OSHA extends new comment period on TB

APIC, others asked for more time to respond

The U.S. Occupational Safety and Health Administration (OSHA) has extended its comment period on the proposed tuberculosis rule until May 24 to allow more time for review of new risk assessment information.

OSHA had reopened the record to solicit comment on the agency’s final risk assessment and the Institute of Medicine’s (IOM) report, Tubercu-losis in the Workplace. An IOM panel had endorsed the concept of a TB standard to set minimum protections for health care workers, but had criticized the agency’s estimates of the tuberculosis threat.

The panel also said the proposed standard fails to provide enough flexibility to hospitals at low-risk for handling TB patients.

When OSHA opened the TB docket, it also released two evaluations of its risk assessment by experts in TB epidemiology and risk assessment.

The Association for Professionals in Infection Control and Epidemiology (APIC), the American Health Care Association, and the American Society for Microbiology had requested more time to review the lengthy documents.

"Two months might have been enough for us to respond, but we also wanted our members to be apprised and be able to respond on their own," says Jennifer Thomas, director of governmental affairs for APIC in Washington, DC. "It’s quite complex, and we do want lots of input."

APIC has long opposed the tuberculosis standard as creating an unnecessary burden on hospitals. The new comment period allows OSHA to accept comments based on the IOM report, and Thomas says she hopes concerns will be raised that will influence the agency to make changes.

"OSHA had vastly overestimated the risk to health care workers," Thomas says. "We’ve always contended that the risk for disease is no greater than the general population. The risk for exposure is probably greater, but there are protections in place."

However, advocates for health care workers termed the extended comment period an unnecessary delay, and they called on OSHA to move forward with the standard.

"We got into the problem of greater exposure to TB in the early ’90s because we weren’t vigilant," says Karen Worthington, MS, RN, COHN-S, occupational safety and health specialist for the American Nurses Association in Washington, DC. "We need to continue vigilance because globally TB is still one of the biggest health problems in the world."

Worthington says the standard is "reasonable and flexible," and she notes that it could help hospitals with bioterrorism preparedness. "A TB standard would put into place many training programs, respiratory protection programs, and patient identification programs that we need to have in place to even think about other potent airborne infectious agents," she says.

[Editor’s note: OSHA asks those who want to submit written comments to send two copies, postmarked no later than May 24, 2002 to: Docket Office, Docket H-371, Room N-2625, Occupational Safety and Health Administration, U.S. Department of Labor, 200 Constitution Ave., N.W., Washington, DC 20210. Comments of 10 pages or fewer may be faxed to (202) 693-1648. (If faxed, the original and one copy of all comments must be sent to the Docket Office as soon as possible).

Comments may also be submitted electronically to http://ecomments.osha.gov. Information such as studies and journal articles cannot be attached to electronic submissions and must be submitted in duplicate to the mailing address. Attachments must clearly identify the respondent’s electronic submission by name, date and subject.

The entire TB rulemaking record, including the peer reviewers’ reports, OSHA’s draft final risk assessment, and the IOM report, is available for review and copying at OSHA’s Docket Office at (202) 693-2350.]