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标准委员会:不要对卫生保健工作者进行结核病保护

By Doug Parker, Executive Director

 

结核病是世界上最致命的传染病之一,估计造成1人死亡.8 million deaths per year worldwide. 加州公共卫生部门(CDPH)估计有2.300万加州人感染了潜伏性肺结核(LTBI). 如果不进行诊断和治疗,10%的LTBI病例有望发展为活动性结核病. 加州是美国大陆结核病发病率最高的州- 5.每年每10万人中有5例,几乎是全国发病率的两倍. 

在治疗病人和保护公众的第一线是卫生保健工作者, 谁患活动性结核病的比率高于一般人群. Cal/OSHA appropriately recognizes that health care workers potentially exposed to patients with active TB are at elevated risk of infection and requires employers to offer these workers annual TB testing.

目前正在提出取消那项保障措施的建议. The California Conference of Local Health Officers (CCLHO) has petitioned the Occupational Safety and Health Standards Board to replace current rules with Centers for Disease Control guidelines issued in 2005 that would eliminate the requirement to offer annual TB testing to some health care workers at risk for exposure. Cal/OSHA在十年前就考虑过这些准则,但在起草现行标准时并未采纳.

On its face, 该提案只会取消对“低风险”暴露工人的检测. As in so much policy making, however, risk is a matter of perspective that can vary widely and tends to be better tolerated by the people who aren’t exposed to it. The proposal defines “low risk” as workers at hospitals with fewer than 6 active TB patients per year (or fewer than 3 per year at smaller facilities).  

这些评估将依赖于对结核病的迅速和准确的诊断. 结核病是一种可能被遗漏或延迟的诊断, and it is typical for patients to visit more than one emergency room or other care facility prior to seeing a doctor who makes the TB diagnosis.

The idea that health care facilities would be relieved of offering TB testing to potentially exposed workers in these settings is at odds with basic principles of occupational health. Our health care workers deserve better.