Risk said lower for health care workers

Proper safeguards are the key

Research presented recently during a workshop at the Institute of Medicine (IOM) on regulating occupational exposure to TB suggests that health care workers are at a much lower risk for developing TB than experts had thought.

Workshop participants addressed the adequacy of current government guidelines for protecting health care workers against TB infection, looking at the potential for stricter measures from the Occupational Safety and Health Administration. Thomas Daniel, MD, a professor and researcher at Case Western Reserve University in Cleveland, told the committee that health care workers’ risk of contracting TB in the workplace has "declined significantly" in response to guidelines from the Centers for Disease Control and Prevention in Atlanta.

"In those health care facilities where modern infection control measures are in place, it now approaches the level of risk incurred by health care workers in the communities in which they reside," Daniels explained in his summary paper to the committee.

Keith Woeltje, MD, hospital epidemiologist at the Medical College of Georgia in Augusta, says the CDC guidelines of 1990 and 1994 were widely implemented by nearly all health care institutions, resulting in a dramatic decrease in TB infections.

Woeltje told the committee that the CDC guidelines are adequate and no further action is needed from OSHA. The CDC guidelines are effective because they are more flexible than the OSHA guidelines, he adds.

The CDC guidelines stress identifying TB patients and getting them into isolation quickly. The IOM conducted an additional closed meeting on regulating occupational exposure to TB in September and will announce its revised recommendations by January 2001.