OSHA Inspection: THE SALVATION ARMY

Issued

May 29, 1998

Abate by

Aug 15, 1998

Penalty

Initial $3,500 · Current $100 Reduced

General-duty citation text

North Carolina General Statute 95-129 (1) of the Occupational
Safety and Health Act of North Carolina:  The employer did not
furnish to each of his employees conditions of 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:
a)facility, employees such as, but not limited to, social
workers and resident assistants were exposed to the
hazard of being infected with Mycobacterium tuberculosis
(TB) through unprotected contact with clients who were
infectious or suspected to be infectious due to failure
to develop and implement a TB infection-control program.
1)No written protocol for the early identification of
individuals with confirmed or suspect tuberculosis had
been established.
2)A medical surveillance program for employees, including
Mantoux skin testing was not provided in accordance with
the most current recommendations of the Center for
Disease Control (CDC).
3)No training and education was provided to employees on
the issues of tuberculosis such as; mode of TB
transmission, its signs and symptoms, medical
surveillance and therapy, and site specific protocols
including the purpose and proper use of controls.
4)The employer did not provide or require the use of
respiratory protection when employees were exposed to
clients with suspected or confirmed tuberculosis.
Feasible and useful abatement methods for reducing this hazard, as
recommended by the 1994 Center for Disease Control (CDC), include,
but are not limited to:
1.Implementation of a protocol for the early identification of
individuals with active tuberculosis.
2.Initiate a medical surveillance program (at no cost to
employees) including:
a)Initial exams.  The employer shall offer TB skin tests to
all current potentially exposed employees and to all new
employees prior to exposure.  The TB skin test shall be
offered at a time and location convenient to workers.
Follow-up  and treatment evaluations are also to be
offered at no cost to workers.
b)Periodic Evaluations.  TB skin testing shall be conducted
every three (3) months for workers in high risk
categories, every six (6) months for workers in
intermediate categories, and annually for low riskpersonnel.  (The CDC has
defined the criteria for high,
intermediate, and low risk categories, see guidelines
provided during inspection, pages 8-17).  Workers with a
documented positive TB skin test who have received
treatment for the disease or preventative therapy for
infection are exempt from the TB skin test but must be
informed periodically about the symptoms of TB and the
need for immediate evaluation of any pulmonary symptoms
suggestive of TB by a physician or trained health care
provider to determine if symptoms of TB disease have
developed.
c)Reassessment following exposure or change in health.
Workers who experience exposure to an individual with
suspect or confirmed infectious TB for whom infection
control precautions have not been taken shall be managed
according to the CDC guidelines.  An employee who
develops symptoms of TB disease shall be immediately
evaluated according to the CDC guidelines.
3.Initiated a program for the management and evaluation of
infected employees including:
a)Protocol for new converters.  Conversion to a positive TB
skin test shall be followed, as soon as possible, by
appropriate physical, laboratory, and radiographic
evaluations to determine whether the employee has
infectious TB. (See guidelines provided during
inspection, page 65).
b)Work restrictions for Infectious Employees.  (See
guidelines provided during inspection, page 41).
4.Provide training and education to ensure employee knowledge of
such issues as:
a)The mode of TB transmission.
b)Its signs and symptoms.
c)Medical surveillance and therapy
d)Site specific protocols including the purpose and proper
use of controls.
5.Develop and implement a respiratory protection program in
accordance with 29 CFR 1910.134 and/or 29 CFR 1910.139.
Note:Training shall be provided for all current employees and
to new workers upon hiring (See guidelines provided
during inspection, pages 36-37).

Issued

May 29, 1998

Abate by

Jul 1, 1998

Penalty

Initial $1,225

Issued

May 29, 1998

Abate by

Jun 8, 1998

Issued

May 29, 1998

Abate by

Jul 1, 1998