Tuberculosis

Transmission of tuberculosis (TB) is a recognized risk to patients and healthcare workers in healthcare settings. Transmission is most likely to occur from patients who have unrecognized TB or have received ineffective treatment. Workers in correctional and detention facilities are also at risk when exposed to prisoners with active TB disease.

TB is a contagious and potentially life-threatening infectious disease caused by a bacterium called Mycobacterium tuberculosis. The TB bacteria are spread from person to person through the air. People with TB disease of the lungs or larynx release the bacteria into the surrounding area when they cough, sneeze, talk, or otherwise expel air, dispersing droplets that contain M. tuberculosis. These droplets can dry into tiny particles called droplet nuclei that remain suspended in air for long periods of time. Other people can breathe the infectious particles into their lungs and become infected. Infection usually requires prolonged sharing of airspace with a person actively spreading TB bacteria into the area. In rare cases, TB infection has been documented after short exposures to such persons with active TB. After becoming infected, most people's immune systems are able to contain the infection, but are not able to eliminate it without help from anti-TB drugs. These people have latent TB infection and remain infected until corrective treatment is completed. Latent TB infection does not cause symptoms and is not contagious. However, without treatment, infected people can lose control of the infection and develop active, clinical disease. People with active TB have symptoms and can spread the disease. The risk of developing active TB disease is greatest in the first few years after infection, but some risk remains throughout life.

TB is preventable and, in most cases, treatable. Infection control practices can help reduce the risk of TB transmission. Treatment of persons with latent TB infection can prevent the subsequent development of active TB, and TB disease can usually be cured by available anti-TB drugs. Even persons with drug-resistant strains can often be cured by alternative regimens of medications.

Effective infection-control practices are critical to prevent the transmission and further spread of in health-care settings and other congregate settings. CDC has established infection-control guidelines which were updated in December 2005 and should continue to be updated as needed.

NIOSHTIC-2 Search

NIOSHTIC-2 search results on Tuberculosis
NIOSHTIC-2 is a searchable bibliographic database of occupational safety and health publications, documents, grant reports, and journal articles supported in whole or in part by the NIOSH.

Occupationally-Related Publications on Tuberculosis

Environmental Control for Tuberculosis: Basic Upper-Room Ultraviolet Germicidal Irradiation Guidelines for Healthcare Settings
DHHS (NIOSH) Publication No. 2009-105 (March 2009)
The purpose of this document is to examine the different parameters necessary for an effective upper-room UVGI system and to provide guidelines on the parameters necessary to install and maintain an effective upper-room UVGI system.

Guidelines for Preventing the Transmission of Mycobacterium Tuberculosis in Health-Care Settings, 2005 MMWR 54/RR-17 (December 30, 2005)

Guidelines for Protecting the Safety and Health of Health Care Workers, 1988
DHHS (NIOSH) Publication No. 88-119 (1988)
Provides information needed to protect the health and safety of health care workers in hospitals and other health care facilities.

NIOSH DVD-Respirators: Your TB Defense / TB Respiratory Protection: Administrator's Review
DHHS (NIOSH) Publication No. 2002-114d (2002)
This includes the programs Respirators: Your TB Defense, TB Respiratory Protection: Administrator's Review, and written materials in electronic format. (These programs are also available separately on VHS by request).

Worker Health Chartbook 2004: Tuberculosis
DHHS (NIOSH) Publication No. 2004-146
Provides data for incidence rates of TB in health care workers, 1994–2000.

Work Related Lung Disease Surveillance Report 2007
DHHS (NIOSH) Publication No. 2008-143 (2007)
The seventh of a series, the Work-Related Lung Disease (WoRLD) Surveillance Report 2007 provides information on various work-related respiratory diseases and associated exposures in the United States. The WoRLD Surveillance Report 2007 describes where these diseases are occurring (by industry and geographic location), who is affected (by race, gender, age, and occupation), how frequently they occur, and temporal trends. Volume 2 focuses on respiratory conditions by NORA industrial sector.

Efficacy of Ultraviolet Irradiation in Controlling the Spread of Tuberculosis
(NIOSH Contract No. 200-97-2602, Final Report, October 2002 pp. 1-80)
This study was conducted to systematically investigate the conditions under which Ultraviolet Germicidal Irradiation (UVGI) can be expected to mitigate the spread of Tuberculosis.

NASD documents by topic as well as Standards/Regulations: Enforcement Policy on Tuberculosis, 1993
National Agriculture Safety Database on the NIOSH Web site.

Tuberculosis Transmission in Multiple Correctional Facilities --- Kansas, 2002--2003
(Morbidity and Mortality Weekly Report, August 20, 2004 / 53(32);734-738)
The Advisory Council for the Elimination of Tuberculosis (ACET) recommends that all correctional facilities have a written TB infection--control plan (TBICP) (4). This report summarizes the results of an investigation in September 2002, after diagnosis of smear-positive pulmonary TB in a prison inmate, the Kansas TB Control Program, with assistance from CDC.

Ending Neglect: Elimination of TB in The US, 2000
(full text with permission)
(National Academy Press Web site)
The book provides important background on the pathology of Tuberculosis, its history and status in the U.S., and the public and private response.

Tuberculosis in the Workplace, 2001
(full text with permission)
(National Academy Press Web site)
This document discusses how effective Tuberculosis control measures in the workplace can be one element for much broader national and international strategies to prevent and eventually eliminate Tuberculosis. It also discusses how Tuberculosis remains a threat that public health programs cannot afford to ignore.

Respiratory Protection

Occupational Respiratory Disease Surveillance (ORDS)
NIOSH Topic Page about occupational respiratory disease medical screening and monitoring

Respirator Information
NIOSH Topic Page about respirators, including news, user notices, and respirator selection and maintenance and more...

NIOSH-Approved Disposable Particulate Respirators (Filtering Facepieces)
Provides a listing of NIOSH-approved disposable particulate respirators that health care workers can use to help protect themselves from diseases potentially spread through the air, such as SARS or Tuberculosis.

Protect Yourself Against Tuberculosis--A Respiratory Protection Guide for Health Care Workers
DHHS (NIOSH) Publication No. 96-102 (1995)
A booklet written to answer questions about respirator use in the health care industry. Serves as a quick reference for health care workers employed in a variety of settings and with varied educational backgrounds.

TB Respiratory Protection Program in Health Care Facilities--Administrator's Guide
DHHS (NIOSH) Publication No. 99-143 (1999)
A manual designed to serve as a practical guide for those individuals responsible for initiating and running a TB respiratory protection program in health care facilities.

NIOSH Health Hazard Evaluations (HHE)

Health Hazard Evaluations (HHEs)
Official NIOSH Health Hazard Evaluation site containing general information, including how to request an Health Hazard Evaluations and more....

Health Hazard Evaluations (HHEs): Tuberculosis (1990-1999)
DHHS NIOSH Publication No. 2001-116 (2001)
Titles and summaries of Health Hazard Evaluations conducted from 1990 through 1999 related to Tuberculosis, organized by type of facility.

Links to Other TB Related Sites