OSHA Inspection: ST. JOSEPH'S HOSPITAL

Issued

Apr 11, 1994

Abate by

Aug 1, 1994

Penalty

Initial $4,500 · Current $3,150 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 in that workers such
as doctors, nurses, admitting clerks, radiology employees, respiratory
therapists, housekeepers
and dietary employees in the emergency room, Xray department, D2, and D3
were exposed
to the hazard of being infected with tuberculosis through contact with
patients who were or may
be infected with tuberculosis in that employees of a health care facility
were exposed to the
exhaled air of individuals with confirmed or suspected TB disease and
employees had exposure
to a high hazard procedure performed on individuals with suspected or
confirmed TB disease
which has the potential to generate potentially infectious airborne
respiratory secretions including
(but not limited to) bronchoscopies and sputum inductions:
a.The facility did not have a program in use for the early
identification,
isolation,
and treatment of known or suspect TB patients.
b.Exposed employees did not receive medical surveillance related to TB as
defined
by the Centers for Disease Control (MMWR 12/7/90).
c.Known or suspect TB patients were not placed in AFB (acid fast bacilli)
isolation
rooms, nor did high hazard procedures take place in negative pressure
treatment
rooms.
d.Employees have not been trained about TB or how to protect themselves
from
exposure.
All of the above took place on or about October 21, 1993.
Feasible and useful abatement methods for reducing this hazard, as
recommended by the Centers
for Disease Control, among others are:
1.Protocol for the early identification of individuals with active
tuberculosis.
2.Medical surveillance (at no cost to the employees) including placement
evaluation,
administration and interpretation of the TB Mantoux skin tests, and
periodic
evaluations shall be offered to employees as follows:  an initial
baseline screening
at the time of employment for all employees in the covered facilities;
annually for
all employees in the covered facilities; retesting every six months for
workers
with exposure.
3.Evaluation and management (at no cost to employees) of workers with a
positive
skin test, or with skin test conversion on repeat testing, or who are
exhibiting
symptoms of TB, including work restrictions for infectious employees.
Workers
who experience a TB exposure incident (exposure to a patient/client with
infections TB for who infection control precautions have not been taken)
shall
also be managed according to CDC recommendations.
4.Placement of individuals with suspected or confirmed TB disease in an
AFB (acid
gast 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 (either directly to the outside away from intake vents or
through
properly designed, installed, and maintained HEPA filters).
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 protocol's including the purpose and proper
use of
controls.

Issued

Apr 11, 1994

Abate by

Jun 30, 1994

Penalty

Initial $4,500 · Current $2,250 Reduced

Issued

Apr 11, 1994

Abate by

Apr 14, 1994

Penalty

Initial $2,250

Issued

Apr 11, 1994

Abate by

Aug 1, 1994

Penalty

Initial $4,500 · Current $3,150 Reduced

Issued

Apr 11, 1994

Abate by

Apr 29, 1994

Penalty

Initial $2,250

Issued

Apr 11, 1994

Abate by

May 16, 1994

Issued

Apr 11, 1994

Abate by

May 31, 1994

Issued

Apr 11, 1994

Abate by

Apr 14, 1994

Issued

Apr 11, 1994

Abate by

Apr 19, 1994