isolation booths must be determined. In the absence of definitive data, "best judgment" recommendations should be developed, perhaps with assessment of the category of proof (strength of evidence ) of efficacy, as in the current CDC guidelines for infection control and isolation (12).
CDC recently concluded that (3):
The efficacy of various technologies for preventing TB transmission (e.g., general and local ventilation, UVGI, and personal protective equipment) has not been adequately evaluated.
B. The Mandates to NIOSH in the Occupational Safety and Health Act of 1970—The Occupational Safety and Health Act of 1970 established the right to safe and healthful working conditions for every working man and woman, and the obligations to provide work and a workplace which are "free of recognized hazards." In its opening paragraphs Congress declared its purpose in passing the Act to be (13):
...to assure so far as possible every working man and woman in the Nation safe and healthful working conditions and to preserve our human resources—...
In Section 20 of the Act, Research and Related Activities, which defines the responsibilities of NIOSH, the Act requires that the Director of NIOSH (13):
...on the basis of such research, demonstrations, and experiments, and any other information available to him, shall develop criteria dealing with toxic substances which will describe exposure levels that are safe for various periods of employment ... exposure levels at which no employee will suffer impaired health or functional capacities or diminished life expectancy as a result of his work experience. (emphasis added)
This mandate sharply defines the obligation of NIOSH to formulate science-based assessments of risk and preventive recommendations which, if implemented, would assure that no worker develops illness as a consequence of exposure at work. Specifically, as regards the occupational transmission of tuberculosis in health-care facilities, NIOSH interpreted its mandate as recommending, where necessary, the use of personal respiratory protection that would assure that no worker will be infected with tubercle bacillus as a result
