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Rh '''III. Methods for Worker Protection—Controlling Airborne Transmission of Tuberculosis'''

A. Previous Recommendations for Personal Respiratory Protection—The existing CDC guidelines include extensive recommendations regarding the use of respirators in certain higher-risk areas for preventing the transmission of tuberculosis in health-care settings (10). These recommendations include in part:

A reexamination by NIOSH of the role of personal respiratory protection, especially the particulate respirator, in protecting health-care-facility workers against tuberculosis infection transmitted in health-care settings is presented in the next section.

B. The "Hierarchy of Controls"—Prudent occupational health practice calls for application of a hierarchy of controls to any occupational health hazard (47,48,49,50). The control hierarchy is long-standing and has wide-spread acceptance in the occupational-health community because it is based on broad practical experience, and scientific and technical logic (51).

NIOSH has supported the necessity of an ordered approach to evaluating a series or combination of effective control strategies to protect workers (47). The Institute has recommended the following essential characteristics of specific control solutions (47):