Respirators, recommendations, and regulations: the controversy surrounding protection of health care workers from tuberculosis.
Jarvis-WR; Bolyard-EA; Bozzi-CJ; Burwen-DR; Dooley-SW; Martin-LS; Mullan-RJ; Simone-PM
Ann Intern Med 1995 Jan; 122(2):142-146
The evolution of current recommendations for protecting health care workers against the spread of tuberculosis and the elucidation of the role of the federal agencies in respiratory protection were described. The Centers for Disease Control (CDC) published guidelines in 1990 pointing out that standard surgical masks may not be effective in preventing inhalation of droplet nuclei and recommended that disposable particulate respirators be used. A particulate respirator was noted as a disposable respiratory protective device designed to filter out particles 1 to 5 microns in diameter. In 1992 NIOSH published a draft report containing peer reviewed data showing that the filters of certain dust mist and dust fume mist respirators allowed significant leakage of small particles. In August 1992, NIOSH recommended the use of NIOSH certified, powered, half mask respirators equipped with high efficiency particulate air filters in areas where patients known or suspected to have tuberculosis were receiving care. Guidelines issued by the CDC in 1993 outlined performance criteria for personal respiratory protection in situations where administrative and engineering controls may not provide sufficient protection. OSHA issued a Compliance Memorandum in October 1993 outlining their enforcement policy on occupational exposure to tuberculosis. The authors conclude that the current NIOSH Notice of Proposed Rule Making on respirator certification solves the problem of merging scientific and theoretical data into a sound approach to protecting health care workers from tuberculosis.
NIOSH-Author; Respiratory-system-disorders; Physicians; Respiratory-protective-equipment; Personal-protective-equipment; Nurses; Infection-control; Health-care-personnel
Dr. Jarvis, Hospital Infections Program, 1600 Clifton Road NE, MS E-69, Atlanta, GA 30333
Annals of Internal Medicine