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To Fit, or Not to Fit

July 19, 2007

C97Given the recent brouhaha over the XDR MDR tuberculosis case and how deadly that disease is, one would think that every effort to protect the public would be made. Apparently, though, when it comes to workplace safety issues, any effort is a bit too much.

Following the sordid tale is retired blogger Jordan Barab, formerly of Confined Space. He tracked the situation as far back as January 2004, when Rep. Roger Wicker (R-MS) first began shilling for the American Hospital Association and the Association for Professionals in Infection Control. At the time, OSHA had withdrawn it’s TB standard for health care workers and first responders, saying that a new respirator standard was in the pipeline, and using that updated language, the TB standard would be written in a stronger fashion. Until that time, though, health care workers and first responders would be covered under the blanket of the new respirator standards, which required fit testing for everyone issued a respirator. (see next link for why fit testing is important) By June 2004, Rep. Wicker stepped up to the plate, asking OSHA to impose a six month moratorium on requiring hospitals to fit test their employees. Fast forward to September 2004, when Rep. Wicker inserted a rider into the Labor appropriations bill that made it through the House. This rider prohibited OSHA from enforcing fit testing for respirators designed to protect health care workers against tuberculosis. A few days later, Rep. Major Owens (D-NY) had this to say:

Mr. Speaker, I wish to express grave concern over a clause in this bill that would seriously erode worker protections against tuberculosis (TB) and bio-terrorism. This provision prohibits the Occupational Safety and Health Administration (OSHA) from fully enforcing its respirator standard for workers at risk of exposure to TB and other deadly infections. At a time when the Bush Administration is invoking daily, color-coded terrorist alerts, it makes absolutely no sense to weaken the only standard we have to protect health care workers against air-borne pathogens or air-borne “weapons of mass destruction.” By prohibiting OSHA from enforcing the annual fit test for workers’ respirators or masks, that is exactly what is possible.
According to Dr. Margaret Hamburg, Vice President for Biological Programs at the Nuclear Threat Initiative, biological agents that might be used as weapons include small pox, pneumonic plague, and drug-resistant TB, among others. To undercut the only protection that front-line health care workers would have against such agents — namely, their respirators — is absolutely unconscionable.
Mr. Speaker, I ask unanimous consent that a letter on this critical issue from the Director of Occupational Health and Safety at the Service Employees International Union (SEIU) be included in the Record at this point. I trust and hope my colleagues in the Senate will see the wisdom of opposing any such effort to weaken workers’ protections against TB and bioterrorism.

In November of 2004, with the various appropriations bill signed into law, Mr. Barab notes that the anti-safety rider made it into law. Now, Rep. Wicker is at it again. He’s sponsoring an amendment to the Labor-HHS-Education appropriations bill that would extend the ban on requiring fit testing which was supposed to end in September. David Michaels of The Pump Handle passes along this description of the amendment:

…[P]rohibit OSHA from fully enforcing its respiratory protection standard to protect health care workers and first responders from tuberculosis. It would exempt tuberculosis exposures from the requirement for an annual fit test to make sure the respirator fits and protects the worker from exposure.

How this sham can continue is amazing. What the reason is for the prohibition in the first place is beyond me; what the reason for extending the prohibition could be is even further beyond me. It’s long past time to require that all health care workers and first responders be protected from tuberculosis and other nefarious agents. To do any less is a slap in the face of the folks that protect us every day.

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