Infection Prevention Manual

EXPOSURE CONTROL PLAN SPECIFIC OSHA STANDARDS APPLICATION Hierarchy of Controls--Employers must implement the CDC and OSHA policy of requiring a hierarchy of controls and good industrial hygiene practice which dictate that engineering and work practice controls be used wherever possible to eliminate or reduce the hazard at its source. When it is not possible to prevent employee exposure to the hazard through engineering controls, administrative and/or work practice controls must be employed. Lastly, personal protective equipment must be used to protect the employee. Respirators--The use of National Institute for Occupational Safety andHealth (NIOSH)-approved high efficiency particulate air (HEPA) respirators is a minimum level of respiratory protection when employees perform high hazard procedures, enter isolation rooms housing individuals who may have tuberculosis or transporting such individuals in a closed vehicle, whenever respirator use is indicated, a complete respirator protection program must be in place. Warnings must be posted outside a respiratory isolation room, stating special respiratory isolation or 'AFB Isolation.' The warnings must say what precautions are required. Records of employee exposures to TB, skin tests, and medical evaluations and treatment must be kept. Tuberculosis infections (positive Mantoux skin tests) and tuberculosis disease are both recordable illnesses in the high-risk facilities identified by the CDC.