Page 60 - L:\GROUP\SDT\zip_disk\Book2.PDF

initially negative PPD test result and who have not had a
documented negative TB skin test result during the preceding 12
months (See Appendix A, pg. 63). TB skin tests shall be offered at a
time and location convenient to workers. Follow-up and treatment
evaluations are also to be offered at no cost to the workers.

Note: The reading and interpretation of the TB skin tests shall be
performed by a qualified individual as described in the CDC
Guidelines.

b. Periodic Evaluations. TB skin testing shall be conducted every three
(3) months for workers in high risk categories, every six (6) months
for workers in intermediate risk categories, and annually for low
risk personnel (The CDC has defined the criteria for high,
intermediate, and low risk categories, see Appendix A, pg. 8-17).
Workers with a documented positive TB skin test who have
received treatment for disease or preventive therapy for infection
are exempt from the TB skin test but must be informed periodically
about the symptoms of TB and the need for immediate evaluation
of any pulmonary symptoms suggestive of TB by a physician or
trained health care provider to determine if symptoms of TB
disease have developed.

Note: If the facility has not completed a risk assessment the CSHO
shall review the TB related records to establish required testing
frequencies for the facility and areas of the facility.

c. Reassessment following exposure or change in health. Workers
who experience exposure to an individual with suspect or
confirmed infectious TB for whom infection control precautions
have not been taken shall be managed according to CDC
recommendations (Appendix A). An employee who develops
symptoms of TB disease shall be immediately evaluated according
to the CDC Guidelines.

3. Case Management of Infected Employees shall include the following:

a. Protocol for New Converters. Conversion to a positive TB skin test
shall be followed as soon as possible, by appropriate physical,
laboratory, and radiographic evaluations to determine whether the
employee has infectious TB disease. (see Appendix A, pg. 65).

b. Work Restrictions for Infectious Employees. See Appendix A, page
41.

4. Worker Education and Training. Training and information to ensure
employee knowledge of such issues as the mode of TB transmission, its
signs and symptoms, medical surveillance and therapy, and site specific
protocols including the purpose and proper use of controls shall be
provided to all current employees and to new workers upon hiring. (See

52