# NIOSH Recommended Guidelines for Personal Respiratory Protection of Workers in Health-Care Facilities Potentially Exposed to Tuberculosis/Table 3

Table 3—NIOSH Recommendations for Minimal Acceptable Personal Respiratory Protection for Health-Care-Facility Workers Potentially Exposed to Tuberculosis
These recommendations are indicated for workers in areas where confirmed or potential tuberculosis transmitters are present (see note 1). These recommendations are also indicated for any clinical and laboratory areas where effective infectious-source controls are not in use and certain procedures that could produce hazardous airborne material are performed on: (A) confirmed or potential tuberculosis transmitters or (B) tissue or fluids that could contain tubercle bacilli.
WARNING—These respirators help protect against airborne tuberculosis transmission by reducing the inhaled concentrations. Failure to follow all instructions and limitations on the use of these respirators and/or failure to wear them during all times of exposure can reduce respirator effectiveness and may result in tuberculosis infection and possible death.
No respirator is capable of assuring that all droplet nuclei are prevented from entering the wearer's breathing zone. Misuse of these respirators will increase the risk of inhaling airborne tubercle bacilli and may cause tuberculosis infection and possible death. For this reason, proper training in the use of these respirators is essential in order for the wearer to receive protection (56).
Without an effective respiratory-protection program, respirator wearers are not likely to receive the protection that can be afforded by their respirator, even if it is a correct choice for the situation. As a minimum, compliance with OSHA regulation 29 CFR 1910.134 for occupational respirator use is essential whenever respirators are used by employees, whether required or on a voluntary basis.
Table 3 (continued)—NIOSH Recommendations for Minimal Acceptable Personal Respiratory Protection for Health-Care-Facility Workers Potentially Exposed to Tuberculosis
| Potential for Aerosolization of Droplet Nuclei | Locations and Procedures Where Confirmed or Potential Tuberculosis Transmitters Are Present or Potentially Present (see note 1) | Minimal Acceptable Personal Respiratory Protection |
| High | Administration of aerosolized pentamidine (and other aerosols) Any cough-inducing procedure Autopsy rooms, aerosol-generating procedures (e.g., irrigating, sawing) Bronchoscopy procedures Endotracheal intubation/suctioning procedures Sputum induction | POSITIVE PRESSURE, AIRLINE, HALFMASK RESPIRATORS USED IN CONJUNCTION WITH AN EFFECTIVE RESPIRATORY PROTECTION PROGRAM |
| Medium | AFB isolation rooms Intensive-care units, routine procedures Laboratories (see note 2) Non-cough-inducting procedures Operating rooms | POWERED, HEPA-FILTER, HALFMASK RESPIRATORS USED IN CONJUNCTION WITH AN EFFECTIVE RESPIRATORY PROTECTION PROGRAM |
| Indeterminant (see note 3) | Admitting areas Emergency rooms (including waiting areas) Hallways Transport of patients Waiting areas (inpatient and outpatient) | POSSIBILITY OF EXPOSURE  POWERED, HEPA-FILTER, HALFMASK RESPIRATORS USED IN CONJUNCTION WITH AN EFFECTIVE RESPIRATORY PROTECTION PROGRAM |
| Indeterminant (see note 3) | Admitting areas Emergency rooms (including waiting areas) Hallways Transport of patients Waiting areas (inpatient and outpatient) | NO POSSIBILITY OF EXPOSURE NO RESPIRATOR NEEDED |
Note 1—As identified with an Admission Screening Plan as discussed in section V.B starting on page 37. Note 2—Respirators are not indicated when effective infectious-source controls are in use such as given in (44). Note 3—Whether or not there is a risk depends on whether or not there is a possibility of exposure to a person with infectious tuberculosis.