Medical Air Solutions, Inc.

Cal/OSHA has published and enforces Interim Tuberculosis Control Enforcement Guidelines. These were published in 1992 and have been updated periodically. The most recent update was in March 1997. Engineering controls mandated for isolation rooms include negative pressure and an air change rate of 12 ACH, which can be achieved by a combination of building ventilation and HEPA filtration. The agency also mandates that ventilation systems be tested at least annually and that records of each test be kept for at least five years.

The California Mechanical Code (CMC) regulates the construction of new isolation rooms in California hospitals. The current version is the 1995 CMC and consists of the 1994 Uniform Building Code (UBC) combined with amendments specific to California. The CMC is enforced by the Office of Statewide Health Planning and Development (OSHPD).

In response to the resurgence of TB, and recognizing the expense of constructing a new CMC-compliant negative pressure isolation room, OSHPD provides a less expensive option for the isolation of TB patients in existing isolation rooms or patient rooms. These requirements were published as Policy Intent Notice (PIN) Number 4 in 1996. PIN Number 4 allows the use of portable HEPA filter units to create negative pressure and increase the effective ventilation rate in TB isolation rooms. The requirements for such rooms include negative pressure, a minimum ventilation air change rate of 12 ACH to match Cal/OSHA requirements, and provision of a permanent room pressure monitor.

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