The L & I “Stay at Work” Program
A couple of weeks ago, the Washington Department of Labor and Industries quietly launched it “stay at work” program which pays employers who help injured employees stay on the job by giving them lighter duties or reassigning them temporarily until they are able to return to their regular duties.
The programs official launch was on January 10, but you can make a claim for any worker who falls in this category effective as of June 15th, 2011. Employers can get reimbursed up to half of the base wage paid to the injured worker with a maximum of $10,000 per claim.
According to the WA L & I website… “The purpose of the new incentive is to encourage more employers to return their injured workers to light-duty or transitional jobs with the doctor’s approval. This medical best practice can help the worker recover, and it also can reduce costs for the employer.”
To find out more or to file a claim, go to http://www.lni.wa.gov/main/stayatwork/
New OSHA White Paper “Injury and Illness Prevention Program”
Based on a proposal back in the spring of 2010, a new white paper by OSHA entitled “Injury and Illness Prevention Programs” makes a convincing case for a proactive approach to health and safety in the workplace through the identification and fixing of potential hazards before they injure employees.
The benefits, according to the white paper, include “higher productivity and quality, reduced turnover, reduced costs, and greater employee satisfaction.”
These findings are not based on conjecture but rather on some 34 states and numerous companies who’ve adopted and implemented this approach to safety in their workplace.
The approach is simple and includes:
- management leadership
- worker participation
- hazard identification and assessment
- hazard prevention and control
- education and training
- program evaluation and improvement
With the escalating cost of medical treatment, lawsuits, time off work, etc… (see chart below), any program that can help reduce the number of injuries and illnesses not only makes sense from the perspective of a company that cares about it’s employees but about the bottom line as well.
You can view and/or download the OSHA White Paper to read more on this subject and find out how to take this proactive approach for your own workplace.
Injuries and fatalities to headphone wearers almost triple in six years
They’re everywhere you turn, walking down the street, in the malls, in the store next to you, even in the vehicle that pulls up to you at the light. I’m talking about headphone wearers who are listening to an mp3 player or some other portable audio device. The days of the boombox on the shoulder may be gone, much to the relief of everyone who didn’t happen to share the musical taste of whoever had the boombox but that doesn’t mean that we are listening to music less than we were.
The problem is that headphone wearers are increasingly getting injured and killed at three times the numbers than they were just six years ago.
A new study published by the University of Maryland Medical Studies, found that “There were 116 reports of death or injury of pedestrians wearing headphones. The majority of victims were male (68%) and under the age of 30 (67%). The majority of vehicles involved in the crashes were trains (55%), and 89% of cases occurred in urban counties. 74% of case reports stated that the victim was wearing headphones at the time of the crash. Many cases (29%) mentioned that a warning was sounded before the crash.”
In other words young men under the age of 30 and increasingly getting killed and seriously injured simply because they are “lost in their own little world” and don’t hear when they’re being warned of immanent danger.
Unfortunately it’s hard to believe that anything will change. That age demographic usually believes itself to be invincible. It may happen to someone else but not to me!
The sad thing is that, as we’ve discussed before on this blog, those who aren’t killed because of their audio players will end up with hearing loss because of the decibel levels that they are listening to them at.
Cold Stress and Hot Air
Got this white paper from Ergodyne. Haven’t been able to locate it on their website but I’ve uploaded it to our website and here’s the link for you to download it as a pdf.
WHITE PAPER: COLD STRESS AND HOT AIR
© 2009 Tenacious Holdings, Inc. All Rights Reserved. All Wrongs Reversed. 2 3/1/20092
When we’re young we take in a lot of tall tales—otherwise known as misinformation. One of them is the idea that cold air causes the common cold. Even though the common term for being sick (having a “cold”) comes from the belief that weather can cause illness, we’re eventually smart enough to know that these are infections caused by bacteria and viruses.
Still, cold air can present a serious threat to the body’s vital organs and systems.
The body uses a few different means to protect itself from cold, the first lines of defense being the nose, mucus system, and lungs.
The nose is built to help protect the lungs. Adding and extracting moisture and temperature, the nose adjusts the air heading to the lungs to a relative humidity of about 75% and a comfortable 98.6 degrees. When a person is exposed to cold temperatures, the tissue lining the nose swells as the capillaries open. This brings warm blood to the nose to heat the cold air. In fact, often it’s too much blood in the nose (not increased mucus) which results in nasal congestion.
The body’s next defense is mucus. The respiratory system is covered by a thin layer of this stuff – the “mucus blanket” – which acts as a filter, protecting the lungs from dangerous particles and organisms (including bacteria that can cause colds and infections). Mucus, like other substances, becomes thicker in cold temperatures. When this happens, the system might not work as effectively to remove inhaled viruses and bacteria.
Further, if cold air does reach the lungs despite nose and mucus defenses, lungs react with histamine – a natural chemical often released by the body during allergic reactions. In people with sensitive airways or asthma this causes wheezing.
On average, a human breathes 1,100 times per hour, with each breath measuring about one liter in volume. When this inhaled air is cold, the body works to heat the air to 98 degrees. This extra work represents a significant heat loss to the body that is preventable. So while catching a respiratory infection requires exposure to bacteria or organism, it still is more likely that an individual will become sick if he or she has been breathing cold air than if they were not.
There are countless other affects that cold can have on the body aside from the respiratory system. Unfortunately, the effects of cold on the body (i.e. cold stress) often go unnoticed until conditions have created a life or death situation. And while these sneak attacks can be deadly, cold stress is actually quite preventable if the proper precautions are taken.
WHAT IS COLD STRESS?
Extreme cold temperatures can affect the body in a number of ways. These include dehydration, numbness, shivering, frostbite, immersion foot (trench foot), and hypothermia. As the list shows, effects can be both local and systemic.
Shivering is the first and most common symptom. It’s also the most often ignored. When the body drops below 98.6 degrees, blood begins to flow away from extremities and towards the core. This results in the immediate cooling of exposed skin and extremities and increases the risk of cold stress, specifically hypothermia. If body temps continue to fall, dexterity decreases and speech may be slurred. At 85 degrees Fahrenheit, severe hypothermia sets in which can result in unconsciousness. And at 78 degrees or below, the body is at maximum risk for brain damage and even death if not treated immediately.
SYMPTOMS OF HEAT LOSS AND HYPOTHERMIA
According to the CDC, early signs and symptoms of heat loss include:
- Shivering (first, most common symptom)
- Fatigue
- Loss of coordination
- Confusion and disorientation
Late symptoms of heat loss include
- No shivering
- Blue skin
- Dilated pupils
- Slowed pulse and breathing
- Loss of consciousness
If enough heat loss occurs, signs and symptoms of the resulting hypothermia include:
- Cool skin
- Slower, irregular breathing
- Slower heartbeat
- Weak pulse
- Uncontrollable shivering
- Severe shaking
- Rigid muscles
- Drowsiness
- Exhaustion
- Slurred speech
- Memory lapses
WHO IS AT RISK?
While workers in the construction, agriculture, maritime, and commercial fishing industries are often exposed to the most extreme risks, cold stress is not exclusive to outdoor workers.
People who work in cold storage or food processing, as well as those in facilities without heat or insulation, are also at risk. If workers do not have proper protection, the body is unable to warm itself, and, this can lead to serious cold-related illnesses, permanent tissue damage, or even death.
While risks are of course highest in colder regions, in areas where the seasons change less drastically, workers are often less prepared, and it can only take near freezing temperatures to trigger the onset of cold stress.
Individuals who are more prone to cold stress than others include those who are:
- Not physically fit
- Living with an underlying condition or illness (those with asthma or other respiratory ailments are particularly at risk)
- Under the influence of alcohol or drugs (illegal or prescription)
- Working in wet or damp conditions
- Exposed to vibration from tools
- Working without proper personal protective equipment (PPE)
- Not acclimated to the cold
NIP COLD STRESS IN THE BUD
- Employers can help protect workers from cold stress through several means. They should Provide training
- Control the work environment with heaters and windbreaks
- Establish worker rotations
- Schedule work during the warmer hours of the day and times of the year
- Remind workers to pace themselves
- And keep emergency supplies on hand
Equally important, workers in cold conditions should themselves take necessary precautions to protect themselves from the cold, including wearing proper PPE and being aware of cold stress warning signs.
The CDC recommends the following safety tips for employers and workers:
- Train employees for the cold and changing weather
- Use a buddy system
- Adjust work schedules to the cold or changing weather
- Eat and drink hot or warm foods and liquids
- Layer clothing (water vapor permeability is important)
- Wear proper PPE
THE BENEFITS OF BREATHING HOT AIR
To prevent the loss of body heat from breathing cold air, mountaineers and other extreme sport participants have used heat exchange facemasks and balaclavas for many decades. Similar to the value provided by putting warm food and liquids into the body, a heat exchanger provides warmth from the inside out. Heat exchangers capture the warmth and humidity from exhaled breath, store it temporarily, and warm and humidify inhaled air. Now, with the recent introduction of this technology to the workplace, workers have an additional opportunity to protect themselves on the job when temperatures are most extreme.
With a proper heat exchanger, condensation produced from exhaled breath stays on the mask – not on your face or your fleece – and most of it is evaporated and returned to your body. Heat exchangers also help workers maintain full lung capacity, which is especially important for individuals with underlying heart or respiratory problems. In fact, heat exchangers are so effective that workers often find that less PPE clothing is required while using one.
SUMMARY
Cold stress is just as dangerous as heat stress – but with its sneaky symptoms, it often goes undetected until it’s too late. Awareness is key. Being informed about the dangers of cold stress and the importance of breathing warm air can help save lives and keeps workers warm, comfortable, and productive.
RESOURCES
CDC
- http://www.cdc.gov/
Benefits of Breathing War Air, Lee Bagby, President, QXtec, Inc
ELcosh
- http://www.elcosh.org/en/document/428/d000420/cold-stress.html
Talus Outdoor Technologies
- http://www.talusoutdoor.com/coldavenger/technical-specifications
PSolar Outdoor Performance Gear
- http://www.psolar.com/faq.html
Don’t Leave Safety Out in the Cold, EHS Today
- http://ehstoday.com/ar/ehs_imp_76091/
State Compensation Insurance Fund
- http://www.scif.com/safety/safetymeeting/Article.asp?ArticleID=17
www.DrGreene.com
Tire Safety Awareness and Tips
Put tires at top of car safe driving list
With winter fully upon us, it’s already a little late to get our vehicles ready for the rough weather and conditions ahead. Getting this accomplished before you need it is the way to go.
Some people call this winterizing and remember about anti-freeze, wiper fluid, water-grabbing gas additives and wiper blades.
While some climates aren’t as severe during the winter, these are all good things to take care of no matter where you call home, and at the top of the list is tires.
Tires
Most of us use all-season tires, so all we need to do is check the condition, age and pressure. The condition is the hard part … tread depth, road damage and sidewall cracks are some of the easy things to miss. Damage can be hard to find, so spend some time looking closely.
Don’t tolerate sidewall cracks. Sometimes called “dry rot,” and these deterioration patterns suggest the rubber is nearing the end of its lifespan. Trying to stretch this can leave you stranded or much worse, so you should have a professional inspect them. They know from experience there’s just no way to predict failure when these cracks start appearing.
If your tires are more than 5 years old, it’s time to think about replacing them. Every tire has a “birthday” stamped on the side, and the Department of Transportation requires tire manufacturers to follow a standard marking scheme. Of course, the tire’s birthday is in code. The “magic decoder ring,” which displays a tire’s birthday, is available on the DOT website.
The “US DOT Tire Identification Number” is stamped on the sidewall near the rim. On some tires, it’s hidden on the axle side, more commonly on raised white lettered tires. You might have to scoot around under the car a bit to find it. Once you find the code, it contains the tire’s birthday. The last four-digits of the DOT number reveal the week and year the tire came out of the factory, so 2809 would be the 28th week of 2009.
Tread depth is easy to remember and all you have to do is use a penny. Turn it upside down and if you can see the top of Lincolns head, YOU DON’T HAVE ENOUGH TREAD!
Pressure
The only tire pressure you need to know is the one printed on the vehicle data plate. Most of these are on the driver’s side door jam. It displays the manufacturer’s recommended tire pressure, as their judgment of the best compromise between traction, handling, noise, wear, etc. They tune the suspension components around this number and have carefully determined how the tread contacts the road, called the contact patch, at that pressure. Any deviation makes you the test pilot.
The factory recommended pressure is a “cold” pressure. The engineers know the pressure will rise with heat, and if you are using the same size and brand the car was born with, no worries. But if you change the tires, you need to make sure the maximum allowable pressure for that tire (also printed on the tire sidewall) gives you some headroom as the tire heats up.
The only way to know how much margin you have is to stop and take a reading on a hot day after some time at highway speeds.
Temperature
That temperature sensitivity (about one psi for every 10 degrees Fahrenheit) means you have to adjust the tire pressure as the seasons change, typically in fall and spring. Now that summer is behind us, many people are probably seeing some tire-pressure warning lights if their vehicle has a tire pressure monitoring system.
If you filled your tires when it was 95 degrees outside last July, when the temps dip into the 30s, you could be almost 10 psi low. It’s best to check first thing in the morning, and in the shade. That will give you a true “cold” reading.
Extra pressure
With gas prices still on the rise, there’s a temptation to “add a little extra” with thoughts of decreasing rolling resistance and increasing gas mileage. The extra air consumes your margin, and causes the contact patch to change shape. It mucks with the handling, wet traction and braking effectiveness, plus it makes the center of the tires wear out faster than the edges.
Nitrogen
There are tons of misinformation on the claimed benefits of using nitrogen in vehicle tires. It would take pages to dispute all the rhetoric out there on this subject, so look at the big ones. First, remember that air is around 80 percent nitrogen to begin with, so we aren’t talking huge differences to start out with.
There are claims that nitrogen is a good deal because it leaks out more slowly (backed up by pointing out nitrogen’s slightly larger molecular size). A consumer magazine took on this myth and found out it’s actually true, but on the order of one or two psi a year. Since you have to adjust your tire pressure at least twice a year anyway, that difference isn’t going to save you a trip to the air pump.
spare tire serves as a backup in case your car has a flat. Vehicles typically carry a spare tire mounted on a rim, to be used in the event of flat tire or flat tire. Many spare tires for modern cars are smaller than normal tires to save on trunk space, gas mileage, weight and cost and should not be driven far before replacement with a full-size tire. Jacks and for emergency replacement of a flat tire with a spare tire are included with a new car. Hand or foot pumps for filling a tire with air are available. Cans of pressurized “gas” can be bought separately for a convenient emergency refill.
Spare Tires
Spare tires come in a variety of sizes and versions. Many cars are equipped with temporary spare tires and wheels, which are noticeably different from regular tires and wheels. Some require higher inflation pressure, or the use of a pressurized canister to inflate the tire. The only type of spare tire that can be used without such restrictions is a conventional, full-sized spare that is the same as the other tires on the vehicle.
The Folding Spare- must be inflated with an air canister prior to mounting.
The Compact Spare- smaller and narrower than the other wheels on the vehicle.
The Lightweight Spare- the same diameter as the other tires on the vehicle but thinner.
These tires are:
- labeled “temporary” spares because of their weight-saving construction.
- are intended for emergency use only and not for sustained or high speed driving.
- not to exceed 50 mph nor to travel further than 50 miles.
Maintenance Tips and Suggestions
Tire Air Pressure -Check the air pressure in your spare tire whenever you check tire pressure to be sure your spare is in top condition in the event of a flat tire.
Know How to Change Your Tire - Become familiar with the equipment needed for changing a tire and be sure essential tire-changing tools are in good repair and where they should be. Practice changing a tire. Always check your owner’s manual and the tire sidewall for instructions on proper use of a temporary spare.
- Locate the jack, handle and lug wrench.
- Know where the jack contacts the vehicle when raising it.
- Locate the key for wheel locks.
- Know how to access the spare tire.
A functional spare that is in good condition is a comfort. By avoiding the following pitfalls, you can be assured that your spare tire is in good form.
- Under inflation - If your spare is low, it may shred on the way home or to the service facility. The distance you can travel before this happens is directly related to the tire’s inflation level. Check the pressure of the spare, as well as the other four tires every month.
- Dry Rotting - Tires deteriorate with age. Tires do have a shelf life. After a period of time, they may begin to develop small cracks in the sidewall.
- Inaccessibility - The leading reason spare tires fall victim to under inflation and dry rotting is inaccessibility. Clear out the trunk and check the spare or take your car to a shop and let an auto tech check your spare.
Spare Tire Safety
- Most space saving spares are limited to 50 miles and 50 m.p.h. Replace a temporary spare with a full-size tire as soon as possible.
- Keep your compact spare and its wheel together and do not use them on another car.
- Do not use tire chains on a space saving spare. They won’t fit and will damage the car as well as the chains.
- Do not drive through a car wash that pulls the car along guide rails with a spare on your car. The spare can get caught on the rail and damage the tire, wheel and very possibly other parts of your car.
The bottom line is keeping up with the tire pressure is probably the single most important user-safety and gas-savings task you can accomplish, and it does take some intervention as the seasons change. However, this is not the place to get creative. Follow the factory numbers, check it often and stay safe.
Information provided by NHTSA and NSC.
Today’s blog post comes to us courtesy of Ken Oswald
Safety and Security Manager for Plateau
koswald@plateautel.com
Power Outage Safety Tips
In Western Washington yesterday, we have a lot of freezing rain which lead to a lot of power outages across the area. Through my facebook account, I received a set of tips on what to do and what not to do when there’s a power outage and I thought that it should be passed along so here it is.
From the Pierce County Emergency Management site:
Power outage safety tips
Posted By ktinsle on Jan 18th, 2012 at 7:55 PM
Several utility companies serving Pierce County residents have reported power outages. Residents are encouraged to follow these safety tips:
Preventing carbon monoxide poisoning:
DO NOT operate gasoline powered machinery such as a generator indoors, including in a garage.
DO NOT place generators near an open window or near a neighbor’s window.
DO NOT warm up your vehicle by idling the engine inside an attached garage.
DO NOT cook or heat with charcoal barbeques inside your home or garage.
DO NOT use “space heaters” unless there is an exhaust vent and never around combustible materials.
DO NOT use a gas oven to heat your home.
DO NOT burn anything in a stove or fireplace that is not vented.
DO follow the manufacturer’s instructions for using generators, space heaters and grills.
DO make sure flues and vents are kept clear of debris that may be blown by the wind.
DO have your furnace, fireplace or wood stove inspected by a professional every year.
DO install carbon monoxide alarms in your home.
Staying warm:
Wear several layers of light weight, warm clothing rather than one layer of heavy clothing.
Watch for signs of frostbite and hypothermia: slurred speech, confusion, uncontrollable shivering, stumbling, drowsiness, and body temperature of 95° F or less. Get medical help immediately if you think someone has frostbite or hypothermia.
Get out of wet clothes immediately and warm up with a blanket or warm fluids like hot herbal tea or soup. Avoid caffeinated or alcoholic beverages if you think you or someone you are trying to help has hypothermia or frostbite.
For the most up to date emergency information visit: http://blog.piercecountywa.org/emergency/
Warehouse safety
As sometimes happens, I got an email from one of my blog readers yesterday with a link to information as related to safety in the warehouse. The information is pretty telling and I thought I’d share it with you.
Thanks Natalie
Warehouse Safety the Dangers of Modern Warehouses and How to Prevent Them
A Whole Mess of Free Safety Stuff
Everyone likes FREE! Free is good, so you’re going to love the link I’m going to provide today because it’s a website on which everything is free and everything relates to safety.
Here’s a brief overview of what you’ll find there:
New ANSI/ASSE Standard for Job-Sites with Multiple Employers
A new standard, just released deals with health and safety on demolition and construction sites where there are more than one contractor present. The standard, which could quickly become an important resource for most large construction companies, is available for purchase on the ASSE website either as a Hard Copy or as a digital download.
From the ASSE Website:
ANSI/ASSE A10.33-2011
Safety & Health Program Requirements for Multi-Employer Projects
A10 Committee Information
Acronym: ASSE (ASC A10)
Developer Name: ASC A10
Committee Title: Safety Requirements for Construction and Demolition Operations
Secretariat: American Society of Safety Engineers
Contact: Tim Fisher
Title: Safety & Health Program Requirements for Multi-Employer Projects
Address: 1800 E. Oakton St., Des Plaines, IL 60018-2187
Phone: (847) 768-3411
Fax: (847) 296-9221
E-mail: tfisher@asse.org
URL: http://www.asse.org
Accreditation Method: Committee
A10 Committee Members: Click here for A10 Foreword and List of Organizations and Members
Scope: This standard sets forth the minimum elements and activities of a program that defines the duties and responsibilities of construction employers working on a construction project where multiple employers are or will be engaged in the common undertaking to complete a construction project.
Tuberculosis Awareness
TUBERCULOSIS AWARENESS
Tuberculosis (TB) is a disease caused by a bacterium called Mycobacterium tuberculosis. The bacteria usually attack the lungs, but TB bacteria can attack any part of the body such as the kidney, spine, and brain. If not treated properly, TB disease can be fatal. TB disease was once the leading cause of death in the United States
BASIC TB FACTS
TB” is short for tuberculosis. TB disease is caused by a bacterium called Mycobacterium tuberculosis. The bacteria usually attack the lungs, but TB bacteria can attack any part of the body such as the kidney, spine, and brain. If not treated properly, TB disease can be fatal.
How TB Spreads
TB is spread through the air from one person to another. The TB bacteria are put into the air when a person with active TB disease of the lungs or throat coughs, sneezes, speaks, or sings. People nearby may breathe in these bacteria and become infected.
TB is NOT spread by
- shaking someone’s hand
- sharing food or drink
- touching bed linens or toilet seats
- sharing toothbrushes
- kissing
Latent TB Infection and TB Disease
Not everyone infected with TB bacteria becomes sick. As a result, two TB-related conditions exist: latent TB infection and active TB disease.
- Latent TB Infection
TB bacteria can live in your body without making you sick. This is called latent TB infection (LTBI). In most people who breathe in TB bacteria and become infected, the body is able to fight the bacteria to stop them from growing. People with latent TB infection do not feel sick and do not have any symptoms. The only sign of TB infection is a positive reaction to the tuberculin skin test or special TB blood test. People with latent TB infection are not infectious and cannot spread TB bacteria to others. However, if TB bacteria become active in the body and multiply, the person will get sick with TB disease.
- TB Disease
TB bacteria become active if the immune system can’t stop them from growing. When TB bacteria are active (multiplying in your body), this is called TB disease. TB disease will make you sick. People with TB disease may spread the bacteria to people they spend time with every day. Many people who have latent TB infection never develop TB disease. Some people develop TB disease soon after becoming infected (within weeks) before their immune system can fight the TB bacteria. Other people may get sick years later, when their immune system becomes weak for another reason.
For persons whose immune systems are weak, especially those with HIV infection, the risk of developing TB disease is much higher than for persons with normal immune systems.
The Difference between Latent TB Infection and TB Disease
|
A Person with Latent TB Infection |
A Person with TB Disease |
| • Has no symptoms | • Has symptoms that may include: - a bad cough that lasts 3 weeks or longer - pain in the chest - coughing up blood or sputum - weakness or fatigue - weight loss - no appetite - chills - fever - sweating at night |
| • Does not feel sick | • Usually feels sick |
| • Cannot spread TB bacteria to others | • May spread TB bacteria to others |
| • Usually has a skin test or blood test result indicating TB infection | • Usually has a skin test or blood test result indicating TB infection |
| • Has a normal chest x-ray and a negative sputum smear | • May have an abnormal chest x-ray, or positive sputum smear or culture |
| • Needs treatment for latent TB infection to prevent active TB disease | • Needs treatment to treat active TB disease |
Testing for TB Infection
There are two kinds of tests that can be used to help detect TB infection – the TB skin test (TST) and TB blood tests. A positive TB skin test or TB blood test only tells that a person has been infected with TB bacteria. It does not tell whether the person has latent TB infection (LTBI) or has progressed to TB disease. Other tests, such as a chest x-ray and a sample of sputum, are needed to see whether the person has TB disease.
- Mantoux tuberculin skin test
The TB skin test (Mantoux tuberculin skin test) is performed by injecting a small amount of fluid (called tuberculin) into the skin in the lower part of the arm. A person given the tuberculin skin test must return within 48 to 72 hours to have a trained health care worker look for a reaction on the arm.
- Tuberculin Skin Testing (fact sheet)
- Tuberculosis and Pregnancy (fact sheet)
- Mantoux Tuberculin Skin Testing Materials
- TB blood tests
TB blood tests (also called interferon-gamma release assays or IGRAs) measure how the immune system reacts to the bacteria that cause TB. If your health care provider or local health department offers TB blood tests, only one visit is required to draw blood for the test. The QuantiFERON®-TB Gold In-Tube test (GFT-GIT) and T-SPOT®.TB test are two Food and Drug Administration approved TB blood tests. Test results are generally available in 24-48 hours.
Who Should Get Tested for TB
Persons should get tested for TB by their doctor or local health department if they
- have spent time with a person known or suspected to have active TB disease; or
- have HIV infection or another condition that weakens the immune system and puts them at high risk for active TB disease; or
- have symptoms of active TB disease; or
- are from a country where active TB disease is very common (most countries in Latin America and the Caribbean, Africa, Asia, Eastern Europe, and Russia); or
- live somewhere in the United States where active TB disease is more common such as a homeless shelter, migrant farm camp, prison or jail, or some nursing homes); or
- inject illegal drugs.
Testing for TB in BCG-Vaccinated Persons
BCG, or bacille Calmette-Guérin, is a vaccine for TB disease. Many persons born outside of the United States have been BCG-vaccinated. BCG vaccination may cause a positive reaction to the TB skin test, which may complicate decisions about prescribing treatment. Despite this potential for BCG to interfere with test results, the TB skin test is not contraindicated for persons who have been vaccinated with BCG. The presence or size of a TB skin test reaction in these persons does not predict whether BCG will provide any protection against TB disease. Furthermore, the size of a TB skin test reaction in a BCG-vaccinated person is not a factor in determining whether the reaction is caused by latent TB infection (LTBI) or the prior BCG vaccination.
TB blood tests (interferon-gamma release assays or IGRAs), unlike the TB skin tests, are not affected by prior BCG vaccination and are not expected to give a false-positive result in persons who have received prior BCG vaccination.
Diagnosis of TB Disease
Persons suspected of having TB disease should be referred for a medical evaluation, which should include
- Medical history,
- Physical examination,
- Test for TB infection (TB skin test or special blood test),
- Chest radiograph (X-ray), and
- Appropriate laboratory tests
Infection Control and Prevention
New, Simpler Way to Treat Latent TB Infection
Treating latent tuberculosis (TB) infection to prevent progression to TB disease is a cornerstone of the U.S. strategy for TB elimination.
People with latent tuberculosis (TB) infection now have another option when it comes to treatment. A new regimen for the treatment of latent TB infection, called the 12-dose regimen, reduces the number of doses and shortens the duration of treatment
Infection Control in Health Care Settings
All health care settings need an infection-control program designed to ensure prompt detection, airborne precautions, and treatment of persons who have suspected or confirmed TB disease. In order to be effective, the primary emphasis of the TB infection-control program should be on achieving these three goals.
In all health-care settings, particularly those in which persons are at high risk for exposure, policies and procedures for TB control should be developed, reviewed periodically, and evaluated for effectiveness to determine the actions necessary to minimize the risk for transmission of TB.
- Infection Control in Health-Care Settings (Fact sheet)
- Respiratory Protection in Health-Care Settings (Fact sheet)
What to Do If You Have Been Exposed to TB
If you think you have been exposed to someone with TB disease, you should contact your doctor or local health department about getting a TB skin test or a special TB blood test. Be sure to tell the doctor or nurse when you spent time with the person who has TB.
Preventing Latent TB Infection from Progressing to TB Disease
Many people who have latent TB infection never develop active TB disease. But some people who have latent TB infection are more likely to develop active TB disease than others. Those at high risk for developing active TB disease include
- People with HIV infection
- People who became infected with TB bacteria in the last 2 years
- Babies and young children
- People who inject illegal drugs
- People who are sick with other diseases that weaken the immune system
- Elderly people
- People who were not treated correctly for TB in the past
If you have latent TB infection and you are in one of these high-risk groups, you need to take medicine to keep from developing active TB disease. This is called treatment for latent TB infection. There are several treatment options. You and your health care provider must decide which treatment is best for you. If you take your medicine as instructed by your doctor or nurse, it can keep you from developing active TB disease. Because there are less bacteria, treatment for latent TB infection is much easier than treatment for TB disease. A person with active TB disease has a large amount of TB bacteria in the body. Several drugs are needed to treat active TB disease.
Preventing Exposure to TB Disease While Traveling Abroad
Travelers should avoid close contact or prolonged time with known TB patients in crowded, enclosed environments (for example, clinics, hospitals, prisons, or homeless shelters).
Travelers who will be working in clinics, hospitals, or other health care settings where TB patients are likely to be encountered should consult infection control or occupational health experts. They should ask about administrative and environmental procedures for preventing exposure to TB. Once those procedures are implemented, additional measures could include using personal respiratory protective devices.
- Tuberculosis Information for International Travelers (Fact sheet)
While TB cases in the United States have been declining since 1993, TB remains one the world’s deadliest diseases. One-third of the world’s population is infected with the bacteria that cause TB, and each year, nearly 9 million people around the world become sick with TB disease.
In the United States a total of 11,182 TB cases were reported in 2010. Achieving the goal of TB elimination in the United States means not only treating those people who already have TB disease, but also successfully treating those with latent TB infection.
Safety First, Safety Always!
Information from CDC and WebMD
Our post today comes to us courtesy of Ken Oswald
Safety and Security Manager for Plateau
koswald@plateautel.com
