OSHA`s federal initiative against TB likely to use cleanroom components
By Myron Struck
Washington, DC — Tuberculosis has taken a beating from modern health care measures over the decades, leaving only the most vulnerable individuals in the population highly at risk. But the at-risk population is fast including not only an estimated 13 million infected poor, sick, aged and homeless — the traditional victims — but also an increasing number of the nation`s health care workers, according to the Occupational Safety and Health Administration (OSHA).
As a result, the federal government is poised to step in over the next several years and cleanroom component manufacturers may find a growing niche market that could mean hundreds of millions of dollars for the companies that provide engineering, component use, and monitoring measures, ac cording to an October announ ce ment of the proposed rulemaking in the Federal Register.
Greg Watchman, acting as sistant Secretary of Labor and the head of OSHA, says in the Federal Register Notice that the goal is to reduce occupational risk.
“OSHA is proposing a standard that would require employers to protect TB-exposed em ployees by means of infection pre vention and control measures that have been demonstrated to be highly effective in re ducing or eliminating job-related TB infections,” Watchman says. “These measures include the use of respirators when performing certain high hazard procedures on infectious individuals, procedures for the early identification and treatment of TB infection, isolation of individuals with infectious TB in rooms designed to protect those in the vicinity of the room from contact with the microorganisms causing TB, and medical follow-up for occupationally exposed workers who become infected.”
Medical research by the Centers for Disease Control and Prevention in Atlanta shows that the number of TB cases is on the rise after a 40-year decline. Over the past five years, infection rates are up 20.1 percent, the research shows. While the overall numbers are small from a medical viewpoint, the analysis shows that the bulk of the increased infections of the communicable disease are in the workplace environment, in institutional settings such as medical research facilities and laboratories, hospitals and even doctors` offices.
Beginning in February, OSHA plans to launch informal hearings to determine the scope of the problem and focus on the range of solutions it outlined in the proposed rule. These solutions include the use of respirators and isolation rooms to limit, or prevent, the transport of infections, especially of the particularly lethal drug-resistant strain mycobacterium tuberculosis.
Under the proposed rule, employees within a facility who are transporting any unmasked individuals with suspected or confirmed infectious TB would be required to wear respirators to filter out airborne contaminants. TB is communicable through airborne particles and is usually inhaled. It is often spread when infected individuals cough, sneeze, sing or speak.
The number of TB cases, like many lethal diseases in modern society, had been on the wane. From 1953 to 1984, due to the use of new medication and increased awareness of how the infection can be communicated, the number of cases fell from 84,304 to 22,255. However, since then, OSHA reports the numbers have risen to 26,673.
OSHA`s rule specifically calls for public investigation of at least 31 specific work-place related issues, including:
An assessment of the types of respirators now used to protect workers against occupational exposure.
An evaluation of respirator usage rates.
An examination of how respirators can be reused and still be maintained in proper working condition.
Areas that are most likely to use cleanroom components are in medical or research laboratories. In these institutional settings, the government is calling for stricter industrial anti-contamination measures. These measures will enforce negative air pressure in rooms and ensure that biosafety cabinets do not leak contaminated materials.
The mitigation measures cover engineering controls, work practice issues, respiratory protection, medical surveillance, signs and labels, and enhanced recordkeeping.
The price tag on the government program is stiff — at least $245.3 million in the first year. Respiratory protection measures are expected to cost $45.8 million, with an expected expenditure of $22.5 million on engineering controls and another $12.9 million on exposure controls.