McDiarmid M, Gamponia M J, Ryan M A, Hirshon J M, Gillen N A, Cox M
Department of Labor and Occupational Safety and Health Administration, Washington, DC 20210.
Infect Control Hosp Epidemiol. 1996 Mar;17(3):159-64. doi: 10.1086/647263.
Inspections of 272 facilities were performed between May 1992 and October 1994 to determine compliance with applicable Occupational Safety and Health Administration (OSHA) requirements for prevention of tuberculosis (TB) transmission.
Retrospective record review of two data sources: (1) OSHA's Computerized Integrated Management Information System and (2) an inspector-completed questionnaire on inspection results.
SETTING/PARTICIPANTS: Inspections of five types of facilities: healthcare institutions, correctional facilities, homeless shelters, long-term-care facilities for the elderly, and others, including drug treatment centers that the Centers for Disease Control and Prevention (CDC) identified as having a higher than expected rate of TB.
The OSHA Compliance Memorandum, based on the 1990 CDC Guidelines, which outlined elements of a TB prevention program, was used in performing 272 inspections of facilities between May 1992 and October 1994. Elements of compliance were recorded and reviewed from the IMIS database and inspectors' questionnaires.
Regulated facilities were not fully compliant with OSHA guidance. Generally, healthcare facilities performed better than other facilities. Most facilities (79%) were compliant with administrative elements of a comprehensive TB control program, such as early identification of known or suspected infectious TB patients and skin testing of workers. Only 29% of inspected facilities were found to have acceptable respiratory protection programs for the prevention of occupational TB.
Facilities have not been fully compliant with the OSHA memorandum describing protection of workers from TB. Facility compliance was better with some traditionally recognized TB infection control elements, but was weaker in the area of respiratory protection programs. This may reflect a lack of familiarity with the latter type of hazard protection.
在1992年5月至1994年10月期间对272家机构进行检查，以确定其是否符合职业安全与健康管理局（OSHA）预防结核病（TB）传播的适用要求。
对两个数据源进行回顾性记录审查：（1）OSHA的计算机综合管理信息系统，以及（2）检查员填写的关于检查结果的问卷。
地点/参与者：对五类机构进行检查：医疗机构、惩教机构、无家可归者收容所、老年人长期护理机构，以及其他机构，包括疾病控制与预防中心（CDC）认定结核病发病率高于预期的戒毒治疗中心。
根据1990年CDC指南制定的OSHA合规备忘录概述了结核病预防计划的要素，在1992年5月至1994年10月期间对272家机构进行检查时使用该备忘录。从IMIS数据库和检查员问卷中记录并审查合规要素。
受监管机构未完全遵守OSHA指南。总体而言，医疗机构的表现优于其他机构。大多数机构（79%）符合全面结核病控制计划的管理要素，如早期识别已知或疑似传染性结核病患者以及对工作人员进行皮肤测试。在接受检查的机构中，只有29%被发现有可接受的预防职业性结核病的呼吸防护计划。
各机构尚未完全遵守描述保护工作人员免受结核病感染的OSHA备忘录。在一些传统认可的结核病感染控制要素方面，机构的合规情况较好，但在呼吸防护计划方面则较弱。这可能反映出对后一种危害防护缺乏了解。
