the Francis J. Curry National Tuberculosis Center (CNTC) creates, enhances and disseminates state-of-the-art resources and models of excellence to control and eliminate tuberculosis nationally and internationally.
• Prevention and Control of Tuberculosis among homeless persons - Recommendations from the Advisory Council for the Elimination of TB.
• CDC/DTBE TB Guidelines – All guidelines listed by Category
• Bronchoscopy Evaluation Form – The Tacoma-Pierce County Health Department designed this sample form to prompt consideration of tuberculosis as a diagnostic possibility, and to identify the need for respiratory protection .
• Slide set - This slide set was developed as an accompaniment to the Guidelines for Preventing the Transmission of Mycobacterium tuberculosis in Health-Care Settings, 2005. This slide set provides an overview of the updated TB infection control recommendations.
• Mantoux Tuberculin Skin Test Video Tape facilitators Guide
• Washington State Department of Health Tuberculosis Program

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