CLINICAL LAB SCIENEC

CHAPTER 6: INTRODUCTION TO INFECTION CONTROL 143
at a clinic or hospital. It is the responsibility of the student to observe all precautions
to which he or she has been introduced. The level of protective gear is
based on the risk posed by the job being performed.
HEPA Mask Fit Test Kit
Workers who may be required to perform direct patient care should be fit-tested
for a HEPA mask . Differing facial sizes and shapes require that a person be tested
for proper fit as one size does not fit all. Facial hair such as beards, mustaches, or
heavy and extensive sideburns that encroach on the face may impede a fit design
that will protect the worker.
Types of Workplaces Covered by These Guidelines
Persons are more susceptible to TB when living in unsanitary
conditions. Those groups confined to crowded areas with poor
ventilation are at greater risk of contracting TB than are others
in less-cramped and better-maintained facilities or homes. The
workplaces listed in the sidebar on the next page have been identified
as being likely to house inhabitants with active TB. They are
considered as workplaces with an inherent potential for exposure
to TB.
What Comprises Exposure Potential to Tuberculosis ?
An exposure potential is defined as an exposure to the inhaled or
exhaled air of a person suspected of TB disease or confirmed to
be infected by a skin test and radiograph. The medical laboratory
worker who is responsible for collecting blood from a patient would
be at some risk if the patient coughed while in close proximity to
the face of the worker. Masks are worn when a patient is under
“Respiratory Precautions” or has been confirmed as being infected
with the TB bacillus. Besides being coughed on by a patient with
TB, the worker who handles contaminated items in the patient’s
room or sputum specimens without conscientious hand washing
can contract the disease.
Certain procedures performed on an individual with suspected or confirmed
TB disease also have an extremely high potential for producing infectious airborne
organisms through respiratory secretions. Specific procedures that place
the medical worker at greatest risk are those involving aerosolized medication
treatments and assisting in or performing bronchoscopies, sputum inductions,
intubations , suctioning procedures, and autopsies . While performing these procedures,
the workers should wear PPE, including a face shield with mask if droplets
and aerosols may be produced. Often after diagnosis, a hospitalized person
will be in a room designed to isolate the patient from other patients and visitors.
Only those who are performing direct care of specimen collections will enter the
Infection Control Alert
The CDC Requirements for Training,
Education, and Use of PPE
The CDC ‘s “Guidelines for Preventing
the Transmission of Tuberculosis in
Health Care Settings (with Special
Focus on HIV-Related Issues)” provides
for postexposure reporting and
follow-up guidelines for TB exposure
in a medical area where there is a
potential for exposure to patients
with TB. The requirements for HEPA
respirator training and education and
the use of PPE are addressed in this
document. These guidelines are to
be in effect until the Occupational
Exposure to Tuberculosis; Proposed
Rule 29 CFR 1910.1035 is acted on by
OSHA. Changes may be required at
that time.
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