OSHA Inspection: LAWRENCE AND MEMORIAL HOSPITAL

Issued

Jul 24, 1996

Abate by

Sep 10, 1996

Penalty

Initial $4,500 · Current $4,500

General-duty citation text

Section 5(a)(1) of the Occupational Safety and Health Act of 1970:  The
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 employees were potentially exposed to
Mycobacterium
tuberculosis through unprotected contact with patients.
SECTION 5(a)(1) OF THE OCCUPATIONAL SAFETY AND HEALTH ACT OF 1970: THE
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 EXPOSED TO THE HAZARDS OF INFECTION FROM MYCOBACTERIUM
TUBERCULOSIS THROUGH UNPROTECTED CONTACT WITH A PATIENT WHO WAS INFECTIOUS
OR
SUSPECTED TO BE INFECTIOUS WITH TUBERCULOSIS. THE EMPLOYER FAILED TO
ENSURE THAT
AN ACID FAST BACILLI (AFB) ISOLATION ROOM LOCATED IN LAWRENCE & MEMORIAL
HOSPITAL, G-WING, INTENSIVE CARE UNIT, WAS UNDER NEGATIVE PRESSURE. THE
ROOM WAS
UNDER POSITIVE PRESSURE. THIS WOULD INCREASE THE POTENTIAL EXPOSURE TO
TUBERCULOSIS FOR ANY EMPLOYEE WALKING IN OR NEAR THE ENTRANCE TO THE
ISOLATION
ROOM.
FEASIBLE AND USEFUL ABATEMENT METHODS FOR REDUCING THIS HAZARD,
RECOMMENDED BY
THE CDC INCLUDE, BUT ARE NOT LIMITED TO:
1.PERIODIC SMOKE TRAIL TESTING FOR NEGATIVE PRESSURE ACID FAST BACILLI
(AFB)
ISOLATION ROOMS TO ENSURE THE PRESSURE DIFFERENTIAL IS INDUCING AIRFLOW
FROM THE CORRIDOR INTO THE ISOLATION ROOM; MONITORING OF AIR FLOW
PATTERNS, MIXING OF AIR AND MONITORING OF PRESSURE DIFFERENTIALS BETWEEN
SUPPLIED AIR AND EXHAUSTED AIR WILL ALSO HELP TO ENSURE NEGATIVE PRESSURE
2.USE OF DIFFERENTIAL PRESSURE SENSING DEVICES EITHER CONTINUOUS OR
NONCONTINUOUS
3.NEGATIVE PRESSURE ENCLOSURES (i.e., TENTS OR BOOTHS) WITHIN THE ISOLATION
ROOMS TO SUPPLEMENT ISOLATION
4.FREQUENT MONITORING OF NEGATIVE PRESSURE ISOLATION ROOMS DURING
RENOVATION
PERIODS. CONSTRUCTION OPERATIONS COULD COMPROMISE HVAC SYSTEM (EX.
VENTILATION EAKS IN DUCT WORK OCCURRING DURING RENOVATIONS)
NOTE: SOURCE INFORMATION INCLUDES, BUT IS NOT LIMITED TO, CENTER FOR
DISEASE
CONTROL, "MMWR, OCTOBER 1994, SUPPLEMENT 3; ENGINEERING CONTROLS, PART II
ON
VENTILATION".

Issued

Jul 24, 1996

Abate by

Jul 29, 1996

Penalty

Initial $4,500

Issued

Jul 24, 1996

Abate by

Aug 5, 1996

Penalty

Initial $1,000 · Current $100 Reduced