In 1993, the California Department of Health Services (CDHS) Occupational Health Branch, in collaboration with the Public Health Institute (formerly the California Public health Foundation) and the University of California, San Francisco Division of Occupational Medicine, undertook a Cooperative Agreement with the National Institute for Occupational Safety and Health (NIOSH) to develop a model program for the prevention of occupational tuberculosis (TB) in health-care facilities. While there was general agreement among experts that early identification and treatment of patients at risk for infectious TB are the cornerstones of preventing nosocomial TB transmission and the efficacy of TB control measures in hospitals was needed to aid in the development of programs capable of preventing TB among health care workers. The overall goal of the TB in Health Care Workers study was to prevent TB by identifying effective TB control measures for use in a health care setting. Three San Francisco Bay-Area hospitals participated in the five-year study: San Francisco General Hospital, Alta Bates Medical Center, and Highland hospital. the study had two primary objectives: (1) to assess adherence by health care institutions to TB control measures specified by the Centers for Disease Control and Prevention (CDC) Guidelines for Preventing the Transmission of Mycobacterium tuberculsosi in health-care Facilities; and (2) to estimate the effectiveness of these control measures through the use of TB skin testing (TST) data and calculation of TB infection rates.
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