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Health hazard evaluation report: evaluation of exposure to tuberculosis among employees at a long-term care facility (revised).

de Perio MA; Niemeier RT
Cincinnati, OH: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, HETA 2012-0137-3178, 2013 Jun; :1-27
Investigators with the HHE Program evaluated employee exposure to Mycobacterium tuberculosis at a long-term care facility. Managers asked for assistance in identifying disease sources and assessing the ventilation system. HHE Program investigators interviewed 216 employees, reviewed employee health records, and reviewed medical records of 53 residents in one area of the facility. The records showed that 12 residents and 16 employees had latent tuberculosis infection. One resident had active pulmonary tuberculosis disease, which was the likely source of latent tuberculosis infection among 8 residents and 16 employees. Investigators did not observe a clear pattern between the ventilation system and tuberculosis transmission. HHE Program investigators recommended that residents be monitored clinically for signs and symptoms of active tuberculosis disease at least once a month. Until a risk assessment shows they can be done less often, tuberculosis screening for residents, employees, and direct care volunteers in the area of concern should be continued at least every 6 months. Similarly, employees with a prior negative skin test should get a tuberculin skin test at least every 6 months and employees with a positive tuberculin skin test in the past should have a medical evaluation for tuberculosis at least every 6 months, or until the risk assessment suggests otherwise. The ventilation system should be upgraded to provide improved filtration in resident areas and air temperatures kept in accordance with current guidelines for nursing homes.
Region-10; Health-care-facilities; Health-care-personnel; Bacteria; Bacterial-disease; Bacterial-infections; Respiratory-system-disorders; Ventilation-systems; Medical-monitoring; Medical-personnel; Nurses; Disease-incidence; Disease-transmission; Infectious-diseases; Pulmonary-system-disorders; Author Keywords: Nursing Care Facilities; Skilled Nursing Facilities; tuberculosis; Mycobacterium tuberculosis; long-term care; nursing home
Publication Date
Document Type
Field Studies; Hazard Evaluation and Technical Assistance
Fiscal Year
NTIS Accession No.
NTIS Price
Identifying No.
HETA-2012-0137-3178; B20130531
NIOSH Division
SIC Code
Source Name
National Institute for Occupational Safety and Health
Page last reviewed: September 4, 2020
Content source: National Institute for Occupational Safety and Health Education and Information Division