From: ndallen@r-node.gts.org (Nigel Allen)
Subject: Workplace Tuberculosis
Organization: Echo Beach, Toronto
Date: Tue, 22 Dec 1992 09:00:30 GMT

Here is a press release from the American Federation of State, 
County and Municipal Employees (AFSCME).

 AFSCME Leads Unions In Petition For Workplace Tuberculosis Standard
 To: National Desk, Health Writers
 Contact: Sondra Dimond, 202-429-1130, or
          Jordan Barab, 202-429-1232, both of the American
          Federation of State, County and Municipal Employees

   WASHINGTON, Dec. 21   -- The American Federation of State, 
County and Municipal Employees (AFSCME), AFL-CIO, led 11 other
unions and the AFL-CIO in requesting the immediate issuance of
tuberculosis enforcement guidelines that would enable the
Occupational Safety and Health Administration (OSHA) to inspect
workplaces and enforce strict TB controls in health care and other
workplaces nationwide.
   "We are calling on the Secretary of Labor to take strong and rapid
actions through the Occupational Safety and Health Administration to
protect America's workforce from the return of an old, almost
forgotten killer disease called tuberculosis," said AFSCME
International President Gerald W. McEntee.  "If this nation is to
successfully fight this fatal disease, pressure needs to be put on
public officials to make sure that the caregivers can do their jobs
on the front lines without fear for their own health."
   The unions, representing more than 1 million health care,
criminal justice and other affected workers throughout the country,
called for guidelines to protect workers in high-risk settings from
exposure to tuberculosis through close, repeated, prolonged indoor
contact with the disease.
   "While we realize that this administration's days are numbered,
this is an action that is urgently needed and can be implemented
immediately," said McEntee.  "We fully expect that the Clinton
administration will begin work on a full TB standard soon after
taking office."
   The proposed guidelines, would be based on Centers for Disease
Control (CDC) tuberculosis guidelines issued in 1990 and on already
existing OSHA TB enforcement guidelines issued by OSHA Region II
which covers New York and New England.  California OSHA is working on
a similar document.
   Under the proposed guidelines, employers would be required to
develop a written TB exposure control plan.  In addition, all
employees in covered facilities must be offered a skin test free of
charge, on work time, and at a time and place convenient to the
employees with test results read and analyzed by a trained
professional.
   Employee training would include education in areas including the
signs and symptoms of TB infection as well as the modes of
transmission; the ways of preventing transmission and information on
how to recognize tasks or areas that might increase the risk of
occupational exposure.  Employee education would show the link
between HIV infection and TB and the facility's policy on providing
alternative work assignments to those who may be at increased risk of
acquiring the disease.
   The proposed TB guidelines would also require exposure control
through management for patients, clients or inmates in facilities
such as hospitals, prisons and nursing homes where there are members
of high-risk groups who have a long duration of stay.  Staff should
be trained to identify TB symptoms and instructed to isolate
suspected cases of active TB in homeless shelters, hospital waiting
rooms or other workplaces where infectious persons may collect on an
outpatient, emergency or ambulatory care basis.
   In the event of an outbreak of tuberculosis in a work setting
where standard TB controls and work practices are not required, the
proposed TB standard would require the employer to develop a response
plan that includes the identification and notification of all
potentially exposed individuals; a training and information session
covering the outbreaks and the risk of infection; offer all affected
individuals free TB screening; and implementation of any controls
that can prevent further exposure to the disease.
   The unions called upon OSHA and the Department of Health and Human
Services (HHS) to issue a comprehensive joint notice on protection
against occupational exposure to tuberculosis as soon as possible.
This would form the basis of a nationwide OSHA compliance document to
be effective until the final standard takes effect.
 -30-
--