Hospitals may be getting a break from onerous new guidelines for dealing with tuberculosis.
The national Centers for Disease Control and Prevention in Atlanta has eased up on what it originally had proposed on how to prevent transmission in healthcare facilities.
"TB-control programs for hospitals will now be based on the prevalence of TB in their communities and their facilities," said Gina Pugliese, director of infection control and environmental safety for the American Hospital Association.
Ms. Pugliese and Abdalla Mutawe, a safety engineer with the Occupational Safety and Health Administration's Seattle office, explained the new guidelines earlier this month at the American Society for Health Care Risk Management's 16th annual meeting in Seattle.
The CDC's recommendations are key because they are typically adopted as standards by OSHA.
OSHA's new standards are scheduled to be issued later this year. OSHA is expected to revise its enforcement procedures and incorporate revised recommendations from the CDC.
Hospitals won't all have to have isolation rooms, according to the CDC. The original proposal for the requirement was adamantly opposed by the AHA because it projected costs of $50,000 to $150,000 per isolation room.
Opponents of such requirements note that half of all counties in the United States have reported no TB cases at all.
Mr. Mutawe said most hospitals haven't experienced any serious TB problems. He suggested that hospitals lacking proper isolation facilities should consider sending TB patients to hospitals with more sophisticated units.
An AHA survey earlier this year of 763 hospitals showed that 88% of the hospitals admit TB patients, and nearly 30% of those polled don't have isolation rooms that meet CDC criteria.
"All of the hospitals with less than six patients a year were lumped into one category (under the draft guidelines)," Ms. Pugliese said. "Now hospitals with no TB in the community or inpatients won't have to have a TB isolation room."
However, Ms. Pugliese said hospitals will have to have someone in charge of TB control and have a written plan to deal with it.
Hospitals can be fined about $7,000 per violation of OSHA standards, Mr. Mutawe said.
Fines in the last two years have ranged from $5,000 to $150,000 for multiple violations, according to ECRI, a Plymouth Meeting, Pa.-based not-for-profit agency that monitors healthcare facilities' safety and use of devices.