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Annual TB mask fit-tests may be required
The Occupational Safety and Health Administration (OSHA) may issue the final version of its much-debated tuberculosis standard by year’s end, an OSHA official has reported.
"We haven’t set a hard-and-fast date, [but] we are shooting for the end of the year," says Amanda Edens, MPH, industrial hygienist in the OSHA health standards program in Washington, DC. The Office of Management and Budget will review the final version of the proposed rules, which drew hundreds of comments and testimony in a series of national hearings.1
Among the issues will be whether the final OSHA regulations diverge too greatly from TB guidelines by the Centers for Disease Control and Prevention, she says.2
"I don’t think that is going to be the case," Edens adds.
While emphasizing that no final decisions have been made about the content of the final standard, Edens shed a little light on recent discussions about fit-testing of TB N95 respirators.
A recently published government study underscored the efficacy of TB respirator fit-testing programs, but there was some question whether annual fit-testing would be required in the final standard.3
However, because annual fit-testing is required in OSHA’s respiratory protection standard, the agency would have to determine that there is something "compelling" about TB or health care workers to leave that requirement out of the TB standard, she explained.
"I think what is before the agency now is that since we have already made the decision that annual fit-testing is an important element to have, is there some reason why TB is different from other agents or chemicals that [annual] fit-testing isn’t necessary?" Edens says.
In addition, Edens clarified that annual TB respirator fit-testing is currently not required.
"We are using the old respiratory protection standard to handle TB now while we are in the process of doing the final TB standard," she says. "The old respiratory protection standard, which has been recodified [as OSHA standard # 1910139], does not have an annual fit-testing element in it."
1. Department of Labor. Occupational Safety and Health Administration. Occupational exposure to tuberculosis; proposed rule. 62 Fed Reg 54,160-54,307 (Oct. 17, 1997).
2. Centers for Disease Control and Prevention. Guidelines for preventing the transmission of Mycobacterium tuberculosis in health care facilities, 1994. MMWR 1994; 43:(No. RR-13)1-133.
3. Centers for Disease Control and Prevention. National Institute for Occupational Safety and Health. Laboratory performance evaluation of N95 filtering face piece respirators, 1996. MMWR 1998; 47:1,045-1,049.