TB Manual

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.