Effective Prevention of Tuberculosis Transmission in Oil and Gas Workplaces: A Programmatic Approach

摘要

Objectives/Scope: 1. Illustrate tuberculosis risk identified in communities and ExxonMobil workplaces 2. Describe approach for program design and targeted global implementation rollout 3. Present accomplishments in preventing TB transmission in ExxonMobil workplaces Methods, Procedures, Process: Tuberculosis (TB) was evaluated in country populations using World Health Organization sources and in Exxon Mobil Corporation (ExxonMobil or Company) and its affiliates’ operation sites to target workplaces with the highest risk. In consultation with external experts, Company health and safety professionals and executives, the existing TB program became required for all offshore sites and camps in areas with ≥20 TB cases per 100,000. An implementation gap assessment and executive rollout communications were performed. For program sustainability, a contractor exhibit was established, and Company operations integrity management systems integrated TB aspects with site and headquarters reporting. Results, Observations, Conclusions: Tuberculosis is now a priority for infectious disease control in ExxonMobil workplaces. Executive Company committee periodically reviews program accomplishments with the intent to prevent workplace transmission, and minimize impact on workers’ health and productivity. TB Program elements include awareness, periodic screening with questionnaire and testing (blood or skin test or chest X-ray), and case management with active TB contact tracing. The gap assessment conducted in 2014 identified inconsistent implementation across eligible sites and among contractors and employees. Following management guidance roll out and support by health and safety teams, all eligible locations implemented the TB program by end 2016. TB exhibits are progressively being integrated in new global contract agreements. Between January and September 2017, 3886 TB screening tests were performed with 481 positive results. Latent TB prevails between 3 and 5% percent in the US and Europe, and about 30 percent in Africa and Papua New Guinea. Identification of latent TB is important for follow up and early detection of active stage and for baseline status of workers during contact tracing. Since 2010, 107 active TB cases have been identified with no workplace transmission, contributing to avert >1000 infections, considering that one case can infect 10 to 15 individuals. Novel/Additive Information: The oil and gas industry operates globally with international, mobile populations and congregate settings that increase TB transmission risk. Targeted TB programs for such sites and workers are pertinent to mitigate risk and consequences. Synergies between public and private institutions, including oil and gas companies, are critical for effective TB programs that can prevent workplace transmission, provide rapid diagnostic, treatment and care, protect Company business and contribute to end the global TB epidemic.