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Tuberculosis in the Workplace (2001)

Chapter: Index

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Suggested Citation:"Index." Institute of Medicine. 2001. Tuberculosis in the Workplace. Washington, DC: The National Academies Press. doi: 10.17226/10045.
×

Index

A

Accreditation and licensure, 6, 53, 58, 82, 117, 140, 141

Acquired immunodeficiency disease, see HIV

Active tuberculosis, 1, 8, 13, 23, 27–28, 88–92, 95–96, 100, 109, 132, 217

see also Drug resistance;

Mortality;

Outbreaks;

Symptoms;

Transmission of disease

compared to latent disease, 25

defined, 83

diagnosis, 25, 30, 32, 33, 37–40, 156;

see also Radiographs;

Sputum smears

general population, risk assessment data, 86–88

medical students, 85

nursing students, 84

OSHA estimates, 152–153

skin tests, 32, 33, 84(n.2)

Administrative controls, 8–9, 86, 98–99, 203

see also Isolation policies, rooms, and areas;

Record keeping;

Regulations and standards

CDC guidelines, 3, 8, 57, 63–74, 104–106, 143, 192, 230, 231, 232, 245–246, 293

CDC guidelines, implementation and effects, 108, 109–116, 120–124, 128, 129, 131, 133–134, 140, 234, 235, 238, 241, 246–250, 263–266, 301, 302

diagnosis, 8, 64, 103

inspection of facilities, 117–119

OSHA rule/standard, 10, 59–60, 63–72, 140, 142–144, 149

outbreaks, 8, 134, 135, 136, 145, 262–263, 300, 301

regulatory burden, 10, 138, 144

Administrative Procedure Act, 280

Adolescents, 27, 87, 196, 219, 220

African Americans, see Black persons

Age factors

see also Adolescents;

Children;

Elderly persons

active tuberculosis treatment, 40

CDC guidelines, implementation and

effects, 128, 130

correctional workers, 210

country comparisons, 27(n7), 92

historical perspectives, 27, 87

prevalence, 27, 87, 88, 92, 93, 98

risk assessment, 87, 88, 92, 93, 98, 192, 195, 202, 204, 213, 217, 219, 220, 223

skin tests, 30, 181

Suggested Citation:"Index." Institute of Medicine. 2001. Tuberculosis in the Workplace. Washington, DC: The National Academies Press. doi: 10.17226/10045.
×

Agency for International Development, 312

AIDS, see HIV

Airflow, see Ventilation

Alcohol abuse, 35, 244

Ambulatory care facilities, 81, 95, 103, 121, 212

CDC guidelines, 58, 109, 129, 252

American Academy of Pediatrics, 175

American Association of Homes and Services for the Aged, 175

American Board of Emergency Medicine, 122

American College of Chest Physicians, 57

American College of Occupational Medicine, 176

American Federation of State, County and Municipal Employees, 115–116, 174

American Hospital Association, 63, 111, 175, 253

American Indians, 87, 197

American Nurses Association, 175

American Public Health Association, 175

American Society for Microbiology, 175

American Thoracic Society (ATS), 13(n.1), 35, 57, 58, 121, 153, 176

Annual risk of infection (ARI), 193–194, 195–201, 203–205, 210, 213, 215

Aplisol, 180

Arkansas, 102

Asians/Pacific Islanders, 87, 197, 214, 215

Association of Professionals in Infection Control and Epidemiology, 63, 242, 243, 257

Atlanta, Georgia, 99, 124–126, 197, 204, 205, 206, 236–237, 247–248, 300

Attitudes, 43

complacency, 137–138

isolation of patients, psychological factors, 39–40

patient treatment preferences, 35, 144

stigma, 32, 144

workers, 44

Attorneys, 208

Autopsies, 26, 85, 95, 98, 149, 212

see also Medical examiners

B

Barnhart, Scott, 293–308

Bass, John, 179–188

Bathrooms in isolation rooms, 251, 257

BCG vaccination, 33, 126, 128, 130, 183, 202, 219, 220

Black persons, 87, 196, 197, 204, 210, 215, 219, 220, 244

Blueprint for Tuberculosis Vaccine Development, 311

Body weight, see Weight factors

Bone, 27, 28

Boostering phenomenon, 33, 185–187

Boston, Massachusetts, 211, 214

Bovine tuberculosis, 24

BCG vaccine, 33, 126, 128, 130, 183, 202, 219, 220

Brain, 27, 28

Britain, see United Kingdom

Bronchoscopy, 94, 95, 106, 121, 130(n.6), 131, 145, 149, 190, 201, 215, 243, 263

Bureau of Mines, 45

Bureau of Prisons, 114

Burris, J.D., 271–292

Byssinosis, 285

C

Cadavers, see Autopsies;

Funeral homes;

Medical examiners

California, 6, 15, 20, 99–100, 118–119, 175, 201, 215, 256

Canada, 130(n.6)

Cancer, 28, 39, 208, 299

Case law, see Litigation

Case management, 11, 72–74, 154, 309, 310

see also Clinical practice guidelines

directly observed therapy, 17, 22, 35, 41, 82, 119, 132, 139, 153

multidisciplinary, 41

Centers for Disease Control and Prevention (CDC), 309, 310, 311, 312

active tuberculosis defined, 83

control practices, surveys, 110–115

epidemiology, 6, 86–92, 311

hospital studies, 91–92, 96, 110–113, 114, 214

immigrant causing outbreak, 95–96

international collaboration, 312

latent tuberculosis defined, 13(n.1)

mortality reports, 86–91, 92, 96, 153

outbreak reports, 8, 20, 37, 91, 95–96, 119–121, 123–131, 133–136, 141, 145, 230, 231–245, 261, 262, 302

prevalence reports, 86–92, 96, 152, 153

Suggested Citation:"Index." Institute of Medicine. 2001. Tuberculosis in the Workplace. Washington, DC: The National Academies Press. doi: 10.17226/10045.
×

skin test demonstration project, 19, 91–92

surveys, 86–92, 110–115

Centers for Disease Control and Prevention (CDC) guidelines, 1, 2–4, 5–6, 8, 9, 11, 16, 43, 56–58, 72–74, 173, 177, 108–136, 293

administrative controls, 3, 8, 57, 63–74, 104–106, 143, 192, 230, 231, 232, 245–246, 293

ambulatory care, 58, 109, 129, 252

clinical practice, 18, 57, 59

community-level factors, 9, 64, 66, 67, 69

confidentiality, 64

contract employees, 236

correctional facilities, 2–3, 19, 57, 58

diagnosis, general, 109, 232;

see also“skin tests” infra

drug-resistant tuberculosis, 64, 66, 73

drug treatment, 35, 37, 73, 109, 234, 235, 241, 248, 302

emergency departments, 58, 73

enforcement powers lacking, 142

engineering controls, general, 3, 57, 63, 64, 65, 68, 74–76

friends of patients, 56–57

health care facilities and workers, 2–3, 4, 8, 18–21, 29, 30, 56–57, 61, 67, 69, 73, 138, 173, 190–191, 231, 232, 234;

see also specific job categories infra and supra

historical perspectives, 2–3, 4, 5–6, 8, 18–20, 43, 56, 57, 230, 231, 233–234

HIV, health care workers infected with, 28, 106

HIV patients, skin tests, 30

homeless shelters, 57, 58, 63

hospitals, 58, 73, 232

immigrants, 11, 57

isolation rooms, 73–74, 75, 76, 109, 111–112, 145, 245–246

laboratory personnel, 30, 58, 112, 118

latent tuberculosis, general, 121, 153

local governments, 66, 68, 232, 310, 312

long-term care facilities, 232, 246

masks, 76, 79, 145–146, 230;

see also “respirators” infra

nurses, 78

OSHA rule/standard compared to, 9, 43, 56–60, 62–80, 138–146 (passim), 152–155, 252, 290

outbreaks, 8, 20, 37, 141, 145

prevalence, 64, 66

public health, 56–57, 65, 71–72, 131, 133, 134, 310, 312

record keeping, 64, 65, 68, 72, 109

respirators, 3, 19, 20, 57, 63, 71, 76–80, 145–146, 230, 232, 293, 295, 300, 301;

see also “masks” supra

skin tests, 3, 29, 30, 33, 57(n.2), 58, 63, 64, 66, 67, 68, 69–70, 71, 142, 183, 232

surveillance, 64–65, 109

symptoms, 64, 246

transmission of disease, 64, 65, 244

worker job and financial protections, 70–71

Centers for Disease Control and Prevention (CDC) guidelines,

implementation and effects, 108– 136, 138, 139, 141, 230–270

administrative controls, 108, 109–116, 120–124, 128, 129, 131, 133–134, 140, 234, 235, 238, 241, 246–250, 263–266, 301, 302

age factors, 128, 130

ambulatory care, 109, 129, 252

clinical practice, 247, 255, 309, 310

community-level factors, 135, 146, 232, 236

contract employees, 236

correctional facilities, 109, 113–115, 129, 130, 132, 133, 138, 246, 259

diagnosis, general, 58, 64–65, 72–74;

see also “radiographs” and “skin tests” infra

drug abusers, 244, 246, 252

drug-resistant tuberculosis, 109, 111, 112, 113, 115, 121, 126–127, 131, 234, 242, 250–251, 312

drug treatment, 109, 234, 235, 241, 248

emergency departments, 112, 129–130, 140, 231, 237, 250, 252, 256, 260, 262

engineering controls, general, 129–131, 134, 135, 136, 230, 232, 238–239, 245, 250–251, 257, 261, 293, 301, 302

Suggested Citation:"Index." Institute of Medicine. 2001. Tuberculosis in the Workplace. Washington, DC: The National Academies Press. doi: 10.17226/10045.
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epidemiology, 131–132, 133, 231, 236, 247, 263, 310

health care facilities and workers, 109, 110–113, 115–136, 142, 174, 230–231, 234–266;

see also specific worker categories infra and supra

historical perspectives, 108, 124, 132, 133, 135–136, 231, 251, 254, 261–262

HIV patients, 120, 121, 126–127, 129, 231, 234–239 (passim), 244–245, 246, 247, 248, 265

homeless shelters, 117, 132, 237, 241, 246

hospitals, 110–113, 114, 116–120, 123, 124–136 (passim), 140, 174, 215, 231, 233, 234–259, 261–266, 301–302

immigrants, 11, 130, 246, 261

isolation rooms, 111–112, 118–133

(passim), 136, 232–262 (passim), 302;

see also negative-pressure isolation rooms” and “ventilation” infra

laboratory personnel, 112, 118

latent tuberculosis, general, 121, 153

local governments, 114, 115

long-term care facilities, 232, 246

masks, 111, 112, 115, 116, 119, 120, 122, 125, 126, 127, 128, 131, 133, 234, 236, 238, 242, 244, 245, 250–258 (passim);

see also “respirators” infra

negative-pressure isolation rooms, 8, 109, 112, 118, 119, 125, 127, 128, 130(n.6), 234, 236, 238, 239, 242, 243, 252, 253, 254, 256–257, 302

nurses, 111, 122, 125, 236, 240, 254, 259, 261–262, 263, 264

outbreaks, 119–121, 123–131, 133–136, 230, 231–245, 261, 262, 302

physicians, 121, 125, 232, 236, 259, 264

public health, 231, 232, 256

radiographs, 115, 124–125, 130, 234, 246, 247, 248, 249, 263, 265

record keeping, 109

respirators, 109, 113, 121, 122, 125, 127–128, 129–131, 134, 136, 145– 146, 237, 243, 245, 252, 254, 256, 301–302, 306;

see also “masks” supra

skin tests, 109, 111, 113–117 (passim), 124–130 (passim), 144–145, 232–258

(passim)

surveillance, 129, 133, 153, 236

symptoms, 64

ventilation, 75, 76, 112, 130–131, 230, 234, 241, 250–258 (passim);

see also “negative-pressure isolation rooms” supra

Chest radiographs, see Radiographs

Chicago, Illinois, 115, 131, 196, 244, 302

Children, 87, 95–96, 196, 219, 220, 257, 262

adolescents, 27, 87, 196, 219, 220

infection likelihood, 27, 28

skin tests, 30

Cities, see Urban areas

Clinical practice guidelines, CDC, 18, 57, 59, 247, 255, 309, 310

see also Case management;

“guidelines” under Centers for Disease Control and Prevention

Clinical trials, 130(n.7), 221–222

BCG vaccination, 219, 220

latent tuberculosis, treatment, 35, 220

Colorado, 215

Community-level factors, 12, 15, 17–18, 106, 124, 135, 138, 139, 156

see also Local governments;

Urban areas

CDC guidelines, 9, 64, 66, 67, 69, 135, 146, 232, 236

definitional issues, 83–85

diagnosis, 29, 31, 38–39

elderly persons, 102

health care workers vs community at large, risk, 7, 10–11, 16, 81, 83–85, 88–89, 92, 98, 105, 135, 142, 189– 191, 192, 194–199, 201, 210, 213, 216, 232, 236

immigrants, 95–96

OSHA rule/standard, 9, 10, 52, 138, 139, 142

outbreaks, 84, 155

prevalence, 7, 9, 31, 52, 64, 67, 69, 132;

see also “health care workers…” supra

skin tests, 29, 31

Computer databases, see Databases

Confidentiality, CDC guidelines/OSHA

rule/standard, 64

Connecticut, 210, 278

Contact tracing, 11, 28, 70

DNA fingerprinting, 38, 59(n.4), 84, 99, 101, 102, 104, 204, 244

skin tests, 29, 30

time factors/costs, 263, 264

Suggested Citation:"Index." Institute of Medicine. 2001. Tuberculosis in the Workplace. Washington, DC: The National Academies Press. doi: 10.17226/10045.
×

Contract employees

OSHA rule/standard, 53–54, 60, 62, 141, 208, 288–289

Control measures, see Administrative

controls;

Engineering controls;

Hierarchy of controls;

Personal

respiratory protection

Correctional facilities, 2, 81, 104, 114, 116

age of workers, 210

CDC guidelines, 2–3, 19, 57, 58

CDC guidelines, implementation and

effects, 109, 113–115, 129, 130, 132, 133, 138, 246, 259

drug-resistant tuberculosis, 121

drug treatment, 114

employees, 6, 7, 15, 81, 89–90, 95, 99– 101, 106, 107, 114–115, 209–210, 259

historical perspectives, 5, 6, 14, 15–16, 18

immigrants, detainees, 101, 121, 208

inmates, 7, 14, 15–16, 62, 89–90, 99– 101, 114, 129, 130, 209–210, 220, 222, 311

inspections of, 117–118

isolation rooms, 118, 130, 133

local governments and, 101, 114, 115

National Commission on Correctional Health Care, 58

OSHA rule/standard, 3, 53, 60, 63, 89(n.5), 138, 152

outbreaks, 99–101, 114, 121, 129, 133, 209

physicians, 95, 99–101

prevalence, 89–90, 152, 215

public health measures, 311

radiographic screening, 130

risk assessment, 81, 89–90, 95, 104, 106, 208, 209–210, 213, 215, 220, 222

skin tests, 95, 99–101, 114, 115, 117, 215, 311

state regulations, 53

urban areas, 101, 115, 209–210

Costs and cost-effectiveness, 39, 261–266

administrative controls, regulatory

burden, 10, 138, 144

control measures, general, 23, 49, 50– 51, 53, 110, 137, 140, 231, 246, 261– 266

contact tracing, 263, 264

drug treatment, 265

education of workers, 266

enforcement of state and local

government worker safety, 53

fines and penalties, 20–21, 47, 55, 274, 275, 276, 290

homeless shelters, regulation, 63

injuries in the workplace, general, 271

inspection of facilities, 117

isolation, 263–266

mortality, 50–51

radiographs, 130

regulation, general, 2, 10, 45, 63, 137, 138, 140, 142, 144, 281, 282–283, 286, 290

respiratory protection, 71, 77, 118, 145, 146–147, 262, 296, 299

skin tests, 71, 142, 144, 261–262, 263, 264, 265

standards implementation, 2, 10, 49, 50–51, 261–266

surveys, 110

Coughing, 1, 13, 25, 26, 37, 103, 131, 190, 245, 246, 259

Court cases, see Litigation

Crabtree, Jamie, 271–292

D

Daniel, Thomas, 189–229

Databases, 85, 86–92, 111, 192, 214, 233, 247, 252, 253

MedLine, 192, 233

Death rates, see Mortality

Definitional issues, 82–85, 151

active tuberculosis, 83, 150

annual risk of infection (ARI), 193

community-level factors, 83–85

elimination of tuberculosis, 135(n.8)

employers and employees, 286

engineering controls, 74

incidence and prevalence, 85(n.4)

latent tuberculosis, 13(n.1), 150

material health impairment, 284

occupational exposure, 82, 83(n.1)

occupationally acquired disease, 82

outbreak, 84

risk, 82–83, 193

Suggested Citation:"Index." Institute of Medicine. 2001. Tuberculosis in the Workplace. Washington, DC: The National Academies Press. doi: 10.17226/10045.
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Demographic factors, 84, 94, 99, 107, 128, 135, 216, 219

see also Age factors;

Epidemiology;

Geographic factors;

Immigrants;

Race/ethnicity;

Socioeconomic

status;

Urban areas

gender factors, 84(n.3), 194, 202, 204, 211, 219, 220, 244

Dental clinics and schools, 113, 232, 260–261

Department of Health and Human Services, 46–47, 313

see also Centers for Disease Control and Prevention;

National Institute for Occupational Safety and Health;

National Institutes of Health

Food and Drug Administration, 180, 183

Health Care Financing

Administration, 51, 118

Public Health Service, 220

Department of Labor, 20, 47, 53, 273

see also Occupational Safety and Health Administration

Federal Advisory Council on Occupational Safety and Health, 47, 273

Developing countries, 1, 6, 15, 21, 107

Mexico, immigrants from, 6, 15, 87, 89, 195, 201

Philippines, immigrants from, 6, 15, 87, 89, 195

Vietnam, immigrants from, 6, 15, 87

Zimbabwe, 15

Diabetes, 28, 30

Diagnosis, 8, 9, 12, 15, 18, 22, 24, 28–34, 140, 156, 222, 223, 310–312

see also Contact tracing;

Latent

infection;

Skin testing;

Surveillance

active tuberculosis, 25, 30, 32, 33, 37– 40, 156;

see also Radiographs;

Sputum smears

administrative controls, 8, 64, 103

CDC guidelines, 58, 64–65, 72–74, 109, 232

community-level factors, 29, 31, 38–39

DNA fingerprinting, 38, 59(n.4), 84, 99, 101, 102, 104, 204, 244

HIV patients, tuberculosis diagnosis, 29, 38(n.13), 39, 127, 221, 311

immigrants, 22, 29, 33, 38, 311

OSHA rule/standard, 29, 64–65, 68, 72–74, 144–145, 151–152

physicians role in, 29, 36, 37, 39

private sector research, 312

record keeping, 37

state government role, active

tuberculosis, 37

time factors, diagnosis, 29, 30, 33, 34, 38–39, 58, 64, 70

time factors, transfer after diagnosis, 73–74

Diet, see Nutrition

Directly observed therapy, 17, 22, 35, 41, 82, 119, 132, 139, 153

Disabled persons, see Long-term care

facilities;

Mental retardation;

Nursing homes

DNA fingerprinting, 38, 59(n.4), 84, 99, 101, 102, 104, 204, 244

Drug abuse, 7, 14, 81, 103, 211, 220–221

see also Alcohol abuse

CDC guidelines, implementation and effects, 244, 246, 252

injection abusers, 30, 246

OSHA rule/standard, 60, 208

Drug resistance, 18, 120, 138, 309, 312

CDC guidelines, implementation and effects, 109, 111, 112, 113, 115, 121, 126–127, 131, 234, 242, 250–251, 312

CDC guidelines/OSHA rule/

standard, 64, 66, 73

correctional facilities, 121

health care workers infected, 7, 89, 91–92, 96, 98, 103, 115, 201

historical perspectives, 4, 5, 6, 11, 13– 14, 15, 19, 23, 154–155, 201, 231

immigrants, 121

mortality, 28, 96, 221, 222, 223

risk assessment, 89, 91–92, 96, 98, 103, 191, 201, 209, 222, 223

surgical treatment, 18

treatment, 40, 41

Drug treatment, 1, 12, 17–18, 22, 24, 82, 126, 155, 186–187, 221–223, 300, 309, 310, 311, 312

see also Case management;

Vaccines

active tuberculosis, 40–42;

see also Drug resistance

adherence, 36, 41, 155, 221, 222, 311

alcohol abuse and, 35

attitudes of patients, 35, 144

Suggested Citation:"Index." Institute of Medicine. 2001. Tuberculosis in the Workplace. Washington, DC: The National Academies Press. doi: 10.17226/10045.
×

CDC guidelines, 35, 37, 73, 109, 234, 235, 241, 248, 302

correctional facilities, 114

costs, 265

directly observed therapy, 17, 22, 35, 41, 82, 119, 132, 139, 153

historical perspectives, 40, 41, 86, 154, 179–180, 182, 199

homeless shelter workers, 58

irritation medication, 190

isoniazid, 4, 13, 35, 40, 150, 216, 220, 221, 241, 248

latent tuberculosis, 24, 34–36, 42, 57(n.2), 121, 144, 150, 152–153, 156, 216, 220, 221, 223, 241

liver damage, 35, 150

mortality, effectiveness in reducing, 28, 40

OSHA rule/standard, 58, 73, 109, 150, 153, 154

pentamidine, 103, 126, 127, 190, 234, 235, 238, 240

physicians, 17, 41

pregnant women, 35

private sector research, 312

pyrazinamide, 35, 40

rifampin, 4, 13, 35, 40, 104

risk levels and, 35–36

side effects, 35–36, 150, 179, 222

skin tests, false positives, 32, 33

time factors, 17–18, 22, 34, 35, 36, 40–41, 143(n.1), 155, 302

Dust-mist/dust-mist-fume respirators, 119, 126, 128, 239, 243, 252, 254, 256, 257, 295, 297, 301, 304

E

Economic factors, 43, 287

see also Cost factors;

Funding;

Socioeconomic status

fines and penalties, 20–21, 47, 55, 274, 275, 276, 290

OSHA rule/standard, 49, 54–55

unemployed persons, 7, 15, 43–44, 89, 153–154, 222

worker job and financial protection, 70–71

Education

see also Students

dental schools, 113, 260–261

health care professionals, 37, 46, 57, 62, 106, 115, 119, 125, 133, 216, 231, 232, 236, 259, 262, 266

mentally retarded persons, 209–210

OSHA, 272

patients with latent tuberculosis, 35– 36, 65, 106

public, 45, 312

workers, general, 44, 46, 54–55, 65, 109, 115, 116, 232, 262, 266, 274, 294, 304–306, 310

Elderly persons, 101–102, 208, 222, 223

see also Nursing homes

infection likelihood, 27(n7), 28

infection rates, 87

OSHA rule/standard, 61

skin tests, 30

Embalming, 26, 61, 104, 116, 212–213

Emergency departments, 95, 118, 122, 135, 260

CDC guidelines, 58, 73

CDC guidelines, implementation and effects, 112, 129–130, 140, 231, 237, 250, 252, 256, 260, 262

OSHA rule/standard, 60, 62, 140, 208

skin tests, 130, 260

Ending Neglect: The Elimination of Tuberculosis in the United States, 11, 12, 21, 41, 144, 154, 155, 309–313

Endotracheal suctioning, 190

Enforcement, 4, 5, 19, 20–21, 46, 56, 59, 133, 140, 234, 274–276, 278

see also Inspection of facilities;

Litigation

CDC powers lacking, 142

fines and penalties, 20–21, 47, 55, 274, 275, 276, 290

state and local government worker

safety, cost of, 53

Engineering controls, 8–9, 110, 120, 300, 301

see also Isolation policies, rooms, and areas;

Ventilation

CDC guidelines, 3, 57, 63, 64, 65, 68, 74–76

CDC guidelines, implementation and effects, 129–131, 134, 135, 136, 230, 232, 238–239, 245, 250–251, 257, 261, 293, 301, 302

defined, 74

Suggested Citation:"Index." Institute of Medicine. 2001. Tuberculosis in the Workplace. Washington, DC: The National Academies Press. doi: 10.17226/10045.
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inspection of facilities, 117

modeling exercises and studies, 8, 130, 134, 136

OSHA rule/standard, 63, 64, 74–76

ultraviolet germicidal irradiation (UVGI), 26, 59–60, 203, 230, 232, 238, 241, 245, 250–251, 253, 258, 302, 304

Epidemiology, 4–5, 6, 10–12, 86–98, 104

see also Prevalence;

Surveillance

annual risk of infection (ARI), 193– 194, 195–201, 203–205, 210, 213, 215

CDC guidelines, implementation and effects, 131–132, 133, 231, 236, 247, 263, 310

historical perspectives, 4–5, 6, 10, 11, 12, 13, 14, 82, 87–88, 90, 131–132, 133, 138, 231

HIV and tuberculosis, 25(n.4)

OSHA estimates, 10, 88

respirators, 148

U.S. government surveys and

databases, 86–92

worldwide, 22

Ethnicity, see Immigrants;

Race/ethnicity

Europe, 199

BCG vaccination, 33

United Kingdom, 217

Executive Order 11612, 47

Executive Order 12196, 288

Executive Order 12866, 47, 50–51, 281, 283

Executive orders, other, 48, 53, 281

F

Family members, 91, 95–96

CDC guidelines, 56–57, 153

isolation of patients from, 39–40

OSHA mortality estimates, 153

outbreak defined, 84

skin tests, 29

visits to patients, 23, 40, 56–57, 62, 79, 208, 245, 257

Federal Advisory Council on Occupational Safety and Health, 47, 273

Federal Coal Mine Health and Safety Act, 46

Federal government, 1, 5, 12, 16–17, 18, 45, 310

see also Centers for Disease Control and Prevention;

Legislation;

National Institute for Occupational Safety and Health;

Occupational Safety and Health Administration;

Office of Technology Assessment;

Regulations and standards;

terms beginning “Executive…”

Agency for International Development, 312

Bureau of Mines, 45

Bureau of Prisons, 114

Department of Labor, 20

employees of, 52–53, 54–55, 58, 61, 288

Immigration and Naturalization Service, 21, 101, 121

Mine Safety and Health Administration, 60

OSHRC, 277

surveys and databases, 86–92, 110–115

Veterans Administration, 101, 102, 176, 246–247

Filters, see High-efficiency particulate air filters;

Masks;

Personal respiratory protection

Fines and penalties, 20–21, 47, 55, 274, 275, 276, 290

see also Litigation

Fit testing and fit, respirators, 77–79, 146– 148, 149, 293, 296, 297–299, 304–306

Florida, 6, 201, 205, 212, 215

Food and Drug Administration, 180, 183

Foreign countries, see International perspectives

Foreign origin, see Immigrants

Friends

CDC guidelines, 56–57

skin tests, 29

visits to patients, 23, 40, 56–57, 62, 79, 208, 245, 257

Funding, 5, 17, 18, 54–55, 310

community programs, 138

risk defined, 83

urban hospitals, 82

Funeral homes, 90–91, 104, 121, 212

embalming, 26, 61, 104, 116, 212–213

OSHA rule, 61

skin testing, 61, 116

Suggested Citation:"Index." Institute of Medicine. 2001. Tuberculosis in the Workplace. Washington, DC: The National Academies Press. doi: 10.17226/10045.
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G

Gender factors, 84(n.3), 194, 202, 204, 211, 219, 220, 244

pregnant women, 35

General-duty clause, OSHA, 47, 53, 59, 108, 117, 140, 141, 252, 273, 276, 279, 280, 288

Geographic factors, 6, 14–15, 97, 99, 104– 105, 128, 135, 136, 139, 142, 183, 190, 195, 201, 202, 206–207, 310

see also Community-level factors;

Immigrants;

International perspectives;

State-level factors;

Urban areas;

specific states and countries

mail surveys, 110

rural areas, 190, 192, 195, 198, 219, 243

Government Organization and Employees

Act, 290

Government role, 44, 45, 82

see also Enforcement;

Federal government;

Local governments;

Public health;

Regulations and standards;

State governments

Granulomas, see Tubercules

Gynecology, see Obstetrics and gynecology

H

Handicapped persons, see Long-term care

facilities;

Mental retardation;

Nursing homes

Harber, Philip, 293–308

Hawaii, 87, 100

Health care facilities and workers, 1, 2, 36, 39

see also Administrative controls;

Ambulatory care facilities;

Contract workers;

Emergency departments;

Engineering controls;

Home care;

Hospices;

Hospitals;

Isolation rooms and areas;

Laboratory personnel;

Long-term care facilities;

Medical

examiners;

Nursing homes;

Nursing personnel;

Personal

respiratory protection;

Risk levels and assessment;

Physicians

bronchoscopy, 94, 95, 106, 121, 130(n.6), 131, 145, 149, 190, 201, 215, 243, 263

CDC guidelines, 2–3, 4, 8, 18–21, 29, 30, 56–57, 61, 67, 69, 73, 138, 173, 190–191, 231, 232, 234

CDC guidelines, implementation and effects, 109, 110–113, 115–136, 121, 122, 125, 127–131, 142, 174, 230– 231, 234–266

committee study at hand, goals and methodology, 7, 16, 92–93, 173–174

community at large vs health care

workers, risk, 7, 10–11, 16, 81, 83– 85, 88–89, 92, 98, 105, 135, 142, 189–191, 192, 194–199, 201, 210, 213, 216, 232, 236

dental clinics and schools, 113, 232, 260–261

drug-resistant tuberculosis, 7, 89, 91– 92, 96, 98, 103, 115, 201

education, general, 44, 46, 54–55, 65, 109, 115, 116, 232, 262, 266, 274, 294, 304–306, 310

education, professionals, 37, 46, 57, 62, 106, 115, 119, 125, 133, 216, 231, 232, 236, 259, 262, 266;

see also “students” infra

historical perspectives, 2–3, 5, 7, 15, 18–20, 86, 199–200

HIV infected workers, 28, 106, 204

housekeeping staff, 98, 200, 202, 205, 206, 259

infected with tuberculosis, 1, 2, 6, 88– 91

isolation of patients;

see Isolation rooms and areas

obstetrics and gynecology, 99, 204

occupational exposure defined, 82

OSHA rule/standard, 4, 29, 59, 60, 61, 62, 69, 73, 138, 142–144, 152, 154, 173, 208, 287

outreach workers, 41, 91, 215

psychiatric facilities, 61, 101, 220

respiratory therapists, 94, 206, 215, 259

risk assessment, 85–86, 88–99, 102, 103, 104, 105–106, 107, 142–144, 189–229

see also “community…” supra

Suggested Citation:"Index." Institute of Medicine. 2001. Tuberculosis in the Workplace. Washington, DC: The National Academies Press. doi: 10.17226/10045.
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skin tests, facilities, 30, 62, 93, 94, 102, 117, 120, 124, 125–126, 128, 129, 151–152, 186, 212, 234

skin tests, workers, 19, 29, 30, 32, 36, 91, 93, 94, 103, 115, 124–128 (passim), 192, 215, 216–218, 232– 262 (passim), 300, 301, 302, 304

students, medical, 62, 85, 99, 100, 196, 287, 216–217, 259, 287

WHO guidelines, 23

Health Care Financing Administration, 51, 118

Medicaid, 53

Medicare, 51, 53, 118

HEPA, see High-efficiency particulate air filters

Hepatic system, see Liver damage

Hierarchy of controls, 57, 58, 76, 129, 134, 136, 145, 148, 230, 293, 300, 302

see also Administrative controls;

Engineering controls;

Personal respiratory protection

High-efficiency particulate air filters (HEPA), 59–60, 148, 230, 236, 242, 254, 256, 257, 258, 261, 297, 301, 302, 304, 305, 306

Hispanics, 87, 196, 197, 215

Mexico, immigrants from, 6, 15, 87, 89, 195, 201

Puerto Ricans, 196, 197, 219, 252

Historical perspectives, 1, 4–6, 15–16, 17, 19, 23, 25, 43, 45–46, 87, 116, 120– 121, 124, 154–155

age factors in prevalence, 27, 87

CDC guidelines, 2–3, 4, 5–6, 8, 18–20, 43, 56, 57, 230, 231, 233–234

CDC guidelines, implementation and effects, 108, 124, 132, 133, 135–136, 231, 251, 254, 261–262

CDC reports of active tuberculosis, 86–87

complacency, 137–138

correctional facilities, 5, 6, 14, 15–16, 18

country comparison studies, 92

drug-resistant tuberculosis, 4, 5, 6, 11, 13–14, 15, 19, 23, 154–155, 201, 231

epidemiology of tuberculosis, 4–5, 6, 10, 11, 12, 13, 14, 82, 87–88, 90, 131–132, 133, 138, 231

funding, 17, 18

health care facilities and workers, 2–3, 5, 7, 15, 18–20, 86, 199–200

hospitals, 5, 199

inspection of facilities, 117

mortality, 4, 14, 15, 19, 106, 221–223

OSHA rule/standard, 3–4, 5–6, 7, 19, 45–47, 56, 57, 108–109, 150–151, 278

outbreaks, 1, 11, 15, 16, 82, 108, 133, 139, 141, 155, 194, 199, 202, 230, 295, 300

public health efforts, 11, 17, 23, 43, 155, 201–202, 231

prevalence, 27, 86–93, 131–132, 133, 138, 150–151

risk assessment, 82, 86–93, 105–106, 189–190, 194–200, 216–217, 219

skin tests, 179–180, 181

state government role, 5, 6, 8, 17, 18

treatment regimens, 40, 41, 86, 154, 179–180, 182, 199

HIV, 5, 6, 7, 14, 15–16, 25(n.4), 28, 40, 51, 71, 139, 154–155, 156

CDC guidelines, 18, 30, 106

CDC guidelines, implementation and effects, 120, 121, 126–127, 129, 231, 234–239 (passim), 244–245, 246, 247, 248, 265

diagnosis of tuberculosis, 29, 38(n.l3), 39, 127, 221, 311;

see also “skin tests” infra

health care workers infected, 28, 106, 204

latent tuberculosis treatment, 34, 35

OSHA rule/standard, 61

risk assessment, 81, 82, 88, 95, 97–98, 104, 106, 191, 201, 202, 203, 204, 207, 211, 220–221, 222

skin tests, 29, 30, 38(n.l3), 127, 311

time factors, tuberculosis infection, 239

Home care

OSHA rule/standard, 60, 62, 289

risk assessment, 81, 103

Homeless persons and shelters, 7, 14, 15, 156

CDC guidelines, 57, 58, 63, 117, 132, 237, 241, 246

cost of regulation of, 63

drug treatment of workers, 58

inspections of, 117–118

Suggested Citation:"Index." Institute of Medicine. 2001. Tuberculosis in the Workplace. Washington, DC: The National Academies Press. doi: 10.17226/10045.
×

OSHA rule/standard, 3, 21, 60, 63, 117, 208

outbreaks, 82, 95, 103, 211

risk assessment, 81, 82, 103, 208, 210– 211, 222, 223

skin tests, 58, 103, 117, 211, 241

WHO guidelines, 23

Hospices

OSHA rule/standard, 60, 62, 208

risk assessment, 95, 103, 211

Hospital Infection Program (CDC), 253, 254

Hospitals, 1, 2, 5, 8, 15, 39, 81, 82, 104, 116, 121

see also Emergency departments;

Isolation rooms and areas

CDC guidelines, 58, 73, 232

CDC guidelines, implementation and

effects, 110–113, 114, 116–120, 123, 124–136 (passim), 140, 174, 215, 231, 233, 234–259, 261–266, 301–302

CDC studies, 91–92, 96, 110–113, 114, 214

contract employees, 53–54, 62, 141, 208, 288–289

employees infected, 5, 30, 91–92, 199– 207, 215, 234

employment duration, 126

historical perspectives, 5, 199

inspections of, 117–119, 133–134, 252

intensive care units, 95, 256

isolation of patients;

see Isolation rooms and areas

OSHA rule/standard, 53–54, 60, 73, 94–95, 138, 139, 140–156, 252, 287

outbreaks, 7, 8, 82, 91, 95, 97, 98–100, 106, 120, 123, 124–129, 131, 133, 203, 204–205, 212, 221, 234–245, 261, 301, 302

risk assessment, 52, 81, 82, 86, 93, 94– 95, 97–100, 102, 103, 104–105, 106, 199–207, 215, 222, 243

skin tests, 30, 62, 93, 94, 102, 117, 120, 124, 125–126, 128, 129, 151–152, 199–207, 215, 231–266 (passim), 300, 301, 302

socioeconomic status of employees, 126, 200, 204

state regulation, 53

Veterans Administration, 101, 102, 176

Housekeeping staff, 98, 200, 202, 205, 206, 259

Human immunodeficiency virus, see HIV

I

Illinois, 6, 115, 131, 196, 244, 302

Immigrants, 7, 11, 14, 15, 22, 121, 135, 155, 156, 311, 312

see also Developing countries;

specific groups

BCG vaccination, 33, 126, 128, 130, 183, 202, 219, 220

CDC guidelines, 11, 57, 130, 246, 261

community-level factors, 95–96

detainees, 101, 121, 208

diagnosis, 22, 29, 33, 38, 311

European, 33, 199

Filipino, 6, 15, 87, 89, 195

geographic factors, 6

Hispanics, 87, 196, 197, 215

Mexican, 6, 15, 87, 89, 195, 201

medical school graduates, 99

OSHA rule/standard, 60

outbreak caused by family member, 95–96

prevalence, 22, 30, 192, 195, 199, 201

public health measures, 12, 22–23, 156

risk assessment, 81, 82, 87, 89, 91, 95– 96, 99, 107, 192, 195, 199, 201, 202, 204, 214, 215

skin tests, 29, 33, 311

Vietnamese, 6, 15, 87

Immigration and Naturalization Service, 21, 101, 121

Immune system, 26–27, 28, 40, 41, 106, 120, 191, 199, 216–220, 223, 244

see also HIV

macrophages, 26–27

skin tests and, 33, 180–183, 185

time factors, 30, 215

tubercules, 27

Implementation of controls, see

Administrative controls;

Engineering controls;

Hierarchy of controls;

Personal respiratory protection

Injection drug abusers, see Drug abuse

Suggested Citation:"Index." Institute of Medicine. 2001. Tuberculosis in the Workplace. Washington, DC: The National Academies Press. doi: 10.17226/10045.
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Inspection of facilities, 8, 20, 53, 55, 72, 109, 116–119, 133–134, 136, 252, 259, 288, 294

hospitals, 117–119, 133–134, 252

Intensive care units, 95, 256

International perspectives, 15, 22–23, 92, 156, 312

see also Developing countries;

Immigrants

age factors in prevalence, 27(n.7), 92

BCG vaccination, 33, 126, 128, 130, 183, 202, 219, 220

Canada, 130(n.6)

control efforts, 12

Europe, 33, 188

funding, 310

Italy, 221

Puerto Ricans, 196, 197, 219, 252

United Kingdom, 217

World Health Organization (WHO), 22–23, 41, 195

Intubation, 190

Isolation policies, rooms, and areas, 39–40, 54, 140, 230

bathrooms in, 251, 257

CDC guidelines, 73–74, 75, 76, 109, 111–112, 145, 245–246

CDC guidelines, implementation and effects, 111–112, 118–133 (passim), 136, 232–262 (passim), 302

correctional facilities, 118, 130, 133

cost factors, 263–266

nursing homes, 118

OSHA rule/standard, 73–74, 75, 76, 109, 111–112, 145, 282

psychological factors, 39–40

time factors, 73–74, 75, 76, 130(n.6), 237, 238, 246, 254

ultraviolet germicidal irradiation

(UVGI), 26, 59–60, 203, 230, 232, 238, 241, 245, 250–251, 253, 258, 302, 304

ventilation, 11, 60, 75, 76, 121, 130– 131, 199, 230, 232, 238, 250, 251, 254, 256–257;

se also Negative-pressure isolation rooms visits to patients, 23, 40, 56–57, 62, 79, 208, 245, 257

Isoniazid, 35, 40, 150, 216, 220, 221, 241, 248

resistance to, 4, 13

Italy, 221

J

Jails, see Correctional facilities

Joint Commission on the Accreditation of Healthcare Organizations, 58, 117

K

Kidneys, 27, 28, 95, 246

Koch, Robert, 179

L

Laboratory personnel, 95, 98, 206

see also Sputum smears

CDC guidelines, 30, 58, 112, 118

OSHA rule/standard, 60, 62, 208

Labor Coalition to Fight TB in the Workplace, 19, 20

Labor unions, 44, 45, 117, 133, 174, 252

Larynx, 1, 28

Latent infection, 1, 13, 22, 23, 24, 27, 42, 156, 216–218, 311

see also Skin testing

American Thoracic Society, 57(n.2), 121

CDC guidelines, 13(n.1), 57(n.2), 121, 153

clinical trials, 35, 220

compared to active disease, 25

defined, 13(n.1), 150

education of patients, 35–36, 65, 106

HIV patients, treatment of latent

tuberculosis, 34, 35

OSHA rule/standard, 88, 121, 152–153

pregnant patients, treatment of, 35

prevalence, 88, 152–153, 216–218, 220, 221

public health measures, 34, 35

risk assessment, 35–36

treatment, 24, 34–36, 42, 57(n.2), 121, 144, 150, 152–153, 156, 216, 220, 221, 223, 241

Legislation, 20, 69(n.7), 71–72, 281

see also Regulations and standards

Administrative Procedure Act, 280

Federal Coal Mine Health and Safety Act, 46

Government Organization and Employees Act, 290

Suggested Citation:"Index." Institute of Medicine. 2001. Tuberculosis in the Workplace. Washington, DC: The National Academies Press. doi: 10.17226/10045.
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National Environmental Policy Act, 281

Occupational Safety and Health Act, 45–48, 54, 271–292;

see also

Occupational Safety and Health Administration

Public Law 106–113, 173

Regulatory Flexibility Act, 281

state, 45–46, 69(n.7), 71–72

Unfunded Mandates Reform Act, 50, 281, 290

Local factors, see Community-level factors;

Urban areas

Local governments, 5

CDC guidelines, 66, 68, 232, 310, 312

CDC guidelines, implementation and effects, 114, 115

correctional facilities, 101, 114, 115

employees of, OSHA rule/standard, 52, 53, 61, 141, 287

Long-term care facilities

see also Nursing homes

CDC guidelines, 116, 232, 246

OSHA rule/standard, 60, 61

outbreaks, 95, 101–103, 208

risk assessment, 81, 101–103, 222

skin tests, 30

Litigation, 44–52 (passim), 82, 264, 271, 276, 277–278, 280, 282, 283–286, 288, 289

see also Enforcement attorneys, 208

OSHRC, 277

Liver damage, 35, 150

Lungs, 1

see also Radiographs

infection processes, 26–27, 28

silicosis, 28

Lymphatic system, 27, 28

M

Macrophages, 26–27

Mantoux method, 181, 182, 258

Maryland, 113, 255

Masks, 40, 298

see also Personal respiratory protection

CDC guidelines, 76, 79, 145–146, 230, 236

CDC guidelines, implementation and effects, 111, 112, 115, 116, 119, 120, 122, 125, 126, 127, 128, 131, 133, 234, 236, 238, 242, 244, 245, 250–258 (passim)

high-efficiency particulate air filters (HEPA), 59–60, 148, 230, 236, 242, 254, 256, 257, 258, 261, 297, 301, 302, 304, 305, 306

N95 respirators, 8, 77, 111, 118, 119, 125, 133, 145, 147, 148, 149, 254, 255, 295, 296, 297, 300, 301, 304, 305, 306

OSHA rule, 73, 74, 76, 78, 79, 145–146, 147, 148, 149, 282

surgical, 111, 112, 115, 120, 122, 126, 127, 128, 133, 234, 235, 238, 240, 242, 243, 245, 251–256 (passim), 296, 300, 301, 302, 304

Material impairment of health, 48–49, 50

Medicaid, 53

Medical examiners, 53, 60, 61, 208

autopsies, 26, 85, 95, 98, 149, 212

Medicare, 51, 53, 118

Medication, see Drug resistance;

Drug treatment

MedLine, 192, 233

Mental health facilities, see Psychiatric facilities

Mental retardation, 209–210

Methodology, see Research methodology

Metropolitan areas, see Urban areas

Mexico, immigrants from, 6, 15, 87, 89, 195, 201

Miami, Florida, 126, 150, 198, 205, 214, 234, 261, 300

Michigan, 103, 211

Migrant workers, CDC guidelines, 57

Military personnel, 88, 94, 95, 194, 196, 197, 205, 206, 217, 220

Veterans Administration, 101, 102, 176, 246–247

Milk, ovine tuberculosis, 24

Mine Safety and Health Administration, 60

Mine workers, 45, 46, 60

Minnesota, 100, 207, 252

Minority groups, see Immigrants;

Race/ethnicity

Suggested Citation:"Index." Institute of Medicine. 2001. Tuberculosis in the Workplace. Washington, DC: The National Academies Press. doi: 10.17226/10045.
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Modeling exercises and studies, 88, 123, 131, 132, 136, 151, 214, 248, 249–250

engineering controls, general, 8, 130, 134, 136

respiratory protection, 9, 145, 147, 148, 303–304

Molecular analysis, see DNA fingerprinting

Morgues, see Medical examiners

Mortality, 90, 191, 216, 221–223

CDC reports, 86–91, 92, 96, 153

cost-effectiveness of regulation, 50–51

drug-resistant tuberculosis, 28, 96, 221, 222, 223

historical perspectives, 4, 14, 15, 19, 106, 221–223

OSHA estimates, 10, 153–154

OSHA rule/standard, 48, 284

treatment absent, 28

treatment effective, 40

Multidrug-resistance, see Drug resistance

Multiple-employer workplaces, see

Contract employees

N

National Advisory Committee on Occupational Safety and Health, 46, 273

National Coalition for the Elimination of Tuberculosis, 312

National Commission on Correctional Health Care, 58

National Environmental Policy Act, 281

National Health Survey, 88, 195

National Institute for Occupational Safety and Health (NIOSH)

inspection of facilities, 118–119

research, 272–273

respirators, certification, 8, 19, 20, 46, 77, 79, 118, 119, 122, 145, 254, 295, 296–298, 298, 301, 306

National Institutes of Health, 311, 312

National Tuberculosis Controllers Association, 175

Native Americans, see American Indians

Negative-pressure isolation rooms, 8, 40(n.14), 203, 302

CDC guidelines, 8, 109, 112, 118, 119, 125, 127, 128, 130(n.6), 234, 236, 238, 239, 242, 243, 252, 253, 254, 256–257, 302

WHO guidelines, 23

Netherlands, 220

New Jersey, 6, 113, 117, 252, 255

New York City, 6, 15, 87, 91, 122, 127–128, 192, 196, 202–203, 204, 205, 206, 209, 210–211, 213, 214, 215, 220– 221, 222, 235, 237–240, 248, 250, 255–256, 260–261, 262, 301

New York State, 6, 15, 117, 118, 209, 252, 278

New York State Public Employees Federation, 175

N95 respirators, 8, 77, 111, 118, 119, 125, 133, 145, 147, 148, 149, 254, 255, 295, 296, 297, 300, 301, 304, 305, 306

NIOSH, see National Institute for Occupational Safety and Health

North Carolina, 151, 208–209, 214

Nursing homes inspections of, 117–118

isolation rooms, 118

risk assessment, 15, 101–102, 104, 208–209, 213

skin tests, 30, 117, 208–209

Nursing personnel, 23, 37, 41, 175, 303

CDC guidelines, 78

CDC guidelines, implementation and effects, 111, 122, 125, 236, 240, 254, 259, 261–262, 263, 264

OSHA regulation, 53, 54, 62

risk assessment, 85, 91, 93, 98, 99, 102, 103, 104, 105, 196, 199–206

(passim), 215, 217, 218

Nutrition, 223

skin test results, 33

O

Obstetrics and gynecology, 99, 204

Occupational Safety and Health Act, 45–48, 54, 271–292

Suggested Citation:"Index." Institute of Medicine. 2001. Tuberculosis in the Workplace. Washington, DC: The National Academies Press. doi: 10.17226/10045.
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Occupational Safety and Health

Administration, 1, 2, 3–4, 5, 7, 9–10, 16, 19, 20, 21, 23, 43–57, 108. 123, 133, 134, 137–154, 173, 189, 271–292

administrative controls, 10, 59–60, 63–72, 140, 142–144, 149

CDC guidelines compared to rule, 9, 43, 56–60, 62–80, 138–146 (passim), 152–155, 252, 290

community-level factors, 9, 10, 52, 138, 139, 142

confidentiality, 64

contract employees, 53–54, 60, 62, 141, 208, 288–289

correctional facilities, 3, 53, 60, 63, 89(n.5), 138, 152

diagnosis, 37, 64–65, 72–74;

see also “skin tests” infra

drug abusers, 60, 208

drug treatment, 58, 73, 109, 150, 153, 154

emergency departments, 60, 62, 140, 208

enforcement, 19, 20–21, 46, 47, 59, 116–118, 133, 140, 141, 234, 271, 272, 274–276, 280

epidemiological estimates, 10, 88

fines and penalties, 20–21, 47, 55, 274, 275, 276, 290

funeral homes, 61

general-duty clause, 47, 53, 59, 108, 117, 140, 141, 252, 273, 276, 279, 280, 288

health care workers and facilities, 4, 29, 59, 60, 61, 62, 69, 73, 138, 142–144, 152, 154, 173, 208, 287;

see also specific job categories infra and supra

historical perspectives on rule/standard, 3–4, 5–6, 7, 19, 45–47, 56, 57, 108–109, 150–151, 278

HIV patients, 61

home care, 60, 62, 289

homeless shelters, 3, 21, 60, 63, 117, 208

hospices, 60, 62, 208

hospitals, 53–54, 60, 73, 94–95, 138, 139, 140–156, 252, 287

immigrants, 60

inspection of facilities, 53, 55, 72, 116–118, 252–253, 274–276, 288

isolation rooms, 73–74, 75, 76, 130(n.6), 237, 238, 246, 254;

see also “ventilation” infra

laboratory personnel, 60, 62, 208

local government employees, 52, 53, 61, 141, 287

long-term care facilities, 60, 61

masks, 73, 74, 76, 78, 79, 145–146, 147, 148, 149, 282;

see also “respirators” infra

mortality, 10, 48, 153–154, 284

nurses, 53, 54, 62

outbreaks, 37, 140, 141, 151–152, 154, 208

patient management, 72–74

physicians, 61, 62, 289

prevalence estimates, 27, 88, 94–95, 150–154

prevalence, OSHA rule/standard, 64, 88, 138

private sector role in rulemaking, 52, 272, 278

procedural requirements, 280–281

psychiatric facilities, 61

public health measures, 65, 71–72, 79, 138, 271, 290

record keeping, 64, 65, 68, 72, 109, 274, 276

respirators, 48, 63, 71, 76–80, 108, 117, 140, 141, 145–149, 232, 282, 293, 300–301, 306;

see also “masks” supra

skin tests, 29, 64, 68, 71, 142, 144–145, 151–152

state governments and, 52, 53, 61, 71–72, 141, 274, 278

state-level prevalence, 88, 150–151

surveillance rule/standard, 64–65, 109, 274

symptoms, 64

time factors for rule, 142, 276, 280, 281

toxic substances, 271, 274, 282, 283, 284–285

ventilation, 60, 75, 76

worker job and financial protections, 70–71, 138

Occupational Safety and Health Review Commission, 47

Office of Technology Assessment, 20

Oklahoma, 100

Omaha, Nebraska, 6, 87

Suggested Citation:"Index." Institute of Medicine. 2001. Tuberculosis in the Workplace. Washington, DC: The National Academies Press. doi: 10.17226/10045.
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Oregon, 215

Organ transplants renal, 95

skin tests, 30

OSHA, see Occupational Safety and Health Act;

Occupational Safety and Health Administration

OSHRC, 277

Outbreaks, 7, 9, 23, 68, 84, 95–104, 105, 123–131, 190, 192

administrative controls, 8, 134, 135, 136, 145, 262–263, 300, 301

CDC guidelines and, 8, 20, 37, 91, 119–121, 123–131, 133–136, 141, 145, 230, 231–245, 261, 262, 302

community-related exposure, 84, 155

correctional facilities, 99–101, 121, 129, 133, 209

defined, 84

DNA fingerprinting, 84, 204

engineering controls, 8–9, 134, 136, 145, 300

historical perspectives, 1, 11, 15, 16, 82, 108, 133, 139, 141, 155, 194, 199, 202, 230, 295, 300

homeless shelters, 82, 95, 103, 211

hospitals, 7, 8, 82, 91, 95, 97, 98–100, 106, 120, 123, 124–129, 131, 133, 203, 204–205, 212, 221, 234–245, 261, 301, 302

immigrant causing, 95–96

long-term care settings, 95, 101–103, 208

OSHA actions, 37, 140, 141, 151–152, 154, 208

research methodology, 96–97, 105, 119–120

shipboard, 221

Outpatient treatment, see Ambulatory care

Outreach workers, 41, 91, 215

Outsourcing, see Contract employees

P

Pacific Islanders, see Asians/Pacific Islanders

Patient education, see Education Penalties, see Fines and penalties

Pennsylvania, 101, 121, 196

Pentamidine, 103, 126, 127, 190, 234, 235, 238, 240

Personal respiratory protection, 8, 9, 177, 293–308

see also Masks

American Thoracic Society, 57

CDC guidelines, 3, 19, 20, 57, 63, 71, 76–80, 145–146, 230, 232, 293, 295, 300, 301

CDC guidelines, implementation and effects, 109, 113, 121, 122, 125, 127–128, 129–131, 134, 136, 145–146, 237, 243, 245, 252, 254, 256, 301–302, 306

cost factors, 71, 77, 118, 145, 146–147, 262, 296, 299

disposable, 131, 295, 299, 301, 304;

see also “N95 respirators” infra

dust-mist/dust-mist-fume respirators, 119, 126, 128, 239, 243, 252, 254, 256, 257, 295, 297, 301, 304

epidemiology and, 148

fit testing and fit, 77–79, 146–148, 149, 293, 296, 297–299, 304–306

high-efficiency particulate air filters, 59–60, 148, 230, 236, 242, 254, 256, 257, 258, 261, 297, 301, 302, 304, 305, 306

inspection of facilities, 117–118, 119

modeling exercises and studies, 9, 145, 147, 148, 303–304

NIOSH certification, 8, 19, 20, 46, 77, 79, 118, 119, 122, 145, 254, 295, 296–298, 298, 301, 306

N95 respirators, 8, 77, 111, 118, 119, 125, 133, 145, 147, 148, 149, 254, 255, 295, 296, 297, 300, 301, 304, 305, 306

OSHA rule/standard, 48, 63, 71, 76– 80, 108, 117, 140, 141, 145–149, 232, 282, 293, 300–301, 306

positive-pressure supplied air

respirators, 295, 296, 304, 305

powered air-purifying respirators (PAPR), 76, 145, 295, 296, 304, 305

risk assessment, 294, 300, 304

time factors, 124, 146–147, 304

Pharmaceuticals, see Drug resistance;

Drug treatment

Philippines, immigrants from, 6, 15, 87, 89, 195

Suggested Citation:"Index." Institute of Medicine. 2001. Tuberculosis in the Workplace. Washington, DC: The National Academies Press. doi: 10.17226/10045.
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Physicians

CDC guidelines, implementation and effects, 121, 125, 232, 236, 259, 264

correctional facilities, 95, 99–101

diagnosis, 29, 36, 37, 39

drug treatment, 17, 41

hospital, rule protecting physicians in, 54

OSHA rule/standard, 61, 62, 289

risk assessment, 95, 98, 99–101, 105, 204, 206, 215, 217

skin tests, 95, 98, 217

Pneumonia, 207, 237

Political factors, 21, 123(n.4)

Positive-pressure supplied air respirators, 295, 296, 304, 305

Poverty, see Socioeconomic status

Powered air-purifying respirators (PAPR), 76, 145, 295, 296, 304, 305

Pregnancy latent tuberculosis treatment, 35

Prevalence, 7, 9, 27(n.7), 107, 131–132, 138, 140, 191, 192, 194–223 (passim)

see also Risk levels and assessment;

Surveillance

age factors, 27, 87, 88, 92, 93, 98

annual risk of infection (ARI), 193–194, 195–201, 203–205, 210, 213, 215

CDC guidelines, 64, 66

CDC reports, 86–92, 96, 152, 153

community-level factors, 7, 9, 31, 52, 64, 67, 69, 132

correctional facilities, 89–90, 152, 215

defined, 85(n.4)

elimination of tuberculosis, defined, 135(n.8)

historical perspectives, 27, 86–93, 131–132, 133, 138, 150–151

immigrants, 22, 30, 192, 195, 199, 201

latent tuberculosis, 88, 152–153, 216–218, 220, 221

OSHA estimates, 27, 88, 94–95, 150–154

OSHA rule/standard, 64, 88, 138

skin tests and, 30, 31, 144, 183, 184–185, 199–207

state-level, OSHA estimates, 88, 150–151

Prisons, see Correctional facilities

Privacy, see Confidentiality

Private sector, 6, 44, 54–55, 108

diagnosis and treatment research, 312

OSHA rule/standard, 52, 272, 278

state rule, 53, 278

Professional education, see Education

Psychiatric facilities, 101, 220

OSHA rule/standard, 61

Psychological factors, see Attitudes

Public health, 1, 12, 21–23, 24, 45, 82, 83, 86, 154, 309, 310

see also Case management;

Community-level factors;

Contact

tracing;

Outbreak investigations;

Surveillance

CDC guidelines, 56–57, 65, 71–72, 131, 133, 134, 310, 312

CDC guidelines, implementation and effects, 231, 232, 256

correctional inmates, 311

educational efforts, 45, 312

historical perspectives, 11, 17, 23, 43, 155, 201–202, 231

immigrants, 12, 22–23, 156

latent tuberculosis treatment, 34, 35

milk, 25

OSHA rule/standard, 65, 71–72, 79, 138, 271, 290

outreach workers, 41, 91, 215

skin tests, 32

Public Health Service, 220

Public Law 91–596, see Occupational Health and Safety Act

Public Law 106–113, 173

PubMed (MedLine), 192, 233

Puerto Ricans, 196, 197, 219, 252

Pyrazinamide, 35, 40

Q

Quarantine, see Isolation policies, rooms, and areas

R

Race/ethnicity, 87, 88, 90–91, 93, 99, 107, 128, 130, 192, 194, 196–198, 200, 204, 206–207, 214, 220, 244

see also Immigrants

Asians/Pacific Islanders, 87, 197, 214, 215

Suggested Citation:"Index." Institute of Medicine. 2001. Tuberculosis in the Workplace. Washington, DC: The National Academies Press. doi: 10.17226/10045.
×

black persons, 87, 196, 197, 204, 210, 215, 219, 220, 244

Hispanics, 87, 196, 197, 215

Puerto Ricans, 196, 197, 219, 252

white persons, 87, 88, 91, 194, 196–197, 198, 200, 215, 219, 220

Radiographs, 25, 30, 37, 38, 39, 83, 86, 95, 98, 102, 311

CDC guidelines, implementation and effects, 115, 124–125, 130, 234, 246, 247, 248, 249, 263, 265

correctional facilities, 130

cost factors, 130

Record keeping, 37

see also Surveillance

CDC guidelines, 64, 65, 68, 72, 109

OSHA rule/standard, 64, 65, 68, 72, 109, 274, 276

skin test results, 29

Regulations and standards, 1, 2, 3–4, 5–6, 7, 9, 16, 43–55, 108, 109, 118, 137–156, 309–310

see also Centers for Disease Control and Prevention (CDC) guidelines;

Centers for Disease Control and

Prevention (CDC) guidelines,

implementation and effects;

Definitional issues;

Enforcement;

Inspection of facilities;

Occupational Safety and Health

Administration;

State governments

accreditation and licensure, 6, 53, 58, 82, 117, 140, 141

American College of Chest Physicians, 57

American Thoracic Society (ATS), 57, 58, 121, 153, 176

cost and cost-effectiveness,

regulations, 2, 10, 45, 63, 137, 138, 140, 142, 144, 281, 282–283, 286, 290

cost and cost-effectiveness,

standards, 2, 10, 49, 50–51, 261–266

Executive Order 11612, 47

Executive Order 12196, 288

Executive Order 12866, 47, 50–51, 281, 283

Executive orders, other, 48, 53, 281

exemptions, 4, 53, 64, 287, 289

litigation, 44–52 (passim), 82, 264, 271, 276, 277–278, 280, 282, 283–286, 288, 289

mine workers, 45, 46, 60

National Advisory Committee on Occupational Safety and Health, 46, 273

National Commission on Correctional Health Care, 58

NIOSH certification of respirators, 8, 19, 20, 46, 77, 79, 118, 119, 122, 145, 254, 295, 296–298, 301, 306

respirators, general, 294

skin tests, 29, 180, 195

treatment, directly observed therapy, 17, 22, 35, 41, 82, 119, 132, 139, 153

treatment observation, state requirements, 41

tuberculin as cure, 180

voluntary standards, 9–10, 54–55, 57, 58, 108, 121, 138, 276

WHO guidelines, 23

Regulatory Flexibility Act, 281

Renal system, see Kidneys

Research methodology, 7, 46, 92–93, 248

see also Epidemiology;

Risk levels and assessment

annual risk of infection (ARI), 193–194

committee study at hand, goals and methodology, 2, 7–9, 16–17, 173–178, 189, 191

controlled studies, 6–7, 20, 122–124

databases, 85, 86–92, 111, 192, 214, 233, 247, 252, 253

literature review, 192–194, 233

mail surveys, 110

OSHA, 272–273

outbreak reports, 96–97, 105, 119–120

time factors, 7, 137, 192

Resistance, see Drug resistance

Respirators, see Personal respiratory protection

Respiratory isolation, see Administrative controls;

Centers for Disease

Control and Prevention (CDC) guidelines;

Isolation policies, rooms, and areas

Respiratory therapists, 94, 206, 215, 259

Rifampin, 35, 40

resistance to, 4, 13, 104

Risk factors, see Risk levels and assessment

Suggested Citation:"Index." Institute of Medicine. 2001. Tuberculosis in the Workplace. Washington, DC: The National Academies Press. doi: 10.17226/10045.
×

Risk levels and assessment, 2, 81–107, 189–229

see also Demographic factors;

Inspection of facilities;

Prevalence;

Surveillance

age factors, 87, 88, 92, 93, 98, 192, 195, 202, 204, 213, 217, 219, 220, 223

annual risk of infection (ARI), 193–194, 195–201, 203–205, 210, 213, 215

CDC guidelines, 2, 64, 66–69, 143, 190–191, 192, 232, 244, 246, 261

CDC studies, 196, 214–216

community at large vs health care workers, risk, 7, 10–11, 16, 81, 83–85, 88–89, 92, 98, 105, 135, 142, 189–191, 192, 194–199, 201, 210, 213, 216, 232, 236

correctional facilities, 81, 89–90, 95, 104, 106, 208, 209–210, 213, 215, 220, 222

definition of risk, 82–83, 193

drug-resistant tuberculosis, 89, 91–92, 96, 98, 103, 191, 201, 209, 222, 223

embalmers, 104, 116

health care workers, 85–86, 88–99, 102, 103, 104, 105–106, 107, 142–144, 189–229

see also “community..." supra

HIV patients, 81, 82, 88, 95, 97–98, 104, 106, 191, 201, 202, 203, 204, 207, 211, 220–221, 222

home care, 81, 103

homeless shelters, 81, 82, 103, 208, 210–211, 222, 223

hospices, 95, 103, 211

hospitals, 52, 81, 82, 86, 93, 94–95, 97–100, 102, 103, 104–105, 106, 199–207, 215, 222, 243

immigrants, 81, 82, 87, 89, 91, 95–96, 99, 107, 192, 195, 199, 201, 202, 204, 214, 215

latent tuberculosis treatment, 35–36

long-term care facilities, 81, 101–103, 222

nurses, 85, 91, 93, 98, 99, 102, 103, 104, 105, 196, 199–206 (passim), 215, 217, 218

nursing homes, 15, 101–102, 104, 208– 209, 213

OSHA rule/standard, 2, 48–50, 52, 64, 66, 68–69, 88, 94–95, 139, 142–144, 148–154, 189, 208, 213–214, 275, 284–286

physicians, 95, 98, 99–101, 105, 204, 206, 215, 217

respirators, 294, 300, 304

respiratory therapists, 94, 206, 215, 259

time factors, 68, 151(n.5), 192, 203, 216, 219, 220, 221, 254

urban areas, 82, 106, 195, 196, 197, 199–200, 201, 202–207, 213, 214, 219

ventilation, 190, 199, 212, 213, 221

Rural areas, 190, 192, 195, 198, 219, 243

S

San Francisco, California, 6, 15, 87, 198, 215, 221

Seattle, Washington, 35, 198, 211, 241, 293

Side effects, drug treatment, 35–36, 150, 179, 222

Silicosis, 28, 91

Skin testing, 22, 23, 25, 28–34, 36, 38(n.13), 93, 156, 180, 186–187, 195, 218–219, 311

accuracy, 30–34, 39, 83, 94, 144, 182– 187, 221

active tuberculosis, 32, 33, 84(n.2)

age factors, 30, 181

American Thoracic Society, 57(n.2)

boostering phenomenon, 33, 185–187

CDC demonstration project, 19, 91–92

CDC guidelines, 3, 29, 30, 33, 57(n.2), 58, 63, 64, 66, 67, 68, 69–70, 71, 142, 183, 232

CDC guidelines, implementation and effects, 109, 111, 113–117 (passim), 124–130 (passim), 144–145, 232–258

(passim)

children, 30

community-level factors, 29, 31

contact tracing and, 29, 30

correctional facilities, 95, 99–101, 114, 115, 117, 215, 311

cost factors, 71, 142, 144, 261–262, 263, 264, 265

dental schools, 113

elderly persons, 30

emergency departments, 130, 260

Suggested Citation:"Index." Institute of Medicine. 2001. Tuberculosis in the Workplace. Washington, DC: The National Academies Press. doi: 10.17226/10045.
×

Food and Drug Administration, 180, 183

friends of patients, 29

funeral home employees, 61, 116

health care facilities, implementation, 30, 62, 93, 94, 102, 117, 120, 124, 125–126, 128, 129, 151–152, 186, 212, 234

health care workers, 19, 29, 30, 32, 36, 91, 93, 94, 103, 115, 124–128

(passim), 192, 215, 216–218, 232–262

(passim), 300, 301, 302, 304

historical perspectives, 179–180, 181

HIV patients, 29, 30, 38(n.13), 127, 311

homeless shelters, 58, 103, 117, 211, 241

hospitals, 30, 62, 93, 94, 102, 117, 120, 124, 125–126, 128, 129, 151–152, 199–207, 215, 231–266 (passim), 300, 301, 302

immigrants, 29, 33, 311

immune response and, 33, 180–183, 185;

see also “HIV patients” supra

infection with tuberculosis defined, 83

long-term care facilities, 30

National Health Survey, 88, 195

nursing homes, 30, 117, 208–209

nutritional factors, 33

organ transplants and, 30

OSHA rule/standard, 29, 64, 68, 71, 142, 144–145, 151–152

overview of, 177, 179–188

physicians, 95, 98, 217

prevalence and, 30, 31, 144, 183, 184– 185, 199–207

public health measures, 32

reading outcomes, 181–182

record keeping, 29

risk assessment, 83, 84(n.2), 88, 91–92, 93–94, 98–99, 102, 107, 194–196, 199–201, 202–207, 209, 211, 212–221

social stigma due to positive, 32, 144

state-level factors, general, 93, 113

students, 62

surveillance and, 29, 33, 34, 83, 144

time factors, 29, 30, 33, 34, 38(n.13), 58, 64, 70, 115, 126, 181, 185–186, 203, 235, 236, 255, 258, 304

vaccines, effects on, 33

Sneezing, 1, 13, 25, 259

Social factors, 43, 104, 311

see also Community-level factors;

Contact tracing;

Family members;

Friends

positive skin tests causing stigma, 32, 144

Social service workers, 115–116

OSHA rule/standard, 60, 61, 208

risk assessment, 98

Society for Healthcare Epidemiology of

America, 112, 176, 242, 243, 253, 302

Society for Occupational and Environmental Health, 239

Socioeconomic status, 81, 85, 91, 93, 107

see also Homeless persons and shelters

hospital personnel, 126, 200, 204

unemployed persons, 7, 15, 43–44, 89, 153–154, 222

South Carolina, 129

Spear, Robert, 293–308

Sputum smears, 25, 37, 38, 41, 72, 73, 112, 124, 125, 126, 234–240 (passim), 246, 247, 248–249, 256, 258, 263, 264, 265

risk assessment, 83, 98, 103, 190, 194, 195, 201, 210

time factors, 256, 264

Standards, see Regulations and standards

State governments, 20, 45–46, 117, 140, 309, 310, 312

accreditation and licensure, 6, 53, 82, 140, 141

control programs, general, 8, 17, 18, 69(n.7), 109

correctional facilities, 53

diagnosis of active tuberculosis, 37

employees of, OSHA rule/standard, 52, 53, 61, 141, 274, 278, 287

funding, 55

historical perspectives, 5, 6, 8, 17, 18

hospitals, regulation of, 53

inspection of facilities, 118–119, 274

legislation, 45–46, 69(n.7), 71–72

OSHA, 52, 53, 61, 71–72, 141, 274, 278

private sector role in rulemaking, 53, 278

public health authorities, CDC

guidelines/OSHA rule/standard, 71–72

Suggested Citation:"Index." Institute of Medicine. 2001. Tuberculosis in the Workplace. Washington, DC: The National Academies Press. doi: 10.17226/10045.
×

treatment observation, 41

worker training, 274

State-level factors, 6, 14–15, 99(n.7), 132, 155, 215

see also specific states

CDC reports of active disease, 86–87

correctional facilities, 100–101, 114, 209

OSHA estimates of prevalence, 88, 150–151

skin tests, 93, 113

St. Louis, Missouri, 198, 205, 206, 250, 266

Stop TB Initiative, 312

Strategic Plan for Tuberculosis Training and Education, 310

Streptomycin, 40

Students

dental, 113, 260–261

medical, 62, 85, 99, 100, 196, 287, 216–217, 259, 287

other, 95–96, 196

Substance abuse, see Drug abuse

Surgical masks, 111, 112, 115, 120, 122, 126, 127, 128, 133, 234, 235, 238, 240, 242, 243, 245, 251–256

(passim), 296, 300, 301, 302, 304

Surgical treatment, 18, 79–80, 95

organ transplants, 30, 95

Surveillance, 11, 81, 86–93, 107, 110–116, 216–219

see also Diagnosis;

Mortality;

Prevalence;

Record keeping

CDC guidelines, 64–65, 109

CDC guidelines, implementation and effects, 129, 133, 153, 236

correctional facilities, 114

federal government surveys and databases, 86–92, 110–115

nursing homes, 102

OSHA rule/standard, 64–65, 109, 274

skin tests, 29, 33, 34, 83, 144

Symptoms, 37–39, 118, 135, 136, 155, 221, 245

CDC definition of active tuberculosis, 83

CDC guidelines, 64, 246

coughing, 1, 13, 25, 26, 37, 103, 131, 190, 245, 246, 259

OSHA rule/standard, 64

sneezing, 1, 13, 25, 259

T

Tennessee, 100

Testing, see Diagnosis;

Skin testing;

Sputum smears

Texas, 6, 113, 209–210

Time factors

autopsies, 98

committee study at hand, 137, 173

contact tracing, 263, 264

correctional facility, length of stay, 115

diagnosed patients, transfer from health care facilities, 73–74

diagnosis, 29, 30, 33, 34, 38–39, 58, 64, 70

drug treatment, 17–18, 22, 34, 35, 36, 40–41, 143(n.l), 155, 302

elimination of tuberculosis, defined, 135(n.8)

emergency department stays, 118

exposure and infection, 26, 98

health care facilities, admission

standards, 4

HIV patients, infection with tuberculosis, 239

hospital employment duration, 126

immigrants, 30, 215

isolation and isolation rooms, 73–74, 75, 76, 130(n.6), 237, 238, 246, 254

OSHA rule/standard, 142, 276, 280, 281

research methodology, 7, 137, 192

respiratory protection, 124, 146–147, 304

risk assessment, 68, 151 (n.5), 192, 203, 216, 219, 220, 221, 254

skin tests, 29, 30, 33, 34, 38(n.13), 58, 64, 70, 115, 126, 181, 185–186, 203, 235, 236, 255, 258, 304

sputum smears, 256, 264

worker benefits following severance, 71

Toilet facilities, see Bathrooms in isolation

rooms

Toxic substances, 57(n.2)

drug toxicity, 222

OSHA, 271, 274, 282, 283, 284–285

Transmission of disease, 25–26, 103, 177, 259

see also Risk levels and assessment

CDC guidelines, 64, 65, 244

Suggested Citation:"Index." Institute of Medicine. 2001. Tuberculosis in the Workplace. Washington, DC: The National Academies Press. doi: 10.17226/10045.
×

coughing, 1, 13, 25, 26, 37, 103, 131, 190, 245, 246, 259

embalming, 26, 61, 104

health care worker knowledge of, 112

milk, 24

OSHA rule/standard, 64, 65

skin test conversion rates and, 186–187

sneezing, 1, 13, 25, 259

Transplants, organs, see Organ transplants

Treatment, see Drug treatment;

Surgical treatment

Tubercules, 27

Tuberculin skin test, see Skin testing

Tubersol, 180

U

Ultraviolet germicidal irradiation (UVGI), 26, 59–60, 203, 230, 232, 238, 241, 245, 250–251, 253, 258, 302, 304

Unemployed persons, 7, 15, 43–44, 89, 153–154, 222

see also Homeless persons and shelters

worker job and financial protections, 70–71

Unfunded Mandates Reform Act, 50, 281, 290

Unions, see Labor unions

United Kingdom, 217

Urban areas, 5, 6, 15, 17, 82, 106, 119, 234, 243, 248

see also Homeless persons and shelters;

specific cities

CDC reports of active disease, 86–87

correctional facilities, 101, 115, 209–210

risk assessment, 82, 106, 195, 196, 197, 199–200, 201, 202–207, 213, 214, 219

UVGI, see Ultraviolet germicidal

irradiation

V

Vaccines, 12, 22, 155, 311, 312

BCG, 33, 126, 128, 130, 183, 202, 219, 220

skin tests and, 33

Ventilation, 11, 23, 26, 103, 125, 304

CDC guidelines, 75, 76, 112, 130–131, 230, 234, 241, 250–258 (passim)

isolation rooms, 11, 60, 75, 76, 121, 130–131, 199, 230, 232, 238, 250, 251, 254, 256–257;

see also

Negative-pressure isolation rooms

nursing homes, 208

OSHA rule/standard, 60, 75, 76

risk assessment, 190, 199, 212, 213, 221

Vermont, 15, 87

Veterans Administration, 101, 102, 176, 246–247

Vietnam, immigrants from, 6, 15, 87

Virgin Islands, 252

Visitors of patients, 23, 40, 56–57, 62, 79, 208, 245, 257

Voluntary standards, 9–10, 54–55, 57, 58, 108, 121, 138, 276

see also Centers for Disease Control and Prevention (CDC) guidelines;

Centers for Disease Control and Prevention (CDC) guidelines,

implementation and effects

WHO guidelines, 23

Volunteers, 54, 62, 278, 287

W

Washington State, 151, 200–201, 208, 214

Weight factors, 28, 37, 245, 265

fit testing, respirators, 298

White persons, 87, 88, 91, 194, 196–197, 198, 200, 215, 219, 220

Woeltje, Keith, 230–270

Workplace hazards, strategies for

reducing, 43–45

World Health Organization (WHO), 22–23, 41, 195

Wyoming, 15

X

X-ray detection, see Radiographs

Z

Zimbabwe, 15

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Before effective treatments were introduced in the 1950s, tuberculosis was a leading cause of death and disability in the United States. Health care workers were at particular risk. Although the occupational risk of tuberculosis has been declining in recent years, this new book from the Institute of Medicine concludes that vigilance in tuberculosis control is still needed in workplaces and communities. Tuberculosis in the Workplace reviews evidence about the effectiveness of control measures—such as those recommended by the Centers for Disease Control and Prevention—intended to prevent transmission of tuberculosis in health care and other workplaces. It discusses whether proposed regulations from the Occupational Safety and Health Administration would likely increase or sustain compliance with effective control measures and would allow adequate flexibility to adapt measures to the degree of risk facing workers.

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