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  1. Tuberculosis in health care settings and the estimated benefits of engineering controls and respiratory protection.

    Article - En anglais

    Intra-institutional spread of tuberculosis (Tb) has re-emerged as a substantial public and occupational health threat.

    To characterize the person-hours and lifetime risks of Tb-related morbidity and mortality, we performed a risk assessment for health care workers (HCWs) developing Tb-related morbidity and mortality at varying levels of exposure, engineering controls, and respiratory protection.

    Under average conditions of exposure, one Tb skin-test conversion is estimated to occur for every 2650 person-hours of work by unprotected workers.

    With higher exposures, a skin-test conversion for an unprotected worker may occur in as few as 3 person-hours.

    Use of respiratory protection is estimated to reduce risks by the following proportions :

    • surgical mask, 2.4-fold ;

    • disposable dust, fume, mist, or disposable high-efficiency particulate air filtering (HEPA) mask, 17.5-fold ;

    • elastomeric HEPA cartridge respirator, 45.5-fold ;

    • or powered air-purifying respirator (PAPR), 238-fold.

    Assuming a lifetime exposure of 250 hours, the risk of a skin-test conversion is estimated to be 9%. We conclude that HCWs are at substantial risk for Tb-related morbidity and mortality, and that administrative controls, engineering controls, and respirators offer substantial benefits in risk reduction.

    Mots-clés Pascal : Personnel sanitaire, Prévention, Mortalité, Tuberculose, Mycobactériose, Bactériose, Infection, Poumon, Morbidité, Risque, Evaluation, Masque protection, Efficacité, Contrôle, Recommandation, Exposition professionnelle, Médecine travail, Appareil respiratoire pathologie, Poumon pathologie

    Mots-clés Pascal anglais : Health staff, Prevention, Mortality, Tuberculosis, Mycobacterial infection, Bacteriosis, Infection, Lung, Morbidity, Risk, Evaluation, Protective mask, Efficiency, Check, Recommendation, Occupational exposure, Occupational medicine, Respiratory disease, Lung disease

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 97-0518592

    Code Inist : 002B05B02O. Création : 13/02/1998.