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ducted through the facility must be kept under negative pressure
until it is discharged safely outside (i.e., away from occupied
areas and air intakes), or

e. The air from isolation and treatment rooms must be
decontaminated by a recognized process (e.g., HEPA filter)
before being recirculated back to the isolation/treatment room.
The use of UV radiation as the sole means of decontamination
shall not be used. The CDC Guidelines allow the use of UV in
waiting rooms, emergency rooms, corridors, and the like where
patients with undiagnosed TB could potentially contaminate the
air. (See appendix A, pg 90)

Note: The opening and closing of doors in an isolation or
treatment room which is not equipped with an anteroom
compromises the ability to maintain negative pressure in the
room. For these rooms, the employer should utilize a
combination of controls and practices to minimize spillage of
contaminated air into the corridor. Recognized controls and
practices include, but are not limited to: minimizing entry to the
room; adjusting the hydraulic closer to slow the door movement
and reduce displacement effects; adjusting doors to swing into
the room where fire codes permit; avoiding placement of room
exhaust intake near the door; etc.

f. If high-hazard procedures are performed within AFB isolation or
treatment rooms without benefit of source control ventilation or
local exhaust ventilation (e.g., hood, booth, tent, etc.), and
droplets are released into the environment (e.g., coughing), then
a purge time interval must be imposed during which personnel
must use a respirator when entering the room. (See Appendix
A, pg. 35 and Suppl. 3, Table S3-1)

g. Interim or supplemental ventilation units equipped with HEPA
filters as described in Appendix A pgs. 70-73 are acceptable.

2. Respiratory Protection - 29 CFR 1910.134 (a) (2) and (b).*
The standard provides in part:

“Respirators shall be provided by the employer when such equipment is
necessary to protect the health of the employee. The employer shall provide
the respirators which are applicable and suitable for the purpose intended.
The employer shall be responsible for the establishment and maintenance of a
respiratory protective program which shall include the requirement outlined in
paragraph (b) of this section.”

a. Requirements for a minimal acceptable program.
The 1994 CDC Guidelines specify standard performance criteria for

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

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