OSHA clarifies TB standard misconceptions

Through comments it has received so far, the Occupational Safety and Health Admini-stration (OSHA) has identified a number of misconceptions about its proposed standard, says Adam Finkel, PhD, the agency's director of health standards programs. The misconceptions include:

o Concern that OSHA is limiting the number of employees entering an isolation room. OSHA's intent in this provision is not to dictate patient management practices nor deny patients access to providers, Finkel notes.

"OSHA is proposing that employers develop policies, where it would be feasible, to reduce the number of employees entering isolation rooms but only to the extent that patient care is not compromised," he explains. For example, dietary service workers might be advised not to enter an isolation room if caregivers can do so instead.

o Concern that OSHA will require employers to delay high-hazard procedures if not medically necessary. OSHA is proposing only that elective procedures should be delayed - not those medically necessary to diagnose TB or to provide essential medical treatment, Finkel says.

"OSHA's only intent here is to delay procedures that are not medically necessary and that can be delayed until an individual is non-infectious."

o Concern that OSHA is allowing only smoke trail testing for checking negative pressure. OSHA has included smoke trail testing as only one example for acceptable methods of checking negative pressure. The proposal would allow the use of continuous monitoring devices and OSHAis seeking more information on other methods, Finkel notes.

o Concern that employers must skin test employees within 30 days after they are terminated. OSHA's choice of wording may have misled people to believe that it was requiring testing after employees left their job, Finkel says. "OSHA is proposing that the employer offer the skin test within 30 days before the employee leaves the job," he explains, adding it may not be feasible when workers leave without adequate notice.

o Concern that employers would be responsible for protecting employees of other employers at their work site. OSHA's intent is that the employer at a work site inform contractors performing work in areas that may be at risk for occupational exposure. The contractors would then be responsible for protecting their employees, he notes.