Notarianni G L
Logan Associates, Inc., Farmington, MI.
J Healthc Mater Manage. 1993 Oct;11(9):28-32.
After a long decline, tuberculosis is making a comeback. Because of this risk, several government agencies have developed in-depth recommendations designed to minimize the transmission of tuberculosis. 1990 CDC guidelines have formed the basis for most current recommendations, but those guidelines are undergoing revision. Great controversy surrounds the recommendations, particularly in the area of respiratory protection. According to NIOSH, the inability to adequately fit-test and fit-check disposable respirators is a major flaw that could compromise their ability to protect the wearer. OSHA has been enforcing guidelines for occupational exposure to TB under several existing standards, especially its respiratory protection standard (29 CFR 1910.134), and is currently enforcing the use of dust/mist/fume respirators. The agency can be expected to issue a National Compliance Directive upgrading required respiratory protection to HEPA filters. The author recommends implementing recommendations for appropriate administrative and engineering controls and using low-maintenance, reusable, half-face elastomeric respirators with disposable filter cartridges for employees in identified high-risk, exposure situations.
在长期减少之后，结核病正在卷土重来。鉴于这种风险，几个政府机构已经制定了深入的建议，旨在尽量减少结核病的传播。1990年美国疾病控制与预防中心（CDC）的指南构成了当前大多数建议的基础，但这些指南正在修订中。这些建议引发了巨大争议，尤其是在呼吸防护领域。根据美国国家职业安全与健康研究所（NIOSH）的说法，无法对一次性呼吸器进行充分的适合性测试和佩戴检查是一个重大缺陷，这可能会损害其保护佩戴者的能力。美国职业安全与健康管理局（OSHA）一直在根据几项现有标准，特别是其呼吸防护标准（29 CFR 1910.134），对职业接触结核病的情况执行相关指南，目前正在强制要求使用防尘/防雾/防毒呼吸器。预计该机构将发布一项全国合规指令，将所需的呼吸防护升级为高效空气过滤器（HEPA）。作者建议实施关于适当行政和工程控制的建议，并为确定处于高风险暴露情况的员工使用低维护、可重复使用的半面罩弹性体呼吸器和一次性滤盒。
