OSHA Inspection: SPOHN HOSPITAL

Issued

Sep 8, 1994

Abate by

Aug 31, 1995

Penalty

Initial $5,000 · Current $3,750 Reduced

General-duty citation text

Section 5(a)(1) of the Occupational Safety and Health Act of 1970: The
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employer did not furnish
employment and a place of employment which were free from recognized
hazards that were
causing or likely to cause death or serious physical harm to employees:
Hospital personnel such as but not limited to nurses, respiratory
therapists,
housekeeping, and maintenance were exposed to the hazard of being infected
with
tuberculosis through contact with patients who were or may be infected with
tuberculosis in that air from "isolation rooms" was exhausted into the
general
return air duct and then recirculated as supply air and was not
appropriately
exhausted outside.
Feasible and useful abatement methods for reducing this hazard,
as recommended by the Center for Disease Control, among others
are:
1. Protocol for the early identification of individuals with active
tuberculosis.
2. Medical surveillance (at no cost to employees) including
preplacement evaluation, administration and interpretation of TB
Mantoux skin tests, and periodic evaluations.
3. Evaluation and management of workers with positive skin test,
or with skin test conversion on repeat testing, or who are
exhibiting symptoms of TB, including work restrictions for
infectious employees.
4. Placement of individuals with suspected or confirmed TB
disease in an AFB (acid fast bacilli) isolation room. AFB isolation
rooms for persons with suspected or confirmed  infectious TB and
areas in which high hazard procedures are performed on such
individuals must be maintained under negative pressure and
appropriately exhausted and monitored to insure negative pressure
is maintained.
5. Training and information to ensure employee knowledge of such
issues as the hazard of TB transmission, its signs and symptoms,
medical surveillance and therapy, and site specific protocols
including the purpose and proper use of controls.
ABATEMENT
Step 1: Provide employees the proper personal protective equipment when
they are exposed to
suspect or confirmed TB patients.
STEP 1 DUE DATE: 09/14/94
Step 2: Submit to the Area Director a written plan of abatement outlining
a schedule for the
implemention of engineering and or administrative measures to control
employee exposure to
suspect or confirmed TB patients. This plan should include, as a minimium,
controls and
completion dates.
STEP 2 DUE DATE:  10/04/94
Step 3: Submit to the Area Director on specified date reports detailing
the progress of the actions
taken.
STEP 3 DUE DATE:  11/02/94
Step 4: Abatement shall be completed by the implemention of feasible
engineering and/or
administrative controls upon verification of their effectiveness in
achieving compliance.
STEP 4 DUE DATE:  12/10/94

Issued

Sep 8, 1994

Abate by

Sep 26, 1994

Penalty

Initial $5,000 · Current $3,750 Reduced

Issued

Sep 8, 1994

Abate by

Sep 16, 1994

Penalty

Initial $2,500 · Current $1,875 Reduced

Issued

Sep 8, 1994

Abate by

Sep 13, 1994

Penalty

Initial $1,000 · Current $750 Reduced