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Note: A “TB Skin Test” means the intradermal injection (Mantoux Method) of
tuberculin antigen (usually PPD) with subsequent measurement of the induration by
designated, trained personnel.

6. If an isolation room is occupied by a patient with confirmed or suspect TB or has not been
adequately purged when a smoke-trail test is performed, then the CSHO should assume
that the isolation room is not under negative pressure. Under such circumstances CSHOs
shall wear a negative pressure HEPA respirator when performing air tests as described in
Appendix B or if entry into the room is determined to be necessary.

K. Citation Policy. Relevant chapters of the FIRM shall be followed when preparing and issuing
citations for hazards related to TB.

1. The following requirements apply when citing hazards found in target workplaces.
Employers must comply with the provisions of these requirements whenever an employee
may be occupationally exposed to TB:

Section 5(a)(1) -- General Duty Clause and Executive Order 12196, Section 1-201(a)
for Federal facilities.

29 CFR 1910.134* -- Respiratory Protection

29 CFR 1910.145 -- Accident Prevention Signs and Tags

29 CFR 1910.20 -- Access to Employee Exposure and Medical Records

29 CFR 1904 -- Recording and Reporting Occupational Injuries & Illness

L. Violations. All elements in this section must be addressed to ensure adequate protection of
employees from TB hazards. Violations of these OSHA requirements will normally be classified as
serious.

1. General Duty Clause - Section 5(a) (1). Section 5(a)(1) provides: “Each employer shall
furnish to each of his employees employment and a place of employment which are free
from recognized hazards that are causing or are likely to cause death or serious physical
harm to his employees.”

a. Section 5(a)(1) citations must meet the requirements outlined in the FIRM, and
shall be issued only when there is no standard that applies to the particular
hazard. The hazard, not the absence of a particular means of abatement, is the
basis for a general duty clause citation. All applicable abatement methods
identified as correcting the same hazard shall be issued under a single 5(a)(1)
citation.

b. Recognition, for purposes of citing section 5(a)(1), is shown by the CDC Guidelines
for the types of exposures detailed below because the CDC is an acknowledged
body of experts familiar with the hazard.

c. Citations shall be issued to employers with employees working in one of the

* 29 CFR 1910.134 is now codified for protection against TB as 29 CFR 1910.139.

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