The 130th Annual Meeting of APHA

Abstract #45266

Andrea N. Slavcev, MS¹, Evalyn Horowitz, MD, ABIM², James Cone, MD, MPH³, Mark Nicas, PhD, MPH, CIH⁴, and Robert Harrison, MD, MPH³. (1) Occupational Health Branch, State of California Department of Health Services, 1515 Clay St, Oakland, CA 94612-1423, (510) 622 4393, aslavcev@dhs.ca.gov, (2) Health Care Services Division (Personal and Confidential), California Department of Corrections, PO box 942883, Sacramento, CA 94283, (3) Occupational Health Branch, California Department of Health Services, 1515 Clay St, Suite 1901, Oakland, CA 94612, (4) Center for Occupational and Environmental Health, School of Public Health, University of California, Berkeley, Room 140, Warren Hall, Berkeley, CA 94720

Objective: Evaluating adherence to Centers for Disease Control (CDC) tuberculosis (MTb) control guidelines and Federal Blood borne Pathogen Standard among four State correctional institutions.

Methods: Cross-sectional study based on-site observations, document reviews and staff interviews using standardized checklists and open-ended questionnaires. Administrative controls, employee access to and use of engineering controls and personal protective equipment, ventilation performance, characteristics and maintenance of high-risk areas were evaluated.

Results: Institutions followed their Exposure Control Plans (ECPs) closely; however, certain elements of MTb and BBP control were missing. The few administrative deficiencies that were detected relate to MTb and BBP risk assessment and training, MTb identification and treatment, hepatitis B vaccination, and BBP post-exposure/reporting programs.

Six of seven isolation rooms exceeded CDC ventilation performance and maintenance guidelines; however, none had all recommended room characteristics. 19/39 high-risk general use areas met ventilation requirements. Sharps containers and safety devices safety evaluation requirements were not met. 58% and 53% of medical areas had suitable and accessible containers, respectively. Certain types of sharps safety devices were widely available yet 16% of employees were observed to use them correctly.

Respiratory protection programs were underdeveloped. 96% of clinical and 83% of custody areas had disposable gloves present. Glove use during phlebotomies and cell searches is estimated at 100% and 62%, respectively.

Conclusion: All institutions made MTb and BBP exposure control an on-going priority. Lack of policies for certain program elements, reduced resources, and inadequate employee training and supervision may be responsible for most deficiencies noted.

Learning Objectives: At the conclusion of the session, the participant in this session will be able to

• Describe the elements of a adequate tuberculosis and bloodborne pathogen program in the correctional environment
• Identify the most common unsafe workplace practices and conditions that place employees at elevated risk of exposure.
• Understand the obstacles that prevent full compliance with program goals.

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.