OSHA Inspection: DR. HARRY HERNANDEZ

Issued

Sep 6, 2002

Abate by

Sep 18, 2002

Penalty

Initial $600 · Current $600

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 exposed to the hazard of being infected with Mycobacterium
tuberculosis through
unprotected contact with patients, who was/were infectious or suspected to
infectious with
tuberculosis.
(a)Initial Exams. The employer did not conduct,TB skin tests (at no cost
to the
employees) to all current employees potentially exposed until after the
employee became
exposed. A two-step baseline should have been accomplished for new
employees who have an
initially negative PPD test result and who have not had a documented
negative TB skin test
result during the preceding 12 months. The employee had not had a TB skin
test for the last two
years of employment with the company.
(b)The follow-up and treatment evaluations were not offer to the employee
at no
cost.
(c)The TB skin test should have been annually, since this is a low risk
area which
was not accomplished.
(d)There was no risk assessment accomplished after the employee tested
positive for
TB skin test.
(e)There was no site specific written training program to ensure employees
knowledge of such issues as the mode of TB transmission, its signs and
symptoms, medical
surveillance and therapy.
Feasible and useful abatement methods for reducing this hazard:
(a)Develop employees education and training for current employees and new
workers
upon hiring, with refresher training as needed to ensure employee
knowledge of such issues as
the mode of TB transmission, its signs and symptoms, medical surveillance
and therapy, and site
specific protocols including the purpose and proper use of controls.
(b)Annual TB skin testing conducted for employees in low risk area.
(c)Train employees to recognize, and report to a designated person, any
patients or
clients with symptoms suggestive of infection.
(d)Develop a medical surveillance program that would not be at no cost to
the
employees, that will cover
(1) Initial examinations: TB skin tests including a two-step baseline for
new
employees, follow-up and treatment evaluations.
(2) Periodic evaluations: TB skin testing at intervals specified by the
CDC guidelines
according to low risk category.unless it changes, then facility must
complete an annual TB risk
assessment to establish required testing frequencies based on the areas.