ABSTRACT
Since the recent increases in health care worker conversions to tuberculosis (TB) and in some cases death, the need to understand and control the transmigration of droplet nuclei has become of paramount importance. Engineering controls, air changes per hour (ach), negative pressure, high-effi - ciency particulate air (HEPA) fi ltration, ultraviolet germicidal irradiation (UVGI), capture at the source, enclosure devices are now industry vocabularies that need to be understood by a variety of scientifi c disciplines in the health care setting. Selection and implementation of control options has become labor intensive and in some cases controversial. Preparing a health care facility to meet the standards for a TB Control Program is multidimensional as there needs to be scientifi c understanding of the aerosolization of TB, control procedures, budgetary considerations, air volume measurements of areas in the hospitals where suspected or identifi ed cases or high-risk medical procedures are to be done, types of engineering controls selected for the various areas of concern, maintenance of engineering controls selected for the various areas of concern, etc. Diff erent scientifi c disciplines within each medical facility must work together harmoniously in order to achieve optimum results, for example, Infection Control, Engineers, Industrial Hygienists, Nursing, and Administrators. In some states, regulatory codes are in confl ict with TB control guidelines and over time these confl icts must be resolved to mutual satisfaction.
