Recommendations for the prevention of healthcare-associated transmission of M. tuberculosis involve application of a tiered framework of measures that enables healthcare organizations to comprehensively evaluate the risk of HCW exposure to workplace hazards, including M. tuberculosis, and the effectiveness of the organization’s mitigation responses.45 This involves collaboration between IPC, Occupational Health Safety and Wellness and building engineers.
The ideal approach to containing a hazard is to implement a hierarchy of controls: 1) elimination; 2) substitution; 3) engineering controls; 4) administrative controls; and 5) PPE.46 Elimination of TB from the healthcare setting is not always possible, but effective treatment of respiratory TB is equivalent. Substitution is not a relevant approach to preventing transmission of TB.
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