Tuberculosis: Plateau or Resurgence?

Only three months after OSHA cannned its tuberculosis standard, the Centers for Disease Control reports that tuberculosis cases are on the rise in California, Texas, New York and 16 other states. TB cases also rose by 5% in New York City.

Overall,

During 2003, a total of 14,871 tuberculosis (TB) cases (5.1 cases per 100,000 population) were reported in the United States, representing a 1.4% decrease in cases and a 1.9% decline in the rate from 2002. This decline is the smallest since 1992, when TB incidence peaked after a 7-year resurgence. In addition, the rate remains higher than the national interim goal of 3.5 cases per 100,000 population that was set for 2000

"We're not sure if this is just a plateau or a resurgence," said Dr. Eileen Schneider, an epidemiologist with the CDC's tuberculosis elimination division.

The trends are fueled a sharp jump in global tuberculosis cases and the US case increases are centered in states with highest number of immigrants, especially from Mexico, the Philippines, Vietnam, India, and China. Among infectious diseases, TB remains the second leading killer of adults in the world, with more than 2 million TB-related deaths each year.

Assistant Secretary for OSHA, John Henshaw announced last May that the administration had decided not to to issue the OSHA TB standard that the agency had been working on since the mid-1990's, despite the fact that the National Institute of Medicine had

concluded that an OSHA standard was needed to maintain national TB rates among health care and other employees at their current levels and to prevent future outbreaks of multidrug resistant and other forms of TB among these workers.

AFSCME, SEIU and a number of other unions petitioned OSHA for a Tuberculosis standard in 1993 in response to a nationwide outbreak of tuberculosis -- including multiple drug resistant TB -- that was exposing and killing health care and corrections workers. The standard was on the verge of being issued at the end of the Clinton administration, but because of OSHA's total focus on ergonomics, the curtain fell before the standard was finalized.

March 24 is World TB Day.