Tuberculosis in health care settings and the estimated benefits of engineering controls and respiratory protection.
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
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0518592
Code Inist : 002B05B02O. Création : 13/02/1998.