TB disease in persons over the age of 65 constitutes a large proportion of TB cases in the United States. Many of these individuals have latent TB infection; however, with aging these individuals' immune function starts to decline, placing them at increased risk of developing active TB disease, and employees in long-term care facilities at risk of occupational exposure to TB.
Exposure to TB through improper housekeeping or venting procedures when cleaning TB contaminated rooms.
[OSHA Directive CPL 02-00-106 Appendix A, CDC, Supplement 5-Decontamination-Cleaning, Disinfecting, and Sterilizing (1994)] addresses cleaning practices when cleaning the room of a person who has infectious TB.Normal cleaning procedures can be used, (i.e., an EPA approved germicide/disinfectant. It does not need to be tuberculocidal for routine cleaning of a TB isolation room).
Products are available if tuberculocidal cleaning is desired for certain processes. The United States Environmental Protection Agency (EPA) Office of Pesticides Program. provides lists of registered anti-microbial products at Antimicrobial Chemical/Registration Number Indexes.
Personnel should follow isolation practices and wear a Class N95 or more protective respirator, while cleaning rooms of an infectious patient.
After the room is vacated by an infectious patient, the precaution sign must remain posted at the entrance to the room, and respirators must be used if entering the room, until the area is ventilated for the time necessary, using the CDC's recommendations, for removal efficiency of 99.9%.
For final cleaning of the isolation room after a patient has been discharged, PPE is not necessary if the room has been ventilated for the appropriate amount of time.
For more information on Nursing Home, see this OSHA guideline.