Respiratory Protection
for M. Tuberculosis
29 CFR 1910.139


                               WHAT ARE AIRBORNE PATHOGENS?

  Airborne pathogens differ from bloodborne pathogens in that they are spread by inhaling the germ. An infectious person's coughing or sneezing can send tiny droplets of moisture into the air that contain the pathogen. Depending on the environment, these contaminants can re­main airborne for several hours.

There are three types of airborne pathogens: Viral,    Bacterial, &  Fungal 

Meningitis, influenza, pneumonia, and tuber­culosis are all examples of diseases transmitted through the air. We will focus on tuber­culosis, since that is a common airborne disease for which employees may be at risk. Many of the precautions you take to prevent tuberculosis will also lower the risk of infection from other air­borne pathogens.

If an airborne pathogen is inhaled, the pathogen may be transmitted. Exposure to air­borne pathogens does not always result in infec­tion, however.  The likelihood of transmission depends on the following:

·    How contagious the infectious person is

·   Where the exposure occurs

·   How long the exposure lasts

·   How healthy you are at the time of the exposure

  Those individuals who are around an infectious person on a regular basis, such as family mem­bers and coworkers, are more susceptible to air­borne pathogens than someone who experiences a single isolated exposure.

Tuberculosis (TB) is caused by a specific bac­teria.  The disease usually affects the lungs, but it can also affect the brain, spine, or kidneys. Many people with a TB infection may not be sick because their bodies are effectively fighting the bacteria, and these people are not contagious. Later, however, they may develop TB disease and become contagious. About 10% of people with a TB infection develop the dis­ease at some point. The risk is greatest one to two years after infection and is higher for peo­ple with certain medical conditions such as:
 HIV, diabetes mellitus,   severe kidney disease,  low body weight &
 
certain types of cancer (leukemia, Hodgkin's disease, or cancer of the head and neck).

According to the CDC, employees in certain workplaces also face a greater risk of exposure. These workplaces include but are not limited to the following:
Commercial airlines,  correctional facilities,  drug and treatment centers,  healthcare facilities,  homeless shelters & long-term care facilities.

How Is TB Spread?

TB is spread when a person inhales the TB pathogen, which is present in the air after an in­fected person coughs or sneezes. Depending on room size, ventilation, and other factors, the TB pathogen can live up to 1 to 1-1/2 hours outside the body.

Symptoms of TB

  People with TB infection often have no symp­toms and do not feel sick. If the infection advances to TB disease, however, the person's symptoms may include:   Weight loss,  fever,  night sweats &  feeling weak.

If the TB affects the person's lungs, the common symptoms include coughing, chest pain, and coughing up blood. Other symptoms depend on the part of the body affected.

  How Do I Know If I Have TB?

The tuberculin skin test, also called the Man­toux test, reveals whether a person is infected with the TB bacteria. This test is performed by injecting a small amount of tuberculin fluid un­der the skin in the lowcr part of the arm. Two or three days later, the test spot result is checked by a healthcare worker.

This test is generally recommended for em­ployees who have been at risk because of being near people who may have TB, such as those employed in the workplaces listed earlier.

General guidelines to reduce the risk of TB exposure may include:

·    Requesting that all employees cover coughs and sneezes with a tissue to help eliminate airborne pathogens

·    Using ventilation systems to circulate fresh air and help reduce the spread of airborne pathogens

·    Using tuberculocidal disinfectants to elimi­nate TB germs on work surfaces

·    Requiring TB tests at the time of hiring, and providing routine testing for TB

TB Exposure

Like an exposure to a bloodborne pathogen, an exposure to a known TB source should be re­ported to your employer.  Similarly, you have the right to know if you have been exposed.  Follow­ing an exposure you should be tested for TB, and if you are infected, you should make ar­rangements for appropriate treatment.

Treatment of TB

TB infections can be treated, although depend­ing on the likelihood that the TB infection will develop into TB disease, sometimes the person is not treated ifthere is little risk of the disease resulting. Factors that influence this decision include the person's age, overall health, lifestyle, and occupation.

TB disease can be cured by taking prescribed antibiotics, generally for 6 to 12 months. The drugs must be taken exactly as prescribed. If taken incorrectly, or if the full round of treat­ment is not completed, the TB germs may be­come resistant to treatment.

SARS

In 2003, an outbreak of severe acute respiratory syndrome (SARS) in some parts of the world caused a new scare.  SARS is primarily an infectious disease, transmitted when an infected person coughs or sneezes within close proximity of others.  During the 2003 epidemic, almost 10% of the approximately 8000 known SARS victoms in the world died.  Only 7 people in the U.S. were known to have contracted SARS, however, all during international travel to epidemic areas.  The U.S. Centers for Disease Control and Prevention continues to monitor the risks of SARS and will issue updates and warnings if new outbreaks occur

 


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