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HHE Search Results
62 HHE reports were found based on your search terms. Reports are listed in order of year published with the most recently published reports listed first.
Year Published and Title
(2004) City of Altus Police Department and Jail, Altus, Oklahoma. (Click to open report) On February 27, 2002, the National Institute for Occupational Safety and Health (NIOSH) received a request from the City of Altus to conduct a Health Hazard Evaluation (HHE) at the City of Altus Police Department (PD) and jail, Altus, Oklahoma. The request concerned potential occupational exposure to Mycobacterium tuberculosis (M. tuberculosis) among employees having contact with a prisoner with infectious tuberculosis (TB) who was incarcerated in the Altus city jail during June 2001. NIOSH resp... (Click to show more)On February 27, 2002, the National Institute for Occupational Safety and Health (NIOSH) received a request from the City of Altus to conduct a Health Hazard Evaluation (HHE) at the City of Altus Police Department (PD) and jail, Altus, Oklahoma. The request concerned potential occupational exposure to Mycobacterium tuberculosis (M. tuberculosis) among employees having contact with a prisoner with infectious tuberculosis (TB) who was incarcerated in the Altus city jail during June 2001. NIOSH responded to the request by conducting a site visit in March 2002. This site visit consisted of confidential medical interviews with staff and employees of the Altus PD and jail, a review of tuberculin skin test (TST) records, and a formal ventilation assessment of the work site. At the time of the site visit, 63 persons were employed by the Altus PD and jail. Fifty-eight (of the 63) were working at the Altus PD and jail between June 4, 2001, and June 25, 2001, the period of incarceration of the infected prisoner. All 58 were considered to be potentially exposed to the prisoner (index case). Approximately two months after the release of the index case from the Altus PD jail (and one month after it became known that the index case had active TB disease), the Jackson County Health Department (JCHD) undertook comprehensive TST screening of the employees of the Altus PD and jail. The only employees excluded from testing were those known to be previously TST positive. A total of 55 employees participated in tuberculin skin testing in August 2001. Twelve persons were identified by the JCHD as having TST readings greater than or equal to (=) 5 millimeters (mm) induration; 4 of 12 (33%) were documented skin test conversions. One employee was diagnosed as having active TB disease. Three months later, in November 2001, 39 employees participated in tuberculin skin testing. At this time, 9 employees were identified as newly TST positive; 3 of 9 (33%) were documented skin test conversions. All nine TST positive employees underwent chest radiography; none were identified as having active TB disease. In January 2002, 5 employees were tested and 1 was identified as newly TST positive. In March 2002, 30 employees who had remained TST negative were tested; 2 were identified as being TST converters at that time. The ventilation assessment conducted by NIOSH investigators revealed that at the time of the site visit, no outdoor air was being supplied to the building through any of the existing heating, ventilation, and air conditioning (HVAC) systems. Coupled with an insufficient fresh air supply, the air within the PD and jail was not being properly vented outside the building. Given the design and operation of the ventilation system in place at the time of this HHE, there were no areas within the building that would have provided adequate isolation for an inmate with infectious TB. NIOSH investigators have determined that there was a health hazard present to the employees and staff of the Altus City PD and jail in 2001 due to occupational exposure to an inmate with unidentified active tuberculosis. The number of employees who developed TB infection as a result of this exposure cannot be completely characterized due to insufficient TST data. Recommendations are included in this report to establish a TB control plan for the City of Altus PD and jail and to make needed renovations to the building's ventilation system.
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(2000) Hawaii State Department of Health, Honolulu, Hawaii. (Click to open report) In December 1999, at the request of the Hawaii State Department of Health (HDOH), National Institute for Occupational Safety and Health (NIOSH) personnel visited the Lanakila Health Center Tuberculosis (TB) Clinic in Honolulu, Hawaii, to evaluate their TB prevention program and review proposed design changes intended to make this a model clinic. The NIOSH evaluation included a ventilation assessment, measurement of ultraviolet (UV) radiation emitted by germicidal lamps, respirator fit testing, a... (Click to show more)In December 1999, at the request of the Hawaii State Department of Health (HDOH), National Institute for Occupational Safety and Health (NIOSH) personnel visited the Lanakila Health Center Tuberculosis (TB) Clinic in Honolulu, Hawaii, to evaluate their TB prevention program and review proposed design changes intended to make this a model clinic. The NIOSH evaluation included a ventilation assessment, measurement of ultraviolet (UV) radiation emitted by germicidal lamps, respirator fit testing, a review of proposed ventilation and clinic layout changes, a review of the employee tuberculin skin test (TST) data, and employee interviews. Design changes to the sputum rooms, waiting areas, and reception areas were evaluated. Changes made in the main waiting area were effective in moving air from a "clean" to "less clean" area, minimizing employee exposures to infectious droplet nuclei. Changes to the sputum rooms were not sufficient because the rooms were not maintained under negative pressure. However, reports of work performed subsequent to the NIOSH visit indicate that the sputum rooms now meet applicable guidelines. The UV radiation measurements indicated that under usual conditions, employees would not be exposed to UV radiation in excess of occupational exposure limits. Several employees did not achieve an acceptable fit with the available respirators. Forty-three of the 44 employees had at least one documented TST in the clinic's database. Twenty (47%) had reactions documented at >/=10 millimeters (mm) in size, considered "positive" according to HDOH policy. However, only eight of these positive employees had a documented prior negative TST, and five of those eight had only two documented TSTs and were positive on their second test, making it possible that the "positive" test could have been due to a booster effect. Two of the other three positive employees had complicated TST histories, making their results difficult to interpret. The final positive employee had two negative (0 mm) tests and then one test with a reaction of 10 mm. This indicated that the employee was most likely a true converter. Numerous environmental and programmatic changes have been made at the Lanakila Health Center TB Clinic to improve TB prevention efforts. Future renovation efforts should include separating areas where individuals with known or suspected infectious TB are seen or evaluated from areas of general TST screening, and the provision of a sufficient number of negative pressure rooms for exams and interviews with clients. To improve the capabilities of the HDOH to assess TST conversion rates in employees, it would be helpful to document baseline two-step TSTs in all employees at the time they are hired, and then to provide periodic TSTs to the employees with negative tests. Recommendations addressing these issues are included in this report.
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(2000) U.S. Silica - Columbia, Cayce - W. Columbia, SC. (Click to open report) In July 1991, the National Institute for Occupational Safety and Health (NIOSH) received a request for technical assistance from the Mine Safety and Health Administration (MSHA) to estimate the prevalence of silicosis among active and retired miners at U.S. Silica Company's Columbia plant, in Cayce-W. Columbia, South Carolina. Current and former workers with one year or greater cumulative tenure since 1970 in the grinding area of the mill or in areas downstream (by material processing) of the g... (Click to show more)In July 1991, the National Institute for Occupational Safety and Health (NIOSH) received a request for technical assistance from the Mine Safety and Health Administration (MSHA) to estimate the prevalence of silicosis among active and retired miners at U.S. Silica Company's Columbia plant, in Cayce-W. Columbia, South Carolina. Current and former workers with one year or greater cumulative tenure since 1970 in the grinding area of the mill or in areas downstream (by material processing) of the grinding process represented the population of primary interest. On February 24-25, 1994, a medical evaluation of current workers was conducted. Former workers were tested on February 26-27, 1994. The medical evaluation included a questionnaire, spirometry, and a single view posterior-anterior(P A) chest x-ray. Chest x-rays were independently classified according to the 1980 International Labour Office (ILO) system by three NIOSH-certified B readers who were unaware of the participant's age, occupation, occupational exposure, smoking history, or any identifying information. For the purposes of this evaluation, silicosis was defined on the basis of a chest x-ray with median small opacity profusion classification of category 1/0 or greater. Thirty-five (90%) of 39 current workers and 11 (65%) of 17 former workers who met the study criterion participated in the NIOSH medical evaluation. Of these 46, four (9%) had a chest x-ray consistent with silicosis. The highest median ILO profusion category was 2/2. Two of the four had a chest x-ray consistent with progressive massive fibrosis (PMF). Twelve (27%) of the 45 participants who performed spirometry had abnormal patterns; all 12 exhibited an obstructive lung pattern. Abnormal spirometry patterns were present in all four of the participants with a positive chest x-ray. U.S. Silica's medical monitoring included all of the screening tests recommended by the National Industrial Sand Association (NISA) as well as those recommended by NIOSH for workers exposed to ground silica. NISA's current guidelines also, recommend multiple readings of all, chest x-rays with a small opacity profusion, classification of 1/0 or greater and 5-10% of those chest x-rays classified as 0//l, based on a single reading. Since 1990, the company reportedly sent chest x-rays initially classified 1/0 or greater by a single reader for additional classifications. Of the company records we reviewed, chest x-rays initially classified as negative (0/0 and 0/1) were not routinely sent for additional readings, and the practice of sending chest x-rays classified 1/0 or greater for additional readings was not consistent. Four (9%) of the 46 survey participants who met the study criterion were found to have chest x-ray findings consistent with silicosis. These results are consistent with patterns of crystalline silica dust exposure at this facility. There were no cases of silicosis among current or former workers with 15 or less years of employment; however, because of the long latency usually associated with chronic silicosis, this finding is not sufficient to conclude that current crystalline silica dust exposure levels are without adverse effect. The company medical monitoring practice of obtaining additional B reader classifications of those chest x-rays initially classified 1/0 or greater may produce an estimated prevalence no higher than and possibly lower than that obtained with a single reading, and those workers with a positive chest x-ray whose chest x-rays are initially read as 0/0 or 0/1 will not be identified. Recommendations are presented in this report and include obtaining at least two readings of all chest x-rays regardless of the initial small opacity profusion classification, increasing the frequency of medical monitoring examinations and modification of the baseline and routine examinations to include skin testing for tuberculosis (TB).
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(2000) U.S. Silica Company, Berkeley Springs, Berkeley Springs, West Virgina. (Click to open report) In July 1991, the National Institute for Occupational Safety and Health (NIOSH) received a request for technical assistance from the Mine Safety and Health Administration (MSHA) to estimate the prevalence of silicosis among active and retired miners at US. Silica Company's Berkeley Springs plant, in Berkeley Springs, West Virginia Current and former workers with one year or greater cumulative tenure since 1970 in the grinding area or the mill or in areas downstream (by material processing) of th... (Click to show more)In July 1991, the National Institute for Occupational Safety and Health (NIOSH) received a request for technical assistance from the Mine Safety and Health Administration (MSHA) to estimate the prevalence of silicosis among active and retired miners at US. Silica Company's Berkeley Springs plant, in Berkeley Springs, West Virginia Current and former workers with one year or greater cumulative tenure since 1970 in the grinding area or the mill or in areas downstream (by material processing) of the grinding process represented the population of primary interest. On June 14-17,1993, a medical evaluation of current workers was conducted. Former workers were tested on June 18,1993. The medical evaluation included a questionnaire, spirometry and a single view posterior/anterior (PA) chest x-ray. Chest x-rays were independently classified according to the 1980 International Labour Office (ILO) system by three NIOSH-certified B readers who were unaware of the participant's age, occupation, occupational exposure, smoking history, or any identifying information. For the purposes of this evaluation, silicosis was defined on the basis of a chest x-ray with median small opacity profusion classification of category 1/0 or greater. Fifty-four (89%) of 61current workers and 13 (41%) of 32 former workers who met the study criterion participated in the NIOSH medical evaluation. Of these 67, seven (10%)) had a chest x-ray consistent with silicosis. The highest median ILO profusion category was 2/2. Two of the seven had a chest x-ray consistent with progressive massive fibrosis (PMF), with "B" size large opacities (based on the median of the three readings). Nineteen (28'%) of the 67 participants who performed spirometry had abnormal patterns; 13 (68'%) of the 19 exhibited an obstructive pattern, four (21%) exhibited a restrictive pattern, and two exhibited a combined restrictive and obstructive pattern. An abnormal spirometry pattern was present in four of the seven participants with a positive chest x-ray. US. Silica's medical monitoring includes all of the screening tests recommended by the National Industrial Sand Association (NISA) as well as those recommended by NIOSH for workers exposed to ground silica. NISA's current guidelines also recommend multiple readings of all chest x-rays with a small opacity profusion classification of 1/0 or greater and 5-10% of those chest x-rays classified as 0/1 based on a single reading. Since 1990, due company reportedly seat chest x-rays initially classified 110 or greater by a single reader for additional classifications of the company records we reviewed, company chest x-rays initially classified as negative (0/0 and 0/1) were not routinely sent for additional readings. Seven (10'%) of the 67 survey participants who met the study criterion were found to have chest x-ray findings consistent with silicosis. These results are consistent with patterns of crystalline silica dust exposure at this facility. There were no cases of silicosis among current or former workers with 15 or less years of tenure; however, because of the long latency usually associated with chronic silicosis, this finding is not sufficient to conclude that current crystalline silica dust exposure levels are without adverse effect. The company medical monitoring practice of obtaining additional B reader classifications of those chest x-rays initially classified 1/0 or greater may produce an estimated prevalence no higher than and possibly lower than that obtained with a single reading, and those workers with a positive chest x-ray whose chest x-rays are initially read as 0/0 or 0/1 will not be identified. Recommendations are presented in this report and include obtaining at least two readings of all chest x-rays regardless of the initial small opacity profusion classification, increasing the frequency of medical monitoring examinations, and modification if the baseline and routine examinations to include skin testing for tuberculosis (TB).
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(2000) United States Department of Agriculture, Animal and Plant Health Inspection Service, Riverdale, Maryland. (Click to open report) In response to a September 1998 request from the United States Department of Agriculture, Animal and Plant Health Inspection Service (USDA/APHIS), a health hazard evaluation was conducted to assess potential zoonotic disease hazards encountered during animal welfare inspections. During the period January 25 to March 24, 1999, site visits were made to 16 facilities in the Eastern and Western regions to observe animal welfare inspections at businesses licensed by or registered with USDA. The busin... (Click to show more)In response to a September 1998 request from the United States Department of Agriculture, Animal and Plant Health Inspection Service (USDA/APHIS), a health hazard evaluation was conducted to assess potential zoonotic disease hazards encountered during animal welfare inspections. During the period January 25 to March 24, 1999, site visits were made to 16 facilities in the Eastern and Western regions to observe animal welfare inspections at businesses licensed by or registered with USDA. The businesses visited included research facilities, animal dealers, exhibitors, and breeders. National Institute for Occupational Safety and Health (NIOSH) investigators observed work practices, personal protective equipment use, and the extent and duration of contact with the animals during the inspections. Interviews were conducted with inspectors and other APHIS personnel, and various health and safety documents were reviewed. The inspections revealed a wide variation in environmental conditions and potential zoonotic disease hazards at these facilities. There was potential for exposure to infectious materials via mucous membrane contact, airborne exposure, direct contact (bites, scratches) and indirect contact. Contact with nonhuman primates was of greatest concern to the inspectors because of the similarities in pathogen susceptibility and the potential for acquiring medically important infections such as tuberculosis (TB) and B Virus. Efforts were generally made by the inspectors to maintain a safe distance from the animals when possible; in some cases inspections were conducted outdoors or from behind a clear barrier. However, at several facilities the inspectors encountered hidden hazards (such as unrestrained animals), poor environmental conditions (such as inadequate lighting or insufficient caging materials), or the presence of undisclosed animals. While baseline serum samples are collected from some USDA employees at the time of employment for evidence of prior brucellosis or psittacosis infection, the extent of participation by animal welfare inspectors was not known. Routine tuberculin skin testing for TB (either annually or semiannually) is required for all animal welfare inspectors, but sufficient information could not be obtained to determine TB infection or conversion rates, or to evaluate whether the tests had been conducted and interpreted according to current Centers for Disease Control and Prevention (CDC) guidelines. Illness and injury logs revealed nonspecific information on infectious diseases reported among APHIS personnel. APHIS employees may be exposed to zoonotic agents during animal welfare inspections. Improved prevention efforts to eliminate or minimize such exposures are needed. Because engineering controls are not often available at the inspected facilities, inspectors must rely primarily on administrative and work practice controls and, secondarily, on the use of personal protective equipment to minimize exposures. Available medical surveillance data were too limited to fully evaluate the risk of infection and effectiveness of current prevention efforts. Recommendations are made in the report to strengthen the zoonotic disease prevention program for animal welfare inspectors.
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(1999) Grady Memorial Hospital, Atlanta, Georgia. (Click to open report) On April 16, 1992, the National Institute for Occupational Safety and Health (NIOSH) received a request from the American Federation of State, County, and Municipal Employees (AFSCME) for a Health Hazard Evaluation (HHE) at Grady Memorial Hospital (GMH) in Atlanta, Georgia. The request concerned the risk of transmission of Mycobacterium tuberculosis (MTB) to hospital workers. Additionally, the hospital requested NIOSH assistance in evaluating aerosol control and containment efforts (i.e., fan sy... (Click to show more)On April 16, 1992, the National Institute for Occupational Safety and Health (NIOSH) received a request from the American Federation of State, County, and Municipal Employees (AFSCME) for a Health Hazard Evaluation (HHE) at Grady Memorial Hospital (GMH) in Atlanta, Georgia. The request concerned the risk of transmission of Mycobacterium tuberculosis (MTB) to hospital workers. Additionally, the hospital requested NIOSH assistance in evaluating aerosol control and containment efforts (i.e., fan systems in patient rooms, new isolation rooms) to reduce the potential for nosocomial MTB infection. In response to these requests, NIOSH investigators conducted numerous site visits to GMH throughout the fall and winter of 1992, and spring of 1993. Information from the evaluation of the hospital environment is described in letters sent to hospital management and union representatives. These letters are included as Appendices to this report. The remainder of this report focuses on the epidemiologic study of the risk of MTB transmission (as defined by tuberculin skin test (TST) conversions) among hospital workers with 'patient contact' compared to workers with 'no patient contact'. This information was described in a letter that was sent to the hospital and union in February 1998.
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(1999) Stericycle facility, Loma Linda, California. (Click to open report) In October, 1998, NIOSH investigators reported the potential for occupational transmission of Mtb and bloodborne pathogens to workers at the Stericycle medical waste processing facility in Morton, Washington. Because there was a Stericycle facility in Loma Linda, California which operated a waste treatment process similar to the one at the Stericycle facility in Morton, Washington, the Occupational Health Branch of the California Department of Health Services (OHBCDH) representatives requested ... (Click to show more)In October, 1998, NIOSH investigators reported the potential for occupational transmission of Mtb and bloodborne pathogens to workers at the Stericycle medical waste processing facility in Morton, Washington. Because there was a Stericycle facility in Loma Linda, California which operated a waste treatment process similar to the one at the Stericycle facility in Morton, Washington, the Occupational Health Branch of the California Department of Health Services (OHBCDH) representatives requested the help of NIOSH to evaluate similar types of exposures at the Loma Linda facility. This letter summarizes the health hazard evaluation (HHE) conducted by the National Institute for Occupational Safety and Health (NIOSH) at the Stericycle facility in Loma Linda, California. NIOSH investigated the potential for Mycobacterium tuberculosis (Mtb) and bloodborne pathogen (hepatitis B, hepatitis C and the human immunodeficiency virus) transmission to employees from their exposure to medical waste.
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(1999) U.S. Silica Company, Mill Creek Plant, Mill Creek, Oklahoma. (Click to open report) In July 1991, the National Institute for Occupational Safety and Health (NIOSH) received a request for technical assistance from the Mine Safety and Health Administration (MSHA) to estimate the prevalence of silicosis among active and retired miners at U.S. Silica Company's Mill Creek plant, in Mill Creek, Oklahoma. Current and former workers with one year or greater cumulative tenure since 1970 in the grinding area of the mill or in areas downstream (by material processing) of the grinding pro... (Click to show more)In July 1991, the National Institute for Occupational Safety and Health (NIOSH) received a request for technical assistance from the Mine Safety and Health Administration (MSHA) to estimate the prevalence of silicosis among active and retired miners at U.S. Silica Company's Mill Creek plant, in Mill Creek, Oklahoma. Current and former workers with one year or greater cumulative tenure since 1970 in the grinding area of the mill or in areas downstream (by material processing) of the grinding process represented the population of primary interest. On August 10-12, 1993, a medical evaluation of current workers was conducted. Former workers were tested on August 13-14, 1993. The medical evaluation included a questionnaire, spirometry, and a single view posterior-anterior (PA) chest x-ray. Chest x-rays were independently classified according to the 1980 International Labour Office (ILO) system by three NIOSH-certified B readers who were unaware of the participant's age, occupation, occupational exposure, smoking history, or any identifying information. For the purposes of this evaluation, silicosis was defined on the basis of a chest x-ray with median small opacity profusion classification of category 1/0 or greater. Twenty-nine (57%) of 51 current workers and 20 (33%) of 61 former workers who met the study criterion participated in the NIOSH medical evaluation. Of these 49, five (10%) had a chest x-ray consistent with silicosis. The highest median ILO profusion category was 22. One of the five had a chest x-ray consistent with progressive massive fibrosis (PMF), with "B" size large opacities as classified by all three readers. Four (9%) of the 46 participants who performed spirometry had abnormal patterns; three exhibited an obstructive lung pattern and one exhibited a combined restrictive and obstructive pattern. An abnormal spirometry pattern was present in one of the five participants with a positive chest x-ray. U.S. Silica's medical monitoring includes all of the screening tests recommended by the National Industrial Sand Association (VISA) as well as those recommended by NIOSH for workers exposed to ground silica. NISA's current guidelines also recommend multiple ''readings of all chest x-rays with a small opacity profusion classification of I/0 or greater and 5-10% of those chest x-rays classified as 0/1 based on a single reading. Of the company records we reviewed, company chest x-rays initially classified as negative (0/0 and 0/1) were not routinely sent for additional readings. Since 1990, the company reportedly sent chest x-rays initially classified 1/0 or greater by a single reader for additional classifications. Five (10%) of the 49 survey participants who met the study criterion were found to have chest x-ray findings consistent with silicosis. These results are consistent with patterns of crystalline silica dust exposure at this facility. There were no cases of silicosis among current workers with 10 or less years of tenure; however, because of the long latency usually associated with chronic silicosis, this finding is not sufficient to conclude that current crystalline silica dust exposure levels are without adverse effect, The company medical monitoring practice of obtaining additional B reader classifications of those chest x-rays initially classified 1/0 or greater will produce an estimated prevalence no higher than and possibly lower than that obtained with a single reading, and those workers with a positive chest x-ray whose chest x-rays are initially read as 0/0 or 0/1 will not be identified. Recommendations are presented in this report and include obtaining at least two readings of all chest x-rays regardless of the initial small opacity profusion classification, increasing the frequency of medical monitoring regardless of examinations (TB) and modification of the baseline and routine examinations to include skin testing for tuberculosis (TB).
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(1998) Stericycle, Inc., Morton, Washington. (Click to open report) At the request of Washington State's Department of Labor and Industries (L&I) and Department of Health (DOH), the National Institute for Occupational Safety and Health (NIOSH) evaluated the potential for occupational exposures to Mycobacterium tuberculosis (Mtb) and bloodborne pathogens from the processing of medical waste. Events leading to the request for technical assistance included an outbreak of suspected occupationally-related tuberculosis (TB) among employees at Stericycle, Inc. in Morto... (Click to show more)At the request of Washington State's Department of Labor and Industries (L&I) and Department of Health (DOH), the National Institute for Occupational Safety and Health (NIOSH) evaluated the potential for occupational exposures to Mycobacterium tuberculosis (Mtb) and bloodborne pathogens from the processing of medical waste. Events leading to the request for technical assistance included an outbreak of suspected occupationally-related tuberculosis (TB) among employees at Stericycle, Inc. in Morton, Washington. An initial site visit was conducted November 18-20, 1997, and a subsequent evaluation of the facility was performed January 26-29, 1998. The information contained in this report reflects conditions at the facility at the time of these evaluations. An interim report, including initial recommendations, was distributed on March 13, 1998.
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(1997) Health and Rehabilitative Service, Office of Laboratory Services, Jacksonville, Florida. (Click to open report) In response to a request from the Florida Department of Health and Rehabilitative Services, an investigation was begun regarding occupational transmission of tuberculosis among state employees in laboratories where clinical specimens were processed. The Florida Health and Rehabilitative Services laboratories (SIC-8071) in Miami, Jacksonville and West Palm Beach were examined; there were 95 employees at the three sites. Of these, 39 met the criteria for participation in the evaluation of tubercul... (Click to show more)In response to a request from the Florida Department of Health and Rehabilitative Services, an investigation was begun regarding occupational transmission of tuberculosis among state employees in laboratories where clinical specimens were processed. The Florida Health and Rehabilitative Services laboratories (SIC-8071) in Miami, Jacksonville and West Palm Beach were examined; there were 95 employees at the three sites. Of these, 39 met the criteria for participation in the evaluation of tuberculin skin test conversion rates. Documented conversions were noted in nine persons between March 1989 and September 1992. Ventilation systems were evaluated at two of the three laboratories. The authors conclude that workers performing laboratory and clerical work with viable Mycobacterium- tuberculosis specimens may be at increased risk of becoming infected. However, the limitations of this study make it difficult to draw any definitive conclusions regarding the risk of occupational transmission of tuberculosis at these laboratories. The authors recommend specific measures to reduce the risk and improve the working environment.
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