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Environmental assessment of a reference mycobacteriology laboratory and five public hospitals in Mexico with regard to occupationally-acquired tuberculosis.

Authors
Martinez-K
Source
American Industrial Hygiene Conference and Exposition, June 2-7, 2001, New Orleans, Louisiana. Fairfax, VA: American Industrial Hygiene Association, 2001 Jun; :5
Link
NIOSHTIC No.
20041347
Abstract
In 1998, NlOSH responded to two separate requests for technical assistance from the Mexican National Institute of Diagnostics and Reference Epidemiology and the Mexican National Institute for Public Health to environmentally evaluate the federal reference mycobacteriology laboratory, five public hospitals, a primary care clinic, and a university research laboratory, all distally located across the nation. Specifically, the requests were concerned with environmental factors that could contribute to occupational exposures to Mycobacterium tuberculosis. On-site surveys were conducted that included observational assessment, smoke visualization to characterize air flow patterns, and measurements, where applicable, for air flow, air static pressure, and particle counts to quantify containment parameters. Measurements were also made of the energy produced by ultraviolet germicidal irradiation (UVGI) lamps. For the reference mycobacteriology laboratory, deficiencies included inappropriate pressure relationships between adjacent areas (including the operation of the Biosafety Level 3 facility); the use of fume hoods as biological safety cabinets with inadequate exhaust; inappropriate respiratory protection; and the lack of a comprehensive UVGI program that includes interlocks, employee training, and preventive maintenance. For the hospitals, assessments were focused in areas where patients suspected of active tuberculosis may reside, such as the emergency room, the outpatient clinic, radiology, surgical recovery, the intensive care unit, and the bacteriology laboratory (where specimens from active patients may be sent for analysis). The level of environmental controls varied with the financial sponsorship of the hospitals, e.g., from natural ventilation to ventilation systems installed with high-efficiency particulate air filtration. Other control deficiencies included the lack of appropriate respiratory protection, improper pressure relationships between adjacent areas, poor isolation procedures (including poor isolation room design), and the lack of appropriate biological safety cabinets. Recommendations were made at the conclusion of each site visit that could be practically implemented, economically, given limited resources, and within a reasonable time frame.
Keywords
Epidemiology; Environmental-factors; Environmental-health; Laboratories; Medical-facilities; Exposure-levels; Occupational-exposure; Bacteria; Air-flow; Air-pressure; Particulates; Particle-counters; Exhaust-ventilation; Exhaust-hoods; Respiratory-protection; Training; Environmental-control; Infection-control; Infectious-diseases; Viral-diseases; Viral-infections; Contagious-diseases
Publication Date
20010602
Document Type
Abstract
Fiscal Year
2001
NTIS Accession No.
NTIS Price
NIOSH Division
DSHEFS
Source Name
American Industrial Hygiene Conference and Exposition, June 2-7, 2001, New Orleans, Louisiana
State
OH
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