TB guidelines to protect health care workers
The American College of Occupational and Environmental Medicine (ACOEM) has released comprehensive guidelines for protecting occupational health providers and other health care workers from the resurgence of active pulmonary tuberculosis. The guidelines were developed because the increase in TB cases and the emergency of multidrug-resistant TB strains increase the risk of health care workers acquiring serious TB infections, says Lawrence Raymond, MD, lead author of the guidelines and a member of the ACOEM Lung Disorders Committee that developed the guidelines. The guidelines note that, as of 1995, multidrug-resistant TB strains infected at least 19 health care workers, and eight of them died.
ACOEM endorses many steps to reduce the risk, including:
• updated training of health care workers;
• good patient flow and ventilation in clinical spaces;
• periodic TB testing of health care workers;
• respiratory protection;
• periodic updating of written TB control plans.
In particular, health care employers are asked to perform two-step TB testing of all newly hired health care workers who have not had a TB test in the previous 12 months. Those who might care for or have airborne exposure from patients with active TB should have tuberculin testing every three to 12 months, according to the guidelines.
ACOEM encourages occupational health physicians to promote an active TB-control program in their health care facilities and other sites where the work force includes those at special risk of acquiring and spreading TB.
The free guidelines are available on the ACOEM World Wide Web site at http://www.acoem.org, or by contacting ACOEM at 55 W. Seegers Road, Arlington, IL 60005. Telephone: (847) 228-6850. Fax: (847) 228-1856.
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