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Niosh tb guidelines.pdf
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Title
NIOSH Recommended Guidelines for Personal Respiratory Protection of Workers in Health-Care Facilities Potentially Exposed to Tuberculosis
Year
1992
Location
Washington D.C.
Source
pdf
Progress
Proofread—All pages of the work proper are proofread, but not all are validated
Transclusion
Fully transcluded
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Contents
Foreword
....................................................................................................................................................................................................................................................
iii
Summary
....................................................................................................................................................................................................................................................
iv
List of Abbreviations
....................................................................................................................................................................................................................................................
viii
Acknowledgments
....................................................................................................................................................................................................................................................
ix
I. Introduction
....................................................................................................................................................................................................................................................
1
A. Current Epidemiology and Control of Tuberculosis
....................................................................................................................................................................................................................................................
1
B. The Mandates to NIOSH in the Occupational Safety and Health Act of 1970
....................................................................................................................................................................................................................................................
4
C. The Principle of Public Health Prudence
....................................................................................................................................................................................................................................................
5
II. Mode of Airborne Transmission and Potential for Worker Exposure
....................................................................................................................................................................................................................................................
6
A. Airborne Transmission of Tubercule Bacilli
....................................................................................................................................................................................................................................................
6
B. Health-Care-Facility Workers' Potential for Exposure to Tuberculosis
....................................................................................................................................................................................................................................................
8
III. Methods for Worker Protection—Controlling Airborne Transmission of Tuberculosis
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10
A. Previous Recommendations for Personal Respiratory Protection
....................................................................................................................................................................................................................................................
10
B. The "Hierarchy of Controls"
....................................................................................................................................................................................................................................................
10
IV. Considerations in the Selection of Respirators
....................................................................................................................................................................................................................................................
16
A. Nature of the Hazard to Workers
....................................................................................................................................................................................................................................................
16
B. Potential Respirator Leakage
....................................................................................................................................................................................................................................................
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C. Hazardous Face-Seal Leakage
....................................................................................................................................................................................................................................................
19
D. Hazardous Leakage Through Filters
....................................................................................................................................................................................................................................................
22
E. Powered, HEPA-Filter Halfmask and Positive-Pressure, Air-Line, Halfmask Respirators
....................................................................................................................................................................................................................................................
23
F. Practical Disadvantages of the Recommended Respirators
....................................................................................................................................................................................................................................................
25
G. Surgical Masks and Other Disposable Particulate Respirators
....................................................................................................................................................................................................................................................
27
V. NIOSH Recommendations for Personal Respiratory Protection
....................................................................................................................................................................................................................................................
31
A. Summary of Conclusions and Recommendations
....................................................................................................................................................................................................................................................
31
B. Identifying Confirmed or Potential Tuberculosis Transmitters in a Health-Care Facility
....................................................................................................................................................................................................................................................
37
C. Selection of Minimal Acceptable Personal Respiratory Protection
....................................................................................................................................................................................................................................................
38
D. Implementing a Personal Respiratory Protection Program
....................................................................................................................................................................................................................................................
42
1. Standard Operating Procedures
....................................................................................................................................................................................................................................................
42
2. Medical Surveillance
....................................................................................................................................................................................................................................................
42
3. Training
....................................................................................................................................................................................................................................................
43
4. Face-Seal Fit Testing and Fit Checking
....................................................................................................................................................................................................................................................
45
5. Respirator Inspection, Cleaning, Maintenance, and Storage
....................................................................................................................................................................................................................................................
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6. Surveillance of the Health-Care Facility and Exposures of Workers in Health-Care-Facilities
....................................................................................................................................................................................................................................................
46
7. Respirator Selection
....................................................................................................................................................................................................................................................
46
8. Pereodic Evaluation of the Personal Respiratory Protection Program
....................................................................................................................................................................................................................................................
47
References
....................................................................................................................................................................................................................................................
48
List of Figures
Figure 1—Example A of a NIOSH-Certified, Powered, HEPA-Filter, Halfmask Respirator
....................................................................................................................................................................................................................................................
34
Figure 2—Example B of a NIOSH-Certified, Powered, HEPA-Filter, Halfmask Respirator
....................................................................................................................................................................................................................................................
35
Figure 3—Example C of a NIOSH-Certified, Powered, HEPA-Filter, Halfmask Respirator
....................................................................................................................................................................................................................................................
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List of Tables
Table 1—Requirements for and Essential Roles of Fit Tests and Fit Checks
....................................................................................................................................................................................................................................................
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Table 2—Summary Comparison of Three Respirator Categories Evaluated for Protection of Health-Care-Facility Workers Potentially Exposed to Tuberculosis
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Table 3—NIOSH Recommendations for Minimal Acceptable Personal Respiratory Protection for Health-Care-Facility Workers Potentially Exposed to Tuberculosis
....................................................................................................................................................................................................................................................
40
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