1741 Promoting osh strategies for global end tb efforts among silica-exposed workers and healthcare workers

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Abstract

Aim of session

Tuberculosis is the greatest public health challenge today. The global health community is actively planning strategies to End TB by 2030, and the occupational health community can play an important role in contributing solutions to prevent TB in high-risk worker populations. This session will review the evidence for the high prevalence of TB among health care workers and silica-exposed workers and outline the practical strategies for reducing these risks. Partners will be sought to engage governments and global health funders to invest in prevention strategies, and to offer assistance to countries in the future to carry out the OSH actions.

Aim of session

Despite decades of global efforts to end tuberculosis (TB), it is still 9th in the top ten causes of death globally, with 10.4 million new cases occurring in 2016. In September 2018 the UN General Assembly will hold a high-level meeting on TB. A preparatory Global Ministerial Meeting was held in Moscow in November 2017. Because it is well established that occupational risk factors contribute to the TB epidemic, ICOH participated in the Moscow Meeting. ICOH members reached out to health ministers to include occupational safety and health (OSH) measures to prevent TB cases by reducing respirable silica dust exposures and taking actions to protect healthcare workers from occupational TB infections. This OSH focus adds additional approaches to the current focus on improving effective medication, which also prevents new TB cases. The Moscow Declaration now includes health care workers, care givers, miners and other workers exposed to silica dust as high risk TB populations. In some high burden TB countries, health care workers have almost a 4-fold incidence of TB compared to the general population. Studies have shown that silica dust exposure increases risk of acquiring TB up to 4-fold, and combined silicosis and HIV in miners increases risk of acquiring active TB by 15 times. Because respirable silica is an IARC Group 1 carcinogen, reduction prevents both cancer and TB. Discussions at the Moscow Meeting appreciated the addition of OSH preventive measures. However, more effort is required to bring governments and global health funders on board to recognise that working conditions and silica dust are significant risk factors for TB that must be addressed as part of a comprehensive strategy. To take these efforts forward, ICOH has formed two Stop TB component efforts: TB-HCW and Silica-TB. Discussions in this Workshop will bring together partners and plans to succeed.

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