On July 13, 2015, the Occupational Safety and Health Administration (OSHA) issued an enforcement directive, Enforcement Procedures and Scheduling for Occupational Exposure to Tuberculosis (CPL 02-02-078) (2015 Directive), which provides general enforcement policies and procedures to be followed by OSHA inspectors when conducting on-site inspections in health-care settings and issuing citations related to occupational exposure to tuberculosis (TB).

The 2015 Directive contains a number of changes from the prior version issued in 1996 and reflects guidance from a report by the Centers for Disease Control and Prevention (CDC), Guidelines for Preventing the Transmission of Mycobacterium tuberculosis in Health-Care Settings, 2005.  According to the 2015 Directive, the 2005 CDC guidelines recommend that employers conduct initial and ongoing risk assessments for TB transmission, regardless of whether patients with suspected or confirmed TB disease are expected to be encountered in the setting.  The screening classifications are low risk, medium risk, and potential ongoing transmission. 

Notably, the 2015 Directive instructs regulators to consider citing employers who fail to “identify and evaluate the respiratory hazard(s) in the workplace” or fail to “assess the workplace to determine if hazards are present, or are likely to be present . . . .”   The prior 1996 directive, now superseded by the new 2015 Directive, did not contain similar citation instructions.  Rather, it had instructed inspectors to review TB-related records to establish required testing schedules if the facility did not complete a risk assessment.

The 2015 Directive is available here