Enforcement Procedures and Scheduling for Occupational Exposure to Tuberculosis

Source: U.S. Department of Labor, Occupational Safety and Health Administration (OSHA), Directive Number: CPL 02-02-078, June 30, 2015

This Instruction provides general enforcement policies and procedures to be followed when conducting inspections and issuing citations related to occupational exposure to tuberculosis (TB).

This Instruction supersedes CPL 02-00-106, Enforcement Procedures and Scheduling for Occupational Exposure to Tuberculosis (February 9, 1996), which reflected guidance from a 1994 report of the Centers for Disease Control and Prevention (CDC), “Guidelines for Preventing the Transmission of Mycobacterium tuberculosis in HealthCare Facilities (1994).” This Instruction reflects guidance from the updated CDC report: “Guidelines for Preventing the Transmission of Mycobacterium tuberculosis in HealthCare Settings, 2005.” And this Instruction provides information concerning OSHA’s general enforcement policy and procedures for conducting inspections and issuing citations related to occupational tuberculosis (TB) hazards.

Significant Changes:
This Instruction explicitly covers additional workplaces regarded as healthcare settings, e.g., settings in which emergency medical services are provided, and laboratories handling clinical specimens that may contain M. tuberculosis. This Instruction uses the term “tuberculin skin test” (TST) instead of “purified protein derivative test” (PPD). This Instruction also introduces a newer screening method: the blood analysis for M. tuberculosis (BAMT). This Instruction uses the following risk classifications for healthcare settings: low, medium, and potential ongoing transmission. Also, in some scenarios this Instruction calls for less frequent TB screening for workers.