House Passes TB Restrictions

The House of Representatives voted today, in an amendment to the Labor Department FY 2005 Appropriations bill to order the Labor Department to rescind its new overtime rules that would take away overtime from millions of workers.

That's the good news.

The bad news is that the Labor Appropriations bill also included a "rider," introduced by Congressman Roger Wicker (R-MS) that would prohibit OSHA from enforcing fit testing for respirators designed to protect health care workers against tuberculosis.

A little background. Regular Confined Space readers may remember (and for those with bad memories, check here) that OSHA had not covered health care workers exposed to tuberculosis in the new respirator standard issued in 2000 because they were going to be covered in the new tuberculosis standard. When Bush's OSHA killed the tuberculosis standard at the end of 2003, the agency (correctly) decided that health care workers who may be exposed to TB would be covered under the general respirator standard (like every other worker who wears a respirator) and required to have annual respirator fit tests.. The American Hospital Association and the Association of Profesionals in Infection Control (APIC) were aghast that they would be forced to fit test health care workers and appealed to Congressman Wicker for help. Wicker sent a letter to OSHA, protesting the respirator requirements. After considering a six-month delay, OSHA finally decided to do the right thing and start enforcing the reqirement on July 1. In a letter to APIC, Assistant Secretary John Henshaw rebuked the association for opposing fit testing when it was already required for hospital workers exposed to ethylene oxide or formaldehyde.

Now Wicker, whose life seems to revolve around making sure that OSHA is not able to protect health care workers against tuberculosis, has succeeded in adding language to the House appropriations bill.

As mentioned above, APIC has been active in urging its members to call their Congressional representatives and remind them that:

"Congressman Roger Wicker added an amendment to the Labor-HHS-Education appropriations bill at the Full Committee Mark-Up in July. Mr. Wicker’s amendment will keep hospitals from being forced to implement a costly and unnecessary OSHA regulation related to tuberculosis that is not supported by science or the CDC. I would like to ask Rep. ___________ to protect this important provision and to OPPOSE any amendment that may be offered on the Floor to strip the Wicker OSHA TB language from the bill."

In response to APIC's lobbying, SEIU Health and Safety Director Bill Borwegen wrote an "open letter" to APIC members detailing the problems with the Wicker amendment:

Let's look at the facts:

1) Last year TB rates had their smallest decline in years; rates increased in twenty states.

2) Without annual fit testing, respirator face seals will erode over time, respirators will leak, and more healthcare workers will experience TB conversions. Respirator manufacturers recommend annual fit testing for their products to work properly.

3) The APIC leadership is misleading you when they say that the Wicker amendment is supported by CDC. This is not true. The official CDC position has never differed from OSHA's position either verbally or in writing.

4) The official position of the Bush Administration in supporting annual fit testing, was articulated in the December 30, 2003 Federal Register OSHA notice, stating that fit testing is crucial to a proper face seal, and that over time that 5% to 50% of all workers will lose a proper face seal each year if annual fit testing is not performed.

5) As far as the argument that there is "no difference" between a surgical mask vs. a properly fitted N95 respirator, a study conducted by Nelson Laboratories in Salt Lake City last year found that a surgical mask filtered out 61.9%-62.3% of particles in the respirable 0.3 micron range vs. 97.9%-99.7% for a properly fitted N95 respirator.

Many of you may recall the clamor of opposition against the bloodborne pathogens standard in the late 1980s. Many dentists claimed that if they wore gloves, that patients wouldn't see them. Today the opposite is the case, while the CDC reports that since the standard took effect, that hepatitis B cases among health care workers have plummeted from 17,000 a year to 400.

The amendment has not been introduced in the Senate which has not yet considered the Labor Department appropriations bill.

We'll keep you posted.