Infectious respiratory hazards in hospitals and laboratories

Health care and laboratory workers are exposed to a variety of respiratory infections in the workplace. Employee health programs have only recently addressed these hazards by applying the classical hierarchy of workplace controls, namely engineering, administrative, and work practice controls as well as personal protection. Historically, tuberculosis has been a significant risk to health care workers, and with its resurgence and the emergence of multiple-drug-resistant tuberculosis, these controls become an imperative. For other respiratory infections such as rubeola, varicella, and influenza, immunizations are an integral component of the primary prevention. Infection with respiratory syncytial virus imparts an incomplete immune response, and a significant percentage of hospital personnel become infected from the hospitalized infants in their care. The impact to the workforce and the risk of transmission to noninfected hospitalized infants are of concern. Although Legionnaires' disease is for the most part of little clinical significance to the health care worker, it can be deadly to the infected surgical transplant patient. This article explores the epidemiology, prevention, and regulatory issues of these infections in the health care setting.